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Treballs Finals de Grau de Nutrició Humana i Dietètica, Facultat de Farmàcia i Ciències de l'Alimentació, Campus de l'Alimentació de Torribera, Universitat de Barcelona. Curs: 2022-2023. Tutor: Carme Caelles Franch, [eng] Obesity-associated insulin resistance and hyperinsulinemia are two interrelated health conditions that have become increasingly prevalent in recent years. For many years, it has been thought that hyperinsulinemia comes after insulin resistance. The truth is that recent data suggests that insulin resistance can follow hyperinsulinemia and vice versa. Obesity is commonly associated with insulin resistance and hyperinsulinemia, but although some molecular mechanisms have been proposed, there is no clear evidence as to which condition occur before in humans. Despite much controversy over the timing of the onset of hyperinsulinemia in obesity, it is well established that the presence of insulin is necessary for obesity to occur and that chronically elevated insulin levels enhance diet-induced obesity. Therefore, the aim of this review is to provide a comprehensive up-to-date on the molecular mechanisms underlying hyperinsulinemia and the relationship between hyperinsulinemia and insulin resistance in obesity. In addition, we will examine the role hyperinsulinemia plays in cellular senescence, cancer and in dysregulating the insulin/IGF-1/GH axis. Finally, we will discuss possible current therapeutic strategies targeting hyperinsulinemia that are being used to treat obesity-associated insulin resistance, including current pharmacological therapies, the effects of multiple dietary interventions, physical exercise, and surgery. We conclude that hyperinsulinemia is a prevalent condition in obesity, but its time of occurrence and relationship with obesity are still under investigation. Dietary interventions, particularly low glycemic load diets and low carbohydrate diets, as well as regular exercise have shown promise in reducing hyperinsulinemia, while the long-term efficacy and potential side effects of pharmacological interventions require further study., [cat] L'obesitat associada a la resistència a la insulina i la hiperinsulinemia són dues condicions de salut interrelacionades que han esdevingut cada vegada més prevalents en els últims anys. Durant molts anys, s'ha pensat que la hiperinsulinèmia ve després de la resistència a la insulina. La veritat és que les dades recents suggereixen que la resistència a la insulina pot seguir la hiperinsulinèmia i viceversa. L'obesitat s'associa comunament amb la resistència a la insulina i la hiperinsulinèmia, però tot i que s'han proposat alguns mecanismes moleculars, no hi ha evidència clara de quina condició ocorre abans en els éssers humans. Malgrat molta controvèrsia sobre el moment de l'aparició de la hiperinsulinèmia en l'obesitat, està ben establert que la presència d'insulina és necessària perquè es produeixi l'obesitat i que els nivells d'insulina crònicament elevats promouen l'obesitat induïda per la dieta. Per tant, l'objectiu d'aquesta revisió és proporcionar una actualització completa dels mecanismes moleculars subjacents a la hiperinsulinèmia i la relació entre la hiperinsulinèmia i la resistència a la insulina en l’obesitat. A més a més, examinarem el paper de la hiperinsulinèmia en la senescència cel·lular, el càncer i en la desregulació de l'eix insulina/IGF-1/GH. Finalment, es discutiran possibles estratègies terapèutiques actuals dirigides a la hiperinsulinemia que s'estan utilitzant per tractar l'obesitat associada a la resistència a la insulina, incloent les teràpies farmacològiques actuals, els efectes de múltiples intervencions dietètiques, l'exercici físic i la cirurgia. Concloem que la hiperinsulinèmia és una condició prevalent en l'obesitat, però el seu inici i relació amb l'obesitat encara estan en investigació. Les intervencions dietètiques, en particular les dietes de baixa càrrega glucèmica i dietes baixes en carbohidrats, a més de l'exercici regular, han demostrat ser prometedores per reduir la hiperinsulinèmia, mentre que l'eficàcia a llarg termini i els possibles efectes secundaris de les intervencions farmacològiques requereixen un estudi addicional.

