Browsing by Author "Echeverría Errázuriz, Guadalupe"

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    Assessment of Diet Quality in Chilean Urban Population through the Alternate Healthy Eating Index 2010: A Cross-Sectional Study
    (2019) Pinto Manzo, Victoria Sabina; Landaeta-Díaz, Leslie; Castillo, Oscar; Villarroel Del Pino, Luis Antonio; Rigotti Rivera, Attilio Gianpietro; Echeverría Errázuriz, Guadalupe
    Most worldwide causes of disease and death are strongly associated with dietary factors and the application of eating indexes has proved to be a useful tool to determine diet quality in populations. The aim of this study was to evaluate the diet quality in Chile through the application of the Alternate Healthy Eating Index 2010 (AHEI-2010). A representative sample (n = 879) of Chilean urban population aged 15-65 years old from the Latin American Study of Nutrition and Health (Estudio Latinoamericano de Nutricion y Salud; ELANS) was used. Dietary intake data were obtained through two 24-hour food recalls and one beverage frequency questionnaire, which were used to calculate AHEI-2010 and its association with sociodemographic and anthropometric variables. In this Chilean sample, the AHEI-2010 score was 43.7 +/- 7.8 points (mean +/- SD). Trans fats and sodium intake were the highest scoring AHEI-2010 components whereas sugar-sweetened beverages and whole grains had the lowest score. Women, older subjects, and individuals in medium-high socioeconomic levels had significantly higher mean AHEI-2010 scores. No association was found between AHEI-2010 and body mass index (BMI), or nutritional status. Conclusions: Diet quality in the Chilean urban population aged 15-65 years old is far from optimal. Thus, there is room for significant improvement of diet quality in Chile through design and implementation of public health policies, particularly in high-risk groups for chronic diseases.
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    Diminishing benefits of urban living for children and adolescents' growth and development
    (Nature Portfolio, 2023) Berrios Carrasola, Ximena; Echeverría Errázuriz, Guadalupe; Ferreccio Readi, Fresia Catterina; Margozzini Maira, Paula Andrea; Miquel Poblete, Juan Francisco; Nervi Oddone, Flavio; Rigotti Rivera, Attilio Gianpietro; Valdivia Cabrera, Gonzalo Sergio; Mishra, A.; Zhou, B.; Rodríguez-Martínez, A.; Bixby, H.; Singleton, R. K.; Carrillo-Larco, R. M.; Sheffer, K. E.; Paciorek, C. J.; Bennett, J. E.; Lhoste, V.; Lurilli, M. L.; Di Cesare, M.
    Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1,2,3,4,5,6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified.
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    Healthy Eating as Potential Mediator of Inverse Association between Purpose in Life and Waist Circumference: Emerging Evidence from US and Chilean Cohorts
    (2023) Berkowitz Fiebich, Loni; Mateo Hernández, Camila; Salazar Vilches, Cristian Javier; Samith Catalán, Bárbara Patricia; Sara Zaror, Daniela Alejandra; Pinto Manzo, Victoria Sabina; Martínez, Ximena; Calzada, Mariana Andrea; Von Schultzendorff Hoyl, Beatriz Andrea; Pedrals, Nuria; Bitrán Carreño, Marcela; Echeverría Errázuriz, Guadalupe; Ruini, Chiara; Ryff, Carol; Rigotti Rivera, Attilio
    High sense of purpose in life, a fundamental domain of eudaimonic well-being, has been consistently associated with lower risk for various obesity-related chronic diseases. Although this psychological feature correlates with some health behaviors as potential mediators, its association with healthy eating remains less explored. In addition, studies of these psycho-behavioral and health relationships in the South American population are lacking. This research sought to assess: (1) the cross-sectional association between self-reported purpose in life and overall healthy eating patterns, and (2) healthy food intake as a potential mediator of the inverse relationship between purpose in life and waist circumference. Data collected of 2060 US adults from the MIDUS study (5 ± 12 years, 55% women, mostly white people, and 42.5% obese) and 223 Chilean adults from the CHILEMED study (46.6 ± 9 years, 58.3% women, and 71.3% obese) were used. Anthropometric and sociodemographic variables were collected. Sense of purpose was assessed using the purpose in life subscale of the Ryff’s psychological well-being questionnaire. Diet quality was evaluated using healthy eating or low-fat diet indexes, according to extant food intake data in each cohort. The relationship between these variables was estimated by bivariate and multivariate linear regressions with appropriate adjustments. To establish whether a better diet quality could mediate a link of purpose in life and improved nutritional status (assessed by waist circumference), the association between these three variables was tested by bootstrapping-based mediation analysis. Our results show significant associations of sense of purpose with healthy eating and low-fat dietary patterns in both US and Chilean cohorts, respectively, even after adjusting for sociodemographic variables. According to the mediation analysis, the relationship between sense of purpose and waist circumference, as an indicator of abdominal obesity, appears to be partially mediated by healthier food intake in both samples. In conclusion, our findings suggest a plausible mechanism underlying the favorable impact of this well-being dimension on physical health. Given its protective effects, interventions aimed at increasing purpose in life may facilitate adherence to better dietary patterns, which, in turn, will reduce the risk for obesity-related chronic diseases.
