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.

Analysis of Fluid Balance and Urine Values in Elite Soccer Players: Impact of Different Environments, Playing Positions, Sexes, and Competitive Levels.

Exercise can disrupt the fluid balance, hindering performance and athlete health. Limited data exist on fluid balance responses in varying climates, sexes, and ages. This study aimed to measure and compare fluid balance and urine values among elite soccer players during training at high and low temperatures, examining the differences between sexes, playing positions, and competitive levels within men's soccer. During the 2022-2023 competitive season, a descriptive observational study was conducted on 87 soccer players from an elite Spanish soccer team. The study found that none of the groups exceeded weight loss values of 1.5% of their body mass. Additionally, the soccer players studied experienced higher weight loss, fluid intake, and a higher sweat rate (SR) during summer training compared to winter training. During the summer, male U23-21 soccer players exhibited higher levels of weight loss, fluid intake, and a higher SR compared to female soccer players or the U19-17 male category. No significant differences were found between playing positions. In conclusion, differences in the fluid balance were observed based on the climatic conditions, competitive level, and sex.

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.

Bioelectrical impedance vector analysis in obese and overweight children.

INTRODUCTION: BMI is the most commonly used indicator to evaluate overweight and obesity, but it cannot distinguish changes in body composition. Over recent years, it has been demonstrated that bioelectrical impedance analysis (BIA) is a more accurate method for analyzing body composition. Bioelectrical impedance vector analysis (BIVA) has revealed its effectiveness as an indicator of nutritional status and hydration. OBJECTIVE: To assess the usefulness of bioimpedance analysis on the study of body composition in a group of children with overweight and obesity. MATERIALS AND METHODS: Cross-sectional observational study. The anthropometric parameters of 167 (79 were older than 12 years) overweight and obese children were recorded. Their body composition was analyzed using BIA and BIVA, and was classified based on different criteria. Concordance was analyzed (intraclass correlation coefficient, Bland-Altman analysis and weighted Kappa coefficient). The BIVA of the subgroups was compared using the Mahalanobis distance and Hotelling's T2. Statistical significance was considered for p<0.05. RESULTS: The BMI revealed that the majority of the assessed subjects were obese, although 12% had a normal percentage of fat mass (%FM). The classification by Z-BMI and Z-%FM significantly discriminate between subjects with different levels of adiposity. In children over the age of 12, the classification of fat mass index also discriminates significantly between obesity and non-obesity. As anticipated, in the tolerance ellipses, most of the individual vectors were situated in the left lower quadrant. CONCLUSIONS: BIVA reflects differences in the bioelectric patterns of children who are classified as being overweight or obese (BMI) and who have different levels of %FM and FMI. BIVA permits a fast and easy monitoring of the evolution of the nutritional state and changes associated with body composition, and it identifies those children whose body compartments may be precisely estimated using traditional BIA methods.

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.

Bioimpedance analysis as an indicator of muscle mass and strength in a group of elderly subjects.

OBJECTIVE: To assess the association between whole-body and calf impedance vectors and muscle mass and strength in a group of elderly individuals. MATERIAL AND METHODS: We carried out a cross-sectional observational study on a sample of 113 elderly people. Anthropometric parameters (weight, height and body circumferences) were determined. Body composition was evaluated using conventional bioimpedance analysis (BIA) and vector bioimpedance analysis (BIVA) (whole-body and calf BIVAs), and muscle strength was determined (manual dynamometry). The results were analyzed using the Student t-test or the Mann-Whitney U, and the correlations using the Pearson or Spearman test. To compare BIVA results among the subgroups established, the Mahalanobis distance (dM) was calculated and the Hotelling T2 statistic was used. Statistical significance was set to p < 0.05. RESULTS: Nearly half the sample was overweight. Based on waist circumference, 66.7% of the males and 94.9% of the females showed risk of metabolic complications; calf circumference indicated no risk of disability or skeletal muscle mass depletion. However, BIA and dynamometry detected risk of sarcopenia in more than half the subjects. Whole-body BIVA results agreed with those of the BIA, given that most impedance vectors in both sexes were to the right of major axis of the tolerance ellipses. This shows cell mass depletion. While the whole-body BIVA distinguished the subjects having loss of muscle mass and strength, the specific BIVA (calf) only did so in individuals with muscle mass loss. CONCLUSIONS: Whole-body BIVA detects loss of muscle mass and strength, while calf BIVA only distinguishes subjects having muscle mass loss. The localized BIVA might be an alternative to conventional BIA or whole-body BIVA to assess body composition in the elderly.

