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Fiber is an essential nutrient in a healthy diet, contributing to health maintenance and preventing the occurrence of different disease. The classification of fiber according to its degree of fermentation within the large bowel categorizes it into two different types, completely fermentable fiber and partially fermentable fiber. The level of fermentability of each fiber will give it characteristic properties. Besides the known effects of fiber on transit and bowel movement regulation, the recent advance on the knowledge on the metabolism of some fermentable fibers, such as inulin, fructo-oligosaccharides, and galacto-oligosaccharides, has shown its prebiotic effect. Because of this fermentation, short chain fatty acids with important colonic and systemic functions are produced. Therefore, it is essential to perform a balanced diet with adequate fiber consumption. [ABSTRACT FROM AUTHOR]

Introduction: The concept of "disease related malnutrition" (DRM) is far from the concept of malnutrition classically diagnosed in public health, which is determined by socio-demographic factors. In 2008, the Spanish Society of Clinical Nutrition and Metabolism (SENPE) and the Spanish Society of Medical Documentation (SEDOM) published a consensus defining more precisely the types of malnutrition seen in hospitals and their corresponding coding. Changes in the International Classification of Diseases (ICD) and the evolution of clinical information have made it necessary to revise and update this consensus in order to establish new criteria to guide the recording and coding of diagnoses of malnutrition in the field of hospital care, thus facilitating the work of both clinicians and coders and improving the visibility of DRE, by adapting from the clinical diagnoses of undernutrition based on the GLIM criteria (Global Leadership Initiative on Malnutrition) proposed by the scientific societies to the current codes proposed by ICD-10-ES. This document reflects the new consensus of the SENPE, SEEN and SEDOM societies, and refers to the coding of DRE, other nutritional diagnoses and medical nutritional treatment procedures, sets out the coding criteria and proposes suggestions to improve coding at the hospital level.

