Adecuación de la ingesta en una población geriátrica institucionalizada

Los ancianos institucionalizados son uno de los colectivos con mayor riesgo de padecer malnutrición o déficits nutricionales importantes. El objetivo de este trabajo ha sido valorar la adecuación nutricional de los menús ofertados en un centro asistencial para personas mayores, comparando la ingesta propuesta por el centro con la ingesta real de algunos de los residentes. Métodos: se seleccionó una muestra de 33 residentes con distintos tipos de demencia en un centro asistencial de Castilla y León a los que se les realizó una valoración del estado nutricional sencilla (IMC) y se evaluó el riesgo de malnutrición (Mini Nutritional Asessment (MNA) e Índice de Riesgo Nutricional Geriátrico (IRNG)). Se evaluó el aporte de nutrientes de las dietas pautadas a los residentes (dieta basal, hipocalórica o metabólica) mediante el análisis de las planillas del centro (ingesta teórica) y del consumo alimentario real a partir de un registro de 3 días (ingesta real), y se compararon con las recomendaciones. La normalidad de las variables se determinó mediante Kolmogorov-Smirnov o Shapiro-Wilk; la valoración nutricional de los tres tipos de dieta se analizó mediante ANOVA o el test de Wilcoxon; las dietas reales y teóricas se compararon con la t de Student o la U de Mann-Whitney;.la significación estadística se alcanzó con p<0,05. Resultados: la la edad media de los sujetos fue de 81,5 años. La mitad de los sujetos presentaban un IMC compatible con la normalidad nutricional. Casi el 70% de los ancianos presentaba riesgo de malnutrición a partir del MNA, pero este riesgo se reduce al 42% de los sujetos con el IRNG. Las dietas planificadas aportan una cantidad de energía suficiente, pero con un déficit de hidratos de carbono, un exceso de proteínas y lípidos, un disbalance del perfil lipídico, con un exceso de colesterol, y un aporte de micronutrientes desequilibrado. Al comparar la ingesta teórica con la real, las mayores diferencias se observan en la dieta basal: una menor ingesta de la planificada genera un perfil nutricional más adecuado (menor aporte de grasas, mejor perfil lipídico y mayor ingesta de carbohidratos). Conclusiones: la planificación dietética del centro no se adecúa a las recomendaciones nutricionales para este colectivo, ya que es deficiente en hidratos de carbono y presenta un exceso de lípidos y colesterol, además de desequilibrios en el aporte de algunos micronutrientes que podrían alterar el status óseo y la función cardiovascular. Los sujetos con dieta basal ingieren significativamente menos cantidad de alimentos de los que se les oferta, resultando una dieta con mejor perfil de macronutrientes.Departamento de Pediatría e Inmunología, Obstetricia y Ginecología, Nutrición y Bromatología, Psiquiatría e Historia de la CienciaGrado en Nutrición Humana y Dietétic

Dietary Intake, Nutritional Adequacy, and Food Sources of Selected Antioxidant Minerals and Vitamins; and Their Relationship with Personal and Family Factors in Spanish Children Aged 1 to <10 Years: Results from the EsNuPI Study

