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.

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.

Is There a Correlation between Dietary and Blood Cholesterol? Evidence from Epidemiological Data and Clinical Interventions.

Dietary cholesterol has been a topic of debate since the 1960s when the first dietary guidelines that limited cholesterol intake to no more than 300 mg/day were set. These recommendations were followed for several years, and it was not until the late 1990s when they were finally challenged by the newer information derived from epidemiological studies and meta-analysis, which confirmed the lack of correlation between dietary and blood cholesterol. Further, dietary interventions in which challenges of cholesterol intake were evaluated in diverse populations not only confirmed these findings but also reported beneficial effects on plasma lipoprotein subfractions and size as well as increases in HDL cholesterol and in the functionality of HDL. In this review, we evaluate the evidence from recent epidemiological analysis and meta-analysis as well as clinical trials to have a better understanding of the lack of correlation between dietary and blood cholesterol.

Dietary Diversity and Micronutrients Adequacy in Women of Childbearing Age: Results from ELANS Study.

Dietary diversity, an important component of diet quality, is associated with an increased probability of adequate micronutrient intake. Women of childbearing age (WCA) are particularly vulnerable to micronutrient inadequacy. The Minimum Dietary Diversity for Women (MDD-W) has been used widely as a proxy measurement of micronutrient adequacy. This study aimed to assess the association between MDD-W and nutrients adequacy among WCA of eight Latin American countries. Nutrient intakes from 3704 WCA were analyzed with two 24-hour dietary recalls. Dietary diversity was calculated based on ten food groups with a cut-off point of intake ≥5 groups. The mean dietary diversity score was 4.72 points, and 57.7% of WCA achieved MDD-W. Vitamin D and E showed a mean Nutrient Adequacy Ratio (NAR) of 0.03 and 0.38, respectively. WCA with a diverse diet (MDD-W > 5) reported a significantly higher intake of most micronutrients and healthy food groups with less consumption of red and processed meats and sugar-sweetened beverages. MDD-W was significantly associated with the mean adequacy ratio (MAR) of 18 micronutrients evaluated. Nevertheless, even those women with a diverse diet fell short of meeting the Estimated Average Requirements (EAR) for vitamins D and E. MDD-W is an appropriate tool to evaluate micronutrients adequacy in WCA from Latin America, showing that women who achieved the MDD-W reported higher adequacy ratios for most micronutrients and an overall healthier diet.

Zeaxanthin: Metabolism, Properties, and Antioxidant Protection of Eyes, Heart, Liver, and Skin.

Zeaxanthin, a non-provitamin A carotenoid that belongs to the xanthophyll family, has been less studied than its isomer lutein. However, zeaxanthin has also been shown to have a number of beneficial effects for human health due to its ability to quench free radicals, exert antioxidant effects, as well as decrease inflammation. It is the purpose of this review to discuss the metabolism of zeaxanthin, including digestion, absorption, transport, and uptake by tissues, as well as the dietary or other factors which affect zeaxanthin bioavailability. In addition, this review also focuses on specific effects of this carotenoid on eye, skin, liver, and cardiovascular health. Data derived from human interventions, animal models of research, and in vitro and cell studies are discussed in this review.

Diet Quality and Diet Diversity in Eight Latin American Countries: Results from the Latin American Study of Nutrition and Health (ELANS).

