Social Media for Nutrition Education-A Randomized Controlled Trial to Promote Fruit and Vegetable Intake in a University Setting: "The University of Valladolid Community Eats Healthy" Study.

Social media- and internet-based interventions are nowadays widely used tools in health interventions. Although evidence of their effectiveness is still low, their applications could be very promising due to their affordability and wide reach. The current paper aims to evaluate the effectiveness of an intervention program, "The University of Valladolid Community Eats Healthy" (UVEH), to increase fruit and vegetable (FV) intake in adults from the University of Valladolid (U. Valladolid) employing three online methodologies. A sample of 211 volunteers was randomly assigned into four groups: virtual campus (VC), Facebook (FB), Instagram (IG), and control. An intervention based on the Theory of Planned Behavior was implemented for seven weeks. Data were collected at the beginning (T0) and the end of the program (T1). The Predimed questionnaire was employed to assess FV intake. Vegetable intake was statistically significantly higher in the VC group (17.4% pre vs. 72.7% post). In the rest of the groups, there was also an increase in intake. Fruit consumption increased slightly only in the VC group (23.9% pre vs. 45.5% post). Participation decreased through the weeks: FB (week 2), IG (week 3), and VC (week 4). Retention was higher in the VC (48%) and control (60%) groups. Internet-based interventions employing interactive platforms such as virtual campus can be effective in enhancing participants' dietary habits in a clinically relevant manner.

Prevalence of Malnutrition in a Group of Institutionalized Psychogeriatric Patients Using Different Diagnostic Criteria.

Malnutrition (MN) is a highly prevalent condition in the elderly. It is associated with functional impairment, disability, frailty, and sarcopenia. The aim was to analyze the capacity of GLIM and ESPEN criteria to diagnose MN in a sample of institutionalized psychogeriatric patients. Clinical and anthropometric data were collected in a cross-sectional study. Patients' frailty, dependence, functional capacity, MNA, hand-grip strength (HS), and sarcopenia were evaluated. Body composition (BC) was estimated by conventional bioimpedance analysis. MN diagnosis was established using the ESPEN and the GLIM criteria based on fat-free mass index (GLIM-FFMI), appendicular skeletal muscle mass index (GLIM-ASMMI), skeletal muscle mass index (GLIM-SMMI), and HS (mGLIM). Ninety-two patients (57.6% men; mean age: 79.4 years) were studied. Depending on the diagnosis criteria, MN prevalence was between 25% (ESPEN) and 41.3% (GLIM-SMMI). Agreement between ESPEN and all GLIM criteria was poor, but it was excellent between all GLIM criteria (kappa > 0.8). Phenotypic criteria carried more weight in the diagnosis of MN than etiological ones. Depending on the parameter used, the prevalence of reduced muscle mass was notably different. Differences in BMI, BC, inflammation, and albumin are detected by the GLIM-FFMI criteria in the MN and non-MN subjects. Also, this criterion is the only one that identified differences in phase angle (PhA) between these groups. In the elderly, PhA can be very useful to monitor nutritional status.

Phase Angle as a Prognostic Indicator of Survival in Institutionalized Psychogeriatric Patients.

Phase angle (PhA) has been evidenced to be a useful survival indicator and predictor of morbi-mortality in different pathologies, but not in psychogeriatric patients. The aim of this study was to evaluate the clinical utility of PhA as a prognostic indicator of survival in a group of institutionalized psychogeriatric patients. A survival study was conducted on 157 patients (46.5% dementia, 43.9% schizophrenia). Functional impairment stage, frailty, dependence, malnutrition (MNA), comorbidity, polypharmacy, BMI, and waist circumference were registered. Body composition was analyzed using a 50-kHz whole-body BIA; PhA was recorded. The association between mortality and standardized-PhA was evaluated through univariate and multivariate Cox regression models and ROC-curve. The risk of death decreased when Z-PhA, BMI, and MNA were higher. Mortality increases with age, frailty, and dependence. The risk of death was statistically significantly lower (56.5%) in patients with schizophrenia vs. dementia (89%). The Z-PhA cut-off point was -0.81 (Sensitivity:0.75; Specificity:0.60). Mortality risk was multiplied by 1.09 in subjects with a Z-PhA < -0.81, regardless of age, presence of dementia, and BMI. PhA presented a remarkable clinical utility as an independent indicator of survival in psychogeriatric patients. Moreover, it could be useful to detect disease-related malnutrition and to identify subjects eligible for an early clinical approach.