Vector bioimpedance detects situations of malnutrition not identified by the indicators commonly used in geriatric nutritional assessment: A pilot study.

OBJECTIVE: To compare body composition as assessed by conventional and vector bioelectrical impedance analysis according to the nutritional cataloging using body mass index (BMI) in a group of institutionalized elderly. METHODS: Cross-sectional study in 38 institutionalized elderly. Body composition was estimated by bioimpedance analysis. Differences in body composition were analyzed using t-test and ANOVA, or their corresponding nonparametric tests. Statistical significance was set at p<0.05. RESULTS: Based on BMI, the sample showed overweight (average BMI: 26.4kg/m2), and women had higher BMI values than men (28.9 vs. 25.5kg/m2). Based on waist circumference, abdominal obesity was detected in 60.7% of men and 80% of women. Conventional bioimpedance analysis (BIA) yielded high fat mass values and slightly depleted skeletal muscle mass, compatible with sarcopenic obesity. All individual impedance vectors were located on the right of the major axis of the tolerance ellipses, reflecting body-cell-mass depletion in all subjects, regardless of BMI cataloging. CONCLUSIONS: Bioelectrical impedance vector analysis (BIVA) detects body compartment changes in institutionalized elderly that are not identified by the most widely used clinical practice nutritional indicators, such as BMI, waist circumference, and BIA-estimated body composition.

[PROPOSAL FOR A NEW FORMULA FOR ESTIMATING RESTING ENERGY EXPENDITURE FOR HEALTHY SPANISH POPULATION]. / PROPUESTA DE UNA NUEVA FÓRMULA DE ESTIMACIÓN DEL GASTO ENERGÉTICO EN REPOSO PARA POBLACIÓN SANA ESPAÑOLA.

INTRODUCTION: although there are precise and accurate techniques for estimating resting energy expenditure, like the indirect calorimetry (IC), daily practice needs faster, easier and cheaper methods as the predictive equations. OBJECTIVE: the aim of the study was to develop a new predictive equation for estimating resting energy expenditure (REE) for healthy Spanish population. Méthods: the REE of 95 healthy normal weighted volunteers was determined by indirect calorimetry (IC). The new equation was obtained by multiple lineal regression by using the analytical criteria of the Cp of Mallows and the adjusted R2. Then, the behavior of the new formula was studied in a group of overweight volunteers through the intraclass correlation coefficient (ICC) and Bland-Almand plots. The level of signification was reached at p < 0,05. RESULTS: the average age was 42 years (range: 2.0-63.2). Mean REE determined by IC was 1 589.1 kcal/d (312.0). The selected equation was: [y = 1 376.4 - 308 Sex (M = 0; W = 1) + 11.1 Weigh (kg) - 8 Age (years)] (R2: 0.68; EE: 175.95). The ICC between the new equation and the IC in normal weighted subjects was 0.901 (95%CI: 0.851 - 0.934). The new formula showed a good level of agreement in the overweight group (ICC: 0.880; 95%IC: 0.772 - 0.937). CONCLUSIONS: we propose a new predictive equation for estimating the REE for healthy Spanish population which has an easy application and includes sex, age and weigh. The selected equation shows an adequate behavior in overweight subjects too.

