Sobrecarga de hierro y alteraciones metabólicas en humanos

Contribuciones y conocimientos que aporta esta tesis El presente trabajo ha confirmado la asociación de las concentraciones elevadas de ferritina con el desarrollo de síndrome metabólico y con el criterio, hipertrigliceridemia, incluido en el diagnostico de síndrome metabólico; mientras que la asociación de ferritina con las concentraciones de colesterol de las HDL es más discutible. Metodología 1. Se realizó una revisión sistemática y metaanálisis de estudios observacionales que determinen la relación entre altos niveles de ferritina y síndrome metabólico desde 1966 hasta diciembre 2012. 2. Se realizó una revisión sistemática y metaanálisis de estudios observacionales que estudien la relación entre altos niveles de ferritina con hipertrigliceridemia, bajo HDL colesterol y LDL colesterol. El odds ratio de los estudios fue combinado utilizando un modelo de efectos aleatorios, ponderando por el inverso de la varianza. La heterogeneidad entre estudios se determinó utilizando el índice estadístico I2. Los sesgos de publicación fueron determinados mediante el gráfico en embudo o funnel plot. Se realizaron análisis de sensibilidad. Conclusiones Altos niveles de ferritina se asocian a la presencia del síndrome metabólico y también a la dislipidemia. El efecto de altos depósitos de hierro sobre estas alteraciones metabólicas necesita confirmarse con más estudios prospectivos. Además son necesarios que permitan identificar un valor de ferritina que se relacione con el aumento del riesgo de aparición de estas alteraciones metabólicas. Publicaciones: 1. Prevalence of overweight and obesity in 6 to 9 year- old school children of Cuenca-Ecuador: relationship with physical activity, poverty and eating habits. Aceptado para publicación en FOOD AND NUTRITION BULLETIN. Factor de Impacto: 1.922 año 2011. Q2. 2. Associations between serum ferritin concentrations and metabolic syndrome (MetS): a systematic review and a meta-analysis of observational studies. Victoria Abril-Ulloa, V, Flores-Mateo G, Solà-Alberich R, Manuel-y-Keenoy B, Arija V. submitted to Editor. 3. High serum Ferritin and lipid metabolism: a systematic review and meta-analysis. Abril-Ulloa V; Solà-Alberich R; Manuel-y-Keenoy B; Arija V. submitted to Editor Congresos: 1. Organizadores: World Public Health Nutrition Association (WPHNA) and of the Brazilian Association of Collective Health (ABRASCO), Universidade do Estado do Rio de Janeiro. Brasil. Poster en “The Wold Nutrition Rio 2012” Titulo:Nutritional status in a sample of 6-9 year-old schoolchildren in Cuenca, Ecuador and the relationship with and physical activity. Fecha: Abril, 2012. Lugar: Rio de Janeiro – Brasil. 2.Organizadores: Confederación Latinoamericana y del Caribe de Dietistas y Nutricionistas (CONFELANyD), Federación Argentina de Graduados de Nutrición, Colegio de Nutricionistas de Santa Fé. Argentina. Poster en el XV Congreso Latinoamericano y del Caribe de Nutricionistas y Dietistas, XI Congreso Argentino de Graduados de Nutricion. Título: Estado Nutricional en niños de 6 a 9 años en Ecuador y su relación con hábitos de actividad física y de desayuno según nivel socioeconómico. Fecha :10-12 de Mayo, 2012 Lugar: Rosario, Santa Fé, Republica de Argentina. 3. Organizadores: European Accreditation Council for Continuing Medical Education. Poster en: World Forum for Nutrition Research Conference. Título: Body iron stores and metabolic syndrome. A Meta-Analysis of observational studies. Fecha: 20-21 Mayo 2013. Lugar: Reus, Tarragona. España

Construcción de un Cuestionario de Frecuencia de Consumo de Alimentos para Adultos Ecuatorianos, estudio transversal.