Health Perception According to the Lifestyle of University Students.

University students are characterized by having inadequate eating habits, along with an unhealthy lifestyle, which, among other factors, can affect the perception they have of their state of health. The aim of the study was to evaluate the health perception of a group of university students according to lifestyle. A cross-sectional observational study was carried out on 214 university students from different universities and branches of knowledge. Anthropometric data were collected. Three questionnaires were administered: PREDIMED (Mediterranean Diet (MD) adherence), SF-36 (perception of health state) and GPAQ (physical activity (PA)). The differences between variables were analyzed using Student-t or Mann-Whitney U, Kruskal-Wallis and Pearson Chi-Square tests. Statistical significance was reached at p < 0.05. Most students were found to be normal weighted. The subjects presented an moderate MD adherence, this being better in Health Sciences students. 75.7% practiced light PA. The health perception is worse for most of the subscales analyzed than that of the reference population (except physical-function, physical-role, and emotional-role). There is an association between PA and health perception: students with intense PA have less body pain and better physical function; the less active, the less vitality. The more physically active subjects the greater MD adherence. Lifestyle and eating habits of health sciences students are healthier than that of students from other branches of knowledge. The physically active subjects have a better perception of quality of life-related to health and greater MD adherence.

Diseño y aplicación de un cuestionario de calidad dietética de los menús escolares / Design and implementation of a questionnaire to evaluate the dietary quality of school meals

Introducción: El comedor escolar es el centro de comida habitual para muchos niños. Aunque actualmente se dispone de guías y recomendaciones para los menús escolares, resulta difícil evaluar su calidad dietética. Objetivos: Diseñar un cuestionario para evaluar la calidad desde el punto de vista dietético de los menús escolares de forma rápida y sencilla. Material y métodos: Partiendo de las recomendaciones, se ha diseñado un cuestionario (COMES) de 15 ítems que hacen referencia a la frecuencia de consumo de alimentos y otras características de los menús escolares. A continuación se realizó un estudio longitudinal prospectivo en el que se analizaron con este cuestionario 36 planillas de menús de 4 empresas de restauración colectiva que prestaban l servicio de comedor escolar en Castilla y León durante los cursos 2006-2007 a 2010-2011. Se analizaron las diferencias en función del sistema de gestión de las empresas mediante la prueba U de Mann-Whitney y el test de Kruskal- Wallis. La significación se alcanzó con una p<0,05. Resultados: Se observó un incumplimiento de la recomendación de ingesta de derivados cárnicos, lácteos y precocinados por exceso en el 97,2%, 94,4% y 27,8% de los menús analizados, respectivamente; y un incumplimiento por defecto en la ingesta de pescado, fruta, legumbre y guarniciones de verduras y hortalizas en el 83,3%, 94,4%, 91,7% y 75% de los menús, respectivamente, aunque sí cumplían las recomendaciones del consenso de comedores para todos los grupos excepto frutas y lácteos. La variedad de alimentos y de técnicas culinarias fue adecuada. No se encontraron diferencias estadísticamente significativas en la puntuación del COMES en función del tipo de gestión (p=0,87), aunque se observó que el sistema de catering ofrece mayor calidad dietética. Conclusiones: Se ha propuesto una herramienta que permite valorar la calidad dietética de los menús escolares de forma rápida y sencilla. La valoración de la frecuencia de consumo de los alimentos más problemáticos para la edad escolar con esta escala es mucho más exigente que las de las recomendaciones actuales. Aún así, los menús analizados presentaban una calidad aceptable en cuanto a variedad de alimentos y técnicas culinarias, pero una excesiva oferta de lácteos a expensas de un déficit de fruta fresca. Por otra parte, el sistema de gestión transportado (catering caliente y línea fría) ofrece menús más acordes con las recomendaciones dietéticas (AU)

