Barriers and Opportunities for Clinical Nutritionists in 13 Latin American Countries: A Qualitative Study.

A clinical nutritionist (CN) is a university-educated professional trained to perform preventive and recovery functions in the health of patients. The actions of these professionals, both worldwide and in Latin America, may face barriers and opportunities that require careful identification and examination. The main objective of this study is to identify the most important barriers and opportunities for the clinical nutritionist in 13 Latin American countries. A qualitative study was carried out; the initial phase involved conducting in-depth individual interviews with 89 informants, experienced CNs from 13 Latin American countries. After calculating the mean and standard deviation, we ranked the top 10 most frequently reported barriers by assigning a score ranging from 1 to 10. Additionally, 3 opportunities were identified with a lower score from 1 to 3. Means and standard deviation were calculated to sort the responses. Results: the most important barrier was the absence of public policies that regulate and/or monitor compliance with the staffing of CNs according to the number of hospital beds, while the most important opportunity was the advances in technology such as software, body analysis equipment and other tools used in Nutritional Care. The identified barriers can interfere with the professional performance of CNs and, moreover, make it difficult to monitor the good nutritional status of patients. It is recommended to consider the barriers identified in this study, as well as the opportunities, with a view to improving the quality of hospital services with an adequate supply of nutritionists.

Association between Sarcopenia and Nutritional Status in Chilean Older People Aged 65 Years and Older.

In 2018 the European Working Group on Sarcopenia in Older People (EWGSOP2) updated the definition of sarcopenia, with loss of muscle strength being the primary feature. The objective is to describe and associate sarcopenia and nutritional status in a group of Chilean older adults aged 65 years and older. METHODS: Descriptive, associative and comparative study, with a cross-sectional design and a quanti-qualitative approach. A number of 155 institutionalized and community-dwelling Chilean older people aged 65 years and older participated in the study (year 2018). Sarcopenia was diagnosed using the algorithm proposed by the EWGSOP2. Muscle strength, muscle quantity and physical performance were assessed; Body Mass Index (BMI) and Mini Nutritional Assessment (MNA) were used. Variables were described according to sex and age groups (65-69; 70-79; and ≥80 years). The association between sarcopenia and nutritional status was studied by the application of multivariate logistic regression analysis with adjustments for age and sex. RESULTS: 49.7% and 5.2% of older adults had probable sarcopenia and severe sarcopenia, respectively; 52.9% and 7% had malnutrition by excess and by deficit, respectively, according to their BMI; and 33.5% had malnutrition according to the MNA. Participants with obesity had 3.2 times more risk of presenting sarcopenia, versus subjects with normal nutritional status (OR: 3.2; 95% CI; 1.24; 8.26). CONCLUSION: Sarcopenia, as defined by the criteria of the EWGSOP2, depends on the nutritional status according to BMI in older people, with obese individuals being at greater risk of suffering from sarcopenia. Nearly 50% had probable sarcopenia, a condition that could be detected early with the purpose of taking preventive measures, such a nutritional approach.

Comparación de criterios diagnósticos de presión arterial entre la rama de nefrología de la Sociedad Chilena de Pediatría y la Academia Americana de Pediatría en escolares / Comparison of diagnostic criteria for blood pressure between the Division of Nephrology of the Chilean Society of Pediatrics and the American Academy of Pediatrics in schoolchildren

Fundamentos: La hipertensión primaria está subdiagnosticada en pediatría, su prevalencia de 3,5% va enaumento. El objetivo fue establecer diferencias diagnósticas entre las tablas de clasificación de infantes de 0 a9 años de la Atención Primaria de Salud de Chile, basadas en la Rama de Nefrología de la Sociedad Chilena dePediatría, 2021 y la Academia Americana de Pediatría, 2017. Métodos: Estudio comparativo, descriptivo, asociativo, diseño no experimental, transversal. Muestra porconveniencia: 230 escolares de 6 a 8 años de Valparaíso. Se evaluó presión arterial, estado nutricional,perímetro de cintura. Los datos se tomaron en 2015, 2018, 2019. Pruebas Chi-cuadrado, Tau-b Kendall. Resultados: sin diferencias significativas de distribución entre las clasificaciones de la Sociedad Chilena dePediatría y la Academia Americana de Pediatría; hay asociación entre el índice de masa corporal y ambasescalas (rτ = 0,179, p = 0,003; rτ = 0,059, p = 0,323 y rτ = 0,203, p = 0,001; rτ = 0,077, p = 0,192),respectivamente. La escala americana tenía un mejor grado de diferenciación en sus categorías elevada,etapas 1 y 2 y con el perímetro de cintura. (AU)

