Heats of combustion of the main carbohydrates contained in plant-source foods.

In a previous review, the experiments of American chemist W.O. Atwater were critically examined, with the findings demonstrating certain weaknesses that could compromise the validity of the values currently used for metabolizable energy. An examination of published works on the heat of combustion of carbohydrates reveals 2 types of weaknesses: the inaccuracy and imprecision of the calorimetric data used, and the averaging procedure employed to estimate such representative values. The present review focuses on the first type of weakness, namely the inaccuracy and imprecision of the calorimetric data used in previous studies. An exhaustive bibliographic search yielded almost 100 heat of combustion values for some of the 6 main carbohydrates contained in plant-source foods (glucose, fructose, sucrose, maltose, starch, and cellulose). These heats of combustion were subjected to rigorous statistical analysis to propose the following for each carbohydrate: (1) an interval (termed a bibliographic interval) that very likely includes the actual heat of combustion value and (2) a "representative value" (calculated to produce the minimum level of inaccuracy). In addition, an estimation of the maximum level of inaccuracy that could be expected when using such a representative value is reported.

Heats of combustion representative of the carbohydrate mass contained in fruits, vegetables, or cereals.

The obtainment of suitable values for metabolizable energy requires the previous knowledge of accurate and precise values of the heat of combustion of the different macronutrients. Thus, in this work, the heats of combustion of six carbohydrates (glucose, fructose, sucrose, maltose, starch, and cellulose) were experimentally measured, and such values were statistically compared with equivalent bibliographic values collected in a parallel work (Heats of combustion of the main carbohydrates in vegetable foods: a bibliographic approach, 2019), proposing, for each carbohydrate, an "overall interval" and an actualized representative value, which were estimated considering jointly the bibliographic and experimental information. Besides, a numerical methodology that used such parameters and the relative content of the different carbohydrates in selected foods was proposed, to estimate the global heat of combustion producible by the carbohydrate mass contained in such foods. The results estimated for 68 foods were globalized to propose the following generalized heats of combustion: (a) for fruits: 3.88 kcal/g, (b) for vegetables: 3.98 kcal/g and, and (c) for cereals: 4.13 kcal/g. These results demonstrated that the use of the Atwater's value (4.2 kcal/g of carbohydrate of vegetable source) involves a clear overestimation of the heat of combustion of the carbohydrate mass contained in vegetable source foods.

[Effects of a revision program on the control of type 2 diabetics followed at the primary care level. Diabetes First program]. / Efectos de un programa de revisión en el control de los diabéticos tipo 2 seguidos en atención primaria. Programa Diabetes First.

BACKGROUND AND OBJECTIVE: To analyze the evolution of the glycosylated hemoglobin and other parameters after performing a control program and follow-up by nurses to improve the control of the patients with type 2 diabetes mellitus (Diabetes First). PATIENTS AND METHOD: Intervention study in type 2 diabetes mellitus patients from Murcia. The inclusion criterium was to be a type 2 diabetes mellitus patient badly controlled on diabetes parameters (glycosylated haemoglobin > or = 7%). We included 831 patients from 8 primary care centers. The program consisted of three visits (first one, after three months and after six months), where the patients received diabetic education. RESULTS: The mean initial glycosylated haemoglobin value was 8.1% +/- 1.3%, after 3 months it decreased to 7.5% +/- 1.1%, and after 6 months from the first visit its value was 7.5% +/- 2.6%. There was a statistically significant (p < 0.001) difference between the initial glycosylated haemoglobin and the values three months later. There was not such a difference between the second and third visit. Total and low-density liporpotein cholesterol decreased significantly after 3 months (p < 0.05). High-density lipoprotein cholesterol and triglycerides showed no difference. Systolic and diastolic blood pressure significantly decreased after three months (p < 0.0001 and p < 0.005). CONCLUSIONS: A simple nursing intervention program performed in primary care centers has a very positive impact on the control and treatment of patients with type 2 diabetes mellitus.

Efectos de un programa de revisión en el control de los diabéticos tipo 2 seguidos en atención primaria. Programa Diabetes First / Effects of a revision program on the control of type 2 diabetics followed at the primary care level. Diabetes First program

