Ana María López Sobaler

Ingesta de calcio y vitamina D en una muestra representativa de mujeres españolas: problemática específica en menopausia

BACKGROUND The accelerated bone demineralization that occurs during the menopause is very conditioned by the intake of calcium and vitamin D, therefore, the aim of the study is examine the adequacy of the diet regarding these nutrients in a menopausal women group. METHODS A representative sample of the Spanish woman population with ages ranging from 17 to 60 years (n = 547), selected from 10 provinces was studied. The group of 108 menopausal women (45-60 years) is given priority attention. The dietary study was performed using a 3-day diet record. Weight and height were measured and then body mass index (BMI) was calculated. RESULTS Calcium intake (992.1 ± 340.7 mg/day) was lower than the recommended intakes (RI) in 79.6% of the menopausal women (MW) (lower than 67% of the RI in the 30.6%). Vitamin D intake (3.08 ± 3.6 μg/day) was even more unfavorable, since the contribution was 61.1% of the RI in MW, an 85.2% of them do not meet the RI and a 75.9% do not meet the 67% of the RI. A 72.6% of the studied women (68.5% of MW) do not meet the RI for calcium neither for vitamin D, while only the 4.0% of them meet the RI for both nutrients (3.7 of MW). Using a logistic regression analysis to examine the dietary modification that may be favorable to meet the RI for calcium and vitamin D simultaneously, having into account the influence of age and BMI, it is observed that the main factor is the consumption of dairy products [OR = 0.188 (0.108-0.327; p < 0.001)] and the same influence is observed when only menopausal women are analyzed [OR= 0.252 (0.067-0.946; p < 0.05)]. It is observed a decreased of BMI when the density of diet in calcium (r = -0.10) and in the vitamin D (r = -0.099) is increased, which suggested a possible role of these nutrients in weight control. CONCLUSIONS A high proportion of the studied women have intakes of calcium and vitamin D lower than the recommended intakes and given that only a 3.7% of the menopausal women have adequate intakes for both nutrients, it is necessary to adopt urgent measures aimed to protect the bone health of the Spanish female population.

Factores sociodemográficos y de estilo de vida implicados en el exceso de peso

Objetivos: ante el aumento creciente del sobrepeso y de la obesidad es importante prestar atencion a todas las influencias sociodemograficas y de estilo de vida que contribuyen a desequilibrar el balance energetico y que favorecen esta tendencia. Metodos: busqueda bibliografica relacionada con el tema. Resultados: como factores asociados al padecimiento de obesidad, se constata el creciente sedentarismo, la escasa actividad fisica, el ocio pasivo, el elevado numero de horas delante de pantallas (television, ordenador…) y la reduccion del tiempo dedicado a dormir. Por otra parte, el bajo nivel de ingresos y el bajo nivel educativo favorecen el exceso de peso, y existe una asociacion adicional entre estos factores sociodemograficos y el incumplimiento de las guias de alimentacion con el alejamiento de la dieta respecto a lo marcado como aconsejable. En concreto, un elevado tiempo ante una pantalla y una corta duracion del sueno se asocian con una mayor frecuencia del consumo de alimentos con alta densidad energetica y pobres en micronutrientes y con bajo consumo de frutas y vegetales. En este sentido, en varones y ajustando por edad, se observa que un consumo insuficiente de cereales (< 4 raciones/dia) y de frutas y verduras (< 5 raciones/dia) se asocia con mayor riesgo de sobrepeso y de adiposidad central. Destaca la peor adherencia a las pautas dieteticas aconsejadas en individuos con exceso de peso y adiposidad central. Conclusiones: las estrategias para prevenir y reducir el exceso de peso deben tener en cuenta estas influencias, que se asocian y potencian, para lograr mas eficacia en la mejora ponderal de la poblacion.OBJECTIVES given the growing increase in overweight and obesity, it is important to pay attention to all sociodemographic and lifestyle influences that contribute to unbalance the energy balance, favoring this trend. METHODS bibliographic searching in relation to the subject. RESULTS as factors associated with the obesity condition, it is observed that sedentary lifestyle, scarce physical activity, passive leisure and a high number of hours in front of screens (TV, computer...) and reduction in the time spent sleeping. Moreover, low level of income and low educational level, favor excess weight, there being an additional association between these sociodemographic factors with non-compliance with the Dietary Guidelines and the gap of the diet from to what is marked as advisable. Particularly, spent a lot of time in front of a screen and a short duration of sleep are associated with more frequent consumption of foods with high energy density and few micronutrients and low consumption of fruits and vegetables. Specifically, in men and adjusting for age, it is observed that an insufficient intake of cereals (< 4 servings / day) and fruits and vegetables (< 5 servings / day) is associated with greater risk of overweight and of central adiposity, being remarkable the worst adherence to recommended dietary guidelines in individuals with excess weight and central adiposity. CONCLUSIONS strategies to prevent and reduce excess weight should consider these influences, which are associated and potentiated, in order to achieve more efficiency in the weight improvement of the population.