Minerals and vitamins involved in the antioxidant defense system are essential for healthy growth and proper development during infancy. Milk and dairy products are of particular importance for improving the supply of these nutrients to children. Indeed, the present study aimed to evaluate the nutrient intake and food sources of zinc (Zn), selenium (Se), retinol and carotenoids (sources of vitamin A), and vitamins C and E, and to analyze their relationships with personal and familiar factors in Spanish children from the EsNuPI study. One subpopulation representative of the Spanish population from 1 to <10 years old (n = 707) (reference group, REF) who reported consuming all types of milk over the last year, and another subpopulation of the same age who reported consuming fortified milk formulas (FMFs) (including follow-on formula, young child formula, growing up milk, toddler’s milk, and enriched and fortified milk) (n = 741) (fortified milk consumers, FMCs) completed two 24 h dietary recalls used to estimate their nutrient intakes and to compare them to the European Food Safety Authority (EFSA) Dietary Reference Values (DRVs). The REF reported higher median intakes than FMCs for Se (61 g/kg vs. 51 g/kg) and carotenoids (1079 g/day vs. 998 g/day). Oppositely, FMCs reported higher intakes than REF for Zn (7.9 mg/day vs. 6.9 mg/day), vitamin A (636 g/day vs. 481 g/day), vitamin E (8.9 mg/day vs. 4.5 mg/day), vitamin C (113 mg/day vs. 71 mg/day), and retinol (376 g/day vs. 233 g/day). In the REF group, more than 50% of the children met the EFSA recommendations for Zn (79.6%), Se (87.1%), vitamin A (71.3%), and vitamin C (96.7%), respectively. On the other hand, 92.2% were below the EFSA recommendations for vitamin E. In the FMC group, more than 50% of the children met the EFSA recommendations for Zn (55.2%), Se (90.8%), vitamin A (75.7%), vitamin E (66.7%), and vitamin C (100%). We found statistically significant differences between subpopulations for all cases except for Se. In both subpopulations, the main sources of all antioxidant nutrients were milk and dairy products. For carotenoids, the main sources were vegetables and fruits followed by milk and dairy products. A high percentage of children had vitamins A and E intakes below the recommendations, information of great importance to stakeholders. More studies using intakes and biomarkers are needed, however, to determine an association with diverse factors of oxidative damage.Instituto Puleva de Nutricion (IPN)FENFINUTdairy company Lactali

A Review of A Priori Defined Oxidative Balance Scores Relative to Their Components and Impact on Health Outcomes

Oxidative Balance Scores (OBSs) are tools that have emerged to evaluate the global balance of individuals’ oxidation—reduction status. The aim was to compare OBSs available in the literature regarding their characteristics and associations with chronic diseases in epidemiological studies. Studies that developed OBSs were searched in PubMed until August 2018. A total of 21 OBSs were identified. These OBSs presented di erent scoring schemes and di erent types of anti- and pro-oxidant components, including dietary factors (dietary intake and/or nutrient biomarkers), lifestyle factors, and medications. Most OBSs were based on over 10 components, and some included only dietary factors. Few considered weighted components in the score. Only three OBSs were validated as potential surrogates of oxidative balance through inflammation and OS-related biomarkers. Notably, all the OBSs were associated—to a varying degree—with a reduced risk of cardiovascular diseases, chronic kidney disease, colorectal adenomas, and di erent cancer types (colorectal and breast cancer), as well as with all-cause and cancer-related mortality. For other outcomes, e.g., prostate cancer, contradictory results were reported. In summary, there is a great heterogeneity in the definition of OBSs. Most studies are concordant in supporting that excessive OS reflected by a lower OBS has deleterious e ects on health. Unified criteria for defining the proper OBSs, valuable to gauge OS-related aspects of the diet and lifestyle that may lead to adverse health outcomes, are needed.This research was co-funded by the Health Research Fund (FIS), Acción Estratégica en Salud (AES), of the Spanish Ministry of Economy and Competitiveness, grant number PI12/00002, and the European Regional Development Fund (ERDF)

Descripción de índices basados en la adhesión al patrón dietético mediterráneo: una revisión

