¿Es suficiente el recurso humano nutricionista en el sistema hospitalario público en Chile?: Una deuda pendiente / Adequacy of nutritionist (dietician) resources in Chilean public hospitals

Background: Human resource deficit is an important management problem in Chilean public hospitals. Aim: To analyze the adequacy of Nutritionist (Dietician) resources in public hospitals. Material and Methods: A questionnaire about Nutritionist resources was sent to head Nutritionists of all public Chilean hospitals, asking about the number of Nutritionists per service, number of hospital beds and number of daily rations served. Results were analyzed based on the Technical Guideline about Nutritional and Feeding Services of public hospitals issued by the Chilean Ministry of Health in 2005. Results: According to the guideline, there should be 1,396 nutritionists working in public hospitals and the results of the survey showed that there were only 603 professionals with a 57% deficit. Conclusions: There is a huge gap between the amount of Nutritionists (Dieticians) required and those effectively working in public hospitals.

Guías alimentarias y su cumplimiento en estudiantes universitarias, Valparaíso, 2013, Chile / Dietary guidelines and compliance in college students, Valparaíso, 2013, Chile

Increased cardiovascular risk factors in young women merit knowing their nutritional profile. The objective of this study was to determine the food consumption of 50 volunteer college students enrolled in physical education (PE), early childhood education (ECA) and nutrition and dietetics (NAD) at the University of Playa Ancha, Valparaiso, Chile. A food frequency questionnaire was used to measure critical nutrient intake (sodium, sugars, saturated fatty acids, trans-fatty acids, cholesterol). Cardiovascular risk factors like alcohol intake were also measured as well as protective nutrients intake (mono and polyunsaturated fatty acids, water, dietary fiber). Consumption frequency was ranked high, moderate and low. Critical and protective nutrients were compared with the Chilean Dietary Guidelines 2013. Results: PE students' diet was high in sodium and dietary fiber; PE and EPA diet was high in added sugars and low in water; the diet of all groups was low in mono and polyunsaturated fatty acids, moderate in saturated fatty acids, trans-fatty acids and cholesterol, and low in alcohol. We conclude that the diets do not meet the recommendations of the Dietary Guidelines.

El aumento de los factores de riesgo cardiovascular en mujeres jóvenes amerita conocer su perfil nutricional. El objetivo del presente estudio fue conocer el consumo alimentario de 50 universitarias voluntarias de educación física (EFI), educación parvularia (EPA) y nutrición y dietética (NYD) de la Universidad de Playa Ancha, Valparaíso, Chile. Se usó un cuestionario de frecuencia para conocer consumo de nutrientes críticos (sodio, azúcares, ácidos grasos saturados, trans, colesterol y además de alcohol, factor riesgo cardiovascular) y protectores (ácidos grasos protectores mono y poliinsaturados, agua, fibra dietética). La frecuencia del consumo se clasificó en alto, moderado, bajo. Los nutrientes críticos y protectores fueron comparados con las guías alimentarias de Chile 2013. Resultados: EFI, fue alto en sodio y fibra dietética; EFI, EPA alto en azúcares agregados y bajo en agua. EFI, EPA NYD estuvieron bajos en ácidos grasos mono y poliinsaturados, moderado en ácidos grasos saturados, trans y colesterol y el alcohol bajo en los tres grupos. Lo observado, no consigue las recomendaciones de consumo de las guías alimentarias.

[Adequacy of nutritionist (dietician) resources in Chilean public hospitals]. / ¿Es suficiente el recurso humano nutricionista en el sistema hospitalario público en Chile?: Una deuda pendiente.

BACKGROUND: Human resource deficit is an important management problem in Chilean public hospitals. AIM: To analyze the adequacy of Nutritionist (Dietician) resources in public hospitals. MATERIAL AND METHODS: A questionnaire about Nutritionist resources was sent to head Nutritionists of all public Chilean hospitals, asking about the number of Nutritionists per service, number of hospital beds and number of daily rations served. Results were analyzed based on the Technical Guideline about Nutritional and Feeding Services of public hospitals issued by the Chilean Ministry of Health in 2005. RESULTS: According to the guideline, there should be 1,396 nutritionists working in public hospitals and the results of the survey showed that there were only 603 professionals with a 57% deficit. CONCLUSIONS: There is a huge gap between the amount of Nutritionists (Dieticians) required and those effectively working in public hospitals.