Introducción: aunque se dispone de técnicas precisas y exactas para la estimación del GER, como la calorimetría indirecta (CI), en la práctica diaria se precisan métodos rápidos, fáciles de aplicar y económicos, como los modelos predictivos. Objetivo: desarrollar una nueva ecuación predictiva del gasto energético en reposo (GER) para población española adulta sana. Métodos: se determinó el GER en 95 sujetos sanos con normopeso mediante CI. Se utilizó la regresión lineal múltiple para la obtención del modelo, empleando como criterios analíticos la Cp de Mallows y el R2 ajustado. Se estudió el comportamiento del modelo generado en una muestra de 39 sujetos con IMC ≥ 25 kg/m2 mediante el coeficiente de correlación intraclase (ICC) y la prueba de Bland-Altman. La significación se alcanzó con p < 0,05. Resultados: la edad media fue de 42 años (rango: 23,0­ 63,2). El valor medio del GER estimado fue de 1.589,1 kcal/d (312,0). La ecuación seleccionada fue: [GER (kcal/d) = 1.376,4 ­ 308 Sexo (V = 0; M = 1) + 11,1 Peso (kg) ­ 8 Edad (años)] (R2: 0,68; EE: 175,95). El CCI entre el nuevo modelo predictivo y la CI fue de 0,901 (IC del 95%: 0,851 ­ 0,934) en la muestra con normopeso. La aplicación del modelo en la muestra de sujetos con IMC ≥ 25 kg/m2 alcanzó una buena concordancia (CCI de 0,880; IC del 95%: 0,772 ­ 0,937). Conclusiones: se presenta un nuevo modelo de estimación del GER para población sana española fácilmente aplicable en la práctica diaria, que incluye las variables sexo, edad y peso. La ecuación propuesta presenta un comportamiento adecuado en sujetos con IMC ≥ 25 kg/m2.

[AGREEMENT BETWEEN INDIRECT CALORIMETRY AND PREDICTIVE EQUATIONS IN A SAMPLE OF SPANISH HEALTHY ADULTS]. / CONCORDANCIA ENTRE CALORIMETRÍA INDIRECTA Y MODELOS PREDICTIVOS EN UNA POBLACIÓN SANA ESPAÑOLA.

OBJECTIVE: the aim of this study was to analyze the agreement between the resting energy expenditure (REE) obtained by indirect calorimetry (IC) and that obtained by prediction equations in a sample of healthy adults from Spain. Méthods: a descriptive cross-sectional study was conducted in 95 healthy, normal-weight adults. REE was determined by IC and 45 population-specific prediction equations which were based on weight, height, sex and/or body composition (BC). The Intraclass Correlation Coefficient (ICC) and Bland-Alman plots were used to analyze the agreement between the REE obtained by IC and that obtained by prediction equations. The level of signification was reached at p < 0,05. RESULTS: mean age was 42 years (range: 23.0-63.2). Mean REE determined by CI was 1589 (312) kcal/d [1822.3 (224.3) kcal/d in men and 1379.3 (216.1) kcal/d in women; p < 0.05]. The De-Lorenzo, Harris-Benedict, Schofield, and especially the Korth equations showed the greatest level of agreement with respect to IC. CONCLUSIONS: there is high variability in the estimates of REE depending on the prediction equation used. The De Lorenzo, Harris-Benedict, and the Schofield equations showed a good level of agreement in our sample; however, the Korth equation was the most appropriate. Equations based on weight and/or height were more accurate than those which included body composition variables.

Objetivo: estudiar la concordancia entre el gasto energético en reposo (GER) obtenido mediante calorimetría indirecta (CI), y las ecuaciones de estimación más utilizadas en población adulta sana española. Métodos: estudio transversal en el que se determinó el GER en 95 sujetos sanos con normopeso mediante calorimetría indirecta y modelos predictivos (se seleccionaron 45 fórmulas desarrolladas en adultos de características similares a la muestra estudiada que incluían peso, talla, sexo y/o composición corporal). La concordancia entre ambos métodos se analizó mediante el Coeficiente de Correlación Intraclase (CCI) y la prueba de Bland-Altman. La significación se alcanzó con p < 0,05. Resultados: la edad media fue de 42 años (rango: 23,0­ 63,2). El GER medio estimado por CI en la muestra fue de 1589 (312) kcal/día [1822,3 (224,3) kcal/día en varones y 1379,3 (216,1) kcal/día en mujeres; p < 0,05]. Las fórmulas que mejor se ajustaron a la muestra fueron las de De-Lorenzo, Harris-Benedict, Schofield y, especialmente, Korth. Conclusiones: existen grandes variaciones en la estimación del gasto energético en reposo en función de la ecuación predictiva utilizada. Las fórmulas de De-Lorenzo, Harris-Benedic y Schofield se comportan adecuadamente en la muestra evaluada; sin embargo, la de Korth demostró ser la más apta. Los modelos que incluyen peso y/o talla obtuvieron mejores resultados que los que contienen variables de composición corporal.