Introduction: diet quality indexes are tools are aimed at quantifying the compliance to a defined dietary pattern. These indexes are a combined measure of dietary factors (food groups, foods, nutrients and ratios) and/or lifestyles factors. The Mediterranean Diet (MD) is a dietary pattern characterized by their positive effects against chronic diseases. There have been many indexes proposed for the assessment of this dietary pattern. An evaluation of their composition and health benefits is therefore convenient. Objective: the objective is to evaluate indexes of adherence to the MD with regard to their definition, methodological issues and validation as reported in epidemiological studies. Methods: we searched in PubMed for studies that developed MD Indexes up to October 2014. Results: a total number of 22 indexes were identified, with differences regarding the number of components (7-28), scoring (0, 1, 2, 3, 4, 5, 8 or 10, in case of compliance), range (0-100) and type of components (which could be food groups/foods or their combination, with nutrients). Among the positive components, fruits and vegetables were the most common and meats, among the negative components. There were also differences with regard to their composition and evaluation (e.g. criteria of moderate alcohol consumption), as well as with the scoring system (in medians, terciles or established servings).Conclusions: this review suggests that since there is great heterogeneity in the definition of MD. It would be therefore convenient to establish more clearly the components to be included and to establish commonly defined criteria to quantify this dietary pattern.Introducción: los índices de calidad la de dieta son herramientas que sirven para cuantificar el cumplimiento de un patrón dietético definido. Estos índices son una medida combinada de factores dietéticos (grupos alimenticios, alimentos, nutrientes y ratios) y/o estilos de vida. La dieta mediterránea (DM) es un patrón dietético que se caracteriza por sus efectos positivos contra ciertas enfermedades crónicas. Existen numerosos índices propuestos para la valoración de este patrón dietético. Es por lo tanto conveniente una evaluación de su composición y sus efectos sobre la salud. Objetivo: el objetivo es evaluar los índices de adhesión al patrón dietético mediterráneo en cuanto a su definición, aspectos metodológicos y validación en estudios epidemiológicos. Métodos: se buscaron en PubMed estudios que desarrollaron índices de DM hasta octubre de 2014. Resultados: se identificaron un total de 22 índices, con diferencias en cuanto al número de componentes (7-28), puntuación (0, 1, 2, 3, 4, 5, 8 o 10, en el caso de cumplimiento), rango (0-100) y tipo de componentes (grupos de alimentos/alimentos o su combinación con nutrientes). Entre los componentes positivos, los más comunes fueron frutas y verduras, y carnes entre los negativos. También hubo diferencias con respecto a su composición y evaluación (p. ej. criterios de consumo moderado de alcohol), así como con el sistema de puntuación (en medianas, terciles o raciones establecidas). Conclusiones: esta revisión sugiere que existe una gran heterogeneidad en la definición de DM. Sería por tanto apropiado establecer con mayor claridad los componentes que deben incluirse, así como definir criterios comunes para cuantificar este patrón dietético.This work was supported by the Spanish Ministry of Health. Health Research Fund. PI12/00002, co-funded ERDF and It’s part of the doctoral thesis named: “Relación entre ingesta y acumulación de productos de Maillard de la dieta con el status endógeno antioxidante/oxidativo/ inflamatorio individual (“Indice de balance oxidativo”) y con la calidad de la dieta

Description of a dietary quality indicator for application in nursing homes: Quality Index For Nutrition In Nursing Homes – QUINN

Introducción: Los indicadores de calidad de la dieta (Diet Quality Indicators, DQIns) son herramientas para evaluar las características de patrones de dieta basados en el conocimiento de la relación entre los factores dietéticos, los estilos de vida y resultados de salud. El objetivo de este artículo fue proponer un nuevo índice de calidad de la dieta utilizando un enfoque a priori para su aplicación en residencias de ancianos, Quality Index for Nutrition in Nursing Homes, índice QUINN. Metodología: La elección de los componentes se basó en una revisión rápida realizada sobre índices previamente publicados y los principales grupos de alimentos relacionados con la prevención de determinados síndromes geriátricos y de las enfermedades crónicas de alta prevalencia en población geriátrica. El índice QUINN se basó en 15 componentes dietéticos-alimentos, 12 de los cuales se referían a alimentos básicos de una dieta saludable (verduras, frutas, legumbres, aceite de oliva –preferiblemente virgen extra–, cereales, lácteos, pescados blancos y mariscos, carnes blancas y huevos, componentes positivos); otras grasas, carnes rojas y procesadas y dulces (componentes negativos), junto con otros 3 componentes adicionales positivos (variedad de verduras y frutas, pescado azul y cereales integrales). Cada componente se clasificó en 4 categorías (0, 1, 2 o 3 puntos), con un rango final de 0 a 45 puntos. Conclusiones: Desde nuestro conocimiento el índice QUINN es el primer índice de calidad de la dieta a priori basado desarrollado específicamente para evaluar los menús ofertados en las residencias de ancianos. Esta herramienta proporcionará información sobre la calidad de la dieta para el diseño de los menús. El índice QUINN podría ser un instrumento útil para implementar estrategias de intervención y así mejorar de forma sencilla la dieta ofertada en las instituciones que redundaría en la mejora del estado nutricional y la salud de la población geriátrica institucionalizada.Introduction: Diet Quality Indicators (DQIns) are tools for assessing the characteristics of dietary patterns based on knowledge of the relationship between dietary factors, lifestyles, and health outcomes. The aim of this paper was to propose a new diet quality index using an a priori approach for application in nursing homes, Quality Index for Nutrition in Nursing Homes, QUINN index. Methodology: The selection of the components was based on a rapid review performed on previously published indexes and the main food groups related to the prevention of geriatric syndromes and chronic diseases of high prevalence in the geriatric population. The QUINN index was based on 15 dietary-food components, 12 of which referred to basic foods of a healthy diet (vegetables, fruits, legumes, olive oil –preferably extra virgin–, cereals, dairy, white fish and shellfish, white meat, and eggs, positive components); other fats, red meat, and sweets (negative components), together with 3 additional positive components (variety of vegetables and fruits, oily fish, and whole grains). Each component was classified into 4 categories (0, 1, 2 or 3 points), with a final range of 0 to 45 points. Conclusions: To our knowledge the QUINN index is the first a priori diet quality index developed specifically to evaluate menus offered in nursing homes. This tool will provide information on diet quality for menu design. The QUINN index could be a useful instrument to implement intervention strategies to improve in a simple way the diet offered in institutions and to improve the nutritional status and health of the institutionalised geriatric population