Purpose: Malnutrition is frequent in hospitalized patients and is related to functional decline and poorer clinical outcomes. The Patient-Generated Subjective Global Assessment (PG-SGA) is a globally implemented malnutrition tool. We aimed to perform a linguistic and content validation of the translation and cultural adaptation of the PG-SGA for the Spanish language setting., Methods: This study was conducted in Mexico and Spain. Cancer patients and healthcare professionals (HCPs) of both countries were enrolled. We followed the 10 steps of the International Society for Pharmacoeconomics and Outcomes Research Principles. Patients and HCPs evaluated comprehensibility (Item: I-CI, Scale: S-CI) and difficulty (Item: I-DI, Scale: S-DI) of the Spanish version of the PG-SGA. HCPs also evaluated content validity (i.e., relevance) of the Spanish PG-SGA (Item: I-CVI, Scale: S-CVI). The data were collected by a questionnaire., Results: The study enrolled 84 HCPs and 196 cancer patients from both countries. HCPs rated comprehensibility and difficulty of the professional component as excellent (S-CI = 0.95, S-DI = 0.92), and content validity of the full PG-SGA also as excellent. Patients rated comprehensibility (S-CI) and difficulty (S-DI) of the patient-generated component, that is, the PG-SGA Short Form, as "excellent" (S-CI = 0.98 and S-DI = 0.98)., Conclusion: Translation and cultural adaptation of the PG-SGA to the Spanish setting according to the International Society for Pharmacoeconomics and Outcomes Research Principles resulted in an instrument perceived as clear and easy to complete by cancer patients and relevant by HCPs to assess the nutritional status., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this article., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: A nationwide, prospective, multicenter, cohort study (the Disease-Related caloric-protein malnutrition EChOgraphy (DRECO) study) was designed to assess the usefulness of ultrasound of the rectus femoris for detecting sarcopenia in hospitalized patients at risk of malnutrition and to define cut-off values of ultrasound measures., Methods: Patients at risk of malnutrition according to the Malnutrition Universal Screening Tool (MUST) underwent handgrip dynamometry, bioelectrical impedance analysis (BIA), a Timed Up and Go (TUG) test, and rectus femoris ultrasound studies. European Working Group on Sarcopenia in Older People (EWGSOP2) criteria were used to define categories of sarcopenia (at risk, probable, confirmed, severe). Receiver operating characteristic (ROC) and area under the curve (AUC) analyses were used to determine the optimal diagnostic sensitivity, specificity, and predictive values of cut-off points of the ultrasound measures for the detection of risk of sarcopenia and probable, confirmed, and severe sarcopenia., Results: A total of 1000 subjects were included and 991 of them (58.9% men, mean age 58.5 years) were evaluated. Risk of sarcopenia was detected in 9.6% patients, probable sarcopenia in 14%, confirmed sarcopenia in 9.7%, and severe sarcopenia in 3.9%, with significant differences in the distribution of groups between men and women ( p < 0.0001). The cross-sectional area (CSA) of the rectus femoris showed a significantly positive correlation with body cell mass of BIA and handgrip strength, and a significant negative correlation with TUG. Cut-off values were similar within each category of sarcopenia, ranging between 2.40 cm 2 and 3.66 cm 2 for CSA, 32.57 mm and 40.21 mm for the X -axis, and 7.85 mm and 10.4 mm for the Y -axis. In general, these cut-off values showed high sensitivities, particularly for the categories of confirmed and severe sarcopenia, with male patients also showing better sensitivities than women., Conclusions: Sarcopenia in hospitalized patients at risk of malnutrition was high. Cut-off values for the better sensitivities and specificities of ultrasound measures of the rectus femoris are established. The use of ultrasound of the rectus femoris could be used for the prediction of sarcopenia and be useful to integrate nutritional study into real clinical practice., Competing Interests: G.G.R. and A.M are full employees of Abbott Laboratories. None of the remaining authors have any conflicts of interest. The authors declare that the project was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Introduction: Background: the underlying cause of the deficiency of ornithine carbamoyltransferase (OTCD) is a gene mutation on the X chromosome. In females, the phenotype is highly variable, ranging from asymptomatic to neurologic compromise secondary to hyperammonemia and it can be prompted by numerous triggers, including pregnancy. Objective: the objective of this article is to report a case of two pregnancies of an OTCD-carrier, and to review the literature describing OTCD and pregnancy, parturition and postpartum. Methods: an extensive search in PubMed in December 2021 was conducted using different search terms. After screening all abstracts, 23 papers that corresponded to our inclusion criteria were identified. Results: the article focuses on the management of OTCD during pregnancy, parturition, and the postpartum period in terms of clinical presentation, ammonia levels and treatment. Conclusions: females with OTCD can certainly plan a pregnancy, but they need a careful management during delivery and particularly during the immediate postpartum period. If possible, a multidisciplinary team of physicians, dietitians, obstetrician-gynecologist, neonatologists, pharmacists, etc. with expertise in this field should participate in the care of women with OTCD and their children during this period and in their adult life.

Introduction: Aim: the objective of this study was to describe the results of the implementation of a home parenteral nutrition (HPN) care programme (Nutrihome©) in a cohort of patients treated at a tertiary hospital. Methods: retrospective study of the patients included in Nutrihome© at Hospital General Universitario Gregorio Marañón, Madrid, Spain. Nutrihome consists of different modules including pre-discharge nursing hospital visits and nursing home visits, deliveries of the infusion pump, consumables and parenteral nutrition bags, patient training, weekly scheduled nursing home visits, scheduled nursing phone calls, stock control phone calls and 24-hour on-call line manned by the nurses. Results: the study included 8 (75 % women) and 10 (70 % women) patients in the Nutrihome© pilot and Nutrihome© programme, respectively. A total 37 adverse events were reported during Nutrihome© pilot, 26 of which were technical, 9 clinical, 1 was catheter-related and 1 other event. Nutrihome© programme registered a total of 107 adverse events reported, 57 of which were technical, 21 clinical, 16 were catheter-related and 13 were other events. A total of 99 % of these events were solved by Nutrihome© via phone calls or home visits. Conclusions: Nutrihome© programme has been extremely useful during this pandemic, facilitaing both the start of HPN and training at the patient home without the need for hospitalisation. Additionally, the adverse events reported and solved by Nutrihome© not only reduced the physicians' burden during those tough times and the patients´ stress of being hospitalised during a pandemic, but supported the entire healthcare system.

Introduction: Medical nutrition therapy is a very useful tool in maintaining and recovering the health of patients with disease-related malnutrition, although its implementation can be complex and is not without risks. Quality processes are understood as sets of activities that are related or interact to transform input elements into results. From the SENPE Management Work Group we present the process of medical nutrition therapy (PMNT), which aims to facilitate the management of clinical nutrition of a multidisciplinary nutrition support team in a hospital setting. This paper describes the seven sub-processes PMNT is comprised of, in addition to a previous nutritional screening sub-process. Each sub-process is divided into a first section with a technical sheet detailing its general aspects, while a second section proposes key objectives, quality indicators, and standards for their evaluation.  .