Ejercicio físico y terapia nutricional en el tratamiento de los trastornos de la conducta alimentaria.Revisión Sistemática. Introducción. Los Trastornos de la Conducta Alimentaria (TCA) son una enfermedad mental grave, causante de morbilidad física y psicosocial. Esta enfermedad tiene una mayor prevalencia entre mujeres jóvenes, y en población deportista. La terapia cognitiva conductual (TCC) es el tratamiento actual más adecuado para este tipo de trastornos, no obstante, cada vez son más los programas que incluyen pautas de ejercicio físico (EF) y Terapia Nutricional (TN) para el tratamiento de los TCA. Objetivo. Realizar una revisión sistemática exploratoria de la literatura que permita conocer el estado actual de los programas de intervención a través del EF y la TN para el tratamiento de los TCA. Materiales y métodos. Se realizó una búsqueda y recopilación de documentos científicos mediante un modelo de acumulación de datos y selección de estudios, en la que se utilizaron las bases de datos informatizadas SCOPUS, Web of Science, y PubMed. En todas las bases de datos consultadas, se empleó la misma frase de búsqueda. Para acotar los resultados, se introdujeron una serie de criterios de inclusión y exclusión. Resultados. La revisión contó con cinco documentos relacionados con la temática de estudio, que cumplían los criterios de inclusión. Conclusión. Las intervenciones con EF y TN para el tratamiento de los TCA suponen una reducción en la severidad de la sintomatología de los pacientes. Estos programas se muestran como una herramienta terapéutica alternativa o complementariaa la terapia convencional. Se requieren más estudios que combinen programas de intervención de EF y TN dirigidos a pacientes con TCA. Arch Latinoam Nutr 2022; 72(1): 60-71. Physical exercise and nutritional therapy in the treatment of eating disorders. Introduction. Eating Disorders (ED) are a severe mental illness that causes physical and psychosocial problems. This illness has a higher prevalence among young women, and between athletes cognitive behavioural therapy (CBT) is the current treatment for this type of disorder. However, more and more programs are including physical exercise (PE) and nutritional therapy (TN) for eating disorders treatment. Objective. To carry out an exploratory systematic review of the literature that allows us to know the current state of intervention programs through physical exercise and nutritional therapy for the treatment of eating disorders. Materials and methods. For the reference search thesame search phrase was used. The terms were entered in English in the following computerized databases: SCOPUS, Web of Science, and PubMed. To limit the search, four inclusion criteria were introduced. Results. The review included five scientific articles related to the study topic, which met the inclusion criteria. Conclusion. Intervention programs for the treatment of eating disorders that include physical exercise and nutritional therapy are shown as an alternative or complementary tool to conventional therapy. These programs involve a reduction in the severity of ED symptoms and an improvement in anthropometric parameters and physical condition. More studies that combine PE and TN programs for people with ED are required. Arch Latinoam Nutr 2022; 72(1): 60-71.

Purpose The COVID-2019 pandemic forced many governments to declare the “to stay at home” which encouraged social distancing and isolation among citizens. The aim of this study was to assess the dietary and lifestyle habit changes that occurred during home confinement in Spain. Methods An European online survey was launched in April 2020. This included 70 questions on sociodemographic characteristics, lifestyle, dietary habits, including key Mediterranean diet (MedDiet) foods. A total of 945 Spanish adults from 1268 European that completed the online survey were included in the analysis. Results Most of the Spanish participants adopted healthier dietary habits during home lockdown, which was translated to a higher MedDiet adherence. However, a negative impact on physical activity levels, sleep quality or smoking rates was observed. Low MedDiet adherence was associated with a higher risk of weight gain (OR = 1.53, CI 1.1–2.1; p = 0.016), while no snacking between meals reduced the risk by 80% (OR = 0.20, CI 0.09–0.45, p Conclusion To conclude, although dietary habits were improved during home lockdown, certain unhealthy behaviours (e.g. increased snacking between meals, increased food intake, and an increase in sedentary behaviour) were increased.

