NAFLD is the world’s most common chronic liver disease, and its increasing prevalence parallels the global rise in diabetes and obesity. It is characterised by fat accumulation in the liver evolving to non-alcoholic steatohepatitis (NASH), an inflammatory subtype that can lead to liver fibrosis and cirrhosis. Currently, there is no effective pharmacotherapeutic treatment for NAFLD. Treatment is therefore based on lifestyle modifications including changes to diet and exercise, although it is unclear what the most effective form of intervention is. The aim of this review, then, is to discuss the role of specific nutrients and the effects of different dietary interventions on NAFLD. It is well established that an unhealthy diet rich in calories, sugars, and saturated fats and low in polyunsaturated fatty acids, fibre, and micronutrients plays a critical role in the development and progression of this disease. However, few clinical trials have evaluated the effects of nutrition interventions on NAFLD. We, therefore, summarise what is currently known about the effects of macronutrients, foods, and dietary patterns on NAFLD prevention and treatment. Most current guidelines recommend low-calorie, plant-based diets, such as the Mediterranean diet, as the most effective dietary pattern to treat NAFLD. More clinical trials are required, however, to identify the best evidence-based dietary treatment approach.

The “legacy effect” describes the long-term benefits that may persist for many years after the end of an intervention period, involving different biological processes. The legacy effect in cardiovascular disease (CVD) prevention has been evaluated by a limited number of studies, mostly based on pharmacological interventions, while few manuscripts on dietary interventions have been published. Most of these studies are focused on intensive treatment regimens, whose main goal is to achieve tight control of one or more cardiovascular risk factors. This review aims to summarise the legacy effect-related results obtained in those studies and to determine the existence of this effect in CVD prevention. There is sufficient data to suggest the existence of a legacy effect after intensive intervention on cardiovascular risk factors; however, this effect is not equivalent for all risk factors and could be influenced by patient characteristics, disease duration, and the type of intervention performed. Currently, available evidence suggests that the legacy effect is greater in subjects with moderately-high cardiovascular risk but without CVD, especially in those patients with recent-onset diabetes. However, preventive treatment for CVD should not be discontinued in high-risk subjects, as the level of existing evidence on the legacy effect is low to moderate.

ResumenIntroducción: la nutrición parenteral (NP) en la infancia es un tratamiento cuyas características son muy variables en función de la edad y la patología que presente el paciente. Material y métodos: el grupo de Estandarización y Protocolos de la Sociedad Española de Nutrición Parenteral y Enteral (SENPE) es un grupo interdisciplinar formado por miembros de la SENPE, Sociedad Española de Gastroenterología, Hepatología y Nutrición Pediátrica (SEGHNP) y Sociedad Española de Farmacia Hospitalaria (SEFH) que pretende poner al día este tema. Para ello, se ha realizado una revisión pormenorizada de la literatura buscando las evidencias que nos permiten elaborar una Guía de Práctica Clínica siguiendo los criterios del Oxford Centre for Evidence-Based Medicine. Resultados: este manuscrito expone de forma resumida las recomendaciones en cuanto a indicaciones, vías de acceso, requerimientos, modifi caciones en situaciones especiales, componentes de las mezclas, prescripción y estandarización, preparación, administración, monitorización, complicaciones y NP domiciliaria. El documento completo se publica como número monográfi co. Conclusiones: esta guía pretende servir de apoyo para la prescripción de la NP pediátrica. Constituye la base para tomar decisiones en el contexto de la evidencia existente. Ninguna guía puede tener en cuenta todas las circunstancias clínicas individuales. Abstract

Objective:Heart failure is a major public health problem and one of the leading causes of ospitalisation and death. Since HFPEF increases with age, it is an increasingly worrisome health problem in countries with higher life expectancies. Since the influence of BP is essential in HFPEF, and its control in the outpatient is not clear, we propose to evaluate this variable in a retrospective cohort.Design and method:Retrospective study of patients with HFPEF, older than 80 years, followed up in outpatient consultation after ospitalisation for HF, in a Teaching Hospital. Data were obtained from electronic medical records with prior authorization from the Ethics Committee.Results:106 patients were included. For analysis we use a cut-off point of SBP (measured in the office at the first visit) below 90 mmHg, between 90 and 139 mmHg and equal or above 140 mm Hg. For DBP we used a a cut-off point of DBP od 70 mmHg. As for the characteristics the only differences were that those with Low SBP had significantly lower LVEF as those with normal or high SBP (54% vs 59 p 0.035). As for DBP, those with low DBP had significantly lower Heart Rate than those with High DBP (72 bpm vs 79 bpm, p 0.039) There were no mortality differences between those with low SBP, normal SBP and high SBP, neither on those with low DBP or Normal High DBP. Kaplan Meier curve showed a non-significant trend to higher mortality on those with lower BPConclusions:In our study, we have not observed differences in mortality between those patients with BP with good control versus those with poor control.Although there may be a selection bias and this is a retrospective study, more studies are needed to assess the influence of BP controls on the evolution of HF in octogenarian patients