Nutrición

Nutrici ó n
  • 文章类型: Journal Article
    背景:母乳喂养似乎可以保护婴儿肥胖的发生。目的是了解母乳喂养持续时间是否与12个月和24个月的婴幼儿肥胖风险有关。
    方法:在PAPenRed研究网络框架内进行的儿科初级保健系统中,对2017年4月至2018年3月在西班牙出生的儿童队列进行了前瞻性纵向研究(LAYDI研究)。分析母乳喂养持续时间(第1组:少于6个月;组:超过6个月)及其与人体测量变量的关联。
    结果:共有1495名患者参加了12个月的预防性儿童健康访问,1073名患者参加了24个月的访问。我们发现母乳喂养时间与年龄体重之间存在统计学上的显着关联,12个月和24个月时的年龄BMI和身长/身高体重;母乳喂养持续时间少于6个月与12个月和24个月时的超重和肥胖(基于年龄BMI和身长/身高体重)显着相关。孕妇孕前BMI是母乳喂养持续时间与超重和肥胖(基于年龄BMI)之间关联的调节器。
    结论:母乳喂养时间少于6个月与12个月和24个月时超重和肥胖的比例更高,尽管孕妇孕前BMI在24个月时改变了这种关系。
    BACKGROUND: Breastfeeding appears to protect the onset of obesity in infants. The aim is to know whether breastfeeding duration is associated with the risk of obesity in infants and toddlers aged 12 and 24 months.
    METHODS: Prospective longitudinal study in a cohort of children born in Spain between April 2017 and March 2018 (LAyDI study) in the paediatric primary care system conducted in the framework of the PAPenRed research network. Analysis of breastfeeding duration (group 1: fewer than 6 months; group: more than 6 months) and its association with anthropometric variables.
    RESULTS: A total of 1495 patients attended the 12 months preventive child health visit and 1073 patients the 24 months visit. We found a statistically significant association between breastfeeding duration and weight-for-age, BMI-for-age and weight-for-length/height at 12 and 24 months; breastfeeding duration of less than 6 months was significantly associated with overweight and obesity (based on BMI-for-age and weight-for-length/height) at ages 12 and 24 months. Maternal pre-pregnancy BMI acted as a modifier on the association between breastfeeding duration and overweight and obesity (based on BMI-for-age).
    CONCLUSIONS: A breastfeeding duration of less than 6 months is associated with a higher percentage of overweight and obesity at ages 12 and 24 months, although maternal pre-pregnancy BMI modifies this relationship at 24 months.
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  • 文章类型: English Abstract
    肠道寄生虫病构成了世界性的公共卫生问题,在发展中国家的患病率更高,主要影响儿童。这项研究的目的是针对圣达菲三个儿童发展中心(CDI)的儿童的母亲/监护人制定教育干预措施,阿根廷,在2018年。使用描述性的,准实验设计,进行干预前和干预后评估。这项干预包括36名母亲,分三个阶段进行:诊断,干预和最终评估。同时,对48名5岁以下儿童进行了共寄生虫学研究,他们在CDI中得到了帮助,目的是了解和解决儿童人群中普遍存在的寄生虫感染。可以比较教育干预前后的正确答案,观察到正确答案的平均数量有统计学上的显着增加(p=0.008742)。在54%的儿童人群中发现了肠寄生虫,10%被寄生,6%有两个以上的寄生物种。最常见的寄生虫是囊胚菌属。,肠贾第鞭毛虫和蛔虫。教育干预是积极的,从而提高了有关肠道寄生虫病及其预防的知识水平。这种教育干预经验强调了持续教育在促进健康生活方式和预防弱势群体寄生虫病方面的重要性。
    Intestinal parasitic diseases constitute a cosmopolitan public health concern, with greater prevalence in developing countries, and mainly affecting children. The aim of this study was to develop an educational intervention aimed at mothers/guardians of children attending three child development centers (CDI) in Santa Fe, Argentina, during 2018. An educational intervention was conducted using a descriptive, quasi-experimental design, with pre- and post-intervention assessment. This intervention included 36 mothers, and was carried out in three stages: diagnosis, intervention and final evaluation. Simultaneously, a coproparasitological study was performed on 48 children under 5 years of age, who were assisted in the CDI, with the aim to understand and address the parasitic infections prevalent in the child population. It was possible to compare the correct answers before and after the educational intervention, observing a statistically significant increase (p=0.008742) in the average number of correct answers. Enteroparasites were identified in 54% of the population of children analyzed, 10% were biparasitized and 6% had more than two parasitic species. The most frequently detected parasites were Blastocystis spp., Giardia intestinalis and Ascaris lumbricoides. The educational intervention was positive, resulting in an improvement in the level of knowledge related to intestinal parasitosis and its prevention. This educational intervention experience highlights the importance of ongoing education in promoting a healthy lifestyle and preventing parasitosis in vulnerable populations.
