Resultados de la encuesta sobre unidades asistenciales y atención a trastornos de la conducta alimentaria en España. Grupo de Trabajo sobre Trastornos de la Conducta Alimentaria de SENPE

Artículo del Grupo de Trabajo SENPE: Trastornos del Comportamiento AlimentarioIntroduction: eating disorders (EDs) entail a therapeutic challenge. Objective: to describe ED care from the perspective of Nutrition Units (NU) in relation to human and care resources, the activities carried out, and satisfaction with care in Spain; to collect demands from professionals to improve assistance. Methods: a cross-sectional, observational study based on a questionnaire sent online to members of the Spanish Society of Clinical Nutrition and Metabolism (SENPE) and to the Nutrition Area of the Spanish Society of Endocrinology and Nutrition (SEEN). The data were analyzed according to number of beds of the hospitals surveyed (< 500/≥ 500). Results: 23 responses from 8 autonomous communities. In 87 % of NUs care was given to eating disorders; 65.2 % had a specific process; 91.3 % collaborated with Psychiatry; 34.8 % had their own hospitalization area; 56.5 % had a day hospital, but 21.7 % participated in it; 39.1 % had a monographic consultation office; nutritional education was carried out in 87 %, especially by nursing; individualized diets and oral supplements were frequently prescribed in 39.1 % and 56.5 %, respectively; only the largest hospitals participated in research on EDs (62.5 %), and 21.7 % collaborated with patient associations. Hospitals with ≥ 500 beds had more resources and were more satisfied. Professionals demanded resources and processes agreed with Psychiatry. Conclusions: resources and care practices are uneven in the NUs surveyed, as well as multidisciplinary collaboration. The collected evidence allows us to design improvement strategies in this area.Depto. de Nutrición y Ciencia de los AlimentosDepto. de MedicinaFac. de FarmaciaFac. de MedicinaTRUEpu

A consensus report by the Working Group on Eating Disorders of Sociedad Española de Nutrición Clínica y Metabolismo (GTTCA-SENPE). Evaluation, medical and nutritional management of anorexia nervosa. Update 2023

Documento de Consenso del grupo de Trabajo SENPE: Trastornos del Comportamiento AlimntarioAnorexia nervosa (AN) is a multifactorial disorder. A possible role of the social network and the gut microbiota in pathogenesis has been added. Exogenous shocks such as the COVID19 pandemic have had a negative impact on patients with AN. The potential medical and nutritional impact of malnutrition and/or compensatory behaviors gives rise to a complex disease with a wide range of severity, the management of which requires a multidisciplinary team with a high level of subject matter expertise. Coordination between levels of care is necessary as well as understanding how to transition the patient from pediatric to adult care is essential. A proper clinical evaluation can detect possible complications, as well as establish the organic risk of the patient. This allows caregivers to tailor the medical-nutritional treatment for each patient. Reestablishing adequate nutritional behaviors is a fundamental pillar of treatment in AN. The design of a personalized nutritional treatment and education program is necessary for this purpose. Depending on the clinical severity, artificial nutrition may be necessary. Although the decision regarding the level of care necessary at diagnosis or during follow-up depends on a number of factors (awareness of the disease, medical stability, complications, suicidal risk, outpatient treatment failure, psychosocial context, etc.), outpatient treatment is the most frequent and most preferred choice. However, more intensive care (total or partial hospitalization) may be necessary in certain cases. In severely malnourished patients, the appearance of refeeding syndrome should be prevented during renourishment. The presence of AN in certain situations (pregnancy, vegetarianism, type 1 diabetes mellitus) requires specific care. Physical activity in these patients must also be addressed correctly.Beca SENPE-Fundación SENPE 2023Depto. de Nutrición y Ciencia de los AlimentosDepto. de MedicinaFac. de FarmaciaFac. de MedicinaTRUEpu

Dietary and Physical Activity Habits as Conditioning Factors of Nutritional Status among Children of GENYAL Study

Excess weight (EW) in children has become a severe public health problem. The present study aimed to describe the main lifestyle characteristics and their possible association with nutritional status in a group of schoolchildren enrolled in the GENYAL study, where 221 children in the first or second grade of primary education (6–9 years old) were included. Anthropometric (BMI and bioimpedance), dietary intake (twice-repeated 24 h food record), and physical activity (twice-repeated 24 h physical activity questionnaire) data were collected. Logistic and linear regressions, with p-values adjusted for multiple tests by Bonferroni’s method and with sex and age as covariates, were applied. The prevalence of EW was 19%, 25.4%, and 32.2%, according to Orbegozo Foundation, IOFT, and WHO criteria, respectively. The results showed a significant association between schoolchildren’s nutritional status and energy balance, defined as the ratio of estimated energy intake to estimated energy expenditure (%), (β = −1.49 (−1.9–1.07), p &lt; 0.01) and KIDMED Mediterranean Diet Quality Index score (β = −0.19 (95% IC −0.38–0), p = 0.04), and between the availability of TV or other technological devices in their room and the child’s BMI (β = 1.15 (95% IC 0.20–2.10), p = 0.017) and their fat mass (β = 3.28 (95% IC 0.69–5.87), p = 0.013). The number of dairy servings/day had a protective effect against EW (OR = 0.48 (0.29–0.75), p adjusted = 0.05)). Studying lifestyle factors associated with obesity is essential for developing tools and strategies for obesity prevention in children.Comunidad de MadridDepto. de Nutrición y Ciencia de los AlimentosFac. de FarmaciaTRUEpubDescuento UC

