Effect of lower sodium intake on health: systematic review and meta-analyses

Objective To assess the effect of decreased sodium intake on blood pressure, related cardiovascular diseases, and potential adverse effects such as changes in blood lipids, catecholamine levels, and renal function. Design Systematic review and meta-analysis. Data sources Cochrane Central Register of Controlled Trials, Medline, Embase, WHO International Clinical Trials Registry Platform, the Latin American and Caribbean health science literature database, and the reference lists of previous reviews. Study selection Randomised controlled trials and prospective cohort studies in non-acutely ill adults and children assessing the relations between sodium intake and blood pressure, renal function, blood lipids, and catecholamine levels, and in non-acutely ill adults all cause mortality, cardiovascular disease, stroke, and coronary heart disease. Study appraisal and synthesis Potential studies were screened independently and in duplicate and study characteristics and outcomes extracted. When possible we conducted a meta-analysis to estimate the effect of lower sodium intake using the inverse variance method and a random effects model. We present results as mean differences or risk ratios, with 95% confidence intervals. Results We included 14 cohort studies and five randomised controlled trials reporting all cause mortality, cardiovascular disease, stroke, or coronary heart disease; and 37 randomised controlled trials measuring blood pressure, renal function, blood lipids, and catecholamine levels in adults. Nine controlled trials and one cohort study in children reporting on blood pressure were also included. In adults a reduction in sodium intake significantly reduced resting systolic blood pressure by 3.39 mm Hg (95% confidence interval 2.46 to 4.31) and resting diastolic blood pressure by 1.54 mm Hg (0.98 to 2.11). When sodium intake was 0.05). There were insufficient randomised controlled trials to assess the effects of reduced sodium intake on mortality and morbidity. The associations in cohort studies between sodium intake and all cause mortality, incident fatal and non-fatal cardiovascular disease, and coronary heart disease were non-significant (P>0.05). Increased sodium intake was associated with an increased risk of stroke (risk ratio 1.24, 95% confidence interval 1.08 to 1.43), stroke mortality (1.63, 1.27 to 2.10), and coronary heart disease mortality (1.32, 1.13 to 1.53). In children, a reduction in sodium intake significantly reduced systolic blood pressure by 0.84 mm Hg (0.25 to 1.43) and diastolic blood pressure by 0.87 mm Hg (0.14 to 1.60). Conclusions High quality evidence in non-acutely ill adults shows that reduced sodium intake reduces blood pressure and has no adverse effect on blood lipids, catecholamine levels, or renal function, and moderate quality evidence in children shows that a reduction in sodium intake reduces blood pressure. Lower sodium intake is also associated with a reduced risk of stroke and fatal coronary heart disease in adults. The totality of evidence suggests that most people will likely benefit from reducing sodium intake

Personalidad del homicida: Una revisión sistemática

La presente investigación tiene como objetivo realizar una revisión sistemática de artículos con investigaciones acerca de la personalidad de los homicidas, publicados en revistas indexadas en los últimos 20 años. Para ello se realizó una búsqueda en las bases de datos: Redalyc, ScienceDirect, Scielo, Dialnet, PubMed, SbscoHost, Proquest, Iris, DOAJ, Redined, Eric y Road, así como en el Buscador (google académico). Tras el análisis de los artículos se obtuvo como muestra un total de 22 artículos. Se concluyó que el 54% de la muestra estudiada fue de sexo masculino en un rango de edad de 18 a 89 años, dentro de los rasgos de personalidad prevalentes en parte de la muestra fueron la inestabilidad y labilidad emocional, rasgos antisociales y rasgos psicóticos. En cuanto a la personalidad propiamente dicha se evidencio que los perpetuadores presentaron mayor tendencia a la personalidad narcisista, límite y antisocial, no obstante, una muestra minoritaria manifestó trastorno esquizofrénico; en cuento a los factores sociodemográficos destaco el abuso sexual y físico en la infancia, dificultades en las relaciones personales y emocionales, además del consumo de alcohol y/o sustancias psicoactivas

Most national, mandatory flour fortification standards do not align with international recommendations for iron, zinc, and vitamin B12 levels

