María D. Ballesteros-Pomar

• PhD, MD
• Consultant at Complejo Asistencial Universitario de León

The Klotho gene is recognized for its anti-aging properties. Its downregulation leads to aging-like phenotypes, whereas overexpression can extend lifespan. Klotho protein exists in three forms: α-klotho, β-klotho and γ-klotho. The α-klotho has two isoforms: a membrane-bound form, primarily in the kidney and brain, and a secreted klotho protein pres...

Obesity and its complications are associated with high morbidity/mortality and a significant healthcare cost burden in Spain. It is therefore essential to know the potential clinical and economic benefits of reducing obesity. The objective of this study is to predict the decrease in rates of onset of potential complications associated with obesity...

Aim: To determine the treatment of hyperglycemia in the stroke unit, and to compare the morbidity and mortality of patients treated with an intravenous (iv) insulin therapy protocol compared to subcutaneous (sc) insulin when reaching glycemia levels of = 155 mg/dL. Patients and methods: We performed a prospective observational study of patients...

Objectives Metabolic bariatric surgery is a critical intervention for patients living with obesity and related health issues. Accurate classification and prediction of patient outcomes are vital for optimizing treatment strategies. This study presents a novel machine learning approach to classify patients in the context of metabolic bariatric surge...

Metabolic dysfunction-associated fatty liver disease is the most common cause of liver disease in our environment. The gold standard for diagnosis continues to be liver biopsy, although, since it is an invasive test, the most commonly used test for the initial diagnosis of steatosis is abdominal ultrasound. We present the results on the diagnostic...

Background The Global Leadership Initiative on Malnutrition (GLIM) approach to malnutrition diagnosis is based on assessment of three phenotypic (weight loss, low body mass index, and reduced skeletal muscle mass) and two etiologic (reduced food intake/assimilation and disease burden/inflammation) criteria, with diagnosis confirmed by fulfillment o...

El concepto de “desnutrición relacionada con la enfermedad” (DRE) dista mucho del concepto de la malnutrición diagnosticada clásicamente en salud pública, que se encuentra determinada por factores sociodemográficos. En el año 2008, la Sociedad Española de Nutrición Clínica y Metabolismo (SENPE) y la Sociedad Española de Documentación Médica (SEDOM)...

Bariatric surgery is increasingly used in women of childbearing age due to the rising prevalence of obesity and the effectiveness and availability of this treatment. Pregnancy in women with previous bariatric surgery deserves special attention. Weight loss induced by surgery reduces the risks that obesity poses to pregnancy. But on the other hand,...

Background: Disease-related malnutrition in polymorbid medical inpatients is a highly prevalent syndrome associated with significantly increased morbidity, disability, short- and long-term mortality, impaired recovery from illness, and cost of care. Aim: As there are uncertainties in applying disease-specific guidelines to patients with multiple...

Bariatric surgery is increasingly used in women of childbearing age due to the rising prevalence of obesity and the effectiveness and availability of this treatment. Pregnancy in women with previous bariatric surgery deserves special attention. Weight loss induced by surgery re-duces the risks that obesity poses for pregnancy. But on the other hand...

Background Bariatric surgery (BS) is a very effective treatment regarding body weight loss but might affect food tolerance and energy and protein intake. The aim of this study was to compare three BS techniques (biliopancreactic diversion (BPD), gastric bypass (GB), and sleeve gastrectomy (SG)) and their effect on food tolerance. Methods Prospecti...

Nutritional ultrasound® is a new concept that uses ultrasound to assess body composition. It is composed of the evaluation of fat-free mass and fat mass. It is an emerging, economical, portable, non-invasive technique that evaluates the musculoskeletal area with linear, broadband, multifrequency probes, with a depth field of 20-100mm. It quantifies...

The European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) launched the Sarcopenic Obesity Global Leadership Initiative (SOGLI) to reach expert consensus on a definition and diagnostic criteria for Sarcopenic Obesity (SO). The present paper describes the proceeding of the Sarcopen...

Introduction: In severe forms of obesity there is a high prevalence of psychopathological comorbidity. Psychiatric evaluation is an important component of comprehensive obesity care and contributes to optimizing therapeutic results after bariatric surgery. Objective: To assess the effectiveness of psychometric tests used in the protocol for sele...

Disease-related malnutrition (DRM) affects approximately a third of hospitalized patients and is associated with an increased risk of morbimortality. However, DRM is often underdiagnosed and undertreated. Our aim is to evaluate the prognostic value of morphofunctional tools and tests for nutritional assessment in clinical practice. A systematic lit...

