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Nutrición Hospitalaria Vol. 28. N.º 2. Marzo-Abril 2013 ARTÍCULO ESPECIAL. SPECIAL ARTICLE Tercera Lección Jesús Culebras - Biología Molecular y Nutrición Clínica; ¿dónde estamos y adónde vamos? Third Jesús Culebras Lecture - Molecular Biology and Clinical Nutrition; ¿where do we stand and where we go? ...... 241 REVISIONES. REVIEWS La alimentación de la madre durante el embarazo condiciona el desarrollo pancreático, el estatus hormonal del feto y la concentración de biomarcadores al nacimiento de diabetes mellitus y síndrome metabólico Maternal nutrition during pregnancy conditions the fetal pancreas development, hormonal status and diabetes mellitus and metabolic syndrome biomarkers at birth .......................................................................................................... 250 Las dietas de muy bajo valor calórico (DMBVC) en el manejo clínico de la obesidad mórbida Very low calorie diets in clinical management of morbid obesity ............................................................................................ 275 Valores del ángulo de fase por bioimpendancia eléctrica; estado nutricional y valor pronóstico Values of the phase angle by bioelectrical impedance; nutritional status and prognostic value ........................................ 286 El efecto del consumo de semillas oleaginosas en el apetito y en el riesgo de desarrollar diabetes mellitus tipo 2 The effect of oilseed consumption on the appetite and on the risk of developing type 2 diabetes mellitus ........................ 296 ORIGINALES. ORIGINALS Ingesta de calcio y vitamina D en una muestra representativa de mujeres españolas; problemática específica en menopausia Calcium and vitamin D intakes in a representative sample of Spanish women; particular problem in menopause ........ 306 Valoración del estado nutricional en el anciano; evaluación de las ecuaciones de Chumlea para el cálculo del peso Assessing nutritional status in the elderly; evaluation of Chumlea’s equations for weight ................................................ 314 Estudio nutricional de un equipo de fútbol de tercera división Nutritional study of a third division soccer team .................................................................................................................. 319 El ejercicio agudo alimenta las concentraciones de homocisteína en varones físicamente activos Acute physical exercise increases homocysteine concentrations in young trained male subjects ...................................... 325 ÓRGANO OFICIAL DE LA SOCIEDAD ESPANOLA DE NUTRICIÓN PARENTERAL Y ENTERAL ÓRGANO OFICIAL DEL CENTRO INTERNACIONAL VIRTUAL DE INVESTIGACIÓN EN NUTRICIÓN ÓRGANO OFICIAL DE LA SOCIEDAD ESPANOLA DE NUTRICIÓN ÓRGANO OFICIAL DE LA FEDERACIÓN LATINO AMERICANA DE NUTRICIÓN PARENTERAL Y ENTERAL ÓRGANO OFICIAL DE LA FEDERACIÓN ESPAÑOLA DE SOCIEDADES DE NUTRICIÓN, ALIMENTACIÓN Y DIETÉTICA Nutr Hosp. 2013;(2)28:241-552 • ISSN (Versión papel): 0212-1611 • ISSN (Versión electrónica): 1699-5198 • CODEN NUHOEQ • S.V.R. 318 Incluida en EMBASE (Excerpta Medica), MEDLINE (Index Medicus), Chemical Abstracts, Cinahl, Cochrane plus, Ebsco, Indice Médico Español, preIBECS, IBECS, MEDES, SENIOR, ScIELO, Science Citation Index Expanded (SciSearch), Cancerlit, Toxline, Aidsline, Health Planning Administration y REDALYC ÍNDICE COMPLETO EN EL INTERIOR DE LA REVISTA www.nutricionhospitalaria.com ISSN 0212-1611 01802

Transcript of Vol. 28. N.º 2. Marzo-Abril 2013 00. PORTADA 2-2013 … · • Valoración del estado nutricional...

  • NutricinHospitalaria

    Vol. 28. N. 2. Marzo-Abril 2013

    ARTCULO ESPECIAL. SPECIAL ARTICLE Tercera Leccin Jess Culebras - Biologa Molecular y Nutricin Clnica; dnde estamos y adnde vamos? Third Jess Culebras Lecture - Molecular Biology and Clinical Nutrition; where do we stand and where we go? ...... 241

    REVISIONES. REVIEWS La alimentacin de la madre durante el embarazo condiciona el desarrollo pancretico, el estatus hormonal del feto y la concentracin de biomarcadores al nacimiento de diabetes mellitus y sndrome metablico Maternal nutrition during pregnancy conditions the fetal pancreas development, hormonal status and diabetes mellitus and metabolic syndrome biomarkers at birth .......................................................................................................... 250

    Las dietas de muy bajo valor calrico (DMBVC) en el manejo clnico de la obesidad mrbida Very low calorie diets in clinical management of morbid obesity ............................................................................................ 275

    Valores del ngulo de fase por bioimpendancia elctrica; estado nutricional y valor pronstico Values of the phase angle by bioelectrical impedance; nutritional status and prognostic value ........................................ 286

    El efecto del consumo de semillas oleaginosas en el apetito y en el riesgo de desarrollar diabetes mellitus tipo 2 The effect of oilseed consumption on the appetite and on the risk of developing type 2 diabetes mellitus ........................ 296

    ORIGINALES. ORIGINALS Ingesta de calcio y vitamina D en una muestra representativa de mujeres espaolas; problemtica especfica

    en menopausia Calcium and vitamin D intakes in a representative sample of Spanish women; particular problem in menopause ........ 306

    Valoracin del estado nutricional en el anciano; evaluacin de las ecuaciones de Chumlea para el clculo del peso Assessing nutritional status in the elderly; evaluation of Chumleas equations for weight ................................................ 314

    Estudio nutricional de un equipo de ftbol de tercera divisin Nutritional study of a third division soccer team .................................................................................................................. 319

    El ejercicio agudo alimenta las concentraciones de homocistena en varones fsicamente activos Acute physical exercise increases homocysteine concentrations in young trained male subjects ...................................... 325

    RGANO OFICIAL DE LA SOCIEDAD ESPANOLA DE NUTRICIN PARENTERAL Y ENTERALRGANO OFICIAL DEL CENTRO INTERNACIONAL VIRTUAL DE INVESTIGACIN EN NUTRICIN

    RGANO OFICIAL DE LA SOCIEDAD ESPANOLA DE NUTRICINRGANO OFICIAL DE LA FEDERACIN LATINO AMERICANA DE NUTRICIN PARENTERAL Y ENTERAL

    RGANO OFICIAL DE LA FEDERACIN ESPAOLA DE SOCIEDADES DE NUTRICIN, ALIMENTACIN Y DIETTICA

    Nutr Hosp. 2013;(2)28:241-552 ISSN (Versin papel): 0212-1611 ISSN (Versin electrnica): 1699-5198 CODEN NUHOEQ S.V.R. 318

    Incluida en EMBASE (Excerpta Medica), MEDLINE (Index Medicus), Chemical Abstracts, Cinahl, Cochrane plus, Ebsco, Indice Mdico Espaol, preIBECS, IBECS, MEDES, SENIOR, ScIELO, Science Citation Index Expanded (SciSearch), Cancerlit, Toxline, Aidsline, Health Planning Administration y REDALYC

    NDICE COMPLETO EN EL INTERIOR DE LA REVISTA

    www.nutricionhospitalaria.com

    ISSN 0212-16110 1 8 0 2

    00. PORTADA 2-2013 (I. DIGITAL)_PORTADA 15/03/13 08:35 Pgina I

  • Vol. 28N. 2 MARZO-ABRIL 2013

    ISSN (Versin papel): 0212-1611ISSN (Versin electrnica): 1699-5198

    N. 2Marzo-Abril 2013 Vol. 28

    Periodicidad bimestral

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    www.nutricinhospitalaria.comIMPACT FACTOR 2011: 1,120 (JCR)

    RGANO OFICIAL DE LA SOCIEDAD ESPAOLA DE NUTRICIN PARENTERAL Y ENTERAL

    RGANO OFICIAL DEL CENTRO INTERNACIONAL VIRTUALDE INVESTIGACIN EN NUTRICIN

    RGANO OFICIAL DE LA SOCIEDAD ESPANOLA DE NUTRICIONRGANO OFICIAL DE LA FEDERACIN LATINO AMERICANA

    DE NUTRICIN PARENTERAL Y ENTERALRGANO OFICIAL DE LA FEDERACIN ESPAOLA

    DE SOCIEDADES DE NUTRICIN, ALIMENTACIN Y DIETTICA

    01. STAFF 2-2013_STAFF 14/03/13 12:06 Pgina III

  • Entra enwww.grupoaulamedica.com/web/nutricion.cfm

    y podrs acceder a:

    Nmero actual

    Nmeros anteriores

    Enlace con la Web Oficial de laSociedad Espaola de NutricinParenteral y Enteral

    www.senpe.comwww.grupoaulamedica.com

    rgano Oficial de la Sociedad Espaola de Nutricin Parenteral y Enteral

    rgano Oficial del Centro InternacionalVirtual de Investigacin en Nutricin

    rgano Oficial de la Sociedad Espaola de Nutricin

    rgano Oficial de la Federacin LatinoAmericana de Nutricin Parenteral y Enteral

    rgano Oficial de la Federacin Espaola de Sociedades de Nutricin, Alimentacin

    y Diettica

    REVISIN. REVIEW

    Estabilidad de vitaminas en nutricin parenteralVitamins stability in parenteral nutrition

    Suplementacin oral nutricional en pacientes hematolgicosOral nutritional supplementation in hematologic patients

    ORIGINALES. ORIGINALS

    Factores de riesgo para el sobrepeso y la obesidad en adolescentes de una universidad de Brasil: un estudio de casos-controlRisk factors for overweight and obesity in adolescents of a Brazilian university: a case-control study

    Indicadores de calidad en ciruga baritrica. Valoracin de la prdida de pesoQuality indicators in bariatric surgery. Weight loss valoration

    Euglucemia y normolipidemia despes de derivacin gstrica anti-obesidadEuglycemia and normolipidemia after anti-obesity gastric bypass

    Efecto del baln intragstrico como mtodo alternativo en la prdida de peso en pacientes obesos. Valencia-VenezuelaEffect of the intragastric balloon as alternative method in the loss of weight in obese patients. Valencia-Venezuela

    Estado nutricional y caractersticas de la dieta de un grupo de adolescentes de la localidad rural de Calama, BoliviaNutritional status and diet characteristics of a group of adolescents from the rural locality Calama, Bolivia

    Comparacin del diagnstico nutritivo, obtenido por diferentes mtodos e indicadores, en pacientes con cncerComparison of the nutritional diagnosis, obtained through different methods and indicators, in patients with cancer

    Fiabilidad de los instrumentos de valoracin nutritiva para predecir una mala evolucin clnica en hospitalizadosAccuracy of nutritional assessment tools for predicting adverse hospital outcomes

    Valoracin de la circunferencia de la pantorrilla como indicador de riesgo de desnutricin en personas mayoresAssessment of calf circumference as an indicator of the risk for hyponutrition in the elderly

    Impacto de la introduccin de un programa de nutricin parenteral por la unidad de nutricin clnica en pacientes quirrgicosImpact of the implementation of a parenteral nutrition program by the clinical nutrition unit in surgical patients