Cambios en el consumo aparente de lácteos, bebidas azucaradas y jugos procesados en el Gran Santiago. Chile. 1987-2007: Changes in the consumption of dairy products, sugary drinks and processed juices in the Chilean population

Background: Nowadays, Chilean population tends to replace or eat a lower amount of food with health protective properties and a higher proportion of unhealthy foodstuff. Aim: To describe and compare the intake of dairy products, sugary drinks and processed juices among Chileans. Material and Methods: An analysis of data compiled from the Survey on Household Budget and Expenses carried out by the Chilean National Institute of Statistics (INE), using a representative sample of households. The sample was surveyed between 1987 and 2007. The analysis was performed for all households surveyed and for households belonging to the second (highest incomes) and fifth quintile (lowest incomes). The Chilean Food Guide and the international recommendations of the Institute of Medicine of the United States and the American Heart Association (in the case of sugars) were used as reference. Results: Even though the intake of dairy products increased during the period of the survey, it was lower than the intake of sugary drinks and juices, which increased. Also, calcium recommendations were not covered. On the other hand, the intake of added sugars increased to figures over current recommendations. Conclusions: The intake of dairy products and calcium is below the recommended amounts established by international organisms, and added sugars intake is greater than the advisable levels recommended by international organisms.

[Household availability of ready-to-consume food and drink products in Chile: impact on nutritional quality of the diet]. / Disponibilidad de productos alimentarios listos para el consumo en los hogares de Chile y su impacto sobre la calidad de la dieta (2006-2007).

BACKGROUND: Processed foodstuff may have a lower nutritional value than natural products. AIM: To analyze the impact of ready-to-consume products on diet quality of Chilean households. MATERIAL AND METHODS: A national representative sample of 10,096 households, based on the 6th Survey on Household Budget and Expenses (VI Encuesta de Presupuestos y Gastos Familiares, 2006-2007), was studied. Foodstuffs were classified as follows: 1) Unprocessed foods or minimally processed foods (G1); 2) Processed culinary ingredients (G2); and 3) Ready-to-consume products (G3). Calorie contribution and energy availability of each household food group, was calculated. The nutritional profile of the national food basket was calculated and compared with two simulated baskets (G3 vs G1+G2), based on international nutritional recommendations. RESULTS: Overall energy availability was of 1,885 kcal per capita/ day; 24% derived from unprocessed foods (G1), 21% from processed culinary ingredients (G2) and 55% from ready-to-consume products (G3), whose proportion increased along with income level. The 2007 national food basket contained an excess of total fat (34% vs 30%), free sugars (16% vs 10%), energy density (2.1 vs 1.3 kcal/gram) and a low amount of fiber (8.4 vs 12.5 g/1,000 kcal). The basket consisting in ready-to-consume products (G3) had a higher percentage of carbohydrates (61% vs 46%) than the basket consisting in unprocessed foods and ingredients (G1+G2). It also had a higher percentage of free sugars (17% vs 15%), less dietary fiber (7 vs. 10 g/1,000 kcal) and, above all, a higher energy density (2.6 vs 1.6 kcal/g). CONCLUSIONS: The Chilean dietary pattern, based on ready-to-consume products (G3), is affecting the nutritional quality of the diet.

Disponibilidad de productos alimentarios listos para el consumo en los hogares de Chile y su impacto sobre la calidad de la dieta (2006-2007) / Household availability of ready-to-consume food and drink products in Chile: impact on nutritional quality of the diet