Background: Primary hypertension is underdiagnosed in pediatric patients, with a prevalence of 3.5% that ison the rise. Objective: To establish differences in the diagnosis of the classification system of the primaryhealthcare network of Chile for children aged 0 - 9 years, based on the guidelines of the Division ofNephrology of the Chilean Society of Pediatrics, 2021, and the American Academy of Pediatrics, 2017. Methods: Comparative, descriptive, associative study, with a non-experimental, cross-sectional design.Convenience sample: 230 schoolchildren aged 6 - 8 years, Valparaiso. Blood pressure, nutritional status andwaist circumference were assessed. Data were collected in 2015, 2018, 2019. Kendall's tau-b and Chi- squaretests were used. Results: there are not significant differences of distribution between the classifications of the Chilean Societyof Pediatrics and the American Academy of Pediatrics; there is an association between body mass index andboth classification systems (rτ = 0.179, p = 0.003; rτ = 0.059, p = 0.323 and rτ = 0.203, p = 0.001; rτ = 0.077, p =0.192), respectively. The American scale shows a better degree of differentiation in the categories high bloodpressure, stage 1 and stage 2, and regarding waist circumference. Conclusions: The American scale shows a better differentiation between categories of classification withrespect to waist circumference. (AU)

Publicidad alimentaria según grupos y sub-grupos de alimentos en la televisión de Chile / Food advertising by groups and sub-groups of food on television of Chile

Introducción: Obesidad, factor en el desarrollo de Enfermedades No Transmisibles. Se destaca entre sus causas el ver televisión que promueve el sedentarismo y consumo de alimentos alto en nutrientes críticos, mediante sus estrategias publicitarias. Objetivo: Describir la frecuencia, duración y contenido nutricional de la publicidad alimentaria emitida en los canales de la Asociación Nacional de Televisión de Chile durante noviembre del 2010, según grupos y sub-grupos de alimentos. Métodos: Estudio transversal con muestra dirigida. Fue observada la publicidad alimentaria emitida en los canales de la Asociación Nacional de Televisión chilena de lunes a domingo de 8:00-22:00 horas entre el 7 y 28 de noviembre del 2010. Se recolectaron los datos por observación estructurada con registro directo en instrumentos pre-diseñados y el análisis fue realizado según grupos y sub-grupos de alimentos. Resultados: De las 392 horas observadas un 17% fue publicidad y de ésta 24% publicidad alimentaria. Los grupos; bebidas e infusiones, lácteos, golosinas y snacks y cereales y los sub-grupos; bebidas gaseosas, yogurt, té y jugos, presentaron la mayor frecuencia y/o duración. La composición nutricional de los grupos de alimentos presentó un rango de carbohidratos de 10,4- 48,6g, grasas totales de 0,4-13,1g, grasas saturadas de 0,4-3,7g y sodio de 25,4-247,7mg por 100g o ml de producto. Discusión: Los resultados demuestran la importancia de regular efectivamente la publicidad alimentaria emitida en la televisión chilena, especialmente la dirigida a menores. Conclusiones: La publicidad alimentaria chilena presenta un alto contenido de nutrientes críticos que pueden impactar sobre la obesidad y enfermedades no transmisibles (AU)

Introduction: Obesity factor in the development of noncommunicable diseases. It stands out among its causes watching television that promotes a sedentary lifestyle and consumption of foods high in critical nutrients through their advertising strategies. Objective: To describe the frequency, duration and nutritional content of food advertising broadcast on channels of the National Association of Television of Chile during November 2010, according to groups and sub-groups of food. Methods: Cross-sectional study shows directed. It was observed food advertising broadcast on channels of the National Association of Chilean TV from Monday to Sunday from 8: 00-22: 00 hours between 7 and 28 November 2010. The data were collected by observation structured with direct registration pre-designed instruments and analysis was performed by groups and sub-groups of food. Results: Of the 392 hours was observed 17% advertising and 24% of this food advertising. The drinks and teas, milk, snacks and grain, groups and soft drinks, yogurt, and juice subgroups had the highest frequency and/or duration. The nutritional composition of the food groups presented a range 10,4-48,6g carbohydrates, 0,4-13,1g total fat, 0,4-3,7g saturated fat and 25,4- 247,7mg sodium per 100g or ml of product. Discussion: The results demonstrate the importance of effectively regulate food advertising broadcast on Chilean television, especially aimed at children. Conclusions: Chilean food advertising has a high content of critical nutrients that may impact on obesity and noncommunicable diseases (AU)