This document seeks to lay down a set of recommendations and to identify key issues that may be useful for the nutritional management of cancer patients.

Introduction: Carnitine is an endogenous metabolite and exogenous nutrient with a pivotal role in lipid metabolism. Plasma levels of carnitine are reduced in type 2 Diabetes Mellitus (T2DM). The aim was to evaluate the metabolic effects of the administration of L-carnitine in T2DM. Method: A systematic review was performed. Relevant randomized, controlled-trials trials were searched in Pubmed, Trip Database and Cochrane Library, and selected when they had enough methodological quality assessed with the Jadad scale. Article search strategy included ?Carnitine? OR ?L-carnitine? AND ?Diabetes ?Mellitus? OR ?Diabetes mellitus, type 2? OR ?Noninsulindependent-diabetes mellitus?. Meta-analysis was performed, and the difference of means calculated with a 95% confidence interval. Heterogeneity was evaluated with the Q statistic. Results: The systematic review included 4 trials with 284 patients. Oral L-carnitine lowered fasting plasma glucose [?14.3?mg/dl (CI95% ???23.2 to ?5.4); p=0,002], total cholesterol [?7.8?mg/dL (95%CI ?15.5 to ?0.1); p=0.09], low density lipoprotein [?8.8?mg/dl (CI95% ?12.2 to ?8.5), p<0.0001], apolipoprotein-B100 [?7.6?mg/dl (CI95% ?13.6 to ?1.6); p=0.013] and apolipoprotein-A1 [?6.0?mg/dl (CI95% ?10.5 a ?1.5); p=0.523]. There was no significant heterogeneity. The changes in triglycerides, lipoprotein (a) or HbA1c were not significant. Conclusion: The administration of L-carnitine in type 2 diabetes mellitus is associated with an improvement in glycaemia and plasma lipids.

The strongest risk factor for childhood and adolescent obesity is parental obesity, and studies show that the strong predictive value of parental BMI results mainly from genetic rather than environmental factors (1,2). Therefore, the study of obese subjects from families with a high occurrence of obesity might reflect a stronger heritable component and prove helpful to increase the potential for detecting genetic associations. Several genome-wide association studies in European populations have identified that genetic variants located in the fat mass and obesity associated (FTO) gene are associated with increased risk of developing obesity (3). In an attempt to finely map the region where the initial signals were described, >100 common single nucleotide polymorphisms (SNPs) across the associated region where the FTO gene lies have been genotyped in populations of different ancestry. The principal signal is found for rs9939609, an SNP which lies in a cluster of highly correlated variants located in a linkage disequilibrium (LD) block of about 47 kb that encompasses parts of the first two introns and exon 2 of the FTO gene (4-6).The aim of this work was to investigate the LD block structure of a 448.4-kb region surrounding the candidate rs9939609 SNP and perform haplotype analyses in order to identify the best SNP combination that could explain the susceptibility to severe early onset obesity. Methods and Procedures Patients and controlsWe selected probandi who reached a weight greater than (mean + 3 s.d.) before 14 years of age and who referred at least two other morbid obesity cases among first-or second-degree relatives. We consider the existence of grade 3 overweight (commonly called morbid obesity) to be a BMI ≥40 kg/m 2 ; in children this corresponds to a BMI greater than the 95th percentile for age-and sex-matched control subjects from our population data.After their completion of an informed consent form, 202 patients were selected for study of their genetic risk profiles of polygenic/nonsyndromic Childhood and adult obesity have been widely associated with FTO genetic variability in different populations. This study aimed to investigate the linkage disequilibrium (LD) block structure of a region surrounding the candidate rs9939609 SNP and determine the best single nucleotide polymorphism (SNP) combination that explains the higher proportion of variability observed in children with severe obesity, including obese subjects from families with a very high occurrence of obesity. A sliding window approach pointed to a block containing the rs1477196/rs17817449/ rs9939609 haplotype (P value 3.1 × 10 −8 ). Carriers of the GGA combination had an increased risk of obesity (odds ratio (OR) 2.07, 95% confidence interval (CI) 1.41-3.04, P = 2.0 × 10 −4 ) with respect to those individuals with the reference ATT haplotype. A further SNP, rs9921255, also showed association with obesity (P = 8.3 × 10 −4 , OR 1.77; 95% CI 1.15-2.74 and OR 5.78; 95% CI 1.22-27.49 for heterozygotes and homozygotes, respectively) and did not s...

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I deficiency is still a worldwide public health problem, with children being especially vulnerable. No nationwide study had been conducted to assess the I status of Spanish children, and thus an observational, multicentre and cross-sectional study was conducted in Spain to assess the I status and thyroid function in schoolchildren aged 6-7 years. The median urinary I (UI) and thyroid-stimulating hormone (TSH) levels in whole blood were used to assess the I status and thyroid function, respectively. A FFQ was used to determine the consumption of I-rich foods.

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Objetivo: comunicar los datos de nutrición parenteral domiciliaria (NPD) obtenidos del registro del grupo NADYA-SENPE (www.nadya-senpe. com) del año 2017.Material y métodos: análisis descriptivo de los datos recogidos de pacientes adultos y pediátricos con NPD en el registro NADYA-SENPE desde el 1 de enero al 31 de diciembre de 2017.Resultados: se registraron 308 pacientes (54,5% mujeres), 38 niños y 270 adultos, procedentes de 45 hospitales españoles, en total 312 episodios, lo que representa una tasa de prevalencia de 6,61 pacientes/millón de habitantes/año 2017. El diagnóstico más frecuente en adultos fue “oncológico paliativo” (25,6%), seguido de “otros”. En niños fue la enfermedad de Hirschsprung, con seis casos (15,8%). El primer motivo de indicación fue síndrome de intestino corto tanto en niños (55,3%) como en adultos (33,7%). El tipo de catéter más utilizado fue el tunelizado tanto en niños (74,3%) como en adultos (38,2%). Finalizaron 81 episodios; la causa más frecuente fue el fallecimiento (62,9%) y que pasaron a vía oral (34,7%).Conclusiones: se mantiene el incremento progresivo de centros y profesionales colaboradores en el registro de pacientes que reciben NPD. Las principales indicaciones de NPD y de motivo de finalización se mantienen estables.

Background: There is no established insulin regimen in T2DM patients receiving parenteral nutrition. Aims: To compare the effectiveness (metabolic control) and safety of two insulin regimens in patients with diabetes receiving TPN.