Background and aims: low muscle mass (LMM) conditions the nutritional status of an individual and has implications for quality of life and prognosis. The aim of this study was to evaluate body composition and determine normal values in the diagnosis of LMM in a control group of healthy individuals. Methods: a cross-sectional study of healthy vol...

Introduction COVID-19 has a wide spectrum of clinical severity and there is evidence that SARS-Cov2 affects several organs and systems. Among the organs affected since the beginning of the pandemic, the relationship between SARS-CoV-2 infection and thyroid involvement has been demonstrated. Novel and highly effective mRNA and DNA-based vaccines hav...

Introduction: The medical specialisation model in Spain is carried out in the context of specialised health training, through the residency programme. The aim of the study is to analyse, by an anonymous survey, the opinion on three aspects among final-year residents in Endocrinology and Nutrition (E&N): self-assessment of the knowledge acquired, w...

Postprandial hyperinsulinaemic hypoglycaemia is a common complication of bariatric surgery. Although in general its evolution is mild and self-limited, it can lead to neuroglycopaenia and compromise the patient's safety and quality of life. The aim of this document is to offer some recommendations to facilitate the clinical care of these complex pa...

Disease-related malnutrition (DRM) continues to be a very significant healthcare problem, both in our hospitals and in the community. It is often not properly diagnosed or treated, despite a growing body of evidence highlighting its clinical and economic consequences. The transition between clinical care in the hospital and community services (Prim...

Dementia is an increasingly prevalent disease in our environment, with significant health and social repercussions. Despite the available scientific evidence, there is still controversy regarding the use of enteral tube nutrition in people with advanced dementia. This document aims to reflect on the key aspects of advanced dementia, tube nutritiona...

Resumen Introducción En las formas graves de obesidad existe alta prevalencia de comorbilidad psicopatológica. La evaluación psiquiátrica es un componente importante de la atención integral de la obesidad y contribuye a optimizar los resultados terapéuticos tras cirugía bariátrica. Objetivo Valorar la efectividad de los test psicométricos emplead...

Introduction: Medical nutrition therapy is a very useful tool in maintaining and recovering the health of patients with disease-related malnutrition, although its implementation can be complex and is not without risks. Quality processes are understood as sets of activities that are related or interact to transform input elements into results. From...

Nutritional ultrasound® is a new concept that uses ultrasound to assess body composition. It is composed of the evaluation of fat-free mass and fat mass. It is an emerging, economical, portable, non-invasive technique that evaluates the musculoskeletal area with linear, broadband, multifrequency probes, with a depth field of 20–100 mm. It quantifie...

Objective: Validation of a questionnaire designed to stratify the level of digital competence in chronic patients. Method: Cross-sectional study, carried out in the Endocrinology and Nutrition Section of the Complejo Asistencial Universitario de León (CAULE). We selected the digital competencies section of the Cambados questionnaire, designed fo...

Resumen Introducción El modelo de especialización médica en España se realiza a través de la formación sanitaria especializada, mediante el sistema médico interno residente (MIR). El objetivo del estudio es analizar, con una encuesta anónima, la percepción de tres aspectos entre los MIR de último año de Endocrinología y Nutrición (EyN): autoevalua...

Introduction Although current recommendations suggest the use of specific formulas in enteral nutrition in people with diabetes, there is little evidence of their long-term effectiveness in glycemic control. The main objective of this study is to evaluate the long-term efficacy (24 weeks) of a specific high-protein hypercaloric enteral nutrition fo...

Background : The compliance in outpatients with gastrointestinal (GI) malabsorption is the key in nutritional treatment. The objective of this study is to assess the compliance of a high-calorie, high-protein, peptide-based oral nutritional supplement (ONS-PBD) in patients with GI impairment and malnutrition. Methods : A prospective, multicenter,...

Background In patients receiving total parenteral nutrition (TPN), the frequency of hyponatraemia is high. However, the causes of hyponatraemia in TPN have not been elucidated, although diagnosis is required for appropriate therapy. The aim of this study is to describe the aetiology of hyponatraemia in non-critical hospitalised patients receiving T...

Introduction: Loss of skeletal muscle mass and function (sarcopenia) is common in individuals with obesity due to metabolic changes associated with a sedentary lifestyle, adipose tissue derangements, comorbidities (acute and chronic diseases) and during the ageing process. Co-existence of excess adiposity and low muscle mass/function is referred t...

Introduction Loss of skeletal muscle mass and function (sarcopenia) is common in individuals with obesity due to metabolic changes associated with a sedentary lifestyle, adipose tissue derangements, comorbidities (acute and chronic diseases), and during the ageing process. Co-existence of excess adiposity and low muscle mass/function is referred to...

