Stefanie Schoppen

An oily fish diet increases insulin sensitivity compared to a red meat diet in young iron-deficient women

Beneficial effects of n-3 fatty acids on a variety of physiological functions have been reported, but information related to the effects of oily fish consumed within a varied diet on glucose metabolism and diabetes risk is scarce. The objective of the study was to compare the effects of a diet rich in oily fish to those of a diet rich in red meat on lipid profile, oxidative status, glucose metabolism and insulin sensitivity in young, iron-deficient women. The study was designed attending the CONSORT statement guidelines. It was a randomised crossover dietary intervention study with two 8-week periods. Two diets were designed differing only in their oily fish or red meat content (four portions per week). Twenty-five young iron-deficient women with normal lipid, glucose and insulin levels participated in the assay. Lipid profile (total, LDL- and HDL-cholesterol, TAG), fasting glucose, fasting insulin, and oxidation (lipoperoxides) and inflammation (soluble intercellular adhesion molecule-1 and soluble vascular cell adhesion molecule-1) biomarkers were analysed. Insulin sensitivity was assessed by the Homeostasis Model Assessment (HOMA) and Quantitative Insulin Sensitivity Check Index (QUICKI). Insulin levels significantly decreased and insulin sensitivity significantly increased with the oily fish diet. HDL-cholesterol significantly increased with the oily fish diet. Other parameters did not significantly differ between diets. An increase in oily fish consumption increases insulin sensitivity in young iron-deficient women. This outcome should be considered when giving dietary advice to this population.

Reduction in cardiovascular risk by sodium-bicarbonated mineral water in moderately hypercholesterolemic young adults

The effects of drinking sodium-bicarbonated mineral water on cardiovascular risk in young men and women with moderate cardiovascular risk were studied. Eighteen young volunteers (total cholesterol levels >5.2 mmol/L) without any disease participated. The study consisted of two 8-week intervention periods. Subjects consumed, as supplement to their usual diet, 1 L/day control low mineral water, followed by 1 L/day bicarbonated mineral water (48 mmol/L sodium, 35 mmol/L bicarbonate and 17 mmol/L chloride). Determinations were performed at the end of the control water period and on Weeks 4 and 8 of the bicarbonated water period. Body weight, body mass index (BMI), blood pressure, dietary intake, total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, apolipoprotein (Apo) A-I, Apo B, triacylgycerols, glucose, insulin, adiponectin, high-sensitivity C-reactive protein (hs-CRP), soluble adhesion molecules [soluble intercellular adhesion molecule (sICAM) and soluble vascular adhesion molecule (sVCAM)], sodium and chloride urinary excretion, and urine pH were measured. Dietary intake, body weight and BMI showed no significant variations. Systolic blood pressure decreased significantly after 4 weeks of bicarbonated water consumption, without significant differences between Weeks 4 and 8. After bicarbonated water consumption, significant reductions in total cholesterol (by 6.3%; P=.012), LDL cholesterol (by 10%; P=.001), total/HDL cholesterol (P=.004), LDL/HDL cholesterol (P=.001) and Apo B (P=.017) were observed. Serum triacylglycerol, Apo A-I, sICAM-1, sVCAM-1 and hs-CRP levels did not change. Serum glucose values tended to decrease during the bicarbonated water intervention (P=.056), but insulin levels did not vary. This sodium-bicarbonated mineral water improves lipid profile in moderately hypercholesterolemic young men and women and could therefore be applied in dietary interventions to reduce cardiovascular risk.

Iron status biomarkers in iron deficient women consuming oily fish versus red meat diet

Specific recommendations for anemic individuals consist in increasing red meat intake, but the population at large is advised to reduce consumption of red meat and increase that of fish, in order to prevent the risk of developing cardiovascular disease. This study aimed to determine the effects of consuming an oily fish compared to a red meat diet on iron status in women with low iron stores. The study was designed attending the Consolidated Standards of Reporting Trials (CONSORT) statement guidelines. It was a randomised crossover dietary intervention study of two 8-week periods. Twenty-five young women with low iron stores completed the study. Two diets containing a total of 8 portions of fish, meat and poultry per week were designed differing only in their oily fish or red meat content (5 portions per week). At the beginning and the end of each period blood samples were taken and hemoglobin, hematocrit, serum ferritin, serum iron, serum transferrin, serum transferrin receptor-2 and the Zn-protoporphyrin/free-protoporphyrin ratio were determined. Food intake and body weight were monitored. During the oily fish diet, PUFA intake was significantly higher (p=0.010) and iron intake lower (mean±SD, 11.5±3.4 mg/dayvs. 13.9±0.1 mg/day, p=0.008), both diets providing lower mean daily iron intake than recommended for menstruating women. Although there were no significant differences after 16 weeks, serum ferritin moderately decreased and soluble transferrin receptor increased with the oily fish, while changes with the red meat diet were the opposite. In conclusion, an oily fish diet compared to a red meat diet does not decrease iron status after 8 weeks in iron deficient women.ResumenLas recomendaciones nutricionales dirigidas a personas con anemia consisten generalmente en aumentar el consumo de carne roja, mientras que las recomendaciones para la población general están enfocadas a la reducción del consumo de esta carne y aumentar el consumo de pescado, con el fin de reducir el riesgo de desarrollar enfermedades cardiovasculares. El presente estudio se diseñó para investigar los efectos del consumo de una dieta basada en pescado azul frente a una de carne roja sobre el estado de hierro de mujeres con bajas reservas de hierro. Este estudio se planteó de acuerdo con la guía CONSORT (patrones consolidados para la publicación de ensayos). Se trató de una intervención nutricional cruzada, aleatorizada, con 2 periodos de 8 semanas cada uno. Veinticinco mujeres finalizaron el estudio. Se diseñaron dos dietas que contenían 8 raciones de pescado, carne y aves a la semana. Sólo se diferenciaban en el contenido de pescado azul o carne roja (4 raciones semanales). Al inicio y final de cada periodo se obtuvieron muestras de sangre y se analizó la concentración de hemoglobina, hematocrito, ferritina, hierro sérico, transferrina, receptor-2 de la transferrina y el cociente Zn-protoporfirina/ protoporfirina libre. El peso y la ingesta de alimentos se controlaron durante el estudio. Durante la dieta de pescado azul la ingesta de ácidos grasos poliinsturados (AGP) fue significativamente mayor (p=0,010) y la ingesta de hierro se redujo (media±SD, 11,5±3,4 frente a 13,9±0,1 mg/día, p=0.008), siendo el aporte de hierro menor al recomendado para esta población. Aunque no se encontraron diferencias significativas durante 16 semanas, la ferritina descendió ligeramente y la concentración del receptor de transferrina aumentó con la dieta de pescado azul, mientras que los cambios observados con la dieta rica en carne roja fueron los opuestos. En conclusión, una dieta basada en pescado azul comparada con una dieta rica en carne roja, no provoca un descenso en el estado de hierro de mujeres con deficiencia de hierro después de 8 semanas.