Abstract As national flour fortification standards are one of the policy documents developed to guide food fortification, the objective was to compare national, mandatory wheat and maize flour fortification standards to World Health Organization (WHO) fortification guidelines. For each nutrient in 72 countries' standards, the type of compound was noted as 'yes' if it was included in international guidelines or 'no' if it was not. Nutrient levels in standards were classified as lower than, equal to, or higher than those suggested by WHO. If another food (i.e. rice, oil, milk) was mass fortified with a nutrient categorized as "lower than," the classification was changed to "less than recommendation and included in other mass fortified food". At least 61% of standards included one or more recommended compounds for all nutrients in standards for wheat flour alone (iron, folic acid, vitamin A, zinc, vitamin B12,), wheat and maize flour together (iron, folic acid, vitamin A, zinc, vitamin B12) and maize flour alone (thiamin, riboflavin, niacin, pyridoxine); no country included pantothenic acid in its maize flour standard. For folic acid, vitamin A, thiamin, riboflavin, niacin and pyridoxine, at least 50% of standards (1) met or exceeded WHO suggested levels, or (2) were lower than suggested levels and another food was mass fortified with the specific nutrient in the country. For iron, zinc and vitamin B12, less than 50% of standards met (1) or (2). In conclusion, iron, zinc and vitamin B12 may require the most attention in national fortification standards

Systematic review of the treatment of moderate acute malnutrition using food products.

There is currently a lack of international guidance on the most appropriate treatment for moderate acute malnutrition (MAM), and discrepancies in national treatment guidelines exist. We aimed to explore whether food interventions are effective for MAM children 6-59 months old and whether they result in better outcomes compared with no treatment or management with nutrition counselling. A systematic literature search was conducted in October 2018, identifying studies that compared treating MAM children with food products versus management with counselling or no intervention. A total of 673 abstracts were screened, 101 full texts were read, and one study was identified that met our inclusion criteria. After broadening the criteria to include micronutrients in the control group and enrolment based on out-dated anthropometric criteria, 11 studies were identified for inclusion. Seven of these found food products to be superior for anthropometric outcomes compared with counselling and/or micronutrient supplementation; two of the studies found no significant benefit of a food product intervention; and two studies were inconclusive. Hence, the majority of studies in this review found that food products resulted in greater anthropometric gains than counselling or micronutrient interventions. This was especially true if the supplementary food provided was of suitable quality and provided for an adequate duration. Improving quality of and adherence to counselling may improve its effectiveness, particularly in food secure contexts. There is currently a paucity of comparable studies on this topic as well as a lack of studies that include important functional outcomes beyond anthropometric proxies

Monitoring and evaluation design of Malawi's Right Foods at the Right Time nutrition program

Abstract Child stunting is a public health problem in Malawi. In 2014, the Government of Malawi launched the Right Foods at the Right Time (RFRT) program in Ntchisi district delivering nutrition social and behavior change communication, a small-quantity lipid-based nutrient supplement to children 6–23 months, and nutrition sensitive activities. Monitoring and evaluation (M&E) systems are key aspects of successful program implementation. We describe these and the methodology for an impact evaluation that was conducted for this program. Two monitoring systems using traditional and electronic platforms were established to register and track program delivery and processes including number of eligible beneficiaries, worker performance, program participation, and to monitor input, output, and outcome indicators. The impact evaluation used comparative cross-sectional and longitudinal designs to assess impact on anthropometric and infant and young child feeding outcomes. Three cross-sectional surveys (base-, mid-, and end-line) and two longitudinal cohorts of children followed in 6-month intervals from 6 to 24 months of age, were conducted in sampled households in the program and a neighboring comparison district. Additional M&E included qualitative studies, a process evaluation, and a cost-effectiveness study. The current paper describes lessons from this program's M&E, and demonstrates how multiple implementation research activities can inform course-correction and program scale-up

Corrigendum to “Viewpoint: Rigorous monitoring is necessary to guide food system transformation in the countdown to the 2030 global goals” [Food Policy 104 (2021) 100784]