Papel del huevo en la dieta de deportistas y personas físicamente activas

The practice of sport and medium-high intensity exercise increases the needs of energy and nutrients. Proper nutrition is very important for reaching the maximum performance, reducing the risk of injury, and ensuring the best recovery. It must also ensure the achievement of optimum nutritional status and prevent health problems at the present and in the future time. Eggs are a very nutritious food that can help athletes to achieve a correct diet. It contains proteins of high quality and bioavailability, a profile of fatty acids very favorable from the cardiovascular point of view, and vitamins and minerals involved in energy and protein metabolism, in defense against oxidative stress and inflammation, in cell growth and tissue repair. However, it is also a food subject to numerous myths that should be corrected, especially in relation to its cholesterol content. The egg, consumed in moderate amounts and properly handled, is a safe and adequate food for more active athletes and groups.

Alimentación oral en la mejora nutricional en hospitales y residencias. Innovaciones de la industria

OBJECTIVES Inpatient and institutionalized elderly patients are population groups vulnerable from the nutritional point of view because oftheir greater risk of deficiencies and because in them the effects of imbalances are more serious than in other groups. Analyzing the possible usefulness of industry innovations offering solutions in the oral feeding of these population groups constitutes the objective of the present work. METHODS Bibliographic search related to the topic. RESULTS Patients with nutritional problems, prior to hospitalization, are at increased risk of complications, higher mortality and longer hospitalization. On the other hand, hospitalized or institutionalized individuals have different nutritional problems that increase their sanitary and functional risk. The most common nutritional problems can lead to sarcopenia, increased cardiovascular risk (by increased sodium intake or suffering from various deficiencies that impair lipid/homocysteine metabolism, blood pressure control, and promote oxidative stress, endothelial deterioration...), cataract disease, COPD, cognitive impairment and less defense against infections. Taking into account the most frequent problems, it is important that there are foods adapted (because of their texture and ease of swallowing), enriched (vitamins C, D, E, folic acid, calcium, zinc...), low sodium and in some cases are useful gluten-free, lactose-free and allergen-free products. In all cases they must guarantee a high nutritional value and achieve the best organoleptic qualities (taste, texture and color), so that they are appetizing and remind the individual (hospitalized or institutionalized) of the traditional cuisine. CONCLUSIONS Diverse nutrition organizations and societies stand out that all individuals must have access to safe and adequate food for optimal nutritional status. The beneficial effect of proper nutrition on health promotion, disease risk reduction and impairment should be emphasized, especially in institutionalized/hospitalized subjects. Industry innovations can play an important role in enabling access to adequate food with nutritional benefits.

Evaluación de la dieta en pacientes con enfermedad renal crónica sin diálisis y su relación con el estado nutricional