Sodium bicarbonated mineral water decreases postprandial lipaemia in postmenopausal women compared to a low mineral water

The role of bicarbonated mineral waters on lipid metabolism and lipoprotein concentrations in man has scarcely been investigated. The present study aimed to investigate whether drinking sodium bicarbonated mineral water affects postprandial cholesterol and triacylglycerol metabolism in postmenopausal women. In a three-way, randomised, crossover study, eighteen healthy postmenopausal women consumed two sodium bicarbonated mineral waters (bicarbonated mineral water 1 and bicarbonated mineral water 2) and a low mineral water (500 ml of each) with a standard fat-rich meal (4552 kJ; 75.3 g fat). The bicarbonated waters were rich in sodium and bicarbonate and bicarbonated mineral water 1 contained 5.7 times more fluoride than bicarbonated mineral water 2. Fasting blood samples and postprandial blood samples were taken at 30, 60, 120, 240, 360 and 420 min after the end of the meal consumption. Cholesterol and triacylglycerols were determined in serum and chylomicrons. A significant water consumption effect was observed in the total area under the curve (TAUC) of serum and chylomicron triacylglycerols (ANOVA, P=0.008 and P=0.027, respectively). TAUC of serum triacylglycerols for bicarbonated mineral water 2 was significantly lower compared to low mineral water (Bonferroni, P=0.039). Peak concentration of serum triacylglycerols showed a significant water effect (P=0.025). Changes in chylomicron cholesterol were not significantly affected by the type of water. Bicarbonated mineral waters 1 and 2 did not show any significant differences. Drinking sodium bicarbonate-rich mineral waters reduces postprandial lipaemia in healthy postmenopausal women compared to drinking a low mineral water.

Does bicarbonated mineral water rich in sodium change insulin sensitivity of postmenopausal women