    Complicaciones inmediatas de la gastrostoma percutnea de alimentacin: 10 aos de experienciaInmediate complications or feeding percutaneous gastrostomy: a 10-year experience

    Evaluacin del ndice de adecuacin de la dieta mediterrnea de un colectivo de ciclistas jvenesAssessment of the mediterranean diet adequacy index of a collective of young cyclists

    Efecto de una dieta con productos modificados de textura en pacientes ancianos ambulatoriosEffect o a diet with products in texture modified diets in elderly ambulatory patients

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    www.grupoaulamedica.com/web/nutricion.cfm

    Nutr Hosp. 2009;(1)24:1-110 ISSN: 0212-1611 CODEN NUHOEQ S.V.R. 318

    Incluida en EMBASE (Excerpta Medica), MEDLINE (Index Medicus), Chemical Abstracts, Cinahl, Cochrane plus, Ebsco,Indice Mdico Espaol, preIBECS, IBECS, MEDES, SENIOR, ScIELO, Science Citation Index Expanded (SciSearch), Cancerlit, Toxline, Aidsline y Health Planning Administration

    RGANO OFICIAL DE LA SOCIEDAD ESPAOLA DE NUTRICIN PARENTERAL Y ENTERALRGANO OFICIAL DE LA SOCIEDAD ESPAOLA DE NUTRICIN

    RGANO OFICIAL DE LA FEDERACIN LATINO AMERICANA DE NUTRICIN PARENTERAL Y ENTERALRGANO OFICIAL DE LA FEDERACIN ESPAOLA DE SOCIEDADES DE NUTRICIN, ALIMENTACIN Y DIETTICA

    NutricinHospitalaria

    Vol. 24. N. 1. Enero-Febrero 2009

    NDICE COMPLETO EN EL INTERIOR

    NUTRICIN HOSPITALARIA

    Vistanos en internet

    Esta publicacin recoge revisiones y trabajos originales, experi-mentales o clnicos, relacionados con el vasto campo de lanutricin. Su nmero extraordinario, dedicado a la reunin oCongreso Nacional de la Sociedad Espaola de Nutricin Pa-renteral y Enteral, presenta en sus pginas los avances ms im-portantes en este campo.

    Esta publicacin se encuentra incluida en EMBASE (ExcerptaMedica), MEDLINE, (Index Medicus), Chemical Abstracts,Cinahl, Cochrane plus, Ebsco, ndice Mdico Espaol, preIBECS,IBECS, MEDES, SENIOR, ScIELO, Science Citation IndexExpanded (SciSearch), Cancerlit, Toxline, Aidsline y HealthPlanning Administration

    Director: J. M. Culebras Fernndez.Redactor Jefe: A. Garca de Lorenzo.

    www.nutricionhospitalaria.com

    NUTRICION HOSPITALARIA

    VISITANOS EN INTERNET (NUEVA):VISITANOS EN INTERNET (NUEVA) 14/09/12 10:23 Pgina 1

  • NUTRICIN HOSPITALARIA, es la publicacin cientfica oficial de la Sociedad Espaola de Nutricin Parenteral y Enteral (SENPE), de laSociedad Espaola de Nutricin (SEN), de la Federacin Latino Americana de Nutricin Parenteral y Enteral (FELANPE) y de la Federa-cin Espaola de Sociedades de Nutricin, Alimentacin y Diettica (FESNAD).

    Publica trabajos en castellano e ingls sobre temas relacionados con el vasto campo de la nutricin. El envo de un manuscrito a larevista implica que es original y no ha sido publicado, ni est siendo evaluado para publicacin, en otra revista y deben haberse elabo-rado siguiendo los Requisitos de Uniformidad del Comit Internacional de Directores de Revistas Mdicas en su ltima versin (versinoficial disponible en ingls en http://www.icme.org; correspondiente traduccin al castellano en: http://www.metodo.uab.es/enlaces/Re-quisitos_de_Uniformidad_2006.pdf).

    IMPORTANTE: A la aceptacin y aprobacin definitiva de cada artculo debern abonarse 150 euros, ms impuestos, en conceptode contribucin parcial al coste del proceso editorial de la revista. El autor recibir un comunicado mediante correo electrnico, desdela empresa editorial, indicndole el procedimiento a seguir.

    1. REMISIN Y PRESENTACIN DE MANUSCRITOSLos trabajos se remitirn por va electrnica a travs del portal www.nutricionhospitalaria.com. En este portal el autor encontrar directrices y faci-

    lidades para la elaboracin de su manuscrito.Cada parte del manuscrito empezar una pgina, respetando siempre el siguiente orden:

    1.1 Carta de presentacinDeber indicar el Tipo de Artculo que se remite a consideracin y contendr: Una breve explicacin de cul es su aportacin as como su relevancia dentro del campo de la nutricin. Declaracin de que es un texto original y no se encuentra en proceso de evaluacin por otra revista, que no se trata de publicacin re-

    dundante, as como declaracin de cualquier tipo de conflicto de intereses o la existencia de cualquier tipo de relacin econmica. Conformidad de los criterios de autora de todos los firmantes y su filiacin profesional. Cesin a la revista NUTRICIN HOSPITALARIA de los derechos exclusivos para editar, publicar, reproducir, distribuir copias, preparar trabajos

    derivados en papel, electrnicos o multimedia e incluir el artculo en ndices nacionales e internacionales o bases de datos. Nombre completo, direccin postal y electrnica, telfono e institucin del autor principal o responsable de la correspondencia. Cuando se presenten estudios realizados en seres humanos, debe enunciarse el cumplimiento de las normas ticas del Comit de In-

    vestigacin o de Ensayos Clnicos correspondiente y de la Declaracin de Helsinki vigente, disponible en: http://www.wma.net/s/index.htm.

    1.2 Pgina de ttuloSe indicarn, en el orden que aqu se cita, los siguientes datos: ttulo del artculo (en castellano y en ingls); se evitarn smbolos y acrnimos

    que no sean de uso comn.Nombre completo y apellido de todos los autores, separados entre s por una coma. Se aconseja que figure un mximo de ocho autores, fi-

    gurando el resto en un anexo al final del texto.Mediante nmeros arbigos, en superndice, se relacionar a cada autor, si procede, con el nombre de la institucin a la que pertenecen.Podr volverse a enunciar los datos del autor responsable de la correspondencia que ya se deben haber incluido en la carta de presenta-

    cin.En la parte inferior se especificar el nmero total de palabras del cuerpo del artculo (excluyendo la carta de presentacin, el resumen,

    agradecimientos, referencias bibliogrficas, tablas y figuras).

    1.3 ResumenSer estructurado en el caso de originales, originales breves y revisiones, cumplimentando los apartados de Introduccin, Objetivos, Mtodos,

    Resultados y Discusin (Conclusiones, en su caso). Deber ser comprensible por s mismo y no contendr citas bibliogrficas.Encabezando nueva pgina se incluir la traduccin al ingls del resumen y las palabras clave, con idntica estructuracin. En caso de no

    incluirse, la traduccin ser realizada por la propia revista.

    1.4 Palabras claveDebe incluirse al final de resumen un mximo de 5 palabras clave que coincidirn con los Descriptores del Medical Subjects Headings

    (MeSH): http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=mesh

    1.5 AbreviaturasSe incluir un listado de las abreviaturas presentes en el cuerpo del trabajo con su correspondiente explicacin. Asimismo, se indicarn la

    primera vez que aparezcan en el texto del artculo.

    1.6 TextoEstructurado en el caso de originales, originales breves y revisiones, cumplimentando los apartados de Introduccin, Objetivos, Mtodos,

    Resultados y Discusin (Conclusiones, en su caso).Se deben citar aquellas referencias bibliogrficas estrictamente necesarias teniendo en cuenta criterios de pertinencia y relevancia.En la metodologa, se especificar el diseo, la poblacin a estudio, los mtodos estadsticos empleados, los procedimientos y las normas

    ticas seguidas en caso de ser necesarias.

    1.7 AnexosMaterial suplementario que sea necesario para el entendimiento del trabajo a publicar.

    1.8 AgradecimientosEsta seccin debe reconocer las ayudas materiales y econmicas, de cualquier ndole, recibidas. Se indicar el organismo, institucin o

    empresa que las otorga y, en su caso, el nmero de proyecto que se le asigna. Se valorar positivamente haber contado con ayudas.Toda persona fsica o jurdica mencionada debe conocer y consentir su inclusin en este apartado.

    1.9 BibliografaLas citas bibliogrficas deben verificarse mediante los originales y debern cumplir los Requisitos de Uniformidad del Comit Internacional

    de Directores de Revistas Mdicas, como se ha indicado anteriormente.Las referencias bibliogrficas se ordenarn y numerarn por orden de aparicin en el texto, identificndose mediante nmeros arbigos en

    superndice.Las referencias a textos no publicados ni pendiente de ello, se debern citar entre parntesis en el cuerpo del texto.Para citar las revistas mdicas se utilizarn las abreviaturas incluidas en el Journals Database, disponible en: http://www. ncbi.nlm.nih.gov/

    entrez/query.fcgi?db=journals.En su defecto en el catlogo de publicaciones peridicas en bibliotecas de ciencias de la salud espaolas: http://www.c17.net/c17/.

    NORMAS DE PUBLICACIN PARA LOSAUTORES DE NUTRICIN HOSPITALARIA

    sss

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  • 1.10 Tablas y FigurasEl contenido ser autoexplicativo y los datos no debern ser redundantes con lo escrito. Las leyendas debern incluir suficiente informacin

    para poder interpretarse sin recurrir al texto y debern estar escritas en el mismo formato que el resto del manuscrito.Se clasificarn con nmeros arbigos, de acuerdo con su orden de aparicin, siendo esta numeracin independiente segn sea tabla o

    figura. Llevarn un ttulo informativo en la parte superior y en caso de necesitar alguna explicacin se situar en la parte inferior. En amboscasos como parte integrante de la tabla o de la figura.

    Se remitirn en fichero aparte, preferiblemente en formato JPEG, GIFF, TIFF o PowerPoint, o bien al final del texto incluyndose cada tablao figura en una hoja independiente.

    1.11 AutorizacionesSi se aporta material sujeto a copyright o que necesite de previa autorizacin para su publicacin, se deber acompaar, al manuscrito, las

    autorizaciones correspondientes.

    2. TIPOS Y ESTRUCTURA DE LOS TRABAJOS2.1 Original: Trabajo de investigacin cuantitativa o cualitativa relacionado con cualquier aspecto de la investigacin en el campo de la nutricin.2.2 Original breve: Trabajo de la misma caracterstica que el original, que por sus condiciones especiales y concrecin, puede ser publicadode manera ms abreviada.

    2.3 Revisin: Trabajo de revisin, preferiblemente sistemtica, sobre temas relevantes y de actualidad para la nutricin.2.4 Notas Clnicas: Descripcin de uno o ms casos, de excepcional inters que supongan una aportacin al conocimiento clnico.2.5 Perspectiva: Artculo que desarrolla nuevos aspectos, tendencias y opiniones. Sirviendo como enlace entre la investigacin y la sociedad.2.6 Editorial: Artculo sobre temas de inters y actualidad. Se escribirn a peticin del Comit Editorial.2.7 Carta al Director: Observacin cientfica y de opinin sobre trabajos publicados recientemente en la revista, as como otros temas de re-levante actualidad.

