Validación en castellano del cuestionario NEMS-P para evaluar el entorno obesogénico

II Congreso de Alimentación, Nutrición y Dietética. Avances en Nutrición y Dietética Clínica: Prevención, Tratamiento y Gestión - Rol del Dietista-Nutricionist

Adherence to the Western, Prudent and Mediterranean dietary patterns and breast cancer risk: MCC-Spain study

Objective To externally validate the previously identified effect on breast cancer risk of the Western, Prudent and Mediterranean dietary patterns. Study design MCC-Spain is a multicase-control study that collected epidemiological information on 1181 incident cases of female breast cancer and 1682 control cases from 10 Spanish provinces. Three dietary patterns derived in another Spanish case-control study were analysed in the MCC-Spain study. These patterns were termed Western (high intakes of fatty and sugary products and red and processed meat), Prudent (high intakes of low-fat dairy products, vegetables, fruits, whole grains and juices) and Mediterranean (high intake of fish, vegetables, legumes, boiled potatoes, fruits, olives, and vegetable oil, and a low intake of juices). Their association with breast cancer was assessed using logistic regression models with random province-specific intercepts considering an interaction with menopausal status. Risk according to tumour subtypes ? based on oestrogen (ER), progesterone (PR) and human epidermal growth factor 2 (HER2) receptors (ER+/PR+&HER2-; HER2+; ER-/PR-&HER2-) ? was evaluated with multinomial regression models. Main outcome measures Breast cancer and histological subtype. Results Our results confirm most of the associations found in the previous case-control study. A high adherence to the Western dietary pattern seems to increase breast cancer risk in both premenopausal women (OR4thvs.1stquartile(95%CI):1.68(1.02;2.79); OR1SD-increase(95%CI): 1.19(1.01;1.40)) and postmenopausal women (OR4thvs.1stquartile(95%CI):1.48(1.07;2.05); OR1SD-increase(95%CI): 1.14(1.01;1.28)). While high adherence to the Prudent pattern did not show any effect on breast cancer, the Mediterranean dietary pattern seemed to be protective, but only among postmenopausal women (OR4thvs.1stquartile (95%CI):0.72(95% CI 0.53;0.98); p-int = 0.075). There were no significant differences by tumour subtype. Conclusion Dietary recommendations based on a departure from the Western dietary pattern in favour of the Mediterranean diet could reduce breast cancer risk in the general population.The study was funded by Carlos III Institute of Health grants (PI12/00488, PI12/00265, PI12/00715, PI12/01270, PI09/00773 and PI08/1770), by the Spanish Ministry of Economy and Competitiveness (IJCI-2014-20900) and by Consejería de Salud de la Junta de Andalucía (PI-0571- 2009 and PI-0306-2011) competitive calls including peer review for scientific quality. Additional funding was provided by the Spanish Federation of Breast Cancer Patients (FECMA: EPY 1169- 10), the Association of Women with Breast Cancer from Elche (AMACMEC:EPY 1394/15), the Marqués de Valdecilla foundation (grant API 10/09), ) and by Acción Transversal del Cancer, approved by the Spanish Ministry Council on October 11, 2007. None of the funders played any role in conducting research or writing the paper

Aceptación de un menú escolar según la valoración de residuos del método de estimación visual Comstock