Objective: To investigate the prevalence of trematode Aspidogastrea in the freshwater mussels in the Yangtze River basin within Anhui province, China. Methods: We initially harvested the freshwater mussels living in the Yangtze River running through Anhui area, and labeled them with corresponding number. Then the samples were dissected for isolating the flukes, which were identified by conventional staining. Results: Infection rate of trematode Aspidogastrea in freshwater mussels in the Yangtze River basin within the territory of Anhui province was 30.38℅(103/339)in general, and a total of 912 flukes of Aspidogastrea were detected in the 103 mussels, with average infection rate of 8.85 for each mussel. Conclusion: Trematode Aspdogastrea is prevalent in the freshwater bivalves living in the Yangtze River basin running through Anhui area, and the treamatode was identified as Aspidogaster sp. belong to Aspidogaste under Aspidogastridae of Aspidogastrea.Objective: to assess the use of oral nutritional supplements analyzing the reason for prescription and its implication in caloric-protein intake. Setting: study performed at a university hospital of 350 beds with medical and surgical specialties. Subjects, patients: Patients inclusion was done by selecting all starting oral nutritional supplement prescription. Exclusion criteria were being younger than 18 years, being admitted to the Intensive Care Unit, having cognition or communication impairments, being on concomitant parenteral nutrition or requiring complete enteral diet, and/or using nasogastric tube for feeding. We also excluded special enteral diets, specifically designed for certain conditions. Interventions: One-year long prospective study on prescription of oral nutritional supplements. Through clinical chart review and personal interview, we recorded demographic data, nutritional parameters, characteristics of the diet and supplement, and caloricprotein intake prescribed and ingested. The data were introduced in an Access97 database and processed by means of SPSS software for Windows®. We performed a descriptive study of quantitative and qualitative variables, a χ2 analysis between qualitative variables, and a comparative analysis between means of all paired data by means of the student’s t test, and variance analysis between quantitative variables. The significance level was set at p < 0.05. Results: we were only able to analyze 77 out of 130 prescriptions for nutritional supplements since we could not adequately interview the remaining patients, mainly due to neurological impairments. Mean age was 74.8 years (SD = 12) and 50.6% were women. The departments prescribing the highest number of supplements were hematology (22.1%) and internal medicine (20.8%). GI neoplasm was the most frequent diagnosis at admission (27.3%). The most frequent indication was kwashiorkor (45.5%), with 15.6% of patients being well nourished. Mean therapy duration was 11 days (SD = 11.1), and the main reason for termination was hospital discharge (70.1%). The supplement was concomitantly prescribed with the meals in 70.6% of the cases, and more than halfMaterial y metodos: Estudio retrospectivo de 55 pacientes de 65,4 ± 14,7 anos, 35,7% mujeres y 64,3% varones con un IMC 27,87 ± 5,56 kg/m (0% con IMC 30 kg/m ) en tratamiento con NPT con una duracion de 28 ± 5 dias (mas de 20 dias en el 75% de los casos). El 16,1% presentaba Diabetes Mellitus previa al inicio de NPT. En el 64,3% de los pacientes, la fistula ocurria tras cirugia reciente: en un 38.8% tras reseccion de colon, 16,6% de intestino delgado y 13,9% de estomago. La NPT se planificaba para aportar diariamente 1,5 × Gasto Energetico Basal, 1,5 g/kg/dia de proteinas, 6 mg de vitamina B 12 y 414 μg de acido folico. Ninguna solucion contenia hierro.Objective. To assess the impact of weight loss in clinical nprogression of the comorbidities in a group of morbid nobese patients submitted to surgical treatment with the nduodenal switch technique. nStudy setting. Between 2001-2006, we have operated by nthe duodenal crossing technique a total of 118 morbid nobese patients (97 women and 21 men), mean age 42.6 nyears. Average pre-surgical BMI was 49.7, with average noverweight of 69.1 kg. nAfter surgical intervention, we have prospectively nassessed the progression of the main comorbidities (arterial nhypertension, diabetes, OSAS, osteoarticular pathology, ndyslipidemia), according to the subscale of the nBAROS scoring system. Postsurgical controls are done at nmonths 3, 6, 12, 18, and 24 and annually thereafter. We nhave followed-up 110 patients, of whom 90 presented ncomorbidities, being the ones studied. nResults. At 3 months post-surgery, we observed a decrease nin the mean value of %WL to 31%, and a mean BMI nvalue of 41.3, the percentage of lost BMI being 40.3%. nMost of the weight loss occurred within 2 years, with %WL nof 74.8% and a percentage of lost BMI of 97.7%. nIn 68 patients (75.5%) there was resolution of their ncomorbidities, 14.4% having improvement, and 10% nwith no improvement in spite of the surgery. Of patients nachieving complete resolution, almost all of them achieved nit within two years after surgery. nCure rates correlate with weight loss, so that at 3 nmonths, with a mean weight loss of 25 kg (BMI decrease nof 8.4 points) the comorbidity resolution rate is 45.5%. At n12 months, with a mean decrease in BMI of 16.4 points, n%WL of 61.6% and % of lost BMI of 70.4%, the comorbidity nresolution rate is 89.7%. nAt two years, by the time most of the main comorbidities nresolved (68 patients), the BMI decreased by 22.4 npoints, the %WL 74.8% and the % of lost BMI 97.9%. nConclusion. The aim of bariatric surgery is weight loss nand overweight-associated comorbidities improvement. nIn our study, most of the comorbidities improvement nstarted at the third month, with the highest improvement nrate occurring within two years, verifying that there is a ndirect relationship between post-surgical weight loss ncomorbidities improvement and resolution in most of the ncases.Objective: To investigate the breeding rate and breeding density of Carpoglyphus lactis in stored Fructus Jujubae in Anhui, China in order to provide a scientific basis for prevention of Carpoglyphus lactis(C. lactis) from spoiling the dried fruit of such category. Methods： By the breeding nature of C. lactis, we collected samples of Fructus Jujubae, which were kept over 6 months in general, from the dried fruit shop and (or) Chinese herbal medicine warehouse, and isolated C. lactis from those samples. The mite specimens were prepared, and microscopically and morphologically identified. Species classification was done in accordance with Hughes (1976). Result:C. lactis was identified in 19 of the 300 samples, with breeding density and breeding rate of 6.52 heads/g and 6.33%. Constitute ratio at distinct developmental phase was associated with adult (including nymph, 85.71%), larva(12.27%), hypopus (0.56%) and egg(1.45%), respectively. The richness index, diversity index and evenness index was1.644, 1.644 and 0.923, respectively. Conclusion： Carpoglyphus lactis appears infesting in large quantity in the Fructus Jujubae stored in the above places in Anhui province, and the density is higher. Therefore, it is urgent to take effective measures to prevent C. lactis from spreading over other dried products stored in the same room and potential human intestinal acariasis as a result of the biological contamination.Objective: To determine possible associations between nthe risk of breast cancer in Brazilian women and demographic, nsocial and economical variables, and past dietary nintake. nMethods: A case-control study was conducted in Joinville, nSanta Catarina, Brazil, between june and november n2003 involving a group of 33 women recently diagnosed nwith breast cancer and a control group of 33 healthy nwomen volunteers. Personal details, health history and npast dietary intake were obtained via questionnaires and ninterviews. Data between groups were compared using χ2, nFisher, and Student’s t test, whilst associations were evaluated nusing a non-conditional logistic regression method nand odds ratio (OR). nResults: Statistically significant differences between the ntwo groups were revealed with respect to age distribution n(P = 0.007), family income level (P = 0.02), educational level n(P 45 years), low family income n(<

A Comparative Study of Iron Bioavailability from Cocoa Supplemented with Ferric Pyrophosphate or Ferrous Fumarate in Rats