Introduction: The school canteen provides a substantial proportion of the daily nutritional intake for manychildren. There are nutritional standards for school meals, however, it is still difficult to assess the dietary quality. Aims: To design a questionnaire for assessing the dietary quality of school meals, quickly and easily. Methods: A dietary questionnaire (COMES) was designed on the basis of the current recommendations. COMES consist of 15 items related to the foodfrequency and to other characteristics of school meals. Then, a longitudinal prospective study was performed in order to analyze, with COMES, 36 school meals of 4 catering companies from Castilla y León during the academic years 2006-2007 to 2010-2011. Differences in dietary quality menus according to the management system of catering companies (in situ vs. transported) were analyzed by using the Mann-Whitney and the Kruskal-Wallis tests. The significance was reached at p <0,05. Results: The frequency intake of meat, dairy and prepared products was higher to the recommended in 97,2%, 94,4% and 27,8% of the analyzed menus, respectively. By contrast, the frequency intake of fish, fruit, legume, and vegetable garnishes were lower to the recommended in 83,3%, 94,4%, 91,7% and 75% of menus, respectively. Nevertheless, recommendations established by our consensus document for school meals are complied for all food groups, except for dairy and fruits. The variety of foods and culinary techniques were appropriate. No significant differences were found in the COMES score according to the management system (p=0,87), although catering system provides higher dietary quality. Conclusions: A new tool to assess quickly and easily the nutritional quality of school meals has been proposed. The assessment of the frequency intake of the most problematic foods for schoolchildren with this scale is much more demanding than the current recommendations. Even so, menus analyzed showed an acceptable quality in terms of variety of foods and culinary techniques, although milk frequency in the menus was excessive at the expense of fresh fruit. On the other hand, the transported system (i.e. catering, both hot and cold-holding) provides menus more consistent with the dietary recommendations (AU)

[Design and implementation of a questionnaire to evaluate the dietary quality of school meals]. / Diseño y aplicación de un cuestionario de calidad dietética de los menús escolares.

INTRODUCTION: The school canteen provides a substantial proportion of the daily nutritional intake for many children. There are nutritional standards for school meals, however, it is still difficult to assess the dietary quality. AIMS: To design a questionnaire for assessing the dietary quality of school meals, quickly and easily. METHODS: A dietary questionnaire (COMES) was designed on the basis of the current recommendations. COMES consist of 15 items related to the food-frequency and to other characteristics of school meals. Then, a longitudinal prospective study was performed in order to analyze, with COMES, 36 school meals of 4 catering companies from Castilla y León during the academic years 2006-2007 to 2010-2011. Differences in dietary quality menus according to the management system of catering companies (in situ vs. transported) were analyzed by using the Mann-Whitney and the Kruskal-Wallis tests. The significance was reached at p <0,05. RESULTS: The frequency intake of meat, dairy and prepared products was higher to the recommended in 97,2%, 94,4% and 27,8% of the analyzed menus, respectively. By contrast, the frequency intake of fish, fruit, legume, and vegetable garnishes were lower to the recommended in 83,3%, 94,4%, 91,7% and 75% of menus, respectively. Nevertheless, recommendations established by our consensus document for school meals are complied for all food groups, except for dairy and fruits. The variety of foods and culinary techniques were appropriate. No significant differences were found in the COMES score according to the management system (p=0,87), although catering system provides higher dietary quality. CONCLUSIONS: A new tool to assess quickly and easily the nutritional quality of school meals has been proposed. The assessment of the frequency intake of the most problematic foods for schoolchildren with this scale is much more demanding than the current recommendations. Even so, menus analyzed showed an acceptable quality in terms of variety of foods and culinary techniques, although milk frequency in the menus was excessive at the expense of fresh fruit. On the other hand, the transported system (i.e. catering, both hot and cold-holding) provides menus more consistent with the dietary recommendations.

Introducción: El comedor escolar es el centro de comida habitual para muchos niños. Aunque actualmente se dispone de guías y recomendaciones para los menús escolares, resulta difícil evaluar su calidad dietética. Objetivos: Diseñar un cuestionario para evaluar la calidad desde el punto de vista dietético de los menús escolares de forma rápida y sencilla. Material y métodos: Partiendo de las recomendaciones, se ha diseñado un cuestionario (COMES) de 15 ítems que hacen referencia a la frecuencia de consumo de alimentos y otras características de los menús escolares. A continuación se realizó un estudio longitudinal prospectivo en el que se analizaron con este cuestionario 36 planillas de menús de 4 empresas de restauración colectiva que prestaban el servicio de comedor escolar en Castilla y León durante los cursos 2006-2007 a 2010-2011. Se analizaron las diferencias en función del sistema de gestión de las empresas mediante la prueba U de Mann-Whitney y el test de Kruskal- Wallis. La significación se alcanzó con una p.