Introduction: There is a great interest to know the menu that is served in the school canteens since children that eat their main food there have increased. Different methods have been used to evaluate the school menus, but they do not allow knowing what really the students consume. The aims are to know the acceptance of the menus offered by the school canteen and to detect the least consumed foods. Material and Methods: There were evaluated 320 trays from a class of 3rd of primary education. There was performed visual estimation of waste on the trays using the Comstock method by a trained nutritionist. Results: The average in the estimation of waste according to the Comstock scale was 1.12 (28% of waste; 25.25% for boys and 30.25% for girls; p<0.05). 17.2% of the trays did not contain waste, 58.4% contained between 1-25% of waste, 19.7% between 26-50% of waste, and 4.7% contained between 51-100% of waste. The most common wastes in the trays were vegetables (24.1%), salad (22.5%) and pulses (21.6%). Egg and yogurt were not found as waste. The main waste were pulses (38.5%; 1.54 in the scale Comstock). Girls leave more vegetables in the plate. Conclusions: Menus offered at the school canteen are accepted by the students since 75.6% of the trays contain ≤25% of waste. Vegetables are the most prevailing waste on the trays and pulses are those which leave in more quantity.Introducción: hay un gran interés en conocer el menú que se sirve en los comedores escolares, ya que han aumentado en ellos los niños que realizan su comida principal. Se han empleado distintos métodos para evaluar menús escolares, pero no permiten conocer lo que realmente ingieren los escolares. El objetivo de este estudio fue conocer la aceptación de los menús ofrecidos por el comedor escolar y detectar los alimentos menos consumidos. Material y métodos: se evaluaron 320 bandejas de una clase de 3º de educación primaria (8-9 años de edad). Se realizó la estimación visual de los residuos de dichas bandejas mediante el método Comstock por un dietista-nutricionista entrenado. Resultados: la media en la estimación de residuos según la escala Comstock fue 1,12 (28% de residuos; 25,25% para niños y 30,25% para niñas; p<0,05). El 17,2% de las bandejas no presentaron residuos, el 58,4% presentaron residuos de 1-25%, el 19,7% de entre 26-50% y el 4,7% de 51-100% de los residuos. Los alimentos más frecuentes como residuos en bandejas fueron verduras (24,1%), ensalada (22,5%) y legumbres (21,6%). Huevo y yogur no se encontraron como residuos. Las legumbres fueron los alimentos que dejan los escolares en mayor cantidad, con un 38,5% de residuos (1,54 en la escala Comstock). Las niñas dejan más verduras en el plato. Conclusiones: los menús ofrecidos en este comedor escolar son aceptados, ya que el 75,6% de las bandejas contienen ≤25% de residuos. Las verduras son los residuos que más predominan en las bandejas y las legumbres son los que dejan en mayor cantidad

Fiabilidad de un cuestionario para evaluar el equilibrio alimentario de menús escolares

Una adecuada planificaci&oacute;n del men&uacute; escolar puede servir como estrategia en la prevenci&oacute;n de la obesidad infantil y las enfermedades cr&oacute;nicas no transmisibles. El objetivo del estudio fue aportar evidencias de fiabilidad de un cuestionario capaz de evaluar el equilibrio alimentario (cualitativo) de men&uacute;s escolares. El cuestionario estudiado constaba de 17 &iacute;tems referidos a grupos de alimentos, t&eacute;cnicas culinarias y la combinaci&oacute;n de los platos para su uso en la evaluaci&oacute;n de la oferta alimentaria en comedores escolares (cuestionario EQ-MEs). Para la fiabilidad se analiz&oacute; la reproducibilidad (coeficiente de correlaci&oacute;n intraclase y de Pearson), tanto el grado de acuerdo intraobservador como entre dos observadores, de una muestra de 255 planificaciones mensuales de men&uacute;s para 20 d&iacute;as ofrecidos en la Comunitat Valenciana (Espa&ntilde;a). Se complet&oacute; el estudio con el an&aacute;lisis gr&aacute;fico de Bland-Altman. La asociaci&oacute;n intraobservador mostr&oacute; un coeficiente de correlaci&oacute;n intraclase entre 0,940 y 1, y de Pearson entre 0,900 y 0,990. La comparativa interobservadores reflej&oacute; una asociaci&oacute;n con valores entre 0,771 y 0,980 para el coeficiente de correlaci&oacute;n intraclase (excepto para el &iacute;tem combinaci&oacute;n de platos con 0,516), y entre 0,895 y 0,845 para el de Pearson (excepto para el &iacute;tem combinaci&oacute;n de platos con 0,350). El an&aacute;lisis gr&aacute;fico de Bland-Altman mostr&oacute; tambi&eacute;n las altas asociaciones encontradas. En conclusi&oacute;n, el cuestionario EQ-MEs es un instrumento fiable para evaluar el equilibrio de men&uacute;s escolares, de f&aacute;cil utilizaci&oacute;n y que permite clasificarlos.Proper school menu planning can serve as a strategy in the prevention of childhood obesity and chronic noncommunicable diseases. The aim of the study was to provide reliable evidence of a questionnaire that allows to evaluate the food balance of school menus. There was studied the reliability of a questionnaire of 17 articles referred to groups of food, culinary technologies and the combination of the plates for his use in the evaluation of the food offer in school dining rooms (questionnaire EQ-MEs). For the reliability there was analyzed the reproducibility (intraclass correlation coefficient and of Pearson), so much degree of agreement intra-observer as between two observers, of a sample of 255 monthly plannings of menus for 20 days offered in the Valencian Community (Spain). The study was completed with the Bland-Altman graphical analysis. The association test-retest showed an intraclass correlation coefficient between 0.940 and 1, and of Pearson between 0.900 and 0.990. Comparative inter-observers it reflected an association with values between 0.771 and 0.980 for the intraclass correlation coefficient (except for the article combination of plates with 0.516), and between 0.895 and 0.845 for that of Pearson (except for the article combination of plates with 0.350). Bland-Altman&rsquo;s graphical analysis showed also the high opposing associations. In conclusion, the EQ-MEs questionnaire is a reliable instrument to evaluate the balance of school menus, easy to use and classifying them