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    Intake of non-nutritive sweeteners in chilean children after enforcement of a new food labeling law that regulates added sugar content in processed foods
    (2020) Martínez Cifuentes, Ximena; Zapata Olivares, Yazmin Alejandra; Pinto Manzo, Victoria Sabina; Cornejo Corvalán, Camila Andrea; Elbers, Martje; Van Der Graaf, Maaike; Villarroel del Pino, Luis A.; Hodgson-Bunster, M. I.; Rigotti Rivera, Attilio; Echeverría Errázuriz, Guadalupe
    After enforcement of a new food labeling law in 2016, Chile exhibits a greater offer to reduced sugar products with addition of non-nutritive sweeteners (NNS). Many of these products are consumed by children, who are at greater risk of reaching the acceptable daily intake (ADI) of these food additives. The objective of this study was to evaluate the intake levels of NNS in Chilean schoolchildren after the enactment of the aforementioned law. A total of 250 Chilean children 6-12 years old were surveyed. NNS intake was assessed through a food frequency questionnaire. All children evaluated consumed at least one NNS during the previous month. Sucralose had the highest consumption frequency reaching 99.2%, followed by acesulfame-K (92.8%), stevia (86.0%), and aspartame (85.2%). Aspartame showed the highest median intake, which came mainly from beverages (96%). No children exceeded the ADI of any NNS. Smaller children exhibited a higher body weight-adjusted intake of sucralose, acesulfame-K, stevia, and aspartame (p< 0.05). In Chile, a wide range of processed foods with NNSs is available and all schoolchildren evaluated consumed at least one product containing NNS. However, this consumption does not exceed defined ADIs for any of the six sweeteners authorized for food use in Chile.
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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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    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.
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    Mediterranean Lifestyle to Promote Physical, Mental, and Environmental Health: The Case of Chile
    (2020) Echeverría Errázuriz, Guadalupe; Tiboni Oschilewski, Ornella; Berkowitz Fiebich, Loni; Pinto Manzo, Victoria Sabina; Samith Catalán, Bárbara Patricia; Von Schultzendorff Hoyl, Beatriz Andrea; Pedrals, Nuria; Bitrán Carreño, Marcela; Ruini, Chiara; Ryff, Carol D.; Del Rio, Daniele; Rigotti Rivera, Attilio
    Chile is currently experiencing a progressive epidemiological transition towards chronic diseases. In this country, >50% of annual deaths are attributed to cardiovascular disease and cancer. Moreover, health surveys have shown high prevalence of obesity, diabetes, hypertension, and elevated cardiovascular disease risk. In addition, mental health issues are also frequent among Chilean adults. On the other hand, the agri-food system contributes to 21-37% of greenhouse gases emissions worldwide. Overall, current health and food chain situation calls out for design and implementation of evidence-based feasible and effective nutritional interventions needed to promote physical and mental health along with addressing food sustainability in Chile. Nowadays, the Mediterranean diet is recognized as one of the healthiest dietary patterns based on observational and interventional studies linked to a wide variety of health outcomes. However, a Mediterranean lifestyle goes well beyond food intake: it includes promotion of psychosocial resources, community life as well as cultural traditions. Indeed, Mediterranean lifestyle is a true modus vivendi that integrally promotes physical, mental, and social well-being. In addition, the Mediterranean diet stands out for its environmental sustainability because it is characterized mainly as a plant-based dietary pattern with low carbon and water footprints. Remarkably, Central Chile has a Mediterranean-like setting with plant and animal food production and availability patterns comparable to those present in countries located around the Mediterranean Sea. Therefore, this article reviews how promotion of Mediterranean lifestyle adherence in Chile offers great potential for management of the ongoing epidemiological transition to chronic diseases as well to promote psychological well-being within a unique food system and dietary sustainability vision for this Latin American country.