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  • 文章类型: Journal Article
    背景:坚持地中海饮食(Dietmed)对心血管疾病(CVD)具有保护作用。在下肢外周动脉疾病(PAD)中,分析这些数据的研究较少。
    目的:为了确定PAD患者对饮食和饮食习惯的依从性,根据CVD病史(冠状动脉和/或脑缺血病理)和踝肱指数(ABI≥或<0.5)。
    方法:在三级医院进行的横断面分析研究。连续收集样品。社会人口统计学和临床史,包括踝臂指数(ABI)和14点饮食依从性饮食问卷。分类变量的分析采用皮尔逊卡方检验,独立样本的T-Student统计检验用于参数变量,非参数变量采用U.Mann-Whitney检验.
    结果:在97名患者中,87,6%的人对饮食的依从性较低,根据PAD的严重程度没有差异。然而,当我们根据他们是否有CVD病史分析数据时,我们观察到饮食中包含的一些项目的依从性很高,具体来说,在CVD组中,瘦肉的消费量(95,5%vs64%;P=.004)。此外,我们观察到无CVD病史组的消耗量存在显著差异(32%vs9.1%;P=0.033).
    结论:在我们的人群中,PAD患者,无论疾病的阶段以及他们是否有相关的冠状动脉或脑缺血病理,对饮食的依从性低。因此,在PAD患者的各个阶段实施营养教育计划非常重要,以及那些已经患有血管事件的患者,以便他们长期坚持健康的饮食习惯。
    BACKGROUND: Adherence to the Mediterranean diet (Dietmed) exerts protective effects on cardiovascular disease (CVD). In the Lower Extremity Peripheral Arterial Disease (PAD) there are fewer studies that analyze these data.
    OBJECTIVE: To determine adherence to Dietmed and dietary habits in patients with PAD, according to a history of CVD (coronary and/or cerebral ischaemic pathology) and according to the ankle-brachial index (ABI ≥ or <0,5).
    METHODS: Cross-sectional analytical study carried out in a tertiary hospital. The sample was collected consecutively. Sociodemographic and clinical history, ankle-brachial index (ABI) and a 14-point Dietmed adherence dietary questionnaire were included. The analysis of categorical variables was carried out using the Pearson\'s Chi-Square test, the T-Student\'s statistic test for independent samples was used for parametric variables and the U. Mann-Whitney test for non-parametric variables.
    RESULTS: Of the 97 patients, 87,6% had low adherence to Dietmed, with no differences according to the severity of PAD. However, when we analysed the data according to whether or not they had a history of CVD, we observed a high adherence to some items included in Dietmed, specifically, in the CVD group, the consumption of lean meat (95,5% vs 64%; P=.004). In addition, we observed a significant difference in the consumption in the group without a history of CVD (32% vs 9,1%; P=.033).
    CONCLUSIONS: In our population, patients with PAD, regardless of the stage of the disease and whether they had associated coronary or cerebral ischaemic pathology, had low adherence to Dietmed. Therefore, it is important to implement nutritional education programmes in patients with PAD in all stages, as well as in those patients who have already suffered a vascular event, so that they maintain adherence to healthy dietary habits in the long term.
