La autoevaluación en la universidad nacional y en su facultad de medicina

En el año de 1996, la facultad de Medicina se compromete en un proceso de Autoevaluación y Acreditación que pretendía lograr la acreditación internacional de los cinco programas de pregrado existentes en la facultad: Medicina, Nutrición, Terapia Física, Terapia Ocupacional y Fonoaudiología. La tarea comienza en el mes de abril del 96, con el inicio de gestiones para presentar el proyecto de Autoevaluación y Acreditación en el nivel central de la Universidad

Adherence to healthy lifestyle and risk of gestational diabetes mellitus: prospective cohort study

Objective: To quantify the association between a combination of healthy lifestyle factors before pregnancy (healthy body weight, healthy diet, regular exercise, and not smoking) and the risk of gestational diabetes. Design: Prospective cohort study. Setting: Nurses’ Health Study II, United States. Participants: 20 136 singleton live births in 14 437 women without chronic disease. Main outcome measure Self reported incident gestational diabetes diagnosed by a physician, validated by medical records in a previous study. Results: Incident first time gestational diabetes was reported in 823 pregnancies. Each lifestyle factor measured was independently and significantly associated with risk of gestational diabetes. The combination of three low risk factors (non-smoker, ≥150 minutes a week of moderate to vigorous physical activity, and healthy eating (top two fifths of Alternate Healthy Eating Index-2010 adherence score)) was associated with a 41% lower risk of gestational diabetes compared with all other pregnancies (relative risk 0.59, 95% confidence interval 0.48 to 0.71). Addition of body mass index (BMI) <25 before pregnancy (giving a combination of four low risk factors) was associated with a 52% lower risk of gestational diabetes compared with all other pregnancies (relative risk 0.48, 0.38 to 0.61). Compared with pregnancies in women who did not meet any of the low risk lifestyle factors, those meeting all four criteria had an 83% lower risk of gestational diabetes (relative risk 0.17, 0.12 to 0.25). The population attributable risk percentage of the four risk factors in combination (smoking, inactivity, overweight, and poor diet) was 47.5% (95% confidence interval 35.6% to 56.6%). A similar population attributable risk percentage (49.2%) was observed when the distributions of the four low risk factors from the US National Health and Nutrition Examination Survey (2007-10) data were applied to the calculation. Conclusions: Adherence to a low risk lifestyle before pregnancy is associated with a low risk of gestational diabetes and could be an effective strategy for the prevention of gestational diabetes

Demographic and behavioural correlates of energy drink consumption

Abstract Objective: Energy drinks are consumed for a variety of reasons, including to boost mental alertness and energy. We assessed associations between demographic factors and various high-risky behaviours with energy drink consumption as they may be linked to adverse health events. Design: We conducted cross-sectional analysis including basic descriptive and multivariable-adjusted logistic regression analyses to characterise demographic and behavioural factors (including diet quality, binge drinking and illicit drug use, among others obtained via questionnaires) in relation to energy drink consumption. Setting: We used data from two large US-based cohorts. Participants: 46 390 participants from Nurses’ Health Study 3 (NHS3, n 37 302; ages 16–31) and Growing Up Today Study (GUTS, n 9088, ages 20–55). Results: Of the 46 390 participants, 13·2 % reported consuming ≥ 1 energy drink every month. Several risky behaviours were associated with energy drink use, including illegal drug use (pooled OR, pOR: 1·45, 95 % CI: 1·16, 1·81), marijuana use (pOR: 1·49, 95 % CI: 1·28, 1·73), smoking (pOR: 1·88. 95 % CI: 1·55, 2·29), tanning bed use (pOR: 2·31, 95 % CI: 1·96, 2·72) and binge drinking (pOR: 2·53, 95 % CI: 2·09, 3·07). Other factors, such as high BMI, e-cigarette use and poor diet quality were found to be significantly associated with higher energy drink consumption (P values < 0·001). Conclusions: Our findings show that energy drink consumption and high-risk behaviours may be related, which could potentially serve as not only as a talking point for providers to address in outreach and communications with patients, but also a warning sign for medical and other health practitioners

Pre-pregnancy habitual intake of vitamin D from diet and supplements in relation to risk of gestational diabetes mellitus: a prospective cohort study

Background Vitamin D may play a pivotal role in regulating insulin secretion and insulin sensitivity. However, the impact of vitamin D intake either from diet or from supplements on the development of gestational diabetes mellitus (GDM) remains unknown. We prospectively examined the association of pre-pregnancy habitual intake of vitamin D from diet and supplements with risk of incident GDM in a well-established cohort. Methods We included 21,356 singleton pregnancies from 15,225 women in the Nurses' Health Study II cohort. Diet information, including vitamin D intakes from food sources and supplements, was assessed in 1991 and every four years thereafter by validated food frequency questionnaires. We used log-binomial models with generalized estimating equations to estimate the relative risks (RRs) and 95% confidence intervals (CIs). Results We documented 865 incident GDM cases during 10 years of follow-up. After adjustment for age, parity, race/ethnicity, family history of diabetes, dietary and lifestyle factors, and body mass index, the RRs (95% CIs) of GDM risk associated with supplemental vitamin D intake of 0, 1–399, ≥ 400 IU/d were 1.00 (reference), 0.80 (0.67-0.96), and 0.71 (0.56-0.90), respectively (P for trend = 0.002). Dietary and total vitamin D intakes were also inversely associated with GDM risk, but the associations were not statistically significant. Conclusions Pre-pregnancy supplemental vitamin D intake was significantly and inversely associated with risk of GDM. Our study indicates potential benefits of increasing vitamin D intake from supplements in the prevention of GDM in women of reproductive age

