What is happening with the clinical nutritionist? Realities and challenges.

BACKGROUND: At hospital level, clinical nutritionists play a fundamental role in health recovery, contributing to shorter hospital stays and addressing hospital malnutrition. However, in Latin America no studies have been conducted on the activities of the nutritionist and the factors influencing their performance. AIMS: to describe the activities of the clinical nutritionist in public and private hospital settings in Latin America and to determine the factors associated with disciplinary practice. METHODS: A cross-sectional analytical, quantitative study was conducted. Participants consisted of hospital nutritionists from 13 Latin American countries who had participated in a previously validated online survey on the activities performed during their daily work, obtaining a Professional Activities Score (PAS). RESULTS: 1222 nutritionists participated. Of the activities associated with the professional role, the only ones who reached over 75 % of execution were: performing nutritional intervention; performing nutritional assessment and diagnosis; providing counseling and dietary prescription; developing nutritional care plans for patients with nutritional problems; and performing the monitoring and evaluation of results of priority patients. The least frequent activities were: university teaching and collaborating in research. Regarding the reasons for not performing activities: 34.0 % reported not being included in the activities, 24.5 % mentioned lack of time, and 13.6 % indicated that the activities were conducted by another professional. Variables positively associated with an increase in the PAS were: having spent more years exercising the profession (Beta: 0.028, 95 % CI: 0.004; 0.051), and having a greater number of specialties (4 or more, Beta: 2.294, 95 % CI: 1.031; 3.557). Working in lower-complexity facilities (Low: Beta: -1.037, 95 % CI: -1.443; -0.630), and having more reasons for not performing the activities (3 or more: Beta: -3.105, 95 % CI: -4.111; -2.099) were inversely associated. From the sample, 1.8 % held a doctorate in clinical nutrition, 43.9 % had a specialty, and 64.4 % had a diploma or postgraduate degree in clinical nutrition. CONCLUSION: None of the activities related to the nutritionist work was performed on a 100 % basis. In Latin America, Ministries of Health should standardize and regulate the functions of the clinical nutritionist, as well as quantifying understaffing and proposing solutions to alleviate the shortage of these professionals, acknowledging the positive impact that they have on the recovery of hospital patients.

Self-Reported Nutritional Status and Breakfast Characterization in Latin American University Students.

OBJECTIVE: To associate breakfast consumption frequency with self-reported nutritional status and dietary patterns of Latin American university students by human development. MATERIAL AND METHODS: This was a cross-sectional, multicenter observational study. University students from 11 Latin American countries (Argentina, Chile, Colombia, Costa Rica, Ecuador, Guatemala, Mexico, Peru, Paraguay, Panama and Uruguay) were invited to participate by answering an online self-administered questionnaire on food consumption and sociodemographic indicators, associations were investigated using logistic regression. RESULTS: The logistic regression analysis showed significant associations between breakfast consumption and the crude model, models 2 and 3 in countries with very high and upper-middle/high human development. However, after adjustment in the most comprehensive model, the association is no longer statistically significant. In the fully adjusted model of the variables, a significant relationship was observed between breakfast consumption and both healthy and unhealthy dietary patterns. Specifically, students who typically consume breakfast exhibit greater consumption of oatmeal and fruits, as well as healthier dinner choices. Conversely, they exhibit lower consumption of fast food, sugary drinks, and juices. In particular, in highly developed countries, along with the mentioned foods, consumption of dairy was linked to breakfast consumption in a positive way, while alcohol consumption was negatively associated. CONCLUSION: University students who eat breakfast on a regular basis maintain a healthier diet in comparison to those who do not, irrespective of their country's level of human development.

Factors associated with the consumption of fruits and vegetables in latin american university students

Objective: Explore the association between compliance with recommended consumption (5-a-day) of fruits and vegetables (F&V) with sociodemographic factors of university students of Latin America. Subjects: We conducted an analytical cross-sectional study in which 4,880 university students from 10 Latin American countries completed a self-administered online survey. Methods: F&V consumption and other sociodemographic variables were measured according to a validated survey. Body mass index was self-reported. Ordinal logistic regression models were applied. Results: Regarding the consumption of F&V, 4.7% of men complied with the recommendation, while in women this value reached 7.7%. In the adjusted model, having a normal weight (OR= 0.59; 95% CI 0.44-0.7; p=<0.001), being female (OR= 0.67; 95% CI 0.49-0.89; p=<0.01), being enrolled in a health-related degree program (OR= 0,60; IC95% 0,45-0,78; p<0.001), having professional parents (OR= 0.75; 95% CI 0.60-0.95; p=<0.05) and practicing physical activity (OR= 0.34; 95% CI 0.27-0.42; p=<0.001) were associated with compliance to F&V consumption recommendations. In the analysis by country, physical activity was the variable most associated with F&V consumption. Conclusion: We observed a low consumption of F&V in university students. The variables associated with compliance to the F&V recommendation were being normal weight, female, being enrolled in a health-related degree program, having professional parents, and practicing physical activity, the latter being the most important variable.