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  • 文章类型: Journal Article
    背景:内分泌学和营养学(EyN)是门诊和医院医学专业。本研究旨在了解EyN在三级医院住院楼层进行的部门间咨询(IC)活动的演变,将其演变与其他医学专业进行比较,比较内分泌IC和营养IC。
    方法:纵向和回顾性研究,分析了2013年1月1日至2022年31月12日期间EyN和其他医学专业的IC注释。
    结果:EyN服务机构共进行了76093例IC(12623例患者)(平均年龄65.4岁;59%为男性),平均每位患者4.8例。平均年增长率为7%,患者为4%(相对于所有其他医疗服务的6%和3%,差异具有统计学意义)。在所有住院4天或更长时间的患者中,EyN从7.9%(2013年)上升到12.3%(2022年)。EyN进行的IC中有66%用于营养原因,而34%用于其他病理。
    结论:EyN服务是大多数患者参加医院IC活动的服务,过去几年的增长速度超过了其他医学专业。营养病理学是IC的主要原因。
    BACKGROUND: Endocrinology and Nutrition (EyN) is an outpatient and hospital medical specialty. This study aims to understand the evolution of the activity of interdepartmental consultation (IC) carried out by EyN in hospitalization floor of a third level hospital, comparing its evolution with other medical specialties, and comparing endocrine IC with nutritional IC.
    METHODS: Longitudinal and retrospective study which analyzes IC notes of EyN and other medical specialties between 01-01-2013 and 31-12-2022.
    RESULTS: A total of 76093 IC notes (12623 patients) were performed by the EyN service (average age 65.4 years; 59% male) with an average of 4.8 notes per patient. Average annual growth was 7% in notes and 4% in patients (versus 6% and 3% of all other medical services, differences statistically significant). Of all patients hospitalized for 4 or more days, EyN went from attending 7.9% (2013) to 12.3% (2022). 66% of the IC performed by EyN was for nutritional cause and 34% for other pathologies.
    CONCLUSIONS: The EyN service is the one that most patients attend in hospital IC activity, with growth over the last few years greater than other medical specialties. Nutritional pathology is the main reason for IC.
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  • 文章类型: Journal Article
    目的:探索需求,动机,以及与健康饮食和数字材料有关的限制,以及确定他们的设计模式,作为针对墨西哥家庭的策略。
    方法:通过焦点小组会议对该现象进行的定性观察研究。
    方法:克雷塔罗市的公共小学教育中心,墨西哥。
    方法:9至11岁的儿童和父母,母亲们,或有孩子在初等教育中的看护人。
    方法:对三组学生进行了12次课程,对家长进行了2次课程,母亲们,或使用采访指南的护理人员。各种数字材料,基于社会认知理论开发的,在会议期间介绍。在参与者或其监护人事先同意的情况下记录会议,并转录分析。对分析的关键点进行编码,信息饱和得到证实。
    结果:学生表达了对促进游戏和实验的数字材料的动机,尤其是在家庭背景下。主要的感知障碍是护理人员对变化的抵抗力。父母表达了动机,需要关于疾病的解释性材料,与经济和时间相关的障碍。
    结论:基于社会认知理论的数字材料,旨在改善营养,如果考虑到目标人群的情况,可以成为营养教育的有效策略。建议包括情感和行为元素,以在家庭中实现有意义的学习。
    OBJECTIVE: To explore the needs, motivations, and limitations related to healthy eating and digital materials, as well as to identify patterns for their design as a strategy aimed at Mexican families.
    METHODS: A qualitative observational study of the phenomenon through focus group sessions.
    METHODS: A public primary education center in the city of Querétaro, Mexico.
    METHODS: Children aged 9 to 11 years and parents, mothers, or caregivers with children in primary education.
    METHODS: Twelve sessions were conducted with three groups of students and two sessions with parents, mothers, or caregivers using an interview guide. Various digital materials, developed based on social cognitive theory, were presented during the sessions. The sessions were recorded with the participants\' or their guardians\' prior consent and transcribed for analysis. Coding was performed for key points of analysis, and information saturation was confirmed.
