A Landscape of Micronutrient Dietary Intake by 15- to 65-Years-Old Urban Population in 8 Latin American Countries: Results From the Latin American Study of Health and Nutrition.

BACKGROUND: Latin American countries have shifted from traditional diets rich in micronutrients to a Westernized diet rich in high energy-dense foods and low in micronutrients. OBJECTIVE: This study aimed to determine the prevalence of adequate micronutrient intakes in urban populations of 8 Latin American countries. METHOD: Micronutrient dietary intake data were collected from September 2014 to August 2015 from 9216 men and women aged 15.0 to 65.0 years living in urban populations of 8 Latin American countries. Dietary intake was collected using two 24-hour recalls on nonconsecutive days. Micronutrient adequacy of intake was calculated using the Estimated Average Requirement cut-off method. RESULTS: In general terms, the prevalence of inadequate intake of thiamine, riboflavin, niacin, folate, cobalamin, iron, phosphorus, copper, and selenium ranged from 0.4% to 9.9%. In contrast, the prevalence of inadequacy of pyridoxine, zinc, vitamin C, and vitamin A ranged from 15.7% to 51.5%. The nutrients with a critical prevalence of inadequacy were magnesium (80.5%), calcium (85.7%), and vitamin D (98.2%). The highest prevalence of inadequate intakes was observed in the low educational level, participants with overweight/obesity, in men, and varies according to socioeconomic status. CONCLUSIONS: There is an urgent need to define direct regional actions and strategies in Latin America aimed at improving micronutrient adequacy, either through staple food fortification programs, agronomic biofortification, or food policies that facilitate economic access to micronutrient-rich foods.

Plain language titleDescription of the Vitamin and Mineral Consumption Status in Urban Cities of Latin America: Results of the Latin American Health and Nutrition Study.Plain language summaryVitamins and minerals are essential for maintaining good health. However, traditional Latin American diets are changing to include foods that have a lot of sugar and fat but fewer vitamins and minerals. This study was designed to analyze the consumption of these nutrients in urban cities of 8 Latin American countries. We collected food consumption information from September 2014 to August 2015 from 9216 men and women between 15 and 65 years old using a method called 24-hour recall. To find out if participants were consuming the necessary daily amounts of vitamins and minerals, intakes were compared with the daily recommended amounts suggested by the Institutes of Medicine of the United States. We found that Latin American urban populations consume fewer vitamins and minerals than recommended. In some cases, few people do not consume the required amounts of vitamins and minerals, but in other cases, many do not. For example, few do not consume enough thiamine, riboflavin, niacin, folate, cobalamin, iron, phosphorus, copper, and selenium. However an intermediate number of people do not consume enough pyridoxine and zinc, a high number consume little vitamin C and vitamin A, and many people consume very little magnesium, calcium, and vitamin D. We found that the people who consume fewer vitamins and minerals are mostly males, overweight/obese, have lower education and varies according to their financial resources. A deficient intake of vitamins and minerals showed up in most age groups, from adolescence to adulthood. To improve vitamins and minerals intake, it is important that some foods that are frequently eaten are fortified or that the price of foods that are high in vitamins and minerals is lowered.

Energy imbalance gap was associated with body mass index and sex in Latin American adolescents-results from the ELANS study.

Introduction: Energy imbalance gap (EIG) is defined as the average daily difference between energy intake (EI) and energy expenditure (EE). This study aimed to examine the associations between EIG and sociodemographic and anthropometric variables in the adolescent population of eight Latin America countries. Methods: A total of 680 adolescents aged 15 to 18 were included in this study. The estimation of EI was based on two non-consecutive 24-h dietary recalls. EE was predicted from Schofield equations using physical activity level obtained through the long version of the International Physical Activity Questionnaire. Sociodemographic data and anthropometric measurements were also obtained. A descriptive analysis and multilevel linear regression models were used to examine associations between variables. Results: The mean EI, EE, and EIG were 2091.3 kcal, 2067.8 kcal, and 23.5 kcal, respectively. Argentina had the highest EI and EIG, whereas Chile had the lowest EI and EIG. Males had a higher EI (2262.4 kcal) and EE (2172.2 kcal) than females (1930.1 kcal and 2084.5 kcal), respectively (p < 0.05). Overweight subjects had a lower EIG than did underweight and normal-weight subjects (p < 0.05). Subjects with low socioeconomic status (SES) had a lower EE (2047.0 kcal) than those with a high SES (2164.2 kcal) (p < 0.05). Conclusion: Sex and BMI were associated with EIG in adolescents from Latin America.

Exploring the FAO Minimum Dietary Diversity Indicator as a Suitable Proxy of Micronutrient Adequacy in Men and Women Across Reproductive and Non-reproductive Ages in 8 Latin American Countries.

BACKGROUND: Women's Dietary Diversity Score (WDDS) is an indicator of dietary diversity, a key component of diet quality in women of reproductive age (WRA). Limited information is available regarding its applicability in other population groups. OBJECTIVE: To examine the ability of the Minimum Dietary Diversity for Women (MDD-W) of 5-food groups cutoff to predict micronutrient adequacy in men and women 15 to 65 years old from 8 Latin American countries. METHODS: We used a 24-hour recall from 9216 participants in the Latin American Study on Nutrition and Health (ELANS) to determine Dietary Diversity Score (DDS) based on the consumption of 10 food groups. The Mean Probability of Adequacy (MPA) was associated with DDS for the overall sample, for men, WRA, and women of nonreproductive age (WNRA). Sensitivity and specificity analyses were performed to determine if the 5-food groups cutoff point for MDD can be used to correctly identify men, WRA, and WNRA with adequate micronutrient adequacy (MPA ≥ 0.70). RESULTS: We found a mean DDS of 4.78 ± 1.33 and an MPA of 0.64 ± 0.16, with 59% of participants showing a diverse diet (DDS ≥ 5). The 5-food groups-cutoff point showed a better balance between sensitivity and specificity predicting an MPA ≥0.70 in men, WRA, and WNRA. MPA was significantly associated with DDS in WRA and for men and WNRA, as well. CONCLUSION: The 5-food group MDD, originally intended to be used in WRA, performed equally well in predicting MPA ≥0.70 in men, WRA, and WNRA, and can be used as a proxy of micronutrient adequacy in Latin American population.

