Dieta baja en grasas tras colecistectomía: ¿se debería recomendar de forma sistemática? / Low-fat diet after cholecystectomy: Should it be systematically recommended?

Introducción: A pesar de la falta de evidencia, tradicionalmente se ha recomendado seguir una dieta baja en grasas tras la colecistectomía. El objetivo principal fue analizar la correlación potencial entre los síntomas postoperatorios y el tipo de dieta tras la colecistectomía. Métodos: Los síntomas fueron evaluados de forma prospectiva mediante el cuestionario Gastrointestinal Quality of Life Index (GIQLI) antes de la intervención, al mes y 6 meses después de la colecistectomía en 83 pacientes operados en nuestro centro. Los pacientes completaron un cuestionario sobre su dieta y fueron clasificados en 4 grupos de acuerdo a la cantidad de grasa ingerida. Las diferencias en la puntuación GIQLI dependiendo del tipo de dieta se evaluaron en el tiempo. Resultados: La puntuación GIQLI total y varias dimensiones aumentaron significativamente tras la cirugía respecto al valor basal, independientemente de la ingesta de grasa en la dieta. Entre los síntomas evaluados por el GIQLI, la diarrea y la urgencia defecatoria empeoraron mientras que el estreñimiento mejoró. Más del 50% de los pacientes experimentaron cambios en el ritmo deposicional después de la cirugía, que fueron persistentes durante 6 meses en el 23% de los casos. Conclusiones: La dieta baja en grasas no parece influir en la mejoría de los síntomas tras la colecistectomía. No obstante, los resultados de un estudio aleatorizado que se está realizando en nuestro centro contribuirán a confirmar los resultados de este estudio prospectivo

Introduction: Even though evidence is lacking, a low-fat diet has been traditionally recommended after cholecystectomy. The main aim of this study was to assess the potential correlation between postoperative symptoms and type of diet after cholecystectomy. Methods: Symptoms were prospectively assessed by the Gastrointestinal Quality of Life Index (GIQLI) score at baseline, one month and 6 months after cholecystectomy in 83 patients operated on at our institution. Patients completed a questionnaire about their diet and were classified into 4 groups according to the amount of fat intake. Differences in the GIQLI score depending on the type of diet were assessed over time. Results: The overall GIQLI score and most subdomains significantly increased after surgery compared to baseline, regardless of the intake of dietary fat. Constipation improved after cholecystectomy compared to baseline, whereas diarrhea and bowel urgency got worse. More than 50% of patients experienced a change in their bowel habit after surgery, which persisted 6 months later in 23% of cases. Conclusions: A low fat diet does not seem to have an influence on the improvement of symptoms after cholecystectomy. However, a randomized study is ongoing at our institution to confirm the results of this prospective study

Low-fat diet after cholecystectomy: Should it be systematically recommended? / Dieta baja en grasas tras colecistectomía: ¿se debería recomendar de forma sistemática?

INTRODUCTION: Even though evidence is lacking, a low-fat diet has been traditionally recommended after cholecystectomy. The main aim of this study was to assess the potential correlation between postoperative symptoms and type of diet after cholecystectomy. METHODS: Symptoms were prospectively assessed by the Gastrointestinal Quality of Life Index (GIQLI) score at baseline, one month and 6 months after cholecystectomy in 83 patients operated on at our institution. Patients completed a questionnaire about their diet and were classified into 4 groups according to the amount of fat intake. Differences in the GIQLI score depending on the type of diet were assessed over time. RESULTS: The overall GIQLI score and most subdomains significantly increased after surgery compared to baseline, regardless of the intake of dietary fat. Constipation improved after cholecystectomy compared to baseline, whereas diarrhea and bowel urgency got worse. More than 50% of patients experienced a change in their bowel habit after surgery, which persisted 6 months later in 23% of cases. CONCLUSIONS: A low fat diet does not seem to have an influence on the improvement of symptoms after cholecystectomy. However, a randomized study is ongoing at our institution to confirm the results of this prospective study.

Low-carbohydrate diet for the treatment of gestational diabetes mellitus: a randomized controlled trial.

OBJECTIVE: Medical nutrition therapy based on the control of the amount and distribution of carbohydrates (CHO) is the initial treatment for gestational diabetes mellitus (GDM), but there is a need for randomized controlled trials comparing different dietary strategies. The purpose of this study was to test the hypothesis that a low-CHO diet for the treatment of GDM would lead to a lower rate of insulin treatment with similar pregnancy outcomes compared with a control diet. RESEARCH DESIGN AND METHODS: A total of 152 women with GDM were included in this open, randomized controlled trial and assigned to follow either a diet with low-CHO content (40% of the total diet energy content as CHO) or a control diet (55% of the total diet energy content as CHO). CHO intake was assessed by 3-day food records. The main pregnancy outcomes were also assessed. RESULTS: The rate of women requiring insulin was not significantly different between the treatment groups (low CHO 54.7% vs. control 54.7%; P = 1). Daily food records confirmed a difference in the amount of CHO consumed between the groups (P = 0.0001). No differences were found in the obstetric and perinatal outcomes between the treatment groups. CONCLUSIONS: Treatment of women with GDM using a low-CHO diet did not reduce the number of women needing insulin and produced similar pregnancy outcomes. In GDM, CHO amount (40 vs. 55% of calories) did not influence insulin need or pregnancy outcomes.

[Attitudes toward influenza vaccination in an urban population older than 60 years]. / Actitudes hacia la vacuna antigripal en una población urbana mayor de 60 años.

OBJECTIVE: To determine the reasons for undergoing or rejecting influenza vaccination among people older than 60 years. METHODS: A cross-sectional descriptive study through telephone survey among patients over 60 years old living in a health district of Barcelona (Dreta de l'Eixample) was performed. A total of 1,700 medical records of patients aged more than 60 years old were randomly chosen and 291 surveys were conducted. RESULTS: Among the patients who received influenza vaccination, the main source of information about the vaccine was the family physician in 63.63% (119; 95% confidence interval (CI), 57.1-70.1), followed by the primary care nurse in 27.80% (52; 95% CI, 21.8-33.8) and the media in 21.92% (41; 95% CI, 16.9-26.9). The main reasons for receiving the vaccine in 2005 were health protection (148; 79.14%; 95% CI, 73.64-84.64) and physician request (49; 26.20%; 95% CI, 20.25-32.15). Non-vaccinated individuals argued that the vaccine was unnecessary since "they never get a cold" (44; 42.30%; 95% CI, 33.97-52.43) or "never get the flu" (23; 22.15%; 95% CI, 14.41-29.89). CONCLUSIONS: The main reason for receiving the influenza vaccine was to protect health. Concept mistakes were detected among patients who did not receive the vaccine. This finding highlights the need to develop new strategies to increase vaccination rates. Physicians remain the main source of information about influenza vaccination, suggesting that nurses should increase their efforts in spreading their functions.