    RESULTS: Students expressed motivation towards digital material that promotes play and experimentation, especially within the family context. The main perceived barrier was the caregivers\' resistance to change. Parents expressed motivation and a need for explanatory material on diseases, with economic and time-related barriers.
    CONCLUSIONS: Digital material based on social cognitive theory, designed to improve nutrition, can be an effective strategy in nutritional education if it considers the circumstances of the target population. It is advisable to include affective and behavioral elements to achieve meaningful learning within households.
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  • 文章类型: Journal Article
    目标:内分泌学和营养学(E&N)及其相关疾病的重要性要求其在医学学位范围内的教学必须符合质量和同质性的适当标准。我们的目标是扩大西班牙E&N本科教学的数据。
    方法:我们设计了一个观察,基于网络的横断面研究针对在2020-2021学年期间教授该学科的42个医学院的E&N教学协调员。
    结果:三分之一的学院有一位E&N专家教授,但不到一半的人拥有E&N的正式教授教学计划有很大的可变性,尽管他们中的大多数都为该主题提供了6ECTS学分。超过三分之二的学院保持理论课程,每班50多名学生。大多数程序花4到6个小时来治疗下丘脑垂体疾病,甲状腺疾病和肾上腺疾病。然而,糖尿病和营养的时间差异很大。在三分之一的院系中,学生不需要在E&N部门进行轮换。大学的教师广泛参与本科/硕士学生的最终项目和硕士学位研究。
    结论:E&N专业在大学中保持着良好的地位,但该学科的教学结构仍然存在很大的异质性。
    OBJECTIVE: Advances in endocrinology and nutrition (E&N) and the importance of its associated disorders require that its teaching within the medical degree meets adequate standards of quality and homogeneity Our objective was to expand the data on E&N undergraduate teaching in Spain.
    METHODS: We designed an observational, cross-sectional web-based study addressed to the coordinators of E&N teaching at the 42 faculties of medicine that had taught the subject during the 2020-2021 academic year.
    RESULTS: One in three faculties had a professor who was an E&N specialist, but less than half had a full professor of E&N. There is great variability in teaching programmes, although most of them dedicate 6 ECTS credits to the subject. Over two-thirds of the faculties maintain theoretical lessons with over 50 students per class. Most programmes dedicate between four and six hours to hypothalamic pituitary disorders, thyroid diseases and adrenal gland disorders. However, there is great variability in the time dedicated to diabetes and nutrition. In one-third of the faculties, students are not required to do a rotation in the E&N department. Teachers at the universities widely participate in undergraduate/master\'s students\' final projects and master\'s degree studies.
    CONCLUSIONS: The E&N specialty maintains a good position within universities, but there is still great heterogeneity in the teaching structure of the subject.
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  • 文章类型: Journal Article
    背景:受SARS-CoV-2影响的危重患者有营养不良的风险。需要避免体积超负荷和延迟达到营养要求的动作,例如内旋,使这些患者的营养方法变得复杂。为了确保适当的治疗,制定了适合COVID-19患者的营养支持方案,作为临床实践指南.
    目的:描述和分析针对SARS-CoV-2患者的营养支持方案的结果,该方案于2020年3月至5月入住瓦伦西亚综合大学(CHGUV)的重症监护病房(ICU)。
    方法:观察性,描述性,描述性回顾性和纵向设计,以评估对营养支持方案的依从性。
    结果:纳入了31例连续患者,但8例患者未能进行营养随访。在剩下的23名患者中,在开始治疗后的第10天(良好依从性组)和第11天(不良依从性组)之后,只有8个达到了80%的热量需求。在“良好依从性”组中,75%(n=6)出院,25%死亡(n=2),与“不良依从性”组相比,其中53%(n=8)出院,47%(n=7)死亡(卡方检验,p值=0.019)。与未住院的患者相比,在ICU住院期间达到80%热量需求的患者住院时间较短(中位入院天数=14,IQR=10-16,中位入院天数=22,IQR=13-39,p值=0.025)。
    结论:在SARS-CoV-2大流行的前几周引入营养方案可以通过促进愈合和减少相关并发症来改善临床结局。
    The critical patient affected by SARS-CoV-2 is at risk of malnutrition. The need to avoid volume overload and manoeuvres that delay reaching nutritional requirements such as pronation make the nutritional approach to these patients complex. To ensure adequate treatment, a nutritional support protocol was developed as a clinical practice guideline adapted to the COVID-19 patient.