    2.8 Carta Cientfica: La multiplicacin de los trabajos originales que se reciben nos obligan a administrar el espacio fsico de la revisa. Porello en ocasiones pediremos que algunos originales se reconviertan en carta cientfica cuyas caractersticas son:

    Ttulo Autor (es) Filiacin Direccin para correspondencia Texto mximo 400 palabras Una figura o una tabla Mximo cinco citas

    La publicacin de una Carta Cientfica no es impedimento para que el artculo in extenso pueda ser publicado posteriormente en otra revista.2.9 Artculo de Recensin: Comentarios sobre libros de inters o reciente publicacin. Generalmente a solicitud del Comit editorial aunquetambin se considerarn aquellos enviados espontneamente.

    2.10 Artculo Especial: El Comit Editorial podr encargar, para esta seccin, otros trabajos de investigacin u opinin que considere de es-pecial relevancia. Aquellos autores que de forma voluntaria deseen colaborar en esta seccin, debern contactar previamente con el Directorde la revista.

    2.11 Artculo Preferente: Artculo de revisin y publicacin preferente de aquellos trabajos de una importancia excepcional. Deben cumplirlos requisitos sealados en este apartado, segn el tipo de trabajo. En la carta de presentacin se indicar de forma notoria la solicitud deArtculo Preferente. Se publicarn en el primer nmero de la revista posible.

    Eventualmente se podr incluir, en la edicin electrnica, una versin ms extensa o informacin adicional.

    3. PROCESO EDITORIALEl Comit de Redaccin acusar recibo de los trabajos recibidos en la revista e informar, en el plazo ms breve posible, de su recepcin.Todos los trabajos recibidos, se someten a evaluacin por el Comit Editorial y por al menos dos revisores expertos.Los autores puden sugerir revisores que a su juicio sean expertos sobre el tema. Lgicamente, por motivos ticos obvios, estos revisores

    propuestos deben ser ajenos al trabajo que se enva. Se deber incluir en el envo del original nombre y apellidos, cargo que ocupan y emailde los revisores que se proponen.

    Las consultas referentes a los manuscritos y su transcurso editorial, pueden hacerse a travs de la pgina web.Previamente a la publicacin de los manuscritos, se enviar una prueba al autor responsable de la correspondencia utilizando el correo electrnico.

    Esta se debe revisar detenidamente, sealar posibles erratas y devolverla corregida a su procedencia en el plazo mximo de 48 horas. Aquellos autoresque desean recibir separatas debern de comunicarlo expresamente. El precio de las separatas (25 ejemplares) es de 125 euros + IVA.

    Abono en concepto de financiacin parcial de la publicacin. En el momento de aceptarse un articulo original o una revision no solicitadase facturar la cantidad de 150 + impuestos para financiar en parte la publicacin del articulo (vease Culebras JM y A Garcia de Lorenzo.El factor de impacto de Nutricin Hospitalaria incrementado y los costes de edicin tambin. Nutr Hosp 2012; 27.(5).

    EXTENSIN ORIENTATIVA DE LOS MANUSCRITOS

    Original Estructurado Estructurado 5 35 250 palabras 4.000 palabras

    Original breve Estructurado Estructurado 2 15 150 palabras 2.000 palabras

    Revisin Estructurado Estructurado 6 150 250 palabras 6.000 palabras

    Notas clnicas 150 palabras 1.500 palabras 2 10

    Perspectiva 150 palabras 1.200 palabras 2 10

    Editorial 2.000 palabras 2 10 a 15

    Carta al Director 400 palabras 1 5

    Tipo de artculo Resumen Texto Tablas y figuras Referencias

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  • Vol. 28N. 2 MARZO-ABRIL 2013

    ISSN (Versin papel): 0212-1611ISSN (Versin electrnica): 1699-5198

    DIRECTORJESUS M. CULEBRASDe la Real Academia de Medicina y Ciruga de Valladolid. Ac. Profesor Titular de UniversidadJefe de Servicio de Ciruga. Complejo Asistencial Universitario de Len.Miembro del Instituto Universitario de Biomedicina (IBIOMED)Universidad de Len. Apto 1351, 24080 [email protected]

    REDACTOR JEFEA. GARCA DE LORENZO Y MATEOSJefe Clnico del Servicio de Medicina Intensiva. Servicio de Medicina Intensiva. Hospital Universitario La Paz. Paseo de la Castellana, 261. 28046Madrid. Director de la Ctedra UAM-Abbott de Medicina Crtica. Dpto. deCiruga. Universidad Autnoma de [email protected]

    Responsable de Casos ClnicosPILAR RIOBO (Madrid)Responsable para LatinoamricaDAN L. WAITZBERG (Brasil)Asesor estadstico y epidemiolgicoGONZALO MARTN PEA (Madrid)Asesor para artculos bsicosNGEL GIL HERNNDEZ (Granada)Coordinadora con el Comit Cientfico de SENPEMERCE PLANAS VILA (Barcelona)Coordinadora de Alimentos funcionalesM. GONZLEZ-GROSS (Madrid)Coordinador con FelanpeLUIS ALBERTO NIN (Uruguay)

    M. ANAYA TURRIENTESM. ARMERO FUSTERJ. LVAREZ HERNNDEZT. BERMEJO VICEDOM. D. BALLESTEROSP. BOLAOS ROSC. DE LA CUERDA COMPSD. DE LUISD. CARDONA PERAM. A. CARBAJO CABALLEROS. CELAYA PREZM. CAINZOS FERNNDEZA. I. COS BLANCOR. DENIA LAFUENTEA. GARCA IGLESIASP. GARCA PERISP. PABLO GARCA LUNAL. GARCA-SANCHO MARTNC. GMEZ CANDELA

    J. GONZLEZ GALLEGOP. GONZLEZ SEVILLAE. JAURRIETA MASJ. JIMNEZ JIMNEZM. JIMNEZ LENDNEZV. JIMNEZ TORRESS. GRISOLIA GARCAF. JORQUERAM. A. LEN SANZJ. LPEZ MARTNEZC. MARTN VILLARESA. MIJN DE LA TORREJ. M. MORENO VILLARESJ. C. MONTEJO GONZLEZC. ORTIZ LEYBAA. ORTIZ GONZLEZJ. ORDEZ GONZLEZJ. ORTIZ DE URBINAV. PALACIOS RUBIO

    A. PREZ DE LA CRUZM. PLANAS VILAI. POLANCO ALLUEN. PRIM VILAROJ. A. RODRGUEZ MONTESM. D. RUIZ LPEZI. RUIZ PRIETOF. RUZA TARRIOJ. SALAS SALVADJ. SNCHEZ NEBRAJ. SANZ VALEROE. TOSCANO NOVELLAM. JESS TUNJ. L. DE ULIBARRI PREZC. VARA THORBECKG. VARELA MOSQUERAC. VAZQUEZ MARTNEZC. WANDEN-BERGHE

    RGANO OFICIAL DE LA SOCIEDAD ESPAOLA DE NUTRICIN PARENTERAL Y ENTERALRGANO OFICIAL DEL CENTRO INTERNACIONAL VIRTUAL DE INVESTIGACIN EN NUTRICIN

    RGANO OFICIAL DE LA SOCIEDAD ESPAOLA DE NUTRICINRGANO OFICIAL DE LA FEDERACIN LATINO AMERICANA DE NUTRICIN PARENTERAL Y ENTERAL

    RGANO OFICIAL DE LA FEDERACIN ESPAOLA DE SOCIEDADES DE NUTRICIN, ALIMENTACIN Y DIETETICA

    COMIT DE REDACCIN

    COORDINADORES DEL COMIT DE REDACCIN

    CoordinadorA. GIL (Espaa)

    C. ANGARITA (Colombia)E. ATALAH (Chile)M. E. CAMILO (Portugal)F. CARRASCO (Chile)A. CRIVELI (Argentina)

    J. M. CULEBRAS (Espaa)J. FAINTUCH (Brasil)M. C. FALCAO (Brasil)A. GARCA DE LORENZO (Espaa)D. DE GIROLAMI (Argentina)J. KLAASEN (Chile)G. KLIGER (Argentina)L. MENDOZA (Paraguay)L. A. MORENO (Espaa)

    S. MUZZO (Chile)F. J. A. PREZ-CUETO (Bolivia)M. PERMAN (Argentina)J. SOTOMAYOR (Colombia)H. VANNUCCHI (Brasil)C. VELZQUEZ ALVA (Mxico)D. WAITZBERG (Brasil)N. ZAVALETA (Per)

    CONSEJO EDITORIAL IBEROAMERICANO

    NUTRICIN HOSPITALARIA ES PROPIEDAD DE SENPE

    IRENE BRETN [email protected]

    ALICIA CALLEJA [email protected]

    CRISTINA CUERDA [email protected]

    IGNACIO JUREGUI [email protected]

    ROSA ANGLICA LAMA [email protected]

    DANIEL DE LUIS [email protected]

    LUIS MIGUEL LUENGO [email protected]

    DAVID MARTINEZ [email protected]

    J. M. MORENO [email protected]

    CARMINA [email protected]

    ISSN (Versin papel): 0212-1611 ISSN (Versin electrnica): 1699-5198www.nutricionhospitalaria.com

    www.nutricionhospitalaria.com

    02. NORMAS NUEVAS OK_Maquetacin 1 14/03/13 07:19 Pgina VI

  • SOCIEDAD ESPAOLA DE NUTRICION PARENTERAL Y ENTERAL

    AGRADECIMIENTOS

    La Sociedad Espaola de Nutricin Parenteral y Enteral, que tiene como objetivosdesde su fundacin el potenciar el desarrollo y la investigacin sobre temas cientficos re-lacionados con el soporte nutricional, agradece su ayuda a los siguientes socios-entidadescolaboradoras.