Introduction: Introduction: quality indicators have been proposed in Spain for assessing the various stages of clinical nutrition. However, reference standards for these indicators (feasible and relevant) based on daily practice of artificial nutrition are not available. Goals: the goal of this study was to propose quality indicators standards for their routine application to artificial nutrition in clinical practice. Material and methods: a multicenter, cross-sectional study-based on a survey applied to health professionals in the field of clinical nutrition-on the fulfilment of eight quality criteria was carried out during 2018 and 2019. The total number of processes and those that were correctly accomplished were assessed and compared with the corresponding proposed theoretical standard. Results: fifteen centers were assessed. Of eight indicators assessed, five were within the theoretical standard (correct identification of parenteral nutrition bags, semi-upright position of patients on enteral nutrition, administration of micronutrients in ready-to-use parenteral nutrition bags, checking placement of feeding tubes, and days with glycemia below 60 mg/dL). Two indicators were very close to the theoretical standard. One indicator, hyperglycemia in patients with parenteral nutrition, was far removed from its theoretical standard (15.7 % vs. 5 %). Conclusion: the administration of artificial nutrition in Spanish hospitals was performed with a high quality level. Therefore, standards based on daily clinical practice regarding artificial nutrition in Spain are proposed.

Introduction: Prevalence of disease-related malnutrition in hospitals ranges from 20%-50%. Use of nutritional screening tools should be the first step in the prevention and treatment of patients at risk of malnutrition and/or undernourished., Aims: To implement a nutritional screening tool at admission to a tertiary hospital., Methods: The nutrition unit prepared a protocol for early detection of nutritional risk and selected the NRS 2002 as screening tool. The protocol was approved by the hospital committee of protocols and procedures and disseminated through the intranet. NRS 2002 was included in the diet prescription software to be implemented by the nursing staff of the hospital wards and as a direct communication system with the nutrition unit. Three phases were designed: pilot phase, implementation phase, and consolidation phase., Results: The pilot phase, NRS 2002 was implemented in 2hospital units to monitor software. The implementation phase was carried out in the same units, and all action protocols related to it were verified. The consolidation phase consisted of sequential extension of the protocol to the other hospital units., Conclusions: Implementation of nutritional screening at hospital admission is a long and complex process that requires involvement of many stakeholders. Computer software has allowed for a rapid, simple, and automatic process, so that the results of the screening are immediately available to the nursing staff of the nutrition unit and activate the nutritional protocols when required., (Copyright © 2019 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.)

Background and Objective: Treatment with oral antineoplastic agents known as tyrosine kinase inhibitors (TKIs) is new and, thus, little is known about their impact on nutritional status (NS), dietary intake, quality of life, and survival. The aim of this study was to provide information on these components in order to guide future nutritional recommendations., Patients and Method: A prospective, observational study in adults who start treatment with TKIs, in whom NS was assessed using the Patient-Generated Subjective Global Assessment (PG-SGA), anthropometric measures, biochemical parameters, and dietary intake (24-hour dietary recall). The EORTC QLQ-C30 was used to assess quality of life. Nonparametric tests were used in statistical analysis, and survival was analyzed using Kaplan-Meier and log-rank curves., Results: Of the overall sample, 21.7% had moderate malnutrition according to PG-SGA, and 74.2% moderate weight loss at 6 months, but no patient had BMI<18.5kg/m 2 . Patients with moderate malnutrition had lower survival at four years of diagnosis (log-rank=0.015). Energy intake was lower than recommended by the ESPEN 2017 congress, and no patient covered the protein requirements (1.5g protein/kg weight) during follow-up. A worse score on the global health scale of the EORTC QLQ-C30 was related to worse NS., Conclusions: Treatment with TKIs does not appear to have a significant impact on NS and quality of life after 6 months of follow-up. Malnutrition should be prevented through individualized nutritional advice because it is related to shorter survival., (Copyright © 2019 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: The Management Working Group of SENPE has among its objectives the development of evaluation processes in Clinical Nutrition. Previously, the document entitled "Process of nutritional care: self-evaluation guide" was prepared as a tool designed to help assess the quality of nutritional therapy in hospitalized patients, mainly from the perspective of artificial nutrition. Now a complementary text of the previous one is presented, that describes the process by which hospitalized patients are fed. We have divided the hospital feeding process into six sections, for which a general description is made and quality indicators are proposed. We hope that this work will serve to improve the quality of hospital food and to help hospital food professionals to make their work more satisfactory and effective.