Objetivo: Explorar la asociación de la frecuencia de cumplimiento de las recomendaciones de consumo (5 al día) de frutas y verduras (F&V) con factores sociodemográficos de estudiantes universitarios de América Latina. Metodología: Se realizó un estudio transversal analítico con 4.880 estudiantes universitarios de 10 países de América Latina, quienes completaron una encuesta en línea autoadministrada. Se midió el consumo de F&V y otras variables sociodemográficas según una encuesta previamente validada. El índice de masa corporal fue autoinformado. Se aplicaron modelos de regresión logística ordinal. Resultados: En cuanto al consumo de F&V, en los hombres el 4,7% cumple con la recomendación, mientras que en las mujeres este valor alcanza el 7,7%. En el modelo más ajustado, presentar normopeso (OR= 0,59; IC 95% 0,44-0,7; p=<0,001), ser mujer (OR= 0,67; IC 95% 0,49-0,89; p=<0,01), estar matriculado en carrera relacionada con la salud (OR= 0,60; IC95% 0,45-0,78; p<0,001), tener padres profesionales (OR= 0,75; IC 95% 0,60-0,95; p=<0,05) y realizar actividad física (OR= 0,34; IC 95% 0,27-0,42; p=<0,001) fueron las variables asociadas al cumplimiento del consumo de F&V. En el análisis por país, la actividad física fue la variable más asociada al consumo de F&V. Conclusión: Se observa un bajo consumo de F&V en estudiantes universitarios, y entre las variables asociadas al cumplimiento de la recomendación de F&V se encuentran estar normopeso, sexo femenino, estar cursando una carrera relacionada con la salud, tener los padres y la práctica de actividad física, siendo esta última la variable más importante.

Barriers and Opportunities for Clinical Nutritionists in 13 Latin American Countries: A Qualitative Study.

A clinical nutritionist (CN) is a university-educated professional trained to perform preventive and recovery functions in the health of patients. The actions of these professionals, both worldwide and in Latin America, may face barriers and opportunities that require careful identification and examination. The main objective of this study is to identify the most important barriers and opportunities for the clinical nutritionist in 13 Latin American countries. A qualitative study was carried out; the initial phase involved conducting in-depth individual interviews with 89 informants, experienced CNs from 13 Latin American countries. After calculating the mean and standard deviation, we ranked the top 10 most frequently reported barriers by assigning a score ranging from 1 to 10. Additionally, 3 opportunities were identified with a lower score from 1 to 3. Means and standard deviation were calculated to sort the responses. Results: the most important barrier was the absence of public policies that regulate and/or monitor compliance with the staffing of CNs according to the number of hospital beds, while the most important opportunity was the advances in technology such as software, body analysis equipment and other tools used in Nutritional Care. The identified barriers can interfere with the professional performance of CNs and, moreover, make it difficult to monitor the good nutritional status of patients. It is recommended to consider the barriers identified in this study, as well as the opportunities, with a view to improving the quality of hospital services with an adequate supply of nutritionists.

[Diet and body weight at the beginning of the COVID-19 pandemic in Mexico]. / Alimentación y peso corporal al inicio de la pandemia por COVID-19 en México.

Background: Weight changes in adults have strong repercussions on people's health status. During the COVID-19 pandemic, these changes could be more evident due to the mandatory confinement, as well as eating habits and lifestyle. In this study, changes in diet and body weight in Mexican population at the beginning of COVID-19 lockdown period (weeks 4-7) were evaluated using an online survey. Objective: To identify the characteristics of the diet and the perceived change in body weight at the beginning of the COVID-19 pandemic in Mexico. Material and methods: Descriptive, cross-sectional study of 1281 people over 18 years of age, electronic survey in weeks 4-7 of confinement with sociodemographic data, food consumption and perception of body weight. Results: The change in food consumption was 53.9%, finding differences according to gender in beverages (carbonated, juices, alcoholic), coffee/tea, fruits, legumes (p < 0.05). The perception of body weight increases by 3.4 (increased) and 2.1 (lowered) times more than the risk of change in diet. Conclusions: The dietary differences refer to a tendency to the type of food consumed, mainly sugary drinks, with the perception of changes in positive body weight in women.

Introducción: los cambios de peso corporal tienen fuertes repercusiones en el estado de salud de las personas. Durante la pandemia, estos cambios podrían verse más pronunciados debido al confinamiento obligatorio, así como a los malos hábitos alimentarios y al estilo de vida. En este estudio se examinaron los cambios en la alimentación y el peso corporal en población mexicana durante el inicio de la pandemia por COVID-19 (semanas 4-7 de confinamiento) mediante una encuesta en línea. Objetivo: identificar las características de la alimentación y el cambio percibido del peso corporal al inicio de la pandemia por COVID-19 en México. Material y métodos: estudio descriptivo, transversal, de 1281 personas mayores de 18 años, mediante encuesta electrónica en las semanas 4-7 de confinamiento, con datos sociodemográficos, consumo alimentario y percepción del peso corporal. Resultados: el cambio de consumo de alimentos fue del 53.9%, encontrando diferencias según sexo en bebidas (carbonatadas, jugos, alcohólicas), café/té, frutas, leguminosas (p < 0.05). La percepción del peso corporal incrementó en 3.4 (subieron) y 2.1 (bajaron) veces más el riesgo de cambio en la alimentación. Conclusiones: las diferencias alimentarias refieren una tendencia al tipo de alimentos que consumen, principalmente bebidas ricas en azúcares, con percepción de cambios en el peso corporal positivo en mujeres.