    ABBOTT BAXTER S.A. B. BRAUN MEDICAL FRESENIUS - KABI GRIFOLS NESTL NUTRICIA NUTRICIN MDICA VEGENAT

    Vol. 28N. 2 MARZO-ABRIL 2013ISSN (Versin papel): 0212-1611ISSN (Versin electrnica): 1699-5198

    02. NORMAS NUEVAS OK_Maquetacin 1 14/03/13 07:19 Pgina VII

  • Coordinadora

    JULIA LVAREZ HERNNDEZ. [email protected]

    Vocales

    MERCEDES CERVERA [email protected]

    CRISTINA DE LA [email protected]

    JESS M. CULEBRAS [email protected]

    LAURA FRAS [email protected]

    ALFONSO MESEJO [email protected]

    GABRIEL OLVEIRA [email protected]

    CLEOF PREZ [email protected]

    M. DOLORES [email protected]

    JUNTA DIRECTIVA DE LA SOCIEDAD ESPAOLA DE NUTRICIN PARENTERAL Y ENTERAL

    Comit Cientfico-Educacional

    Coordinador de la pgina web

    JORDI SALAS [email protected]

    Miembros de honor

    A. AGUADO MATORRAS A. GARCA DE LORENZO Y MATEOS

    F. GONZLEZ HERMOSO S. GRISOLA GARCA

    F. D. MOORE A. SITGES CREUS G. VZQUEZ MATA

    J. VOLTAS BARO J. ZALDUMBIDE AMEZAGA

    SOCIEDAD ESPAOLA DE NUTRICION PARENTERAL Y ENTERAL

    Presidente

    ABELARDO GARCA DELORENZO Y MATEOS

    [email protected]

    Vocales

    JULIA [email protected]

    LORENA [email protected]

    ROSA [email protected]

    PEDRO PABLO GARCA [email protected]

    GUADALUPE PIEIRO [email protected]

    Presidente de honor

    J. M. CULEBRAS [email protected]

    Tesorero

    PEDRO MARS [email protected]

    Vicepresidente

    MERCE PLANAS [email protected]

    Secretario

    JUAN CARLOS MONTEJO GONZLEZ

    [email protected]

    Vol. 28N. 2 MARZO-ABRIL 2013

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  • SUMARIO

    Vol. 28 N. 2 MARZO-ABRIL 2013

    ISSN (Versin papel): 0212-1611ISSN (Versin electrnica): 1699-5198

    ARTCULO ESPECIAL TERCERA LECCIN JESS CULEBRAS - BIOLOGA MOLECULAR Y NUTRICIN CLNICA; DNDE ESTAMOS Y ADNDE VAMOS? ............................................................................................................ 241 ngel Gil

    REVISIONES LA ALIMENTACIN DE LA MADRE DURANTE EL EMBARAZO CONDICIONA EL DESARROLLO PANCRETICO, EL ESTATUS HORMONAL DEL FETO Y LA CONCENTRACIN DE BIOMARCADORES AL NACIMIENTO DE DIABETES MELLITUS Y SNDROME METABLICO ............... 250 F. J. Snchez-Muniz, E. Gesteiro, M. Esprrago Rodilla, B. Rodrguez Bernal y S. Bastida

    LAS DIETAS DE MUY BAJO VALOR CALRICO (DMBVC) EN EL MANEJO CLNICO DE LA OBESIDAD MRBIDA ............................................................................................................................................ 275 Francisco Javier Vilchez Lpez, Cristina Campos Martn, Mara Jos Amaya Garca, Pilar Snchez Vera y Jos Luis Pereira Cunill

    VALORES DEL NGULO DE FASE POR BIOIMPEDANCIA ELCTRICA; ESTADO NUTRICIONAL Y VALOR PRONSTICO ......................................................................................................................................... 286 L. Llames, V. Baldomero, M. L. Iglesias y L. P. Rodota

    EL EFECTO DEL CONSUMO DE SEMILLAS OLEAGINOSAS EN EL APETITO Y EN EL RIESGO DE DESARROLLAR DIABETES MELLITUS TIPO 2 ........................................................................................... 296 Daniela Neves Ribeiro, Rita de Cssia Gonalves Alfenas, Josefina Bressan y Neuza Maria Brunoro Costa

    ORIGINALES INGESTA DE CALCIO Y VITAMINA D EN UNA MUESTRA REPRESENTATIVA DE MUJERES

    ESPAOLAS; PROBLEMTICA ESPECFICA EN MENOPAUSIA .................................................................... 306 Rosa M. Ortega Anta, Liliana G. Gonzlez Rodrguez, Beatriz Navia Lombn, Jos Miguel Perea Snchez, Arnzazu Aparicio Vizuete, Ana Mara Lpez Sobaler; grupo de investigacin n. 920030

    VALORACIN DEL ESTADO NUTRICIONAL EN EL ANCIANO; EVALUACIN DE LASECUACIONES DE CHUMLEA PARA EL CLCULO DEL PESO ........................................................................ 314

    Montserrat Barcel, Olga Torres, Jordi Mascar, Esther Francia, Daniel Cardona y Domingo Ruiz

    ESTUDIO NUTRICIONAL DE UN EQUIPO DE FTBOL DE TERCERA DIVISIN ........................................ 319 Cristian Martnez Ren y Pilar Snchez Collado

    EL EJERCICIO AGUDO AUMENTA LAS CONCENTRACIONES DE HOMOCISTENA EN VARONESFSICAMENTE ACTIVOS ....................................................................................................................................... 325

    Beatriz Maroto-Snchez, Jara Valtuea, Ulrike Albers, Pedro J. Benito, Marcela Gonzlez-Gross; Imfine Research Group

    EFECTO RESIDUAL DEL EJERCICIO DE FUERZA MUSCULAR EN LA PREVENCIN SECUNDARIADE LA OBESIDAD INFANTIL ................................................................................................................................ 333

    Fabin Vsquez, Erik Daz, Lydia Lera, Jorge Meza, Isabel Salas, Pamela Rojas, Eduardo Atalah y Raquel Burrows

    EFECTO DEL ENTRENAMIENTO RESISTENCIA Y FUERZA SOBRE LA MASA GRASA REGIONALY EL PERFIL LIPDICO ........................................................................................................................................... 340

    Jorge Perez-Gomez, Germn Vicente-Rodrguez, Ignacio Ara Royo, Diana Martnez-Redondo, Jos Puzo Foncillas,Luis A. Moreno, Carmen Dez-Snchez y Jos A. Casajs

    IMPACTO DEL EJERCICIO DE FUERZA MUSCULAR EN LA PREVENCIN SECUNDARIA DE LAOBESIDAD INFANTIL; INTERVENCIN AL INTERIOR DEL SISTEMA ESCOLAR ...................................... 347

    Fabin Vsquez, Erik Daz, Lydia Lera, Jorge Meza, Isabel Salas, Pamela Rojas, Eduardo Atalah y Raquel Burrows

    COMPARACIN DEL GASTO ENERGTICO EN REPOSO DETERMINADO MEDIANTECALORIMETRA INDIRECTA Y ESTIMADO MEDIANTE FRMULAS PREDICTIVAS EN MUJERESCON GRADOS DE OBESIDAD I A III ..................................................................................................................... 357

    Alicia Parra-Carriedo, Loren Cherem-Cherem, Daniela Galindo-De Noriega, Mary Carmen Daz-Gutirrez, Ana Bertha Prez-Lizaur y Csar Hernndez-Guerrero

    Si no recibe la revista o le llega con retraso escriba a: NH, aptdo. 1351, 24080 LEN o a: [email protected]

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  • ISSN (Versin papel): 0212-1611ISSN (Versin electrnica): 1699-5198

    Si no recibe la revista o le llega con retraso escriba a: NH, aptdo. 1351, 24080 LEN o a: [email protected]

    COMPOSICIN DE AMINOCIDOS, CALIFICACIN QUMICA Y DIGESTIBILIDAD PROTEICAIN VITRO DE ALIMENTOS CONSUMIDOS FRECUENTEMENTE EN EL NOROESTE DE MXICO ............. 365

    Graciels Caire-Juvera, Francisco A. Vzquez-Ortiz y Mara I. Grijalva-Haro

    DESNUTRICIN EN PACIENTES CON CNCER; UNA EXPERIENCIA DE CUATRO AOS ........................ 372 Mara Teresa Fernndez Lpez, Cecicia Alejandra Saenz Fernndez, Mara Trinidad de Ss Prada, Susana Alonso Urrutia, Mara Luisa Bardasco Alonso, Mara Teresa Alves Prez, Mara Teresa Rivero Luis, Paulas lvarez Vzquez y Jos Antonio Mato Mato

    DISEO Y MTODOS DEL ESTUDIO GLYNDIET; EVALUANDO EL PAPEL DEL NDICE GLUCMICOSOBRE LA PRDIDA DE PESO CORPORAL Y MARCADORES DE RIESGO METABLICO ........................ 382

    Mart Juanola-Falgarona, Nria Ibarrola-Jurado, Jordi Salas-Salvad, A. Rabassa-Soler y Mnica Bull

    EFECTOS DE LA SUPLEMENTACIN CON CREATINA EN PRACTICANTES DE TAEKWONDO ............... 391 Rafael Manjarrez-Montes de Oca, Fernando Farfn-Gonzlez, Socorro Camarillo-Romero, Patricia Tlatempa-Sotelo, Carlos Francisco-Argelles, Alexander Kormanovski, Javier Gonzlez-Gallego y Ildefonso Alvear-Ordenes

    EFECTOS DE APOYO NUTRICIONAL POR VA ORAL EN PACIENTES HOSPITALIZADOS CON SIDA ..... 400 Renata Pereira da Silva, sis Luclia Santos Borges de Arajo, Poliana Coelho Cabral y

    Mara Goretti Pessoa de Arajo Burgos

    EL ESTADO NUTRICIONAL DE LOS PACIENTES CON CNCER GASTROINTESTINALATENDIDOS EN UN HOSPITAL PBLICO; 2010-2011 ....................................................................................... 405

    Corina Dias do Prado y Juliana Alvares Duarte Bonini Campos

    ESTADO NUTRICIONAL DE LOS PACIENTES DE CNCER COLORRECTAL ............................................... 412 Joana Pedro Lopes, Paula Manuela de Castro Cardoso Pereira, Ana Filipa dos Reis Baltazar Vicente, Alexandra Bernardo y Maria Fernanda de Mesquita

    EVALUACIN DE FACTORES INFLUYENTES SOBRE EL DESECHO DE ALIMENTOS POR PARTEDE PACIENTES PROCEDENTES DE DIFERENTES RECINTOS HOSPITALARIOS ......................................... 419

    A. Valero y A. M. Caracuel

    EXPECTATIVAS DEL BENEFICIO Y RIESGO DE LA INGESTA DE CALCIO EN MUJERES CONTRATAMIENTOS PARA OSTEOPOROSIS DE ASTURIAS; ESTUDIO ASFARCAL .......................................... 428

    Ana Isabel Rigueira Garca, Emma Zardain Tamargo, Inmaculada Lpez Gonzlez y Luis Snchez lvarez

    HBITOS ALIMENTARIOS Y EVALUACIN NUTRICIONAL EN UNA POBLACIN UNIVERSITARIA ..... 438 Faustino Cervera Burriel, Ramn Serrano Urrea, Cruz Vico Garca, Marta Milla Tobarra y Mara Jos Garca Meseguer

    HBITOS ALIMENTARIOS, ACTIVIDAD FSICA Y NIVEL SOCIOECONMICO EN ESTUDIANTESUNIVERSITARIOS DE CHILE ................................................................................................................................ 447

    Fernando Rodrguez R., Ximena Palma L., ngela Romo B., Daniela Escobar B., Brbara Arag G., Luis Espinoza O., Norman MacMillan K. y Jorge Glvez C.