Diseño de un cuestionario para evaluar el equilibrio alimentario de menús escolares

Objective: To design a questionnaire to evaluate the food balance of school menus based on an index and a scale that quantifies it. Material and Methods: Instrumental study for the creation and the validation of content of a questionnaire for the evaluation of the food balance and classification of school menus, across recommendations of official organisms and experts’ panel. There was studied frequency of groups of food, culinary technologies, suitable information and combination. It was summarized in an index and a scale of balance. Results: The tool was elaborated by the recommendation of the experts and the new recommendations of official organisms, proposing an index of 17 articles and the scale of 4, of very slightly balanced to balanced. Conclusions: A qualitative complete and easy to use tool was proposed. The validation of the questionnaire, together with the index and the scale proposed for further works, is necessary.Objetivo: Diseñar un cuestionario para evaluar el equilibrio alimentario de menús escolares, basado en un índice y una escala que lo cuantifique. Material y Métodos: Estudio instrumental para la creación y la validación de contenido de un cuestionario para la evaluación del equilibrio alimentario y clasificación de menús escolares, a través de recomendaciones de organismos oficiales y panel de expertos. Se estudió frecuencia de grupos de alimentos, técnicas culinarias, adecuada información y combinación. Se resumió en un índice y una escala de equilibrio. Resultados: Se elaboró la herramienta con la recomendación de los expertos y las nuevas recomendaciones de organismos oficiales, proponiendo un índice de 17 ítems y la escala de 4, de muy poco equilibrado a equilibrado. Conclusiones: Se ha propuesto una herramienta cualitativa completa y fácil de usar. Es necesaria la validación del cuestionario, junto con el índice y la escala, que se propone para posteriores trabajos

Programa de cribado de cáncer colorrectal de la Comunidad Valenciana: resultados de la primera ronda: 2005-2008