Ultra-processed food and homemade fried food consumption is associated with overweight/obesity in Latin American university students during COVID-19.

OBJECTIVE: We estimated the association between the consumption of select ultra-processed food (UPF), homemade fried food and overweight/obesity in Latin American university undergraduate students during the COVID-19 pandemic. METHODS: We conducted an analytical cross-sectional study. 4539 university students (73.6% female, mean age 22.5 ± 4.4) from 10 Latin American countries completed a self-administered online survey. UPF eating habits and homemade fried food were measured according to a validated survey. Height and body weight were self-reported. Body mass index (BMI) was calculated. A BMI ≥25 kg/m2 was categorized as overweight/obesity. Ordinal logistic regression models were applied. RESULTS: Snacks (36.2%) and homemade fried food (30.2%) had a higher prevalence of consumption than sugary drinks (22.5%) and fast food (7.2%). The greatest strength of association was found between fast food consumption [odds ratio (OR) = 2.16; 95% confidence interval (CI): 1.63-2.85], sugary drinks [OR = 2.05; CI: 1.63-2.59] and homemade fried food [OR = 1.46; CI: 1.16-1.85] with overweight/obesity. CONCLUSION: Latin American university undergraduates present risky eating behaviors associated with overweight and obesity. Effective policies to promote healthy eating should be incorporated and issued from universities to reduce the consumption of UPF and promote homemade, healthier and more natural food.

Asociación entre consumo de alcohol y exceso de peso entre estudiantes universitarios de América Latina

Introducción: El sobrepeso y la obesidad son problemas de salud pública de nivel mundial. Si bien existe información respecto al consumo de alcohol en estudiantes universitarios durante la pandemia, pocos autores han señalado la asociación entre este hábito y el exceso de peso en esta población. El objetivo fue determinar la asociación entre el consumo de alcohol y el exceso de peso en estudiantes universitarios de 10 países de Latinoamérica durante la pandemia por COVID-19. Metodología: Se realizó un estudio transversal y multicéntrico con 4.539 estudiantes universitarios matriculados en diez países de América Latina. Para la valoración del consumo de alcohol se utilizó la pregunta ¿Consumes bebidas alcohólicas? (1 porción 1 vaso de 200 ml). El índice de masa corporal (IMC) se determinó a partir del peso y la altura auto informado. Para determinar si el exceso de peso (IMC ≥25 kg/m2) estaba asociado con el consumo de alcohol, se utilizó un análisis de regresión logística, ajustado por edad, sexo, año de estudio, nivel socioeconómico, actividad física y tabaquismo. Resultados: Entre los estudiantes con estado nutricional normal, un 59,6% no consumía alcohol, mientras entre los que presentaban un exceso de peso era un 55,1%. Los estudiantes que consumían 2 o más porciones de alcohol al día tenían 2,18 veces más riesgo de tener exceso de peso (OR: 2.18 [95% IC: 1,26 a 3,77]), comparado con aquellos que no consumían alcohol. Conclusión: Se observó que aquellos estudiantes que consumieron más alcohol tuvieron más probabilidades de tener exceso de peso.

Introduction: Overweight and obesity are public health problems worldwide. Alcoholic beverages could increase total energy intake causing an increase in body weight. However, few authors have pointed out the association between this habit and excess weight in this population. The objective of this study was to determine the association between alcohol consumption and excess weight in university students from 10 Latin American countries during the COVID-19 pandemic. Methodology: A cross-sectional and multicenter study was carried out with 4,539 university students enrolled in ten Latin American countries. To assess alcohol consumption, the question Do you consume alcoholic beverages? (1 portion 1 glass of 200 ml). Body mass index (BMI) kg/m2 was determined from self-reported weight and height. To determine if excess weight was associated with alcohol consumption, a logistic regression analysis was used, adjusted for age, sex, year of study, socioeconomic level, physical activity, and smoking. Results: Among students with normal nutritional status, 59.6% did not consume alcohol, while among those with a BMI ≥25 kg/m2 it was 55.1%. Students who consumed 2 or more servings of alcohol per day had a 2.18 times greater risk of being overweight (OR: 2.18 [95% CI: 1.26 to 3.77]), compared with those who did not consume alcohol. Conclusion: It was observed that those students who consumed more alcohol were more likely to be overweight.

Healthy Lifestyle Habits in Latin American University Students during COVID-19 Pandemic: A Multi-Center Study.

Background: Deterioration in the health-related quality of life (HRQoL) and healthy eating behavior due to the effect of COVID-19 lockdown has been reported. The aim of this study was to associate eating habits and HRQoL with physical activity behavior in Latin American university students during COVID-19 pandemic.Methods: Measured 4,859 university students with a mean age of 22.4 years and they were mostly female (73.7%) from 10 Latin American countries (Argentina, Chile, Colombia, Costa Rica, Ecuador, Guatemala, Mexico, Panama, Paraguay and, Peru). Eating habits were measured using a survey validated with other university students, HRQoL was assessments using the short version of the World Health Organization (WHOQOL-BREF) scale and physical activity behavior with a dicotomous question based on the international recommendations for physical activity.Results: There is a higher complaince for all the international recommendations for healthy foods intake in the physically active group of students (p < 0.01), with the exception of alcohol and salt. In addition, physically active students presented a significantly higher HRQoL (p < 0.001) in all the dimensions analyzed when compared to physically inactive students.Conclusions: Latin American university students who are physically active are more likely to have a healthier eating behavior and a lower risk of a decreased HRQoL during COVID-19 pandemic.

