AISLAMIENTO POR COVID-19 EN EL AMBA Y EN EL RESTO DEL PAÍS: ESTUDIO TRANSVERSAL DE CAMBIOS EN HÁBITOS Y ESTILO DE VIDA

ABSTRACT Introduction: the confinement imposed to reduce the spread of COVID-19 induces changes in habits and unhealthy lifestyles. Objectives: to verify changes associated with confinement in eating habits and lifestyle in the Argentine population and their differences between the metropolitan area of Buenos Aires (AMBA) and the rest of the country. Materials and methods: cross-sectional, descriptive, and analytical study, through an “online” survey (December 2020) carried out on adults residing in Argentina. Age, gender and place of residence were surveyed, as well as the changes registered regarding weight, eating habits, physical activity, desire to eat and quality of sleep. A descriptive analysis of the valid surveys received (N=1,536) was carried out, verifying differences between the regions using parametric and nonparametric tests, considering significant p<0.05. Results: 75.1% of the participants were women (38.8±13.1 years), 60.5% from the AMBA and 39.5% from the rest of the country. Isolation was associated with changes that impacted on the psychological, stress, healthy habits, and sleep, with some significant regional differences. However, the common end result between AMBA and the rest of the country was the greater increase in caloric intake and the decrease in physical activity that led to 39.7% of the participants increasing their weight (mean 4.8±2,8 kg). Conclusions: isolation was associated with undesirable side effects, which could be diminished through the virtual promotion of healthy habits that would simultaneously decrease the growth of obesity and diabetes. Key words: COVID-19; social isolation; eating habits; lifestyle; physical activity.

METODOLOGÍAS DE MEDICIÓN DE LA SEGURIDAD ALIMENTARIA NUTRICIONAL EN LA REPÚBLICA ARGENTINA

ABSTRACT Introduction: food is a human right and a basic need for their subsistence and development. enough food is produced worldwide to supply all inhabitants and satisfy their caloric and nutritional needs. But the mere fact of producing them does not ensure access to safe and nutritious food for all. Therefore, the correct measurement of nutritional food insecurity is essential for a better understanding of this phenomenon, allowing better communication between society, decision-makers and the political agenda. Objectives: analyze the strengths and limitations of the methodologies used to measure nutritional food security in the Argentine Republic between 1984 and 2017. Materials and methods: a systematic review of articles published in five electronic databases was carried out: Scopus, SciELO, PubMed, BVS and Redalyc. The categories analyzed were the nutritional food security measurement methodologies (when people enjoy food security in addition to a healthy environment, as well as adequate health, education and care), with their type of technique, level, duration and dimension evaluated, limitations and strengths. The search terms used were food insecurity, food security, hunger, food sovereignty, food policy, food availability, nutritional programs, nutritional policies and food assistance. Results: after the search, 22 articles were selected for analysis. Conclusions: all the methodologies analyzed take partial aspects. A methodology has not yet been developed that reflects the multisectoral (food, agricultural, governmental, economic, social, etc.) and multidimensional (access, availability, use and stability) nature of the concept of nutritional food security. Having an adequate measurement of nutritional food security is essential to assess the state of nutritional food insecurity in the Argentine Republic, the government policies that are developed under this concept and verify its impact on the health and nutrition of the Argentine population. Key words: food security; food insecurity; hunger; nutrition policy; Argentina.

Microbioma en los trastornos de la conducta alimentaria

Introduction: eating disorders are serious illnesses with genetic and neurobiological bases where the main organs affected are the gastrointestinal tract and the neurologic system making important the role of the microbiome. Objectives: summarize the results of the latest microbiome research that could be future tools in the management of eating disorders. Materials and methods: umbrella review of pubmed publications in humans of the last 10 years regarding microbiome and eating disorders. Results: since the discovery of the microbiome and the function on the cerebral-intestinal axis, through pathways such as vagal nerve, neurotransmitters and immune system, related to symptoms presented on anorexic patients. Conclusions: psychobiotics, live organisms that when ingested in adequate amounts produce health benefits in patients suffering from psychiatric illnesses are the new topic of future research in eating disorders.