[Effect of refeeding on the body composition of females with restrictive anorexia nervosa; anthropometry versus bioelectrical impedance]. / Efecto de la realimentación en la composición corporal de mujeres con anorexia nerviosa restrictiva; antropometría frente a impedancia bioeléctrica.

OBJECTIVE: To assess the body composition in a group of malnourished patients with anorexia nervosa as compared to healthy controls, before and after nutritional support, by means of anthropometry and bioimpedance. METHODS: Prospective observational study. Complete anthropometry was performed as well as bioimpedance analysis in 12 women (24.5 years) with restrictive anorexia nervosa at hospital admission and weekly thereafter during re-feeding. The control group was formed by 24 healthy women (21 years). The Student's t test, the Mann-Whitney U test, the Student's t test for repeated measurements, and the Wilcoxon's test were applied. The level of agreement between anthropometry and BIA was calculated by the interclass correlation coefficient and the Bland-Altman s test. RESULTS: The patients had significant improvements in all indexes of body composition throughout their hospital staying although their values at discharge still were lower than those of the control subjects. The average weight gain was 5.22 kg (SD: 1.42), of which 51.4% was fat mass, preferentially centrally distributed. In the control subjects, the BIA equation that correlated the best with anthropometrics was Sun s equation (CCI = 0.896); in the patients, the level of agreement was weaker, both at hospital admission and at hospital discharge. CONCLUSIONS: Re-feeding produces weight gain, essentially at the expense of fat mass, which is centrally distributed; the nutritional status is not reestablished. The level of agreement between anthropometry and bioimpedance for studying body composition is acceptable, especially in healthy subjects. In those cases with severe changes in body composition and/or water balance, anthropometry is recommended when vectorial BIA or some other gold standard method are not available for the analysis of body composition.

Objetivo: Evaluar la composición corporal en un grupo de pacientes desnutridas con anorexia nerviosa, respecto de controles sanas, antes y después del soporte nutricional, mediante antropometría y bioimpedancia. Métodos: Estudio observacional prospectivo. Se realizó una antropometría completa y un análisis de bioimpedancia a 12 mujeres con anorexia nerviosa restrictiva (24,5 años) al ingreso hospitalario y semanalmente durante la realimentación. El grupo control estuvo formado por 24 mujeres sanas (21 años). Se aplicaron los test t-Student, U-Mann-Whitney, t-Student para medidas repetidas o Wilcoxon. La concordancia entre antropometría y BIA se analizó mediante el coeficiente de correlación intraclase y Bland-Altman. Resultados: Las pacientes mejoraron significativamente todos los índices de composición corporal a lo largo de la estancia hospitalaria, aunque sus valores al alta siguieron siendo menores que los de las controles. La media de peso ganado fue 5,22 kg (DE: 1,42), de los que el 51,4% fueron masa grasa, con distribución central preferentemente. En las controles la ecuación de BIA que mejor concuerda con antropometría es la de Sun (CCI = 0,896); en las pacientes la concordancia fue más débil, al ingreso y al alta. Conclusiones: La realimentación produce una ganancia ponderal, fundamentalmente a expensas de masa grasa, con distribución central; no se consigue restablecer el estado nutricional. La concordancia entre antropometría y bioimpedancia para el estudio de la composición corporal es aceptable, especialmente en sujetos sanos. Se recomienda emplear antropometría, si no se dispone de BIA vectorial o algún método gold estandard para el análisis de la composición corporal, en casos de alteraciones importantes en la composición corporal y/o el balance hídrico.