Plain language titleAssessment of the FAO Minimum Dietary Diversity Index to Estimate Micronutrients Intake in Urban Cities of 8 Latin America CountriesPlain language summaryThe Women's Dietary Diversity Score (WDDS) proposed by the Food and Agriculture Organization is an indicator that measures the variety of foods consumed by women of reproductive age (WRA), and it has been reported in several studies that the more diverse the diet, the greater the probability of meeting micronutrients requirements. This indicator has not been validated in other population, but few studies have been conducted in the Latin American region. So, we aimed to investigate whether the Minimum Dietary Diversity for Women (MDD-W) established for WRA could also predict sufficient micronutrient intake in men and women aged 15 to 65 years in the Latin American population. To accomplish this objective, we used data from the Latin American Study of Nutrition and Health (Estudio Latino Americano de Nutrición y Salud­ELANS) that collected dietary data from 24-h recalls from 9216 participants and analyzed the association between DDS and the Mean Probability of Adequacy (MPA). Additionally, we determined if the MDD cutoff point could correctly identify individuals with appropriate vitamin and mineral intake. We found that the overall mean DDS was 4.78 ± 1.33, the MPA was 0.64 ± 0.16, and approximately 59% of participants had a diverse diet. The MDD of 5-food groups cutoff point was demonstrated to be useful in predicting sufficient micronutrient intake for men, WRA, and women over 50 years. Respondents with a DDS ≥5 had higher micronutrient adequacy. These findings suggest that DDS can serve as a proxy for assessing micronutrient adequacy in urban populations beyond WRA. The effect of promoting diverse diets on micronutrient adequacy as part of intervention programs can be captured by the DDS in urban Latin American populations.

Mejoría de la adherencia a la dieta mediterránea en preescolares asistentes al jardín infantil / Improvement in adherence to Mediterranean diet in children attending preschool centers

Introducción: la dieta mediterránea se ha asociado a menor prevalencia de obesidad y síndrome metabólico y a estilos de vida saludable enadultos y escolares, siendo escasa la información en edades menores. La región central de Chile tiene un ecosistema de tipo mediterráneo, loque, junto con su gastronomía tradicional, facilitaría la adopción de este estilo de alimentación.Objetivos: determinar la adherencia a la dieta mediterránea en preescolares y sus padres y evaluar el impacto de una intervención educativay su implementación.Métodos: estudio de cohorte prospectiva. Se aplicaron los índices KidMed en niños/as mayores de 18 meses y el índice Chileno de DietaMediterránea (IDM-Chile) en los padres, antes y después de una intervención educativa remota.Resultados: participaron 139 familias, con 95 preescolares, 56 % mujeres, con edad de 26,2 ± 8,7 meses. Inicialmente, el KidMed en los niñosfue de 7,4 ± 1,9 puntos y aumentó hasta 7,9 ± 1,9 puntos postintervención (p = 0,1). El IDM-Chile en los padres fue de 6,9 ± 1,8 y 7,1 ± 1,7puntos, respectivamente (p = 0,09). Al separar por categorías, hubo mejoría desde una adherencia baja o moderada hacia una óptima en losniños y adultos (Chi2, p = 0,009 y p = 0,04). En 58 diadas hubo una correlación positiva entre los índices KidMed e IDM-Chile preintervencióny postintervención (R Pearson: 0,3 y 0,34; p = 0,004 y 0,003, respectivamente).Conclusiones: la mayoría de esta muestra de preescolares y sus padres presentaron una adherencia moderada a dieta mediterránea, con unamejoría posterior a la intervención educativa.(AU)

Background: the Mediterranean diet has been associated with a lower prevalence of obesity and metabolic syndrome, and with healthierlifestyles in adults and children, but data is scarce in younger ages. The Mediterranean-type ecosystem of the central region of Chile as well asits traditional gastronomy would facilitate the adoption of this dietary pattern.Objectives: to assess the adherence to Mediterranean diet in preschoolers and their parents, and to evaluate the impact of a nutrition educationintervention and diet implementation.Methods: prospective cohort study. The KidMed index was applied to children older than 18 months, and the Mediterranean Dietary Index inChile (Chilean-MDI) to their parents, before and after a remote educational intervention.Results: one hundred and thirty-nine families participated, with 95 preschoolers; 56 % were girls, aged 26.2 ± 8.7 months. The basal meanKidMed score was 7.4 ± 1.9 and increased to 7.9 ± 1.9 after the intervention (p = 0.1). The Chilean-MDI score was 6.9 ± 1.8 and 7.1 ± 1.7,respectively (p = 0.09). When separated by categories, there was improvement from low and moderate adherence to optimal adherence in bothchildren and their parents (Chi2, p = 0.009 y p = 0.04). In 58 dyads, there was a positive correlation between the KidMed and the Chilean-MDIindex, pre- and post-intervention (Pearson R = 0.3 y 0.34; p = 0.004 y 0.003, respectively).Conclusions: most of these sample of preschoolers and their parents had a moderate adherence to Mediterranean diet, with an improvementafter an educational intervention.(AU)

Reduced burnout and higher mindfulness in medical students after a self-care program during the COVID-19 pandemic / Reducción del agotamiento en estudiantes de medicina mediante auto-cuidado durante la pandemia COVID-19

ABSTRACT Background: Medical students experience high levels of psychological stress during clinical training. However, most medical curricula do not teach self-care skills. The COVID-19 pandemic has disrupted medical education causing increased distress among students. Aim: To report the implementation and impact of an eight-week multifaceted mindfulness-based self-care program on medical students' distress and well-being during the COVID-19 pandemic. Material and Methods: One hundred twenty-three fourth-year medical students attended the program as part of a mandatory course from April to May 2020, during the rising phase of COVID-19 in Chile. They were evaluated using validated tests before and immediately after the program. The measures included burnout, dispositional mindfulness, perceived stress, traumatic stress reactions, general well-being, resilience, and stress coping strategies. Results: Burnout prevalence decreased from 48% to 24%, whereas students with high dispositional mindfulness increased from 25% to 44%. Burnout reduction was mostly due to decreased emotional exhaustion. Additionally, students reported lower levels of stress, self-blaming, and traumatic stress reactions alongside an increased use of active coping strategies and resilience levels after the program. Conclusions: A formal educational intervention, teaching self-awareness and self-regulation skills can help reduce medical students' distress and promote their well-being even amidst a pandemic.

Antecedentes: Los estudiantes de medicina experimentan altos niveles de estrés y burnout durante la formación clínica. Sin embargo, la mayoría de los planes de estudios médicos no enseñan habilidades de autocuidado. La pandemia de COVID-19 ha conmocionado la educación médica provocando mayor distrés entre los estudiantes. Objetivo: Informar sobre la implementación y el impacto de un programa multifacético de autocuidado -basado en mindfulness (atención consciente)-sobre el distrés y el bienestar de los estudiantes de medicina durante la pandemia de COVID-19. Material y Métodos: Ciento veintitrés estudiantes de medicina de cuarto año asistieron al programa como parte de un curso obligatorio de abril a mayo de 2020, durante la fase ascendente de COVID-19 en Chile. Fueron evaluados mediante pruebas validadas antes e inmediatamente después del programa. Las medidas incluyeron burnout, mindfulness disposicional, estrés percibido, reacciones de estrés traumático, bienestar general, resiliencia y estrategias de afrontamiento del estrés. Resultados: La prevalencia del burnout disminuyó del 48% al 24%, mientras que los estudiantes con alto mindfulness aumentaron del 25% al 44%. La reducción del burnout se debió principalmente a la disminución del agotamiento emocional. Además, los estudiantes informaron niveles más bajos de estrés, autoinculpación y reacciones de estrés traumático junto con un mayor uso de estrategias activas de afrontamiento y mayores niveles de resiliencia, después del programa de autocuidado. Conclusiones: Una intervención educativa formal que enseñe habilidades de autoconciencia y autorregulación puede ayudar a reducir el burnout de los estudiantes de medicina y promover su bienestar incluso en medio de una pandemia.