Introduction COVID-19 disease has become a priority for our healthcare system. The resident physicians training in endocrinology and nutrition (E&N residents) have been integrated into the COVID-19 teams. This study has been designed with the aim of analysing the educational, occupational and health impact on E&N residents. Material and methods Cr...

Background The Enhanced Recovery After Surgery (ERAS) care pathways include evidence-based items designed to accelerate recovery after surgery. Interdisciplinarity is one of the key points of ERAS programs. Objective To prepare a consensus document among the members of the Nutrition Area of the Spanish Society of Endocrinology and Nutrition (SEEN)...

Resumen La demencia es una enfermedad cada vez más prevalente en nuestro entorno, con importantes repercusiones sanitarias y sociales. Pese a la evidencia científica disponible, aún existe controversia sobre el empleo de la nutrición enteral por sonda en las personas con demencia avanzada. En el presente documento se pretende reflexionar sobre los...

Introduction Amyotrophic Lateral Sclerosis (ALS) is a neurodegenerative disease in which specialized nutritional support is essential. The objectives of our study were to describe nutritional support at the beginning of follow-up and its impact on anthropometry and survival. Methods An interhospital registry was created for the hospitals of Castil...

Resumen La desnutrición relacionada con la enfermedad (DRE) sigue siendo un problema asistencial muy significativo, tanto en nuestros hospitales como en la comunidad. A menudo no se diagnostica ni trata adecuadamente, a pesar de un creciente número de pruebas que ponen en evidencia sus consecuencias clínicas y económicas. La transición entre la ate...

Resumen La hipoglucemia hiperinsulinémica posprandial es una complicación frecuente de la cirugía bariátrica. Aunque en general tiene una evolución leve y autolimitada, puede cursar con neuroglucopenia y comprometer la seguridad y la calidad de vida del paciente. El objetivo de este documento es ofrecer unas recomendaciones para facilitar la atenci...

Endocrinology and Nutrition is a medical specialty covering the study and treatment of diseases of the endocrine system, metabolism and those derived from the nutritional process, including knowledge of diagnostic techniques and dietary and therapeutic measures. In order to develop these activities and plan the management of resources allocated for...

In order to complete and better understand our research article entitled "Long-term effects of bariatric surgery on gut microbiota composition and faecal metabolome related to obesity remission" and published in Nutrients journal (https://doi.org/10.3390/nu13082519), we created on Encyclopedia platform a video abstract that highlights the main aspe...

Introduction Obesity is a chronic disease associated with other comorbidities, including atherogenic dyslipidemia (AD). Bariatric surgery (BS) has shown to reduce cardiovascular risk (CVR) by achieving a significant weight reduction and improving the lipid profile. Different surgical techniques may have a different effect on the lipoprotein profile...

(1) Background: Both sarcopenia and disease-related malnutrition (DRM) are unfortunately underdiagnosed and undertreated in our Western hospitals, which could lead to worse clinical outcomes. Our objectives included to determine the impact of low muscle mass (MM) and strength, and also DRM and sarcopenia, on clinical outcomes (length of stay, death...

Dysphagia is a highly prevalent symptom in Amyotrophic Lateral Sclerosis (ALS), and the implantation of a percutaneous endoscopic gastrostomy (PEG) is a very frequent event. The aim of this study was to evaluate the influence of PEG implantation on survival and complications in ALS. An interhospital registry of patients with ALS of six hospitals in...

Obesity is one of the main worldwide public health concerns whose clinical management demands new therapeutic approaches. Bariatric surgery is the most efficient treatment when other therapies have previously failed. Due to the role of gut microbiota in obesity development, the knowledge of the link between bariatric surgery and gut microbiota coul...

Background In patients receiving total parenteral nutrition (TPN), the frequency of hyponatraemia is high. However, the causes of hyponatraemia in TPN have not been elucidated, although diagnosis is required for appropriate therapy. The aim of this study is to describe the aetiology of hyponatraemia in non-critical hospitalised patients receiving T...

Obesity and diabetes are two closely related disorders. Lifestyle changes and drug treatment do not achieve successful diabetes remission. A treatment option for these patients is bariatric surgery (BS). The partial and complete remission rates vary, depending on the type of technique used (restrictive or malabsorptive), with malabsorptive surgery...

Background: Obesity is a challenge for bioelectrical impedance (BIA) estimations of skeletal muscle and fat mass (FM) and none of the equations used for appendicular lean mass (ALM) has been developed in people with obesity. We aimed to assess the estimation of FM and ALM using BIA compared to Dual Energy X-ray absorptiometry (DXA) (DXA) as a refer...