Bodyweight change and its association with food and beverage consumption at the beginning COVID-19 confinement.

OBJECTIVES: SARS-CoV-2, a newly identified coronavirus responsible for the COVID-19 pandemic, has challenged health services and profoundly impacted people's lifestyles. The objective of the present study was to evaluate the effect of confinement during the COVID-19 pandemic on food consumption patterns and body weight in adults from 12 Ibero-American countries. METHODS: Multicentric, cross-sectional study. Data was collected using an online survey disseminated by social networks. The sample included 10 552 people from Spain and 11 Latin American countries who were selected by snowball sampling. RESULTS: While 38.50% of the sample reported weight gain, 16.90% reported weight lost. Weight change was associated with sex, age, country of residence, and education level. People who were not confined more often reported having maintained their weight in comparison to people who were confined. All Latin American countries showed an increased consumption of sweetened drinks, pastry products, fried foods, and alcoholic beverages during confinement. Consumption of eggs and dairy products was independent from body weight change. People who consumed more fruits and vegetables during confinement more often reported having lost weight. In contrast, body weight gain during confinement was associated with increased intake of sugary drinks, baked goods and pastries, pizza, fried foods, and alcoholic beverages. CONCLUSION: During COVID-19 confinement, the Latin American countries included in this study showed a change in their consumption patterns toward less healthy diets, which in turn was associated with an increase in the body weight of their population.

Conocimientos de la población adulta sobre etiquetado nutricional de alimentos

Los consumidores a menudo informan dificultades para interpretar la información cuantitativa contenida en las etiquetas nutricionales de los alimentos. El objetivo fue estudiar los principales conocimientos sobre etiquetado de alimentos que la población adulta del Paraguay tiene incorporado en el periodo de agosto de 2021. Este es un estudio descriptivo observacional de corte trasversal en el cual se evaluaron a adultos de ambos sexos de 18 a 60 años consumidores de alimentos con etiquetado nutricional. Se recabarón datos sociodemográficos y de conocimientos sobre etiquetado nutricional de alimentos a través de una encuesta tipo on-line con la herramienta de Google forms. El 73% fueron del sexo femenino, la edad promedio fue de 36,9 años, 57,1% residía en Gran Asunción, 49,1% tenía nivel educativo universitario y 37,5%eran profesionales de la salud. Los aspectos generales sobre etiquetado nutricional revelaron que 88,3% sabía su concepto, 55,3% refirió que lo lee casi siempre, 84% sabía que es obligatorio y 44% se fijaba más en las calorías. Al evaluar los conocimientos generales, 91% sabía la diferencia entre caducidad y consumo preferente, 71,4% conocía el concepto de cantidades orientativas, 62,5% supo cuáles son las grasas menos saludables, y 71,4% respondió correctamente el concepto de alimento light. Los encuestados tuvieron un conocimiento general adecuado sobre etiquetado nutricional, no obstante, hubo un porcentaje considerable de individuos que no supieron los conceptos básicos, por lo que se debe realizar intervenciones de educación nutricional enfocadas al consumidor.

Consumers often report difficulties in interpreting the quantitative information contained in the nutritional labels of foods. The objective was to study the main knowledge about food labeling that the adult population of Paraguay has incorporated in the period of August 2021. This is a cross-sectional descriptive observational study in which male and female adults between 18 and 60 years old consumers of foods with nutrition labelling were evaluated. Sociodemographic data and knowledge about nutritional labeling of food was collected through an online survey with the Google forms tool. Seventy three percent was female, the average age was 36.9 years, 57.1% lived in Greater Asunción, 49.1% had a university education level, and 37.5% were health professionals. The general aspects about nutritional labeling revealed that 88.3% knew the concept, 55.3% said that they read it almost always, 84% knew that it was mandatory and 44% paid more attention to calories. When evaluating general knowledge, 91% knew the difference between expiration and preferential consumption, 71.4% knew the concept of indicative quantities, 62.5% knew which are the less healthy fats, and 71.4% correctly answered the concept of light food. The survey respondents had an adequate general knowledge about nutrition labeling, however, there was a considerable percentage of individuals who did not know the basic concepts, for which consumer-focused nutrition education interventions should be carried out.

