Effectiveness of α-, γ- and δ-Tocopherol in a CLA-Rich Oil.

Conjugated linoleic acid (CLA) is a mixture of positional and geometric isomers of octadecadienoic acid with conjugated double bounds. Positive health properties have been attributed to some isomers, such as anticarcinogenic activity, antiartherosclerotic effects and reduction of body fat gain. Hence, oils rich in CLA such as Tonalin(®) oil (TO), normally obtained through alkaline isomerization of safflower oil (SO), an oil rich in linoleic acid (LA), are currently used in functional foods. However, special care must be taken to protect them from oxidation to ensure the quality of the supplemented foods. The objective of this work was to evaluate the oxidation and effectiveness of different tocopherol homologues (α-, γ- and δ-), alone or in combination with synergists (ascorbyl palmitate and lecithin), in TO compared to SO at different conditions, ambient temperature (25 °C) and accelerated conditions in Rancimat (100 °C). The oils, the oils devoid of their antioxidants and the latter containing the antioxidants added were assayed. Results showed great differences between SO and TO in terms of formation of hydroperoxides and polymers and also in the effectiveness of tocopherols to delay oxidation. TO showed higher levels of polymerization and, in general, the effectiveness of tocopherol homologues, alone or in combination with synergists, was also lower in the TO.

[Nutritional support with parenteral nutrition. Course and associated complications]. / Soporte nutricional con nutrición parenteral. Evolución y complicaciones asociadas.

INTRODUCTION: Parenteral nutrition (PN) is an integral part of medical management of patients who do not have a functioning or accessible gastrointestinal tract. This paper discusses the clinical characteristics of patients receiving PN in a 420-bed hospital from 2009 to 2011. In addition, nutritional parameters were assessed at the start and end of PN and associated complications were analyzed. MATERIAL AND METHODS: retrospective, observational study of PN episodes in adults conducted at the Nutrition Unit of Hospital Universitario de Guadalajara. Variables collected included epidemiological and clinical data, number and type of routes used, anthropometric data, analytical data, number of days on PN, reason for withdrawal, caloric provision, prevalence of phlebitis, metabolic complications (hypertriglyceridemia, abnormal liver function tests, hyperglycemia, and refeeding syndrome), and prevalence of bacteremia associated with central venous catheter (BAC). RESULTS: There were 312 episodes of PN. The immediate indication was postoperative ileus in 53.8% of the episodes. There was a statistically significant improvement in all analytical parameters assessed (albumin, prealbumin, retinol binding protein, transferrin, cholesterol, and lymphocytes). Caloric provision (kcal per kg) was 25.1±6.6. No metabolic complication occurred in 16.3% of the episodes, and hyperglycemia was the most common complication (79.8%). There were 10 cases of phlebitis (32.2%) and 30 episodes of BAC (8.7%). Bacteriemia rate was 8.1 per 1000 days of PN. DISCUSSION: Although PN is an effective nutritional support technique, it is associated with complications of varying severity. Use of PN should therefore comply with the instructions accepted in the main clinical practice guidelines and requires careful monitoring by experienced professionals.

Concentraciones deficientes de vitamina D en pacientes con obesidad mórbida. Estudio de caso-control / Vitamin D deficiency in morbidly obese patients. A case-control study

