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.

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.

Caracterización de patrones alimentarios al inicio de la pandemia por covid 19 en chile / Characterization of the dietary profile of the old adults in Ibero-american during of pandemic by COVID 19

Objetivo: Caracterizar el perfil alimentario de las Personas Mayores de Iberoamérica en tiempos de pandemia por COVID 19.Material y métodos: Estudio multicéntrico en 12 países de Iberoamérica, se aplicó una encuesta en línea que incluyó preguntas sociodemográficas y un cuestionario de Ingesta de Alimentos que incluyo la frecuencia de consumo para verduras, bebidas azucaradas, legumbres, lácteos y porción de los alimentos.Resultados: La muestra quedó conformada por 624 participantes, 72,1% (n= 450) de mujeres. El 54,7% de mujeres no consume bebidas azucaradas, en cambio en hombres un 54% consume al menos un vaso al día (p=0,012). El 35,6% de hombres consumieron ≥3 por semana legumbres versus el 23% mujeres (p=0,020). El 37,3% de las mujeres consumen ≥2 porciones diarias de lácteos, en hombres solo un 28,1% (p= 0,030). Las mujeres presentan un mayor consumo de verduras (44,7%, n= 201) respecto de los hombres (28,7%), (p=0,001). El 17,4% de la muestra total aumentó el tamaño de la porción de alimentos, sin do mayor en mujeres (p=0.005).Conclusión: Las mujeres presentan hábitos alimentarios más saludables que los hombres en base a frutas, verduras, por otra parte, la variación del tamaño se observa un incremento en especial en mujeres lo que puede relacionarse con el aumento de la obesidad.(AU)

Objective: To characterize the food profile of the OlderPeople of Ibero-America in times of the COVID 19 pandemic.Material and methods: Multicenter study in 12 Ibero-American countries, an online survey was applied thatincluded sociodemographic questions and a Food Intakequestionnaire that included the frequency of consumption forvegetables, sugary drinks, legumes, dairy products andportion of food.Results: The sample was made up of 624 participants,72.1% (n= 450) of women. 54.7% of women do not consumesugary drinks, while in men 54% consume at least one glassa day (p=0.012). 35.6% of men consumed ≥3 legumes perweek versus 23% of women (p=0.020). 37.3% of womenconsume ≥2 daily servings of dairy products, in men only28.1% (p= 0.030). Women have a higher consumption ofvegetables (44.7%, n= 201) compared to men (28.7%),(p=0.001). 17.4% of the total sample increased the size ofthe food portion, being higher in women (p=0.005).Conclusion: Women have healthier eating habits thanmen based on fruits, vegetables, on the other hand, thevariation in size increases, especially in women.(AU)

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.

Herramientas para identificar consumo y desperdicio de la dieta hospitalaria. Revisión Sistemática

RESUMEN Introducción: Uno de los factores que influyen en la desnutrición hospitalaria es la incapacidad del paciente para alimentarse correctamente. Un bajo consumo de la dieta hospitalaria aumenta el riesgo a sufrir complicaciones de salud, además genera impacto económico y ambiental, producto del aumento de desperdicio de alimentos. Generar estrategias encaminadas a mitigar este problema debe ser prioridad para el sector salud. Objetivo: Identificar herramientas técnicas utilizadas para medir el consumo y/o desperdicio de alimentos en la dieta hospitalaria. Materiales y métodos: Búsqueda sistemática de estudios publicados en las bases de datos de EMBASE y MEDLINE a través de la plataforma Pubmed, en febrero del 2019, temporalidad 20 años. Se buscaron por términos controlados sobre dieta hospitalaria, desperdicio de alimentos y la satisfacción del paciente. Resultados: Se encontraron 410 artículos en inglés, español y portugués. Se seleccionaron 21 artículos para análisis de texto completo por cumplimiento de criterios de selección. Conclusiones: Las herramientas encontradas para la medición del desperdicio de alimentos se basaron principalmente en el pesaje, y la medición visual ya sea directa o por imágenes; otras aproximaciones incluyeron cuestionarios y métodos de múltiples componentes, la mayoría sin hacer discriminación del componente alimenticio desperdiciado.