Efecto de la realimentación en la composición corporal de mujeres con anorexia nerviosa restrictiva; antropometría frente a impedancia bioeléctrica / Effect of refeeding on the body composition of females with restrictive anorexia nervosa; anthropometry versus bioelectrical impedance

Objetivo: Evaluar la composición corporal en un grupo de pacientes desnutridas con anorexia nerviosa, respecto de controles sanas, antes y después del soporte nutricional, mediante antropometría y bioimpedancia. Métodos: Estudio observacional prospectivo. Se realizó una antropometría completa y un análisis de bioimpedancia a 12 mujeres con anorexia nerviosa restrictiva (24,5 años) al ingreso hospitalario y semanalmente durante la realimentación. El grupo control estuvo formado por 24 mujeres sanas (21 años). Se aplicaron los test t-Student, U-Mann-Whitney, t-Student para medidas repetidas o Wilcoxon. La concordancia entre antropometría y BIA se analizó mediante el coeficiente de correlación intraclase y Bland-Altman. Resultados: Las pacientes mejoraron significativamente todos los índices de composición corporal a lo largo de la estancia hospitalaria, aunque sus valores al alta siguieron siendo menores que los de las controles. La media de peso ganado fue 5,22 kg (DE: 1,42), de los que el 51,4% fueron masa grasa, con distribución central preferentemente. En las controles la ecuación de BIA que mejor concuerda con antropometría es la de Sun (CCI = 0,896); en las pacientes la concordancia fue más débil, al ingreso y al alta. Conclusiones: La realimentación produce una ganancia ponderal, fundamentalmente a expensas de masa grasa, con distribución central; no se consigue restablecer el estado nutricional. La concordancia entre antropometría y bioimpedancia para el estudio de la composición corporal es aceptable, especialmente en sujetos sanos. Se recomienda emplear antropometría, si no se dispone de BIA vectorial o algún método gold estandard para el análisis de la composición corporal, en casos de alteraciones importantes en la composición corporal y/o el balance hídrico (AU)

OBJECTIVE: To assess the body composition in a group of malnourished patients with anorexia nervosa as compared to healthy controls, before and after nutritional support, by means of anthropometry and bioimpedance. METHODS: Prospective observational study. Complete anthropometry was performed as well as bioimpedance analysis in 12 women (24.5 years) with restrictive anorexia nervosa at hospital admission and weekly thereafter during re-feeding. The control group was formed by 24 healthy women (21 years). The Student's t test, the Mann-Whitney U test, the Student's t test for repeated measurements, and the Wilcoxon's test were applied. The level of agreement between anthropometry and BIA was calculated by the interclass correlation coefficient and the Bland-Altman s test. RESULTS: The patients had significant improvements in all indexes of body composition throughout their hospital staying although their values at discharge still were lower than those of the control subjects. The average weight gain was 5.22 kg (SD: 1.42), of which 51.4% was fat mass, preferentially centrally distributed. In the control subjects, the BIA equation that correlated the best with anthropometrics was Sun s equation (CCI = 0.896); in the patients, the level of agreement was weaker, both at hospital admission and at hospital discharge. CONCLUSIONS: Re-feeding produces weight gain, essentially at the expense of fat mass, which is centrally distributed; the nutritional status is not reestablished. The level of agreement between anthropometry and bioimpedance for studying body composition is acceptable, especially in healthy subjects. In those cases with severe changes in body composition and/or water balance, anthropometry is recommended when vectorial BIA or some other gold standard method are not available for the analysis of body composition (AU)

Effect of nutritional support on mitochondrial complex I activity in malnourished patients with anorexia nervosa.

Previous studies have shown a reduction in lymphocyte mitochondrial complex I activity (CIA) in malnourished patients, which is restored after refeeding. Our aim was to evaluate the usefulness of CIA as an indicator of nutritional status in anorexia nervosa patients. Twelve malnourished anorexia nervosa females (mean age, 24.5 years) were admitted to the Eating Disorders Unit. Basal and weekly anthropometrics, bioelectric impedance (BIA), body composition, and CIA were performed until discharge. Patients were matched to 25 healthy females and refeeding was adjusted according to the Unit's protocol. Statistics were used as appropriated and significance was reached at p < 0.05. Patients showed a significant reduction in body mass index, fat mass and fat free mass (FFM), triceps skinfold, and waist circumference on admission as compared with the control group. Parameters improved during hospitalization, but they failed to reach normal values at discharge. Compared with controls, CIA was significantly lower in patients on admission (2.16 vs. 5.68 nmol·min(-1)·mg protein(-1)). Refeeding and weight gain did not restore CIA. A positive association (r(2) = 0.69) was found between FFM and CIA in patients at discharge. Malnourished females with anorexia nervosa have lower CIA than controls that is not recovered after refeeding. This could be because of a low FFM exacerbated by physical inactivity while in hospital.