Angel Gil Hernández

Los alimentos como fuente de mono y disacáridos: aspectos bioquímicos y metabólicos

Carbohydrates are important and necessary components of human diet. Although they primarily play an energetic function, they also have structural and functional roles. According to the European Food Safety Authority, carbohydrate intake should range between 45 and 60 percent of the energy in adults and children older than one year of age. An important part of carbohydrates available in foods are mono and disaccharides, commonly referred to as sugars. Dietary sources of sugars include fruits, fruit juices, vegetables, milk and milk products, and foods containing added sucrose and starch hydrolyzates. Despite their importance in daily life, there is currently no clear and adequate terminology on the various types of carbohydrates, particularly sugars. Nor are there available sugar intake recommendations or food composition tables. Without these recommendations or reference values, dietary unbalances might occur, which subsequently may end in the premature onset of most chronic or degenerative diseases of our society. The aims of the present work are: to classify dietary carbohydrates, to define the biochemical and common terms for sugars, to explain their nutritional value and their metabolism as well as their food sources and to carry out a SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis about the nomenclature and dietary intakes of sugars.

Dietary sources and intakes of folates and vitamin B12 in the Spanish population: Findings from the ANIBES study

Background Folates and vitamin B12 are key nutrients in one-carbon metabolism and related diseases. Updated and plausible information on population intakes and their major dietary sources is scarce and urgently needed in Spain in order to increase the knowledge that can lead as previous step to prevention by fortification and supplementation policies. Aims The present study aims to evaluate main dietary folate and vitamin B12 sources and intakes in the Spanish population. Materials and methods Results were derived from the ANIBES cross-sectional study using a nationally representative sample of the Spanish population (9–75 years, n = 2,009). Results Food groups with the highest mean proportional contribution to total folate intakes in both males and females were vegetables (21.7–24.9%) and cereals (10.7–11.2%), while meat and meat products (26.4%) and milk and dairy products (27.3%) were for B12. Total median folate and B12 intakes amongst women were 156.3 μg/d and 4.0 μg/d while for men were 163.6 μg/d and 4.5 μg/d, respectively. In all age groups, vitamin intakes were significantly higher in plausible than in non-plausible energy reporters. Conclusion A limited number of participants had adequate folate intakes, whereas vitamin B12 intakes were adequate for practically the entire population. There is a clear need for improving folates intake in the Spanish population.

Innovación en la incorporación de macronutrientes en fórmulas de nutrición enteral

Enteral nutrition consists of the administration of chemically defined nutrients which are partially or fully metabolised in the intestinal tract, by the oral route or through a tube, to get an adequate and efficient nutritional supply. Enteral nutrition is the first option when one needs artificial nutrition, keeping parenteral nutrition only for those cases for which enteral nutrition would be insufficient or impossible. Enteral nutrition formulas are classified according to their composition with complete or uncompleted supply of nutrients, administration route, and protein content, energy density and type and content of fibre, and in second term according to general or special purposes utilization. Indeed, enteral nutrition formulas can be grouped as polymeric, oligomeric, organ-specific, therapeutic formulas, and nutrition supplements and modules. All these formulas are susceptible of improvement and innovation based mainly on the knowledge of diseases physiopathology, composition and functionality of food ingredients, which in turn contain a number of specific nutrients and bioactive compounds able to exert particular effects on the patient, and on technological treatment technology that will result in the amelioration of nutrient bioavailability. The present work reviews some of the most relevant functional ingredients used today in the innovation of enteral formulas, as well as their main physiological and biochemical effects in selected pathologies.Enteral nutrition consists of the administration of chemically defined nutrients which are partially or fully metabolised in the intestinal tract, by the oral route or through a tube, to get an adequate and efficient nutritional supply. Enteral nutrition is the first option when one needs artificial nutrition, keeping parenteral nutrition only for those cases for which enteral nutrition would be insufficient or impossible. Enteral nutrition formulas are classified according to their composition with complete or uncompleted supply of nutrients, administration route, and protein content, energy density and type and content of fibre, and in second term according to general or special purposes utilization. Indeed, enteral nutrition formulas can be grouped as polymeric, oligomeric, organ-specific, therapeutic formulas, and nutrition supplements and modules. All these formulas are susceptible of improvement and innovation based mainly on the knowledge of diseases physiopathology, composition and functionality of food ingredients, which in turn contain a number of specific nutrients and bioactive compounds able to exert particular effects on the patient, and on technological treatment technology that will result in the amelioration of nutrient bioavailability. The present work reviews some of the most relevant functional ingredients used today in the innovation of enteral formulas, as well as their main physiological and biochemical effects in selected pathologies.

Atorvastatin versus Bezafibrate in Mixed Hyperlipidaemia Randomised Clinical Trial of Efficacy and Safety (the ATOMIX Study)

AbstractObjective: Combined hyperlipidaemia is a common and highly atherogenic lipid phenotype with multiple lipoprotein abnormalities that are difficult to normalise with single-drug therapy. The ATOMIX multicentre, controlled clinical trial compared the efficacy and safety of atorvastatin and bezafibrate in patients with diet-resistant combined hyperlipidaemia. Patients and study design: Following a 6-week placebo run-in period, 138 patients received atorvastatin 10mg or bezafibrate 400mg once daily in a randomised, double-blind, placebo-controlled trial. To meet predefined low-density lipoprotein-cholesterol (LDL-C) target levels, atorvastatin dosages were increased to 20mg or 40mg once daily after 8 and 16 weeks, respectively. Results: After 52 weeks, atorvastatin achieved greater reductions in LDL-C than bezafibrate (percentage decrease 35 vs 5; p < 0.0001), while bezafibrate achieved greater reductions in triglyceride than atorvastatin (percentage decrease 33 vs 21; p < 0.05) and greater increases in high-density lipoprotein-cholesterol (HDL-C) [percentage increase 28 vs 17; p < 0.01 ]. Target LDL-C levels (according to global risk) were attained in 62% of atorvastatin recipients and 6% of bezafibrate recipients, and triglyceride levels <200 mg/dL were achieved in 52% and 60% of patients, respectively. In patients with normal baseline HDL-C, bezafibrate was superior to atorvastatin for raising HDL-C, while in those with baseline HDL-C <35 mg/dL, the two drugs raised HDL-C to a similar extent after adjustment for baseline values. Both drugs were well tolerated. Conclusion: The results show that atorvastatin has an overall better efficacy than bezafibrate in concomitantly reaching LDL-C and triglyceride target levels in combined hyperlipidaemia, thus supporting its use as monotherapy in patients with this lipid phenotype.