ABSTRACT Introduction: One of the factors that influences hospital malnutrition is the inability of the patient to eat properly. A low consumption of the hospital diet increases the risk of suffering health complications, in addition to generating an economic and environmental impact, as a result of the increase in food waste. Generating strategies aimed at mitigating this problem should be a priority for the health sector. Objective: Identify technical tools used to measure food consumption and / or waste in the hospital diet. Materials and methods: Systematic search for studies published in the EMBASE and MEDLINE databases through the Pubmed platform was conducted in February 2019, searching articles published in the last 20 years. We searched for controlled terms on hospital diet, food waste, and patient satisfaction. Results: 410 articles were found in English, Spanish and Portuguese. Twenty-one articles were selected for full-text analysis by meeting the selection criteria. Conclusions: The tools found for the measurement of food consumption were based mainly on weighing, and visual measurement either direct or by images; other approaches included questionnaires and multi-component methods, most of the tools did not discriminate the food component wasted.

Consumo de bebidas azucaradas durante la pandemia por Covid-19 en doce países iberoamericanos: Un estudio transversal

RESUMEN Objetivo: Evaluar el consumo de bebidas azucaradas (BA) durante el confinamiento por la pandemia por Covid-19 y su relación con factores sociodemográficos y dietéticos. Material y Métodos: Estudio multicéntrico. Fueron invitados a participar residentes en 12 países (Argentina, Chile, Colombia, Costa Rica, Ecuador, España, Guatemala, México, Perú, Paraguay, Panamá y Uruguay) a quienes se les aplicó un cuestionario online de consumo de alimentos e indicadores sociodemográficos. Resultados: Se analizaron 10.573 cuestionarios. Con respecto al consumo de BA el 78,0% de las mujeres tuvieron un consumo bajo versus un 69,2% de los hombres. Por edad, las frecuencias de consumo de BA fueron similares según grupo etario. Por nivel educacional, un 13,4% personas con nivel universitario reportó un excesivo consumo de BA versus un 23,1% de personas de con nivel de educación primaria o básica (p<0,001). Por procedencia, urbano o rural, la frecuencia de consumo de BA fue similar. Según auto reporte un 19,0% aumento de peso por consumo excesivo de BA versus un 10,4% de aquellos que bajaron de peso (p<0,001). Cifras similares se encontró en auto reporte de cambio de tamaño de porción, un 19,3% que aumentaron su porción consumieron BA en exceso versus un 10,0% que disminuyeron el tamaño de porción. Finalmente, en un modelo de regresión: ser de sexo masculino, tener entre 40 y 59 años, nivel académico primario, el aumento de peso y presentar cambios en la dieta, aumentaron la probabilidad de tener un nivel alto de consumo BA. Conclusión: el consumo de BA en general es bajo, pero relevantemente excesivo en algunos grupos de las variables de estudio, además existe una relación entre el consumo de BA y las variables estudiadas.

ABSTRACT Objective: To evaluate the consumption of sugar-sweetened beverages (SSB) during confinement due to the Covid-19 pandemic and its relationship with sociodemographic and dietary factors. Material and Methods: Multicenter study. Citizens residing in 12 countries were invited to participate (Argentina, Chile, Colombia, Costa Rica, Ecuador, Spain, Guatemala, Mexico, Peru, Paraguay, Panama, and Uruguay) to whom an online survey on food consumption and sociodemographic indicators was applied. Results: 10,573 questionnaires were analyzed. Regarding the consumption of sugar-sweetened beverages, 78.0% of women had low consumption versus 69.2% of men. Frequency of SSB consumption was similar according to age group. For education, 13.4% of people with a university-level education reported excessive consumption versus 23.1% of people with a primary or basic education level (p<0.001). The frequency of SSB consumption was similar by urban versus rural residence. According to self-report, 19.0% of weight gain was due to excessive consumption of SSB compared to 10.4% of those who lost weight (p<0.001). Similar figures were found in self-reported portion size change, 19.3% who increased their portion consumed SSB in excess versus 10.0% who decreased portion size. Finally, in a regression model: being a man, being between 40 and 59 years old, primary academic level, weight gain, and presenting changes in diet, increased the probability of having a high level of SSB consumption. Conclusion: The consumption of SSB, in general, is low but excessively relevant in some groups of the study variables, in addition, there is a relationship between the consumption of SSB and the variables studied.