    To describe and analyse the results of introducing a nutritional support protocol aimed at SARS-CoV-2 patients admitted to the intensive care unit (ICU) of the Consorcio Hospital General Universitario de Valencia (CHGUV) from March to May 2020.
    Observational, descriptive, retrospective and longitudinal design to evaluate compliance with a nutritional support protocol.
    Thirty-one consecutive patients were included but nutritional follow-up could not be performed in eight. Of the remaining 23 patients, only eight reached 80% of caloric requirements before the tenth day after starting treatment (good compliance group) and 15 after the eleventh day (poor compliance group). In the group with «good compliance» 75% (n=6) were discharged and 25% died (n=2), compared to the group with «bad compliance» where 53% (n=8) were discharged and 47% (n=7) died (Chi square test, p-value=0.019). Those patients who reached 80% of caloric needs during ICU stay had a shorter length of stay compared to those who did not (median days of admission=14, IQR=10-16 and median days of admission=22, IQR=13-39, p-value=0.025).
    Introducing a nutritional protocol during the first weeks of the SARS-CoV-2 pandemic could improve clinical outcomes by promoting healing and reducing associated complications.
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  • 文章类型: Journal Article
    假性甲状旁腺功能减退症(PHP)是一类疾病,其特征是靶组织对甲状旁腺激素的作用不敏感,因此,由于严重程度不同的高磷血症和低钙血症的存在。早发性肥胖是PHP1A型的特征。本文讨论了建立统一的标准以指导PHP患者的营养管理的必要性。能量消耗的减少需要调整饮食中的能量含量。减少富含无机磷的食物的摄入量有助于控制高磷酸盐血症。有针对性的营养应该是儿童和青少年PHP治疗计划的一部分,因为它有助于调节这些患者的钙和磷代谢失衡特征。
    Pseudohypoparathyroidism (PHP) is a spectrum of diseases characterized by insensitivity of target tissues to the action of parathyroid hormone and, consequently, by the presence of hyperphosphatemia and hypocalcaemia of varying severity. Early-onset obesity is a feature of PHP type 1A. This article discusses the need to establish uniform criteria to guide the nutritional management of patients with PHP. A decrease in energy expenditure calls for an adjustment of the energy content of the diet. Reducing the intake of foods rich in inorganic phosphorus helps to manage hyperphosphataemia. Targeted nutrition should be part of the treatment plan of children and adolescents with PHP, since it contributes to modulating the calcium and phosphorus metabolism imbalances characteristic of these patients.
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  • 文章类型: Observational Study
    背景:PraderWilli综合征(PWS)的主要特征之一是饮食过多和肥胖。这项研究旨在评估非药物跨学科方法下PWS患者与饮食亢进相关的行为。
    方法:这项观察性研究包括接受常规跨学科治疗(RTT)的传统非药物营养方法的PWS患者和没有RTT的PWS个体对照组。所有个体均使用临床试验饮食亢进问卷(HQ-CT)进行评估。
    结果:对43个人进行了评估。基线(治疗开始)时的平均年龄在RTT组为18.4±8.3岁,在对照组为19.1±6.9岁(p=0.74)。在RTT患者中,与饮食过度相关的行为明显较低(RTT5.7±3.7与对照组13.1±7.5,p<0.0001)。这也在三个类别中确定:争论或操纵以获得食物(2.71±2.1vs5.41±3.2,p=0.003),偷吃(1.33±1.5vs3.55±3.3,p=0.007),与食物有关的愤怒或发脾气(1.67±1.8vs4.09±2.7,p=0.001)。平均治疗时间为41.0个月后,RTT组的体重指数降低(基线38.7±17.1kg/m2与随访29.2±9.2kg/m2;p<0.0001).确定了RTT持续时间与BMI降低之间的显着关联(p=0.037)。
    结论:我们观察到,作为RTT的一部分,在非药物营养方法的背景下,PWS个体对与饮食过多和BMI降低相关的行为产生积极影响。
    BACKGROUND: One of the main characteristics of Prader Willi syndrome (PWS) is hyperphagia and obesity. This study sought to evaluate behaviours related to hyperphagia in individuals with PWS under a non-pharmacological transdisciplinary approach.