Principales alimentos con azúcares añadidos y su variación geográfica y sociodemográfica: estudio latinoamericano de nutrición y salud (ELANS) / Main foods with added sugars and their geographic and sociodemographic variation: Latin American study of nutrition and health (ELANS)

Diversos estudios epidemiológicos y de intervención apuntan a una asociación fuerte y consistente entre la ingesta excesiva de azúcares y el riesgo de desarrollar caries dentales y enfermedades crónicas no transmisibles. El objetivo fue describir los 10 principales alimentos que contribuyen a la ingesta de azúcares añadidos en muestras representativas de poblaciones urbanas de ocho países latinoamericanos, y considerar diferencias por país, sexo, nivel socioeconómico (NSE) y grupo de edad. Se realizó una encuesta transversal multinacional en hogares de Argentina, Brasil, Chile, Colombia, Costa Rica, Ecuador, Perú y Venezuela (N=9218; 15­65 años). La contribución porcentual a la ingesta total del nutriente sirvió para identificar los alimentos aportadores. Los datos se estratificaron por país, sexo, NSE y grupo de edad y se compararon los gramos por día. Excepto en Perú y en el grupo de 50 a 65 años, los refrescos figuraron como el principal contribuyente a la ingesta de azúcares añadidos. Las bebidas caseras y las industrializadas también destacaron. Argentina fue el país con mayor ingesta de azúcares añadidos aportados por bebidas industrializadas, y Chile el país con menor frecuencia de bebidas como fuentes. Entre los 10 contribuyentes, la ingesta de azúcares añadidos fue mayor en el sexo masculino, excepto para sacarosa y pasteles dulces. Mayores ingestas de azúcares provenientes del jugo de fruta natural y sacarosa fueron observadas en el NSE más bajo. Las mayores y menores ingestas en los grupos de edad cambian de acuerdo con la fuente alimentaria. En conclusión, las bebidas azucaradas fueron los principales contribuyentes a la ingesta de azúcares añadidos, y la ingesta varió según la ubicación geográfica y los factores sociodemográficos(AU)

This study aimed to describe the top 10 foods that contribute to added sugars intake in representative samples of urban populations in eight Latin American countries, and consider differences by country, sex, socioeconomic level (SEL), and age group. A household-based, multinational, cross-sectional survey was conducted in Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela (N=9218; 15­65 years). Contributors to added sugars were identified and listed based on the percentage of contribution to total intake of this nutrient. Data were stratified by country, sex, SEL, and age group, and the grams per day compared. Except in Peru and in the 50 to 65 years age group, soft drinks were the leading contributor to added sugar intake. Homemade beverages together industrialized beverages have been a prominent position on ranking. In general, the highest intake of added sugars by industrialized beverages was from Argentina, and the lowest frequency of beverages as sources of added sugars was observed in Chile. Among the top 10 contributors, male sex had highest added sugar intake, except for sucrose and sweet cakes. Higher intakes of sugars from natural fruit juice and sucrose were observed in the lower SEL. The highest and lowest intakes in the age groups change according to the food source. In conclusion, sugar-sweetened beverages were main contributors to added sugar intake, and the intake vary with geographical location and sociodemographic factors(AU)

Remodelado cardíaco en el modelo preclínico de falla cardíaca isquémica experimental por dislipidemia en el ratón SR-B1 KO/ApoER6 1h/h / Cardiac remodeling in experimental cardiac failure induced by hyperlipidemia in mice

INTRODUCCIÓN: Los ratones SR-B1 KO/ApoER6 1h/h que son alimentados con una dieta rica en grasas saturadas, desarrollan enfermedad coronaria aterosclerótica severa, complicaciones isquémicas e insuficiencia cardíaca, con alta mortalidad. Los estudios con este modelo se han enfocado fundamentalmente en la enfermedad coronaria y menos en el remodelado cardíaco. El OBJETIVO del trabajo ha sido caracterizar el remodelado miocárdico, evaluar la evolución temporal de la función ventricular izquierda y la sobrevida asociada a enfermedad cardíaca por ateromatosis. MÉTODO: Ratones homocigotos SR-B1 KO/ApoER6 1h/h fueron alimentados por 8 semanas con dieta aterogénica o dieta normal y se comparó la sobrevida en ambos grupos. A las 4 semanas se realizó un ecocardiograma bidimensional. En los ratones eutanasiados se evaluó en la pared cardíaca fibrosis miocárdica y tamaño de los cardiomiocitos por morfometría, apoptosis con técnica de TUNEL e infiltración por células inflamatorias mononucleares (ED1) por inmunohistoquímica. RESULTADOS: En el grupo que recibió dieta aterogénica la sobrevida se redujo en 46,7% (p < 0.001), debido a muerte súbita y a falla cardíaca progresiva. En este grupo, a las 4 semanas se observó dilatación de cavidades izquierdas y disminución de la fracción de eyección del ventrículo izquierdo en comparación con el grupo control (79,3 ± 1,3% vs 66 ± 3,7%, p<0,01). También se observó aumento de la masa cardíaca relativa de 2.1 veces (p<0,001) y del peso pulmonar relativo en 80% (p<0,001), sin cambios en las dimensiones de los cardiomiocitos. En el miocardio de los ratones que recibieron dieta aterogénica hubo un aumento de la fibrosis cardíaca de 7.9 veces (p < 0.01) y del número de cardiomiocitos apoptóticos en 55.9 veces (p < 0.01), junto a un aumento del número de células inflamatorias mononucleares ED1. CONCLUSIONES: En el modelo de falla cardíaca severa de etiología isquémica con alta mortalidad en el ratón homocigoto SR-B1 KO/ApoER6 1h/h sometido a una dieta aterogénica, con falla cardíaca izquierda por disfunción sistólica, el remodelado patológico del miocardio está dado fundamentalmente por apoptosis y fibrosis. También se observa un aumento discreto de macrófagos en la pared cardíaca. Es posible que el edema parietal también pueda ser un mecanismo de remodelado relevante en este modelo.