Introduction: catheter-related bloodstream infections (CRBSI) are one of the most serious concerns in patients on home parenteral nutrition (HPN) which involve high morbidity and cost for the healthcare system. In the last years, taurolidine lock has proven to be beneficial in the prevention of CRBSI; however, the evidence of its efficiency is limited., Objective: to determine if taurolidine lock is a cost-effective intervention in patients on HPN., Materials and Methods: retrospective study in patients on HPN with taurolidine lock. We compared the CRBSI rate and cost of its complications before and during taurolidine lock., Results: thirteen patients, six (46%) males and seven (54%) females, with a mean age of 61.08 (SD = 14.18) years received taurolidine lock. The total days of catheterization pre and per-taurolidine were 12,186 and 5,293, respectively. The underlying disease was benign in five patients (38.5%) and malignant in eight (61.5%). The CRBSI rate pre vs per-taurolidine was 3.12 vs 0.76 episodes per 1,000 catheter days (p = 0.0058). When the indication was a high CRBSI rate, this was 9.72 vs 0.39 (p < 0.001) in pre and per-taurolidine period respectively. No differences have been observed in the occlusion rates. None of the patients reported any adverse effects. The total cost of CRBSI in the pre-taurolidine period was 151,264.14 euros vs 24,331.19 euros in the per-taurolidine period., Conclusions: our study shows that taurolidine lock is a cost-effective intervention in patients on HPN with high risk of CRBSI.

Aim: To determine the impact of the type of hospital kitchen on the dietary intake of patients., Methods: A cross-sectional, two-centre study, of cooking in a traditional kitchen (TK) and in a chilled kitchen (CK). Subjective global assessment (SGA) was used for nutritional diagnosis. Before study start, a dietician performed a nutritional assessment of the menus of each hospital. All dishes were weighed upon arrival to the ward and at the end of the meal., Results: 201 and 41 patients from the centres with TK and CK respectively were evaluated. Prevalence of malnutrition risk was 50.2% at the hospital with TK and 48.8% at the hospital with CK (p=0.328). Forty-eight and 56 dishes were nutritionally evaluated at the hospitals with TK and CK respectively. Intake analysis consisted of 1993 and 846 evaluations in the hospitals with TK and CK respectively. Median food consumption was 76.83% at the hospital with TK (IQR 45.76%) and 83.43% (IQR 40.49%) at the hospital with CK (p<0.001). Based on the prevalence of malnutrition, a higher protein and energy intake was seen in malnourished patients from the CK as compared to the TK hospital, but differences were not significant after adjustment for other factors., Conclusions: Cooking in a chilled kitchen, as compared to a traditional kitchen, may increase energy and protein intake in hospitalized patients, which is particularly beneficial for malnourished patients., (Copyright © 2017 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: the implementation of quality management systems (QMS) in the health sector has made great progress in recent years, remains a key tool for the management and improvement of services provides to patients., Aim: to describe the process of implementing a quality management system (QMS) according to the standard ISO 9001:2008 in a Nutrition Unit., Methods: the implementation began in October 2012. Nutrition Unit was supported by Hospital Preventive Medicine and Quality Management Service (PMQM). Initially training sessions on QMS and ISO standards for staff were held. Quality Committee (QC) was established with representation of the medical and nursing staff. Every week, meeting took place among members of the QC and PMQM to define processes, procedures and quality indicators. We carry on a 2 months follow-up of these documents after their validation., Results: a total of 4 processes were identified and documented (Nutritional status assessment, Nutritional treatment, Monitoring of nutritional treatment and Planning and control of oral feeding) and 13 operating procedures in which all the activity of the Unit were described. The interactions among them were defined in the processes map. Each process has associated specific quality indicators for measuring the state of the QMS, and identifying opportunities for improvement. All the documents associated with requirements of ISO 9001:2008 were developed: quality policy, quality objectives, quality manual, documents and records control, internal audit, nonconformities and corrective and preventive actions. The unit was certified by AENOR in April 2013., Conclusion: the implementation of a QMS causes a reorganization of the activities of the Unit in order to meet customer's expectations. Documenting these activities ensures a better understanding of the organization, defines the responsibilities of all staff and brings a better management of time and resources. QMS also improves the internal communication and is a motivational element. Explore the satisfaction and expectations of patients can include their view in the design of care processes., (Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.)