Antecedentes y objetivo: Analizar la evolución de la glucohemoglobina y otros parámetros tras aplicar un programa de revisión y seguimiento de enfermería (Diabetes First) para mejorar el control de sujetos con diabetes mellitus tipo 2. Pacientes y método: Estudio de intervención, realizado con pacientes diabéticos tipo 2 de la Región de Murcia. El criterio de inclusión era ser diabético tipo 2 no controlado (glucohemoglobina ¡Ý 7%). Se obtuvo una muestra final de 831 pacientes pertenecientes a ocho centros de salud. El programa constaba de tres visitas (inicial, a los 3 y a los 6 meses) en las que se daba educación diabetológica. Resultados: La glucohemoglobina inicial fue una media del 8,1% ¡À 1,3%; a los 3 meses descendió al 7,5% ¡À 1,1%, y a los 6 meses de la visita inicial era del 7,5% ¡À 2,6%. La comparación de los valores de la visita inicial y a los 3 meses mostró significación estadística (p < 0,001). Entre la segunda visita (3 meses) y la tercera (6 meses) no hubo diferencias significativas. Las cifras de colesterol total y colesterol de las lipoproteínas de baja densidad disminuyeron significativamente entre el inicio y los 3 meses (p < 0,05). El colesterol de las lipoproteínas de alta densidad y los triglicéridos no mostraron diferencias. Respecto a la presión arterial sistólica y diastólica, disminuyeron significativamente las cifras entre el inicio y los 3 meses (p < 0,0001 y p < 0,005 respectivamente). Conclusiones: Un programa de intervención enfermera sencillo realizado en las consultas de atención primaria tiene un impacto muy favorable en el control y el tratamiento de los pacientes diabéticos tipo 2 (AU)

Background and objective: To analyze the evolution of the glycosylated hemoglobin and other parameters after performing a control program and follow-up by nurses to improve the control of the patients with type 2 diabetes mellitus (Diabetes First). Patients and method: Intervention study in type 2 diabetes mellitus patients from Murcia. The inclusion criterium was to be a type 2 diabetes mellitus patient badly controlled on diabetes parameters (glycosylated haemoglobin ¡Ý 7%). We included 831 patients from 8 primary care centers. The program consisted of three visits (first one, after three months and after six months), where the patients received diabetic education. Results: The mean initial glycosylated haemoglobin value was 8.1% ¡À 1.3%, after 3 months it decreased to 7.5% ¡À 1.1%, and after 6 months from the first visit its value was 7.5% ¡À 2.6%. There was a statistically significant (p < 0.001) difference between the initial glycosylated haemoglobin and the values three months later. There was not such a difference between the second and third visit. Total and low-density liporpotein cholesterol decreased significantly after 3 months (p < 0.05). High-density lipoprotein cholesterol and triglycerides showed no difference. Systolic and diastolic blood pressure significantly decreased after three months (p < 0.0001 and p < 0.005). Conclusions: A simple nursing intervention program performed in primary care centers has a very positive impact on the control and treatment of patients with type 2 diabetes mellitus (AU)

Relación entre el consumo de tabaco y alcohol y el ejercicio físico con el paso por la universidad / Association between the consumption of tobacco and alcohol and physical exercise while at university

ObjetivosAveriguar la influencia que tiene el paso por la universidad en la modificación de los hábitos de consumo de tabaco y alcohol y el ejercicio físico en los estudiantes universitarios.DiseñoEstudio descriptivo, transversal.EmplazamientoÁmbito universitario de Murcia.ParticipantesSe selecciona una muestra de 1.179 alumnos.IntervencionesSe utiliza un cuestionario autocumplimentado y anónimo. Consta de 36 preguntas con 4 escalas de medida: grado de información sanitaria sobre RCV, consumo de tabaco, consumo de alcohol y realización de ejercicio físico.ResultadosLos estudiantes universitarios (EU) del último curso se declaran fumadores: el 39,2 frente al 36,4% de los de primer curso (NS). El 81,6% de los de primer curso consumen alcohol durante los fines de semana, frente al 81,1% de los del último curso (NS). En la valoración general del consumo de alcohol el 13% deja de consumir o consume menos y el 10% consume más, aunque la mayoría (55,2%) no modifica su hábito de consumo. Respecto al ejercicio físico, la frecuencia de EU que refieren practicar más ejercicio es de un 21,2% en los del primer curso frente al 20% en los del último curso (NS).ConclusionesEl paso por la universidad no parece tener influencia positiva en los hábitos y estilos de vida de los jóvenes. Es necesario aplicar medidas para potenciar estilos de vida saludables entre los universitarios(AU)

ObjectiveTo find out the influence that going to University has on changing smoking and alcohol habits, and on physical exercise in students in the EU.DesignCross-sectional descriptive study.SettingUniversity of Murcia.ParticipantsA sample of 1179 students was selected.InterventionsA self-filled and anonymous questionnaire was used. It consisted of 36 questions using 4 measurement scales: level of health information on cardiovascular risks (CVR), smoking, alcohol consumption and doing physical exercise.ResultsA total of 39.2% of university students in their last academic year said they were smokers, compared to 36.4% in the first year (NS). A total of 81.6% of first year students had consumed alcohol at weekends, compared to 81.1% of those in their last year (NS). In the overall assessment of alcohol consumption, 13% «stopped drinking or drank less» and 10% «drank more», although the majority (55%), did not change their drinking habits. As regards physical exercise, the number of students who did more physical exercise was 21.2% in the first academic year, compared to 20% of students in their last year (NS).ConclusionsGoing to University does not seem to exercise a positive influence on the habits and lifestyles of young people. Measures should be taken to encourage healthy lifestyles in Universities(AU)