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ABSTRACT: The phenylalanine hydroxylase (PAH) in the liver hydroxylates phenylalanine from the diet. Fetuses depend for the hydroxylation of phenylalanine the maternal metabolism , fetal maturity does not come until week 26. Though the women with PAH deficiency (phenylketonuria, PKU) not adequately hydroxylate phenylalanine diet so their blood levels are high. Fenilalaninemia levels are considered neurotoxic teratogenic and above 360 umol/L (N < 120). Pregnant women should strictly follow PKU dietary treatment and/or drug to maintain levels of fenilalaninemia < 180 umol/L and avoid the teratogenic complications in the fetus (Hyperphenylalaninaemias Maternal Fetal Syndrome), as the case presented. We recommend discarding Phenylketonuria in women who have not been done a neonatal screening and/or have abortions, children with microcephaly, cardiac or renal malformations.
Nutricion hospitalaria: organo oficial de la Sociedad Espanola de Nutricion Parenteral y Enteral 10/2012; 27(5):1658-61. · 1.12 Impact Factor
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C Vázquez Martínez
Revista Clínica Española 10/2010; 210(9):454-6. · 2.01 Impact Factor
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C Vázquez Martínez
Revista Clínica Española 11/2009; 209(10):516-8. · 2.01 Impact Factor
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C Vázquez Martínez
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ABSTRACT: 1. Medical and surgical stress (major surgery, sepsis, injuries,...) increases requirements of certain essential nutrients and others considered non-essential or semi-essential. 2. Some nutrients such as glutamine, arginine, omega 3 fatty acids nucleotides, ... have a considerable influence on the immune function (delayed hypersensitivity, lymphocyte sub-population counts, immunological tests,..) and improve certain metabolic and nutritional indices (nitrogen balance, medium and short life proteins,...). For this reason, they are called "immunonutrients" or "immunity regulators". 3. The supply of special enteral formulas for situations of immunological compromise, with the addition of one or more of the nutrients considered today as "immunity regulators" has increased since 1988 in both absolute and percentage terms. 4. These nutrient-enriched enteral formulas improve the rate of infections, reduce the number of days on ventilator equipment, the length of hospital stays for critical patients, with a more marked effect on surgical patients. 5. The evidence seems today to support the use of enriched formulas with critical patients. Nonetheless, some caution must be maintained as it has not been possible to show any reduction in the mortality of the cases studied nor, in short, in the prognosis of patients affected by situations of hypercatabolism and reduced immunity. 6. We feel that their use should, therefore, be carried out in accordance with the protocols and in patients expected to survive, where the evolution reveals severe catabolism unhindered by conventional therapy.
Nutricion hospitalaria: organo oficial de la Sociedad Espanola de Nutricion Parenteral y Enteral 02/2000; 15 Suppl 1:69-74. · 1.12 Impact Factor
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ABSTRACT: In our society advertising compaigns promote consumption of superfluous foods, such as sweets and snacks, displacing the intake of other basic nutrients. The aim of this study is to assess the intake of these foods by children, their relative contribution to overall macronutrient intake and their effects on health.
A dietary assessment was performed on a representative sample of scholar children from the Autonomous Community of Madrid. It reflects food consumption for a 4-days period (3 week-days and 1 weekend day) in 2,698 boys and girls aged 6 to 15 years. The intake is expressed as grams per 1,000 kcal to standardize nutrient consumption in boys and girls. Lipid profile and several markers of nutritional status are also determined.
The consumption of sweets and snacks items per 1,000 kcal is higher in boys than in girls (35.8 +/- 20.0 and 34.2 +/- 19.6 g/1,000 kcal, respectively; p = 0.01) and increases during adolescence (12 and 13 years) in both sexes. Sweets and snacks provide 16.1% of dietary total caloric intake, 7.1% of saturated fatty acids, 10.7% of monounsaturated fatty acids, 10.4% of polyunsaturated fatty acids and 11.3% of cholesterol. Children of ages 6, 7, 8 and 9 years with high calculated LDL-cholesterol levels (> or = 120 mg/dl) consume significative higher amounts of sweet foods than children with low calculated LDL-cholesterol levels (< or = 90 mg/dl).