A review of a priori defined oxidative balance scores relative to their components and impact on health outcomes

Oxidative Balance Scores (OBSs) are tools that have emerged to evaluate the global balance of individuals’ oxidation—reduction status. The aim was to compare OBSs available in the literature regarding their characteristics and associations with chronic diseases in epidemiological studies. Studies that developed OBSs were searched in PubMed until August 2018. A total of 21 OBSs were identified. These OBSs presented different scoring schemes and different types of anti- and pro-oxidant components, including dietary factors (dietary intake and/or nutrient biomarkers), lifestyle factors, and medications. Most OBSs were based on over 10 components, and some included only dietary factors. Few considered weighted components in the score. Only three OBSs were validated as potential surrogates of oxidative balance through inflammation and OS-related biomarkers. Notably, all the OBSs were associated—to a varying degree—with a reduced risk of cardiovascular diseases, chronic kidney disease, colorectal adenomas, and different cancer types (colorectal and breast cancer), as well as with all-cause and cancer-related mortality. For other outcomes, e.g., prostate cancer, contradictory results were reported. In summary, there is a great heterogeneity in the definition of OBSs. Most studies are concordant in supporting that excessive OS reflected by a lower OBS has deleterious effects on health. Unified criteria for defining the proper OBSs, valuable to gauge OS-related aspects of the diet and lifestyle that may lead to adverse health outcomes, are needed

Dietary Intake, Nutritional Adequacy, and Food Sources of Protein and Relationships with Personal and Family Factors in Spanish Children Aged One to <10 Years: Findings of the EsNuPI Study