This study aimed to assess diet quality score (DQS), considering healthy and unhealthy foods and nutrients, and diet diversity score (DDS) as indicators of risk of noncommunicable diseases in eight Latin American countries, and to verify the possible differences considering country, sex, age, socioeconomic, and nutritional status. A multicenter household population-based cross-sectional survey was conducted with 9218 individuals (age range 15-65 years). Sociodemographic and anthropometric data were collected. Dietary intake was measured using two non-consecutive 24-h recalls and diet quality and diversity were assessed. In the whole sample, scores were observed from 63.0% ± 9.3% to total DQS, 65.0% ± 13.6% to healthy dietary items and 60.2% ± 13.6% to unhealthy items, and 5.6 ± 1.1 out of 9 points to DDS. Women presented lower DDS compared to men (5.5 ± 1.1 vs. 5.6 ± 1.1, p < 0.001). Healthy DQS was higher as the socio-economic level increased, and unhealthy DQS was the opposite (p < 0.05). Total DQS was significantly lower only at the low socio-economic level (p < 0.05). Chile and Venezuela showed the lowest healthy (62.2 ± 15.2 and 61.9 ± 11.7, p < 0.05) and total DQS (61.4 ± 10.3, 61.2 ± 8.7, p < 0.05). No effects were observed when considering the age and anthropometric measurements. Promoting consumption of a diverse and high-quality diet is an essential challenge to accomplish.

Prevalence and determinants of misreporting of energy intake among Latin American populations: results from ELANS study.

Underreporting and overreporting of energy intake (EI) have been recognized as potential sources of bias. Dietary data mainly rely on proxy respondents, but little is known about the determinants of misreporting of EI among Latin American (LA) populations. This study was conducted using data from the multicenter Latin American Study of Nutrition and Health that consisted of information about sociodemographics, physical activity, and dietary intake from 9218 individuals aged 15 to 65 years who were living in urban areas in 8 LA countries (Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela). Goldberg methodology was applied to classify the participants into categories of overreporter (OR), plausible reporter (PR), or underreporter (UR) of EI. Associations between misreporting and covariates were examined by the Kruskal-Wallis test, logistic regression, and linear regression. The prevalence of UR was 12.1% and OR was 14.1%. Costa Rica had the highest percentage of UR (24.4%) and the lowest of OR (7.3%), and Colombia had the lowest of UR (5.7%) and the highest of OR (22.4%). Furthermore, underreporters were more likely to be females from older groups with minimal education, white, physically active, overweight or obese, and living in Costa Rica. Overreporters were more likely to be younger, single, of low socioeconomic level, nonwhite, physically active, underweight or with normal weight, and from Colombia. The results demonstrated that sex, age, race, education status, and nationality seemed to influence the reporting behavior, which is essential to correctly interpreting potentially biased associations between diet and health outcomes, and improving nutritional interventions and public health policies.

TA-65, A Telomerase Activator improves Cardiovascular Markers in Patients with Metabolic Syndrome.

BACKGROUND: Telomerase Activator 65 (TA-65), a compound extracted from Astragalus membranaceus has been used in Chinese traditional medicine for extending lifespan. Scarce information exists on the effects of TA-65 on parameters of metabolic syndrome (MetS). METHODS: We recruited 40 patients with MetS to determine the effects of TA-65 on dyslipidemias, hypertension, and oxidative stress in this at-risk population. The study was a double-blind, randomized crossover design in which patients were allocated to consume either 16 mg daily of a TA-65 supplement or a placebo for 12 weeks. Following a 3-week washout, participants were allocated to the alternate treatment for an additional 12 weeks. Anthropometric and biological markers were measured at the end of each treatment. Plasma lipids, glucose, CReactive Protein (CRP), liver enzymes, and glycosylated hemoglobin were measured using a Cobas c-111. Inflammatory cytokines were measured by Luminex technology and markers of oxidative stress by the use of spectroscopy. RESULTS: Compared to the placebo period, HDL cholesterol (HDL-C) was higher while body mass index, waist circumference, and the LDL/HDL ratio were lower (p < 0.05) during TA-65 treatment. In addition, plasma tumor necrosis factor-α (TNF-α) was lower during the TA-65 period (p < 0.05). Positive correlations were observed in changes between the placebo and the TA-65 periods in HDL-C and CRP (r = -0.511, p < 0.01), alanine aminotransferase (r = -0.61, p < 0.001) and TNF-α (r = -0.550, p < 0.001) suggesting that the favorable changes observed in HDL were associated with decreases in inflammation. CONCLUSION: TA-65 improved key markers of cardiovascular disease risk, which were also associated with reductions in inflammation.