BACKGROUND Diet is one of the pillars of the treatment for patients with chronic kidney disease without dialysis (NDD-CKD). Despite this, very few studies have evaluated the diet in Spanish population. OBJECTIVE To evaluate the diet of a group of patients with advanced CKD, comparing it with the recommendations, and its relation with nutritional status. MATERIAL AND METHODS A cross-sectional study of 74 patients (39 men), with a mean age of 70.9 ± 13.6 years and creatinine clearance of 15.3 ± 2.1 mL/min. Biochemical, anthropometric and intake variables (3-day dietary record) were collected, comparing them with the recommendations for patients with CKD and, if they did not exist, with nutritional recommendations and objectives for the Spanish population. The nutritional status was assessed by modified criteria of protein-energy wasting (PEW). RESULTS The mean energy intake was 23.2 ± 6.5 kcal/kg body weight/day, and the protein intake was 0.93 ± 0.2 g/kg body weight/day. Men had a higher intake of alcohol and vitamin D whereas women presented a higher intake of trans fatty acids and vitamin B1. In addition, 91.4% of patients had high intake of phosphorus and 73% of potassium. Only 2.7% showed an adequate intake of vitamin D and 21.6% of folates; 18.9% of patients presented PEW. A positive correlation was found between albumin, body mass index (BMI) and creatinine clearance. CONCLUSION Most patients with non-dialysis CKD do not meet dietary recommendations or nutritional goals, regardless of gender and PEW status, considering renal function as a limiting factor.

Pautas nutricionales en prevención y control de la hipertensión arterial

Objectives: Hypertension is a common health problem and with severe health impacts, underdiagnosed and modulated by dietary habits, lifestyle and intake of several nutrients, so analyze the latest data on the involvement of nutrition in preventing and control of hypertension is the subject of this review. Methods: Literature search regarding the topic. Results: Although the best known and followed patterns are the restriction in sodium intake, weight control, and moderation in alcohol consumption; improving diet (increasing consumption of cereals, vegetables, fruits...) and physical activity seem to have a major impact on the control of blood pressure, also consume less saturated fat (with increased MUFA and omega-3), adequate intake of calcium, magnesium, protein, vitamin D and fiber and improving the antioxidant capacity of the diet can have great importance in fighting the problem of hypertension. Given that the average Spanish diet does not meet the advised requirements for many of the nutrients mentioned as favorable in control of the blood pressure, an approximation of the diet to the theoretical ideal can be very helpful in the fight against this problem that has great health impact. Conclusions: Improving feeding, increasing the intake of vegetables, legumes, whole grains, dairy, fish, avoiding an inadequate supply of nutrients (especially calcium, magnesium, protein, and vitamin D) can have a greater benefit in controlling blood pressure, than most widespread monitoring restrictive guidelines in practice.

Calcium and vitamin D intakes in a representative sample of spanish women: particular problem in menopause

BACKGROUND The accelerated bone demineralization that occurs during the menopause is very conditioned by the intake of calcium and vitamin D, therefore, the aim of the study is examine the adequacy of the diet regarding these nutrients in a menopausal women group. METHODS A representative sample of the Spanish woman population with ages ranging from 17 to 60 years (n = 547), selected from 10 provinces was studied. The group of 108 menopausal women (45-60 years) is given priority attention. The dietary study was performed using a 3-day diet record. Weight and height were measured and then body mass index (BMI) was calculated. RESULTS Calcium intake (992.1 ± 340.7 mg/day) was lower than the recommended intakes (RI) in 79.6% of the menopausal women (MW) (lower than 67% of the RI in the 30.6%). Vitamin D intake (3.08 ± 3.6 μg/day) was even more unfavorable, since the contribution was 61.1% of the RI in MW, an 85.2% of them do not meet the RI and a 75.9% do not meet the 67% of the RI. A 72.6% of the studied women (68.5% of MW) do not meet the RI for calcium neither for vitamin D, while only the 4.0% of them meet the RI for both nutrients (3.7 of MW). Using a logistic regression analysis to examine the dietary modification that may be favorable to meet the RI for calcium and vitamin D simultaneously, having into account the influence of age and BMI, it is observed that the main factor is the consumption of dairy products [OR = 0.188 (0.108-0.327; p < 0.001)] and the same influence is observed when only menopausal women are analyzed [OR= 0.252 (0.067-0.946; p < 0.05)]. It is observed a decreased of BMI when the density of diet in calcium (r = -0.10) and in the vitamin D (r = -0.099) is increased, which suggested a possible role of these nutrients in weight control. CONCLUSIONS A high proportion of the studied women have intakes of calcium and vitamin D lower than the recommended intakes and given that only a 3.7% of the menopausal women have adequate intakes for both nutrients, it is necessary to adopt urgent measures aimed to protect the bone health of the Spanish female population.