Utilidad de la circunferencia de pantorrilla como marcador de desnutrición comparado con el mini nutritional assessment, nutritional risk screening 2002 y albúmina sérica en adultos mayores / Utility of calf circumference as a marker of malnutrition in relation to the mini nutritional assessment, nutritional risk screening 2002 and serum albumin in older adults

Introducción:la evaluación de la desnutrición en el adulto mayor puede basarse en medidas antropométricas, parámetros bioquímicos, pruebas nutricionales y la circunferencia de la pantorrilla que es uno de los métodos de evaluación nutricional. Objetivo:evaluar la utilidad de la circunferencia de la pantorrilla como marcador de desnutrición comparadaal Mini Nutritional Assessment(MNA), Nutrition Risk Screening2002 (NRS-2002) y la albúmina plasmática en adultos mayores hospitalizados en el Hospital Geriátrico Prof. Dr. Gerardo Buongermini ­IPS entre marzo y abril de 2019. Metodología:estudio observacional descriptivo transversal en 300 adultos mayores hospitalizados en el Hospital Geriátrico. Se estudiaron variables demográficas y de evaluación nutricional. Se evaluó la sensibilidad y especificidad de la circunferencia de la pantorrilla en relación con el MNA, NRS-2002 y albúmina plasmática. Resultados:el 60,3% de los pacientes estaba en el rango de edad de 75 a 90 años, el 57,7% de sexo femenino. El riesgo nutricional según la circunferencia de la pantorrilla fue del 69%, según MNA, la desnutrición fue en 54,7% y riesgo de desnutrición 34%, según NRS-2002, 69,7% presentó riesgo de desnutrición y según albúmina plasmática el 32,3% tuvo desnutrición leve. La sensibilidad del perímetro de la pantorrilla con respecto al MNA, NRS-2002 y albúmina plasmática fueron del 91%, 95,6%, 100% y la especificidad 100%, 65,3% y 65,3%, respectivamente. Conclusión:la circunferencia de la pantorrilla tuvo una alta sensibilidad y es elmétodo ideal y de bajo costo para evaluar de manera rápida y segura a esta población.

Introduction:the evaluation of malnutrition in the elderly can be based on anthropometric measurements, biochemical parameters, nutritional tests and calf circumference is one of the methods of nutritional evaluation. Objective: To evaluate the usefulness of calf circumference as a marker of malnutrition in relation to the Mini Nutritional Assessment (MNA), Nutrition Risk Screening 2002 (NRS-2002) and plasma albumin in older adults hospitalized at the Hospital Geriatrico Prof. Dr. Gerardo Buongermini ­IPS between March and April 2019. Methodology:cross-sectional descriptive observational study in 300 older adults hospitalized in the nursing hospital. Sociodemographic variables and nutritional assessment were studied. The sensitivity and specificity of calf circumference compared to MNA, NRS 2002 and plasma albumin were evaluated. Results:60.3% of the patients were in the age range of 75 to 90 years, 57.7% were female. Nutritional risk according to calf circumference was present in 69%, malnutrition in 54.7% and risk of malnutrition 34% according to MNA, 69.7% risk of malnutrition according to NRS-2002 and mild malnutrition in 32.3% according to plasma albumin. The sensitivity of calf circumference with respect to MNA, NRS 2002 and plasma albumin were 91%, 95.6%, and 100%, and specificity 100%, 65.3% and 65.3%, respectively. Conclusion:calf circumference had a high sensitivity and it is the ideal method and low cost to quickly and safely evaluate this population.

Relevant laboratory parameters in patients at hospital admission between July 2020 and October 2021 due to covid-19 at the Tesãi Foundation Hospital

Background:in the fight against COVID-19, the identification of laboratory predictors in the progression of severe and fatal forms is urgently needed. Aims:to describe the alterations of laboratory parameters of patients diagnosed with COVID-19 at admission to Tesãi Foundation Hospital in Ciudad del Este-Paraguay between July 2020 to October 2021.Methods:A retrospective study using the medical charts of 103 patients admitted to the hospital due to a diagnosis of COVID-19 was carried out. Demographic, clinical, and laboratory data were collected at hospital admission. Results:53.4% of the patients were male, mean age of 62.3±15.4 years, and 43.6% were admitted due to pneumonia. According to the complete blood count, 54.3% had lymphopenia, 26% thrombocytopenia, and 27% anemia. In the liver and kidney profiles, 37.9% had elevated urea levels, 56.3% elevated GOT levels, 26% elevated GPT, and 61% GGT levels. Regarding biomarkers, 80% had elevated LDH levels, 34% elevated D-dimer levels, 100% elevated C-reactive protein, 43.7% elevated procalcitonin, and 89.3% elevated ferritin. Significant differences (p<0.05) were found according to sex for the parameters of hemoglobin, hematocrit, creatinine, and the LMR ratio. Conclusion:patients presented several alterations in hematological, renal, hepatic, and inflammatory marker parameters, which offer a general overviewof the state of health with which the patient with COVID-19 is admitted to the hospital.

