Actividad Dietética最新文献

Introduction

After surgery on severe obesity (BMI = 40 kg/m² or BMI > 35 kg/m² with at least 2 associated pathologies), the development of nutritional deficiencies which, in some cases, already existed before the surgical intervention, has been described.

Objective

To examine the dietetic intake and the prevalence of nutritional deficiencies in obese patients who are candidates for obesity surgery in the Barcelona Hospital Clinic (centre of reference for bariatric surgery).

Methodology

A consecutive evaluation was made of 272 obese patients who were candidates for obesity surgery between January, 2003 and December, 2005. These included 202 women (74.3%) and 70 men (25.7%) (p < 0.005) with an average age ± standard deviation of 45.8 ± 10.4 years and a body mass index (BMI) of 48.6 ± 6.8 kg/m². The evaluation of the intake was carried out by monitoring it for 4 days (one holiday and 3 working days), and was completed with a 24-hour follow-up. In order to assess the nutritional relacondition, the establishment of some analytical parameters was included. The data obtained were statistically analysed. The significance level was provided for a value of p < 0.05.

Results

The average energy intake was 2,553 ± 1,000 Kcal/day in men and 1,971 ± 728 Kcal/day in women (p < 0.05). The carbohydrate intake was 38.2 ± 10.9% in men and 40.0 ± 9.4% in women (p = NS). The lipid intake was 42.8 ± 10.4% in men and 41.6 ± 9.3% in women (p = NS). The protein intake was 19.09 ± 7.9% in men and 18.14 ± 5.1% in women (p = NS). The calcium intake in both genders and the iron intake in women of the group being studied were lower than the dietetic intakes of reference. Likewise, a deficit in the biochemical parameters of different vitamins and minerals can be seen.

Conclusions

The nutritional deficiencies observed in the obese group which is a candidate for obesity surgery could be due to following unbalanced, excessively restrictive and/or uncontrolled diets that they have been on during several periods of their lives until they came for surgical treatment. They could also be related to the lack of dietetic-nutritional education, social factors, the existence of food behaviour disorders or diseases associated with obesity. It is important to detect and correct these altered parameters before surgery, for after it has been performed (BPG) there is an increase in these deficits.

In this article, details are given of the consolidation process of the official studies leading to the qualification that authorizes the practice of the dietician-nutritionist profession in Spain. Also, reflections on the actions that have allowed the dietician-nutritionist to now have a high level of training are put forward, and the steps followed in the educational framework are listed.

Introduction

There is a clear lack of information regarding the relation between the consumption of meal substitutes and the regulation of the satiation and hunger mechanisms.

Objective

To examine five aspects related with the appetite, hunger and satiation after eating meal substitute bars or a normocaloric meal established by a Dietician-Nutritionist using a validated visual scale (Visual Analogue Scale [VAS]).

Methods

A randomized, open crossed test lasting 6 days on 20 adults who are not elite athletes, who have no obesity, diabetes or other metabolic pathologies. A normocaloric diet was established for the volunteers, which they followed for the days the protocol lasted, and they were asked to do no sports during those days. On the third day, the meal was substituted by meal substitutes in one group (group A) and not in the other (group B), chosen at random, and aspects to do with the appetite, hunger and satiation were assessed in both groups. The assessment was carried out one hour before the meal and after it, plus three times more coinciding with the following three hours after the ingestion (i.e. a total of five times). From then on, the volunteers continued with the originally established diet for another two days, and, on the third day, the five aspects mentioned were assessed again, but this time by crossing the treatment groups, i.e. the group which was not given substitute bars the first time (group B) took them.

Results

In the Visual Analogue Scales analysed, no statistically significant differences were seen with regards to feelings of appetite, hunger and satiation in each of the treatment groups. Neither were statistically significant differences found with respect to the treatment groups and the value of the VAS scales in each of the times observed, except at the moment 0 (just after eating), for the assessment of the desire to eat something fatty, salty, sweet or tasty, where the substitutes seemed to curb this desire more efficiently.

Conclusions

The meal substitutes offered the same sensation of appetite, hunger and satiation as a balanced normocaloric meal, in spite of providing a considerably lower amount of calories and dietetic fibre. Just after a meal, the group which had eaten meal substitutes had less desire to eat something fatty, salty, sweet or tasty. More studies with a larger number of volunteers and which last longer are required to draw final conclusions.

In this article, the vitamin supply provided by different hypocaloric diets, whether they are controlled or not by a professional, is analysed through a bibliographic review. The bibliographic sources that affirm that vitamin and mineral supplements must be taken when hypocaloric diets are followed provide no scientific study that supports this statement. Neither has evidence been found that sustains this hypothesis, which makes it clear that there is a void in the scientific bibliography regarding the vitamin and mineral supply in hypocaloric diets. Even so, the available data make it clear that the general population does not cover its recommended allowances of reference, which must be due to both bad food habits and to the possibility of the vitamin and mineral intake being modified when a slimming diet is followed.