Abstract: SR-B1 KO/ApoER6 1h/h mice fed a high saturated fat diet develop severe coronary atheromatosis, and cardiac failure with a high mortality rate. Cardiac remodeling under these conditions has not been well studied. AIM: To evaluate the time course of left ventricular function, cardiac remodeling and survival associated to the administration of an atherogenic diet. METHOD: Homozygote SR-B1 KO/ApoER6 1h/h mice received an atherogenic diet for 8 weeks. Mice receiving a normal diet served as controls. Survival rate, myocardial fibrosis, cardiomyocyte size, apoptosis and infiltration by inflammatory or mononuclear cells were compared between groups. A TUNEL technique was used to evaluate apoptosis. RESULTS: A 46.7% survival reduction compared to controls was observed in the experimental group (p<0.01), due to left ventricular and atrial dilatation associated to a decrease in ejection fraction (79,3 ± 1,3% vs 66 ± 3,7%, p<0,01, respectively). Also, an increased cardiac weight, 2.6 times greater was observed in the experimental group, compared to controls. Mice receiving the atherogenic diet showed an 80% increased lung weight. There was no evident change in cardiomyocytes, but there was more (7.9 times) cardiac fibrosis (p<0.01) and 55.9 times more apoptotic cells. (p<0.01), along with a greater number of inflammatory cells and ED1 mononuclear cells. CONCLUSION: Mice receiving an atherogenic diet develop heart failure and reduced survival rate. This is associated with cardiac remodeling with underlying apoptosis an ventricular wall fibrosis. It is posible that wall edema might contribute to the observed cardiac remodeling.

Niveles de colesterol no HDL en la población chilena y su asociación con enfermedad cardiovascular y diabetes mellitus: estudio de corte transversal en Encuesta Nacional de Salud 2009-2010 / Non-HDL cholesterol levels in Chilean population and their association with diabetes mellitus and cardiovascular disease

Background Despite aggressive treatment aimed at lowering LDL cholesterol (LDL-C) levels with statins, there is a high residual prevalence of cardiovascular diseases, which may depend on plasma cholesterol transported in other atherogenic lipoproteins. Aims To describe non-HDL cholesterol (non-HDL-C) levels in the Chilean population and their association with diabetes mellitus and cardiovascular disease. To evaluate compliance with non-HDL-C therapeutic goals -according to individual cardiovascular risk- at different levels of triglycerides, in comparison with LDL-C goal achievement. Material and Methods: We analyzed data from 2,792 Chilean subjects aged ≥ 15 years who were included in the 2009-2010 National Health Survey and had valid data for blood lipids, diabetes, and cardiovascular disease. Results Forty five percent of subjects had high non-HDL-C levels. The proportion of diabetic and non-diabetic subjects with high non-HDL-C levels was 81 and 42%, respectively (p < 0.01). A significant discordance was observed in the achievement of therapeutic objectives when LDL-C or non-HDL-C levels were considered, particularly in presence of triglycerides ≥ 150 mg/dl. Namely, 8% of the population showed elevated levels of high non-HDL-C despite adequate LDL-C levels. Conclusions Evaluation and management of elevated non-HDL-C in patients with adequate levels of LDL-C seems worthwhile considering the discordance observed between these blood cholesterol fractions. This strategy may be effective to reduce the residual cardiovascular risk in the Chilean population.

Burnout en la formación de profesionales de la salud en Chile: factores de protección y riesgo, y propuestas de abordaje desde la perspectiva de los educadores / Burnout in students of health-care professions: risk and protection factors

Background: The burnout syndrome affects more than half of students and professionals involved in healthcare worldwide and is characterized by emotional exhaustion, depersonalization and a low perception of self-efficacy. Several studies indicate that when students are burnt-out, clinical work, professionalism and ethical behavior, as well as empathy, are negatively affected, while the risk of academic attrition, depression and suicidal ideation tend to increase. At a national level, recent information shows that one out of every two medical students suffer burnout at the beginning of the clinical cycle, a situation that does not improve after finishing undergraduate medical training. There is no consensus on which are the most appropriate strategies to face the problem of burnout in students and health-care professionals. Some studies indicate that the experience of medical and health educators may be key to the design of effective strategies to address this problem. Aim: To identify the burnout risk and protection factors of students at different medical schools. Material and Methods: In this study -in which 34 expert health educators from eight Chilean medical schools and other health-related schools participated- we used a qualitative methodology based on the appreciative inquiry to explore the key elements associated with the occurrence of burnout, identify protective and risk factors, as well as discuss possible effective interventions to prevent it. Results: There are personal, academic and contextual elements that act as protective or risk factors of burnout. In addition, the educators identified key elements to design organizational and curricular interventions to face the problem of burnout at a local level. Conclusions: Burnout is a serious problem in the formation of health care professionals. Teacher training aimed at promoting student'well-being must include the teaching of communication skills that consider both the generation gap and the profile of the professional medical schools intend to form.

Impacto de la dieta mediterránea sobre las lipoproteínas de alta densidad / Mediterranean diet and HDL

Los niveles, la composición lipídica y proteica y las propiedades funcionales de las li-poproteínas de alta densidad (HDL) determinan las funciones biológicas de esta fracción lipoproteica y su papel protector contra el desarrollo de enfermedad cardiovascular. Estos parámetros de las HDL pueden ser modulados por intervenciones farmacológicas y no farmacológicas. En las dos últimas décadas, se ha establecido que el consumo de una dieta mediterránea, especialmente cuando se suplementa con aceite de oliva extra virgen, mejora diferentes parámetros cuantitativos (niveles de colesterol y número de partículas, en particular de mayor tamaño) y cualitativo-funcionales (capacidad de eflujo celular y esterificadora de colesterol libre, así como las actividades antioxidantes, de relajación endotelial y antiinflamatoria) de las partículas de HDL en humanos. Estos efectos probablemente contribuyen a la acción protectora ampliamente demostrada para la dieta mediterránea frente a diferentes enfermedades crónicas.

Levels, lipid and protein composition, and functional properties of high density lipoproteins (HDL) determine the biological functions of this lipoprotein fraction and its protective role in cardiovascular disease. These HDL-related parameters can be modulated by pharmacological and non-pharmacological interventions. In the last two decades, it has been established that consumption of Mediterranean diet, especially when supplemented with extra virgin olive oil, improves different quantitative parameters (cholesterol levels and number of particles, as well as particle size) and functional properties (cell cholesterol efflux, cholesterol esterification as well as antioxidant, endothelial relaxation, and anti-inflammatory activities) of HDL in humans. Most likely, these effects contribute to the widely demonstrated benefits of Mediterranean diet intake against different chronic diseases.