Introducción: en la lucha contra el COVID-19 es urgente la identificación de predictores de laboratorio en la progresión de formas graves y fatales. Objetivo:describir las alteraciones de los parámetros de laboratorio de pacientes con COVID 19 ingresados al Hospital Fundación Tesãi de Ciudad del Este-Paraguay en el período de julio de 2020 a octubre de 2021. Métodos:estudio retrospectivo, utilizando los registros de 103 pacientes ingresados al hospital por diagnóstico de COVID 19. Se recolectaron datos demográficos, clínicos y de laboratorio al ingreso hospitalario. Resultados:el 53,4% de los pacientes era del sexo masculino, edad media de 62,3±15,4 años y el 43,6% ingresó por neumonía. El 54,3% presentaba linfopenia, el 26% trombocitopenia y el 27% anemia. En el perfil hepático y renal, el 37,9% tenían niveles elevados de urea, el 56,3% niveles elevados de GOT, 26% y 61% niveles elevados de GPT y GGT, respectivamente. En cuanto a los biomarcadores, el 80 % tenía niveles elevados de LDH, el 34 % niveles elevados de dímero D, el 100 % proteína C reactiva elevada, el 43,7 % procalcitonina elevada y el 89,3 % ferritina elevada. Se encontraron diferencias significativas (p<0,05) según el sexo en los parámetros de hemoglobina, hematocrito, creatinina y el índice LMR. Conclusión:los pacientes presentaron diversas alteraciones en casi todos los parámetros evaluados, resultados que ofrecen un panorama general del estado de salud con el que ingresa el paciente con COVID 19 al hospital.

Quality of the diet during the COVID-19 pandemic in 11 Latin-American countries.

BACKGROUND AND OBJECTIVES: The confinement by COVID-19 has affected the food chain and environments, which added to factors such as anxiety, frustration, fear and stress have modified the quality of the diet in the population around the world. The purpose of this study was to explore diet quality during the COVID-19 pandemic in 11 Latin American countries. METHODOLOGY: Multicentric, cross-sectional study. An online survey was applied to residents of 11 Latin-American countries, during April and May 2020, when confinement was mandatory. Diet quality was evaluated using a validated questionnaire. RESULT: 10,573 people participated in the study. The quality of the food by country shows that Colombia presented the best quality, while Chile and Paraguay presented the lowest. When comparing the overall results of diet quality by gender, schooling and age, women, people with more schooling and people under 30 years of age, presented better diet quality. The regression model showed that the variables associated with diet quality were: age (df = 3, F = 4. 57, p < 0.001), sex (df = 1, F = 131.01, p < 0.001), level of education (df = 1, F = 38.29, p < 0.001), perception of weight change (df = 2, F = 135.31, p < 0.001), basis services (df = 1, F = 8.63, p = 0.003), and quarantine (df = 1, F = 12.14, p = 0.001). CONCLUSION: It is necessary for governments to intervene to reverse these indicators, considering that inadequate feeding favors the appearance of no communicable diseases, which favor a higher risk of infection and worse prognosis with COVID-19.

Body weight in relation to hours of sleep, and physical activity in Latin American university students during the Covid-19 pandemic.

Introduction: Short sleep, physical inactivity, and being locked up are risk factors for weight gain. Objective: We evaluated weight gain according to sex, age, hours of sleep and physical activity in university students from 10 Latin American countries during the COVID-19 pandemic. Methods: Cross-sectional and multicenter study (n = 4880). Results: The average age was 22.5 ± 4.4 years. 60.2% were currently locked up. 73.6% were women, 48.2% increased their body weight, 66% reported insufficient sleep hours, and 65.9% were inactive. Women gained more weight than men (73.2%) and younger students gained more weight (85.1%). Those who had insufficient sleep hours gained most weight (67.6%). Inactive participants gained most weight (74.7%). Students who have insufficient sleep are 21% more likely to have changes in body weight compared to students who have optimal sleep. Conclusion: The increase in body weight and its risk factors during confinement should be considered as emerging from public health.

Calidad de la dieta, estado nutricional y nivel de actividad físicaen estudiantes universitarios de la carrera de enfermería / Diet quality, nutritional status and physical activity level in university students of the nursing career

Fundamentos: Para los estudiantes comenzar los estudios en la universidad es un momento en donde lospatrones nutricionales adquiridos previamente, relacionados con la satisfacción de las necesidades dietéticas,se fijan o se forman nuevos patrones de comportamiento. El objetivo fue evaluar la calidad de la dieta, elestado nutricional y el nivel de actividad física de estudiantes universitarios de enfermería.Métodos: estudio observacional, analítico de corte transversal realizado en 50 universitarios de primer ysegundo año de enfermería. Se recabaron datos sociodemográficos como sexo, estado civil, ocupación yprocedencia, datos antropométricos como peso, talla e IMC; y datos de nivel de actividad física a través delcuestionario internacional versión corta IPAQ. Para evaluar la calidad de la dieta, se aplicó una encuestacerrada de frecuencia de consumo de alimentos basada en las Guías Alimentarias del Paraguay.Resultados: la edad promedio fue de 22,2±4,9 años, 76% fue del sexo femenino, el 86% de los estudiantestenía una calidad poco saludable. 52% de la población se encontraba con estado nutricional adecuado, el 58%de la población universitaria tiene un nivel de actividad física bajo. La calidad de dieta según el sexo, mostróque las mujeres tienen la mayor proporción de dieta poco saludable (64%). Según el estado nutricional, losque se encontraban en normopeso tuvieron la mayor proporción de dieta poco saludable seguidos de losobesos 44% y 28%, respectivamente; y según el nivel de actividad física, los que presentaban un nivel bajo,fueron los que mayormente tuvieron una dieta poco saludable. Se encontraron diferencias significativas entodos los grupos (p<0,05).Conclusiones: la mayor parte de la población universitaria tiene una dieta poco saludable y bajo nivel deactividad física. (AU)