Introduction: Dietary surveys include Food Frequency Questionnaire (FFQ) is an inexpensive method, relatively easy to apply, and necessary for the evaluation of the diet of individuals and populations. The objective of this study was to develop an FFQ for the Ecuadorian adult population. Materials and methods: Cross-sectional study, in 255 adult individuals of both sexes between 18 and 68 years old residing in 10 provinces of Ecuador. A 24-hour reminder (R24h) was applied to obtain information on the dietary consumption of the population and the construction of the instrument. The preparation of the list of foods that make up the CFCA was made from the percentage contribution of each food for the total estimate of energy and nutrients of interest, using the Block method. Results: An instrument composed of 91 items distributed in 7 categories were obtained. The instrument was reviewed by experts from 4 universities belonging to the region, coast, highlands, and Amazon of Ecuador. Conclusions: This instrument makes an approximation of the dietary consumption of the three regions of continental Ecuador.Introducción: Las encuestas alimentarias, incluidas el cuestionario de frecuencia de consumo de alimentos (CFCA) son un método económico, relativamente fácil de aplicar y necesario para la evaluación de la dieta de individuos y poblaciones. El objetivo de este estudio fue desarrollar un CFCA para población adulta ecuatoriana. Materiales y métodos: Estudio transversal, en 255 individuos adultos de ambos sexos entre 18 y 68 años residentes en 10 provincias del Ecuador. Se aplicó una encuesta recordatorio de 24 horas (R24h) para obtener información sobre el consumo dietético de la población y la construcción del instrumento. La elaboración de la lista de alimentos que compone el CFCA fue hecha a partir de la contribución porcentual de cada alimento para la estimación total de aporte de energía y nutrientes de interés, empleándose el método de Block. Resultados: se obtuvo un instrumento compuesto por 91 ítems alimentarios distribuidos en 7 categorías. El instrumento fue revisado por expertos de 4 universidades pertenecientes a la región, costa, sierra, y amazonia del Ecuador. Conclusiones: Este instrumento realiza una aproximación del consumo dietético de las tres regiones del Ecuador continental

Call for emergency action to restore dietary diversity and protect global food systems in times of COVID-19 and beyond: Results from a cross-sectional study in 38 countries

Background: The COVID-19 pandemic has revealed the fragility of the global food system, sending shockwaves across countries' societies and economy. This has presented formidable challenges to sustaining a healthy and resilient lifestyle. The objective of this study is to examine the food consumption patterns and assess diet diversity indicators, primarily focusing on the food consumption score (FCS), among households in 38 countries both before and during the first wave of the COVID-19 pandemic. Methods: A cross-sectional study with 37 207 participants (mean age: 36.70 ± 14.79, with 77 % women) was conducted in 38 countries through an online survey administered between April and June 2020. The study utilized a pre-tested food frequency questionnaire to explore food consumption patterns both before and during the COVID-19 periods. Additionally, the study computed Food Consumption Score (FCS) as a proxy indicator for assessing the dietary diversity of households. Findings: This quantification of global, regional and national dietary diversity across 38 countries showed an increment in the consumption of all food groups but a drop in the intake of vegetables and in the dietary diversity. The household's food consumption scores indicating dietary diversity varied across regions. It decreased in the Middle East and North Africa (MENA) countries, including Lebanon (p < 0.001) and increased in the Gulf Cooperation Council countries including Bahrain (p = 0.003), Egypt (p < 0.001) and United Arab Emirates (p = 0.013). A decline in the household's dietary diversity was observed in Australia (p < 0.001), in South Africa including Uganda (p < 0.001), in Europe including Belgium (p < 0.001), Denmark (p = 0.002), Finland (p < 0.001) and Netherland (p = 0.027) and in South America including Ecuador (p < 0.001), Brazil (p < 0.001), Mexico (p < 0.0001) and Peru (p < 0.001). Middle and older ages [OR = 1.2; 95 % CI = [1.125–1.426] [OR = 2.5; 95 % CI = [1.951–3.064], being a woman [OR = 1.2; 95 % CI = [1.117–1.367], having a high education (p < 0.001), and showing amelioration in food-related behaviors [OR = 1.4; 95 % CI = [1.292–1.709] were all linked to having a higher dietary diversity. Conclusion: The minor to moderate changes in food consumption patterns observed across the 38 countries within relatively short time frames could become lasting, leading to a significant and prolonged reduction in dietary diversity, as demonstrated by our findings.Revisión por pare

Call for emergency action to restore dietary diversity and protect global food systems in times of COVID-19 and beyond: Results from a cross-sectional study in 38 countries