Origen, componentes y posibles mecanismos de acción de la dieta mediterránea / Origin, components and mechanisms of action of the Mediterranean diet

The Mediterranean diet is currently considered a healthy dietary pattern. It includes a great variety of foods, which are eaten in moderation and within a positive social environment. The generic term “Mediterranean diet” was born after the “Seven Countries Study” led by Ancel Keys around 1960. This dietary pattern is characterized by a high intake of fruits and vegetables, whole grains, legumes, nuts, fish, white meats and olive oil. It also includes moderate consumption of fermented dairy products, low intake of red meat and drinking wine with moderation during meals. Nutritionally, this diet is low in saturated fats and animal protein, high in antioxidants, fiber and monounsaturated fats, and exhibits an adequate omega-6/omega-3 fatty acid balance. The main bioactive compounds, which explain the health benefits of this dietary pattern, are antioxidants, fiber, monounsaturated and omega-3 fatty acids, phytosterols and probiotics. This diet is not exclusively confined to the Mediterranean Basin. Central Chile has a Mediterranean climate and our agriculture and culinary traditions are similar to those found in Mediterranean countries. Therefore, it is fundamental to increase awareness about the richness of our natural produce as well as our culinary culture, which may bring many health benefits and improve the quality of life in our population.

Consumo de huevo y enfermedad cardiovascular: una revisión de la literatura científica / Egg intake and cardiovascular disease: a scientific literature review

El huevo es un alimento que aporta proteína de alta calidad y numerosos nutrientes con potenciales beneficios para la salud. Sin embargo, la aparición de la enfermedad cardiovascular como importante causa de morbilidad y mortalidad en el mundo, junto con la identificación de los niveles elevados de colesterol plasmático como factor de riesgo para esta patología, llevó, en los años 70, a profesionales e instituciones de salud a limitar el consumo de colesterol y, por tanto, de huevo en la población. Hasta la fecha, los análisis de cohortes prospectivas tienden a mostrar que el consumo de hasta un huevo diario no aumenta significativamente el riesgo cardiovascular en la población sana. Sin embargo, esta evidencia no es clara en los pacientes diabéticos y pone en duda que este alimento consumido en cantidades elevadas sea del todo inocuo en esta población en particular. Asimismo, estudios de intervención a corto plazo han mostrado que, en general, el consumo de huevo no afecta negativamente los factores de riesgo cardiovascular en individuos sanos así como en aquellos con enfermedad cardiometabólica. Además, estos estudios sugieren que la incorporación del huevo en la dieta podría traer beneficios adicionales, promoviendo un perfil lipídico menos aterogénico (AU)

Eggs are a highly nutritive food. They contain high quality protein and several nutrients with potential health benefits. Nevertheless, the appearance of cardiovascular disease as an important public health issue, with high morbidity and mortality rates worldwide, along with the identification of high blood cholesterol levels as a risk factor for this disease, was responsible for the advice to limit dietary cholesterol (and, therefore, eggs) that was promoted by health care professionals and institutions during the 70s. To date, several cohort studies show that the intake of one egg a day does not increase cardiovascular risk in the general population. However, this evidence is not clear among diabetic patients, and raises the question whether its consumption in large quantities is entirely safe in this particular population. Additionally, intervention studies have shown that egg consumption does not adversely affect cardiovascular risk factors neither in healthy individuals nor in those with cardiometabolic disease. Moreover, these studies suggest that the incorporation of egg to the diet could bring additional benefits such as promoting a less atherogenic lipid profile (AU)

Validation of a Spanish Version of the Mental Health Continuum-Short Form Questionnaire / Validación de la versión en español del Cuestionario del Continuo de Salud Mental-Versión Corta

BACKGROUND: The Mental Health Continuum-Short Form (MHC-SF) is a multidimensional measure of well-being designed to assess emotional, psychological and social well-being. It has been translated into different languages; however, there is no validated Spanish version. Our aim was to provide the Spanish-speaking community with a validated version of the MHC-SF. METHOD: We translated the questionnaire into Spanish (s-MHC-SF) and assessed its validity in a sample of 3,355 Chilean adults. The data was subjected to a confirmatory factor analysis using the original correlated-traits three-factor model and a recently described bifactor model. RESULTS: The scores obtained with s-MHC-SF had excellent reliability (α = .94). While the correlated-traits three-factor model provided an acceptable fit to the data, the bifactor model yielded a superior fit. According to measurement invariance results, both models could be used to compare scores over gender, geographical region, age, and time in the sample. CONCLUSION: s-MHC-SF is a valid questionnaire for the evaluation of personal well-being in Spanish-speaking populations

ANTECEDENTES: el Mental Health Continuum-Short Form (MHC-SF) es un instrumento multidimensional diseñado para evaluar los componentes emocional, psicológico y social del bienestar personal. Ha sido traducido a varios idiomas; sin embargo, no hay una versión validada en español. Nuestro objetivo fue proveer a la comunidad hispanoparlante de una versión válida del MHC-SF. MÉTODO: MHC-SF se tradujo al español (s-MHC-SF) y se aplicó a una muestra de 3.355 adultos chilenos. Se realizó un análisis factorial confirmatorio usando el modelo original de tres factores correlacionados y un modelo bifactorial recientemente descrito. RESULTADOS: los puntajes obtenidos con el s-MHC-SF mostraron alta confiabilidad (α = .94). Mientras el modelo correlacionado presentó un ajuste aceptable a los datos, el bifactorial mostró un ajuste superior. Según las pruebas de invarianza de medición, ambos modelos podrían ser utilizados para comparar puntajes según sexo, edad, región geográfica y tiempo en la muestra. CONCLUSIÓN: s-MHC-SF es un cuestionario válido para evaluar el bienestar en la población de habla hispana

Consumo de huevo y diabetes mellitus tipo 2: Una revisión de la literatura científica / Egg intake and diabetes mellitus type 2: A review of the scientific literature

RESUMEN El huevo es un alimento altamente nutritivo con potenciales beneficios para la salud. Sin embargo, debido a su elevado contenido de colesterol, su consumo ha sido restringido en la población general. El objetivo de esta revisión es difundir en la comunidad científica la evidencia más reciente sobre los efectos del consumo de huevo específicamente en sujetos con diabetes mellitus. Estudios observacionales muestran que el consumo de hasta un huevo al día no se asocia a una mayor prevalencia de enfermedad cardiovascular en la población general, pero podría aumentar el riesgo entre los diabéticos. Asimismo, algunos de estos estudios han mostrado que un elevado consumo de huevo se asocia a un aumento en la incidencia de diabetes en la población general. Por otro lado, estudios de intervención a corto plazo en este subgrupo muestra que el consumo de huevo no afecta negativamente los factores de riesgo cardiovascular ni control glicémico en estos pacientes. Además, su consumo podría aumentar el impacto del uso de dietas hipocalóricas en la disminución de peso corporal, una importante herramienta en el manejo médico de la diabetes.