Dietary and Physical Activity Habits as Conditioning Factors of Nutritional Status among Children of GENYAL Study

Excess weight (EW) in children has become a severe public health problem. The present study aimed to describe the main lifestyle characteristics and their possible association with nutritional status in a group of schoolchildren enrolled in the GENYAL study, where 221 children in the first or second grade of primary education (6–9 years old) were included. Anthropometric (BMI and bioimpedance), dietary intake (twice-repeated 24 h food record), and physical activity (twice-repeated 24 h physical activity questionnaire) data were collected. Logistic and linear regressions, with p-values adjusted for multiple tests by Bonferroni’s method and with sex and age as covariates, were applied. The prevalence of EW was 19%, 25.4%, and 32.2%, according to Orbegozo Foundation, IOFT, and WHO criteria, respectively. The results showed a significant association between schoolchildren’s nutritional status and energy balance, defined as the ratio of estimated energy intake to estimated energy expenditure (%), (β = −1.49 (−1.9–1.07), p &lt; 0.01) and KIDMED Mediterranean Diet Quality Index score (β = −0.19 (95% IC −0.38–0), p = 0.04), and between the availability of TV or other technological devices in their room and the child’s BMI (β = 1.15 (95% IC 0.20–2.10), p = 0.017) and their fat mass (β = 3.28 (95% IC 0.69–5.87), p = 0.013). The number of dairy servings/day had a protective effect against EW (OR = 0.48 (0.29–0.75), p adjusted = 0.05)). Studying lifestyle factors associated with obesity is essential for developing tools and strategies for obesity prevention in children.Conserjería de Educación, Universidades y Ciencia de la Comunidad de MadridDepto. de Nutrición y Ciencia de los AlimentosFac. de FarmaciaTRUEpubDescuento UC

A comprehensive map of microbial biomarkers along the gastrointestinal tract for celiac disease patients

Dysbiosis of the microbiome has been related to Celiac disease (CeD) progress, an autoimmune disease characterized by gluten intolerance developed in genetically susceptible individuals under certain environmental factors. The microbiome contributes to CeD pathophysiology, modulating the immune response by the action of short-chain fatty acids (SCFA), affecting gut barrier integrity allowing the entrance of gluten-derived proteins, and degrading immunogenic peptides of gluten through endoprolyl peptidase enzymes. Despite the evidence suggesting the implication of gut microbiome over CeD pathogenesis, there is no consensus about the specific microbial changes observed in this pathology. Here, we compiled the largest dataset of 16S prokaryotic ribosomal RNA gene high-throughput sequencing for consensus profiling. We present for the first time an integrative analysis of metataxonomic data from patients with CeD, including samples from different body sites (saliva, pharynx, duodenum, and stool). We found the presence of coordinated changes through the gastrointestinal tract (GIT) characterized by an increase in Actinobacteria species in the upper GIT (pharynx and duodenum) and an increase in Proteobacteria in the lower GIT (duodenum and stool), as well as site-specific changes evidencing a dysbiosis in patients with CeD’ microbiota. Moreover, we described the effect of adherence to a gluten-free diet (GFD) evidenced by an increase in beneficial bacteria and a decrease in some Betaproteobacteriales but not fully restoring CeD-related dysbiosis. Finally, we built a Random Forest model to classify patients based on the lower GIT composition achieving good performance.European Society of Clinical Microbiology and Infectious Diseases (ESCMID)Convocatoria FEDER INNTERCONECTA 2015Juan de la CiervaMinisterio de Ciencia, Innovación y UniversidadesDepto. de Nutrición y Ciencia de los AlimentosFac. de FarmaciaTRUEpu

Milk fat globule membrane-enriched milk improves episodic memory: A randomized, parallel, double-blind, placebo-controlled trial in older adults

Cognitive decline is one of the most important consequences of aging and pharmacological therapies had been largely unsuccessful. Other strategies include the use of functional foods to reduce the burden of cognitive decline. The MFGM is an important source of polar lipids and glycoproteins that decline in the aging brain. We have developed a milk drink fortified with MFGM (MFGM-M) as a dietary supplement and studied it in a randomized clinical pilot study. Forty-four > 65-year-old healthy or mildly cognitively impaired subjects received MFGM-M or control milk (CM) for 14 weeks, during which they underwent a battery of cognitive tests. Lipidomic analyzes were also performed. The female participants showed improvement in episodic memory, the ability to recall events in our lives. It is conceivable that any intervention should be started before clinical symptoms manifest, as a preventive measure against cognitive decline. Future long-term studies may shed further light on this point.Ministerio de Ciencia, Innovación y UniversidadesDepto. de Nutrición y Ciencia de los AlimentosFac. de FarmaciaTRUEpubAPC financiada por la UC