520/month), poor educational level (primary school nlevel or lower) and past regular consumption of pork fat nand fatty meat may be factors associated with an increased nrisk of breast cancer.A case of peritoneal mucinous carcinomatosis in a patient nwho suffered a Hirschsprung disease 30 year before nis presented. TH present condition caused an irreversible nintestinal obstruction and the patients received home nparenteral nutrition without unremarkable complications nlonger than two years.Introduction: Clinical nutrition is an activity realized in most of Health Centres of France, Canada, Great Britain and USA. The aim of our work was to determine activity and resources of Nutrition Units of Hospitals in the Community of Castilla y Leon. Material and methods: A questionnaire was send to all Hospitals of Castilla y Leon (SACYL); Hospital UniMaterial y método: Se estudió una población de pacientes postquirúrgicos (n = 22; 12 hombres y 10 mujeres) de 72,9 años de promedio (DE = 13,5) que fueron apareados en razón de edad y además un 40% de ellos por sexo, en dos grupos: A) con gastrectomía total (73%) o parcial (23%) por neoplasia y B) control, presencia de íleo paralítico postquirúrgico de causa no neoplásica. La duración media de la NPT fue de 14 días (DE = 2) y 13 días (DE = 2) respectivamente siendo la composición estándar de 12 g/N2, 100 kcal no proteicas/g N2, carbohidratos/lípidos: 63/38; volumen: 1.550-2.250 mL. Se realizaron controles basales habituales antes de la cirugía y al final de la NPT. Se analizaron los niveles de: Hb, Hto, contaje de linfocitos, contaje de neutrófilos y bioquímicos: glucosa, urea, creatinina, proteínas y albúmina. Análisis estadístico: test no paramétrico U de Mann Whitney y correlación de Pearson.El Órgano Oficial de SENPE, Nutrición Hospitalaria, no ha parado de crecer y prosperar a lo largo de sus 26 años de existencia. La revista se ha ido haciendo un hueco merecido en las bases de datos electrónicas y repositorios, alcanzando a los lectores interesados en su temática, no solo en España e Iberoamérica, sino también en países de ámbito sajón y en otros muy lejanos. El éxito ha traído parejo un incremento de originales, que en 2006 permitió alcanzar la cifra de 1.000 páginas publicadas. La creciente exigencia de los revisores, rechazando un treinta por ciento de los artículos recibidos, no ha sido impedimento para esta progresión, de lo que nos congratulamos. Otro de los éxitos positivos de este éxito editorial ha sido el aumento de números suplementarios de NUTR HOSP, documentos monográficos relativos a congresos, cursos, eventos o conclusiones de grupos de trabajo. La proliferación de los suplementos, muy halagüeña al comienzo, empezó a preocuparnos por las posibles desviaciones de la esencia de la revista. Vaya por delante que todos los suplementos han cumplido siempre las pautas éticas exigibles por la revista y por la SENPE, pero lo que escapaba al ámbito del comité editorial era la garantía de originalidad de todas las contribuciones, la homogeneidad en su estructura de acuerdo con las normas de publicación de la revista y, lo que es más importante, la falta de revisión por pares de sus contenidos. Esto último contradice formalmente la esencia de una revista científica. Por ello, Nutrición Hospitalaria y su comité editorial se encontraron ante un dilema: si se renuncia a la edición de suplementos que apoyan acciones especiales de la SENPE, se deja de prestar un servicio muy importante a la sociedad. Si se continua, incumplimos la normativa de revisión por pares. Hemos consultado los entornos científicos internacionales y rápidamente encontramos la solución, que colegas como Clin Nutr vienen aplicando desde hace uno o dos años: los suplementos deben aparecer bajo la cobertura de un ISSN diferente, llevando su propia paginación correlativa, en volúmenes independientes. Esta solución, que nos ha parecido la idónea, ha sido refrendada por el Comité Científico y la Junta Directiva de la Sociedad, y empezará a implementarse a partir de mayo de 2008. Así, el lector recibirá, a lo largo de los próximos meses, suplementos de Nutr Hosp ligeramente distintos. Los contenidos científicos de esta nueva línea editorial vendrán avalados por el Comité Científico Educacional y la Junta Directiva de SENPE. Creemos que con esta nueva fórmula que, como decimos, está ampliamente implantada en otras revistas científicas, se propiciará la multiplicación de los suplementos científicos de diversa índole que, en definitiva, redundará en beneficio de los miembros de SENPE y de nuestros lectores en general, sin menoscabo de las características referentes a originalidad y control que se exigen a los artículos que se publiquen en Nutrición Hospitalaria.OBJECTIVES: To analyze the complications related to enteral nutritional support in patients with lateral amyotrophic sclerosis included in our home-based mechanical ventilation program (HMVP), with a special emphasis on gastrointestinal complications. METHOD: Retrospective, descriptive study of the patients included in our HMVP directed by intensive care physicians, by means of systematic review of the medical records (included in a Microsoft Access database) during the period 2004-2011. RESULTS: In the period 2004-2011, 73 patients with a diagnosis of lateral amyotrophic sclerosis were followed: 34 (46.6%) refused nutritional support through gastrostomy or nasogastric tube, whereas 39 (53.4%) accepted. Twenty (51.3%) of the 39 patients with (home-based nutritional support) were females. The mean age of the patients was 60.6 + 13.4 years (95% CI 56.4-64.8). Diagnoses at the time of inclusion in the HMVP were: LAS, 21 cases (53.8%), and LAS with bulbar impairment 18 (43.1%). 34 patients (87.2%) were fed through percutaneous endoscopic gastrostomy (PEG), 3 (7.7%) through surgical gastrostomy, and 3 (7.7%). PEG was performed at the time of inclusion of the patients in the program, with a mean duration of 222.7 + 356.6 days (95% CI: 110.8-334.7). In patients with LAS, the mean duration was 271.4 + 449.5 days (95% CI: 130.3-412.1), and with LAS and bulbar impairment of 126.4 + 131.3 days (95% CI: 90-172.6). The mean duration of the nasogastric tube was 7.3 + 4.8 months (95% CI: 4-10.6). The mean duration of enteral nutrition was 578.6 + 872.9 days (95% CI: 304.7-852.6). There were complications in 35 patients (89.7%), and no complications occurred in only 4 patients (10.3%) (See table 2). Constipation occurred after initiating EN in 30 patients (76.9%); however, it was already present in 18 of them (60%). The remaining gastrointestinal complications observed were: abdominal bloating (9 patients; 23.1%); abdominal pain (6; 15,.4%); nausea and vomiting (5; 12.8%); diarrhea (3; 7.7%). CONCLUSIONS: Gastrointestinal complications are the most common ones; constipation stands out as the main problem in patients with LAS and HEN. However it may not be considered as a complication exclusively due to nutritional support since it is also a manifestation in the disease course. The occurrence of granulomas is also common.Obesity combined with breast cancer is a public health problem, given the high incidence and prevalence of both diseases. The aim of this review is to determine the current status of research on the relationship between the body weight of breast cancer patients and their prognosis. Overweight and obesity at the time of diagnosis are associated with a worse prognosis in breast cancer survivors. Observational studies show that breast cancer mortality is 33% higher in obese than in non-obese survivors. Furthermore, weight gain after diagnosis is common in these patients and is even greater in those receiving chemotherapy. Weight gains of 2-8 kg are observed in 68% of patients 3 years after diagnosis. Each 5 kg increase in body weight is associated with a 13% increase in breast cancer specific mortality. The mechanisms that cause this weight gain are not totally known. A higher weight gain is also associated with higher the risk of co-morbid cardiometabolic diseases, which worsen the quality of life and shorten overall survival. On the other hand, excess adipose tissue is an indirect promoter of tumor cell proliferation and releases circulating estrogens. Hence, preventing