This research was funded by Instituto Puleva de Nutricion (IPN), which is a non-profit entity that promotes scientific research, mainly in the field of nutrition and health: child nutrition, cardiovascular, bone and digestive health, etc., as well as the dissemination of quality scientific content. While the IPN is funded by the dairy company Lactalis, its actions are based on the decisions of an independent scientific board formed by renowned international scientists. A. G. is co-financed by the Research Plan of the Vice-Rectorate of Research and Transfer of the University of Granada, Spain.The authors would like to thank IPN for its support and technical advice. The results presented in this article constitute part of Casandra Madrigal Arellano’s doctoral thesis, performed in the Nutrition and Food Sciences Doctorate Program of the University of Granada and financed by the Consejo Nacional de Ciencia y Tecnología (CONACYT).Diet in the first years of life is an important factor in growth and development. Dietary protein is a critical macronutrient that provides both essential and nonessential amino acids required for sustaining all body functions and procedures, providing the structural basis to maintain life and healthy development and growth in children. In this study, our aim was to describe the total protein intake, type and food sources of protein, the adequacy to the Population Reference Intake (PRI) for protein by the European Food Safety Authority (EFSA), and the Recommended Dietary Allowance (RDA) by the Institute of Medicine (IoM). Furthermore, we analyzed whether the consumption of dairy products (including regular milk, dairy products, or adapted milk formulas) is associated with nutrient adequacy and the contribution of protein to diet and whole dietary profile in the two cohorts of the EsNuPI (in English, Nutritional Study in the Spanish Pediatric Population) study; one cohort was representative of the Spanish population from one to <10 years old (n = 707) (Spanish reference cohort, SRS) who reported consuming all kinds of milk and one was a cohort of the same age who reported consuming adapted milk over the last year (including follow-on formula, growing up milk, toddler's milk, and enriched and fortified milks) (n = 741) (adapted milk consumers cohort, AMS). The children of both cohorts had a high contribution from protein to total energy intake (16.79% SRS and 15.63% AMS) and a high total protein intake (60.89 g/day SRS and 53.43 g/day AMS). We observed that protein intake in Spanish children aged one to <10 years old was above the European and international recommendations, as well as the recommended percentages for energy intakes. The main protein sources were milk and dairy products (28% SRS and 29% AMS) and meat and meat products (27% SRS and 26% AMS), followed by cereals (16% SRS and 15% AMS), fish and shellfish (8% in both cohorts), eggs (5% SRS and 6% AMS), and legumes (4% in both cohorts). In our study population, protein intake was mainly from an animal origin (meat and meat products, milk and dairy products, fish and shellfish, and eggs) rather than from a plant origin (cereals and legumes). Future studies should investigate the long-term effect of dietary protein in early childhood on growth and body composition, and whether high protein intake affects health later in life.Instituto Puleva de Nutricion (IPN)dairy company LactalisResearch Plan of the Vice-Rectorate of Research and Transfer of the University of Granada, Spai

Usual Dietary Intake, Nutritional Adequacy and Food Sources of Calcium, Phosphorus, Magnesium and Vitamin D of Spanish Children Aged One to <10 Years. Findings from the EsNuPI Study †

The authors would like to thank IPN for its support and technical advice.Bone problems in the population begin to be establish in childhood. The present study aims to assess the usual calcium, phosphorus, magnesium, and vitamin D intakes, along with the food sources of these nutrients, in Spanish children participating in the EsNuPI (Estudio Nutricional en Población Infantil Española) study. Two 24 h dietary recalls were applied to 1448 children (1 to <10 years) divided into two sub-samples: one reference sample (RS) of the general population [n = 707] and another sample which exclusively included children consuming enriched or fortified milks, here called “adapted milks” (AMS) [n = 741]. Estimation of the usual intake shows that nutrient intake increased with age for all nutrients except vitamin D. Using as reference the Dietary Reference Values from the European Food Safety Authority (EFSA), calcium and magnesium intakes were found to be below the average requirement (AR) and adequate intake (AI), respectively, in a considerable percentage of children. Furthermore, phosphorus exceeded the AI in 100% of individuals and vitamin D was lower than the AI in almost all children studied. The results were very similar when considering only plausible reporters. When analyzing the food sources of the nutrients studied, milk and dairy products contributed the most to calcium, phosphorus, magnesium, and vitamin D. Other sources of calcium were cereals and vegetables; for phosphorus: meat, meat products, and cereals; for magnesium: cereals and fruits; and, for vitamin D: fish and eggs. These results highlight the desirability of improving the intake concerning these nutrients, which are involved in bone and metabolic health in children. The AMS group appeared to contribute better to the adequacy of those nutrients than the RS group, but both still need further improvement. Of special interest are the results of vitamin D intakes, which were significantly higher in the AMS group (although still below the AI), independent of age.Instituto Puleva de Nutricion (IPN

Dietary Intake of Individual (Intrinsic and Added) Sugars and Food Sources from Spanish Children Aged One to <10 Years—Results from the EsNuPI Study