ABSTRACT Eggs are a highly nutritious food with potential health benefits. However, because of its high cholesterol content, physicians have recommended consumption restrictions in the general population. The aim of this review is to update the scientific community on the latest research about the impact of egg consumption in subjects with diabetes mellitus. Although several observational studies show that an intake of one egg a day does not increase cardiovascular risk in the general population, however risk may increase among diabetics. Additionally, some prospective cohorts have associated associated higher egg intake with an increased diabetes incidence in the general population. On the other hand, short-term intervention studies have not shown any adverse outcome in terms of cardiovascular risk or glycemic control with egg intake. Moreover, there are studies that suggest a beneficial effect of egg consumption in weight reduction, an important therapeutic tool in diabetes management.

Developing a cooperative multicenter study in Latin America: Lessons learned from the Latin American Study of Nutrition and Health Project

[ABSTRACT]. This report examines the challenges of conducting a multicenter, cross-sectional study of countries with diverse cultures, and shares the lessons learned. The Latin American Study of Nutrition and Health (ELANS) was used as a feasibility study involving the most populous cities of eight countries in Latin America (Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela) in 2014–2015, about 40% of the population of the Americas. The target sample included 9 000 individuals, 15–65 years of age, and was stratified by geographic location (only urban areas), gender, age, and socioeconomic status. Six principal challenges were identified: team structuring and site selections; developing a single protocol; obtaining ethic approvals; completing simultaneous fieldwork; ensuring data quality; and extracting data and maintaining consistency across databases. Lessons learned show that harmonization, pilot study, uniformity of procedures, high data quality control, and communication and collaboration across sites are imperative. Barriers included organizational complexity, recruitment of collaborators and research staff, institutional cooperation, development of infrastructure, and identification of resources. Consensus on uniform measures and outcomes and data collection methodology, as well as a plan for data management and analysis, communication, publication, and dissemination of study results should be in place prior to beginning fieldwork. While challenging, such studies offer great potential for building a scientific base for studies on nutrition, physical activity, and other health topics, while facilitating comparisons among countries.

[RESUMEN]. En este informe se examinan los retos de llevar a cabo un estudio transversal multicéntrico en países con culturas diversas y se transmiten las enseñanzas extraídas. Se usó el Estudio Latinoamericano de Nutrición y Salud (ELANS) como un estudio de factibilidad realizado en el período 2014–2015, que incluyó las ciudades más populosas de ocho países de América Latina (Argentina, Brasil, Chile, Colombia, Costa Rica, Ecuador, Perú y Venezuela) y abarcó a cerca de 40% de la población de la Región de las Américas. La muestra establecida incluyó a 9 000 personas de 15 a 65 años de edad, y fue estratificada según la ubicación geográfica (solo zonas urbanas) y por sexo, edad y situación socioeconómica. Se encontraron seis retos principales: estructurar los equipos y seleccionar los sitios; preparar un protocolo único; obtener las aprobaciones éticas; terminar simultáneamente el trabajo sobre el terreno; velar por la calidad de los datos y extraer datos y mantener la uniformidad en todas las bases de datos. Las enseñanzas extraídas muestran que la armonización, los estudios piloto, la uniformidad de los procedimientos, el riguroso control de la calidad de los datos y la comunicación y colaboración entre todos los sitios son imperativos. Los obstáculos incluyeron la complejidad de la organización, el reclutamiento de colaboradores y personal de investigación, la cooperación institucional, el desarrollo de infraestructura y la definición de los recursos. Antes de comenzar el trabajo sobre el terreno, se debe llegar a un consenso acerca de mediciones y resultados uniformes y la metodología de recopilación de datos, así como un plan para la gestión y el análisis de los datos y la comunicación, publicación y difusión de los resultados del estudio. A pesar de que estos estudios constituyen un desafío, hacen posible establecer una base científica para los estudios sobre la nutrición, la actividad física y otros temas de salud, al facilitar las comparaciones entre los países de América Latina.

[RESUMO]. Neste relato se examinam os desafios de realizar um estudo transversal multicêntrico em países com culturas diversas e os ensinamentos tirados. O Estudo Latino-americano de Nutrição e Saúde (ELANS) serviu de estudo de viabilidade, englobando as cidades mais populosas de oito países da América Latina (Argentina, Brasil, Chile, Colômbia, Costa Rica, Equador, Peru e Venezuela) em 2014–2015, representando cerca de 40% da população das Américas. A amostra pretendida compreendeu 9.000 indivíduos com 15 a 65 anos de idade e foi estratificada por localização geográfica (exclusivamente áreas urbanas), sexo, idade e nível socioeconômico. Os seis principais desafios identificados foram: estruturar as equipes e selecionar as sedes, elaborar um único protocolo, obter as aprovações dos comitês de ética, realizar trabalho de campo simultâneo, assegurar a qualidade dos dados e extrair os dados e manter a consistência em todas as bases de dados. Os ensinamentos tirados demonstram serem imprescindíveis harmonização, estudo-piloto, uniformidade dos procedimentos, ótimo controle da qualidade dos dados e comunicação e colaboração entre as sedes. Entre as barreiras estão a complexidade organizacional, recrutamento de colaboradores e pessoal de pesquisa, cooperação institucional, desenvolvimento de infraestrutura e identificação dos recursos. Antes do início do trabalho de campo, deve-se chegar a um consenso sobre medidas e resultados uniformes e metodologia de coleta de dados assim como um plano para o gerenciamento e análise dos dados, comunicação, publicação e disseminação dos resultados dos estudos. Apesar da sua complexidade, tais estudos têm um grande potencial de fundar uma base científica para estudos de nutrição, atividade física e outros tópicos relacionados à saúde, ao mesmo tempo que facilitam comparações entre os países da América Latina.

Developing a cooperative multicenter study in Latin America: Lessons learned from the Latin American Study of Nutrition and Health Project / Elaboração de estudo cooperativo multicêntrico na América Latina: ensinamentos do Projeto do Estudo Latino-americano de Nutrição e Saúde / Elaboración de un estudio colaborativo multicéntrico en América Latina: enseñanzas extraídas del Estudio Latinoamericano de Nutrición y Salud

ABSTRACT This report examines the challenges of conducting a multicenter, cross-sectional study of countries with diverse cultures, and shares the lessons learned. The Latin American Study of Nutrition and Health (ELANS) was used as a feasibility study involving the most populous cities of eight countries in Latin America (Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela) in 2014-2015, about 40% of the population of the Americas. The target sample included 9 000 individuals, 15-65 years of age, and was stratified by geographic location (only urban areas), gender, age, and socioeconomic status. Six principal challenges were identified: team structuring and site selections; developing a single protocol; obtaining ethic approvals; completing simultaneous fieldwork; ensuring data quality; and extracting data and maintaining consistency across databases. Lessons learned show that harmonization, pilot study, uniformity of procedures, high data quality control, and communication and collaboration across sites are imperative. Barriers included organizational complexity, recruitment of collaborators and research staff, institutional cooperation, development of infrastructure, and identification of resources. Consensus on uniform measures and outcomes and data collection methodology, as well as a plan for data management and analysis, communication, publication, and dissemination of study results should be in place prior to beginning fieldwork. While challenging, such studies offer great potential for building a scientific base for studies on nutrition, physical activity, and other health topics, while facilitating comparisons among countries.