excess weight is important in these patients. An important limitation is the small number of randomised controlled trials investigating the type of diet that could be recommended specifically to breast cancer survivors. The evidence from current studies suggests that a healthy diet, low in fat and simple sugars and with a high proportion of fruit, vegetables and wholegrain products, has the potential to reduce morbidity and the risk of recurrence significantly, thus improving prognosis and quality of life in the long term.OBJECTIVEnTo compare measured resting energy expenditure (REE) with that predicted by formulas derived from populations with normal weight or obesity and from women with severe and morbid obesity.nnnMATERIAL AND METHODSn66 women (aged 35.6 +/- 10.3 y and BMI of 44.7 +/- 4.9 kg/m2) were evaluated by indirect calorimetry with a metabolic monitor Deltatrac (Datex Inst., Finland), before undergoing gastric bypass. REE was calculated with the following equations: Harris-Benedicts with both actual and adjusted weight, Ireton-Jones, Mifflins, and Carrascos Fast Estimation, which corresponds to 16.2 kcal x kg actual weight.nnnRESULTSn(mean +/- sd). Measured REE was 1797 +/- 239 kcal/day. All formulas, except Harris-Benedicts with adjusted weight, overestimated REE. The Ireton-Jones equation presented the greater overestimation (689 +/- 329 kcal/day), whereas Mifflins equation overestimated REE only by 6 +/- 202 kcal/day. No significant differences were detected between measured and calculated REE by Mifflins and Carrascos Fast Estimation. Accuracy (defined as difference between calculated and measured REE within +/- 10%) was greater with Mifflins equation (68%), followed by Harris-Benedicts with actual weight (64%) and Carrascos Fast Estimation (61%). By using the Bland-Altman analysis, significant correlations were observed between calculated-measured REE and mean REE (calculated + measured/2) with all equations except Carrascos Fast Estimation. This means that all but one formula underestimate or overestimate REE depending on the level of measured REE.nnnCONCLUSIONnIn severe and morbid obese women, Mifflins and Carrascos Fast Estimation equations provided the best performance to estimate REE. Before recommending an equation in an a subset of individuals it is necessary to make previous validation studies to determine that equation with the best predictive power for this particular group of patients.Objective To investigate the species and breeding density of acaroid mites in the stored rhizomatic traditional Chinese medicinal materials in Anhui province, China, in order to supply evidences for control and prevention of such species. Methods The stored traditional Chinese medicinal materials of root-stock origins were collected in 30 herb stores and warehouses in 17 cities across Anhui province. Mites were collected by using Tullgren funnel and directicopy, and identified under microscopy. Results 22 species of acaroid mites, belonging to 15 genera under 5 families, were identified from the total 47 stored samples, in which Tyrophagus putrescentiae，Acarus farinae, Carpoglyphus lactis, and Cologlyplus berlesei were predominant. Conclusion Breeding density of acaroid mites was high in the stored rhizomatic traditional Chinese medicinal materials in Anhui province. This indicates that the traditional Chinese medicinal herbs of root-stock origins in storage are seriously contaminated by the acaroid mites, and such infestation should be positively controlled to reduce the potential harm to public health.INTRODUCTIONnFor critically patients, enteral immunonutrition results in notable reductions in infections and in length of stay in hospital, but not on mortality, raising the question as to whether this relate to the heterogeneous nature of critically ill patients or to the absence of the altered absorption of specific nutrients within the immunonutrient mix (e.g. iron). Immune-associated functional iron deficiency (FID) is not only one of the many causes or anaemia in the critically ill, but also a cause of inappropriate immune response, leading to a longer duration of episodes of systemic inflammatory response syndrome and poor outcome.nnnOBJECTIVEnThis prospective cross-sectional study was undertaken to assess the prevalence of FID in critically ill patients during their stay in intensive care (ICU) in order to find the more appropriate population of patients that can benefit from iron therapy.nnnMETHODnFull blood cell counts, including reticulocytes (RETIC), serum iron (SI), transferring levels (TRF) and saturation (satTRF), serum TFR receptor (sTfR), ferritin (FRT) and C-reactive protein (CRP) were measured in venous blood samples from 131 random patients admitted to the ICU for at least 24 h (Length of ICU stay, LIS; min: 1 day; max: 38 days).nnnRESULTSnAnaemia (Hb < 12 g/dL) was present in 76% of the patients (Hb < 10 g/dL in 33%), hypoferremia (SI < 45 microg/dl) in 69%; satTRF < 20% in 53%; FRT < 100 ng/mL in 23%; sTfR > 2.3 mg/dL in 13%; and CRP > 0.5 mg/dL in 88%. Statistically significant correlations (r of Pearson; *p < 0.05, **p < 0.01) were obtained for serum CRP levels and WBC**, Hb*, TRF**, satTRF*, and FRT**. There was also a strong correlation between TRF and FRT (-0.650**), but not between FRT and satTRF or SI. LIS correlated with Hb*, CRP**, TRF*, satTRF* and FRT**.nnnCONCLUSIONSnA large proportion of critically ill patients admitted to the ICU presented the typical functional iron deficiency (FID) of acute inflammation-related anaemia (AIRA). This FID correlates with the inflammatory status and the length of stay at the ICU. However, 21% of the ICU patients with AIRA had an associated real iron deficiency (satTRF < 20; FRT < 100 and sTfR > 2.3). Since oral supplementation of iron seems to be ineffective, all these patients might benefit of iv iron therapy for correction of real or functional iron deficiency, which in turn might help to ameliorate their inflammatory status.In August 1976, a young man named LeRoy fell from a ledge, fracturing his femur. Major internal bleeding was nsuspected. During a laparotomy, the trauma team ensured that all internal organs were intact and the orthopedic nteam set his fracture. Thirty days later, LeRoy died. He had eaten little; each day he only received three liters of nglucose, the equivalent of 510 calories, intravenously. The glucose was insufficient to meet his nutritional needs, nand he lost over 20% of his body weight during his hospital stay. The cause of death was due to “physicianinduced” nmalnutrition. Meanwhile, a paper around the same time documented that the prevalence of malnutrition nin Boston hospitals was 44% and that malnutrition itself was a predictor of higher complication and death rates. nAs a result, like-minded physicians formed a society that created training programs and encouraged formation of nhospital nutrition teams. Industry produced nutrition formulas and catheters. Complications in sick hospitalized npatients plummeted while survival rates rose, and California passed legislation to mandate nutritional support. nThough the health care industry recognized the importance of nutrition in patient care, Congress failed to pass nfiscal support for nutrition teams. As a result, hospitals disbanded their newly created nutrition teams, nutrition neducation and skills declined, and hospital complications and death rates have risen again.Some bioethicists consider older age as a limiting factor nfor receiving special medical care. Older adults comprise nthe majority of home enteral nutrition patients n(neoplams of the head, neck, and upper gastrointestinal ntract neuromuscular swallowing disorders, dementia, netc) On the contrary, there are very few data on Home nParenteral Nutrition (HPN) in the elderly. We report nthese of a 75 years old man affected from a severe short nbowel syndrome due to mesenteric thrombosis. After a nhospital stay of two months he was sent home on HPN. nHis current caregiver was her wife, a 72 year old woman nsuffering from incipient Parkinson’s disease. nHPN lasted for 11 years and was stopped because of clinical ndeterioration. During this time he presented 5 catheter- nrelated infections (1.3 episodes/1,000 days). 