Caracterización de la seguridad alimentaria en familias colombianas durante el confinamiento por COVID-19 / Characterization of food security in Colombian families during confinement by COVID-19

FUNDAMENTOS: el confinamiento voluntario y posteriormente la cuarentena obligatoria, es una estrategia de los gobiernos para la contención y mitigación de los efectos derivados del contagio por COVID-19. El objetivo fue caracterizar la seguridad alimentaria, percepción de la alteración ponderal y estilos de vida en familias colombianas durante el aislamiento social por COVID-19. MÉTODOS: estudio transversal con enfoque cuantitativo de tipo descriptivo en una muestra no probabilística, participante voluntaria en una encuesta de acceso electrónico. La información se obtuvo mediante una encuesta estructurada con la herramienta Google Forms Drive, con tres componentes, sociodemográfico, consumo alimentario y nivel de seguridad alimentaria. El enlace de la encuesta digital se socializó en todas las regiones colombianas, durante las semanas 15, 16 y 17 del mes de abril correspondientes al calendario epidemiológico colombiano 2020. Se realizó análisis univariado y bivariado asociados al eje consumo y acceso de alimentos, en el programa estadístico SPSS v25 y organizando bases de datos en Microsoft Excel. RESULTADOS: de las 1470 encuestas aplicadas en el 97% del territorio colombiano (31 departamentos), el 76% fue diligenciada por mujeres. La edad promedio de la muestra por conveniencia fue de 39 +13 años, la composición familiar del 48% fue de más de tres integrantes y el 60% consideró que su peso era normal. El 62% consideró de alta prioridad la compra de carnes. De forma general. se observa que alimentos como lácteos, cereales, frutas-verduras tuvieron alta prioridad de compra; no compraron bebidas azucaradas, alcohólicas y alimentos procesados; 64% no compra agua embotellada; 35% de las familias informaron haber tenido falta de dinero para comprar alimentos, mientras que el 15,3% refirieron comer menos en las comidas principales. CONCLUSIONES: se presentó inseguridad alimentaria por falta de dinero y compra de alimentos; una alteración ponderal por ganancia de peso y modificaciones en cuanto a la compra, consumo, higiene y desperdicio de alimentos y actividad física

BACKGROUND: Voluntary confinement, and subsequently compulsory quarantine, is a government strategy for containing and mitigating the effects of COVID-19 contagion. The objective was to characterize food security in Colombian families, perception of weight change and lifestyles during social isolation by COVID-19. METHODS: cross-sectional study with a descriptive quantitative approach in a non-probabilistic sample, voluntary participant in an electronic access survey. The information was obtained through a structured survey with the Google Forms Drive tool, with three components, sociodemographic, food consumption and level of food safety. The link of the digital survey was socialized in all Colombian regions, during weeks 15, 16 and 17 of the month of April corresponding to the Colombian epidemiological calendar 2020. Univariate and bivariate analysis associated with the axis of food consumption and access was carried out, in the statistical program SPSS v25 and organizing databases in Microsoft Excel. RESULTS: Of the 1,470 surveys applied in 97% of the Colombian territory (31 departments), 76% were completed by women. The average age of the convenience sample was 39 +13 years, the family composition of 48% was more than three members and 60% considered that their weight is normal. 62% considered the purchase of meat a high priority. Generally. It is observed that foods such as dairy products, cereals, fruits-vegetables had a high purchase priority; they did not buy sugary drinks, alcoholic beverages and processed foods; 64% do not buy bottled water; 35% of the families reported having a lack of money to buy food, while 15.3% reported eating less with their main meals. CONCLUSIONS: there was food insecurity due to lack of money and the purchase of food; a change in weight due to weight gain and modifications in lifestyles in terms of the purchase, consumption, hygiene and waste of food and physical activity

Interdisciplinary management of infantile colic / Manejo interdisciplinario del cólico del lactante