Treballs Finals de Grau de Nutrició Humana i Dietètica, Facultat de Farmàcia i Ciències de l'Alimentació, Campus de l'Alimentació de Torribera, Universitat de Barcelona. Curs: 2022-2023. Tutor: Joana Relat Pardo, [eng] Postprandial studies are essential to understand metabolism functioning after food intake and, the metabolic syndrome is a combination of different cardiovascular risk factors which can endanger human health. Thus, this review aims to describe the relationship between the postprandial metabolism of the organism and its possible connection with metabolic syndrome. An electronic search was performed using the databases “Cercabib”, “PubMed”, “Scopus” and “Google Academy” and articles published after the 2000’s were selected. The data indicate that the postprandial response is linked to the ability to suffer from metabolic syndrome. Alterations in the postprandial metabolism of the organism, adherence to Western diets, decrease in physical activity, etc., they are characteristics that are part of the complex definition of the postprandial state, and it will favor the appearance of metabolic syndrome. The conclusion of this work is that more research is needed to prevent the development of metabolic syndrome. Also, there is a great need to promote healthy life in the community and physical activity., [cat] Els estudis postprandial són essencials per comprendre el funcionament del metabolisme després de la ingesta d'aliments i, la síndrome metabòlica és una combinació de diferents factors de risc cardiovascular que poden posar en perill la salut humana. Així, aquesta revisió pretén descriure la relació entre el metabolisme postprandial de l'organisme i la possible connexió amb la síndrome metabòlica. Es va realitzar una cerca electrònica utilitzant les bases de dades "Cercabib", "PubMed", "Scopus" i "Google Academy" i es van seleccionar els articles publicats després dels anys 2000. Les dades indiquen que la resposta postprandial està vinculada a la capacitat de patir de síndrome metabòlica. Alteracions en el metabolisme postprandial de l'organisme, adherència a dietes occidentals, disminució de l'activitat física, etc., són característiques que formen part de la definició complexa de l'estat postprandial, i afavoriran l'aparició de la síndrome metabòlica. La conclusió d'aquest treball és que cal més investigació per prevenir el desenvolupament de la síndrome metabòlica. A més, hi ha una gran necessitat de promoure la vida saludable a la comunitat i l'activitat física.

Treballs Finals de Grau de Nutrició Humana i Dietètica, Facultat de Farmàcia i Ciències de l'Alimentació, Campus de l'Alimentació de Torribera, Universitat de Barcelona. Curs: 2022-2023. Tutor: Maria Grau Magaña, [cat] L’adhesió a un patró alimentari saludable i sostenible, com la Dieta Mediterrània, forma part del tractament de persones que han sofert un esdeveniment cardiovascular. Pot ajudar a la seva prompta recuperació a més de a prevenir l’aparició d’un altre episodi advers. Els objectius d’aquest treball són: (1) adaptar un protocol d’educació nutricional destinat a pacients supervivents d’un episodi cardiovascular isquèmic; (2) avaluar la usabilitat i factibilitat d’aquest programa. S’ha adaptat un protocol d’una intervenció d’educació nutricional per promoure hàbits dietètics saludables dissenyat prèviament per la Xarxa Fit4foodBcn. A continuació, s’ha realitzat aquesta intervenció a 3 pacients ingressats per infart agut de miocardi en un hospital de tercer nivell. S’han avaluat els materials utilitzats, la informació transmesa i el desenvolupament de les diferents sessions del programa a través de qüestionaris i entrevistes. D’aquestes s’extreuen suggeriments de millora i també observacions dels educadors durant les sessions. L’hospital com a emplaçament de la intervenció comporta dificultats, tal com l’estat d’ànim i de salut del pacient al moment de realitzar les sessions, però alhora és un facilitador, degut a que el pacient no s’ha de desplaçar i té temps disponible per realitzar les sessions. Els participants manifesten un nivell alt de satisfacció amb la intervenció, així com una adequada comprensibilitat i utilitat de la informació i els materials, pel qual la intervenció resulta factible de realitzar en aquest hospital., [eng] Adherence to a healthy and sustainable dietary pattern, such as the Mediterranean Diet, is part of the treatment for people who