5 catheters nwere used (average length 788 days). He was nhospitalized four times because of HPN complications. nFunctional status was maintained along almost all the nlength of HPN. nConclusions: The rate of complications in this patient nwas similar to other groups of age receiving HPN. The ntechnique was not burdensome for the family. Older age ncannot be consider, by itself a limiting factor when receiving nlong term nutritional support.Patients submitted to hematopoietic stem cells transplantation (HSCT) have an increased risk for having hyponutrition, both in the phase prior to transplantation and after this one. The indication of specialized nutritional support is common in allogenic HSCT, whereas patients submitted to auto-HSCT need it in the presence of complications that compromise an adequate nutrients intake. Enteral nutrition through a nasogastric tube has difficulties in these patients; the presence of mucositis delays the indication for enteral nutrition, which usually is poorly tolerated. Thus, frequently parenteral nutrition needs to be used as the route for nutritional support. The use of specific substrates, such as glutamine, is a controversial issue.La edad media fue 4,29 anos (0,1-14,4); el 48% de los ninos tenian menos de 3,5 anos. En el 70% de los casos, el motivo de la indicacion fue la disminucion de la ingesta. La duracion media fue 116,16 dias (4-1.165), manteniendose durante menos de 100 dias en el 79% de los pacientes. El porcentaje calorico medio administrado fue del 68%, precisando el 48% de la serie un aporte < 50%. El tipo de acceso inicial fue la sonda nasogastrica en el 92% de los ninos, la gastrostomia en el 5% y la sonda nasoyeyunal en el 3%. El modo de alimentacion mas frecuentemente utilizado fue la administracion exclusivamente nocturna en el 39% de los casos. El soporte de modo continuo se realizo en el 32%. La dieta polimerica pediatrica se empleo en el 70% de los pacientes. Los datos antropometricos, a excepcion de la talla, mejoraron de forma significativa tras la aplicacion del soporte. El 33% de los pacientes mostraban un indice de Waterlow inicial ≥ 90%.Metodo: Se realizo una busqueda de GPC disponibles en Internet en New Zeland Guidelines Group, Nacional Institute for Clinical Excellence, Scottish Intercollegiate Guidelines Network, Canadian Medical Association Infobase, Health Services/Technology Assesment, Fisterra y Medline. Se incluyeron ademas las direcciones de la ASPEN y la SENPE. Se recuperaron todas aquellas guias editadas o actualizadas en los ultimos cinco anos, en idioma ingles o castellano.Resumen es: Las enfermedades cardiovasculares representan la primera causa de muerte en Venezuela desde el ano 1967. Existen evidencias que demuestran que la lesion ...Material y metodo: Estudio retrospectivo. Cuando existe indicacion de administrar nutricion enteral en intestino, las enfermeras de nuestra Unidad colocan este tipo de sonda en la misma habitacion del enfermo, segun tecnica descrita por el fabricante. Despues de 24 horas de su colocacion, y sin fijarla en el ala de la nariz durante este tiempo, se realiza una radiografia de abdomen en decubito supino para valorar la situacion de la punta de la sonda (gastrica vs intestinal). Si no progresa a intestino, se reajusta la longitud introducida de la sonda y se repite la radiografia en las siguientes 24 horas. Ninguno de los pacientes tenian ventilacion asistida o sedo-relajacion. El exito en la colocacion se expresa como porcentaje de paso a traves del piloro.Introduction: Significant malnutrition exists in a high percentage of patients with head and neck cancer. Malnutrition is associated with defects in immune function that may impair the host response to malignancy. Malnutrition and immunosupression make patients highly susceptible to postoperative infections and complications. Objectives: Compare two immunoenhanced enteral nutritions with a control diet, and evaluate the effect in postoperative infections, length of stay and inflammatory markers. nPatients: A population of 44 patients with oral and laryngeal cancer was enrolled in a randomized trial. At surgery, patients were randomly allocated to three groups: (group I); patients receiving an arginine-enhanced formula (group II); patients receiving a standard polymeric formula, and (group III) patients receiving an arginine, RNA and omega-3 fatty acids enhanced formula, in an isonitrogenous way. nResults: The duration of enteral nutrition in the three groups was similar with an average duration of 14,5 ± 8 days. The length of postoperative stay was similar, with an average of 19,8 ± 8,5 days. Wound infections and general infections were more frequent in the control group. Fistula rates were not improved in the enhanced diet groups. No significant intergroup differences in the trend of the two plasma proteins (albumin, transferrin), lymphocytes, weight, IL-6, CPR and TNFα were detected. The control group showed the highest levels of TNFα at the fourteenth postoperative day. Gastrointestinal tolerance and diarrhoea rate were similar in all the patients. Conclusions: Immunoenhanced enteral nutrition formulas nimproved the infection rate in the postoperative of nhead and neck cancer patients. In the fistula rates, we nobserved that technical problems and nutritional status nmight have played an equally important role, and therefore nthe positive effect of immunonutrition in this parameter nmight have been overestimated.Introduction: Due to the high prevalence of overweight and obesity, new strategies are needed for its prevention and treatment. Nutritional Coaching (NC) has been shown to be effective in weight reduction, even though the innovation of this concept, it’s not always used properly. nObjective: To verify if NC, added to dietary assessment, is an effective approach for weight loss in overweight or obese population, compared with only technical dietary assessment. nMethodology: We performed a search for papers related to NC to establish quality parameters for this intervention. A systematic review was conducted, including randomized controlled trials that apply CN according to the selected parameters and comparing it with technical dietary assessment. nResults: Eight high quality studies were included in the analysis. Among these, six revealed statistical differences on behalf of the group that received NC. nConclusion: Nutritional Coaching is an effective approach for weight reduction. Future nutritional coaching intervention research would benefit from clear definitions of this new model.Introducción: El control de calidad es fundamental en cualquier intervención de enfermería clínico-asistencial y más aun en el paciente crítico. El protocolo de Enfermería de Nutrición Parenteral Total (NPT), que incluye el cambio de bolsa de nutrición, equipo de perfusión y cuidado del catéter venoso central (CVC) define unas actividades básicas. Fundamentamos el seguimiento en dos aspectos principales: 1. El paciente tiene un potencial de complicaciones relacionadas con la inserción del CVC y su manipulación, y 2. las repetidas manipulaciones de la conexión del CVC al equipo durante el tratamiento puede incidir en las infecciones del mismo.Material y metodo: Se estudiaron 27 pacientes (16 hombres y 11 mujeres) con carcinoma de colon y una edad media de 62,1 anos ? 11,2 (M?DE), de los cuales un 59% estaban en un estadio III de la enfermedad. De los pacientes incluidos, 11 habian recibido tratamiento quimioterapico previo y 16 no. El protocolo de Oncologia supuso la administracion aislada de 5fluoracilo en el 80% de los pacientes combinado con Oxaliplatino en un 17%. En todos los casos se registraron parametros antropometricos y analiticos (hemograma completo, glucosa, creatinina, bilirrubina, ALAT, ASAT, fosfatasa alcalina, albumina y marcadores tumorales) determinados antes de la cirugia y al final de la nutricion parenteral. Para evaluar la posible influencia del soporte nutricional los pacientes fueron divididos en dos grupos, en funcion de si habian o no recibido tratamiento citostatico previo a la intervencion. El analisis estadistico se realizo con el test ?2 y el de Wilcoxon (SPSS 10.0), aceptandose un nivel de significacion estadistica para p < 0,05.