    HIPOALBUMINEMIA Y OTROS FACTORES PRONSTICOS DE MORTALIDAD EN DISTINTOSPERIODOS TRAS UNA TROMBOSIS ISQUMICA ............................................................................................. 456

    Victoria Alczar Lzaro, Teodoro del Ser Quijano y Raquel Barba Martn

    INFLUENCIA DE FACTORES AMBIENTALES TEMPRANOS SOBRE LAS SUBPOBLACIONESDE LINFOCITOS Y LA MICROBIOTA INTESTINAL DE NIOS CON RIESGO DE DESARROLLARENFERMEDAD CELACA; EL ESTUDIO PROFICEL .......................................................................................... 464

    Tamara Pozo-Rubio, Glada de Palma, Jorge R. Mujico, Marta Olivares, Ascensin Marcos, Mara Dolores Acua, Isabel Polanco, Yolanda Sanz y Esther Nova

    INGESTA DE CIDOS GRASOS Y PARMETROS INMUNES EN ANCIANOS ................................................ 474 Sonia Gonzlez, Patricia Lpez, Aberlardo Margolles, Ana Surez, ngeles M. Patterson, Adriana Cuervo,

    Clara G. de los Reyes-Gaviln y Miguel Gueimonde

    SUMARIO (continuacin)

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  • SUMARIO

    Vol. 28 N. 2 MARZO-ABRIL 2013

    ISSN (Versin papel): 0212-1611ISSN (Versin electrnica): 1699-5198

    PREVALENCIA DE OBESIDAD Y OBESIDAD ABDOMINAL EN NIOS DE CUATRO A 16 AOSRESIDENTES EN UNA CIUDAD FRONTERIZA DE MXICO ............................................................................ 479

    Montserrat Bacard-Gascn, Elizabeth G. Jones y Arturo Jimnez-Cruz

    LA ACTIVIDAD FSICA DE LA ENZIMA SUPERXIDO DISMUTASA Y ZINCEMIA EN MUJERESCON PREECLAMPSIA ............................................................................................................................................ 486

    Jos Arajo Brito, Dilina do Nascimento Marreiro, Jos Machado Moita Neto, Danilla Michelle Costa e Silva, Kaluce Gonalves de Sousa Almondes, Joo de Deus Valadares Neto y Nadir do Nascimento Nogueira

    LA PREVALENCIA DE SOBREPESO Y OBESIDAD EN ADOLESCENTES DE BAHA, BRASIL .................... 491 Cibele Dantas Ferreira Marques, Rita de Cssia Ribeiro Silva, Maria Ester C. Machado, Mnica Leila Portela de Santana, Romilda Castro de Andrade Cairo, Elizabete de Jess Pinto, Leonardo Oliveira Reis Maciel y Luciana Rodrigues Silva

    LA TERAPIA PSICOEDUCATIVA GRUPAL EN ATENCIN PRIMARIA AYUDA EN EL CONTROLDE LA DIABETES TIPO 2 ....................................................................................................................................... 497

    Miguel ngel Cervantes Cuesta, Noelia Victoria Garca-Talavera Espn, Josefa Brotons Romn, M. ngeles Nez Snchez, Pedro Brocal Ibez, Pilar Villalba Martn, Carmen Saura Garca, Tomasa Snchez Esteban, Helena Romero Lpez-Reinoso, Mara Jos Delgado Aroca, Dolores Snchez Gil, Amparo Meoro Avils, Jos Soriano Palao; grupo de colaboracin de la Unidad de Diabetes del Hospital Universitario Reina Sofia. Murcia. Espaa.

    METALES EN HARINA DE TRIGO. ESTUDIO COMPARATIVO Y CONTROL DE SU SEGURIDAD .............. 506 Raquel L. Tejera, Gara Luis, Dailos Gonzlez-Weller, Jos M. Caballero, ngel J. Gutirrez, Carmen Rubio y Arturo Hardisson

    RELACIN ENTRE SARCOPENIA, DESNUTRICIN, MOVILIDAD FSICA Y ACTIVIDADES BSICASDE LA VIDA DIARIA EN UN GRUPO DE ANCIANAS DE LA CIUDAD DE MXICO ...................................... 514

    Mara del Consuelo Velzquez Alva, Mara Esther Irigoyen Camacho, Jaime Delgadillo Vzquez y Irina Lazarevich

    SNDROME METABLICO EN PERSONAL DEL REA DE LA SALUD DE LA UNIVERSIDAD DEANTIOQUA-COLOMBIA; ESTUDIO LATINMETS ............................................................................................ 522

    Laura I. Gonzlez-Zapata, Gloria Cecilia Deossa, Julia Monsalve-lvarez, Juliana Daz-Garca, Nancy Babio y Jordi Salas-Salvad

    VALORACIN DEL PERFIL E INGESTA DE NUTRIENTES DE UN GRUPO DE ESTUDIANTESIBEROAMERICANOS DE POSTGRADOS EN NUTRICIN ............................................................................... 532

    Sandra Sumalla, Iali Elo, Irma Domnguez, Rubn Caldern, gueda Garca, Federico Fernndez, Santos Gracia, Luis Dzul, Maurizio Battino y Hctor Antonio Solano

    VARIABILIDAD DE LAS RESPUESTAS GLUCMICA Y DE INSULINA, INTRA E INTERSUJETO, A UNA COMIDA ESTNDAR EN INDIVIDUOS SANOS .................................................................................... 541 Sandra Hirsch, Gladys Barrera, Laura Leiva, Mara Pa de la Maza y Daniel Bunout

    LA ADIPOSIDAD VISCERAL INFLUYE EN EL METABOLISMO DE LA GLUCOSA Y EL GLUCGENOEN ANIMALES CONTROL Y CON ALIMENTACIN HIPERLIPDICA ............................................................. 545

    Danielle Kaiser de Souza, Fabiana A. de Souza, L. Strmer de Fraga, Signor Peres Konrad, Adriane Bell-Klein, Roselis Silveira Martins da Silva y Luiz Carlos R. Kucharski

    Si no recibe la revista o le llega con retraso escriba a: NH, aptdo. 1351, 24080 LEN o a: [email protected]

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  • SUMMARYSPECIAL ARTICLE THIRD JESS CULEBRAS LECTURE - MOLECULAR BIOLOGY AND CLINICAL NUTRITION; WHERE DO WE STAND AND WHERE DO WE GO? ............................................................................................ 241 ngel Gil

    REVIEWS MATERNAL NUTRITION DURING PREGNANCY CONDITIONS THE FETAL PANCREAS DEVELOPMENT, HORMONAL STATUS AND DIABETES MELLITUS AND METABOLIC SYNDROME BIOMARKERS AT BIRTH ....................................................................................................................................... 250 F. J. Snchez-Muniz, E. Gesteiro, M. Esprrago Rodilla, B. Rodrguez Bernal and S. Bastida

    VERY LOW CALORIE DIETS IN CLINICAL MANAGEMENT OF MORBID OBESITY ................................... 275 Francisco Javier Vilchez Lpez, Cristina Campos Martn, Mara Jos Amaya Garca, Pilar Snchez Vera and Jos Luis Pereira Cunill

    VALUES OF THE PHASE ANGLE BY BIOELECTRICAL IMPEDANCE; NUTRITIONAL STATUS AND PROGNOSTIC VALUE ................................................................................................................................... 286 L. Llames, V. Baldomero, M. L. Iglesias and L. P. Rodota

    THE EFFECT OF OILSEED CONSUMPTION ON APPETITE AND ON THE RISK OF DEVELOPING TYPE 2 DIABETES MELLITUS .................................................................................................... 296 Daniela Neves Ribeiro, Rita de Cssia Gonalves Alfenas, Josefina Bressan and Neuza Maria Brunoro Costa

    ORIGINALS CALCIUM AND VITAMIN D INTAKES IN A REPRESENTATIVE SAMPLE OF SPANISH WOMEN;

    PARTICULAR PROBLEM IN MENOPAUSE .......................................................................................................... 306 Rosa M. Ortega Anta, Liliana G. Gonzlez Rodrguez, Beatriz Navia Lombn, Jos Miguel Perea Snchez, Arnzazu Aparicio Vizuete, Ana Mara Lpez Sobaler; grupo de investigacin n. 920030

    ASSESSING NUTRITIONAL STATUS IN THE ELDERLY EVALUATION OF CHUMLEASEQUATIONS FOR WEIGHT .................................................................................................................................... 314

    Montserrat Barcel, Olga Torres, Jordi Mascar, Esther Francia, Daniel Cardona and Domingo Ruiz

    NUTRITIONAL STUDY OF A THIRD DIVISION SOCCER TEAM ..................................................................... 319 Cristian Martnez Ren and Pilar Snchez Collado

    ACUTE PHYSICAL EXERCISE INCREASES HOMOCYSTEINE CONCENTRATIONS IN YOUNGTRAINED MALE SUBJECTS .................................................................................................................................. 325

    Beatriz Maroto-Snchez, Jara Valtuea, Ulrike Albers, Pedro J. Benito, Marcela Gonzlez-Gross; Imfine Research Group

    RESIDUAL EFFECT OF MUSCLE STRENGTH EXERCISE IN SECONDARY PREVENTIONOF CHILDREN OBESITY ........................................................................................................................................ 333

    Fabin Vsquez, Erik Daz, Lydia Lera, Jorge Meza, Isabel Salas, Pamela Rojas, Eduardo Atalah and Raquel Burrows

    EFFECT OF ENDURANCE AND RESISTANCE TRAINING ON REGIONAL FAT MASS ANDLIPID PROFILE ........................................................................................................................................................ 340

    Jorge Perez-Gomez, Germn Vicente-Rodrguez, Ignacio Ara Royo, Diana Martnez-Redondo, Jos Puzo Foncillas,Luis A. Moreno, Carmen Dez-Snchez and Jos A. Casajs

    IMPACT OF STRENGTH TRAINING EXERCISE ON SECONDARY PREVENTION OF CHILDHOODOBESITY; AN INTERVENTION WITHIN THE SCHOOL SYSTEM .................................................................... 347

    Fabin Vsquez, Erik Daz, Lydia Lera, Jorge Meza, Isabel Salas, Pamela Rojas, Eduardo Atalah and Raquel Burrows

    COMPARISON OF RESTING ENERGY EXPENDITURE DETERMINED BY INDIRECT CALORIMETRYAND ESTIMATED BY PREDICTIVE FORMULAS IN WOMEN WITH OBESITY DEGREES I TO III ............. 357

    Alicia Parra-Carriedo, Loren Cherem-Cherem, Daniela Galindo-De Noriega, Mary Carmen Daz-Gutirrez, Ana Bertha Prez-Lizaur and Csar Hernndez-Guerrero

    If you have problems with your subscription write to:NH, po BOX 1351, Len, Spain or mail to: [email protected]

    continued

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  • SUMMARY AMINO ACID COMPOSITION, SCORE AND IN VITRO PROTEIN DIGESTIBILITY OF FOODS

    COMMONLY IN NORTHWEST MEXICO ............................................................................................................. 365 Graciels Caire-Juvera, Francisco A. Vzquez-Ortiz and Mara I. Grijalva-Haro

    MALNUTRITION IN PATIENTS WITH CANCER; FOUR YEARS EXPERIENCE .............................................. 372 Mara Teresa Fernndez Lpez, Cecicia Alejandra Saenz Fernndez, Mara Trinidad de Ss Prada, Susana Alonso Urrutia, Mara Luisa Bardasco Alonso, Mara Teresa Alves Prez, Mara Teresa Rivero Luis, Paulas lvarez Vzquez and Jos Antonio Mato Mato

    DESIGN AND METHODS OF THE GLYNDIET STUDY; ASSESSING THE ROLE OF GLYCEMIC INDEXON WEIGHT LOSS AND METABOLIC RISK MARKERS .................................................................................... 382

    Mart Juanola-Falgarona, Nria Ibarrola-Jurado, Jordi Salas-Salvad, A. Rabassa-Soler and Mnica Bull