have suffered a cardiovascular event. It can faster their recovery and prevent the appearance of another adverse episode. The aims of this project are: (1) adapt a nutritional education protocol intended for patients who have survived an ischemic cardiovascular episode; (2) evaluate the usability and feasibility of this program. It has been adapted a protocol of a nutritional education intervention to promote healthy dietary habits previously designed by the Fit4foodBcn Network. Then, this intervention was performed on 3 inpatients admitted for myocardial infarction in a third-level hospital. The materials used, the information transmitted, and the development of the different sessions of the program have been evaluated through questionnaires and interviews. Suggestions for improvement including observations of the educators during the sessions are extracted. The hospital as the place of the intervention entails difficulties, such as the patient’s state of mind and health at the time of the sessions but is also a facilitator since the patient does not have to travel and has time available to carry out the sessions. The participants express a high level of satisfaction with the intervention, just as well as adequate comprehensibility and usefulness to the information and materials, which makes the program feasible to perform in this hospital.

[spa] Debido al incremento sostenido de la prevalencia del asma y la presencia de fenotipos graves, resulta de interés el desarrollo de modelos animales que permitan estudiar nuevos tratamientos y coadyuvantes. En los últimos años, el cacao ha demostrado influir en el sistema inmunitario, modificando la composición de linfocitos y la producción de anticuerpos y citocinas. En base a estos factores, el objetivo de la presente tesis ha sido establecer el efecto antiasmático del cacao, en particular de cuatro cacaos nativos del Perú procedentes de distintas regiones del país: Blanco de Piura (BPC), Amazonas Perú (APC), Criollo de Montaña (CMC) y Chuncho (CCC). Para lograr este objetivo, se desarrolló un modelo de asma alérgica que permitiera la inducción y la cuantificación objetiva de una respuesta anafiláctica utilizando ovoalbúmina como alérgeno y alum y toxina Bordetella pertussis como adyuvantes. Paralelamente se determinaron los compuestos bioactivos de los cacaos y se estudió el efecto in vitro en células del sistema inmune, macrófagos peritoneales y linfocitos del bazo. Los resultados mostraron una mayor concentración de polifenoles, metilxantinas, capacidad antioxidante y efecto antiinflamatorio en los cacaos Amazonas Perú y Criollo de Montaña, por lo que fueron seleccionados para su estudio en el modelo de asma alérgica desarrollado. A continuación, se determinó el efecto de una dieta enriquecida al 10% de cacao Amazonas Perú, Criollo de Montaña o un cacao ordinario no autóctono en el modelo de asma alérgica establecido. Los resultados demuestran que las dietas ricas en cacao son capaces de reducir la síntesis de anticuerpos asociados a la respuesta inmunitaria Th2, sin embargo, el cacao ordinario mostró un efecto mayor que los cacaos nativos, siendo capaz de reducir la concentración de IgE sistémica y respiratoria. La dieta con Criollo de Montaña disminuyó la concentración de IgE en lavado broncoalveolar, con una tendencia en suero, y la dieta con Amazonas Perú solo mostró un cierto efecto a nivel respiratorio. Resultados similares se observaron en la concentración de proteasa mastocitaria II, indicativa de la degranulación mastocitaria. Las tres dietas ricas en cacao redujeron la producción de IgG1 sistémica y eosinófilos y leucotrienos en la vía respiratoria de forma similar, mientras que la dieta con Amazonas Perú mostró un efecto mayor que el resto de las dietas en la reducción de IgG2a. Las dietas con cacao Criollo de Montaña y cacao ordinario, pero no dieta con Amazonas Perú, disminuyeron la concentración de IgA mucosal. Por consiguiente, los cacaos fueron capaces de paliar la respuesta inmunitaria Th2, especialmente la síntesis de IgE y la degranulación de los mastocitos, aunque se observaron diferencias entre los cacaos que no se pueden atribuidos a un solo compuesto bioactivo, debiendo influir tanto el contenido en teobromina como la concentración y perfil de flavonoides de cada cacao, que varía según su origen., [eng] Due to the sustained increase in the prevalence of asthma and the presence of