Family influences on food choices and nutrition: What does the literature say?

ABSTRACT The prevention of diseases related to nutrition requires an approach that considers aspects that transcend the individual level in understanding food decisions. In this context, the family as an interpersonal determinant of eating behavior is gaining importance in developing behavioral change interventions that seek better nutritional health. This manuscript aims to describe the current evidence of how family variables influence its members' food choices and nutritional status. Specifically, we present evidence on family functioning, parental feeding styles, and family meals, as they are recent topics of interest in the area. The evidence shows that a better or balanced family functioning or some of its components (communication, conflicts, cohesion, among others); a parental feeding style that demands but listens to the requirements from children; and a higher frequency of family meals are associated with a lower Body Mass Index (BMI) and healthier eating habits, especially in children and adolescents. A deep understanding of family variables could guide weight management interventions and provide information that could explain why some interventions work and others do not.

RESUMEN La prevención de enfermedades relacionadas con la nutrición requiere de un enfoque que considere aspectos que transciendan el nivel individual en el entendimiento de las decisiones alimentarias. En este contexto, la familia como un determinante interpersonal de las conductas alimentarias, está ganando importancia en el desarrollo de intervenciones de cambio conductual que buscan una mejor salud nutricional. Este artículo tiene como objetivo describir la evidencia actual de cómo variables familiares influyen en las elecciones alimentarias y el estado nutricional de sus miembros. Específicamente, presentamos evidencia sobre el funcionamiento familiar, los estilos parentales de alimentación y las comidas familiares, ya que son temas recientes de interés en el área. La evidencia muestra que un mejor o equilibrado funcionamiento familiar o de algunos de sus componentes (comunicación, conflictos, cohesión, entre otros); un estilo parental que exige, pero escucha los requerimientos de los niños; y una mayor frecuencia de comidas familiares se asocian con un menor Índice de Masa Corporal (IMC) y hábitos alimentarios más saludables, especialmente en niños y adolescentes. Una comprensión profunda de las variables familiares podría orientar las intervenciones de control de peso y brindar información que explicaría por qué algunas intervenciones funcionan y otras no.

Derecho a la alimentación y COVID-19: Estudio cualitativo de percepciones de actores clave en Chile

RESUMEN La pandemia por COVID-19 y las medidas sanitarias para su control han afectado la alimentación de las personas, lo que probablemente lleve a cifras elevadas de malnutrición en todas sus formas. El objetivo de este estudio fue describir las percepciones de un grupo de actores clave sobre el aseguramiento del derecho a la alimentación en contexto de pandemia en Chile. El presente es un estudio cualitativo realizado en Chile. Los/as entrevistados fueron seleccionados/as por conveniencia y con una visión transdisciplinaria. Se realizaron 26 entrevistas semiestructuradas online, durante septiembre y octubre de 2020. El análisis de los datos se realizó utilizando un enfoque inductivo y un análisis temático, organizando la información en el software Atlas.ti 9.0. Los discursos de las y los participantes permitieron obtener 4 temas: 1. Seguridad alimentaria en tiempos de pandemia, 2. Apreciación de las estrategias alimentarias gubernamentales, 3. Respuesta comunitaria a la pandemia y 4. Otras miradas para el enfrentamiento de la pandemia. Se concluye que el acceso a los alimentos es la dimensión del derecho a la alimentación más afectada en el país en pandemia. Se reconocen estrategias estatales para mantener la alimentación de la población, sin embargo, estas se perciben como insuficientes. Por otro lado, se destaca la relevancia de la organización comunitaria. Se hace necesario realizar un seguimiento sobre las acciones tomadas para garantizar el derecho a la alimentación en el país y conocer la experiencia de otros países de América Latina y el Caribe para prepararse para futuras crisis.