Branched Chain Amino Acids, Androgen Hormones, and Metabolic Risk Across Early Adolescence: A Prospective Study in Project Viva

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/143686/1/oby22164.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/143686/2/oby22164_am.pd

Association between intake of fruits and vegetables by pesticide residue status and coronary heart disease risk

Background: Fruit and vegetable (FV) intake is recommended for the prevention of coronary heart disease (CHD). FVs are also an important source of exposure to pesticide residues. Whether the relations of FV intake with CHD differ according to pesticide residue status is unknown. Objective: To examine the associations of high- and low-pesticide-residue FVs with the risk of CHD. Methods: We followed 145,789 women and 24,353 men free of cardiovascular disease and cancer (excluding non-melanoma skin cancer) at baseline and participating in three ongoing prospective cohorts: the Nurses' Health Study (NHS: 1998–2012), the NHS-II (1999–2013), and the Health Professionals Follow-up Study (HPFS: 1998–2012). FV intake was assessed via food frequency questionnaires. We categorized FVs as having high- or low-pesticide-residues using a validated method based on pesticide surveillance data from the US Department of Agriculture. Multivariable Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95%CI) of CHD in relation to high- and low-pesticide-residue FV intake. Results: A total of 3707 incident CHD events were identified during 2,241,977 person-years of follow-up. In multivariable-adjusted models, a greater intake of low-pesticide-residue FVs was associated with a lower risk of CHD whereas high-pesticide-residue FV intake was unrelated to CHD risk. Specifically, compared with individuals consuming<1 serving/day of low-pesticide-residue FVs, those consuming ≥4 servings/day had 20% (95CI: 4%, 33%) lower risk of CHD. The corresponding HR (comparing ≥4 servings/day to<1 serving/day) for high-pesticide-residue FV intake and CHD was 0.97 (95%CI: 0.72, 1.30). Conclusions: Our data suggested exposure to pesticide residues through FV intake may modify some cardiovascular benefits of FV consumption. Further confirmation of these findings, especially using biomarkers for assessment of pesticide exposure, is neededThis work was supported by research grants [U01 HL145386, UM1 CA186107, R01 HL034594, UM1 CA176726, UM1 CA167552, R01 HL35464, P30DK046200, and P30ES000002] from the National Institutes of Health (NIH). Dr. Bhupathiraju is supported by a Career Development Grant from the NIH [K01 DK107804]. Dr. Ley was supported by grant P20GM109036 from the National Institute of General Medical Sciences of the National Institutes of Health

Association of Dietary Patterns With Testicular Function in Young Danish Men

Publisher's version (útgefin grein)Importance: Diet may play a role in testicular function, but data on how adherence to different diet patterns influences human testicular function are scarce. Objective: To determine whether adherence to specific dietary patterns is associated with testicular function in young men. Design, Setting, and Participants: This cross-sectional study included 2935 young Danish men unselected regarding fertility status who were enrolled from April 1, 2008, through May 31, 2017. Data were analyzed from July 1, 2017, to January 30, 2019. Exposures: Dietary patterns identified with principal component analysis based on responses to a validated food frequency questionnaire. Main Outcomes and Measures: Standard semen quality assessment; serum concentrations of testosterone, free testosterone, estradiol, inhibin B, follicle-stimulating hormone, luteinizing hormone, and sex hormone-binding globulin; and testicular volume measured with ultrasonography. Results: Among the 2935 participants included in the analysis, median age was 19 (interquartile range, 19-20) years and 2290 (78.0%) had normal body mass index. The 4 dietary patterns identified included Western, prudent, open-sandwich (a traditional Danish eating pattern), and vegetarianlike. The greatest adherence to the prudent pattern was associated with the highest total sperm count (median, 167 [95% CI, 146-183] million), followed by adherence to vegetarianlike (median, 151 [95% CI, 134-168] million) and open-sandwich (median, 146 [95% CI, 131-163] million) patterns. Adherence to the Western pattern was associated with the lowest total sperm count (median, 122 [95% CI, 109-138] million), which was significantly lower than sperm count in the other 3 diet patterns. After adjusting for confounders, the median total sperm count for men in the highest quintile of adherence to the Western pattern was 26 million lower (95% CI, -42 to -9 million) than for men in the lowest quintile of adherence to this pattern. Conversely, the median total sperm count of men in the highest quintile of adherence to the prudent pattern was 43 million (95% CI, 23-63 million) higher than that of men in the lowest quintile. Men with the highest adherence to the Western pattern had a lower median ratio of inhibin B to follicle-stimulating hormone (-12 [95% CI, -20 to -3]) and higher median ratio of free testosterone to luteinizing hormone (10 [95% CI, 2-19]) compared with men with lowest adherence to this pattern. Conclusions and Relevance: In this cross-sectional study, adherence to generally healthy diet patterns was associated with better semen quality, with potentially more favorable fertility potential among adult men.This work was supported by project 2101-08-0058 from the Danish Council for Strategic Research, Program Commission on Health, Food and Welfare, grant 8020-00218B from the Independent Research Fund Denmark, grant 212844 from the European Union, DEER, the Danish Ministry of Health, the Danish Environmental Protection Agency, grant 95-103-72087 from the Kirsten and Freddy Johansen Foundation, and grant P30DK046200 from the National Institutes of Health.Peer Reviewe

Dietary Patterns and PFAS Plasma Concentrations in Childhood: Project Viva, USA

Children who adhered to a dietary pattern of primarily packaged foods and fish had higher plasma concentrations of select PFAS, reflective of food intake and/or correlated lifestyle factors.https://knowledgeconnection.mainehealth.org/lambrew-retreat-2021/1011/thumbnail.jp