severe phenotypes, the development of animal models that allow the study of new treatments and adjuvants, such as cocoa, which in recent years has been shown to influence the immune system, is of interest. Based on these factors, the objective of this thesis has been to establish the anti-asthmatic effect of four native Peruvian cocoas from different regions of the country: Blanco de Piura (BPC), Amazonas Peru (APC), Criollo de Montaña (CMC) and Chuncho (CCC). To achieve this, an allergic asthma model was developed that would allow the induction and objective quantification of an anaphylactic response using ovalbumin as allergen. At the same time, the bioactive compounds of cocoa were determined and the in vitro effect on immune cells was studied. The results showed a higher concentration of polyphenols, methylxanthines, antioxidant capacity and anti-inflammatory effect in Amazonas Peru and Criollo de Montaña cocoas. Next, the effect of diets enriched with 10% of these cocoas or a non-native ordinary cocoa was determined in the model of allergic asthma. The results show that cocoa diets are able to reduce the synthesis of antibodies associated with the Th2 immune response, however, ordinary cocoa showed a greater effect than native cocoa, being able to reduce the concentration of systemic and respiratory IgE. The Criollo de Montaña diet decreased the concentration of IgE in bronchoalveolar lavage fluid, while the Amazonas Peru diet only showed a tendency. Similar results were observed in the concentration of mast cell protease II. All cocoa diets reduced the production of systemic IgG1 and eosinophils and leukotrienes in the respiratory tract similarly, while the diet with Amazonas Peru showed a greater effect in reducing IgG2a. The diets with Criollo de Montaña cocoa and ordinary cocoa decreased the concentration of mucosal IgA . Therefore, the cocoas were able to palliate the Th2 immune response, although differences were observed between the cocoas, influencing both the theobromine content and flavonoid concentration and profile of each cocoa, which varies according to its origin.

Background: Epidemiological studies have demonstrated an association between the degree of food processing in our diet and the risk of various chronic diseases. Much of this evidence is based on the international Nova classification system, which classifies food into four groups based on the type of processing: (1) Unprocessed and minimally processed foods, (2) Processed culinary ingredients, (3) Processed foods, and (4) “Ultra-processed” foods (UPF). The ability of the Nova classification to accurately characterise the degree of food processing across consumption patterns in various European populations has not been investigated so far. Therefore, we applied the Nova coding to data from the European Prospective Investigation into Cancer and Nutrition (EPIC) in order to characterize the degree of food processing in our diet across European populations with diverse cultural and socio-economic backgrounds and to validate this Nova classification through comparison with objective biomarker measurements. Methods: After grouping foods in the EPIC dataset according to the Nova classification, a total of 476,768 participants in the EPIC cohort (71.5% women; mean age 51 [standard deviation (SD) 9.93]; median age 52 [percentile (p)25– p75: 58–66] years) were included in the cross-sectional analysis that characterised consumption patterns based on the Nova classification. The consumption of food products classified as different Nova categories were compared to relevant circulating biomarkers denoting food processing, measured in various subsamples (N between 417 and 9,460) within the EPIC cohort via (partial) correlation analyses (unadjusted and adjusted by sex, age, BMI and country). These biomarkers included an industrial transfatty acid (ITFA) isomer (elaidic acid; exogenous fatty acid generated during oil hydrogenation and heating) and urinary 4-methyl syringol sulfate (an indicator for the consumption of smoked food and a component of liquid smoke used in UPF). Results: Contributions of UPF intake to the overall diet in % grams/day varied across countries from 7% (France) to 23% (Norway) and their contributions to overall % energy intake from 16% (Spain and Italy) to >45% (in the UK and Norway). Differences were also found between sociodemographic groups; participants in the