Background: The COVID-19 pandemic has revealed the fragility of the global food system, sending shockwaves across countries\u27 societies and economy. This has presented formidable challenges to sustaining a healthy and resilient lifestyle. The objective of this study is to examine the food consumption patterns and assess diet diversity indicators, primarily focusing on the food consumption score (FCS), among households in 38 countries both before and during the first wave of the COVID-19 pandemic. Methods: A cross-sectional study with 37 207 participants (mean age: 36.70 ± 14.79, with 77 % women) was conducted in 38 countries through an online survey administered between April and June 2020. The study utilized a pre-tested food frequency questionnaire to explore food consumption patterns both before and during the COVID-19 periods. Additionally, the study computed Food Consumption Score (FCS) as a proxy indicator for assessing the dietary diversity of households. Findings: This quantification of global, regional and national dietary diversity across 38 countries showed an increment in the consumption of all food groups but a drop in the intake of vegetables and in the dietary diversity. The household\u27s food consumption scores indicating dietary diversity varied across regions. It decreased in the Middle East and North Africa (MENA) countries, including Lebanon (p \u3c 0.001) and increased in the Gulf Cooperation Council countries including Bahrain (p = 0.003), Egypt (p \u3c 0.001) and United Arab Emirates (p = 0.013). A decline in the household\u27s dietary diversity was observed in Australia (p \u3c 0.001), in South Africa including Uganda (p \u3c 0.001), in Europe including Belgium (p \u3c 0.001), Denmark (p = 0.002), Finland (p \u3c 0.001) and Netherland (p = 0.027) and in South America including Ecuador (p \u3c 0.001), Brazil (p \u3c 0.001), Mexico (p \u3c 0.0001) and Peru (p \u3c 0.001). Middle and older ages [OR = 1.2; 95 % CI = [1.125–1.426] [OR = 2.5; 95 % CI = [1.951–3.064], being a woman [OR = 1.2; 95 % CI = [1.117–1.367], having a high education (p \u3c 0.001), and showing amelioration in food-related behaviors [OR = 1.4; 95 % CI = [1.292–1.709] were all linked to having a higher dietary diversity. Conclusion: The minor to moderate changes in food consumption patterns observed across the 38 countries within relatively short time frames could become lasting, leading to a significant and prolonged reduction in dietary diversity, as demonstrated by our findings

Ferritin levels and risk of metabolic syndrome: Meta-analysis of observational studies

Background: Elevated ferritin levels have been associated with single cardiovascular risk factors but the relationship to the presence of metabolic syndrome is inconclusive.The aim of this systematic review and meta-analysis of published observational studies was to estimate the association between serum ferritin levels and metabolic syndrome in adults. Methods. The Pubmed, SCOPUS and the Cochrane Library databases were searched for epidemiological studies that assessed the association between ferritin levels and metabolic syndrome and were published before September 2013. There were no language restrictions. Two investigators independently selected eligible studies. Measures of association were pooled by using an inverse-variance weighted random-effects model. The heterogeneity among studies was examined using the I 2 index. Publication bias was evaluated using the funnel plot. Results: Twelve cross-sectional, one case-control and two prospective studies met our inclusion criteria including data from a total of 56,053 participants. The pooled odds ratio (OR) for the metabolic syndrome comparing the highest and lowest category of ferritin levels was 1.73 (95% CI: 1.54, 1.95; I2 = 75,4%). Subgroup analyses indicate that pooled OR was 1.92 (95% CI: 1.61, 2.30; I 2 = 78%) for studies adjusting for C-reactive protein (CRP), and 1.52 (95% CI:1. 36, 1.69; I2 = 41%) for studies that did not adjust for CRP (P = 0.044). This finding was remarkably robust in the sensitivity analysis. We did not find publication bias. Conclusions: The meta-analysis suggests that increased ferritin levels are independently and positively associated with the presence of the metabolic syndrome with an odds ratio higher than 1.73. © 2014Abril-Ulloa et al.; licensee BioMed Central Ltd