Background: Processed foodstuff may have a lower nutritional value than natural products. Aim: To analyze the impact of ready-to-consume products on diet quality of Chilean households. Material and Methods: A national representative sample of 10,096 households, based on the 6th Survey on Household Budget and Expenses (VI Encuesta de Presupuestos y Gastos Familiares, 2006-2007), was studied. Foodstuffs were classified as follows: 1) Unprocessed foods or minimally processed foods (G1); 2) Processed culinary ingredients (G2); and 3) Ready-to-consume products (G3). Calorie contribution and energy availability of each household food group, was calculated. The nutritional profile of the national food basket was calculated and compared with two simulated baskets (G3 vs G1+G2), based on international nutritional recommendations. Results: Overall energy availability was of 1,885 kcal per capita/ day; 24% derived from unprocessed foods (G1), 21% from processed culinary ingredients (G2) and 55% from ready-to-consume products (G3), whose proportion increased along with income level. The 2007 national food basket contained an excess of total fat (34% vs 30%), free sugars (16% vs 10%), energy density (2.1 vs 1.3 kcal/gram) and a low amount of fiber (8.4 vs 12.5 g/1,000 kcal). The basket consisting in ready-to-consume products (G3) had a higher percentage of carbohydrates (61% vs 46%) than the basket consisting in unprocessed foods and ingredients (G1 + G2). It also had a higher percentage of free sugars (17% vs 15%), less dietary fiber (7 vs. 10 g/1,000 kcal) and, above all, a higher energy density (2.6 vs 1.6 kcal/g). Conclusions: The Chilean dietary pattern, based on ready-to-consume products (G3), is affecting the nutritional quality of the diet.

Estudio descriptivo de la frecuencia y duración de la publicidad alimentaria emitida en la programación de canales de televisión asociados a anatel / Descriptive study of the frequency and duration of food advertisement in the programming of the television channels members of the anatel group

The objective of this study was to analyze television advertisements from different TV channels which are part of the Chilean National Television Association. During one week in January and one week in February of 2010 the advertisements were screened. The analysis selected and classified food's advertising as healthy, moderately healthy and unhealthy based on food's critic nutritional components: total fat, saturated fat, carbohydrates and sodium using as reference a classification chart called "Traffic Light System" and created by the UK Food Standard Agency. Sixty thousand four hundred and twenty five (6.425) advertisements were registered and analyzed accounting for 56 hours and 36 minutes in total. One thousand forty five (1.045) advertisements were identified as food advertisements (16 percent) accounting for 7 hours and 42 minutes (14 percent) of the total. Nutritional labels of the products were studied in order to classify and select them as described above. From the total offood advertisements it was observed that 64 percent were related to unhealthy food; 27 percent to moderately healthy and 9 percent to healthy food; accounting for respectively 62 percent, 30 percent and 8 percent, respectively, of the total time reported on food advertisement. Food advertisements are mostly unhealthy, promoting food consumption with high levels of fat, sugar and sodium. The broadcasting of this type of advertisements by television promotes the population to follow unhealthy life styles which result in a deterioration of their health.

El objetivo de este estudio, fue describir la Publicidad Alimentaria emitida por los canales pertenecientes a la Asociación Nacional de Televisión. En una semana de enero y una de febrero del año 2010 se seleccionó y clasificó la publicidad alimentaria emitida como saludable, medianamente saludable y no saludable, en base al contenido de nutrientes críticos; grasa total, grasa saturada, hidratos de carbono simples y sodio. Se utilizó como criterio de referencia, la tabla de clasificación de la Agencia Nacional de Alimentos de Inglaterra, denominada "semáforo nutricional". Se registraron y analizaron 6425 anuncios correspondientes a 56 horas 36 minutos continuas de tiempo, de ellos, se identificaron 1045 anuncios alimentarios (16 por ciento), equivalente en tiempo a 7 horas 42 minutos (14 por ciento) del total. Se examinaron las etiquetas nutricionales de los productos para la selección y calificación en saludable, medianamente saludable y no saludable. Se observó, que del total de la publicidad alimentaria, el 64 por ciento correspondió a publicidad alimentaria no saludable; el 27 por ciento, a publicidad alimentaria medianamente saludable y, el 9 por ciento publicidad alimentaria saludable, con un tiempo de emisión de un 62 por ciento, 30 por ciento y 8 por ciento, respectivamente. La publicidad alimentaria emitida es principalmente no saludable, promueve el consumo de alimentos altos en grasa, azúcar y sodio. La televisión al emitir esta publicidad promueve e incentiva a la población a llevar estilos de vida no saludables, en desmedro de la salud de la población.

