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With the increase of life expectancy, the desire to maintain good health, functionality and maximum quality of life at advanced ages, for which nutrition plays a critical role, is a priority for the elderly. Though genetic factors are a determinant of life expectancy, there are several extrinsic factors which have a great influence on the quality of life of the elderly. Diet and nutritional status have a great influence, especially in the prevention and treatment of several diseases, which affect this heterogeneous and vulnerable age group. The nutritional status and needs of elderly people are associated with age-related biological, psychological and often socio-economic changes. All of these changes can increase the risk of developing a number of age-related diseases. In developed countries the elderly are the most affected by malnutrition, either because of a deficiency (energy and several nutrients) or an excess, leading to obesity and related diseases. This review highlights the most important factors affecting nutritional status in elderly people and focus on the need to maintain adequate physical activity level and an optimal physic, psychic and social functional capacity. It discusses dietary reference intakes and guidelines to improve and/or maintain adequate nutritional status in older people in order to reduce susceptibility to some illness and disease.

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La publicación de las nuevas Ingestas Dietéticas de Referencia (DRI, Dietary Reference Intakes) por parte del Instituto de Medicina de EEUU desde finales de 1997, ha supuesto una completa renovación del concepto de las ingestas recomendadas de energía y nutrientes. Además de establecer el estado actual del conocimiento científico para cada uno de los nutrientes, de emplear nuevos criterios con una tendencia clara hacia la medicina preventiva e incluir por primera vez no nutrientes, están sirviendo de referencia para otros países y facilitan su aplicación mediante la introducción de nuevos conceptos. Uno de los mayores problemas de los estudios epidemiológicos nutricionales de los últimos años ha sido establecer el estado nutricional real de los grupos de población estudiados, debido a que con frecuencia se limitan a comparar los datos de ingesta de nutrientes obtenidos con las RDA (Recommended Dietary Allowances). Esto puede llevar a obtener conclusiones erróneas. Por tanto, resulta de enorme trascendencia que en las DRI se den a conocer las bases estadísticas y la metodología correcta para realizar la valoración del estado nutricional mediante datos dietéticos. En el presente artículo se detallan estos nuevos conceptos y se analizan mediante un ejemplo (AU)

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Con el incremento de la esperanza de vida, el deseo de mantener una buena salud, funcionalidad y una máxima calidad de vida en edades avanzadas constituye una prioridad en las personas mayores. Aunque la genética es un determinante de esta expectativa de vida, existen otros factores extrínsecos directamente implicados en la calidad de vida del anciano, entre los que cabe destacar la alimentación. La dieta y el estado nutricional tienen gran influencia, particularmente en la prevención o tratamiento de diversas enfermedades que afectan a este grupo, uno de los más heterogéneos y vulnerables de la población de los países desarrollados con un mayor riesgo de sufrir desequilibrios, carencias y problemas nutricionales. Esto es debido, por un lado, a que las necesidades de algunos nutrientes pueden ser mayores que en etapas anteriores y, por otro, a su menor capacidad para regular todos los procesos relacionados con la ingesta de alimentos como consecuencia del progresivo deterioro de casi todas las funciones biológicas. Los numerosos cambios físicos, psíquicos y sociales que acompañan al envejecimiento y la mayor prevalencia de enfermedades crónicas, también contribuyen a esta situación. Diversos estudios han puesto de manifiesto el riesgo de ingestas inadecuadas y de malnutrición proteico-energética, aumentando la vulnerabilidad a otras enfermedades. En este trabajo se hace una revisión de los principales condicionantes del estado nutricional en el anciano, de la importancia de la capacidad funcional física, psíquica y social y de la actividad física y de su repercusión en el estado nutricional. Se describen las ingestas de referencia y las recomendaciones dietéticas más actuales, tratando de establecer las condiciones dietéticas y de estilo de vida que pueden contribuir a preservar las funciones corporales y minimizar las enfermedades crónicas en las personas de edad (AU)