ABSTRACT The COVID-19 pandemic and the sanitary measures to control it have affected people's diets, which is likely to lead to high rates of malnutrition in all its forms. The objective of this study was to describe the perceptions of a group of key actors on the assurance of the right to food in the context of a pandemic. This was a qualitative study conducted in Chile. The interviewees were selected by convenience with a transdisciplinary approach. We conducted 26 semi-structured interviews online, during September and October 2020. Data analysis was carried out using an inductive approach and a thematic analysis. We organized information using Atlas.ti 9.0 software. From the participants' narratives, we obtained 4 themes: 1. Food security in times of pandemic, 2. Appreciation of government food strategies, 3. Community response to the pandemic and 4. Other perspectives for facing the pandemic. We concluded that access to food is the dimension of the right to food most affected during the pandemic. State strategies are recognized as maintaining the population's nutrition; however, these are perceived as insufficient. On the other hand, the relevance of community organization stands out. It is necessary to monitor the actions taken to guarantee the right to food in the country and learn about the experience of other Latin American and Caribbean countries to prepare for future crises.

Una aproximación a la alfabetización nutricional, evaluación del estado nutricional y calidad de la alimentación en una muestra a conveniencia de mujeres de comunas con pobreza multidimensional

RESUMEN La obesidad es factor de riesgo para las enfermedades crónicas no transmisibles. Esta condición afecta principalmente a mujeres de bajo nivel socioeconómico. La alfabetización nutricional, referida al conocimiento en alimentación y nutrición, podría estar determinando la calidad de la dieta, la que a su vez podría favorecer el desarrollo de la obesidad. Los objetivos del estudio fueron 1) Describir la alfabetización nutricional, el estado nutricional y la calidad de la alimentación, y 2) Explorar la relación entre estas tres variables, en un grupo de mujeres de comunas con pobreza multidimensional de la Región Metropolitana. Se diseñó un estudio transversal, no probabilístico, en donde participaron 122 mujeres. Se evalúo el estado nutricional mediante el cálculo del Índice de Masa Corporal, midiendo peso y talla. La calidad de la alimentación se evaluó utilizando una encuesta de tendencia de consumo alimentaria y el Índice de Alimentación Saludable, y la alfabetización nutricional, con el cuestionario Nutritional Literacy en español (NLit-S), adaptado a la población chilena. La prevalencia de obesidad fue 47,5% y el 88,5% de las mujeres presentó necesidad de cambios en su alimentación. Un 66,4% presentó una alfabetización nutricional deficiente, con más mujeres con exceso de peso en esta categoría. Dominio de etiquetado nutricional fue el que obtuvo peores resultados. Se concluye que la condición alimentaria nutricional de las mujeres de nuestro estudio sugiere un desafío para el trabajo por parte de profesionales de la salud, así como para quienes toman decisiones en alimentación y nutrición.

ABSTRACT Obesity is a risk factor for chronic non-communicable diseases. This condition mainly affects women of low socioeconomic status. Nutritional literacy, understood as knowledge of food and nutrition, could determine the quality of the diet, which in turn could cause the development of obesity. The aims were 1) To describe the nutritional literacy, nutritional status, and food quality, and 2) To explore the relationship between these three variables, in a group of women from communes with multidimensional poverty in the Metropolitan Region. We conducted a cross-sectional, non-probabilistic study in which 122 women participated. The nutritional status was evaluated by calculating the Body Mass Index using weight and height measurements. The diet quality was evaluated using a survey of food consumption trends and the Healthy Eating Index. Nutritional literacy was evaluated with the Nutritional Literacy questionnaire in Spanish adapted for the Chilean population. The prevalence of obesity was 47.5%, and 88.5% of the women presented the need for changes in their diet. 66.4% of women had low nutritional literacy, with more overweight women in this category. The nutrition labeling domain was the one with the worst results. We concluded that women's food and nutritional condition suggests a challenge for health professionals and those who make decisions about food and nutrition.