VITAMINA D Y DIABETES MELLITUS. PARTE 1

Introduction: diabetes mellitus (DM) has become a major global public health problem. Vitamin D (VD) deficiency, on the other hand, has pandemic characteristics and its consequences go beyond its known effect on bone metabolism. The discovery of vitamin receptors in various tissues has led to increased interest in non-skeletal functions, many of which are related to the prevention and progression of DM. 25(OH) D is the main circulating form and is the most appropriate and most widely used marker for assessing the nutritional status of VD, since it reflects both endogenous production and intake of the vitamin. Objectives: as a Working Group we proposed to make a review of the topic VD and Diabetes. In this first part we analyzed the VD: metabolic aspects, food intake and controversies about the definition of adequate serum levels. Materials and methods: a bibliographic search was carried out using the PubMed, MEDLINE, Cochrane, Research Gate search engines. The search criteria were "vitamin D", "vitamin D and diabetes", "vitamin D functions, metabolism, sources" "vitamin D toxicity". Complete articles related to the topic were selected. The vitamin D content of foods was obtained from the Souci Fachmann Kraut and USDA food composition data bases. Conclusions: considering the scarce distribution of VD in natural foods, the low consumption of source foods in the Argentine population and the current recommendations to limit sun exposure due to skin cancer, it is necessary to have fortified foods for massive consumption, in addition to milk. Nutritional supplements offer a safe option to supplement the diet as long as serum levels are monitored. There is no consensus on reference levels for considering an individual deficient, although most authors agree on the need to maintain serum levels above 30 ng/ml.

PRODUCTOS ELABORADOS CON VERDOLAGA (PORTULACA OLERACEA L.): VALORACIÓN NUTRICIONAL, CONOCIMIENTO, CARACTERÍSTICAS ORGANOLÉPTICAS, ACEPTABILIDAD Y SATISFACCIÓN

Introduction: portulaca oleracea, known as purslane (verdolaga), culturally considered an undergrowth, has multiple beneficial properties allowing to be used as a food, due to its easy access and low cost. There are not many studies on the subject. Objectives: the objective of present work was to prepare food products using purslane as raw material, with adequate organoleptic characteristics. To calculate their nutritional value and to determine the recommended dietary allowance (RDA) percentage they cover. Also, to identify the level of knowledge that a certain population has about purslane and its nutritional properties, and to define the organoleptic characteristics of the foods elaborated, evaluating the degree of acceptability and satisfaction in the population under study. Materials and methods: the study was descriptive, nonexperimental and experimental (pre-experiment), cross-sectional. Three preparations with purslane were elaborated and subjected to tasting: soup (S), omelette (O) and salad (E). Results: tthe caloric value per serving of the preparations was S: 24.2 kcal/200 g; O: 129.2 Kcal/200 g, and E: 116.16 kcal/150 g. The percentages of RDA covered by a serving of each food were: S: 1.21% kcal, 1.31% carbohydrates, 1.96% proteins, 0.54% fats; T: 6.43% kcal, 3.48% carbohydrates, 9.54% proteins, 11.81% fats, and E: 5.8% kcal, 5.06% carbohydrates, 4.28% proteins and 8.6% fats. The values were calculated on referred to the recommended daily intake (RDI), which are: 2,000 kcal, 300 g carbohydrates, 75 g proteins y 55 g fats, defined to a group of adult women and men between 18 and 60 years old. The sample included 50 people with 42 years average age, 58% female and 42%male, 40% with secondary studies, 34% university (N=17), 18% tertiary (N=9) and 8% primary. 76% of the participants presented a low knowledge about purslane and its nutritional properties. The preparations were satisfactory for 82% of the participants and accepted by 90%. Conclusions: due to the suggested nutritional properties and its versatility for its incorporation in various recipes, purslane can be indicated as an excellent alternative for human consumption.