Iron overload and metabolic disorders in humans

Contribuciones y conocimientos que aporta esta tesis El presente trabajo ha confirmado la asociación de las concentraciones elevadas de ferritina con el desarrollo de síndrome metabólico y con el criterio, hipertrigliceridemia, incluido en el diagnostico de síndrome metabólico; mientras que la asociación de ferritina con las concentraciones de colesterol de las HDL es más discutible. Metodología 1. Se realizó una revisión sistemática y metaanálisis de estudios observacionales que determinen la relación entre altos niveles de ferritina y síndrome metabólico desde 1966 hasta diciembre 2012. 2. Se realizó una revisión sistemática y metaanálisis de estudios observacionales que estudien la relación entre altos niveles de ferritina con hipertrigliceridemia, bajo HDL colesterol y LDL colesterol. El odds ratio de los estudios fue combinado utilizando un modelo de efectos aleatorios, ponderando por el inverso de la varianza. La heterogeneidad entre estudios se determinó utilizando el índice estadístico I2. Los sesgos de publicación fueron determinados mediante el gráfico en embudo o funnel plot. Se realizaron análisis de sensibilidad. Conclusiones Altos niveles de ferritina se asocian a la presencia del síndrome metabólico y también a la dislipidemia. El efecto de altos depósitos de hierro sobre estas alteraciones metabólicas necesita confirmarse con más estudios prospectivos. Además son necesarios que permitan identificar un valor de ferritina que se relacione con el aumento del riesgo de aparición de estas alteraciones metabólicas. Publicaciones: 1. Prevalence of overweight and obesity in 6 to 9 year- old school children of Cuenca-Ecuador: relationship with physical activity, poverty and eating habits. Aceptado para publicación en FOOD AND NUTRITION BULLETIN. Factor de Impacto: 1.922 año 2011. Q2. 2. Associations between serum ferritin concentrations and metabolic syndrome (MetS): a systematic review and a meta-analysis of observational studies. Victoria Abril-Ulloa, V, Flores-Mateo G, Solà-Alberich R, Manuel-y-Keenoy B, Arija V. submitted to Editor. 3. High serum Ferritin and lipid metabolism: a systematic review and meta-analysis. Abril-Ulloa V; Solà-Alberich R; Manuel-y-Keenoy B; Arija V. submitted to Editor Congresos: 1. Organizadores: World Public Health Nutrition Association (WPHNA) and of the Brazilian Association of Collective Health (ABRASCO), Universidade do Estado do Rio de Janeiro. Brasil. Poster en “The Wold Nutrition Rio 2012” Titulo:Nutritional status in a sample of 6-9 year-old schoolchildren in Cuenca, Ecuador and the relationship with and physical activity. Fecha: Abril, 2012. Lugar: Rio de Janeiro – Brasil. 2.Organizadores: Confederación Latinoamericana y del Caribe de Dietistas y Nutricionistas (CONFELANyD), Federación Argentina de Graduados de Nutrición, Colegio de Nutricionistas de Santa Fé. Argentina. Poster en el XV Congreso Latinoamericano y del Caribe de Nutricionistas y Dietistas, XI Congreso Argentino de Graduados de Nutricion. Título: Estado Nutricional en niños de 6 a 9 años en Ecuador y su relación con hábitos de actividad física y de desayuno según nivel socioeconómico. Fecha :10-12 de Mayo, 2012 Lugar: Rosario, Santa Fé, Republica de Argentina. 3. Organizadores: European Accreditation Council for Continuing Medical Education. Poster en: World Forum for Nutrition Research Conference. Título: Body iron stores and metabolic syndrome. A Meta-Analysis of observational studies. Fecha: 20-21 Mayo 2013. Lugar: Reus, Tarragona. España.Reu

Healthcare professionals’ experiences and perceptions regarding health care of indigenous pregnant women in Ecuador.

Background: Pregnancy is an important life experience that requires uniquely tailored approach to health care. The socio-cultural care practices of indigenous pregnant women (IPW) are passed along the maternal line with respect to identity, worldview and nature. The cultural differences between non-indigenous healthcare professionals (HPs) and IPW could present a great challenge in women’s health care. This article presents an analysis from a human rights and gender perspective of this potential cultural divide that could affect the health of the IPW in an Andean region of Ecuador with the objective of describing the health challenges of IPWs as rights holders through the experiences and perceptions of HP as guarantors of rights. Methods: We conducted 15 in-depth interviews with HPs who care for IPW in Chimborazo, Pichincha provinces of Ecuador. We utilized a semi-structured interview guide including questions about the experiences and perceptions of HPs in delivering health care to IPW. The interviews were recorded, transcribed and subjected to thematic analysis in Spanish and translated for reporting. Results: We found disagreements and discrepancies in the Ecuadorian health service that led to the ignorance of indigenous cultural values. Common characteristics among the indigenous population such as illiteracy, low income and the age of pregnancy are important challenges for the health system. The gender approach highlights the enormous challenges: machismo, gender stereotypes and communication problems that IPWs face in accessing quality healthcare. Conclusions: Understanding the diverse perspectives of IPW, acknowledging their human rights particularly those related to gender, has the potential to lead to more comprehensive and respectful health care delivery in Ecuador. Further, recognizing there is a gender and power differential between the provider and the IPW can lead to improvements in the quality of health care delivery and reproductive, maternal and child health outcomes. © 2022, The Author(s)

