Gestión del tratamiento dietético cuali-cuantitativo en el sobrepeso y la obesidad: metodología y una nueva perspectiva de asesoramiento individualizado

%WL: porcentaje de pérdida de peso; %FL: porcentaje de pérdida de grasa. Objetivo: describir la metodología en la gestión del tratamiento dietético cuali-cuantitativo en el sobrepeso y la obesidad. Método: se llevaron a cabo 4.625 consultas con 616 pacientes mayores de 25 años con sobrepeso y obesidad, en el sur-este de España, durante los años 2006-12. Se utilizó una dieta equilibrada, hipocalórica, cuali-cuantitativa con alimentos de la zona. Se describió la metodología del tratamiento dietético en la pérdida y el mantenimiento. Se trató qué unidades de medida son adecuadas para la expresión del éxito en la pérdida; una nueva visión del asesoramiento individualizado y el tratamiento multidisciplinar. Resultados: el 80% de los pacientes obtienen un %FL ≥ 5% (22,6 ± 11,8 - 11,2 ± 7,4), y asistieron a la consulta más de mes y medio. Conclusión: se presenta un esquema de la metodología del tratamiento dietético; se han recomendado las unidades de medidas a utilizar en consulta y en la publicación de ensayos clínicos, creando un precedente con grado de evidencia de cómo determinar la pérdida exitosa; se recomienda medir los perímetros de cadera y cintura, e incorporar el estudio de la imagen corporal; se presenta una nueva visión del asesoramiento individualizado y una atención multidisciplinar avanzada, independiente de la edad, el estado de gestación y las minusvalías físicas. La postura del sanitario debe de ser considerada como el gestor encargado de determinar qué técnicas podrían ser más efectivas en dicha pérdida.

Indicators of success in the dietary management of overweight and obesity: weight, body fat loss and quality

Concepts: %WL: Percentage of weight loss; %FL: Percentage of fat loss. Objective: evaluate which unit of measurement for weight loss could determine the success or failure of dietary treatment for overweight and obesity. Method: 4,625 consultations carried out on 616 patients in the southeast of Spain from 2006 to 2012. All of the patients were over 25 years of age and suffered from overweight or obesity. The consultations were carried out every fortnight, using the Mediterranean or low-calorie diet. The patients were divided into four groups according to their %WL and %FL. Results: most of the sample consisted of: women; participants between 25-45 years of age; attended consultations for over a month and a half; obese. 80% of the patients obtained a %FL ≥ 5% (15.5 ± 12.8). The groups with a higher %FL obtained significant differences in weight loss (22.6 vs 11.2%, p = 0.000). The multinomial analysis shows significant differences between the groups with the highest %FL and the lowest %WL and %FL: sex (p = 0.006 vs p = 0.005), BMI (p = 0.010 vs p = 0.003) and attendance (p = 0.000 vs p = 0.000). Conclusion: the patients who lost < 5% of fat had higher initial parameters (percentage of weight and fat); most of the sample lost ≥ 5% of fat. This means that the method of personalised dietary treatment results in a high fat loss; fat is an indicator of the quality loss obtained. Recommendations: use the measurement of fat as a complementary unit of measurement to weight loss; establish a limit of 5% to evaluate such loss; and increase this type of research in any method of weight loss.

Colour morphotypes of Elysia timida (Sacoglossa, Gastropoda) are determined by light acclimation in food algae

Elysia timida (Risso, 1818) colonizing the shallow waters of the Mar Menor Lagoon (Spain) exhibit a brown and a green morph. It was hypothesised that these morphs were the result of feeding preferentially on brown and green algae, respectively. E. timida and its potential food sources, Acetabularia acetabulum (Chlorophyta) and Halopteris filicina (Heterokontophyta) were collected by snorkelling during April 2010. Photosynthetic pigments were analysed by HPLC, photo-physiological parameters were estimated by PAM fluorometry and body colour was characterized by spectral reflectance. Digital photography was used to count the number and area of red spots (small red dots on the slug’s surface) on the parapodia of the 2 morphs. In the laboratory, green E. timida was fed with A. acetabulum cultured under 2 light treatments (high light, 600 µmol E m−2 s−1 and low light, 40 µmol E m−2 s−1), and digital photography was used to monitor colour alterations in E. timida. Spectral reflectance confirmed the colour differences, but both morphs showed a pigment composition similar to the green alga A. acetabulum and showed none of the pigments present in the brown alga H. filicina, neither immediately after collection of the slugs in situ, nor after the feeding experiment. A. acetabulum grown under high light intensity changed from green to brown colour and E. timida changed to brown colour when fed with high-light acclimated A. acetabulum. Thus, E. timida colour differences could not be attributed to feeding on different algae groups but was likely the result of feeding on A. acetabulum growing under different light intensities.