Nutricion hospitalaria最新文献

Introduction: Introduction: precision nutritional epidemiology studies require the development of initiatives to obtain objective population data that enable the implementation of health strategies. Therefore, the integration of health determinants and risk factors is essential to ensure the quality of life associated with nutrition through the use of new health indicators such as nutritypes and nutritional indices. Objective: the aim of the PLENUFAR 7 project was to design and promote the use of nutritypes and nutritional indices, integrating metabolic variables and nutritional markers of the Spanish population through nutritional education. Methodology: the project was developed in two phases. The first phase involved training and evaluating healthcare professionals. The second phase recruited 5,496 volunteers, collecting information on health, habits, and quality of life. Machine learning tools were used to classify population subgroups through an algorithm, and quantitative nutritypes were employed to determine metabolic risks. Results: the nutritional indices indicated an adequate health status: MEDLIFE (9.3/21 p), HHS (13/100 %), and MHL (2.4/5 p). Additionally, five nutritypes were identified for the Spanish population based on dietary patterns and metabolic determinants: westernized millennial, healthy, active Mediterranean, dysmetabolic, and metabolically vulnerable. Conclusion: the Spanish population exhibits a Mediterranean lifestyle with westernized influences, maintaining good health. PLENUFAR 7 trained professionals to provide personalized dietary advice, considering habits and lifestyles, supported by advanced computational tools.

Introduction: Introduction: in Latin America, access to specialized treatment for eating disorders (EDs) remains limited. Despite advances in detection and diagnosis, there are still major gaps in the availability of intensive and appropriate services, particularly outside large urban centers. Most existing treatment models were developed in high-income countries and do not always reflect the sociocultural, economic, and structural realities of the region. Objective: this report aims to document the implementation and evaluation of a scalable intermediate care model for EDs, with implications for adoption in public health systems across Latin America. Methods: the model integrates outpatient care and partial hospitalization through a structured three-phase therapeutic program focused on symptom interruption, cognitive-behavioral restructuring, and relapse prevention. The interdisciplinary team includes professionals in psychology, psychiatry, nutrition, and internal medicine, using evidence-based approaches adapted to the Mexican context. Since 2000, the program has treated over 700 patients diagnosed with anorexia nervosa, bulimia nervosa, binge eating disorder, and other ED presentations. Results: clinical data from a subsample of 502 patients indicate significant improvements in ED symptoms and psychological functioning, maintained at 6- and 12-month follow-up. Conclusion: this experience demonstrates the feasibility, effectiveness, and sustainability of an intensive outpatient model tailored to Latin American contexts. Its implementation may help bridge the treatment gap for EDs in middle-income countries and support the development of more equitable and accessible mental health systems in the region.

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Introduction: Introduction: severe vitamin B12 deficiency presents a diagnostic challenge due to its various clinical manifestations. Case report: the case we present here, a 17-month-old infant who presented with asthenia, hyporexia, paleness and regression of maturational patterns of approximately 2 months of evolution, illustrates the unique characteristics of severe vitamin B12 deficiency, highlighting the key differentiators from other conditions, including decreased reticulocyte counts and elevated lactate dehydrogenase levels, indicative of suppressed erythropoiesis. Discussion: advanced cobalamin deficiency affects all cell lines and produces peripheral pancytopenia. Proposed mechanisms include fragile red blood cells prone to tearing, leading to schistocyte formation, and oxidative stress that exacerbates hemolysis. In conclusion, prompt recognition and treatment with vitamin B12 replacement is essential to prevent serious hematological complications.