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    Mediterraneización de la alimentación en preescolares que asisten a los jardines infantiles de la Pontificia Universidad Católica de Chile
    (2022) Mallea Vivanco, Claudia Francisca; Barja Y., Salesa; Rigotti Rivera, Attilio; Echeverría Errázuriz, Guadalupe; Pontificia Universidad Católica de Chile. Escuela de Medicina
    Antecedentes: La dieta mediterránea es el patrón alimentario con mayores beneficios sobre la salud en adultos, pero la evidencia es escasa en población pediátrica, y menor aún en preescolares. Objetivos: Mediterraneizar la alimentación que reciben preescolares en jardines infantiles y analizar su adecuación a las recomendaciones dietarias, composición nutricional y costo. Método: Estudio analítico de la dieta de preescolares asistentes a los jardines infantiles de la Pontificia Universidad Católica de Chile en 2019. Se adaptó la minuta del 2019, de un mes por trimestre, hacia un patrón de dieta mediterránea, comparando la adecuación a recomendaciones nutricionales, la composición nutricional y los costos, calculados en base a precios de alimentos de cadenas de supermercados y Vega Central. Se utilizó el programa Food Processor® y el índice KIDMED para los análisis nutricionales. Se aplicó la prueba t de Student para datos pareados (comparación de la minuta 2019 vs. la mediterránea), y test de Kruskal Wallis (comparación de puntajes KIDMED) usando el programa Scipy Stats. Resultados: La mediterraneización de las minutas de alimentación de los jardines infantiles PUC aumentó en 3 puntos el puntaje KIDMED, mantuvo el aporte energético de 40,5±4,7 kcal/kg/jornada (distribuido como 50% carbohidratos, 16% proteínas y 34% lípidos) y mejoró la razón de ácidos grasos Ω6: Ω3 desde 16,5:1 a 2,9:1. El aporte proteico aumentó de 1,5±0,1 a 1,7±0,2 g/kg/jornada, siendo 0,9:1 la razón de proteína alto/bajo valor biológico. El aporte de carbohidratos fue 5,2±0,1 g/kg/jornada, mejorando la fibra a 11,1±2,9 g/jornada. El aporte de hierro fue 4,1±1,8, zinc 1,8±0,7 y magnesio 94±40,6 mg/jornada, respectivamente. El costo diario de la dieta 2019 fue $1.115,1±169,5 y el de la minuta mediterránea $1.115,5±203,9 (ns). Conclusiones: Fue posible mediterraneizar las minutas de alimentación en los jardines infantiles PUC sin aumentar el costo, mejorando la calidad lipídica, el valor biológico proteico y el aporte de fibra, preservando el aporte de micronutrientes.