    EFFECTS OF CREATINE SUPPLEMENTATION IN TAEKWONDO PRACTITIONERS .................................... 391 Rafael Manjarrez-Montes de Oca, Fernando Farfn-Gonzlez, Socorro Camarillo-Romero, Patricia Tlatempa-Sotelo, Carlos Francisco-Argelles, Alexander Kormanovski, Javier Gonzlez-Gallego and Ildefonso Alvear-Ordenes

    EFFECTS OF ORAL NUTRITIONAL SUPPORT IN HOSPITALIZED PATIENTS WITH AIDS .......................... 400 Renata Pereira da Silva, sis Luclia Santos Borges de Arajo, Poliana Coelho Cabral and

    Mara Goretti Pessoa de Arajo Burgos

    NUTRITIONAL STATUS OF PATIENTS WITH GASTROINTESTINAL CANCER RECEIVING CAREIN A PUBLIC HOSPITAL; 2010-2011 ...................................................................................................................... 405

    Corina Dias do Prado and Juliana Alvares Duarte Bonini Campos

    NUTRITIONAL STATUS ASSESSMENT IN COLORECTAL CANCER PATIENTS ............................................ 412 Joana Pedro Lopes, Paula Manuela de Castro Cardoso Pereira, Ana Filipa dos Reis Baltazar Vicente, Alexandra Bernardo and Maria Fernanda de Mesquita

    EVALUATION OF FACTORS AFFECTING PLATE WASTE OF INPATIENTS IN DIFFERENTHEALTHCARE SETTINGS ..................................................................................................................................... 419

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    EXPECTATIONS OF BENEFIT/RISK OF CALCIUM INTAKE IN WOMEN WITH OSTEOPOROSISTREATMENT OF ASTURIAS; ASFARCAL STUDY ............................................................................................. 428

    Ana Isabel Rigueira Garca, Emma Zardain Tamargo, Inmaculada Lpez Gonzlez and Luis Snchez lvarez

    FOOD HABITS AND NUTRITIONAL ASSESSMENT IN A UNIVERSITY POPULATION ................................ 438 Faustino Cervera Burriel, Ramn Serrano Urrea, Cruz Vico Garca, Marta Milla Tobarra and Mara Jos Garca Meseguer

    EATING HABITS, PHYSICAL ACTIVITY AND SOCIOECONOMIC LEVEL IN UNIVERSITYSTUDENTS OF CHILE ............................................................................................................................................ 447

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    HYPOALBUMINEMIA AND OTHER PROGNOSTIC FACTORS OF MORTALITY AT DIFFERENTTIME POINTS AFTER ISCHEMIC STROKE .......................................................................................................... 456

    Victoria Alczar Lzaro, Teodoro del Ser Quijano and Raquel Barba Martn

    INFLUENCE OF EARLY ENVIRONMENTAL FACTORS ON LYMPHOCYTE SUBSETS AND GUTMICROBIOTA IN INFANTS AT RISK OF CELIAC DISEASE; THE PROFICEL STUDY .................................... 464

    Tamara Pozo-Rubio, Glada de Palma, Jorge R. Mujico, Marta Olivares, Ascensin Marcos, Mara Dolores Acua, Isabel Polanco, Yolanda Sanz and Esther Nova

    FATTY ACIDS INTAKE AND IMMUNE PARAMETERS IN THE ELDERLY ...................................................... 474 Sonia Gonzlez, Patricia Lpez, Aberlardo Margolles, Ana Surez, ngeles M. Patterson, Adriana Cuervo,

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    sss

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  • SUMMARY

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    PREVALENCE OF OBESITY AND ABDOMINAL OBESITY FROM FOUR TO 16 YEARS OLD CHILDRENLIVING IN THE MEXICO-USA BORDER ............................................................................................................. 479

    Montserrat Bacard-Gascn, Elizabeth G. Jones and Arturo Jimnez-Cruz

    ENZYME ACTIVITY OF SUPEROXIDE DISMUTASE AND ZINCEMIA IN WOMEN WITHPREECLAMPSIA ..................................................................................................................................................... 486

    Jos Arajo Brito, Dilina do Nascimento Marreiro, Jos Machado Moita Neto, Danilla Michelle Costa e Silva, Kaluce Gonalves de Sousa Almondes, Joo de Deus Valadares Neto and Nadir do Nascimento Nogueira

    THE PREVALENCE OF OVERWEIGHT AND OBESITY IN ADOLESCENTS IN BAHIA, BRAZIL ................. 491 Cibele Dantas Ferreira Marques, Rita de Cssia Ribeiro Silva, Maria Ester C. Machado, Mnica Leila Portela de Santana, Romilda Castro de Andrade Cairo, Elizabete de Jess Pinto, Leonardo Oliveira Reis Maciel and Luciana Rodrigues Silva

    PSYCHOEDUCATIVE GROUPS HELP CONTROL TYPE 2 DIABETES IN A PRIMARY CARESETTING ................................................................................................................................................................... 497

    Miguel ngel Cervantes Cuesta, Noelia Victoria Garca-Talavera Espn, Josefa Brotons Romn, M. ngeles Nez Snchez, Pedro Brocal Ibez, Pilar Villalba Martn, Carmen Saura Garca, Tomasa Snchez Esteban, Helena Romero Lpez-Reinoso, Mara Jos Delgado Aroca, Dolores Snchez Gil, Amparo Meoro Avils, Jos Soriano Palao; grupo de colaboracin de la Unidad de Diabetes del Hospital Universitario Reina Sofia. Murcia. Espaa.

    METALS IN WHEAT FLOUR; COMPARATIVE STUDY AND SAFETY CONTROL .......................................... 506 Raquel L. Tejera, Gara Luis, Dailos Gonzlez-Weller, Jos M. Caballero, ngel J. Gutirrez, Carmen Rubio and Arturo Hardisson

    THE RELATIONSHIP BETWEEN SARCOPENIA,UNDERNUTRITION, PHYSICAL MOBILITY ANDBASIC ACTIVITIES OF DAILY LIVING IN A GROUP OF ELDERLY WOMEN OF MEXICO CITY ................. 514

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    METABOLIC SYNDROME IN HEALTHCARE PERSONNEL OF THE UNIVERSITY OF ANTIOQUIA-COLOMBIA; LATINMETS STUDY ........................................................................................................................ 522

    Laura I. Gonzlez-Zapata, Gloria Cecilia Deossa, Julia Monsalve-lvarez, Juliana Daz-Garca, Nancy Babio and Jordi Salas-Salvad

    ASSESSING THE PROFILE AND NUTRITIONAL INTAKE OF AN IBERO-AMERICAN GROUPOF NUTRITION POSTGRADUATE STUDENTS ................................................................................................... 532

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    VARIABILITY OF GLYCEMIC AND INSULIN RESPONSE TO A STANDARD MEAL, WITHINAND BETWEEN HEALTHY SUBJECTS ................................................................................................................ 541

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    VISCERAL ADIPOSITY INFLUENCES GLUCOSE AND GLYCOGEN METABOLISM IN CONTROL AND HYPERLIPIDIC-FED ANIMALS ................................................................................................................... 545 Danielle Kaiser de Souza, Fabiana A. de Souza, L. Strmer de Fraga, Signor Peres Konrad, Adriane Bell-Klein, Roselis Silveira Martins da Silva and Luiz Carlos R. Kucharski

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  • 241

    Nutr Hosp. 2013;28(2):241-249ISSN 0212-1611 CODEN NUHOEQ

    S.V.R. 318

    Artculo especialThird Jess Culebras Lecture - Molecular Biology and Clinical Nutrition;where do we stand and where do we go?ngel Gil

    Departament of Biochemistry and Molecular Biology II. Institute of Nutrition and Food Technology Jos Mataix.Biomedical Research Center. University of Granada. Armilla. Granada. Spain.

    TERCERA LECCIN JESS CULEBRAS -BIOLOGA MOLECULAR Y NUTRICIN CLNICA;

    DNDE ESTAMOS Y ADNDE VAMOS?

    Resumen

    La Nutricin desempea un papel fundamental en elmantenimiento de la salud y en el tratamiento de lasenfermedades, sirviendo de encrucijada para muchasotras disciplinas. La Bioqumica y la Biologa Moleculares una Ciencia clave para determinar los mecanismos deaccin de los nutrientes y de otros compuestos bioactivosde los alimentos tanto en la salud como en la enfermedad.El objeto de esta 3 Leccin Jess M. Culebras es conside-rar el futuro de las relaciones de la Biologa Molecular yde la Nutricin Clnica y comentar la utilizacin de lasnuevas herramientas moleculares y genticas en el estu-dio de las respuestas de los factores dietticos y de las con-secuencias metablicas de la ingesta de alimentos, ascomo considerar los desafos ms importantes de la nutri-cin humana en el siglo XXI. En particular, se aborda laimportancia de disponer de nuevos biomarcadores deinters nutricional en las enfermedades inflamatorias.Asimismo, se discute la importancia del microbiomahumano y de cmo poder utilizar de forma segura losmicroorganismos en la prevencin y el tratamiento de lasenfermedades. Adems, se considera la importancia clavede la nutrigentica, la nutrigenmica y la epigentica enla nueva era de la nutricin. La nutrigentica se refiere alpapel de las variantes de secuencias del DNA en las res-puestas de los individuos a los nutrientes, mientras que lanutrigenmica aborda el estudio de las modificaciones deexpresin gnica mediadas por los nutrientes. La epigen-tica es el estudio de las modificaciones en la expresingnica mediadas por las alteraciones del DNA heredablespor mitosis. Durante la ltima dcada, se ha prestadoimportancia especial a la desregulacin de los mecanis-mos epigenticos causantes de enfermedad. Por tanto,existe un inters especial en conocer los mecanismos epi-genticos que modifican el fenotipo inducidos por losnutrientes.

    (Nutr Hosp. 2013;28:241-249)DOI:10.3305/nh.2013.28.2.6424

    Palabras clave: Biologa molecular. Biomarcadores. Epi-gnetica. Microbiota. Nutrigentica. Nutrigenmica. Nutri-cin clnica. Probiticos.

    Abstract

    Nutrition plays a fundamental role in the maintenanceof health and the treatment of disease, and serves as thecrossroads for many disciplines. Biochemistry and Mole-cular Biology represents a key brand of science to ascer-tain the mechanism of action of nutrients and other foodbioactive compounds in health and disease. The aim ofthe present Jess M. Culebras lecture is to consider thefuture of the relationships between Molecular Biologyand Clinical Nutrition and to discuss the use of molecularand genetic tools to study molecular responses to dietaryfactors and the metabolic consequences of food and toconsider major challenges on human nutrition sciences inthe 21st century. Particular emphasis is given to the identi-fication and use of novel biomarkers in inflammatorydiseases. Likewise, the importance of the human micro-biome and how microorganisms can be safely utilized inthe prevention and management of infectious and chronicdiseases are discussed. Moreover, the key role of nutrige-netics, nutrigenomics and epigenetics in the new era ofnutrition is considered. Nutrigenetics refers to the role ofDNA sequence variation in the responses to nutrients,whereas nutrigenomics is the study of the role of nutrientsin gene expression. Epigenetics is the study of mitoticallyheritable alterations in gene expression potential that arenot caused by DNA sequence alterations. In the pastdecade, it has increasingly been recognized that dysregu-lation of epigenetic mechanisms may play an importantrole in human disease. Indeed, there is increasing interestin epigenetic mechanisms underlying phenotype modifi-cation modulated by nutrients. Further research in thoseareas should contribute to evaluate functionality ofspecific nutrients and bioactive compounds in ClinicalNutrition and allow personalized nutritional advice.