Fenotipo de comportamiento alimentario y emociones como predictores de ganancia de peso durante el confinamiento por COVID-19

Introduction: situations characterized by a high emotional load might favor weight gain. Objectives: the aim of the present study was to evaluate the association between eating behavior phenotype, emotions and feelings perception and weight gaining in the context of COVID-19 pandemia. Materials and methods: a transversal, descriptive study was carried out by means of an online survey on adults participants, residents in Argentina. The evaluation consisted of demographic and anthropometric data, physical activity level, sleep habits and eating behavior phenotype. The increase in the perception of different emotions and feeling during the confinement was evaluated. Results: 2,619 participants (84.9 females, mean age 39.27±15.21 year old). 40.3% of the subjects reported having gained weight during the confinement. 77.3% of the subjects showed some sort of sleep disturbance. The main feelings and emotions that were reported to have increased were anxiety (50.7%), demotivation (45.1%) and sadness (38.9%). Logistic regression model evidenced that the diminishment in physical activity during the confinement, as well as basal body mass index were associated to weight gain. The hedonic eater eating behavior phenotype predicted weight gain (B=0,408).The increase in the perception of boring (B=0,255), demotivation (B=0,244) and anxiety (B=0,409) during the confinement was also associated to weigh gain during this period, meanwhile those who experienced an increase in the feeling of strength presented a lower risk (B=-0,536). Introduction: situations characterized by a high emotional load might favor weight gain. Objectives: the aim of the present study was to evaluate the association between eating behavior phenotype, emotions and feelings perception and weight gaining in the context of COVID-19 pandemia. Materials and methods: a transversal, descriptive study was carried out by means of an online survey on adults participants, residents in Argentina. The evaluation consisted of demographic and anthropometric data, physical activity level, sleep habits and eating behavior phenotype. The increase in the perception of different emotions and feeling during the confinement was evaluated. Results: 2,619 participants (84.9 females, mean age 39.27±15.21 year old). 40.3% of the subjects reported having gained weight during the confinement. 77.3% of the subjects showed some sort of sleep disturbance. The main feelings and emotions that were reported to have increased were anxiety (50.7%), demotivation (45.1%) and sadness (38.9%). Logistic regression model evidenced that the diminishment in physical activity during the confinement, as well as basal body mass index were associated to weight gain. The hedonic eater eating behavior phenotype predicted weight gain (B=0,408).The increase in the perception of boring (B=0,255), demotivation (B=0,244) and anxiety (B=0,409) during the confinement was also associated to weigh gain during this period, meanwhile those who experienced an increase in the feeling of strength presented a lower risk (B=-0,536). Conclusions: the hedonic eater eating behavior phenotype and the perception of negative emotions were associated to weight gaining in the context of the confinement. This remarks the importance of the addressing emotional aspects and identifying individual eating behavior phenotypes in order to promote adequate preventive strategies. Key words: COVID-19; obesity; hedonic eater, eating behavior phenotypes.

Inadecuación de micronutrientes en adolescentes y adultos argentinos de población urbana. Resultados del Estudio Latinoamericano de Nutrición y Salud (ELANS)

Introduction: knowing the deficiency of micronutrients intake is essential to develop intervention strategies and to evaluate programs aimed at improving nutritional status. Objectives: to determine the consumption and inadequacy of the intake of iron, calcium, zinc, folic acid and vitamins A, B12, C, D and E, in the diet of the Argentine population. Materials and methods: the sample consisted of 1,266 individuals (urban population 15-65 years old), stratified by region, age, sex and socioeconomic level (SEL). Intake data was collected with two 24-hour reminders (R24). Results: the relative risk (RR) of inadequate intake of calcium, folic acid, and vitamin B12 was higher for women. Iron consumption and inadequacy showed significant differences by sex (0.3% men, 11% women). Vitamin D inadequacy was almost 100% for the entire sample. All age groups presented high prevalence of inadequacy in calcium and vitamins C, A and D. Adolescents, adults over 50 years and the low SEL population presented a higher RR of calcium inadequacy (1.18, 1.21 and 1.17, respectively). A significant decrease in the average consumption of calcium (mg) (856.4, 770.5, 745.3), vitamins A (mcg) (643.6, 601.8, 536.2), C (mg) (54.2, 52.3, 44.8) and D (mcg) (3.7, 3.7, 3.2) was observed as the SEL decreased. Calcium inadequacy increased significantly with the body mass index. Conclusions: improving the intake of deficient micronutrients through public policies based on food education and scientific development is a public health priority.