Abstract Infantile colic is one of the main reasons for consultation in pediatric gastroenterology and pediatric nutrition services. This pathology has multiple etiologies such as family dysfunction, gastrointestinal alterations, food allergies or intolerances, food imbalance and improper eating habits. It is acute, of sudden onset, and tends to disappear between 3 and 6 months of age. To date there is no consensus on the management protocols of this condition or indicators of therapeutic efficacy. Medications, dietary regimens and dietary supplements specific to this pathology (anti-colic) have been developed for some years to help address this issue. This article presents a structural review of evidence on the fundamentals and progress in the treatment of infantile colic, and compiles the characteristics of this pathology, the medical and nutritional therapeutic measures, the clinical approach and the techniques to help the patient and his family. This study seeks to provide technical tools to health professionals whose target population is children younger than 2 years of age.

Resumen El cólico del lactante es uno de los principales motivos de consulta en los servicios de pediatría, gastroenterología y nutrición pediátrica. Esta patología posee múltiples características etiológicas como disfunción de la mecánica familiar, alteraciones gastrointestinales, alergias o intolerancias alimentarias, desbalance alimentario e inadecuados hábitos alimenticios. Es de carácter agudo, con inicio súbito que tiende a desaparecer entre los 3 y 6 meses de edad. Hasta el momento no existe un consenso sobre los protocolos de manejo de esta condición o sobre sus indicadores de eficacia terapéutica. Desde hace algunos años se han desarrollado fármacos, regímenes dietarios y complementos alimentarios específicos para esta patología (anticólico). Este trabajo es una revisión de la evidencia sobre los fundamentos y avances en el tratamiento del cólico del lactante en el que se recopilan las características de esta patología, las medidas terapéuticas médicas y nutricionales, el abordaje clínico y las técnicas para ayudar al paciente y su entorno familiar. El presente estudio busca brindar herramientas técnicas al profesional de la salud cuya población objeto de atención es menor de 2 años.

Recall en la industria alimentaria: una estrategia sanitaria por implementar en Colombia / Recall in the food industry: a health strategy to implement in Colombia

Resumen Las medidas sanitarias y fitosanitarias en los mercados internacionales han llevado a que la industria alimentaria cuente con alarmas técnicas durante sus procesos de comercialización; una de las estrategias utilizadas por algunos estados para regular las alarmas es el Recall. Este proceso, que consiste en el retiro de productos del mercado, previene impactos negativos en la salud de la población y en la reputación de la industria del sector alimentario ya que garantiza la inocuidad y calidad de los alimentos que llegan al consumidor. El Recall obliga a un plan de retiro en anaquel en los sitios de venta o en alguna de las fases de producción, para lo cual se debe implementar un sistema de trazabilidad que permita rastrear un producto durante toda la cadena productiva a través de una adecuada codificación. Del mismo modo, esta estrategia demanda un marco jurídico y regulatorio en cada país que requiere colaboración de la industria, el consumidor y las ligas y asociaciones de consumidores. Colombia tiene acciones de gestión de alerta sanitaria para tomar decisiones a fin de proteger la salud pública del país, pero están limitadas a dos sistemas de alerta que trabajan en coordinación con las alertas sanitarias emitidas por organismos reguladores internacionales que cuentan con un sistema propio.

Abstract Sanitary and phytosanitary measures taken by international markets have led the food industry to develop technical warnings during marketing processes. Recall is one of the strategies used by some states to regulate such warnings. This process, which involves withdrawal of products from the market, prevents negative impacts on the health of the population and the reputation of the food industry, since safety and quality of food that reaches the consumer is ensured. Recall requires a withdrawal plan from shelves at retail sites or at any of the stages of production; therefore, a tracking system must be implemented to track products throughout the entire production chain by using proper coding. Similarly, this strategy requires a legal and regulatory framework in each country and collaboration from the industry, consumers and consumer associations and leagues. Colombia has developed a management system for health warnings to make decisions in order to protect public health in the country, but they are limited to two warning systems working in coordination with the health warnings issued by international regulatory bodies with their own systems.