Introduction: Introduction: human milk (HM) is a balanced, harmonious biofluid with immunoprotective properties that are important for full-term newborns, but essential for premature infants. Objective: To evaluate the effects of the lack of direct contact between home milk donors and the Human Milk Bank (HMB) team, the influence of the bottle volume used for storing raw milk during home collection, and the impact of seasonal variations on the hygiene and sanitary quality of the donated milk. Methods: analysis of data from an HMB from January 1, 2018, to December 31, 2022. Analyses of the association between the evaluated year, season, and quantity and reason for discarding HM. Results: an increase in donated volume was observed, with a 21.2 % rise in 2020 and 7 % in 2021 compared to 2019. In 2020, HM disposal was 31.6 % and in 2021 34.9 %. In 2021, the disposal of bottles was 32.3 %, with a risk of disposal of 4.53 times. In the spring, the risk of disposal was the highest (1.73 times) compared to the other seasons. In autumn, losses were smaller (0.88 risk). Regarding the bottle volume, the greater the bottle volume, the greater the losses. Conclusions: the findings highlight the importance of recommending face-to-face visits by the HMB team to home-based donors to improve adherence to guidelines and address any doubts. Additionally, the use of smaller bottles for storage and intensive monitoring during hot weather and periods of low relative humidity are strongly advised.

Introduction: Introduction: type 2 diabetes mellitus (T2DM) is a metabolic disorder characterized by chronic hyperglycemia, associated with increased oxidative stress (OS), defined as the imbalance between the production of reactive oxygen species (ROS) and antioxidant capacity. Aim: to evaluate and compare serum concentrations of OS markers in patients with T2DM, differentiating between those with and without microvascular complications. Materials and methods: an observational, cross-sectional, and analytical study. Patients diagnosed with T2DM and an apparently healthy control group were included. All participants underwent anthropometric assessments, as well as biochemical and oxidative stress determinations. Results: statistically significant differences were observed between the T2DM group and the control group in terms of body mass index (BMI), glucose, triglycerides, LDL cholesterol, VLDL cholesterol, glycosylated hemoglobin, malondialdehyde (MDA), advanced protein oxidation products (PAOP), nitric oxide (NO), total antioxidant capacity (TAC), and oxidative stress index (OSI). When analyzing subgroups of patients with T2DM according to the number of microvascular complications, significant differences were detected in BMI, glucose, triglycerides, VLDL cholesterol, and glycosylated hemoglobin. Likewise, when comparing patients without complications with those who had one or two microvascular complications, a significant difference in CAT levels was identified. Conclusions: the biomarkers MDA and PAOP show particular clinical utility in monitoring the redox status in patients with T2DM, especially in the presence of microvascular complications, which supports their potential inclusion in personalized therapeutic and nutritional strategies.

Introduction: Introduction: this study evaluated the predictive value of inflammatory indices including neutrophil-percentage-to-albumin ratio (NPAR), systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR) and eosinophil-to-lymphocyte ratio (ELR) for mortality in adults with chronic kidney disease (CKD). Methods: this study analyzed adults aged 40-79 years with CKD from the National Health and Nutrition Examination Survey (NHANES) 1999-2018. Cox regression models assessed associations between inflammatory indices and all-cause/cardiovascular disease (CVD) mortality. Receiver operating characteristic curves evaluated their predictive accuracy. Restricted cubic splines and recursive algorithm analyzed threshold effects. Subgroup analyses were performed by demographic and clinical characteristics. Results: among 2496 subjects, elevated NPAR (HR: 2.05, 95 % CI: 1.62-2.59), NLR (HR: 2.28, 95 % CI: 1.78-2.93), ELR (HR: 1.61, 95 % CI: 1.27-2.03) and SII (HR: 1.61, 95 % CI: 1.26-2.06) were independently associated with increased all-cause mortality risk after adjustment. Similar patterns were observed for CVD mortality. NPAR showed the highest predictive value for both all-cause mortality (AUC: 0.610) and CVD mortality (AUC: 0.599). Non-linear relationships and threshold effects were identified between NPAR and mortality. The associations remained consistent across subgroups, with NPAR showing enhanced prediction in diabetic patients (p for interaction = 0.029). Conclusion: NPAR, SII, and NLR independently predicted mortality in CKD patients. NPAR demonstrated the strongest predictive capability, particularly in patients with diabetes, suggesting its potential as a practical tool for mortality risk stratification in CKD.

