Laura Mª Bermejo López

Indicaciones de diferentes tipos de fibra en distintas patologías

INTRODUCTION Fiber definition includes all those carbohydrates which are not digested nor absorbed in the upper gastrointestinal tract allowing them to reach the colon with no previous processing. Traditionally fiber has been classified according to their solubility into soluble and insoluble and different physiological properties have been defined for each type. The physiologic role of the fiber intake has been studied in diabetes, dyslipidemia or obesity. Fiber intake has also demonstrated to be beneficial in the prevention of many neoplastic diseases like colorectal cancer. It´s also known that fiber plays an important role in the faecal excretion of nitrogen. AIM To evaluate the current evidence that fiber intake plays in the management and prevention of several different diseases, being able to determine, if possible, the most recommended fiber type for each clinical condition. METHODS A non-systematic review by searching the Medline and Pubmed was made and studies which met the inclusion criteria were identified and selected for analysis. RESULTS Different fiber types can be useful for the treatment of several gastrointestinal diseases like constipation, diarrhea, irritable bowel syndrome, ulcerative colitis remission or short bowel syndrome. Patients diagnosed with diabetes, obesity, hyperlipidemia, hypertension and other cardiometabolic diseases can get a clinical improvement with soluble fiber intake. Dietary fiber has demonstrated to play a role in the prevention of colorrectal cancer and other neoplastic diseases. Patients with hepatic encephalopathy or chronic kidney disease will also benefit from fermentable fiber intake. DISCUSSION Fiber plays an important role in the prevention and treatment of many clinical conditions. However further investigations are needed to establish specific fiber intake recommendations.

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

OBJECTIVES To identify predictive variables of low adherence to a pilot Lifestyle Modification Program (LMP) for overweight and obesity treatment in primary health care (PC ). MATERIAL AND METHODS Sixty 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. RESULTS Twenty-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). CONCLUSION Have 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.

On Finding the Source of Human Energy: The Influence of Famous Quotations on Willpower

Positive psychology focuses on aspects that human beings can improve, thereby enhancing their growth and happiness. One of these aspects is willpower, a quality that has been demonstrated to have various benefits on people, as widely shown in the literature. As a result, a growing body of research is attempting to establish the conditions under which an individual’s willpower can be increased. This work attempts to confirm whether the famous quotations that people often use to inspire or motivate themselves can have a real effect on willpower. Two experiments were conducted assigning randomly subjects to a group and priming them with famous quotations, and afterwards comparing their performance in a willpower task with a control group. The second experiment added a willpower depletion task before priming. As a result, primed subjects endured the willpower task significantly more time than control group, demonstrating that famous quotations related to willpower help to increase this capacity and to counteract the effect of willpower depletion.