Carmen Gómez-Candela

The Role of Omega-3 Fatty Acids in Diets.

The article is a summary of Dra. Carmen Gómez Candelas presentation at the Science in Nutrition 3rd International Congress in Milan, March 2014. The article covers omega-3 fatty acids use in different medical areas and several institutions opinions in relation to the topic. Omega-3 acids are essential fatty acids. A certain amount of omega-3 is needed in our daily diet; however, the usual consumption is generally less than the recommended amount. Changes in dietary patterns in the course of history have led to deficit levels of omega-3 in the human body. Currently, there is increasing evidence of the benefits of omega-3 in different medical specialities. There are still some gaps regarding its role in illnesses such as dementia, psychiatric disorders, and inflammatory diseases. Nevertheless, stronger evidence is being proved in cardiovascular diseases and cancer. This article provides a reflection on possible ways to increase omega-3 daily consumption and the constraints associated with food with high contents of heavy metals, which, in turn, are also rich in omega-3s.

Variables predictoras de baja adherencia a un programa de modificación de estilos de vida para el tratamiento del exceso de peso en atención primaria

OBJECTIVESnTo identify predictive variables of low adherence to a pilot Lifestyle Modification Program (LMP) for overweight and obesity treatment in primary health care (PC ).nnnMATERIAL AND METHODSnSixty subjects with BMI > 27 kg/m(2) were recruited. Health professionals directed the program in a group structure and biweekly, based on nutrition education with individualized dietary guidelines, promotion of physical activity and motivational support. A validated questionnaire on lifestyle habits for overweight and obesity subjects was used to identify variables related with program adherence and anthropometric variables were measured before and 6 months after intervention. Low adherence was considered when patients attended to less than 80% of visits.nnnRESULTSnTwenty-seven subjects (45%) presented high adherence to the program. The variables associated to low adherence were related to baseline with IMC ≥ 35 kg/m(2) (p < 0.05); ex smoker period ≤ 4 months (p < 0.01); high caloric diet (p < 0.01) and scarce physical activity (p < 0.05). At 6 months the subjects who finalized the program presented a significant decrease of weight (86.0 ± 15.6 vs 79.2 ± 13.4 kg; p < 0,001); fat mass percentage (41,6 ± 4,6 vs 38.8 ± 5,4%; p < 0.001), blood glucose (108 ± 45.48 vs 94.38 ± 11.97 mg/dl; p < 0.01). It also improved caloric diet profile, above all decreasing the percentage of fat (39.6 ± 4.8 vs 35.5 ± 5.6%; p < 0.01).nnnCONCLUSIONnHave recently left smoking, obesity degree two or higher, a high caloric diet and scarce physical activity were basal variables identified as predictive of a low adhesion to a LMP for the treatment of overweight and obesity in primary health care. We do not consider this pilot experience as satisfactory and other new strategies are under development.

Assessment of nutritional status in the healthcare setting in Spain.

Early identification of undernourished patients in the healthcare setting, and their nutritional treatment, are essential if the harmful effects of poor nourishment are to be avoided and care costs kept down. The aim of assessing nutritional status is to determine the general health of a patient from a nutritional viewpoint. All hospitalised patients should undergo nutritional screening within 24-48 h of admission, as should any patient who shows signs of being malnourished when visiting any healthcare centre. The infrastructure and resources available, the possibilities of automisation, and the healthcare setting in which such assessment must be performed, etc., determine which method can be used. The European Society of Parenteral and Enteral Nutrition (ESPEN) recommends the use of the Nutritional Risk Screening-2002 (NRS-2002) method for hospitalised patients, the Malnutrition Universal Screening Tool (MUST) in the community healthcare setting, and the first part of the Mini-Nutritional Assessment (MNA) for elderly patients. In centres where screening can be computerised, the CONUT® or INFORNUT® methods can be used. A nutritional diagnosis is arrived at using the patients medical history, a physical examination (including anthropometric assessment), biochemical analysis, and functional tests. No single variable allows a diagnosis to be made. The Subjective Global Assessment (SGA) and MNA tests are useful in nutritional assessment, but they are not universally regarded as the gold standard. At our hospital, and at many other centres in the Spanish health system, the Nutritional Status Assessment (NSA) method (in Spanish Valoración del Estado Nutricional) is used, which involves the SGA method, the taking of anthropometric measurements, and biochemical analysis. After making a nutritional diagnosis, which should be included in the patients medical history adhering to International Classification of Diseases code 9 (ICD- 9), and prescribing a nutritional treatment, the patient should be followed up. No single marker can be used to monitor progress; interpretations will once again require examination of the patients medical history, the taking of anthropometric measurements and laboratory tests. Depending on whether a patient is ambulatory or hospitalised, the follow-up assessment times and variables measured will differ.