Objetivos Estudios recientes muestran una elevada prevalencia de déficit de vitamina D en la población general, sobre todo en pacientes ancianos. También existen estudios que describen esta misma situación en los sujetos con obesidad mórbida (OM), aunque en pocos se compara a sujetos con OM y sin obesidad. Los objetivos de este estudio fueron estimar la prevalencia de déficit de vitamina D e hiperparatiroidismo secundario en ambos grupos y valorar si existe relación entre OM y deficiencia de vitamina D. Métodos El estudio se realizó en el Hospital Universitario de Guadalajara (España), desde diciembre de 2008 hasta diciembre de 2009, obteniéndose los datos de 138 sujetos. El 50,7% presentaba OM y el 49,3% no presentaba obesidad. En ambos grupos se obtuvo una muestra de sangre en ayunas para la determinación de 25-hidroxivitamina D, paratirina intacta, calcio, albúmina y fósforo, entre otros constituyentes bioquímicos. Resultados En el grupo de sujetos con OM, la concentración media de 25-hidroxivitamina D fue de 16,6±8,12ng/ml, mientras que en el grupo de sujetos sin obesidad fue de 21,9±7,34ng/ml (p<0,0001). El déficit de vitamina D fue del 80% en el grupo de pacientes con OM y del 41% en los sujetos sin obesidad (p<0,0001). No se obtuvieron diferencias estadísticamente significativas en las concentraciones de paratirina intacta, calcio y fósforo entre ambos grupos. Conclusiones Se confirma la elevada prevalencia de deficiencia de vitamina D en los grupos estudiados, aunque la concentración de 25-hidroxivitamina D fue significativamente menor en los sujetos con OM. La OM es un factor asociado a que exista déficit de vitamina D, por lo que podría valorarse incluir la determinación de 25-hidroxivitamina D en las guías para el manejo de los pacientes con OM con el fin de evitar estados carenciales (AU)

Objectives Recent studies show a high prevalence of vitamin D deficiency in the general population, especially in the elderly. There are also studies reporting the same observations in the morbidly obese, although few of these studies have compared morbidly obese individuals with non-obese persons. The objectives of this study were to estimate the prevalence of vitamin D deficiency and secondary hyperparathyroidism in both groups and to assess whether there is a relationship between obesity and vitamin D deficiency. Methods This study was carried out in 138 patients in the Guadalajara University Hospital (Spain) between December 2008 and December 2009. Of these, 50.7% were morbidly obese and 49.3% were not obese. Fasting blood samples were taken from both groups for determination of 25-hydroxyvitamin D, intact parathyroid hormone, calcium, albumin and phosphorus, among other biochemical parameters. Results The mean concentration of 25-hydroxyvitamin D was 16.6±8.12ng/ml in the morbidly obese group and 21.9±7.34ng/ml in the non-obese group (p<0.0001). The prevalence of vitamin D deficiency was 80% in morbidly obese patients and 41% in non-obese patients (p<0.0001). There were no statistically significant differences in concentrations of parathyroid hormone, calcium or phosphorus between the two groups. Conclusions A high prevalence of vitamin D deficiency was found in both groups studied, although the concentration of 25-hydroxyvitamin D was significantly lower in the morbidly obese. Morbid obesity is closely linked to vitamin D deficiency. To prevent this deficiency, determination of 25-hydroxyvitamin D should be included in clinical practice guidelines for the treatment of obesity (AU)

[Vitamin D deficiency in morbidly obese patients. A case-control study]. / Concentraciones deficientes de vitamina D en pacientes con obesidad mórbida. Estudio de caso-control.

OBJECTIVES: Recent studies show a high prevalence of vitamin D deficiency in the general population, especially in the elderly. There are also studies reporting the same observations in the morbidly obese, although few of these studies have compared morbidly obese individuals with non-obese persons. The objectives of this study were to estimate the prevalence of vitamin D deficiency and secondary hyperparathyroidism in both groups and to assess whether there is a relationship between obesity and vitamin D deficiency. METHODS: This study was carried out in 138 patients in the Guadalajara University Hospital (Spain) between December 2008 and December 2009. Of these, 50.7% were morbidly obese and 49.3% were not obese. Fasting blood samples were taken from both groups for determination of 25-hydroxyvitamin D, intact parathyroid hormone, calcium, albumin and phosphorus, among other biochemical parameters. RESULTS: The mean concentration of 25-hydroxyvitamin D was 16.6+/-8.12 ng/ml in the morbidly obese group and 21.9+/-7.34 ng/ml in the non-obese group (p<0.0001). The prevalence of vitamin D deficiency was 80% in morbidly obese patients and 41% in non-obese patients (p<0.0001). There were no statistically significant differences in concentrations of parathyroid hormone, calcium or phosphorus between the two groups. CONCLUSIONS: A high prevalence of vitamin D deficiency was found in both groups studied, although the concentration of 25-hydroxyvitamin D was significantly lower in the morbidly obese. Morbid obesity is closely linked to vitamin D deficiency. To prevent this deficiency, determination of 25-hydroxyvitamin D should be included in clinical practice guidelines for the treatment of obesity.