This research was funded by Instituto Puleva de Nutricion (IPN), which is a non-profit entity that promotes scientific research, mainly in the field of nutrition and health: child nutrition, cardiovascular, bone and digestive health, etc., as well as the dissemination of quality scientific content. While the IPN is funded by the dairy company Lactalis, its actions are based on the decisions of an independent scientific board formed by renowned international scientists. a. G. is co-financed by the Research Plan of the Vice-Rectorate of Research and Transfer of the University of Granada, Spain.Currently, in Spain there are no studies assessing the intakes and sources of intrinsic and added sugars by both children consuming standard milks and children regularly consuming adapted milk formulas. Our goal was to evaluate current sugar intake levels (intrinsic and added) and their major dietary sources within the EsNuPI study participants by applying two 24-h dietary recalls that were completed by 1448 children (1 to <10 years) divided into two subsamples: One “Spanish Reference Sample” (SRS) of the general population (n = 707) and another sample which included children consuming adapted milks including follow-on milk, toddler’s or growing up milk and fortified and enriched milks, here called “Adapted Milk Consumers Sample” (AMS) (n = 741). Estimates of intrinsic and added sugar intakes from the Spanish EsNuPI population as well as the adherence to recommendations varied notably according to age segment, but no major differences between subsamples were found. Younger children (1 to <3 years) showed the highest added sugar contribution to total energy intake (TEI) (SRS: 12.5% for boys and 11.7% for girls; AMS: 12.2% for boys and 11.3% for girls) and the lowest adherence to recommendations set at <10% TEI (SRS: 27.4% for boys and 37.2% for girls; AMS: 31.3% for boys and 34.7% for girls). Adherence increased with age but remains inadequate, with approximately one in two children from the older age segment (6 to <10 years) exceeding the recommendations. Main food sources of intrinsic sugars for both subsamples were milk and dairy products, fruits, vegetables and cereals, while for added sugars, these were milk and dairy products (mainly yogurts), sugars and sweets (mainly sugary cocoa and nougat), bakery products (mainly cookies) and cereals (mainly bread and wheat flour). However, for the AMS, the groups milk and dairy products and cereals showed a significantly lower contribution to intrinsic sugar intake but a significantly higher contribution to that of added sugars. These results demonstrate that sugar intake and the adherence to recommendations in the studied population varied notably according to age but not to the type of milk consumed. In addition, our results highlight the need to monitor the consumption of added sugars by the infant population, as well as the need to make efforts to facilitate this task, such as harmonizing the recommendations regarding free/added sugars and the inclusion of information on their content on the nutritional labeling of products in order to incorporate them into food composition databases.Instituto Puleva de Nutrición (IPN)dairy company LactalisResearch Plan of the Vice-Rectorate of Research and Transfer of the University of Granada, Spai

Electrochemical sensors modified with combinations of sulfur containing phthalocyanines and capped gold nanoparticles: A study of the influence of the nature of the interaction between sensing materials

Producción CientíficaVoltametric sensors formed by the combination of a sulfur-substituted zinc phthalocyanine (ZnPcRS) and gold nanoparticles capped with tetraoctylammonium bromide (AuNPtOcBr) have been developed. The influence of the nature of the interaction between both components in the response towards catechol has been evaluated. Electrodes modified with a mixture of nanoparticles and phthalocyanine (AuNPtOcBr/ZnPcRS) show an increase in the intensity of the peak associated with the reduction of catechol. Electrodes modified with a covalent adduct-both component are linked through a thioether bond-(AuNPtOcBr-S-ZnPcR), show an increase in the intensity of the oxidation peak. Voltammograms registered at increasing scan rates show that charge transfer coefficients are different in both types of electrodes confirming that the kinetics of the electrochemical reaction is influenced by the nature of the interaction between both electrocatalytic materials. The limits of detection attained are 0.9 × 10−6 mol∙L−1 for the electrode modified with the mixture AuNPtOcBr/ZnPcRS and 1.3 × 10−7 mol∙L−1 for the electrode modified with the covalent adduct AuNPtOcBr-S-ZnPcR. These results indicate that the establishment of covalent bonds between nanoparticles and phthalocyanines can be a good strategy to obtain sensors with enhanced performance, improving the charge transfer rate and the detection limits of voltammetric sensors.Ministerio de Economía, Industria y Competitividad - Fondo Europeo de Desarrollo Regional (projects RTI2018-097990-B-I00 / CTQ2017-87102-R)Junta de Castilla y Leon - Fondo Europeo de Desarrollo Regional (project VA275P18