Bone remodelling is not affected by consumption of a sodium-rich carbonated mineral water in healthy postmenopausal women

Background: Food iron fortification can be a good strategy to prevent iron deficiency. Iron bioavailability from cocoa powder enriched with ferric pyrophosphate encapsulated in liposomes or ferrous fumarate was assessed in rats. Methods: Three groups of rats consumed during 28 days either a control diet or two diets prepared with ferric pyrophosphate- or ferrous fumarate-enriched cocoa powder as the unique source of iron. Body weight and food intake were monitored and last-week feces were collected. On day 28, animals were sacrificed and livers and spleens were removed. Hemoglobin and total iron binding capacity (TIBC) were determined. Results: There were no significant differences in body weight and food intake. Apparent iron absorption and % absorption/intake were significantly lower in rats consuming enriched cocoa compared to the control group, without significant differences due to the iron form. Enriched cocoa groups showed significantly lower spleen iron content and concentration than the control. Liver iron was lower in the ferric pyrophosphate group compared to the other two groups. Hemoglobin and TIBC values showed a deficient iron status in ferric pyrophosphate rats. Conclusion: Cocoa powder is a good vehicle for iron fortification when enriched with ferrous fumarate compared to ferric pyrophosphate encapsulated in liposomes.

Sodium-bicarbonated mineral water decreases aldosterone levels without affecting urinary excretion of bone minerals

