Beatriz Navia Lombán

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.

The Effects of Physical Activity on Dietary Habits in Young Adults from Madrid

BACKGROUND The main objective of the study was to analyze the relation between the physical activity levels and diet quality of a group of young adults from Madrid. METHODS The nutritional and activity records of a group of 222 young adults (113 females and 109 males), with ages ranging from 18 to 30 years, were evaluated using dietary and activity questionnaires, and anthropometric measurements. From the data collected, the food, energy, macro and micronutrients intake, activity coefficient, body mass index, and body fat percentage were calculated. RESULTS The study revealed that 67.1 % of the individuals evaluated (82.3 % of the females and 51.3 % of the males) were classified as sedentary. The sedentary individuals had a higher percentage of body fat compared to active individuals. Generally, active individuals consumed more cereals and less fat. The nutritional intake of the participants did not follow the recommended daily intake, however the nutritional intake of the active individuals was closer to the recommended, with higher micronutrient intakes. CONCLUSION These results suggest that active individuals follow healthier diets and keep a more adequate body weight, which provides protection against several chronic diseases.

Suplementos en gestación: últimas recomendaciones

El embarazo representa un desafio desde el punto de vista nutricional, debido a que las necesidades de nutrientes estan aumentadas y una alteracion en su ingesta puede afectar la salud materno-fetal. Estados deficitarios en micronutrientes estan relacionados con preeclampsia, retraso del crecimiento intrauterino, aborto y anomalias congenitas. Actualmente, la dieta de muchas madres gestantes es insuficiente en micronutrientes, siendo necesaria su suplementacion. Se recomienda la suplementacion con acido folico en dosis de 400 μg/dia, y de 5 mg en embarazadas de riesgo, debiendo comenzar al menos 1 mes antes de la concepcion y durante las primeras 12 semanas de gestacion, y prolongarla durante todo el embarazo en madres con riesgo nutricional. Es importante vigilar la dosis adecuada de acido folico para prevenir los posibles efectos adversos derivados de su acumulacion plasmatica no metabolizada. Un elevado porcentaje de gestantes presenta anemia ferropenica, estando recomendado el uso intermitente de suplementos con hierro (menor alteracion gastrointestinal y estres oxidativo); no recomendandose en madres no anemicas (con hemoglobina > 13,5 g/L). Dado que la absorcion de calcio esta aumentada hasta un 40% en gestacion, no se recomienda su suplementacion en madres con ingestas adecuadas (3 lacteos/dia), debiendose reservar su uso a madres con ingestas insuficientes y/o que tengan alto riesgo de preeclampsia. Respecto al iodo, existen posicionamientos contradictorios por parte de distintos grupos de trabajo, estableciendose la suplementacion con yoduro potasico en mujeres que no alcanzan las ingestas recomendadas con su dieta (3 raciones de leche y derivados lacteos + 2 g de sal yodada). Dado que la vitamina A y D pueden ser toxicas para la madre y el feto, no esta recomendada su suplementacion excepto en casos de deficiencia. Aunque la administracion de suplementos con varios micronutrientes puede repercutir favorablemente en el resultado del embarazo, es necesaria una mayor evidencia cientifica para establecer el reemplazo de hierro y acido folico con un suplemento de micronutrientes multiple.Pregnancy is a challenge from the nutritional point of view, because nutrient requirements are increased and alter its intake can affect maternal and fetal health. Micronutrient defi ciency states are related to preeclampsia, intrauterine growth restriction, abortion and congenital anomalies. Currently, the diet of many expectant mothers is insufficient in micronutrients, in this cases supplementation is necessary. It is recommended supplementation with folic acid in doses of 400 mcg / day and 5 mg/day in risk pregnant, and should begin at least one month before conception and during the first 12 weeks gestation, and extend it throughout pregnancy in mothers with nutritional risk. It is important to keep watch the proper dose of folic acid to prevent possible adverse effects of unmetabolized accumulation in plasma. A high percentage of pregnant women presented iron deficiency anemia, being recommended intermittent use of iron supplements (with lower gastrointestinal alteration and oxidative stress); not recommended for mothers without anemia (hemoglobin> 13.5 g / L). Since calcium absorption is increased up to 40% in gestation, its supplementation is not recommended for mothers with adequate intakes (3 dairy / day), and its use must be reserved to women with inadequate intakes and / or high risk of preeclampsia. Regarding the iodine, there are confl icting positions by different working groups established potassium iodide supplementation in women who do not reach their recommended intake (3 servings of milk and dairy products + 2 g of iodized salt), with their diets. Given that vitamin A and D can be toxic to mother and fetus, it is not recommended its supplementation except in cases of deficiency. Although the use of multiple micronutrients supplements may favorably impact the outcome of pregnancy, more scientific evidence is needed to establish the replacement of iron and folic acid with a multiple micronutrient supplement.

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.