Children from the Autonomous Community of Madrid, Spain consume excessive sweets, which could be responsible for a higher prevalence of diseases related to this intake, such as caries, obesity and obesity-related associate diseases.
Medicina Clínica 06/1997; 109(3):88-91. · 1.38 Impact Factor
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ABSTRACT: The aim of this study was to assess the intake of foods of animal origin other than milk, as well as their role in the diet of children, in a representative sample of a school-aged population from the Community of Madrid (CAENPE study). A 4 day assessment of the dietary intake was conducted by applying a combination of the methods of 24-hour recall and a written record of the estimated consumption. We studied 2,608 schoolchildren between the ages of 6 and 14 years. The subjects were divided into groups according to age and sex. We found that the average meat intake was 213 +/- 87 g/person/day. The consumption of meat was significantly higher in boys (p < 0.05) and increased with age both in boys (p < 0.001) and girls (p < 0.05). Meat provided 40% of the saturated fat, 34% of the cholesterol and 33.5% of the protein in the diet. Fish intake was 77 +/- 64 g/person/day, with higher consumption in boys (p < 0.05) and with no influence of age. Fish supplied 11% of the dietary protein and only 1.2% of the saturated fat. Egg consumption was 31 +/- 20 g/day/person, which represents 3 eggs per week. The consumption of eggs was also higher in boys than in girls (p < 0.05) and provides 28% of the dietary cholesterol. We conclude that meat provides more than one third of the dietary protein and alone covers the RDA for protein. In addition, meat also contributes the highest amount of dietary saturated fat and cholesterol. Egg and fish intake is adequate; hence, it would be desirable to reduce the excessive meat intake in order to equilibrate the macronutrients and cholesterol supplied by the diet.
Anales espanoles de pediatria 04/1996; 44(3):209-13.
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ABSTRACT: The aim of this report, included in the CAENPE study, was to assess the actual intake of milk products by children from Madrid and their nutrient contribution to the diet. In a sample of 2,608 children, 1,343 boys and 1,265 girls, between 6 and 14 years of age, representative of the school child population from Madrid, a dietary assessment of 4 non-consecutive days was carried out by applying a combination of the methods of 24-hour recall (2 days) and an estimated food intake record (2 days). We found that the average total milk product intake was 410 +/- 173 g/person/day, with this being significantly higher in boys (p < 0.0001) and increasing with age (p < 0.001). Milk products are the primary source of calcium, 1,076 +/- 374 mg/person/day, which represents 61% of the total calcium intake and is below the RDA for children over 10 years of age. In addition, following meat and meat products, dairy products are the second largest source of saturated fat (28% of total intake). They also supply 31% of the dietary phosphorus, 17% of protein, 16% of total fat, 15% of the cholesterol, 10% of the carbohydrates and 14% of the the energy intake. We conclude that milk products are the major source of calcium in the diet of schoolchildren. Their low consumption explains the insufficient calcium intake in certain age groups, which might be associated to a higher risk of osteoporosis in later life. We encourage an increase in the intake of milk products, especially milk, and a reduction in the consumption of sweets and meat in order to decrease the dietary saturated fats.
Anales espanoles de pediatria 04/1996; 44(3):214-8.
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ABSTRACT: We present the outcomes of GIQLI Questionnaire (Gastrointestinal Quality of Life) application to three groups of healthy individuals: the first one, consumers of pasteurized yogurt; the second one, consumers of non-pasteurized yogurt; and the third one, a comparison control group of non-consumers. The results from the three groups are in agreement with other validation studies of the Questionnaire, not finding significant differences between groups.