This study was designed to investigate the possible effects of consuming Na-rich carbonated mineral water on bone remodelling and urinary mineral excretion in postmenopausal women. Women (n 18) included were amenorrhoeic (>1 year), healthy and not obese (BMI <30 kg/m2). No woman was taking oestrogen replacement therapy, mineral and vitamin supplements, phyto-oestrogens or medications known to affect bone and lipid metabolism. In two consecutive interventions that lasted 8 weeks each, women drank 1 litre of control mineral water daily and 1 litre of carbonated mineral water, rich in Na, HCO3- and Cl-, daily. Body weight and height were measured, BMI was calculated and blood pressure was measured. Blood samples were taken from fasting subjects and serum obtained to analyse the biochemical bone markers, procollagen I amino-terminal propeptide (PINP) and beta-carboxy-terminal telopeptide of collagen (beta-CTX). At the end of each period, 24 h urine samples were collected to determine Ca, Mg, P, Na+, K+, Cl-, urine excretion and urinary pH. No changes in body weight, BMI or blood pressure were observed during the experimental period. Ca excretion was lower after the intake of carbonated water than after intake of the control water (P=0.037) while P excretion was higher (P=0.015). Total urine, Na and Cl- excretion did not differ between the two periods but urinary pH was increased after the intake of carbonated mineral water. PINP and beta-CTX did not differ between the two periods. Daily consumption of 1 litre of Na-rich carbonated mineral water for 8 weeks does not affect bone remodelling in healthy postmenopausal women.

Iron Bioavailability from Pate Enriched with Encapsulated Ferric Pyrophosphate or Ferrous Gluconate in Rats

Aim To assess in healthy postmenopausal women the influence of consuming sodium-bicarbonated mineral water on postprandial evolution of serum aldosterone and urinary electrolyte excretion. Methods Eighteen postmenopausal women consumed 500 ml of two sodium-bicarbonated mineral waters (sodium-bicarbonated mineral water 1 and sodium-bicarbonated mineral water 2) and a low-mineral water with a standard meal. Postprandial blood samples were taken at 60, 120, 240, 360 and 420 min and aldosterone concentrations were measured. Postprandial urinary minerals were determined. Results Urinary and total mineral excretion and urinary mineral concentrations did not differ except for sodium concentration, which was significantly higher with sodium-bicarbonated mineral water 1 than with low-mineral water (P=0.005). There was a time effect (P=0.003) on the aldosterone concentration. At 120 min, aldosterone concentrations were lower with sodium-bicarbonated mineral water 1 (P=0.021) and sodium-bicarbonated mineral water 2 (P=0.030) compared with low-mineral water. Conclusion Drinking a sodium-rich bicarbonated mineral water with a meal increases urinary sodium concentration excretion without changes in the excretion of potassium and bone minerals.

Agua mineral natural y riesgo cardiovascular

Fortifying food with iron has been widely studied as a strategy to prevent iron deficiency anaemia. This work comparatively assessed the bioavailability of two forms of iron, ferrous gluconate or ferric pyrophosphate encapsulated in liposomes (lipofer®), when used as fortificants in meat pate. Three groups of growing rats consumed during 28 days either a control diet (AIN-93G), or two diets prepared with enriched pate as the unique source of iron and fat. Body weight and diet intake were measured weekly, and during the last week faeces were collected. On day 28 animals were sacrificed, livers and spleens were removed and stored. Haemoglobin and total iron binding capacity (TIBC) were determined. There were not significant differences among the three groups in body weight and apparent iron absorption, although food intake in the two pate groups was significantly higher compared to the control group. There were not differences in liver and spleen iron content and concentration, neither in haemoglobin and TIBC values. These results indicated that iron bioavailability of pate enriched with ferrous gluconate or ferric pyrophosphate encapsulated in liposomes was similar, and thus both sources of iron are good candidates to be used as fortifiers in meat based products. The present outcome needs to be validated in humans.