[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.

[Changes in body composition in relation to the stage of dementia in a group of institutionalized elderly]. / Cambios en la composición corporal en función del grado de demencia en un grupo de ancianos institucionalizados.

OBJECTIVE: To assess the nutritional status of a group of institutionalized elderly with dementia by analysing the changes in the body composition according to their evolutionary state. METHOD: A cross-sectional study was carried out assessing the nutritional status and the body composition (anthropometry, MNA and bioimpedance) in 63 institutionalized elderly with a diagnosis of dementia in evolutionary stages 5, 6 and 7 of the GDS (Global Deterioration Scale) scales and the FAST (Functional Assessment Stating) scale. The fat mass index (FMI) and the fat-free mass index (FFMI) were calculated. The results were analysed by one-factor ANOVA and Kruskal-Wallis factorial ANOVA and Scheffé's a posteriori contrasts. The significance level was set at p < 0.05. RESULTS: Mean age was 80.6 years (95%CI: 78.3-83.0; Range: 51-95). According to MNA, 38.1% of the sample had hyponutrition, 60.3% was at risk for malnourishment; and 1.6% had normal nutrition. The average body mass index was 23.06 (22.01-24.10) kg/m2, without any significant difference by the degree of evolutionary state, except for those on palliative care (mean: 19.85; 95%CI: 78.3-83.0 kg/m2). The patients in the non-palliative stages GDS/FAST 5, 6 and 7 presented a Z-Score of FMI close to a 0 SD, and a Z-Score for the FFMI of approximately -1 DS. These results are compatible with a sarcopenia situation. In patients on palliative care (GDS/FAST =?7c) both indexes were significantly lower. CONCLUSION: The analysis of body composition should always be included in the assessment of the nutritional status. If not, it would not be possible to detect situations of sarcopenic obesity, which is rather prevalent in elderly people with these characteristics.

Objetivo: Valorar el estado nutricional de un grupo de ancianos institucionalizados con demencia, analizando los cambios en la composición corporal en función de su estadío evolutivo. Método: Se ha realizado un estudio transversal en el que se valoró el estado nutricional y la composición corporal (antropometría, MNA, y bioimpedancia) en 63 ancianos institucionalizados con diagnóstico de demencia en estadíos evolutivos 5, 6 y 7 de las escalas GDS (Global Deterioration Scale) y FAST (Functional Assessment Stating). Se calcularon los índices de masa grasa (IMG) y de masa libre de grasa (IMLG). Los resultados se analizaron mediante el ANOVA de un factor y ANOVA factorial o Kruskal-Wallis, y contrastes a posteriori de Scheffé. La significación se alcanzó con p < 0,05. Resultados: La media de edad fue 80,6 (IC 95%: 78,3- 83,0; Rango: 51-95) años. Según el MNA, el 38,1% de la muestra presentaba malnutrición, el 60,3% riesgo de malnutrición, y el 1,6% normalidad nutricional. La media del índice de masa corporal fue 23,06 (22,01-24,10) kg/m2, sin diferencias significativas en función del estadío evolutivo, salvo en los paliativos (media: 19,85; IC 95%: 78,3-83,0 kg/m2). Los pacientes en estadíos GDS/FAST 5, 6 y 7 no paliativos presentan una Z-Score del IMG próxima a 0 DS, y una Z-Score del IMLG de aproximadamente -1 DS, resultados compatibles con una situación de sarcopenia. En los paliativos (GDS/FAST =?7c) ambos índices son significativamente inferiores. Conclusión: El análisis de la composición corporal debe ser incluido en la valoración del estado nutricional siempre. De lo contrario no sería posible detectar situaciones de obesidad sarcopénica, muy prevalentes en ancianos con estas características.