Prevalencia y factores asociados a malnutrición en adultos mayores del cantón Gualaceo, 2016

Antecedentes: la malnutrición en adultos mayores es motivo de gran preocupación a nivel mundial. Es un problema de salud pública y está asociada a una serie de factores, algunos de ellos modificables. Objetivo: determinar la prevalencia y factores asociados a malnutrición en adultos mayores del cantón Gualaceo, 2016. Metodología: estudio analítico de corte transversal. El muestreo fue probabilístico, estratificado y aleatorizado que valoró a 250 adultos mayores. Se evaluó el estado nutricional mediante el Mini Nutritional Assessment (MNA). Los datos se tabularon en el programa SPSS versión 20.0. La caracterización de la población se realizó mediante estadística descriptiva y medidas de tendencia central; la asociación estadística se midió con razón de prevalencia (RP), el intervalo de confianza (IC) al 95% y se consideró estadísticamente significativo valores de p < 0,05. Además, se realizó un análisis multivariado. Resultados: la prevalencia de malnutrición fue 20,4%. La media de edad 76,31 (± 8,19). Los factores asociados fueron: depresión RP 4,90 (IC95%: 3,08 – 7,79, p< 0,000); sedentarismo RP 4,52 (IC95%: 2,81 – 7,28, p< 0.000); bajo nivel socioeconómico RP 4,04 (IC95%: 1,51 – 10,7, p< 0,001); anemia tanto en hombres y mujeres RP 2,43 (IC95%: 1,23 – 4,77, p< 0.018) y RP 4,02 (IC95%: 2,17 – 7,63, p< 0.000) respectivamente e hipoalbuminemia RP 2,87 (IC95%: 1,08 – 4,58, p< 0.000). Mediante el análisis multivariado se corroboró esta asociación excepto para hipoalbuminemia. Conclusiones: la prevalencia de malnutrición fue de 20,4% y se asoció a: depresión, sedentarismo, bajo nivel socioeconómico, anemia e hipoalbuminemiaIntroduction: malnutrition in the elderly is a major concern worldwide. It is a public health problem and it is associated with a number of factors, some of them are modifiable. Objective: to determine the prevalence and factors associated with malnutrition in older adults in Gualaceo town, 2016. Methodology: an analytical cross-sectional study. Sampling was probabilistic, stratified and randomized, which assessed 250 elderly. Nutritional status was assessed using the Mini Nutritional Assessment (MNA). Data were tabulated in SPSS version 20.0. Characterization of the population was performed through descriptive statistics and central trend measures, statistical association was measured with prevalence ratio (RP), 95% confidence interval (IC) and values of p <0.05 were considered statistically significant. In addition, a multivariate analysis was performed. Results: the prevalence of malnutrition was 20,4%. The average age 76,31 (± 8,19). The associated factors were: depression RP 4,90 (95% CI: 3,08 – 7,79, p< 0,000); sedentary lifestyle RP 4,52 (95% CI: 2,81 – 7,28, p <0,000); low socioeconomic level RP 4,04 (95% CI: 1,51 – 10,7, p<0,001); anemia for both men and women RP 2,43 (95% CI: 1,23 – 4,77, p<0,018) and RP 4,02 (95% CI: 2,17 – 7,63, p<0,000) respectively and hypoalbuminemia RP 2,87 (95% CI: 1,08 – 4,58, p<, 0,000). Multivariate analysis corroborated this association except for hypoalbuminemia. Conclusions: the prevalence of malnutrition was 20,4% and it is associated to: depression, sedentary lifestyle, low socioeconomic status, anemia and hypoalbuminemiaMagíster en Investigación de la SaludCuenc

Determinación de remoción de quistes de entamoeba coli, entamoeba histolytica, huevos de ascaris sp; tenia solium-saginata, en Planta de Tratamiento de Agua Potable de Tixán

Para confirmar la remoción de parásitos durante los diferentes procesos de potabilización, realizamos el presente estudio basándonos en la presencia de entamoeba coli, huevos de ascaris sp, tenia solium-saginata entamoeba histolytica, en el agua que ingresa a la planta después de los procesos de cuagulación, floculación, sedimentación en el agua tratada, siendo necesario conservar volúmenes grandes de agua y posterior análisis microscópico, confirmando al final la remoción total de los parásitos indicados en el agua tratadaDoctor en Bioquímica y FarmaciaCuenc