Background: for students, starting their studies at the university is the moment where previously acquirednutritional patterns, related to the satisfaction of dietary needs, are fixed or new patterns of behavior areformed. Objective: to evaluate the quality of the diet, the nutritional status and the level of physical activity ofuniversity nursing students.Methods: observational, analytical cross-sectional study carried out in 50 first- and second-year nursingstudents. Sociodemographic data such as sex, marital status, occupation and origin, anthropometric data suchas weight, height and BMI, physical activity level data were collected through the international short versionIPAQ questionnaire. To evaluate the quality of the diet, a closed survey of food consumption frequency wasapplied, based on the Food Guidelines of Paraguay.Results: the average age was 22.2 ± 4.9 years, 76% were female, 86% of the students had an unhealthyquality. 52% of the population had adequate nutritional status, most of the university population has a lowlevel of physical activity (58%). The quality of diet according to sex, showed that women have the highestproportion of unhealthy diet (64%). According to the nutritional status, the normal weight had the highestproportion of an unhealthy diet followed by the obese 44% and 28% respectively and according to the level ofphysical activity, those who had a low level were the ones who had an unhealthy diet the most. Significantdifferences were found in all groups (p <0.05).Conclusions: most of the university population has an unhealthy diet and low level of physical activity. (AU)

Nutrientes críticos de alimentos procesados y ultraprocesados destinados a celíacos y su adecuación al perfil de la Organización Panamericana de la Salud / Critical nutrients of processed and ultra-processed foods intended for celiacs and their adequacy to the profile of the Panamerican Health Organization

Fundamentos: la enfermedad celiaca supone una dieta libre de gluten de por vida para esos pacientes,teniendo acceso a poca variedad de productos que puedan consumir y a que además podrían ser alimentosprocesados y ultraprocesados, por esta razón el presente trabajo tiene por objetivo evaluar la composiciónnutricional en cuanto a los nutrientes críticos declarados por la Organización Panamericana de la Salud (OPS)en alimentos aptos para celíacos.Métodos: estudio transversal, observacional y descriptivo en el que se analizaron 50 productos: 25procesados y 25 ultraprocesados según la clasificación NOVA, de dos supermercados de Asunción – Paraguay.Resultados: la relación sodio/kcal fue elevada en 3 categorías tanto de alimentos procesados comoultraprocesados. La cantidad de azúcares fue elevada en 4 categorías de alimentos procesados y en 2 deultraprocesados. En cuanto a las grasas totales, en los alimentos procesados y ultraprocesados, 4 categoríassobrepasaron el rango establecido, las grasas saturadas fueron elevadas en 2 categorías para los procesados y4 para los ultraprocesados, las grasas trans fueron elevadas en los embutidos.Conclusiones: debido a que al menos un nutriente crítico sobrepasa lo establecido en alimentos procesadosy ultraprocesados, es indispensable una ley del etiquetado que permita a los celiacos elegir las mejoresopciones para su alimentación dada a la escasa oferta de alimentos de este tipo. (AU)

Background: celiac disease constitutes a gluten-free diet for life for these patients, having access to littlevariety of products that they can consume since they could also be processed and ultra-processed foods, forthis reason the present work aims to evaluate the composition in terms of the critical nutrients declared byPAHO in foods suitable for celiacs.Methods: cross-sectional, observational and descriptive study in which 50 products were analyzed: 25processed and 25 ultra-processed according to the NOVA classification, from two supermarkets in Asunción -Paraguay.Results: the sodium / kcal ratio was elevated in 3 categories of both processed and ultra-processed foods.The amount of sugars was high in 4 categories of processed foods and in 2 of ultra-processed. Regarding totalfats, in processed and ultra-processed foods, 4 categories exceeded the established range, saturated fatswere elevated in 2 categories for processed and 4 for ultra-processed foods, trans fats were elevated insausages.Conclusions: since at least one critical nutrient exceeds what is established in processed and ultra-processedfoods, the labeling law is essential to allow celiacs to choose the best options for their diet, given that thefood supply for this population is scarce. (AU)

Evaluación del estado nutricional, los patrones de alimentación y realización de actividad física de los médicos residentes del Hospital General de Luque del año 2020

RESUMEN Los médicos residentes enfrentan cambios en el estilo de vida, adquisición de hábitos alimenticios inadecuados, influencia de modas, publicidad y necesidad de pertenecer a un grupo social, por lo cual se encuentran en riesgo de padecer sobrepeso y obesidad. Nuestro objetivo fue determinar el estado nutricional, los patrones de alimentación y la realización de actividad física de los médicos residentes del Hospital General de Luque del año 2019. Se realizó un estudio descriptivo, observacional de corte transversal en el que se evaluaron variables sociodemográficas, antropométricas, estado nutricional, patrón alimentario y actividad física. Se incluyó un total de 58 médicos residentes de los cuales 66% fueron del sexo femenino, y la edad promedio fue de 28,12 años. Según el IMC, la mayoría presentó sobrepeso (34,5%). En cuanto a los patrones de alimentación, la mayoría no cumplía con las recomendaciones de las Guías Alimentarias del Paraguay de consumir 3 frutas por día ni de evitar alimentos ricos en grasas, sodio y altos en calorías como lo son las comidas rápidas. Se observó que 49% no realizaba actividad física. Los médicos residentes del Hospital General de Luque presentaron en su mayoría exceso de peso, tenían un patrón alimentario inadecuado y no realizaban actividad física.