highest fourth of UPF consumption tended to be younger, taller, less educated, current smokers, more physically active, have a higher reported intake of energy and lower reported intake of alcohol. The UPF pattern as defined based on the Nova classification (group 4;% kcal/day) was positively associated with blood levels of industrial elaidic acid (r = 0.54) and 4-methyl syringol sulfate (r = 0.43). Associations for the other 3 Nova groups with these food processing biomarkers were either inverse or non-significant (e.g., for unprocessed and minimally processed foods these correlations were –0.07 and –0.37 for elaidic acid and 4-methyl syringol sulfate, respectively). Conclusion: These results, based on a large pan-European cohort, demonstrate sociodemographic and geographical differences in the consumption of UPF. Furthermore, these results suggest that the Nova classification can accurately capture consumption of UPF, reflected by stronger correlations with circulating levels of industrial elaidic acid and a syringol metabolite compared to diets high in minimally processed foods., International Agency for Research on Cancer (IARC), Imperial College London, NIHR Imperial Biomedical Research Centre (BRC), Danish Cancer Society (Denmark), Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l’Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France), German Cancer Aid, German Cancer Research Center (DKFZ), German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Federal Ministry of Education and Research (BMBF) (Germany), Associazione Italiana per la Ricerca sul Cancro- AIRC-Italy, Compagnia di SanPaolo and National Research Council (Italy), Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (Netherlands), Health Research Fund (FIS) - Instituto de Salud Carlos III (ISCIII), Regional Governments of Andalucía, Asturias, Basque Country, Murcia and Navarra, and the Catalan Institute of Oncology - ICO (Spain), Swedish Cancer Society, Swedish Research Council and County Councils of Skåne and Västerbotten (Sweden), Cancer Research UK (14136 to EPIC-Norfolk; C8221/A29017 to EPIC-Oxford), Medical Research Council (1000143 to EPIC-Norfolk; MR/M012190/1 to EPIC-Oxford) (United Kingdom)

ObjectivesThe aim of this cross-sectional study was to investigate the association between sleep dimensions (duration, patterns, and disturbances) with body mass index (BMI), diet quality, and eating behaviors in school-aged children. Additionally, we aimed to investigate whether obesogenic eating behaviors (higher food responsiveness, lower satiety responsiveness, and less slowness in eating) and poor diet quality could mediate the potential association between sleep and obesity in school-aged children.Materials and methodsFor all participants (n = 588 children, age 5–12 years; 51% girls) we evaluated: sleep dimensions, BMI, diet quality, eating behaviors (food responsiveness, satiety responsiveness and slowness in eating). Linear regression models were used to test associations between exposure and outcome variables. Additionally, path analysis was conducted to test whether eating behaviors mediated the relationship between sleep and obesity.ResultsShorter sleep duration (β = −0.722, p = 0.009) and greater sleep disturbances (β = 0.031, p = 0.012) were significantly associated with BMI. Additionally, we observed that diet quality was significantly associated with sleep duration (β = 0.430, p = 0.004), the midpoint of sleep (β = −0.927, p < 0.001), and sleep disturbances (β = −0.029, p < 0.001). Among other findings, greater sleep disturbances were associated with food responsiveness (β = 0.017, p < 0.001), satiety responsiveness (β = 0.015, p < 0.001), and slowness in eating (β = 0.012, p < 0.001). Importantly, food responsiveness was found as significant mediator of the relationship between sleep and BMI (R = 0.427, R2 = 0.182, p < 0.001).ConclusionsLate sleep patterns, short sleep duration, and greater sleep disturbances are significantly related with what and how school-aged children eat. Importantly, poor diet quality was significantly related to all three sleep dimensions, while eating behaviors had a significant relationship with greater sleep disturbances. These findings may be relevant to the development of behavioral targets to prevent childhood obesity, including sleep hygiene guidelines as a strategy to improve children's eating habits, as well as their BMI.