Impact of cooked functional meat enriched with omega-3 fatty acids and rosemary extract on inflammatory and oxidative status; A randomised, double-blind, crossover study

BACKGROUND & AIMnn-3 fatty acid intake has been associated with inflammatory benefits in cardiovascular disease (CVD). Functionalising meat may be of great interest. The aim of the present study was to assess the effect of functional meat containing n-3 and rosemary extract on inflammatory and oxidative status markers in subjects with risk for CVD.nnnMETHODS AND RESULTSnA randomised, double-blind, cross-over study was undertaken to compare the effects on the above markers of consuming functional or control meat products. 43 volunteers with at least two lipid profile variables showing risk for CVD were randomly assigned to receive functional meat (FM) or control meat (CM) over 12-weeks with a 4-week wash-out interval before crossover. Functional effects were assessed by examining lipid profile, CRP, PAI-1, TNF-alpha, IL-6, fibrinogen (inflammatory markers), and TBARS, FRAP and 8-iso-PGF2 (oxidative status markers). 33 subjects (24 women) aged 50.7±8.8 years completed the study. In FM treatment, PAI-1, fibrinogen and 8-iso-PGF2 decreased significantly after 12 weeks, while FRAP significantly increased. In contrast, in CM treatment, a significant increase was seen in PAI-1, while FRAP significantly declined. Significant differences were also seen between the FM and CM treatments after 12 weeks in terms of the change observed in PAI-1, FRAP and 8-iso-PGF2 values. No significant differences were seen in anthropometric variables nor were adverse effects reported.nnnCONCLUSIONnThe consumption of FM containing n-3 and rosemary extract improved oxidative and inflammatory status of people with at least two lipid profile variables showing risk for CVD. The inclusion of such functional meat in a balanced diet might be a healthy lifestyle option.

New, Immunomodulatory, Oral Nutrition Formula for Use Prior to Surgery in Patients With Head and Neck Cancer: An Exploratory Study

BACKGROUNDnThe perioperative use of immunomodulatory nutrition formulas in patients with head and neck cancer reduces the number of postoperative infections and the length of hospital stay.nnnOBJECTIVEnAn exploratory, randomized, controlled, blind, clinical trial was designed to examine the effect of the preoperative consumption of a new, immunomodulatory, oral nutrition formula in patients with head and neck cancer.nnnMETHODSnThirty-eight patients were randomized to receive either 400 mL/d of either the new immunomodulatory formula (IF) or that commonly used in clinical practice (CF) over 10 days prior to surgery. Thirty-three patients completed the study. Compliance, tolerance, the length of hospital stay, the incidence of infections and noninfectious complications before discharge, and the same up to 15 and 30 days after discharge were recorded.nnnRESULTSnThe percentage of patients who developed infections before discharge was significantly lower in the IF than in the CF group (P = .013), as was the number of infections/100 patients/d (P = .035). The length of hospital stay was significantly shorter in the IF group (P = .001). Both formulas were safe and well tolerated. No other differences were detected. These results suggest preoperative consumption of the new formula to be beneficial for patients with neck and head cancer. Further trials are needed to confirm these results and to test the efficacy of the formula in patients with other conditions.nnnCONCLUSIONnThe new formula can be safely prescribed as part of the preoperative treatment of patients with head and neck cancer and might reduce the problem of postoperative infection.

Hydration status in patients diagnosed of chronic idiopathic constipation by rome III criteria

Introduction: the relationship between thirst and dehydration in terminal patients at end of life is limited and the current bibliography agree with this controversy. Due to the lacking of scientific evidences the decision to rehydrate of these patients is based on the usual clinical practice. nObjectives: to evaluate the hydration status of oncological patients with palliative care by Bioelectrical impedance analysis (BIA). nMethod: this scientific initiative will evaluate the hydration status of 50 oncological patients admitted with palliative care at University Hospital La Paz by BIA, excluding those who according with their Palliative-Pronostic-Score (PaP-Score) get a 30-day survival probability <30%. It is a descriptive, observational and cross-sectional study. The main variable will be nthe phase angle and as secondary variables: evaluation of the nutritional status by Subjective-Global-Assessment (SGA), corporal composition (BIA) and functional capability (dynamometry). Besides it will evaluate: PaP-Score, Palliative-Performance-Scale (PPS), disability (Barthel-Test), cognitive function (Pfeffer-Test), dehydration symptoms and biochemical parameters. nResults: preliminary results of statistical analysis will be exposed once they achieve the estimated sample size (confidence level 95%, differences’ average 0.610, DS 2,200). nConclusions: the study of the oncological with palliative care patient’s hydration status provides scientific evidence to implementation of action protocols to properly rehydrate those patients.

Perception about the importance of feeding in a group of hematologic cancer patients

INTRODUCTIONnOncohematologic patients usually present nutritional deficits associated with the disease, the treatments and side effects, etc. However, there are hardly any descriptive data about the dietary recommendations used and the patients self-perception of its usefulness in their disease.nnnAIMnTo assess the self-perception of the nutritional importance in a group of oncohematologic patients.nnnMATERIALS AND METHODSn111 oncohematologic patients self-reported a questionnaire containing items about socio-sanitary data and self-perception of the nutritional importance in their disease.nnnRESULTSnThe mean age was 40.0 ± 12.8 years (64.86% women). The most frequent diagnosis and treatment was lymphoma (83.78%) and chemotheraphy (92.80%). 75% considered very important relationship between oncohematologic disease and nutritional status. Only 54.1% received dietary advice. And 53.2% and 50.5% considered that the use of nutritional supplements improve quality of life and/or disease respectively.nnnCONCLUSIONSnA significant percentage of patients had advanced stages of their disease. However, half the group had not received dietary advice despite high interest in receiving nutritional care. Therefore, the nutritional assessment and the personalized nutritional support implementation of the patient should be included in routine clinical practice.