Barreras en la consulta nutricional en atención primaria a personas migradas internacionales. Perspectiva de nutricionistas

RESUMEN La migración internacional ha aumentado exponencialmente en Chile, lo que ha representado un desafío para el sistema de salud. El presente estudio transversal exploratorio, de metodología cualitativa y abordaje multidisciplinario, busca describir barreras y dificultades en la consulta nutricional a personas migradas, desde la perspectiva de profesionales nutricionistas de los centros de salud familiar de una comuna de la Región Metropolitana; dada la relevancia de la Atención Primaria en el sistema de salud nacional, y la particularidad de la alimentación, que conjuga valores nutricionales relacionadas con la salud, así como aspectos simbólicos significativos para las personas, posicionando a las nutricionistas en un escenario donde buscan mantener un estado nutricional óptimo en una población culturalmente diferente. Se realizaron once entrevistas a nutricionistas, las cuales fueron codificadas y analizadas temáticamente, identificando cuatro ejes narrativos de barreras y dificultades: escasez de recursos en la atención de una demanda poblacional creciente, problemas lingüísticos de comunicación (idiomáticos y dialectales), desconocimiento del funcionamiento del sistema sanitario chileno por parte de los/las usuarios/as migrados/as, y divergencia de prácticas y concepciones sanitarias entre migrados/as y nutricionistas. Del estudio se concluye que la atención nutricional con el usuario/a migrante internacional es compleja y se debe considerar abordar los temas antes mencionados al momento de generar respuestas institucionales de atención, programas y políticas enfocadas en la atención al usuario/a migrante internacional, de manera de lograr una promoción auténtica y pertinente de hábitos alimentarios saludables y el mantenimiento del Efecto Migrante Sano.

ABSTRACT International migration has increased exponentially in Chile, which has represented a challenge for the health system. Using qualitative methods and a multidisciplinary approach, this cross-sectional exploratory study seeks to describe barriers and difficulties for nutritional care for migrants from the perspective of nutritionists who work in health centers in a neighborhood of the Metropolitan Region of Chile. Given the relevance of primary care in the national health system and the particularity of food, which combines nutritional values related to health, as well as significant symbolic aspects for people, nutritionists are positioned to encourage optimal nutritional status in a culturally different population. Eleven interviews were conducted with nutritionists. The transcribed interviews were coded and analyzed thematically, identifying four narrative axes of barriers and difficulties: lack of resources for a growing population demand, linguistic communication problems (idiomatic and dialect), lack of knowledge about the functioning of the Chilean health system by migrants, and divergence of health practices and conceptions between migrants and nutritionists. The study concludes that nutritional care with international migrants is complex. The concerns mentioned above should be addressed when generating institutional responses of care, or creating programs and policies focused on the care of international migrants to achieve an authentic and pertinent promotion of healthy eating habits and the maintenance of the Healthy Migrant Effect.

Adipose-derived mesenchymal stem cells (AdMSC) for the treatment of secondary-progressive multiple sclerosis: A triple blinded, placebo controlled, randomized phase I/II safety and feasibility study.

BACKGROUND: Currently available treatments for secondary progressive multiple sclerosis(SPMS) have limited efficacy and/or safety concerns. Adipose-mesenchymal derived stem cells(AdMSCs) represent a promising option and can be readily obtained using minimally invasive procedures. PATIENTS AND METHODS: In this triple-blind, placebo-controlled study, cell samples were obtained from consenting patients by lipectomy and subsequently expanded. Patients were randomized to a single infusion of placebo, low-dose(1x106cells/kg) or high-dose(4x106cells/kg) autologous AdMSC product and followed for 12 months. Safety was monitored recording adverse events, laboratory parameters, vital signs and spirometry. Expanded disability status score (EDSS), magnetic-resonance-imaging, and other measures of possible treatment effects were also recorded. RESULTS: Thirty-four patients underwent lipectomy for AdMSCs collection, were randomized and thirty were infused (11 placebo, 10 low-dose and 9 high-dose); 4 randomized patients were not infused because of karyotype abnormalities in the cell product. Only one serious adverse event was observed in the treatment arms (urinary infection, considered not related to study treatment). No other safety parameters showed changes. Measures of treatment effect showed an inconclusive trend of efficacy. CONCLUSION: Infusion of autologous AdMSCs is safe and feasible in patients with SPMS. Larger studies and probably treatment at earlier phases would be needed to investigate the potential therapeutic benefit of this technique.