Nutricion hospitalaria: organo oficial de la Sociedad Espanola de Nutricion Parenteral y Enteral 20(6):420-8. · 1.12 Impact Factor
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J J de Dios Sanz,
C Fernández Estívariz,
D del Olmo García,
V Alcázar Lázaro,
M Gargallo Fernández,
I Miranda Nicolás,
D Sarrión Pelous,
T López del Val,
M A Jaunsolo Barrenechea,
P Martínez de Icaya Ortiz de Urbina, C Vázquez Martínez
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ABSTRACT: To evaluate the influence of health care education of the diet, we studied, in a sample of 68 workers (47 men and 21 women), the usual food intake (by means of a weekly registration technique), the anthropometry and the lipid profile, before and after giving a nutritional information program which lasted one year. At the end thereof, we observed a significant reduction in the global caloric intake, at the expense of a lower supply of proteins and fats (mainly saturated fats), which translated into a percentile distribution of macronutrients, which more closely resembles the dietary recommendations. The average anthropometric parameters did not vary. With respect to the lipid profile, a decrease of the plasma levels of LDL and HDL cholesterol was observed. These results confirm the capacity of educational interventions in changing the eating habits to a more healthy style, with repercussions on the lipid profile.
Nutricion hospitalaria: organo oficial de la Sociedad Espanola de Nutricion Parenteral y Enteral 11(6):334-8. · 1.12 Impact Factor
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ABSTRACT: Enteral nutrition is an artificial form of nutrition which is expanding an there are thus a great many commercial preparations on the market which are rapidly being developed. This study is a presentation of the quantitative and qualitative changes in these preparations from 1988-1991, classified depending upon their main nutrient: proteins. In global terms, there has been an increase of 18 formulae, distributed among different types, but with the most spectacular increase in special diets. Discussion of the trends observed, which respond to further knowledge on the absorption or tolerance of nutrients and nutritional needs in different pathologies.
Nutricion hospitalaria: organo oficial de la Sociedad Espanola de Nutricion Parenteral y Enteral 7(2):130-6. · 1.12 Impact Factor
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ABSTRACT: Inappropriate dietary treatments against obesity may worsen patients' metabolic and cardiovascular risk, lead to malnutrition, facilitate the appearance in predisposed individuals of eating disorders and ultimately favor the recovery of previously lost weight. Nonetheless, incorrect therapies aimed at reducing weight, sometimes accompanied by promises of miraculous results, are still rather frequent in our country. The public criticism by Drs. Monereo and Vazquez of a concrete method used by several very popular clinics in Madrid, resulted in the director of those centers suing them for libel. In this special article, we summarize the facts, analyze the methods used in those clinics and their likely negative consequences as well as sketch the content of the verdict of one of the trials, already concluded. Its main conclusions are the following: 1) Health education and the defense of public health is a professional duty; 2) The incorrect treatment of obesity can increase the risks associated with it; 3) There is a sufficient spanish and international consensus as well as Guidelines that clearly specifies the requisites of good medical practice with regard to obesity; 4) In spite of that, there are still treatments that constitute deception and fraud of different kinds and that respond more to business motivations rather than professional ones; 5) The fact of being sued as a result of activities that make part of a responsible behavior within an institution and whose purpose is the public benefit has entailed a serious, difficult and painful situation. We consider that the relevance and interest of the verdict warrants its diffusion because it constitutes a reference for professionals and may be decisive in the struggle against bad practices in obesity treatment.
Nutricion hospitalaria: organo oficial de la Sociedad Espanola de Nutricion Parenteral y Enteral 23(3):177-82. · 1.12 Impact Factor
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ABSTRACT: Integrated and shared information systems allow obtaining a high degree of information about processes, costs and outcomes, and considerably reducing prescription errors. Assisted electronic prescription, in the setting of total parenteral nutrition, integrated with other hospital databases and with the hospital drugs management system, is a tool that allows increasing patient' safety (by reducing prescription errors), improving quality assistance, improving information systems and information management and the efficiency of used resources. In this work, implementation of an assisted electronic prescription system applied to parenteral nutrition in a hospital and processes reengineering performed in the nutrition setting are described. This implementation was performed by medical staff from the Nutrition and Diet Department and pharmacists from the Pharmacy Department of Ramón y Cajal Hospital using "Nutriwin" computer software. For two months prior and after its implementation, a follow-up of time consumed in the circuit prescription-validation-elaboration-dispensation of parenteral nutrition formulas has been performed. After implementation, treatment orders reach on average 1 h and 15 minutes sooner the Pharmacy Department; by avoiding transcription, a saving of 3 min per nutrition formula calculations is achieved, besides reducing potential errors; elaboration of nutrition formulas can be started on average 1 h and 20 minutes sooner as compared to manual prescription. Besides, the staff that writes down the prescription may know in real time the nutritional profile for each patient in the current episode and the patient's historic. Electronic prescription of treatment orders in this area has represented for our hospital an optimization of the employed resources, a reduction of potential errors that may occur, an improvement in consumption management, and an increase in the whole process quality.