Fundamento: Diferentes estudios de cribado de cáncer colorrectal (CCR) mediante test de sangre oculta en heces (TSOH) han mostrado reducciones significativas en la mortalidad por este tumor. El objetivo del trabajo es describir los resultados de la primera ronda del programa de cribado de CCR en población de riesgo medio de la Comunidad Valenciana y valorar su factibilidad y aceptabilidad. Métodos: Estudio piloto de cribado de cáncer colorrectal mediante la realización de TSOH bienal. Población diana: 106.000 personas de edades comprendidas entre 50-69 años (un subgrupo de 70-74 años), de 3 Departamentos de Salud que mediante correo postal fueron invitadas a participar. Alas que tuvieron TSOH positivo se les remitió al hospital para la realización de una colonoscopia. Se calcularon: las tasas de participación, de positividad del test, de aceptación de la colonoscopia, porcentaje colonoscopias realizadas y porcentaje y tasa de lesiones precursoras y cánceres invasores, así como el valor predicitivo positivo del TSOH como indicador de calidad del programa. Resultados: La participación alcanzada fue de 35.231 personas (35,70% de las invitadas). El número de test positivos del TSOH fue de 579 (1,64% del total de test analizados). Aceptaron hacerse colonoscopia 548 personas (tasa de aceptación: 94,69%). Se detectaron 61 CCR, 61 adenomas de alto riesgo y 153 adenomas de bajo riesgo (tasas del 1,77, 1,77 y 4,46% por 1.000 participantes). Los valores predictivos positivos para cáncer, adenomas de bajo riesgo y adenomas de alto riesgo fueron de 10,95%, 10,95% y 27,46% respectivamente. Conclusiones: Los indicadores del programa sugieren que un programa poblacional de cáncer colorrectal es factible en nuestro contesto ya que los indicadores de proceso obtenidos son similares a los que se dan en otros programas realizados en España y Europa

Adherence to nutrition-based cancer prevention guidelines and breast, prostate and colorectal cancer risk in the MCC-Spain case-control study

Prostate, breast and colorectal cancer are the most common tumours in Spain. The aim of the present study was to evaluate the association between adherence to nutrition-based guidelines for cancer prevention and prostate, breast and colorectal cancer, in the MCC-Spain case-control study. A total of 1,718 colorectal, 1,343 breast and 864 prostate cancer cases and 3,431 population-based controls recruited between 2007 and 2012, were included in the present study. The World Cancer Research Fund/American Institute for Cancer Research (WCRC/AICR) score based on six recommendations for cancer prevention (on body fatness, physical activity, foods and drinks that promote weight gain, plant foods, animal foods and alcoholic drinks; score range 0-6) was constructed. We used unconditional logistic regression analysis adjusting for potential confounders. One-point increment in the WCRF/AICR score was associated with 25% (95% CI 19-30%) lower risk of colorectal, and 15% (95% CI 7-22%) lower risk of breast cancer; no association with prostate cancer was detected, except for cases with a Gleason score ≥7 (poorly differentiated/undifferentiated tumours) (OR 0.87, 95% CI 0.76-0.99). These results add to the wealth of evidence indicating that a great proportion of common cancer cases could be avoided by adopting healthy lifestyle habits.This study was supported by Acción Transversal del Cancer and Instituto de Salud Carlos III-FEDER; Grant numbers: PI08/1770, PI08/0533, PI08/1359, PS09/00773, PS09/01286, PS09/01903, PS09/02078, PS09/01662, PI11/01403, PI11/01889, PI11/00226, PI11/01810, PI11/02213, PI12/ 00488, PI12/00265, PI12/01270, PI12/00715, PI12/00150; Grant sponsor: Fundación Marqués de Valdecilla; Grant number: API 10/09; Grant sponsors: ICGC International Cancer Genome Consortium CLL and Junta de Castilla y León; Grant number: LE22A10-2; Grant sponsor: Consejería de Salud of the Junta de Andalucía; Grant number: PI-0571; Grant sponsor: Conselleria de Sanitat of the Generalitat Valenciana; Grant number: AP 061/10; Grant sponsor: Recercaixa; Grant number: 2010ACUP 00310; Grant sponsors: Regional Government of the Basque Country and European Commission; Grant number: FOOD-CT-2006–036224-HIWATE; Grant sponsors: Spanish Association Against Cancer (AECC) Scientific Foundation and The Catalan Government DURSI Grant; Grant number: 2009SGR1489; Grant sponsors: Ministerio de Economía y Competitividad, Spain and European Regional Development Fund; Grant number: RYC-2011–0879