Rac1/p21-activated kinase pathway controls retinoblastoma protein phosphorylation and E2F transcription factor activation in B lymphocytes.

Small GTPases of the Ras superfamily are capable of activating E2F-dependent transcription leading to cell proliferation, but the molecular mechanisms are poorly understood. In this study, using immortalized chicken DT40 B cell lines to investigate the role of the Vav/Rac signalling cascade on B cell proliferation, it is shown that the proliferative response triggered by B cell receptor activation is dramatically reduced in the absence of Vav3 expression. Analysis of this proliferative defect shows that in the absence of Vav3 expression, retinoblastoma protein (RB) phosphorylation and the subsequent E2F activation do not take place. By combining pharmacological and genetic approaches, phosphatidylinositol-3-kinase and phospholipase Cγ2 (PLCγ2) were identified as the key regulatory signalling molecules upstream of the Vav3/Rac pathway leading to RB phosphorylation and E2F transcription factor activation. Additionally, vav3(-/-) and plcγ2(-/-) DT40 B cells were not able to activate the RB-E2F complex wild-type phenotype when these genetically modified cells were transfected with constitutively active forms of RhoA or Cdc42. However, when these knockout cells were transfected with different constitutively active versions of PLCγ, Vav or Rac1, not only activation of the RB-E2F complex wild-type phenotype was recovered but also the cellular proliferation. Furthermore, by evaluating the effect of two known effector mutants of Rac1 (Rac1(Q61L/F37A) and Rac1(Q61L/Y40C) ), the RB-E2F complex activation dependency on p21-activated kinase (PAK) and protein kinase Cε (PKCε) activities was established, being independent of both actin cytoskeleton reorganization and Ras activity. These results suggest that PAK1 and PKCε may be potential therapeutic targets to stop uncontrolled B cell proliferation mediated by the Vav/Rac pathway.

Communicating about eating behaviors. A qualitative study of Chilean women and their health-care providers.

Good communication between health care providers (HCPs) and patients is critical in achieving positive health outcomes. The purpose of this article was to compare the perceptions of Chilean woman and their HCPs with respect to determinants of eating behaviors. Semi-structured interviews were conducted with women (n=15) visiting a public health care center in Chile and with their HCPs (n=8) who were in charge of promoting healthy eating behaviors among women. Data from the interviews indicated similarities and inconsistencies in determinants of eating behaviors between the groups. Both mentioned many important factors that influence women's eating behaviors, including food preferences, dietary knowledge, self-control and self-efficacy, family, food cost, and food availability. HCPs appeared to be less aware of the role that personality traits and past experiences play as potential determinants which women mentioned. In contrast, women were less aware of the influence of anxiety and low self-esteem on eating choices, which HCPs noted as key factors. Although it was encouraging to see agreement between women and their HCPs in some areas, it is important to work on increasing understanding among the groups with respect to the important role psychological factors play in influencing eating behavior. We suggest that HCPs should focus on the importance of women's personality traits and past eating behaviors, as well as work on improving women's self-esteem and helping to decrease their anxiety levels. HCPs should be encouraged to develop good communication with each person in order to help them understand the roles that external and internal factors play in eating behaviors.

Developing a Culturally Sensitive Lifestyle Behavior Change Program for Older Latinas.