RESUMEN En este informe se examinan los retos de llevar a cabo un estudio transversal multicéntrico en países con culturas diversas y se transmiten las enseñanzas extraídas. Se usó el Estudio Latinoamericano de Nutrición y Salud (ELANS) como un estudio de factibilidad realizado en el período 2014-2015, que incluyó las ciudades más populosas de ocho países de América Latina (Argentina, Brasil, Chile, Colombia, Costa Rica, Ecuador, Perú y Venezuela) y abarcó a cerca de 40% de la población de la Región de las Américas. La muestra establecida incluyó a 9 000 personas de 15 a 65 años de edad, y fue estratificada según la ubicación geográfica (solo zonas urbanas) y por sexo, edad y situación socioeconómica. Se encontraron seis retos principales: estructurar los equipos y seleccionar los sitios; preparar un protocolo único; obtener las aprobaciones éticas; terminar simultáneamente el trabajo sobre el terreno; velar por la calidad de los datos y extraer datos y mantener la uniformidad en todas las bases de datos. Las enseñanzas extraídas muestran que la armonización, los estudios piloto, la uniformidad de los procedimientos, el riguroso control de la calidad de los datos y la comunicación y colaboración entre todos los sitios son imperativos. Los obstáculos incluyeron la complejidad de la organización, el reclutamiento de colaboradores y personal de investigación, la cooperación institucional, el desarrollo de infraestructura y la definición de los recursos. Antes de comenzar el trabajo sobre el terreno, se debe llegar a un consenso acerca de mediciones y resultados uniformes y la metodología de recopilación de datos, así como un plan para la gestión y el análisis de los datos y la comunicación, publicación y difusión de los resultados del estudio. A pesar de que estos estudios constituyen un desafío, hacen posible establecer una base científica para los estudios sobre la nutrición, la actividad física y otros temas de salud, al facilitar las comparaciones entre los países de América Latina.

RESUMO Neste relato se examinam os desafios de realizar um estudo transversal multicêntrico em países com culturas diversas e os ensinamentos tirados. O Estudo Latino-americano de Nutrição e Saúde (ELANS) serviu de estudo de viabilidade, englobando as cidades mais populosas de oito países da América Latina (Argentina, Brasil, Chile, Colômbia, Costa Rica, Equador, Peru e Venezuela) em 2014-2015, representando cerca de 40% da população das Américas. A amostra pretendida compreendeu 9.000 indivíduos com 15 a 65 anos de idade e foi estratificada por localização geográfica (exclusivamente áreas urbanas), sexo, idade e nível socioeconômico. Os seis principais desafios identificados foram: estruturar as equipes e selecionar as sedes, elaborar um único protocolo, obter as aprovações dos comitês de ética, realizar trabalho de campo simultâneo, assegurar a qualidade dos dados e extrair os dados e manter a consistência em todas as bases de dados. Os ensinamentos tirados demonstram serem imprescindíveis harmonização, estudo-piloto, uniformidade dos procedimentos, ótimo controle da qualidade dos dados e comunicação e colaboração entre as sedes. Entre as barreiras estão a complexidade organizacional, recrutamento de colaboradores e pessoal de pesquisa, cooperação institucional, desenvolvimento de infraestrutura e identificação dos recursos. Antes do início do trabalho de campo, deve-se chegar a um consenso sobre medidas e resultados uniformes e metodologia de coleta de dados assim como um plano para o gerenciamento e análise dos dados, comunicação, publicação e disseminação dos resultados dos estudos. Apesar da sua complexidade, tais estudos têm um grande potencial de fundar uma base científica para estudos de nutrição, atividade física e outros tópicos relacionados à saúde, ao mesmo tempo que facilitam comparações entre os países da América Latina.

Evidencia actual sobre los beneficios de la dieta mediterránea en salud / Current evidence on health benefits of the mediterranean diet

The Mediterranean diet is currently considered a functional diet with an increasing amount of scientific evidence that supports its beneficial effects in human health. Several observational cross-sectional and prospective cohort studies show an association between this diet and a lower prevalence and incidence of chronic diseases, such as cardiovascular disease, cancer, metabolic syndrome, diabetes, and neurodegenerative diseases as well as a reduced overall mortality. Additionally, clinical interventional studies, particularly the PREDIMED (Prevención con Dieta Mediterránea) initiative, have shown, with high quality scientific evidence, that a Mediterranean diet -supplemented either with olive oil or nuts- can lower by 30% the incidence of cardiovascular disease, reverse the metabolic syndrome, and prevent the development of diabetes and aging-related cognitive decline. Chile has one of the five Mediterranean ecosystems in the world, and therefore the implementation of this food pattern and lifestyle in our country may determine large benefits to the health status and quality of life in the Chilean population.

Efecto del ciprofibrato sobre el metabolismo del colesterol HDL y la capacidad antioxidante plasmática en el ratón / Effect of ciprofibrate on HDL cholesterol metabolism and plasma anti-oxidant capacity in mice

Antecedentes: Las dislipidemias, ya sea un aumento en los niveles de colesterol LDL y/o una disminución en las cifras de colesterol HDL, son muy relevantes para el desarrollo de la enfermedad cardiovascular ateroesclerótica, siendo el colesterol HDL bajo la dislipidemia más frecuente en la población chilena. Con respecto al colesterol HDL bajo y los tri -glicéridos elevados, los fibratos, agonistas del receptor nuclear PPAR-a que modula la transcripción de genes involucrados en el metabolismo de lípidos, representan una importante alternativa de manejo farmacológico de las dislipidemias. Sin embargo, estudios clínicos recientes no han sido concluyentes con respecto a su beneficio real sobre el control de la ateroesclerosis cuando se usan combinados con estatinas. Objetivo: Evaluar el impacto de la administración de fibratos sobre el metabolismo del colesterol HDL y la función antioxidante del plasma usando el ratón como modelo experimental. Metodología: Los ratones de la cepa C57BL/6 fueron tratados con ciprofibrato al 0,2% en dieta control durante 7 días. Luego del tratamiento, se analizaron los niveles de colesterol plasmático y triglicéridos, la expresión hepática de proteínas claves involucradas en el metabolismo de colesterol HDL, el contenido de colesterol hepático, la secreción de colesterol biliar y el daño oxidativo y la función antioxidante plasmática. Resultados: El tratamiento con ciprofibrato disminuyó significativamente los niveles de triglicéridos plasmáticos y la expresión hepática del receptor de HDL SR-BI, efecto que se correlacionó con un aumento en el tamaño de las partículas de HDL, pero no en los niveles de colesterol HDL. Además, el ciprofibrato disminuyó los niveles proteicos de los transportadores de colesterol ABCG1 y ABCG8, aunque no modificó ABCA1, en conjunto con una reducción del contenido hepático de colesterol y un aumento en la secreción de colesterol hacia la bilis. Finalmente, el uso de este hipolipemiante mejoró la función antioxidante del plasma, aunque se detectó un aumento en el daño nitrosativo de las proteínas plasmáticas. Conclusión: Este estudio ha permitido obtener nueva información sobre el efecto metabólico y funcional de la administración de fibratos en ratones, lo cual podría ayudar comprender los resultados de estudios clínicos recientes que han usado esta clase de hipolipemiantes en humanos.