Consumo de suplementos nutricionales en gimnasios, perfil del consumidor y características de su uso / Nutritional supplement intake in gymnasium, consumer profile and charateristics of their use

Nowadays the great offer of dietary supplements (DS) in the market has led to a situation in which the use of these products are not only acquired by sportspersons but also to a great population related with physical activity. The main objective of our study was to know the characteristics of the DS consumers and to evaluate its consumption through a survey previously validated and applied to 314 users (198 males and 116 females) from 6 gyms in Viña del Mar. The results showed that more than half of the subjects consumed DS products (54.5 percent). Within male consumers, a 69.4 percent use these products in order to increase muscular mass, while within women, a 62.2 percent consumed them in order to diminish their body fat. There were 5 kinds ofDS products consumed the most: Proteins (55.6 percent), amino acids (25.9 percent), vitamins and minerals (25.1 percent), food substitutes (6.4 percent), caffeine (6.4 percent), and L-carnitine (6.4 percent). The consumer profile is represented by young male individuals, those who follow a special diet, with long practice in gym and who exercise several days a week. Much of consumers did not provide an adequate association between DSN used and the purpose of consuming these supplements.

La gran oferta de suplementos nutricionales (SN) dispuestos en el mercado, ha llevado a que el uso de estos productos no sea adquirido únicamente por deportistas, sino que por parte importante de la población relacionada con la actividad física. El objetivo de este estudio es conocer las características de los consumidores de SN, evaluando su consumo en 314 usuarios (198 hombres y 116 mujeres) de 6 gimnasios de la ciudad de Viña del Mar. Los resultados revelan que más de la mitad de los usuarios consumen SN (54,5 por ciento). De los hombres consumidores, un 69,4 por ciento lo realiza para aumentar masa muscular, mientras que del total de las mujeres, un 62,2 por ciento lo utiliza para disminuir grasa corporal. Los cinco tipos de SN más consumidos en relación a su composición de nutrientes y otras fuentes fueron: proteínas (55,6 por ciento), aminoácidos (25,9 por ciento), vitaminas y minerales (25,1 por ciento), sustitutivos de comida (6,4 por ciento), cafeína (6,4 por ciento) y L- carnitina (6,4 por ciento). El perfil del consumidor, está representado por individuos jóvenes, de sexo masculino, los que siguen una dieta especial de alimentación, con largo tiempo de práctica en gimnasio y que se ejercitan varios días y horas a la semana. Gran parte de los consumidores no presentó una adecuada asociación entre el SN utilizado y el objetivo de consumo de estos suplementos.

Estado nutricional, conocimientos y conductas en escolares de kínder y primer año básico en 3 escuelas focalizadas por obesidad infantil en la comuna de Valparaíso, Chile / Nutritional status, knowledge and nutritional behaviourin school children from kindergarten and first grade from three schools identified for child obesity in the zone of Valparaiso, Chile

In 2008, under the National Plan for Health Promotion and Community Plan for the Promotion of Health, actions to address school obesity by intervening with the Global Strategy Against Obesity schools with the highest obesity prevalence focusing on kindergarten levels (school children between 5-6years) and first grade (students between 6-7 years). The actions of the Community Plan for the Promotion of Health in selected schools of Valparaiso were evaluated. The objectives of this intervention were: 1) assess the nutritional status of children from the participating levels, 2) gather background information on knowledge and behaviors related to food, nutrition and lifestyle in school and 3) identify strengths and difficulties facing the implementation of health policies at local level. We performed a descriptive, non-experimental, non-random convenience sample, which included 267 schools. Results: It was detected 18.8 percent obesity in the transition level (kindergarten and 27 percent in the first grade evaluated according to Technical Standards of the Ministry of Health of Chile based on 2006 WHO reference tables. In order to assess knowledge and behavior, we developed and applied the tools "Caritas" and "Healthier Snacks" observing 77 percent and 87 percent and 90 percent and 64 percent of correct associations for knowledge and behaviors, respectively. Facilitators: cooperative work and valuation from education. Barriers: outdated actions altering school curriculum planning. Figures of malnutrition by excess and the difficulty to reverse this reality require programs to in identify nutritional knowledge and eating behaviors of the population.