Breakfast Quality and Insulin Resistance in Spanish Schoolchildren: A Cross-Sectional Study

Background: Breakfast has traditionally been considered one of the most important meals of the day; however, there is little evidence for the influence of breakfast quality and insulin resistance (IR). This study aimed to assess the quality of breakfast in a group of schoolchildren, and its association with IR. Methods: A cross-sectional study with 852 children (8–13 years) was carried out. Fasting plasma glucose, insulin and anthropometric parameters were measured. A three-day dietary record was used to assess their diet and to calculate the Breakfast Quality Index (BQI). The sample was divided into tertiles according to the BQI (tertile 3: better breakfast quality). The homeostatic model was used to assess insulin resistance (HOMA-IR), and IR was defined as HOMA-IR &gt; 3.16. Results: The prevalence of IR was 5.2%. The mean BQI score was 4.50 ± 1.25, and boys had lower scores than girls. Children in the BQI tertile 3 had a better global diet quality. In boys, being in the BQI tertile 3 was associated with a lower risk of IR (OR [95% CI]: 0.10 [0.01–0.77], p &lt; 0.05). Conclusions: A higher-quality breakfast was associated with better overall diet quality and a lower risk of IR, especially in boys.FISS project PI060318, INCERHPAN-UCM contract 210/2008Universidad Complutense de MadridDepto. de Nutrición y Ciencia de los AlimentosFac. de FarmaciaTRUEpubDescuento UC

“GENYAL” Study to Childhood Obesity Prevention: Methodology and Preliminary Results

Clinical Trial Registration: This study has been registered in ClinicalTrials.gov with the identifier NCT03419520, https://clinicaltrials.gov/ct2/show/NCT03419520.Objective: This article describes the methodology and summarizes some preliminary results of the GENYAL study aiming to design and validate a predictive model, considering both environmental and genetic factors, that identifies children who would benefit most from actions aimed at reducing the risk of obesity and its complications. Design: The study is a cluster randomized clinical trial with 5-year follow-up. The initial evaluation was carried out in 2017. The schools were randomly split into intervention (nutritional education) and control schools. Anthropometric measurements, social and health as well as dietary and physical activity data of schoolchildren and their families are annually collected. A total of 26 single nucleotide polymorphisms (SNPs) were assessed. Machine Learning models are being designed to predict obesity phenotypes after the 5-year follow-up. Settings: Six schools in Madrid. Participants: A total of 221 schoolchildren (6-8 years old). Results: Collected results show that the prevalence of excess weight was 19.0, 25.4, and 32.2% (according to World Health Organization, International Obesity Task Force and Orbegozo Foundation criteria, respectively). Associations between the nutritional state of children with mother BMI [β = 0.21 (0.13-0.3), p (adjusted) <0.001], geographical location of the school [OR = 2.74 (1.24-6.22), p (adjusted) = 0.06], dairy servings per day [OR = 0.48 (0.29-0.75), p (adjusted) = 0.05] and 8 SNPs [rs1260326, rs780094, rs10913469, rs328, rs7647305, rs3101336, rs2568958, rs925946; p (not adjusted) <0.05] were found. Conclusions: These baseline data support the evidence that environmental and genetic factors play a role in the development of childhood obesity. After 5-year follow-up, the GENYAL study pretends to validate the predictive model as a new strategy to fight against obesity.Conserjería de Educación, Universidades y Ciencia de la Comunidad de Madrid, Dirección General de Educación Infantil, Primaria y Secundaria.Depto. de Nutrición y Ciencia de los AlimentosFac. de FarmaciaTRUEpu

High-Protein Processed Foods: Impact on Diet, Nutritional Status, and Possible Effects on Health

Proteins are macronutrients with multiple health benefits, but excessive consumption can negatively affect health. This study aimed to evaluate the characteristics of a sample of high-protein processed foods (HPPFs), describe how their consumption affects dietary balance, and acquire knowledge of the consumption patterns of these products in a Spanish population. A sample of HPPFs available in supermarkets and on websites was collected. The contribution to recommended protein intakes was calculated using national and international references and considering the single consumption of the HPPFs and the product plus 150 g of meat. Furthermore, an online survey was conducted among a convenience sample. A total of 36 enriched protein products were evaluated. The percentage of proteins in these products ranges from 10 to 88%. The contribution of the protein recommended intake was within a range of 87.4–306.6% and 66.4–232.8% (women and men, respectively), only considering the additional proteins from 150 g of meat. One hundred thirty-nine participants completed the survey; 67.6% affirmed that they had consumed HPPFs, and half consumed them without following any consumption control. Since these products are accessible to everyone in supermarkets and protein intake is generally higher than the recommended limits, regulating the mass sale of HPPFs is essential to ensure they do not lead to protein overconsumption.Depto. de Nutrición y Ciencia de los AlimentosFac. de FarmaciaTRUEpubDescuento UC

Use of nutritional education to promote well-being for all people of all ages: “nutrieducar@prendiendo” service-learning project

Oficina de Aprendizaje y ServicioDepto. de Nutrición y Ciencia de los AlimentosFac. de FarmaciaTRUEpu