There is currently no treatment for early/intermediate Age-related Macular Degeneration (AMD) but Eye Care Professionals (ECPs) are recommended to advise patients about modifiable lifestyle factors, including dietary changes, that can slow disease progression. The aim of this review was to understand advice currently given to patients with AMD by ECPs and to evaluate evidence regarding patient compliance. A systematic review was conducted of literature published in electronic databases: CINAHL, MEDLINE, PsycINFO, PyscARTICLES, EMBASE, AMED. Methods followed PRISMA guidelines (PROSPERO registration number: CRD42020223724). Twenty-four reports were eligible for inclusion, 12 focused on ECP experience, 7 on patient experience, and 6 on impact of advice (one paper reported on the ECP and patient experience). Studies reported that a substantial proportion of patients did not recall receiving lifestyle modification advice from their ECP (57.95%, range 2–95% across patient based studies). Practitioners were most likely to provide advice about nutritional supplements (80%, range 67–93% across ECP studies), and least likely about smoking (44%, range 28–71% across ECP studies), however supplements advised did not always comply with evidence-based guidelines. The main reason for patients not following lifestyle advice was lack of provision by the ECP (54.5%, range 21–94% across studies on the impact of advice). The review highlighted a need for more studies to understand patient preferences for receiving advice and research on ECP perceived barriers to advice provision. S.D. is funded by The Macular Society

The education sector is a cornerstone in the battle against malnutrition in children. However, there are still no consolidated protocols that outline strategies for how nutrition programs in low- and middle-income countries can be delivered through the education sector. Establishing the correct community diagnosis is essential prior to the elaboration of an intervention plan for a school population that takes into account more than just traditional variables related to the nutritional status. A total of 574 boys and girls aged 3–11 years from three educational institutions in different municipalities in Ecuador participated in the study. Sociodemographic, anthropometric (weight and height) and coproparasitological data were obtained. Nutrimetry, which is a combination of two classical anthropometrics indicators, was used for the analysis of the nutritional status, and the indicators’ frequencies varied among the schools. In order to improve the nutritional status of children, we proposed a framework mainly focusing on establishing alliances with the education sector and taking into account gender equality; respect for the environment; and the customs, beliefs and traditions of each population. The results obtained from the analyses of other variables demonstrated the importance of an adequate diagnosis prior to any type of intervention at the nutritional level, since characteristics could vary by local area and have an impact on the successfulness of the intervention.

Purpose: Malnutrition is a common problem among pancreatic cancer (PC) patients that negatively impacts on their quality of life (QoL) and clinical outcomes. The main objective of this consensus is to address the role of Medical Nutrition Therapy (MNT) into the comprehensive therapeutic management of PC patients. Methods: A Spanish multidisciplinary group of specialists from the areas of Medical Oncology; Radiation Oncology; Endocrinology and Nutrition; and General Surgery agreed to assess the role of MNT as part of the best therapeutic management of PC patients. Results: The panel established different recommendations focused on nutritional screening and nutritional screening tools, MNT strategies according to PC status, and MNT in palliative treatment. Conclusions: There is an unmet need to integrate nutritional therapy as a crucial part of the multimodal care process in PC patients. Health authorities, health care professionals, cancer patients, and their families should be aware of the relevance of nutritional status and MNT on clinical outcomes and QoL of PC patients, Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature. Logistics of the meetings and the assistance with the medical writing have been provided by unrestricted Grant from Baxter Laboratories