Compared to an Oatmeal Breakfast, Two Eggs/Day Increased Plasma Carotenoids and Choline without Increasing Trimethyl Amine N-Oxide Concentrations.

BACKGROUND: Habitual consumption of eggs has been hypothesized to positively modify biomarkers of cardiovascular disease risk through proposed antioxidant properties. OBJECTIVES: To examine this relationship, 50 young, healthy men and women were enrolled into a randomized crossover clinical intervention. METHODS: Participants consumed either 2 eggs per day or one packet of oatmeal a day for 4 weeks, followed by a 3-week wash-out and crossed over to the alternate breakfast. Fasting blood samples and peripheral blood mononuclear cells (PBMCs) were collected at the end of each intervention period. RESULTS: Increases in plasma large high-density lipoprotein (HDL) and large low-density lipoprotein (LDL) particle concentrations as measured by nuclear magnetic resonance were found following egg consumption (p < 0.001, p < 0.05), respectively, with increases in apolipoprotein concentration as well (p < 0.05). Though there was no difference in the intake of antioxidants lutein and zeaxanthin, a significant increase in plasma concentrations of these carotenoids was observed (p < 0.001) after egg consumption. There was no change in lecithin-cholesterol acyl transferase, cholesteryl ester transfer protein, or paroxanase-1 arylesterase activities between breakfast interventions. Dietary and plasma choline were both higher following egg consumption compared to oatmeal consumption (p < 0.001); however, there was no change in plasma trimethylamine N-oxide (TMAO) concentrations. Two eggs per day had no impact on PBMC gene expression related to cholesterol metabolism, oxidation, or TMAO production. CONCLUSIONS: These results suggest that compared to oatmeal, consumption of 2 eggs for breakfast provided increased plasma carotenoids and improved biomarkers of cardiovascular disease (CVD) risk while not affecting TMAO levels in this population.

Moringa Leaves Prevent Hepatic Lipid Accumulation and Inflammation in Guinea Pigs by Reducing the Expression of Genes Involved in Lipid Metabolism.

To investigate the mechanisms by which Moringa oleifera leaves (ML) modulate hepatic lipids, guinea pigs were allocated to either control (0% ML), 10% Low Moringa (LM) or 15% High Moringa (HM) diets with 0.25% dietary cholesterol to induce hepatic steatosis. After 6 weeks, guinea pigs were sacrificed and liver and plasma were collected to determine plasma lipids, hepatic lipids, cytokines and the expression of genes involved in hepatic cholesterol (CH) and triglyceride (TG) metabolism. There were no differences in plasma lipids among groups. A dose-response effect of ML was observed in hepatic lipids (CH and TG) with the lowest concentrations in the HM group (p < 0.001), consistent with histological evaluation of lipid droplets. Hepatic gene expression of diglyceride acyltransferase-2 and peroxisome proliferator activated receptor-γ, as well as protein concentrations interleukin (IL)-1ß and interferon-γ, were lowest in the HM group (p < 0.005). Hepatic gene expression of cluster of differentiation-68 and sterol regulatory element binding protein-1c were 60% lower in both the LM and HM groups compared to controls (p < 0.01). This study demonstrates that ML may prevent hepatic steatosis by affecting gene expression related to hepatic lipids synthesis resulting in lower concentrations of cholesterol and triglycerides and reduced inflammation in the liver.

Consuming Two Eggs per Day, as Compared to an Oatmeal Breakfast, Decreases Plasma Ghrelin while Maintaining the LDL/HDL Ratio.