Background: in recent years, researching about new oral antineoplastics has progressed while its impact on dietary intake and nutritional status (NS) hasn't developed enough yet., Objectives: dietary intake and NS assessment in patients who start treatment with tyrosine kinase inhibitors (TKI) and evaluate its impact on them., Methods: an observational, prospective-six-months study, in which were included patients starting treatment with TKI. The intake was evaluated by a 24 h dietary record and a food frequency questionnaire. The NS was evaluated by anthropometric measurements and the patient-generated Global Subjective Assessment (PG-GSA); the results were compared with the Spanish references (SENC-semFYC, 2007 and O. Moreiras, 2013). Friedman test, χ2, Wilcoxon, Kruskal-Wallis and Mann-Whitney were used in the statistical analysis. Significance p < 0.05., Results: 22 patients (54.5% male) were included. At baseline, NS was adequate in 73.9% of patients according PG-GSA. Weight loss was no significant, although a high percentage of the energy and protein requirements hadn't been reached. The caloric intake was positively related with the number of meals. Dietary habits did not change during treatment., Conclusion: dietary intake did not reach nutritional requirements at baseline. The TKI don't seem to affect the patient's intake and nutritional status. The research about these parameters before starting treatment could prevent future complications and it would guide the dietary advice., (Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.)

Fiber is an essential nutrient in a healthy diet, contributing to health maintenance and preventing the occurrence of different disease. The classification of fiber according to its degree of fermentation within the large bowel categorizes it into two different types, completely fermentable fiber and partially fermentable fiber. The level of fermentability of each fiber will give it characteristic properties. Besides the known effects of fiber on transit and bowel movement regulation, the recent advance on the knowledge on the metabolism of some fermentable fibers, such as inulin, fructo-oligosaccharides, and galacto-oligosaccharides, has shown its prebiotic effect. Because of this fermentation, short chain fatty acids with important colonic and systemic functions are produced. Therefore, it is essential to perform a balanced diet with adequate fiber consumption.

Unlabelled: Nutritional management is essential in anorexia nervosa (AN), although nutrient replenishment must be done progressively to prevent the occurrence of re-alimentation syndrome., Objective: to compare resting enengy expenditure (REE) by means of indirect calorimetry and by different equations in AN female patients., Material and Methods: we studied 21 women admitted for AN (DSM-IV), mean age 17 years (SD 5.9), range 12-34 years. Admission stay was 55.1 +/- 20.7 days (21-91). Initial nutritional assessment included anthropometrics (BMJ, TSF, SSE, MAC, MAMC) and tetrapolar bioimpedance (HoltainBC). Indirect calorimetry (IC) was done after overnight fasting (Deltatrac II MBM-200). In 9 patients, the same study was repeated before hospital discharge. We compared REE (Kcal/24 h) measured by IC with that obtained by several equations [Fleish, Harris- Benedict, FAO, Schofield-HW (SHW), Schebendach] through the intraclass correlation coefficient (ICC) and the Bland-Altman method., Results: Nutritional status significantly improved during hospital admission. Fifty percent of the recovered weight was fat mass. REE significantly increased during admission. The equations overestimated REE as compared to IC (p < 0.05), except for the Schebendach equation that underestimated REE. The agreement between direct measurement of REE by IC and its estimation through equations was poor [Fleish (ICC = 0.21); HB (ICC = 0.21), SHW (ICC = 0.19), Schebendach (ICC = 0.15)]. Through the Bland-Altman method, we observed that there was a variable bias between IC and equations, with a clinically acceptable agreement for REW values of around 1200 Kcal/day., Conclusions: 1) In our study we obtained a poor agreement between REW values measured by indirect calorimetry and those estimated by equations. 2) Through the Bland-Altman method, we observed that all equations present a variable bias as for IC, the agreement being clinically acceptable for REE values of around 1200 Kcal/day. 3) Thus, indirect calorimetry seems to be a very useful tool to calculate the energy requirements of anorexia nervosa patients.