We regret that the original Fig. 3 was based on a spreadsheet later discovered to have an aggregation error, overestimating the number of food system workers. A corrected Fig. 3 has replaced the erroneous figure. We are deeply grateful to Natalia Piedrahita of FAO for her careful attention and discovery of the error

Viewpoint: Rigorous monitoring is necessary to guide food system transformation in the countdown to the 2030 global goals

Food systems that support healthy diets in sustainable, resilient, just, and equitable ways can engender progress in eradicating poverty and malnutrition; protecting human rights; and restoring natural resources. Food system activities have contributed to great gains for humanity but have also led to significant challenges, including hunger, poor diet quality, inequity, and threats to nature. While it is recognized that food systems are central to multiple global commitments and goals, including the Sustainable Development Goals, current trajectories are not aligned to meet these objectives. As mounting crises further stress food systems, the consequences of inaction are clear. The goal of food system transformation is to generate a future where all people have access to healthy diets, which are produced in sustainable and resilient ways that restore nature and deliver just, equitable livelihoods

Rigorous monitoring is necessary to guide food system transformation in the countdown to the 2030 global goals

Food systems that support healthy diets in sustainable, resilient, just, and equitable ways can engender progress in eradicating poverty and malnutrition; protecting human rights; and restoring natural resources. Food system activities have contributed to great gains for humanity but have also led to significant challenges, including hunger, poor diet quality, inequity, and threats to nature. While it is recognized that food systems are central to multiple global commitments and goals, including the Sustainable Development Goals, current trajectories are not aligned to meet these objectives. As mounting crises further stress food systems, the consequences of inaction are clear. The goal of food system transformation is to generate a future where all people have access to healthy diets, which are produced in sustainable and resilient ways that restore nature and deliver just, equitable livelihoods. A rigorous, science-based monitoring framework can support evidence-based policymaking and the work of those who hold key actors accountable in this transformation process. Monitoring can illustrate current performance, facilitate comparisons across geographies and over time, and track progress. We propose a framework centered around five thematic areas related to (1) diets, nutrition, and health; (2) environment and climate; and (3) livelihoods, poverty, and equity; (4) governance; and (5) resilience and sustainability. We hope to call attention to the need to monitor food systems globally to inform decisions and support accountability for better governance of food systems as part of the transformation process. Transformation is possible in the next decade, but rigorous evidence is needed in the countdown to the 2030 SDG global goals

The state of food systems worldwide in the countdown to 2030

This Analysis presents a recently developed food system indicator framework and holistic monitoring architecture to track food system transformation towards global development, health and sustainability goals. Five themes are considered: (1) diets, nutrition and health; (2) environment, natural resources and production; (3) livelihoods, poverty and equity; (4) governance; and (5) resilience. Each theme is divided into three to five indicator domains, and indicators were selected to reflect each domain through a consultative process. In total, 50 indicators were selected, with at least one indicator available for every domain. Harmonized data of these 50 indicators provide a baseline assessment of the world’s food systems. We show that every country can claim positive outcomes in some parts of food systems, but none are among the highest ranked across all domains. Furthermore, some indicators are independent of national income, and each highlights a specific aspiration for healthy, sustainable and just food systems. The Food Systems Countdown Initiative will track food systems annually to U. Rashid Sumaila, Maximo Torero Cullen, Francesco N. Tubiello, Jose-Luis Vivero-Pol, Patrick Webb & Keith Wieb

Evaluación de la calidad del servicio de nutrición Hospital Dr. Luis F. Nachón

Para Avedis Donabedian, la calidad es una propiedad de la atención médica, la cual tiene tres dimensiones: aspectos técnicos, interpersonales y amenidades; para evaluar la dimensión técnica propone tres enfoques: estructura, proceso y resultado. El presente estudio tiene como pregunta de investigación ¿cuál es la calidad, en la dimensión interpersonal y técnica, del servicio de nutrición en el Hospital “Dr. Luís F. Nachón”, en abril de 2009?. El objetivo del estudio fue, evaluar la calidad, en sus dimensiones interpersonal y técnica, del servicio de nutrición, identificando las subdimensiones que influyen en ellas, para proponer alternativas de solución, en el Hospital “Dr. Luís F. Nachón”..