Eggs contain high quality protein, vitamins, minerals and antioxidants, yet regular consumption is still met with uncertainty. Therefore, the purpose of this study was to compare the effects of consuming two eggs per day or a heart-healthy oatmeal breakfast on biomarkers of cardiovascular disease (CVD) risk and satiety measures in a young, healthy population. Fifty subjects participated in a randomized crossover clinical intervention; subjects were randomly allocated to consume either two eggs or one packet of oatmeal per day for breakfast for four weeks. After a three-week washout period, participants were allocated to the alternative breakfast. Fasting blood samples were collected at the end of each intervention period to assess plasma lipids and plasma ghrelin. Subjects completed visual analog scales (VAS) concurrent to dietary records to assess satiety and hunger. Along with an increase in cholesterol intake, there were significant increases in both low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol following the egg consumption period (p < 0.01). However, there was no difference in the LDL/HDL ratio, a recognized biomarker of CVD risk, nor in the plasma glucose, triglycerides or liver enzymes, between diet periods. Several self-reported satiety measures were increased following the consumption of eggs, which were associated with lower plasma ghrelin concentrations (p < 0.05). These results demonstrate that compared to an oatmeal breakfast, two eggs per day do not adversely affect the biomarkers associated with CVD risk, but increase satiety throughout the day in a young healthy population.

Intake of up to 3 Eggs/Day Increases HDL Cholesterol and Plasma Choline While Plasma Trimethylamine-N-oxide is Unchanged in a Healthy Population.

Eggs are a source of cholesterol and choline and may impact plasma lipids and trimethylamine-N-oxide (TMAO) concentrations, which are biomarkers for cardiovascular disease (CVD) risk. Therefore, the effects of increasing egg intake (0, 1, 2, and 3 eggs/day) on these and other CVD risk biomarkers were evaluated in a young, healthy population. Thirty-eight subjects [19 men/19 women, 24.1 ± 2.2 years, body mass index (BMI) 24.3 ± 2.5 kg/m2] participated in this 14-week crossover intervention. Participants underwent a 2-week washout with no egg consumption, followed by intake of 1, 2, and 3 eggs/day for 4 weeks each. Anthropometric data, blood pressure (BP), dietary records, and plasma biomarkers (lipids, glucose, choline, and TMAO) were measured during each intervention phase. BMI, waist circumference, systolic BP, plasma glucose, and plasma triacylglycerol did not change throughout the intervention. Diastolic BP decreased with egg intake (P < 0.05). Compared to 0 eggs/day, intake of 1 egg/day increased HDL cholesterol (HDL-c) (P < 0.05), and decreased LDL cholesterol (LDL-c) (P < 0.05) and the LDL-c/HDL-c ratio (P < 0.01). With intake of 2-3 eggs/day, these changes were maintained. Plasma choline increased dose-dependently with egg intake (P < 0.0001) while fasting plasma TMAO was unchanged. These results indicate that in a healthy population, consuming up to 3 eggs/day results in an overall beneficial effect on biomarkers associated with CVD risk, as documented by increased HDL-c, a reduced LDL-c/HDL-c ratio, and increased plasma choline in combination with no change in plasma LDL-c or TMAO concentrations.

The Potential of Non-Provitamin A Carotenoids for the Prevention and Treatment of Non-Alcoholic Fatty Liver Disease.

Non-alcoholic fatty liver disease (NAFLD) is an obesity-associated spectrum of comorbidities defined by the presence of metabolic dysfunction, oxidative stress, inflammation, and fibrosis in the liver. If left untreated, NAFLD can progress to cirrhosis, liver failure, or hepatocellular carcinoma. NAFLD is recognized as the most common liver disease in the United States, affecting around 30% of the population. Identification of dietary components capable of reducing or preventing NAFLD is therefore essential to battle this condition. Dietary carotenoids including astaxanthin, lycopene, lutein, and zeaxanthin have been demonstrated to be potent antioxidants as well as to exhibit anti-inflammatory effects. Many studies report the protective effect(s) of these carotenoids against different conditions such as atherosclerosis, diabetic complications, age-related macular degeneration, and liver diseases. In this review, we will focus on the effects of these carotenoids in the prevention or reduction of NAFLD as seen in epidemiological observations and clinical trials, as well as the suggested mechanism of action derived from animal and cell studies.

