Browsing by Author "Calzada, Mariana"

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    Asociación entre los niveles séricos de ácido úrico y síndrome metabólico en pacientes chilenos y respuesta a intervención con dieta mediterránea
    (2024) Ovalle Inostroza, Pía Alejandra; Calzada, Mariana; Rigotti Rivera, Attilio; Pontificia Universidad Católica de Chile. Escuela de Medicina
    Introducción: Aunque la asociación entre hiperuricemia y síndrome metabólico (SMet) ha sido demostrada, existe escasa evidencia para confirmar su valor pronóstico en esta condición. Adicionalmente, una intervención basada en dieta mediterránea (DM) podría disminuir la uricemia. Objetivos: Evaluar la asociación entre niveles de AU y SMet y si estos son modificados por una intervención con DM. Métodos: Estudio transversal y de intervención derivado del estudio CHILEMED que considera 3 grupos: dieta baja en grasas (DBG), DM y DM + apoyo en bienestar psicológico (DM+BP). Se incluyeron participantes adultos con SMet y evaluados sin SMet. Se midieron niveles de AU y adherencia a DM a través del Índice de DM para Chile (IDM Chile) a 0 y 6 meses de intervención. Resultados: Se seleccionaron 325 participantes [244 (75%) con SMet y 81 (25%) sin SMet], 59% mujeres con una mediana de edad de 46 años [40-54]. La mediana de AU en los participantes sin SMet fue 4,7 mg/dL [4-5,6] versus 5,2 mg/dL [4,4-6,2] en aquellos con SMet (p = 0,002). Los modelos de regresión logística identificaron una asociación entre AU y SMet al ajustar por edad, sexo y variables componentes del SMet en participantes hombres (p = 0,034; R2 Nagelkerke = 57,9%). No se demostró correlación entre los cambios de AU e IDM Chile (p = 0,877). Al evaluar los niveles de AU en aquellos con SMet intervenidos con DBG y DM, no se observaron cambios significativos a 6 meses (p = 0,273 y p = 0,149, respectivamente). Conclusiones: Se identificó una asociación entre AU y SMet al ajustar por edad y componentes del SMet en los participantes hombres. No se identificó una reducción significativa en la uricemia de participantes intervenidos con DM.
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    Limitaciones y oportunidades para la adopción de la dieta mediterránea en adultos chilenos con elementos diagnósticos del síndrome metabólico
    (2024) Calderón, Maribel; Plaza Paz, Gianella; Gómez, Marisol; Samith Catalán, Bárbara Patricia; Pinto Manzo, Victoria Sabina; Martínez Cifuentes, Ximena; Sara Zaror, Daniela Alejandra; Echeverría Errázuriz, Guadalupe; Calzada, Mariana; Berkowitz Fiebich, Loni; Von Schultzendorff Hoyl, Beatriz Andrea; Pedrals, Nuria; Bitrán Carreño, Marcela; Rigotti Rivera, Attilio
    Background: a healthy food intake pattern, specifically the Mediterranean diet (MedDiet), is a factor associated with reduced risk, lower prevalence, and better management of chronic diseases. However, there is limited information regarding how patients integrate proposals for adherence to this food pattern in their daily lives. Objective: to identify factors and conditions that influence adherence to the MedDiet in Chile. Methods: an exploratory qualitative study was applied in 35 to 65-year-old patients of both sexes who presented at least one diagnostic criterion of metabolic syndrome (MetS). Through in-depth interviews and focal groups, knowledge, assessment, attitudes, and practices associated with changes and maintenance of healthy eating habits, with emphasis on the MedDiet, were investigated. Information analysis was carried out under the grounded theory approach using the ATLAS.ti software. Results: participants recognized the value of healthy eating, including the MedDiet, but declared low knowledge (identification of single foods items) together with facilitators (variety of ingredients) and limiting factors (taste, availability/cost of some items, family dynamics) for its routine adoption. In addition, change in eating habits generates a high initial cognitive and emotional load that requires not only individual but also relational effort as it implies modifications of family and collective practices. Conclusions: information obtained on barriers and opportunities to adhere to healthy eating such as the MedDiet is key to design and implement nutritional interventions based on this food pattern and that can be sustainable in time for chronic disease management in Chile.