Despite the burgeoning U.S. Latino population and their increased risk of chronic disease, little emphasis had been placed on developing culturally sensitive lifestyle interventions in this area. This article examines older Latinas' sociocultural context relative to health with the goal of developing a culturally sensitive health behavior intervention. Photo-elicitation indicated two emerging themes that influenced lifestyle choices: family caregiving and religion. Researchers partnered with a faith-based organization to develop and implement a 6-month lifestyle intervention for Latinas ages 50 and older: Abuelas en Acción (AEA). At completion, interviews were conducted to understand women's experiences and the influence AEA had on their lifestyles and health. Findings suggest that religious content empowered and deeply affected women; however, the intergenerational content presented significant challenges for instruction, retention, and implementation. We discuss findings in relation to the health intervention literature and provide suggestions for future interventions drawing on religion, family, and health behavior change.

Enhancing effect of glucose microspheres in the viability of human mesenchymal stem cell suspensions for clinical administration.

PURPOSE: A critical limiting factor of cell therapy is the short life of the stem cells. In this study, glucose containing alginate microspheres were developed and characterized to provide a sustained release system prolonging the viability of human mesenchymal stem cells (hMSCs) in a suspension for clinical application. METHODS: The glucose microspheres were satisfactorily elaborated with alginate by emulsification/internal gelation method. Particle size was evaluated by light diffraction and optical microscopy. Shape and surface texture by scanning electron microscopy (SEM). Zeta potential, infrared spectra and release studies were also conducted. Also, rheological properties and stability of hMSCs suspensions with microspheres were tested. The viability of hMSCs was determined by trypan blue dye exclusion staining. RESULTS: Microspheres of 86.62 µm, spherical shaped and -32.54 mV zeta potential with excellent stability, good encapsulation efficiency and providing an exponential release of glucose were obtained. hMSCs had better survival rate when they were packed with glucose microspheres. Microspheres maintained the aseptic conditions of the cell suspension without rheological, morphological or immunophenotypic disturbances on hMSCs. CONCLUSIONS: Developed microspheres were able to enhance the functionality of hMSC suspension. This strategy could be broadly applied to various therapeutic approaches in which prolonged viability of cells is necessary.

Standard requirement of a microbiological quality control program for the manufacture of human mesenchymal stem cells for clinical use.

The manufacturing of human mesenchymal stem cells (hMSCs) as cell-based products for clinical use should be performed with appropriate controls that ensure its safety and quality. The use of hMSCs in cell therapy has increased considerably in the past few years. In line with this, the assessment and management of contamination risks by microbial agents that could affect the quality of cells and the safety of patients have to be considered. It is necessary to implant a quality control program (QCP) covering the entire procedure of the ex vivo expansion, from the source of cells, starting materials, and reagents, such as intermediate products, to the final cellular medicine. We defined a QCP to detect microbiological contamination during manufacturing of autologous hMSCs for clinical application. The methods used include sterility test, Gram stain, detection of mycoplasma, endotoxin assay, and microbiological monitoring in process according to the European Pharmacopoeia (Ph. Eur.) and each analytical technique was validated in accordance with three different cell cultures. Results showed no microbiological contamination in any phases of the cultures, meeting all the acceptance criteria for sterility test, detection of mycoplasma and endotoxin, and environmental and staff monitoring. Each analytical technique was validated demonstrating the sensitivity, limit of detection, and robustness of the method. The quality and safety of MSCs must be controlled to ensure their final use in patients. The evaluation of the proposed QCP revealed satisfactory results in order to standardize this procedure for clinical use of cells.

[The future of new therapies in clinical medicine]. / El futuro de la medicina clínica hacia nuevas terapias: terapia celular, génica y nanomedicina.

Advanced therapies provide a new concept of personalized medicament of autologous, allogeneic or xenogeneic origin, based on cells (cell therapy), genes (gene therapy) or tissues (tissue engineering), which, together with nanosystems, provide new advances in the diagnosis, prevention and treatment of diseases. The basis and different fields of action of cell therapy, gene therapy and nanomedicine are described in this review.