Alimentación hospitalaria como un criterio para la acreditación en salud / Hospital nutrition programs as a criterion for accreditation in health

RESUMEN Introducción: la alimentación es un acto fisiológico que implica unas interacciones sociales y culturales. La historia de la alimentación hospitalaria y la dietoterapia, se ha desarrollado paralelamente a la ciencia médica, con base en la evidencia científica. Objetivo: analizar los cambios de la dietoterapia hospitalaria frente a los sistemas de gestión de la calidad en salud y la acreditación. Materiales y métodos: se realizó una búsqueda documental en bases de datos virtuales: PubMed, Medline, Lilacs y Google Scholar, utilizando palabras claves como: dietoterapia, alimentación hospitalaria y calidad alimentaria en hospitales, temporizada entre los años 1990 y 2016. Resultados y discusión: en las últimas tres décadas los hospitales se han ajustado a la globalización, sistemas de control de la calidad y políticas de seguridad del paciente. La calidad de la alimentación unida a la condición clínica del paciente, puede ser una causa de disminución del consumo de nutrientes y ocasionar desnutrición hospitalaria, lo que incrementa estancia y costos sanitarios. Conclusiones: las técnicas de la industria gastronómica junto con la dietética hospitalaria han promovido el mejoramiento continuo de los procesos de calidad que exigen los estándares de acreditación en salud y la misma competencia en el sector.

ABSTRACT Introduction: Eating is a physiological act that involves social and cultural interactions. The history of hospital feeding and diet therapy has developed in parallel with medical science, based on scientific evidence. Objective: Analizar los cambios de la dietoterapia hospitalaria frente a los sistemas de gestión de la calidad en salud y la acreditación. To analyze the changes in hospital nutrition programsin the face ofquality management and accreditation systems. Materials and methods: A literature search was done in virtual databases: Pubmed, Medline, Lilacs and Google Scholar, using key words such as: diet therapy, hospital feeding and hospital food quality, and published between the years1990 and 2016. Results and discussion: In the last three decades hospitals have adjusted to globalization, to quality control systems, and to patient safety policies. The quality of hospital nutrition programs coupled with the clinical condition of the patient may be a cause of decrease in nutrient consumption and hospital malnutrition, which leads to increases in length of stay and health costs. Conclusions: The techniques of the food industry together with hospital dietetics have promoted the continuous improvement of quality control processes that demand accreditation standards in healthcare and the same competence in the entire health sector.

Los alimentos y bebidas ultra-procesados que ingresan a Colombia por el tratado de libre comercio: ¿influirán en el peso de los colombianos? / Ultra-processed foods and beverages products entering Colombia through international trade agreements: Will they have an impact on the weight of colombians?

Ultra-processed products are characterized by high contents of sugar, saturated fat and sodium. These products are entering the Colombian market through free trade agreements. One concern related to their consumption is the impact on weight gain and comorbidities associated with overweight and obesity, as well as changes in cultural habits and food sovereignty Scientific evidence has documented that consumption of ultra processed products contributes to chronic disease, thus increasing health care costs of treatment and rehabilitation. We must implement public policies that protect and inform the consumer, increasing the access and the right to a healthy diet, while reducing consumption of ultra-processed products such as sugar sweetened beverages and snacks. Inter-sectorial strategies are needed to face the potential purchasing and consumption patterns changes, promoting the development of food systems that recognize local dynamics of production. Increase control over the type and quality of ultra-processed products that are entering the country, and promote actions, along with food and nutrition education are also needed.

Los alimentos ultra-procesados se caracterizan por su alto contenido de azúcares, grasas saturadas y sodio. Estos alimentos están ingresando a Colombia por los Tratados de Libre Comercio (TLC). Una preocupación de su consumo es el impacto en la ganancia de peso progresiva y las comorbilidades asociadas al sobrepeso y la obesidad, así como el cambio de hábitos culturales y la soberanía alimentaria. La evidencia científica destaca que estos alimentos pueden generar enfermedades crónicas lo que incrementa los costos sanitarios debido al tratamiento y rehabilitación. Es necesario formular políticas públicas que protejan y orienten al consumidor, facilitando el acceso y el derecho a una alimentación saludable y mitigando el consumo de productos ultra-procesados como las bebidas azucaradas y los empaquetados. Se requieren estrategias y actores intersectoriales para hacer frente a los posibles cambios de compra y consumo, promover el desarrollo de sistemas alimentarios que reconozcan las dinámicas locales de producción. Realizar vigilancia y control sobre los productos ultra-procesados que ingresan al país y promover acciones de educación alimentaria y nutricional.