En el 2008, en el marco del Plan Nacional de Promoción de la Salud y del Plan Comunal de Promoción de la Salud se priorizan acciones para abordar la obesidad escolar interviniendo con la Estrategia Global contra la Obesidad las escuelas con los más altos índices de obesidad a nivel comunal, focalizando en escolares de kinder (escolares entre 5-6 años de edad) y primer año básico (escolares entre 6-7 años de edad). En Valparaíso, se evaluaron las acciones del Plan Comunal de Promoción de la Salud en 3 de las 4 Escuelas seleccionadas. Los objetivos de esta intervención fueron; 1) evaluar el estado nutricional de los niños/niñas de los niveles participantes; 2) recopilar antecedentes sobre conocimientos y conductas asociadas a la alimentación y nutrición y estilos de vida en los escolares de kinder y primer año básico y 3) identificar dificultades y fortalezas que enfrentan la implementación de las políticas sanitarias a nivel local. Se realizó un estudio descriptivo, diseño no experimental, muestra intencionada no aleatoria. La muestra incluyó a 267 escolares. Resultados; se detectó 18,8 por ciento obesidad en el nivel de transición mayor y 27 por ciento en el primer año básico evaluados según Normas Técnicas del Ministerio de Salud de Chile (MTNSAL) en base a la referencia de la OMS 2006; para evaluar conocimientos y conductas los autores elaboraron y aplicáronlos instrumentos "Caritas" y "Colaciones más saludables". Se observó un 77 por ciento y 87 por ciento; y 90 por ciento y 64 por ciento de asociaciones correctas para conocimientos y conductas, respectivamente. Facilitadores; trabajo intersectorial y valoración desde educación; obstaculizadores; acciones desfasadas que alteran la planificación curricular de las escuelas. Las cifras de malnutrición por exceso y la dificultad para revertir esta realidad, requiere avanzar en identificar conocimientos y conductas alimentarias nutricionales en la población.

Antecedentes internacionales y nacionales de la promoción de salud en Chile: lecciones aprendidas y lecciones futuras / International and national background of the Chilean health promotion policy: lessons learned and future proyections

The objective of this paper is to analyze different guidelines from rector institutions related with health risk factors, changes in lifestyles and its impact in chronic diseases in the last three decades. Technical documents and policy guidelines were reviewed since 1978 as well as World Health Organization (WHO) reports in health promotion and the prevention of chronic diseases. Chilean Ministry of Health, Universities and other institutions documents were reviewed at the national level and health promotion policies were analyzed. In conclusion, the Health Promotion Policy was incorporated in 1997 with the creation of the National Board for Health Promotion also named VIDA CHILE, in 1998, with important advances until 2003 in implementation of national and regional VIDA CHILE, including VIDA CHILE programs in 341 counties throughout the country. Plans of health promotion involving projects in food and nutrition, physical activity, tobacco and psychosocial and environmental problems were developed in each county. These accomplishments were possible thanks to an agreement between the Government of Chile and the academic sector. Since the year 2003, the Health Promotion Policy continued working at the regional and local level thanks to trained human resources, the support of the Ministry of Health and the local governments. At the world level, in the Bangkok meeting carried out in 2005, WHO incorporated the determinants of health with the purpose of decreasing inequities in the globalized world, modifying the concept of health promotion, and shifting the emphasis in the behavior of the population to a more structural vision of the determinants of health. The authors propose to integrate both concepts (health promotion and determinants of health) developing a State Policy similar to the policy utilized for the eradication of under nutrition in Chile, with a broad consensus and continuity on time, with an strategic agreement among Government...