Compared with Powdered Lutein, a Lutein Nanoemulsion Increases Plasma and Liver Lutein, Protects against Hepatic Steatosis, and Affects Lipoprotein Metabolism in Guinea Pigs.

BACKGROUND: It is not clear how oil-in-water nanoemulsions of lutein may affect bioavailability and consequently alter lipoprotein metabolism, oxidative stress, and inflammation. OBJECTIVE: The bioavailability as well as effects of a powdered lutein (PL) and an oil-in-water lutein nanoemulsion (NANO; particle size: 254.2 nm; polydispersity index: 0.29; and ζ-potential: -65 mV) on metabolic variables in liver, plasma, and adipose tissue in a guinea pig model of hepatic steatosis were evaluated. METHODS: Twenty-four 2-mo-old male Hartley guinea pigs, weighing 200-300 g (n = 8/group), were fed diets containing 0.25 g cholesterol/100 g to induce liver injury for the duration of the study. They were allocated to control (0 mg lutein), PL (3.5 mg/d), or NANO (3.5 mg/d) groups. After 6 wk, plasma, liver, and adipose tissue were collected for determination of lutein, plasma lipids, tissue cholesterol, and inflammatory cytokines. RESULTS: The NANO group had 2-fold higher concentrations of lutein in plasma (P < 0.001) and 1.6-fold higher concentrations in liver (P < 0.001) than did the PL group, indicating greater bioavailability of this carotenoid. The NANO group also had 24% lower hepatic steatosis scores (P < 0.05), 31% lower hepatic cholesterol accumulation (P < 0.05), and 64% lower plasma alanine aminotransferase (P < 0.05) than did the control group. Hepatic oxidized LDL was 55% lower in both the PL and NANO groups than in the control group (P < 0.05). In plasma, the NANO group had 2-fold higher concentrations of LDL and HDL cholesterol as well as a 2-fold higher number of VLDL, LDL, and HDL particles than did the other 2 groups as evaluated by nuclear magnetic resonance. Furthermore, the NANO group had 15% higher concentrations of free cholesterol in adipose tissue, resulting in higher concentrations of inflammatory markers, than did the other 2 groups. CONCLUSIONS: These results indicate that, although this lutein nanoemulsion exerted protective effects against hepatic steatosis, plasma lipoproteins and adipose tissue cholesterol were increased. These data suggest that the metabolic effects of this particular nanoemulsion might not be protective in all tissues in guinea pigs.

Postmenopausal Women Have Higher HDL and Decreased Incidence of Low HDL than Premenopausal Women with Metabolic Syndrome.

It is well known that plasma lipids, waist circumference (WC) and blood pressure (BP) increase following menopause. In addition, there is a perceived notion that plasma high-density lipoprotein-cholesterol (HDL-C) concentrations also decrease in postmenopausal women. In this cross-sectional study, we evaluated plasma lipids, fasting glucose, anthropometrics and BP in 88 post and 100 pre-menopausal women diagnosed with metabolic syndrome. No differences were observed in plasma low-density lipoprotein-cholesterol cholesterol, triglycerides, fasting glucose or systolic and diastolic BP between groups. However, plasma HDL-C was higher (p < 0.01) in postmenopausal women and the percentage of women who had low HDL (<50 mg/dL) was higher (p < 0.01) among premenopausal women. In addition, negative correlations were found between WC and HDL-C (r = -0.148, p < 0.05) and BMI and HDL-C (r = -0.258, p < 0.01) for all subjects indicating that increases in weight and abdominal fat have a deleterious effect on plasma HDL-C. Interestingly, there was a positive correlation between age and plasma HDL-C (r = 0.237 p < 0.01). The results from this study suggest that although HDL is decreased by visceral fat and overall weight, low HDL is not a main characteristic of metabolic syndrome in postmenopausal women. Further, HDL appears to increase, not decrease, with age.