With the increase of life expectancy, the desire to maintain good health, functionality and maximum quality of life at advanced ages, for which nutrition plays a critical role, is a priority for the elderly. Though genetic factors are a determinant of life expectancy, there are several extrinsic factors which have a great influence on the quality of life of the elderly. Diet and nutritional status have a great influence, especially in the prevention and treatment of several diseases, which affect this heterogeneous and vulnerable age group. The nutritional status and needs of elderly people are associated with age-related biological, psychological and often socio-economic changes. All of these changes can increase the risk of developing a number of age-related diseases. In developed countries the elderly are the most affected by malnutrition, either because of a deficiency (energy and several nutrients) or an excess, leading to obesity and related diseases. This review highlights the most important factors affecting nutritional status in elderly people and focus on the need to maintain adequate physical activity level and an optimal physic, psychic and social functional capacity. It discusses dietary reference intakes and guidelines to improve and/or maintain adequate nutritional status in older people in order to reduce susceptibility to some illness and disease (AU)

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BACKGROUND: Adolescence is a decisive period in human life due to the multiple physiological and psychological changes that take place. These changes will condition both nutritional requirements and eating/physical activity behavior. It has been demonstrated that these "adolescence" factors are of significant influence in health status during adult life. Due to its importance and adequate development the project has been granted by the Fondo de Investigación Sanitaria of the Institute of Health Carlos III. OBJECTIVE: To develop a methodology to evaluate the health and nutritional status of a representative population of Spanish adolescents. Specific attention is paid to three specific health problems: obesity, anorexia nervosa/bulimia, dislipidemia. METHODOLOGY: The following magnitudes will be studied: 1) dietary intake, food habits and nutrition knowledge; 2) daily physical activity and personal approach; 3) physical condition; 4) anthropometry and body composition; 5) hematobiochemical study: plasma lipid phenotypic and metabolic profile, blood cell counts; 6) genotipic profile of cardiovascular risk lipid factors; 7) immune function profile related to nutritional status; 8) psychological profile. CONCLUSION: This project includes the co-ordinate activity of five Spanish centers of five different cities (Granada, Madrid, Murcia, Santander, Zaragoza). Each center is specialized in a specific area and will be responsible for the corresponding part of the study. From the data obtained, we will elaborate a specific intervention program in order to improve nutrition and neutralize the risk for nutritional related problems in adolescence. By this, we will contribute to improve the health status of the Spanish population in the new millennium.

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BACKGROUND: In the last decade, research in the field of nutrition has grown both in width and depth, and has incorporated the advances of other scientific fields, like artificial intelligence theories. Specifically in the case of recommended nutrient intakes, the fuzzy theory is an interesting contribution to the development of a new concept for the recommendations. The recommended intakes have passed from avoiding deficiency status to preventing several pathological aspects and reducing risk factors. OBJECTIVE: To establish whether the recommended dietary intakes for Spain (IREs) must be reviewed, taking into account the current scientific state of the art. METHODS: We have compared IREs, published in 1994, with the recently published 'Dietary Reference Intakes' (DRIs) for the American and Canadian population, the 'Referenzwerte für die Nährstoffzufuhr' (DACH) for the German, Swiss and Austrian population. In addition, the main guidelines of the EURODIET criteria (Nutrition and Diet for Healthy Lifestyles), which was developed for the population of the European Union Member States, were taken into account. As an example, comparisons were made for the elderly population group, establishing differences and similarities between the different scientific communities and the adequacy of Spanish recommended intakes for energy and nutrients. RESULTS: Recommended intakes for folate, calcium and vitamins C, D and E are lower in the IREs and probably should be increased. Recommended intakes for nutrients which have not previously been included in the IREs, such as vitamin K, selenium, copper, chromium, molybdenum, manganese, phosphorus, sodium, potassium, and water need to be developed. CONCLUSIONS: The current recommended intakes for the Spanish population need to be reviewed in order to encompass current scientific knowledge. Moreover, the opportunity to include non-nutrients (bioactive compounds) should be considered.

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