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    Limitations and opportunities for the appropriation of the Mediterranean diet in Chilean adults with diagnostic elements of metabolic syndrome
    (2024) Calderon, Maribel; Plaza, Gianella; Gomez, Marisol; Samith, Barbara; Pinto, Victoria; Martinez, Ximena; Sara, Daniela; Echeverria, Guadalupe; Calzada, Mariana; Berkowitz, Loni; von Schultzendorf, Andrea; Pedrals, Nuria; Bitran, Marcela; Rigotti, Attilio
    Background: a healthy food intake pattern, specifically the Mediterranean diet (MedDiet), is a factor associated with reduced risk, lower prevalence, and better management of chronic diseases. However, there is limited information regarding how patients integrate proposals for adherence to this food pattern in their daily lives. Objective: to identify factors and conditions that influence adherence to the MedDiet in Chile. Methods: an exploratory qualitative study was applied in 35 to 65 -year -old patients of both sexes who presented at least one diagnostic criterion of metabolic syndrome (MetS). Through in-depth interviews and focal groups, knowledge, assessment, attitudes, and practices associated with changes and maintenance of healthy eating habits, with emphasis on the MedDiet, were investigated. Information analysis was carried out under the grounded theory approach using the ATLAS.ti software. Results: participants recognized the value of healthy eating, including the MedDiet, but declared low knowledge (identification of single foods items) together with facilitators (variety of ingredients) and limiting factors (taste, availability/cost of some items, family dynamics) for its routine adoption. In addition, change in eating habits generates a high initial cognitive and emotional load that requires not only individual but also relational effort as it implies modifications of family and collective practices. Conclusions: information obtained on barriers and opportunities to adhere to healthy eating such as the MedDiet is key to design and implement nutritional interventions based on this food pattern and that can be sustainable in time for chronic disease management in Chile.
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    Mediterranean diet and psychological well-being intervention to reverse metabolic syndrome in Chile (CHILEMED trial)
    (2023) Echeverría Errázuriz, Guadalupe; Samith Catalán, Bárbara Patricia; Von Schultzendorff Hoyl, Beatriz Andrea; Pinto Manzo, Victoria Sabina; Martínez Cifuentes, Ximena; Sara Zaror, Daniela Alejandra; Calzada, Mariana; Pacheco Gutiérrez, Josefina; Plaza Paz, Gianella; Scott Escorza, Francesca Angelina; Romero Romero, Javiera Constanza; Mateo Hernández, Camila; Julio Gonzalez, Maria Verónica; Utreras Mendoza, Yildy; Binder Correa, María Victoria; Gutiérrez Medina, Florencia Antonia; Riquelme Stagnaro, María Emilia; Cuevas Guzmán, Margarita María; Willatt, Rosario; Sánchez González, Omayra Margarita De Jesús; Keilendt Astete, Aracelli Tiare; Butron, Patricia; Jarufe Calabrese, Alessandra Antonia; Huete Rubio, Isidora Sofia; Tobar Bavestrello, Josefina Isidora; Martin. Sofía; Alfaro, Valentina; Olivos Celedón, Matilde; Pedrals, Nuria; Bitrán Carreño, Marcela; Ávalos, Ivette; Ruini, Chiara; Ryff, Carol; Pérez Pons, Druso Diego; Berkowitz Fiebich, Loni; Rigotti Rivera, Attilio
    Psychosocial status and lifestyle are key risk factors of non-communicable diseases (NCDs), which, in turn, are main drivers of healthcare costs and morbimortality worldwide, including Chile. Mediterranean diet (MedDiet) is one of the healthiest dietary patterns under study. However, its impact on high-risk conditions, such as metabolic syndrome (MetS), and NCDs outside the Mediterranean Basin remains mostly unexplored. Even though Central Chile has an environment, food production, and culinary traditions comparable to those present in Mediterranean countries, few studies -some with significant methodological limitations- have evaluated the effect of MedDiet on health and/or disease in Chilean subjects. Importantly, a Mediterranean lifestyle is a modus vivendi that integrates physical health with mental and social well-being. Psychological well-being (PWB) is associated with healthy behaviors, positive health outcomes, and longevity, thereby emerging as a novel healthcare goal. We report here an ongoing randomized controlled clinical trial in Chilean patients with MetS seeking to test whether (1) a PWB theory-based intervention facilitates induction to and increases long-term adherence to a locally adapted MedDiet, and (2) a MedDiet intervention -implemented alone or combined with well-being promotion- is more effective at reversing MetS compared to individuals following a low-fat diet without psychological support. The CHILEan MEDiterranean (CHILEMED) diet intervention study is a 1-year trial including patients with MetS living in Chile. Participants will be assigned randomly by a computer-generated random number sequence to one of the three intervention arms: a) low-fat diet as control group, b) MedDiet alone, and c) MedDiet plus well-being support. Patients will be followed-up by individual and/or group online nutritional sessions or phone cal as well as 6- and 12-month in-person re-assessment of medical history, medication use, food intake, PWB, anthropometrics/physical exam, and blood collection for laboratory analysis. The primary outcome of the trial will be the effect of the MedDiet -with or without PWB intervention- on overall reversal of MetS compared to low-fat diet alone. Based on a statistical superiority trial, expected impact, and patient loss, the estimated study sample is 339 subjects (113 individuals per arm in 3 equal-sized groups). Currently, we have enrolled 179 patients, predominantly women, evenly distributed by age (group means ranging from 45.7 to 48,9 years-old), 3/4 are obese with almost all of them showing abdominal obesity, 70% are hypertensive, whereas <10% exhibit diabetes. If findings turn out as expected (e.g., MedDiet -with or without PWB intervention- is better than the low-fat diet for reversion of MetS at 1-year follow-up), CHILEMED will provide further beneficial evidence of the MedDiet on NCD risk conditions beyond the Mediterranean region.