Déficit de vitamina B12 en grupos vulnerables con alimentación omnívora

Introduction: vitamin B12 plays an essential role in growth and neurodevelopment. Vitamin B12 deficiency is a public health problem in Argentina, with a high prevalence in a highrisk population, such as pregnant women and children with a vulnerable social situation, although their omnivorous diet. Objectives: to update the information available on vitamin B12 deficiency in vulnerable populations, in order to highlight the importance of the subject, to achieve an early diagnosis and timely treatment and thus prevent irreversible complications. Results: it is important that the pediatrician knows the different types of vitamin B12 deficiency presentation and to consider it as a differential diagnosis in children with neurological symptoms, even in the absence of anemia, to achieve early interventions and diminish the burden of disease. Many researchers have concluded that an isolated marker can lead to misdiagnoses, so it is currently recommended to use at least two. Most of the treatments evaluated, agree on the administration of 1 mg of B12, for 7 to 10 days, either intramuscular or orally, followed by 3 to 11 weeks of a weekly dose. Conclusions: it is important to update data on the prevalence of B12 deficiency in our country, as well as the implementation of therapeutic interventions and preventive public policies.

Evaluación del consumo de grasas en pacientes con diabetes mellitus tipo 2 que asisten a un centro asistencial de la ciudad de Rosario

Introduction: the evidence showed that fats have a role in diabetes development. Even though fat ideal amount in this pathology`s treatments controversial; it is known that fat quality is more important that fat quantity. Objectives: to assay the fat intake in type 2 diabetes (T2D) patients who attended in a health care center in Rosario. Materials and methods: a descriptive, observational and cross-sectional study was conducted. The sample included 88 male and female adults, with T2D aged 45.55±12.33. The total energy, total fat, satured, unsatured fatty acids and cholesterol intakes were estimated through three 24-hour food recall instruments and then were compared with recommended values. Statistical analysis was performed using R statistical software 4.0.2 version. Results: mean total energy intake was 1851 kcal. Mean total fat intake was 43.30%, satured fatty acid intake 13.44%, monounsatured 14.10%, polyunsatured 12.86% and choresterol 388.55 mg. Total fat, satured and monounsatured fatty acids and cholesterol intakes were significantly higher in men (p=0.008, p=0.004, p=0.023, p=0.027; respectively). The 78.41% exceeded total fat intake. Satured fatty acid intake was inadequate in 99% of participants. The 92% had a monounsatured intake adequate to recommendations. Polyunsatured fatty acid showed an inadequate intake in 68% of patients. Cholesterol intake was inadequate in 83% of participants. There were not found significant differences in adherence to recommendations between sex. Conclusions: more than a half of T2D patients show and excessive total fat intake with inadequate intakes of saturated and polyunsaturated fatty acids and cholesterol. Only monounsaturated fat intake was adequate to recommendations.

Importancia de los ácidos grasos omega 3 en la salud

Omega 3 fatty acids are polyunsaturated fatty acids, essential since the human body does not produce them and they are obtained mainly from the diet. They confer flexibility, fluidity and selective permeability to the membranes, which favors cardiovascular health, reduces the risk of deficiencies in vision and neural development in infants and children, and dementia in older adults; some of them are precursors in the synthesis of prostaglandins. Some effects have also been seen in the prevention and treatment of coronary heart disease, hypertension, diabetes, arthritis, inflammation, autoimmune disorders, and cancer. These effects can be explained through the specific actions of each of them. Dietary fat influences the modulation of immune functions and inflammatory processes; most of the impact is attributed to long-chain polyunsaturated fatty acids (LCPUFA). The EPA exerts: hypotriglyceridemic effect at LDL and VLDL level; hypocholesterolemic effect due to increase in bile efflux and reverse cholesterol transport; antithrombotic effect due to the formation of Series 3 eicosanoids. DHA: increases the fluidity of neuronal, glial, and cone and rod membranes; decreases neuronal apoptosis; facilitates the recycling of neurotransmitters; regulates the expression of enzymes involved in lipid metabolism as a ligand for PPARs; inhibits insulin resistance to muscle and fat tissues. The intake recommendations are: 6 polyunsaturated fatty acids: 2.5-9% of energy intake/daily, and ω3 polyunsaturated fatty acids: 0.6-2.0% of energy intake/daily. Key words: omega-3 fatty acids; food sources; immune system; pathologies.