El objetivo de este artículo es analizar las orientaciones técnicas y directrices que han entregado los organismos rectores sobre los factores de riesgo en salud, los cambios en los estilos de vida y su impacto en las Enfermedades Crónicas No Trasmisibles (ECNT) en las últimas tres décadas. Se revisan documentos técnicos y directrices de política desde 1978 a la fecha e informes anuales de la Organización Mundial de la Salud en promoción de la salud y de prevención de ECNT. A nivel nacional, se revisan documentos del Ministerio de Salud, (MINSAL), Universidades y entidades relacionadas; se analizan las políticas de promoción de salud y se hacen propuestas nacionales para enfrentar el tema. Se concluye que la estrategia de Promoción de Salud fue incorporada en las políticas nacionales desde 1997, creándose el Consejo Nacional de Promoción de Salud VIDA CHILE en 1998, con avances muy importantes hasta el año 2003, logrando consolidar las acciones de promoción de la salud con VIDA CHILE nacional, VIDA CHILE regionales y VIDA CHILE locales en 341 comunas del país. Encada comuna se desarrollaron planes comunales de Promoción de la Salud, con proyectos en alimentación, actividad física, tabaco, temas psicosociales y ambientales. Esto se logró por una alianza estratégica entre el gobierno, principalmente MINSAL, Chiledeportes, Educación, y el sector académico (intersectorialidad). Desde el año 2003, la Promoción de Salud continuó funcionando en el nivel local y regional, en gran medida, por los recursos humanos capacitados en el área, al apoyo del MINSAL y los gobiernos locales. A nivel mundial, en el 2005, en la reunión de Bangkok, la OMS incorpora los determinantes de la salud con el objeto de disminuir las desigualdades en el mundo globalizado, lo que modifica en parte el concepto de promoción de salud, desde un énfasis en cambios de conducta en la población hacia una visión más estructural de los determinantes de salud. Se propone integrar ambos...

Cambios en la estructura alimentaria y consumo aparente de nutrientes de los hogares del gran Santiago 1988-1997 / Changes in food structure and food consumption in 2 household surveys in the metropolitan area of Santiago, 1988-1997

El análisis comparativo de la evolución del gasto en alimentos es una muestra representativa del Gran Santiago contenida en la IV y V Encuesta de Presupuestos Familiares (1987-1988-1996-1997), permite apreciar el aumento en el gasto en alimentos en el período y los cambios en los patrones alimentarios de los hogares del Gran Santiago. Estos cambios se reflejan en las modificaciones en la estructura del gasto en alimentos, el que evoluciona hacia alimentos de orígen animal y procesados ricos en grasas saturadas y azúcares con una gran importancia en la proporción del gasto destinado a comidas y bebidas fuera del hogar, comidas preparadas para llevar al hogar, bebidas y jugos, productos cárneos, pastelerías, helados y chocolates con una disminución de la importancia en la proporción del gasto en pan, cereales, féculas, verduras, frutas, legumbres y productos del mar. El incremento del gasto en alimentos refleja también el aumento en el consumo aparente de nutrientes, destacando la variación experimentada en grasa, indicando que este patrón de consumo no ha sido el más adecuado para mejorar la calidad alimentaria de la población

Promoción de salud en la transición epidemiológica de Chile / Health promotion in the chilean epidemiological transition

En el contexto de la transición epidemiológica se hace un análisis de los factores de riesgo relacionados con las principales causas de enfermedad, discapacidad y muerte en el país, que son las enfermedades crónicas no transmisibles, en especial, las cardiovasculares. Destacan la alta prevalencia de obesidad en las mujeres adultas (superior a 20 por ciento); de sedentarismo (mas del 90 por ciento en las mujeres); de hipertensión arterial (10-15 por ciento de los adultos); de hipercolesterolemia (alrededor del 40 por ciento de los adultos) y de hábito tabáquico: en 1998 el 45 por ciento de los hombres y 35 por ciento de las mujeres manifestaron haber fumado el último mes, sin cambios desde 1994. Los factores psicosociales se expresan por la alta prevalencia de problemas de salud mental que en Chile alcanzan cifras alarmantes (35 por ciento de la problación adulta) destacándose el alcoholismo y los trastornos afectivos. Se plantea la estrategia de promoción de salud como la única forma de enfrentar estos factores de riesgo en forma global. La promoción debe dirigirse hacia la obtención de cambios de estilo de vida, con énfasis en la alimentación, la actividad física y los ambientes saludables. Ello mejoraría la calidad de vida de los chilenos, permitiendo no sólo que la vida se prolongue, sino que sea más saludable