ABSTRACT Resident physicians face changes in lifestyle, acquisition of inappropriate eating habits, influence of fashions, advertising and the need to belong to a social group, which is why they are at risk of being overweight and obese. Our objective was to determine the nutritional status, eating patterns and physical activity of the resident doctors of the General Hospital of Luque in 2019. A descriptive, observational cross-sectional study was carried out in which sociodemographic variables, anthropometric, nutritional status, eating pattern and physical activity were evaluated. A total of 58 resident physicians were included, of which 66% was female, and the average age was 28.12 years. According to the BMI, the majority were overweight (34.5%). Regarding eating patterns, most did not comply with the recommendations of the Paraguayan Dietary Guidelines of consuming 3 fruits per day or avoiding foods rich in fat, sodium and high in calories such as fast foods. It was observed that 49% did not perform physical activity. The resident physicians of the General Hospital of Luque were mostly overweight, had an inadequate eating pattern and did not perform physical activity.

Psychological factors of diet quality among rural populations of Latin America during the COVID-19 pandemic: a cross-sectional study.

INTRODUCTION: This study aimed to determine the relationship between symptoms of anxiety and/or anhedonia (inability to feel pleasure) and diet quality during confinement due to COVID-19 in rural populations in Latin America. METHODS: This was a multicentric, cross-sectional study. An online survey was applied, which included the Beck Anxiety Inventory, Snaith-Hamilton Pleasure Scale for assessing the presence of anhedonia, the Food Intake Questionnaire and sociodemographic questions. RESULTS: The study included 10 552 people from 11 countries; 708 participants were living in rural areas. More than half of the participants were quarantined at the time of the survey. Diet quality was inversely associated with anhedonia (p<0.001) and anxiety (p=0.003). In addition, a healthier diet was associated with being female (p=0.030), having a higher level of education (p=0.008) and country of residence (p=0.001). CONCLUSION: Among the rural population during the COVID pandemic, this study found a worse diet quality was associated with symptoms of anhedonia and anxiety, as well as lower level of education and being male. Proposals to improve the quality of the diet could include interventions aimed at people's mental health.

Processed and ultra-processed foods consumption in adults and its relationship with quality of life and quality of sleep / Consumo de alimentos processados e ultraprocessados em adultos e sua relação com qualidade de vida e qualidade do sono

ABSTRACT Objective: To evaluate the consumption of processed and ultra-processed foods in Paraguayan adults and its relationship with quality of life and sleep quality. Methods: A cross-sectional descriptive observational study was carried out on Paraguayan adults in May 2022. An online survey was applied in which sociodemographic data, frequency of food consumption using the NOVA classification and Pan American Health Organization criteria, quality of life evaluated by the European Quality of Life-5 Dimensions and report of hours of sleep were collected. Results: A total of 273 Paraguayan adults were included in the study, of which 71.1% were female, 51.6% lived in the capital, 53.1% were single, 66% had a university educational level and the average age was 36.48±13.2. Regarding the consumption of processed and ultra-processed foods, the critical nutrients most consumed daily were free sugars by 34.0%, and fats by 23.4% of the population. The global quality of life index was low (0,58±0,05) and 69.0% reported insufficient hours of sleep. Statistically significant relationships were found between the consumption of processed and ultra-processed foods with quality of life and quality of sleep (p<0.05 for both). Conclusion: The most consumed critical nutrients in the Paraguayan adult population are free sugars and fats, finding a significant relationship between the consumption of processed and ultra-processed foods with quality of life and quality of sleep.

RESUMO Objetivo: Avaliar o consumo de alimentos processados e ultraprocessados em adultos paraguaios e sua relação com a qualidade de vida e qualidade do sono. Métodos: Foi realizado um estudo observacional descritivo transversal em adultos paraguaios em maio de 2022. Foi aplicado um questionário online onde foram questionados datos sociodemográficos, frequência de consumo alimentar pela classificação NOVA e critérios da Organização Pan-Americana da Saúde, qualidade de vida avaliada pelo Qualidade de Vida Europeia-5 Dimensões - foram coletados e relato de horas de sono. Resultados: Foram incluídas no estudo 273 paraguaios, das quais 71,1% eram do sexo feminino, 51,6% residiam na capital, 53,1% eram solteiras, 66,0% tinham nível universitário e a média de idade foi de 36,48±13,2 anos. Em relação ao consumo de alimentos processados e ultraprocessados, os nutrientes críticos mais consumidos diariamente foram os açúcares livres por 34.0% e as gorduras por 23,4% da população. O índice global de qualidade de vida foi baixo (0,58±0,05) e 69.0% relataram horas insuficientes de sono. Foram encontradas relações estatisticamente significativas entre o consumo de alimentos processados e ultraprocessados com qualidade de vida e qualidade do sono (p<0,05 para ambos). Conclusão: Os nutrientes críticos mais consumidos na população adulta paraguaia são os açúcares e gorduras livres, encontrando uma relação significativa entre o consumo de alimentos processados e ultraprocessados com a qualidade de vida e qualidade do sono.