Background: Increased serum levels of LDL cholesterol and/or decreased values of HDL cholesterol are very relevant for atherosclerotic cardiovascular disease. Low HDL cholesterol is the most prevalent dyslipidemia in the Chilean population. Regarding reduced HDL cholesterol and high triglyceride levels, fibrates, nuclear receptor PPAR-a agonists that modulate transcription of genes involved in lipid metabolism, represent an important alternative for pharmacological management of dyslipidemia. However, recent clinical studies have been inconclusive with respect to their real benefit on atherosclerosis when used in combination with statins. Aim: To evaluate the impact of fibrate administration on HDL cholesterol metabolism and antioxidant plasma functionality using the mouse as experimental model. Methodology: Using wild-type C57BL/6 mice, ciprofibrate was administered at 0.2% in chow diet for 7 days. After treatment, plasma cholesterol and triglycerides levels, hepatic expression of key proteins involved in HDL cholesterol metabolism, liver cholesterol content, biliary cholesterol secretion, and plasma oxidative damage and antioxidant function were analyzed. Results: Ciprofibrate treatment significantly decreased plasma triglycerides levels and hepatic HDL receptor SR-BI expression. This latter finding was associated with increased HDL particle size, without changes in HDL cholesterol levels. Furthermore, ci-profibrate decreased hepatic expression of cholesterol transporters ABCG1 and ABCG8, but not ABCA1, which correlated with reduced liver cholesterol content and increased biliary cholesterol secretion. Fina-lly, fibrate therapy improved plasma antioxidant func-tion, even though increased nitrosative plasma protein damage was detected. Conclusion: This study has provided new information on metabolic and functional effects derived from fibrate use in mice and it may help to better understand recent clinical findings using this lipid-lowering drug class in humans.

Validación de cuestionario autoaplicable para un índice de alimentación mediterránea en Chile / Validation of self-applicable questionnaire for a Mediterranean dietary index in Chile

Background: Availability of brief dietary indexes that can effectively evaluate dietary patterns and their association with health is critical for prevention and management of several chronic disease conditions. Aim: To adapt a self-applicable Mediterranean Dietary Index in Chile (Chilean-MDI). Material and Methods: The Chilean-MDI was developed based on a previous Mediterranean eating score that was adapted to Chilean dietary habits. This index was further validated in a sample of 153 adults by comparing the concordance between the results obtained by self-application of the Chilean-MDI with those obtained by a trained nutritionist. Additionally, the index was applied in a sample of 53,366 Chilean adults in order to describe the diet quality of our population. Results: There was an adequate concordance between findings obtained by self-application of the Chilean-MDI and those achieved by the nutritionist. The application of the index in Chilean adult population showed a better diet quality (high Mediterranean diet adherence) among women, with advanced age and among people with higher educational levels. Conclusions: The Chilean-MDI can be successfully self-applied to portray the overall diet quality in the Chilean adult population. Additionally, this dietary index describes overall food intake in Chilean adults, showing demographic trends that are comparable to those obtained with similar indexes applied in other populations.

Una alimentación poco saludable se asocia a mayor prevalencia de síndrome metabólico en la población adulta chilena: estudio de corte transversal en la Encuesta Nacional de Salud 2009-2010 / Unhealthy food intake is linked to higher prevalence of metabolic syndrome in Chilean adult population: cross sectional study in 2009-2010 national health survey

Introducción: el síndrome metabólico (SM) es un conjunto de factores de riesgo que predisponen a padecer enfermedad cardiovascular y diabetes. Una dieta poco saludable juega un rol importante en el desarrollo de esta condición. En este estudio evaluamos la prevalencia de síndrome metabólico y su asociación con la calidad de la dieta en adultos chilenos. Métodos: se analizaron los datos de 2.561 adultos mayores de 18 años de edad incluidos en la última Encuesta Nacional de Salud (ENS 2009-2010), que contaban con información para el diagnóstico de síndrome metabólico siguiendo los criterios de ATP III-NCEP. La frecuencia de consumo de pescado, cereales integrales, frutas, verduras y lácteos fue analizada y asociada a la presencia de SM. Por medio de un índice de dieta saludable (IDS), se evaluó la calidad global de la dieta y se correlacionó con la prevalencia de este síndrome. Resultados: un menor consumo de cereales integrales se asoció a una mayor prevalencia de síndrome metabólico (OR=1,78; 95% IC: 1,088-2,919; p=0,022). El IDS mostró que el consumo de alimentos tiene mejor calidad en mujeres y a mayor edad y mejor nivel educacional. Un IDS <3 puntos se asoció con un mayor riesgo de síndrome metabólico (OR IDS<3 / IDSmás o menos3=3,69 95% IC: 1,884- 7,225, p<0,001). Conclusión: la población adulta chilena presenta una elevada prevalencia de síndrome metabólico asociado al consumo de una alimentación de mala calidad (AU)

Introduction: metabolic syndrome (MS) is a clustering of risk factors known to promote cardiovascular disease and diabetes. Environmental factors, such as unhealthy diet, play a major role in the development of this condition. In this study, we evaluated the prevalence of MS and its association with food intake quality among Chilean adults. Methods: we analyzed data of 2 561 adults (greater than or equal to 18 years-old) included in the last National Health Survey (NHS 2009-2010) who had appropriate information to diagnose MS based on ATP III-NCEP guidelines. Consumption frequency of fish, whole grains, dairy, fruits and vegetables was also analyzed and associated with MS prevalence. Using a healthy diet score (HDS), we described the overall diet quality and further correlated it with MS prevalence. Results: we found that lower whole grain intake was associated with greater MS prevalence (OR=1.78; 95% CI: 1.088-2.919; p=0.022). HDS showed better diet quality among women and in subjects with increasing age and higher educational level. A HDS<3 points was associated with an increased risk of MS (OR HDS<3 / HDSgreater than or equal to 3=3.69; 95% CI 1.884-7.225, p<0.001). Conclusion: Chilean adult population exhibits a high prevalence of MS linked to a poor diet quality (AU)