    METHODS: This observational study included PWS patients under a traditional non-pharmacological nutritional approach immersed within a regular transdisciplinary treatment (RTT) and a control group of PWS individuals without RTT. All individuals were evaluated using the Hyperphagia Questionnaire for Clinical Trials (HQ-CT).
    RESULTS: Forty-three individuals were evaluated. The mean age at baseline (treatment onset) was 18.4±8.3 years in the RTT group and 19.1±6.9 years in the control group (p=0.74). Hyperphagia-related behaviours were significantly lower among those under RTT (RTT 5.7±3.7 vs control 13.1±7.5, p<0.0001). This was also identified within the three categories: arguing or manipulating to obtain food (2.71±2.1 vs 5.41±3.2, p=0.003), sneaking food (1.33±1.5 vs 3.55±3.3, p=0.007), and anger or tantrums related to food (1.67±1.8 vs 4.09±2.7, p=0.001). After a mean treatment duration of 41.0 months, the RTT group had a reduction in body mass index (baseline 38.7±17.1kg/m2 vs follow-up 29.2±9.2kg/m2; p<0.0001). A significant association between RTT duration and BMI reduction (p=0.037) was identified.
    CONCLUSIONS: We observed a positive impact on behaviours related to hyperphagia and a BMI reduction in PWS individuals in a context of a non-pharmacological nutritional approach as part of an RTT.
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  • 文章类型: Journal Article
    comprobar la influencia de los conocimientos y los hábitos alimenticios en la sobrecarga ponderal según el ámbito de residencia (urbano o rural).
    se administró un cuestionario a 451 personas, residentes en la zona básica de salud de Villaviciosa (Asturias, España), entre 35 y 65 años, distribuidas en zona rural y urbana, formulario compuesto por preguntas sobre datos sociodemográficos, hábitos y conocimientos nutricionales. Se calcularon frecuencias relativas (%) para las variables cualitativas, y medias aritméticas (desviaciones estándar) para las cuantitativas. Se empleó la correlación de Pearson para comprobar o descartar la relación entre la puntuación en el cuestionario de conocimientos sobre nutrición y el índice de masa corporal (IMC). Para estudiar la relación entre cada pregunta del cuestionario de hábitos y el ámbito de residencia se empleó la prueba chi-cuadrado. Para comparar las medias del IMC por ámbito se aplicó la prueba t para muestras independientes. Se realizaron regresiones logísticas para calcular las odds ratio (OR) entre la variable dependiente (sobrecarga ponderal) y las variables sociodemográficas.
    la edad media de los encuestados fue de 49.96 años y el IMC promedio de 26.87 kg/m2, presentando sobrecarga ponderal el 57.6 % total. No leer las etiquetas nutricionales aumenta el riesgo de tener sobrecarga ponderal (OR = 2.2; p = 0.001); quienes consideran que comen en exceso muchas veces presentan mayor probabilidad de sobrecarga ponderal (OR = 8.6; p < 0.001); comer fuera de casa varias veces por semana (OR = 11.6; p = 0.019), así como el consumo de refrescos o zumos procesados (OR = 3.3; p = 0.013) y alcohol de baja graduación (OR = 2.8; p = 0.003) durante las comidas aumentan la probabilidad de sobrecarga ponderal.
    los hábitos alimenticios y los patrones de actividad física son los principales responsables de sobrecarga ponderal. El adecuado conocimiento en la población puede ayudar a la elaboración de un plan preventivo que permita frenar el crecimiento del sobrepeso y la obesidad.
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