Algunos peligros químicos y nutricionales del consumo de los alimentos de venta en espacios públicos / Some chemical and nutritional dangers of consuming food sales in public spaces

Los alimentos manufacturados y comercializados pueden contener peligros químicos por sustancias adicionadas intencionalmente como los aditivos que utiliza la industria, otros añadidos por el consumidor y contaminantes naturales como metales que se pueden obtener del aire en el espacio público; también se consideran peligrosos los cambios químicos que tienen algunos nutrientes como las grasas y los aceites (lípidos) y el uso excesivo de estas en la dieta. Algunos métodos de cocción empleados y el material de elaboración de los utensilios pueden llevar, a largo plazo, a desarrollar enfermedades crónicas y toxicidad. Este documento aborda aquellos alimentos y productos que se expenden en los espacios públicos, restaurantes, cafeterías y centros gastronómicos. Esta revisión no tiene intención de sancionar el expendio en espacios públicos, pero sí alertar sobre algunos métodos de cocción, el uso de aditivos alimentarios comúnmente utilizados y las prácticas alimentarias poco responsables, para concientizar al consumidor sobre los peligros.

Manufactured and marketed foods may contain chemical hazards intentionally spiked substances such as additives used by industry, others added by the consumer and natural contaminants such as metals that can get air in public spaces; chemical changes taking some nutrients such as fats and oils (lipids) and overuse of these in the diet are also considered hazardous. Some cooking methods employed and material processing utensils can lead to long term, developing chronic diseases and toxicity. This paper addresses those foods and products that are sold in public places, restaurants, cafes and gastronomic centers. This review does not intend to punish the dispensing in public spaces, but warn about some cooking methods, the use of food additives commonly used and little food practices responsible for consumer awareness about the dangers.

Alimentación penitenciaria: entre higiene y derechos / Prison feeding: between hygiene and rights

La Comisión Interamericana de Derechos Humanos (CIDH) y el Comité Internacional de la Cruz Roja (CICR) recomiendan las condiciones en las cuales debe desarrollarse la detención de las personas privadas de la libertad, incluyendo las referidas al suministro de alimentación, permitiendo que sobre esa base se constituyan las normas, procesos y procedimientos en los Establecimientos de Reclusión del Orden Nacional (ERON). En Colombia, y en muchos otros países, estos escenarios de producción de alimentación resultan insuficientes; entre las variables a considerar se encuentran la infraestructura física, el tipo de contratación, los hábitos alimentarios regionales por la procedencia heterogénea de la población interna y muchas veces sus preferencias, las patologías crónicas que se manejan, la seguridad en el ingreso de materias primas y el suministro de la alimentación al interior de los ERON. Es importante mencionar que cualquier brote de enfermedad trasmitida por alimentos (ETA) puede desencadenar una epidemia que se complica aún más por la situación de reclusión. Otras dificultades son la comercialización no permitida, el ingreso de alimentos y la conservación de estos en las celdas, lo cual puede ocasionar la pérdida de calidad higiénico-sanitaria y pone en peligro la salud de esta población.

The Inter-American Commission on Human Rights (IACHR) and the International Committee of the Red Cross (ICRC) recommend the conditions under which the detention of persons deprived of liberty must be developed, including those relating to food supply. This establishes the basis for the standards, processes and procedures in National Order Detention Facilities (ERON, in its Spanish acronym). In Colombia, and in many other countries, these scenarios of food production are insufficient; among the variables to consider are the physical infrastructure, contract types, regional food habits due to the heterogeneous origin of the inmate population and often their preferences, chronic pathologies that are handled, the security for raw materials entrance and food supply within the ERON. It is noteworthy that any outbreak of foodborne disease (FBD) can trigger an epidemic that is further complicated by the situation in prison. Other difficulties are non-permitted marketing, food entrance and its conservation in cells, which can produce loss of sanitary quality and endanger the health of this population.