Nutricion hospitalaria: organo oficial de la Sociedad Espanola de Nutricion Parenteral y Enteral 20(3):173-81. · 1.12 Impact Factor
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ABSTRACT: The first ecological epidemiological studies revealed the possible preventive role of some foods which contain antioxidant compounds on cardiovascular disease and on some types of cancer. Nevertheless, later further research and the initial population-based supplementary tests at therapeutic doses have rendered contradictory results. To elucidate the cause-effect relationship of the antioxidant nutrients, the SU.VI.MAX study was considered in France. This is a prospective population-based study of randomized, double blind intervention, the prime objective of which is that of evaluating the effectiveness of a combination of antioxidant minerals and vitamins at nutritional dosages on the morbimortality by cancer and ischemic heart disease of a cohort of 12,749 volunteers of both sexes, ranging from 35 to 60 years of age, spread throughout France over an eight-year period. Likewise, an evaluation was also made of the impact of the supplement on the incidence of infectious disease, cataracts, the individual feeling of well-being and the use of health care resources, the biological markers of the vitamin and mineral status, the antioxidant activity, the immune condition and the evolution of the cardiovascular risk factors. The final points of this study are: the overall mortality, the specific mortality by cancer and/or ischemic heart disease, the incidence of cancer (of any type) and the incidence of ischemic heart disease. The assessment tools employed were: a monthly health questionnaire filled out telematically, a yearly clinical or analytical health check-up every other year, as well as the exhaustive monitoring and documentation of the adverse events and serious health problems. To ascertain the eating behavior and the evolution thereof in the individuals comprising the cohort, an eating survey was filled out twice a month. A description is provided of the means and methods employed in this study, the originality and magnitude of which entail unique aspects which serve to remedy some problems of nutritional epidemiology, as well as the strategies employed for maintaining the active collaboration of the cohort and the exhaustive monitoring thereof. Two years into this study, the consolidation of the monitoring organization and the low drop-out rate afford the possibility of anticipating that the SU.VI.MAX study is going to provide some answers of interest with regard to the relationship between antioxidants and good health.
Revista Española de Salud Pública 72(3):173-83. · 0.71 Impact Factor
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ABSTRACT: To evaluate the effectiveness of PRECEDE model for health education, in the metabolic control and the reduction of cardiovascular risk factors, in type 2 diabetic patients followed for over two years in primary health care services.
PRECEDE model for health education was used in 318 patients with type 2 diabetes, from five primary health care centres. The study was conducted during two years of monitoring.
After two years of follow-up was observed decrease in diastolic and systolic pressures (p < 0.05), as well as in levels of total cholesterol and LDL-cholesterol (p < 0.05). Patients with good metabolic control (glycated hemoglobin A1c < 7% and LDL cholesterol < 100 mg/dl), increased from 9.9% to 16.8% (p < 0,05). On the other hand, 27% of patients improved their level of therapeutic adherence, and there was a decreased in the number of patients with microalbuminuria from 8.4% to 6.3% (p = 0.05). Finally, we found no differences in levels of glycated hemoglobin A1c, BMI and cardiovascular risk. Mortality after two years was 0.7%.
PRECEDE model for health education is a useful method in the management of type 2 diabetes, that reduce the levels of blood pressure both systolic and diastolic, decrease the lipid levels, and improve the level of therapeutic adherence in type 2 diabetic patients, followed for two years.
Revista Clínica Española 209(7):325-31. · 2.01 Impact Factor