Potential of Dietary Non-Provitamin A Carotenoids in the Prevention and Treatment of Diabetic Microvascular Complications.

Diabetes is a chronic metabolic disease that affects a substantial part of the population around the world. Whether type I or type II, this disease has serious macro- and microvascular complications that constitute the primary cause of death in diabetic patients. Microvascular complications include diabetic retinopathy, nephropathy, and neuropathy. Although these complications are clinically and etiologically diverse, they share a common factor: glucose-induced damage. In the progression of diabetic complications, oxidative stress, inflammation, and the formation of glycation end products play an important role. Previous studies have shown that a healthy diet is vital in preventing these complications; in particular, the intake of antioxidants has been studied for their potential effect in ameliorating hyperglycemic injuries. Carotenoids are lipid-soluble pigments synthesized by plants, bacteria, and some kinds of algae that are responsible for the yellow, red, and orange colors in food. These compounds are part of the antioxidant machinery in plants and have also shown their efficacy in quenching free radicals, scavenging reactive oxygen species, modulating gene expression, and reducing inflammation in vitro and in vivo, showing that they can potentially be used as part of a preventive strategy for metabolic disorders, including diabetes and its related complications. This review highlights the potential protective effects of 4 non-provitamin A carotenoids--lutein, zeaxanthin, lycopene, and astaxanthin--in the development and progression of diabetic microvascular complications.

Discrepancias entre el diagnóstico Clínico y Anatomo-Patológico en el Hospital Escuela Universitario De Honduras / Discrepancies between the Clinical and Anatomy-Pathological diagnosis at the Hospital Escuela Universitario in Honduras

La calidad diagnóstica es el resultado de integrar el conocimiento médico y reconocimiento de los errores clínicos, se alcanza únicamente con la identificación de las causas de muerte; es la correlación clínico patológica la herramienta principal para dicha acción. El objetivo general de la investigación fue determinar la discrepancia clínico-patológica y su relación con otras variables en las autopsias realizadas en la institución. Se revisaron 159 protocolos de autopsia del período comprendido entre enero 2012 y junio 2016, elaborados por el Servicio de Patología del Hospital Escuela Universitario de Tegucigalpa, Honduras. Se excluyeron 36 por no cumplir los criterios de inclusión. Se utilizaron la CIE-10 y la clasificación de Goldman et al. para clasificar las patologías y establecer las discrepancias diagnósticas, respectivamente. El sexo predominante fue el femenino (2,96:1), la edad media fue de 38 años; prevalecieron los diagnósticos de embarazo/parto/puerperio y enfermedades infecciosas y parasitarias. Concluimos que en 46% de los casos existe discrepancia diagnóstica y la glomerulonefritis fue la principal causa de error, seguida de bronconeumonía. Se recomienda estandarizar el protocolo de autopsias y promover sesiones clínico-patológicas periódicas e integrales.

Diagnostic quality is the result of the integration of medical knowledge and recognition of clinical error, achieved only by identifying the cause of death; clinical pathological correlation is the primary tool for this action. The overall objective of this research was to determine clinical pathological discrepancy and its relationship with other variables within the autopsies performed at the institution. 159 autopsy protocols, elaborated by the Department of Pathology of Hospital Escuela Universitario in Tegucigalpa, Honduras, from January 2012 to June 2016, were reviewed. 36 were excluded for not meeting the inclusion criteria. ICD-10 and Goldman et al. modified by Battle criteria were used to classify diseases and establish diagnostic discrepancies, respectively. The majority of patients were female (2.96:1), the mean age was 38 years old; diagnoses of pregnancy/birth/puerperium and infectious and parasitic diseases prevailed. We conclude that diagnostic discrepancies exist in 46% of all cases and glomerulonephritis was the leading cause of error, followed by bronchopneumonia. It is recommended that autopsy protocols be standardized, and integrative clinical pathological sessions are promoted and integral.