Introduction: Background: exercise impacts hand-grip strength (HGS) performance in adults. There is controversy regarding anthropometric and body composition indicators associated with HGS. We analyzed the association between HGS, anthropometry, and body composition parameters according to exercise level. Methods: we evaluated 209 participants, 104 men and 105 women between 18 and 59 y/o. Subjects were categorized according to the Global Physical Activity Questionnaire and the American Physical Activity Guidelines into two groups: Non-Adequate Level of Exercise (NALE) and Adequate Level of Exercise (ALE). Physical activity level was determined using the FAO/WHO factorial method. Body composition was performed using electrical bioimpedance. HGS was measured with a digital dynamometer (BTE™). Results: age did not correlate with HGS. Men and women in the ALE group had a lower level of fat mass index (p < 0.05) and higher levels of skeletal muscle index (SMI) (p < 0.05) and HGS (p = 0.008). Men in the normal SMI and overweight body mass index groups exhibited higher handgrip strength (HGS). In both sexes, the taller group had higher HGS values (p = 0.03). Significant correlations were observed in men between HGS and height, exercise, fat-free mass, and SMI. In women, there were significant correlations between fat mass and height. In no case was the effect size strong. HGS estimation models by sex are presented. Conclusion: height, exercise, and muscle mass influenced hand-grip strength in men, while height and adiposity did so in women.

Introduction: Objective: to evaluate the factors associated with non-compliance with the Quality Indicators in Nutritional Therapy (QINT) related to the prescribed and infused volume of Enteral Nutritional Therapy (ENT). Method: cross-sectional study, aligned with a prospective cohort, carried out in two clinical wards and two surgical wards of a Brazilian public hospital of high complexity and reference in ENT. Patients aged > 18 years, of both sexes, who required ENT exclusively by tube were included. The QINT "enteral volume infused index" and "frequency of days of adequate administration of the prescribed volume X volume infused in patients on ENT" were analyzed. Multivariate Poisson regression was adopted to identify factors associated with the outcome. Results: the 159 patients included totaled 565 days using ENT. The independent risk factors for non-compliance with the "enteral volume infused index" indicator were: being a surgical patient (HR: 2.12; 95 % CI: 1.31-3.41; p = 0.002), the presence of chronic obstructive pulmonary disease (COPD) (HR: 2.34; 95 % CI: 1.54-3.57; p = 0.002) and use of antidiarrheals (HR: 2.35; 95 % CI: 1.45-3.80; p = 0.001). The use of antidiarrheals (HR 19.75; 95 % CI: 10.05-38.79; p = 0.000) was the only risk factor identified for non-compliance with the indicator "frequency of days of adequate administration of the prescribed volume X volume infused in patients on ENT." Conclusions: surgical patients, those with COPD, and those using antidiarrheals are at greater risk of not reaching the prescribed ENT volume over the prescribed days.

Introduction: Introduction: in the context of the climate crisis and growing concern for sustainable food systems, understanding public perceptions is key to informing public policies and intervention strategies. Objective: to explore the knowledge and perceptions of Chilean adults regarding the environmental, cultural, and nutritional factors that influence the adoption of sustainable dietary practices. Methods: a cross-sectional study that analyzed the perceptions of 470 Chilean adults on environmental, cultural, and nutritional factors related to sustainable eating. A survey was carried out between January and August 2024, assessing 12 dimensions associated with food sustainability. Results: younger participants (18-30 years), women, and individuals with higher educational levels placed greater importance on aspects such as low environmental impact, respect for biodiversity, and the consumption of organic products. Statistically significant differences were observed by age group, educational level, and sex, revealing sociocultural patterns associated with interest in and knowledge of sustainable food practices. Conclusion: these findings highlight the need for targeted public policies, inclusive educational strategies, and actions that promote sustainable dietary habits across diverse population sectors.