[Nutritional problems in cis and trans women]. / Problemática nutricional de mujeres cis y trans.

Introduction: Women deserve special attention due to the different requirements they have in comparison with men. In the same way, transgender women need individualized attention. Transgender women are at greater risk of suffering heart attacks or ischemic accidents, among other diseases, and are also at greater risk of developing eating disorders, poorer weight control and poorer perception of their image. Hormone therapy for gender reaffirmation in trans women modifies their body composition, and may also increase the risk of suffering from some pathologies. The nutritional needs of cisgender women are different from those of men, and trans women also have special needs, which may depend on whether or not they follow hormone therapy. Dietary studies, although scarce, suggest that transgender women have poor dietary habits and lifestyle. It is necessary to deepen the study of the nutritional situation of the female group, considering its diversity, and to develop standards and references appropriate to each case that allow better attention to the needs of these groups.

Introducción: El colectivo femenino merece una especial atención debido a los diferentes requerimientos que tienen en comparación con el colectivo masculino. De la misma manera, se necesita atender de manera individualizada al colectivo transgénero. En concreto, las mujeres trans tienen más riesgo de sufrir infartos o accidentes isquémicos, entre otras enfermedades, y también tienen mayor riesgo de desarrollar trastornos del comportamiento alimentario y peor control de peso y percepción de su imagen. La terapia hormonal de reafirmación de género en mujeres trans modifica su composición corporal y también puede aumentar el riesgo de padecer algunas patologías. Las necesidades nutricionales de las mujeres cisgénero son diferentes a las de los varones, y también tienen necesidades especiales las mujeres trans, que pueden depender del seguimiento o no de un tratamiento hormonal. Los estudios dietéticos, aunque escasos, sugieren que las mujeres transgénero tienen unos hábitos dietéticos y un estilo de vida menos saludables. Es necesario profundizar en el estudio de la situación nutricional del colectivo femenino, atendiendo a la diversidad del mismo, y desarrollar estándares y referencias adecuadas a cada caso que permitan una mejor atención de las necesidades de estos colectivos.

Problemática nutricional de mujeres cis y trans / Nutritional problems in cis and trans women

El colectivo femenino merece una especial atención debido a los diferentes requerimientos que tienen en comparación con el colectivo masculino.De la misma manera, se necesita atender de manera individualizada al colectivo transgénero. En concreto, las mujeres trans tienen más riesgo desufrir infartos o accidentes isquémicos, entre otras enfermedades, y también tienen mayor riesgo de desarrollar trastornos del comportamientoalimentario y peor control de peso y percepción de su imagen. La terapia hormonal de reafirmación de género en mujeres trans modifica sucomposición corporal y también puede aumentar el riesgo de padecer algunas patologías. Las necesidades nutricionales de las mujeres cisgéneroson diferentes a las de los varones, y también tienen necesidades especiales las mujeres trans, que pueden depender del seguimiento o no de untratamiento hormonal. Los estudios dietéticos, aunque escasos, sugieren que las mujeres transgénero tienen unos hábitos dietéticos y un estilode vida menos saludables. Es necesario profundizar en el estudio de la situación nutricional del colectivo femenino, atendiendo a la diversidad delmismo, y desarrollar estándares y referencias adecuadas a cada caso que permitan una mejor atención de las necesidades de estos colectivos. (AU)

Women deserve special attention due to the different requirements they have in comparison with men. In the same way, transgender womenneed individualized attention. Transgender women are at greater risk of suffering heart attacks or ischemic accidents, among other diseases,and are also at greater risk of developing eating disorders, poorer weight control and poorer perception of their image. Hormone therapy forgender reaffirmation in trans women modifies their body composition, and may also increase the risk of suffering from some pathologies. Thenutritional needs of cisgender women are different from those of men, and trans women also have special needs, which may depend on whetheror not they follow hormone therapy. Dietary studies, although scarce, suggest that transgender women have poor dietary habits and lifestyle. It isnecessary to deepen the study of the nutritional situation of the female group, considering its diversity, and to develop standards and referencesappropriate to each case that allow better attention to the needs of these groups. (AU)

Effectiveness of the Godelieve Denys-Struyf (GDS) method in people with low back pain: cluster randomized controlled trial.

BACKGROUND: The Godelieve Denys-Struyf method (GDS) is a motor learning intervention that may be applied in group or individualized sessions. OBJECTIVE: The study objective was to compare the effectiveness of routine physical therapy, group GDS (GDS-G) sessions, and group and individualized GDS (GDS-I) sessions. DESIGN: This was a cluster randomized controlled trial. SETTING: The study took place in 21 primary care physical therapy units ("clusters") of the Spanish National Health Service (SNHS). PARTICIPANTS: The participants were 461 people with subacute and chronic low back pain (LBP). INTERVENTION: Clusters were randomized into 3 groups. All participants received medical treatment and a 15-minute group education session on active management. Additional interventions were as follows: control (fifteen 40-minute sessions of transcutaneous electrical nerve stimulation, microwave treatment, and standardized exercises), GDS-G (eleven 50-minute group GDS sessions), and GDS-I (the same 11 sessions plus four 50-minute individualized GDS sessions). MEASUREMENTS: Primary outcomes at baseline and 2, 6, and 12 months later were LBP and pain referred down the leg (separate pain intensity numeric rating scales) and disability (Roland-Morris Questionnaire [RMQ]). Secondary outcomes were use of medication and self-reported health (mental and physical component summaries of the 12-Item Short-Form Health Survey [SF-12]). Separate linear mixed models for LBP, pain referred down the leg, and disability were developed to adjust for potential confounders. Randomization, outcome assessment, and data analyses were masked. RESULTS: At 12 months, disability improved 0.7 (95% confidence interval [CI]=-0.4, 1.8) RMQ point in the control group, 1.5 (95% CI=0.4, 2.7) RMQ points in the GDS-I group, and 2.2 (95% CI=1.2, 3.2) RMQ points in the GDS-G group. There were no differences in pain. LIMITATIONS: The amount of exercise was smaller in the control group, and GDS-I sessions were provided by junior physical therapists. CONCLUSIONS: The improvement in disability was slightly higher with group GDS sessions than with the program routinely used in clusters within the SNHS. Adding individualized GDS sessions eliminated this advantage. Further studies should compare the GDS with other types of exercise.