IDENTIFICATION OF E-YOUNG CHRONICS THROUGH QUESTIONNAIRE D. Barajas Galindo1 , M. Martı´nez Pillado2 , M. Ballesteros Pomar1 , I. Said Criado3 , I. Cano Rodrı´guez1 1 Complejo Asistencial Universitario de Leo´n, Endocrinologı´a Y Nutricio´n, Leo´n, Spain, 2 Complexo Hospitalario de Pontevedra, Unidad De Calidad, Vigo, Spain, 3 Hospital A´lvaro Cunq...

Resumen Antecedentes La recuperación intensificada en cirugía abdominal (RICA) constituye un conjunto de estrategias perioperatorias encaminadas a acelerar la recuperación del paciente. La interdisciplinariedad es uno de los puntos claves de los programas RICA. Objetivo Elaborar un documento de consenso entre los miembros del Área de Nutrición de...

From the third decade of life and due to multiple causes, muscle mass and strength are gradually lost, which affects the function of the musculoskeletal system. This combined loss of muscle mass and strength with aging is called sarcopenia, and is associated with greater morbidity and mortality in the elderly. Early treatment is therefore essential...

Resumen Introducción La esclerosis lateral amiotrófica es una enfermedad neurodegenerativa en la que el soporte nutricional especializado es básico. Los objetivos de nuestro estudio fueron describir el soporte nutricional al inicio del seguimiento y su impacto en la antropometría y supervivencia. Material y métodos Se creó un registro interhospit...

Resumen Introducción Aunque las recomendaciones actuales sugieren el empleo de fórmulas específicas en nutrición enteral en personas con diabetes, hay poca evidencia de su efectividad a largo plazo en el control glucémico. El objetivo principal de este estudio es evaluar la eficacia a largo plazo (24 semanas) de una fórmula de nutrición enteral hi...

Resumen Introducción: La enfermedad COVID-19 se ha convertido en una prioridad para nuestro sistema sanitario. Los MIR de Endocrinología y Nutrición (MIR-EyN) se han integrado en los equipos COVID-19. Se ha diseñado este estudio con el objetivo de analizar el impacto a nivel formativo, laboral y en la salud de MIR-EyN. Material y métodos: Estudio o...

Resumen La Endocrinología y Nutrición es una especialidad médica que abarca el estudio y tratamiento de las enfermedades del sistema endocrino, del metabolismo y las derivadas del proceso nutricional, incluyendo el conocimiento de sus técnicas diagnósticas y medidas dietéticas y terapéuticas. Para desarrollar estas actividades y planificar la gesti...

Introduction: disease-related malnutrition has a negative impact on the outcome in surgical patients. Our objective was to assess the prevalence of nutritional risk in the field of vascular surgery, as well as its consequences on patient outcome and health expenditure. Patients and methods: this is a prospective, observational study conducted du...

Obesity is one of the great challenges in healthcare nowadays with important implications for health so requiring comprehensive management. This document aims to establish practical and evidence-based recommendations for the diagnosis and management of in Spain, from the perspective of the clinical endocrinologist. A position statement has been mad...

Introduction: although nutritional differences between different types of texture-modified diet (TMD) have been evaluated, the resources and costs associated with their preparation have been less studied. Objective: to describe the nutritional, microbiological properties and costs of: 1) in-home produced pureed food (hTMD); 2) concentrated nutri...

Background Bariatric surgery (BS) is an effective treatment. However, there have been concerns regarding the negative effect on the bone. The aim of this study was to assess changes in bone metabolism and the risk of fracture after biliopancreatic diversion (BPD). Material and methods A retrospective analysis of obese patients undergoing BPD betwe...

Introduction: Few areas of current medicine have undergone change and evolution in recent years such as those of clinical nutrition. Currently, 98 % of endocrinology and nutrition departments in hospitals with 500 or more beds incorporate a clinical nutrition and dietetics Unit. The training of the professionals that integrate these units has been...

The selection of the most appropriate formula in long-term home enteral nutrition is a controversial issue. Our objective was to study a high protein hypercaloric enteral nutrition formula in patients with long-term feeding (180 days). Methods Prospective observational multicenter real-life study with high-protein hypercaloric formula (2 kcal/ml a...

Background Bariatric surgery (BS) is an effective treatment. However, there have been concerns regarding the negative effect on the bone. The aim of this study was to assess changes in bone metabolism and the risk of fracture after biliopancreatic diversion (BPD). Material and methods A retrospective analysis of obese patients undergoing BPD betwe...