Aporte calórico-proteico durante la recuperación nutricional y estado nutricional alcanzado / Energy protein intake during nutritional recovery and nutritional status achieved

Hace 30 años los niños chilenos que se recuperaban en CONIN recibían alimentación ad libitum, que podría haber favorecido la aparición de sobrepeso y obesidad (SP/OB). Por este motivo el objetivo de este estudio fue evaluar la relación entre la ingesta energético-proteica durante la recuperación nutricional y la aparición de sobrepeso-obesidad (SP/OB) al alta. Se diseño un estudio retrospectivo, analítico del universo formado por las 168 fichas encontradas de menores de 2 años, desnutridos primarios recuperados en CONIN entre 1977-1982. Se evaluó el estado nutricional por Sempé (referencia de crecimiento utilizada en esos años) y OMS (referencia actual), desde el ingreso hasta el cuarto mes de estadía y al alta. Según referencia de Sempé la desnutrición al ingreso fue 25 por ciento grave, 63 por ciento moderada y 12 por ciento leve; por OMS (P/T) estas cifras eran 14.9 por ciento, 29.2 por ciento y 38.1 por ciento, respectivamente; el resto era eutrófico. Al alta, no había niños con SP/OB por P/E (Sempé), mientras que según P/T, el 6 por ciento tenía SP/OB a los 3 meses de tratamiento y el 13,8 por ciento al alta. La ingesta alimentaria promedio, aportada ad libitum, fue de 148 kcals/Kg/día y 4 g prot/kg/día. Los niños con SP/OB tuvieron mayor ganancia de peso diario (30,3 vs 19,2 g/día) que sus pares no obesos y mayor ganancia de peso diario comparado al promedio para la edad (19,7 vs 8,2 g/día). La alimentación prescrita alcanzó valores elevados dentro del rango utilizado actualmente; la ingesta real, administrada ad-libitum, fue significativamente menor y se asoció a una frecuencia de 13,8 por ciento SP/OB.

Thirty years ago malnourished Chilean children were recovered by CONIN; they were fed ad libitum and this may have favoured the appearance of overweight-obesity (SP/OB). The objective of this study was to evaluate the relationship between energy-calorie intake during nutritional recovery and the appearance of overweight-obesity (SP/OB). The design was a retrospective, analytical study of the universe formed by the 168 clinical records found, of children below 2 years of age, recovered by CONIN between 1977 and 1982. Nutritional status was assessed using the Sempé criteria (applied in the period evaluated) and those of WHO, (currently in use), on admission, after 4 month treatment and on discharge. By Sempé criteria, malnutrition on admission was classified 25 percent severe, 63 percent moderate and 12 percent mild; instead, using WHO standards these figures were 14,9 percent, 29,2 percent y 38,1 percent, respectively; the remaining children were well nourished. On discharge, there was no SP/OB by W/A (Sempé), but by W/H (WHO) 6 percent and 13.8 percent were SP/OB after 3 months and on discharge, respectively. Food intake, administered ad libitum, reached a mean of 148 kcals/kg/d and 4 g prot/kg/d. SP/OB children had greater daily weight gain (30,3 vs 19,2 g/d) than the non-obese children and greater daily weight gain than the mean for age and sex (19,7 vs 8,2 g/día). The prescribed feeding reached values considered high by currently used criteria; actual intake, administered ad-libitum, was significantly lower and was associated with 13.8 percent of children with overweight-obesity at the time of discharge.

Análisis cefalométrico al alta y un año después del tratamiento ortodóntico / Cephalometric analysis at discharge and one year after orthodontic treatment

Se realiza un estudio de un grupo de pacientes tratados y dados de alta en Ortodoncia, para evaluar cefalométricamente el comportamiento de algunas variables durante el tratamiento y un año después. La muestra estuvo constituida por 18 pacientes, 10 de Clase I y 8 de Clase II esqueletal. De cada uno de ellos se utilizaron las telerradiografías iniciales, finales y al año del alta. Se realizaron 4 mediciones lineales y se compararon sus valores mediante la prueba de Wilcoxon con un estimado de confiabilidad del 95 por ciento . Se encontraron cambios estadísticamente significativos en las variables estudiadas.