    (Nutr Hosp. 2013;28:241-249)DOI:10.3305/nh.2013.28.2.6424

    Key words: Biomarkers. Clinical nutrition. Epigenetics.Microbiota. Probiotics. Molecular biology. Nutrigenetics.Nutrigenomics.

    Correspondence: ngel Gil.Instituto de Nutricin y Tecnologa de los Alimentos Jos Mataix (INyTA).Centro de Investigacin Biomdica (CIBM). Universidad de Granada.Avenida del Conocimiento s/n.18100 Armilla. Granada. Espaa.E-mail: [email protected]

    Recibido: 12-XI-2012.Aceptado: 26-XI-2012.

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  • Introduction

    I am deeply honored to be the recipient of the ThirdJess M. Culebras Award. I met Prof. Culebras for thefirst time at the 3rd Congress of the Spanish Society ofParenteral and Enteral Nutrition (SENPE) held inGranada in May1986, organized by Dr. Antonio Perezde la Cruz. At that time I was involved in the identifica-tion of new biochemical biomarkers of nutritionalstatus in low-birth weight infants1-3 and in the evalua-tion of the functional roles of dietary nucleotides,particularly on intestinal microbiota4 and on thelipoprotein and polyunsaturated fatty acid metabolismsin early life.5-7 Moreover, I was interested in thechanges of plasma amino acids and polyunsaturatedfatty acid (PUFA) profiles in severely trauma injuredand infected children.8,9 In fact, one year later I joinedthe SENPE and I published my first two articles inNutricin Hospitalaria, the journal created and directedby Prof. Culebras for now about 40 years, on the rolesof dietary nucleotides in lipid metabolism in infants10

    and on the effects on lipid metabolism of free-lipidparenteral nutrition in severely ill patients.11

    At that Congress I also met Prof. Miquel A. Gassulland we discussed the possibility to starting to collaboratein the area of nutrition and major gastrointestinal diseasesas in our lab we used modern tools in Biochemistry andthey had patients with severe diseases, namely livercirrhosis and inflammatory bowel disease. This was alarge and long lasted collaboration of biochemists andgastroenterologists in Clinical Nutrition, which resultedin the identification of severe alterations of the polyunsat-urated fatty acid metabolism in those diseases and novelapproaches in the designing and utilization of modernenteral nutrition diets.12-15

    I joined the Scientific and Educational Committee ofthe SENPE (CCE) by 1996 and started to work withProf. Simon Schwartz and later with Dr. Merc Planasand Dr. Julia Alvarez until 2010. During those 14 years Ihad the opportunity to interact, work and to become afriend of Prof. Jess Culebras as he was, and he is, theCouncil member within the CEE representing the inter-ests of Nutricion Hospitalaria, the official journal ofSENPE. I always tried to collaborate and support him toget the dream of having a nutrition focused journal ofrecognized international interest, a feature he attainedrecently. Besides that, Prof. Culebras also supported mein the two editions of the Treatise of Nutrition (Tratadode Nutricin) and had a major role in my appointment asPresident of the Iberoamerican Council of NutritionJournals in Montevideo, with the occasion of the 5th

    FELANPE Congress. Thank you very much to JessCulebras for giving me the opportunity to be his friend.

    Nutrition plays a fundamental role in the maintenanceof health and the treatment of disease, and serves as thecrossroads for many disciplines. Human nutritiondescribes the processes whereby cellular organelles,cells, tissues organs, systems, and the body as a whole,obtain and use necessary substances obtained from

    foods (nutrients) to maintain structural and functionalintegrity and to growth and development. It alsocomprises studies on how nutrients interact with cellreceptors and transporters and how are utilized at themolecular and cellular level and studies on gene-nutri-tion-environment interactions.16 Hence, Biochemistryand Molecular Biology represents a key brand of scienceto ascertain how nutrients and other food bioactivecompounds are used by humans and what their influ-ences at the molecular level are in order to be able toascertain their mechanisms of action in health anddisease.

    During the second half of the 20th century Nutritionbecame a recognized multidisciplinary science thatfocused on the evaluation of the effects of nutrient defi-ciencies on organs, systems and human subjects. Themajor pathways by which nutrients are digested andmetabolized were also identified. Likewise, a number ofbiochemical biomarkers associated with nutritionaldiseases were reported and described.17 Those biomarkersserved as important tools to ascertain the specific biolog-ical effects of nutrients and their requirements in patientssuffering many diseases and building up Clinical Nutri-tion as an important brunch of nutrition sciences.

    The most important challenges of human nutrition inthe 21st century is to know how nutrients and food bioac-tive compounds interact with different cell signalingcascades in different organs and systems and theirspecific effects on cell processes including gene activityregulation, metabolism, growth and apoptosis. More-over, understanding how nutrients and other foodcomponents, as well as healthy lifestyle and environ-mental factors, are influencing the epigenetic processesand until what extent changes in the methylation patternof DNA could be inherited represent an outstanding chal-lenge for nutrition sciences. Furthermore, another majoraim is to identify and ascertain how nutrients and foodbioactive compounds are able to influence the humanmicrobiome, and in turn how changes in the humanmicroorganism ecology, particularly at the intestinallevel, would have an influence in health an disease.

    The main goal of the present lecture is to think aboutthe future of relationships between Molecular Biologyand Clinical Nutrition and to discuss the use of molec-ular and genetic tools to study molecular responses todietary factors and the metabolic consequences of foodand to consider major challenges on human nutritionsciences in the 21st century.

    New biomarkers in nutrition: metabolomics can help

    For the last decades numerous biomarkers have beenidentified and related to nutrient status in health andmany diseases. In particular, many biomarkers arecurrently used in routine clinical nutrition to evaluatethe nutritional status of populations, individualsubjects and patients and to diagnose a number of

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  • pathologies and to assess the risk factors for certainpathologies.

    Metabolomics is a metabolic-biology systemapproach focused on the metabolic responses under-standing of living systems to physio-pathologicalstimuli by using multivariate statistical data on humanbody fluids obtained by different instrumental tech-niques. A metabolomic approach based on an analyt-ical platform could be able to separate, detect, charac-terize and quantify a wide range of metabolites and itsmetabolic pathways. This instrumental approach has agood potential in the identification and detection ofspecific food intake and diseases biomarkers.18

    In the present work it would be impossible to describethe new research concerning novel biomarkers of impor-tance in nutrition. However, there some relevant find-ings that may serve to exemplify recent development inthis area. Polyunsaturated fatty acids (PUFA) both ofthe omega-6 and omega-3 families have a profoundinfluence on inflammation and regular intake ofomega-3 fatty acids have a direct effect in the preven-tion of a number of inflammatory disorders includingcardiovascular diseases, diabetes, rheumatoid arthritisand in the alleviation of symptoms for inflammatorybowel diseases as well as neurological disorders suchas Alzheimers disease and age-related macular dege -neration.19,20 The resolution of inflammation is not apassive process, as believed earlier; instead, resolutionis a biosynthetically active process, regulated bybiochemical mediators and receptor-signaling path-ways, and driven by specialized pro-resolving media-tors (SPM). A number of findings by Serhan and hisgroup, systematically investigated a number of SPM(biomarkers) derived from PUFA, including lipoxins,E-series resolvins, D-series resolvins, protectins/neuroprotectins, and, most recently, maresins.21-23

    These substances are mainly derived from eicosapen-taenoic acid (EPA) and docosahexaenoic acid (DHA).The distinct properties of EPA and DHA to formprimarily pro-resolving lipid mediators may explaintheir well-known beneficial health effects. These novelpathways may also explain some of the beneficialeffects of aspirin, since they generate epimeric lipidmediators that are more metabolically stable andlonger lasting.21

    The human microbiome and the use of probiotics in Clinical Nutrition

    A variety of microbial communities and their genes(the microbiome) exist throughout the human body,with fundamental roles in human health and disease.24-26

    Diverse microbial communities from habitats withinthe human airways, skin, oral cavity, gut, and vaginacan be found and microbiota may help to explain indi-vidual variability in health outcomes and be a source ofnew biomarkers for environmental exposures and ofnovel prognostic and diagnostic indicators.

    The National Institutes of Health (NIH)-fundedHuman Microbiome Project Consortium has recentlyestablished a population-scale framework to developmetagenomic protocols, resulting in a broad range ofquality-controlled resources and data including stan-dardized methods for creating, processing and inter-preting distinct types of high-throughput metagenomicdata available to the scientific community.24,25 Theresources from a population of 242 healthy adultssampled at 15 or 18 body sites up to three times, whichhave generated 5,177 microbial taxonomic profilesfrom 16S ribosomal RNA genes and over 3.5 terabasesof metagenomic sequence have now been presented. Inparallel, approximately 800 reference strains isolatedfrom the human body have been sequenced. Collec-tively the data represent a treasure trove that can bemined toidentify new organisms, gene functions, andmetabolic and regulatory networks, as well as correla-tions between microbial community structure andhealth and disease. Among other future benefits, thisresource should contribute to promote the developmentof novel prophylactic strategies such as the applicationof prebiotics and probiotics to foster human health.24

    Microbes in the human gut undergo selective pres-sure from the host as well as from microbial competi-tors. This typically leads to a homeostasis of theecosystem in which some species occur in high andmany in low abundance, with some low abundancespecies, performing specialized functions beneficial tothe host.27 Over the past few years, the application ofnext-generation sequencing approaches (metage-nomics) to the study of human-associated microorgan-isms has shown that the composition of the microbiotawithin the guts of different individuals is distinct. Thisdistinctiveness is possible because of the marked vari-ability that is evident at the species and strain levelswithin the microbiota. By contrast, variability at thephylum level is not individual specific. Indeed, morethan 90% of gut bacteria are members of only twophyla, Bacteroidetes and Firmicutes, and the relativeproportions of these two major divisions exhibit acontinuous gradient within the human population, withsome individuals having a predominance of the former,others having a predominance of the latter, but themajority having similar proportions of each.24-26

    The very recent studies of the human microbiome)have revealed that even healthy individuals differremarkably in the microbes that occupy habitats suchas the gut, skin and vagina.24,25 Much of this diversityremains unexplained, although diet, environment, hostgenetics and early microbial exposure have all beenimplicated. Recently, it has been reported that thediversity and abundance of each habitats signaturemicrobes to vary widely even among healthy subjects,with strong niche specialization both within and amongindividuals.26,28 These results delineate the range ofstructural and functional configurations normal in themicrobial communities of a healthy population,enabling future characterization of the epidemiology,

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  • ecology and translational applications of the humanmicrobiome.

    In an apparent contrast to the phylum distributions, ithas been suggested that variation at the species level isdiscontinuous, with three clusters, or enterotypes, thatvary in proportional composition.27 This proposal wasbased on multidimensional cluster analysis and prin-cipal component analysis of faecal metagenomes from39 samples involving six nationalities and including 22newly sequenced European faecal samples. Theproposed enterotypes were identified by their enrich-ment in Bacteroides spp. (enterotype 1), Prevotellaspp. (enterotype 2) and Ruminococcus spp. (enterotype3), and were unrelated to nationality or host character-istics such as body mass index, age or gender. It wassubsequently suggested that faecotypes might havebeen a more accurate descriptor than enterotypes, asmicrobial composition and abundance varies along thegastrointestinal tract.29

    Shortly after the enterotype concept was mooted,27

    Wu et al.30 showed that in subjects aged 2-50 years old,two enterotypes were associated with diet: long-termdiets enriched for protein and animal fat were associ-ated with the Bacteroides enterotype, whereas dietsenriched for carbohydrate were associated with thePrevotella enterotype.

    Although the enterotype distinctions appear to beless clear than was first thought, and regardless ofwhether we are dealing with gradients or clusters, traitsor states, the concept of linking patterns of microbialcomposition with function is both biologically plau-sible and clinically relevant.28 We need to move fromretrospective correlative analysis to prospectivestudies linking microbiota variation with clinicallyrelevant outcomes. Categorizing the microbiota intodiscrete groups would be attractive if these groupsoverlapped with, for example, responders or non-responders to particular therapeutics (reflecting therole of the gut microbiota as a bioreactor capable ofdrug modification)or with rates of progression inimmune-mediated disease. The struggle to clarifymicrobial complexity within the gut and to link it toclinical traits should continue. It will require longitu-dinal studies of different populations with differentlifestyles and dietary patterns so that clustering, transi-tions and intermediates can be identified.

    Currently, there is an increasing interest in anddemand for probiotics, after a long history of safe usein fermented dairy products and an increased recogni-tion of the beneficial effects of probiotics to human guthealth.31 According to the Food and Agriculture Organ-isation of the United Nations and the World HealthOrganisation,32 probiotics are live microorganismswhich, when administered in adequate amounts, confera health benefit on the host. In particular, strainsbelonging to Bifidobacterium and Lactobacillus, thepredominant and subdominant groups of the gastroin-testinal microbiota, respectively,33 are the most widelyused probiotic bacteria and are included in many func-

    tional foods and dietary supplements.34-36 The yeastSaccharomyces boulardii has also been shown to havehealth benefits.37

    For probiotics to be successful, they must possesscertain characteristics. The criteria for the selection ofprobiotics include tolerance to gastrointestinal condi-tions (gastric acid and bile), ability to adhere to thegastrointestinal mucosa and competitive exclusion ofpathogens.38-40

    The results of evidence-based analyses from humanstudies and animal models have shown the potentialclinical effectiveness of probiotics on many diseases.41

    In fact, probiotics have been reported to suppress diar-rhoea,42 alleviate lactose intolerance43 and postopera-tive complications,14 exhibit antimicrobial45 and anti-colorectal cancer activities,46,47 reduce irritable bowelsymptoms48 and prevent inflammatory bowel disease.49

    However, generalisations concerning the potentialhealth benefits of probiotics should be not madebecause probiotic effects tend to be strain-specific;thus, the health benefit attributed to one strain is notnecessarily applicable to another strain, even withinone species.50

    Probiotics have been shown to promote a variety ofbiological effects in a number of physiological condi-tions and pathologies, including allergy, intestinal andliver diseases, urinary and upper respiratory infections,AIDS and metabolic diseases. These effects are strain-specific and are primarily mediated through changes inthe faecal microbiota and immune modulation. RCTsconcerning the appropriate clinical evaluation of probi-otics with an adequate and statistically sufficientnumber of subjects related to main outcome variablesshould be performed in a variety of diseases. In addi-tion, multicentre and replicate studies are necessary toevaluate the actual role of probiotics in the ameliora-tion of symptoms for many diseases. The number ofstudies concerning the mechanism of probiotics in celland animal models is scarce. Apparently, many probi-otics are able to modulate both the innate and adaptiveimmune responses; however, the molecular basis ofthese effects remains unknown.51

    The mechanisms underlying the beneficial effects ofprobiotics are largely unknown but are likely to bemultifactorial, including modificationof the gut micro-biota, competitive adherence to the mucosa and epithe-lium, strengthening of the gut epithelial barrier andmodulation of the immune system to convey an advan-tage to the host (fig. 1).52 Accumulating evidencedemonstrates that probiotics communicate with thehost by pattern recognition receptors, such as toll-likereceptors and nucleotide binding oligomerizationdomain-containing protein-like receptors, whichmodulate key signaling pathways, such as nuclearfactor-B and mitogen-activated protein kinase, toenhance or suppress activation and influence down-stream pathways. This recognition is crucial for elic-iting measured antimicrobial responses with minimalinflammation damage. A clear understanding of these

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  • mechanisms will allow for appropriate probiotic strainselection for specific applications and may uncovernovel probiotic functions.52

    Nutrigenomics and nutrigenetics: are we ready for personalised nutrition?

    The efficacy by which dietary interventions influ-ence risk markers of multi-factorial diseases is mainlydetermined by taking population-based approaches.However, there exists considerable inter-individualvariation in response to dietary interventions, and someinterventions may benefit certain individuals or popu-lation subgroups more than others.53

    The execution of the Human Genome Project hasbrought forth a wealth of information about the structureof the genome, which can now be used to study how theinterplay between our genes and factors from the environ-ment such as nutrition relate to a state of health or disease.To enable such studies, novel technologies have beendesigned in particular to monitor the activity of multiplegenes simultaneously at the level of the RNA by transcrip-tomics, or the level of the proteins by proteomics (fig. 2).In addition, genome information has boosted approachesto study the role of genetic variation to explain individualdifferences in responses to nutrition, underlying in part thesusceptibility for nutrition-related disorders.

    Nutrigenetics refers to the role of DNA sequencevariation in the responses to nutrients, whereas nutrige-

    Molecular Biology and ClinicalNutrition

    245Nutr Hosp. 2013;28(2):241-249

    Fig. 1.Mechanisms of action of probiotics.

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  • nomics is the study of the role of nutrients in geneexpression (fig. 3). This research is predicated on theassumption that there are individual differences inresponsiveness to acute or repeated exposures to agiven nutrient or combination of nutrients. Throughouthuman history, diet has affected the expression ofgenes, resulting in phenotypes that are able to success-fully respond to environmental challenges and thatallow better exploitation of food resources. Theseadaptations have been key to human growth anddevelopment. Technological advances have made itpossible to investigate not only specific genes but alsoto explore in unbiased designs the whole genome-wide complement of DNA sequence variants or tran-scriptome. These advances provide an opportunity toestablish the foundation for incorporating biologicalindividuality into dietary recommendations, withsignificant therapeutic potential i.e. personalized nutri-tion.53-54

    The influence of nutrition on genome activity isstudied almost always in a comparative manner eitherby a direct or an indirect approach. The direct approachinvolves changes in the nutrients presented to a modelsystem followed by monitoring the changes in geneexpression. The indirect approach involves the study ofnutrition-related traits and disorders such as obesity,type II diabetes and cardiovascular disorders. In thosestudies, gene expression is compared between subjectswith and without the disorder and, from the differ-ences, scientists hope to deduce the relevant molecularpathways leading from health to disease under theinfluence of diet and lifestyle.55 The results of thosestudies should lead to new targets for pharmacologicalor dietary intervention and to novel functional foods.56

    One of the possibilities of nutrigenomic technologiesto further the concept of personalised nutrition, as wellas the process to take personalised nutrition to themarketplace. The modulation of an individuals

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    Fig. 2.Interactions between nutrients and the human genome; new omic sciences.

    Fig. 3.Nutrigenetics and nutrigenomics.

    GENES

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  • response is influenced by both genetic and environ-mental factors. Many nutrigenetics studies haveattempted to explain variability in responses based on asingle or a few genotypes so that a genotype may be usedto define personalised dietary advice. It has, however,proven very challenging to define an individualsresponsiveness to complex diets based on commongenetic variations. In addition, there is a limited under-standing of what constitutes an optimal responsebecause we lack key health biomarkers and signatures.In conclusion, advances in nutrigenomics will undoubt-edly further the understanding of the complex interplaybetween genotype, phenotype and environment, whichare required to enhance the development of personalisednutrition in the future. At the same time, however, issuesrelating to consumer acceptance, privacy protection aswell as marketing and distribution of personalised prod-ucts need to be addressed before personalised nutritioncan become commercially viable.53

    Nutritional advice has mainly focused on popula-tion-level recommendations. Recent developments innutrition, communication, and marketing scienceshave enabled potential deviations from this dominantbusiness model in the direction of personalisation ofnutrition advice. Such personalisation efforts can takeon many forms, but these have in common that they canonly be effective if they are supported by a viable busi-ness model. Future research should explore theconsumer responses to the diversity of archetypicalbusiness models for personalised nutrition advice as asource of market information on which the delivery ofnutrigenomics-based personalised nutrition advicemay further build.57

    The relationships between diet and nutrigenomic-metabolomic profiles, as well as between these profilesand health, are being elucidated, and this will dramaticallyalter clinical practice in nutrition. In fact, nutrigenomicsand metabolomics provide methodology that allows clini-cians to view a broader footprint of what is going on inmetabolism than they can get using current clinical chem-istry panels. This could greatly refine the practice of clin-ical nutrition. When a nutrition clinical trial is conducted,nutrigenomic methods can help investigators to under-stand why a subgroup of study subjects responded to treat-ment, while others did not. This could reduce the noisethat often clouds such clinical studies.58

    Epigenetics is the study of mitotically heritablealterations in gene expression potential that are notcaused by DNA sequence alterations.58 By stably regu-lating gene expression potential in differentiatedtissues, epigenetic mechanisms such as DNA methyla-tion play a critical role in mammalian development(fig. 4). In the past decade, it has increasingly beenrecognized that dysregulation of epigenetic mecha-nisms may play an important role in human disease.60

    Indeed, there is increasing interest in epigenetic mech-anisms underlying phenotype modification modulatedby nutrients (fig. 5). Further research in this area shouldcontribute to evaluate functionality of specific nutri-ents and bioactive compounds in Clinical Nutrition.

    Conclusions

    New biomarkers useful in the diagnosis and follow-up of chronic diseases and in the evaluation of nutri-

    Molecular Biology and ClinicalNutrition

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    Fig. 4.Tissue-specific DNA methylation and epigenetic heterogeneity among individuals (Adapted from Brenna et al. Nature Genetics2006; 38, 1359-1360).

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  • tional treatments are expanding due to the use ofmetabolomics opening a new era in Clinical Nutrition

    The identification of human microbiome and itsfunctions as well as the ascertaining of the mechanismsunderlying the effects of probiotics is opening newperspectives to the use of microorganims in the preven-tion and treatment of chronic diseases.

    The new omic sciences i.e. transcriptomics,proteomics and metabolomics are allowing to deter-mine the interactions between nutrients and otherbioactive food components and genes. This wouldcontribute to a better treatment of diseases and to apersonalized nutrition.

    The incidence of chronic diseases in the adult isrelated to epigenetic changes that can occur even inearly life. The prevention of those diseases throughappropriate interactions between diet, the environmentand the host constitutes one of the biggest challenges ofnutrition in the 21st Century.

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