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    Prevalencia de niveles muy altos de colesterol HDL y su asociación con factores de riesgo cardiovascular y enfermedad cardiovascular aterosclerótica en Chile
    (2023) Rojas Silva, María Paz; Echeverría Errázuriz, Guadalupe; Rigotti Rivera, Attilio; Pontificia Universidad Católica de Chile. Escuela de Medicina
    En estudios de tipo observacional y ensayos clínicos randomizados, se ha descrito una posible asociación entre niveles de colesterol HDL muy altos con la pérdida del efecto protector contra la aterosclerosis e incluso también se han asociado con un aumento del riesgo cardiovascular. Establecer si los niveles de colesterol HDL muy altos se asocian con factores de riesgo y enfermedad cardiovascular ateroesclerótica en la población chilena estudiada en la Encuesta Nacional de Salud (ENS) 2016-2017. Se analizaron 3.560 adultos, mayores de 18 años de edad, evaluados en la Encuesta Nacional de Salud 2016-2017 con información de niveles de colesterol HDL y se correlacionaron los niveles de colesterol HDL muy altos con variables sociodemográficas, de estilo de vida y parámetros clínicos para identificar una posible relación de colesterol HDL muy alto con factores de riesgo cardiovascular y enfermedad aterosclerótica en Chile. Se definió como punto de corte para niveles de colesterol HDL muy alto en Chile al percentil 97,5 de la distribución que correspondió a 74/82 mg/dL en hombres y mujeres, respectivamente. Se observó que los sujetos con niveles de colesterol HDL muy altos tienen mayor edad y mayor chance de presentar cifras más elevadas de colesterol total, glicemia y presión arterial sistólica, pero menor probabilidad de reportar ECV previa (ECVP) (p=0,022) y que a mayor edad e IMC más alto aumenta la probabilidad de desarrollar ECVP (p=0,000 y p=0,02; respectivamente). Por otro lado, aquellos sujetos ex-fumadores y sujetos que tienen actividad física baja también presentan mayor chance de reportar eventos cardiovasculares analizados en este estudio (p=0,000 y p=0,001; respectivamente). En este estudio observacional de tipo transversal, se observó asociación entre niveles de colesterol HDL muy alto con factores de riesgo cardiovascular, más específicamente una relación inversa con enfermedad cardiovascular previa. Sin embargo, el análisis de esta relación requiere estudios con mayor tamaño muestral y de tipo longitudinal para validar o rechazar más cabalmente esta hipótesis en el contexto de nuestra población.
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    The Chilean diet and the omega-6/omega-3 balance
    (S.Karger AG, 2011) Leighton, Federico; Echeverría Errázuriz, Guadalupe; Urquiaga Reus, Inés
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    Volvamos Juntos: evaluation of the implementation of a Social Health Intervention to mitigate the impact of Covid-19 in businesses in Antofagasta, Chile
    (2025) Sapag Muñoz, Jaime; Molina Aiquel, Mónica; Martínez Pérez, Mayra; Cordón Slowing, Paola; Cespedes Maturana, Patricio Ignacio; Concha, Mauro; Fuentes, Marcelo; Fernández, Andrea; Zuzulich Pavéz, María Soledad; Repetto, Paula; Echeverría Errázuriz, Guadalupe; Cáceres, Hernán; Peñaloza Hidalgo, Blanca Elvira
    Abstract Background The COVID-19 pandemic has had an impact not only on healthcare but also on labor and socioeconomic sectors worldwide, leading to the development of strategies to mitigate the crisis’ widespread repercussions. In Antofagasta, Chile, an innovation project entitled Volvamos Juntos (“Let’s Return Together”) was developed to support a diverse group of micro and small businesses. The project consisted of accompanying companies in the process of reopening safely and included interventions ranging from educating and testing employees for COVID-19 to developing protocols to avoid contagion and other preventive measures. The evaluation of the project’s implementation is presented here. Methods A mixed-methods, collaborative study was conducted, adhering to the Consolidated Framework for Implementation Research (CFIR) and Proctor’s Implementation Outcomes, with an online survey, interviews, and focus groups with businesses’ representatives, the implementation team, and program stakeholders. Quantitative analyses were descriptive: frequencies and means were calculated, along with dispersion measures as appropriate, and in some cases, ANOVA tests were performed to assess differences. Qualitative information was processed with content analysis. Finally, an integrated hybrid analysis was conducted, guided by the study’s objectives and theoretical framework. Results A total of 156 leaders from 203 participating businesses answered the online survey (response rate: 76.8%), and 46 people participated in the qualitative component (31 in interviews, 15 in focus groups). Overall, the program’s implementation according to different CFIR dimensions and certain outcomes was evaluated satisfactorily. In the survey, 96.7% participants rated the program’s suitability as satisfactory to maximum (grades 5 to 7 out of 7), 92.3% rated the feasibility with an average of 6.0, 97.4% rated the sustainability with an average of 5.9, and 94.3% indicated that they would favorably recommend (grades 6 or 7) the program to other institutions. Strengths and weaknesses were identified, and lessons learned include the need to plan for changing contexts, the relevance of collaborative and interdisciplinary work, and the importance of flexible support processes that promote autonomy and sustainability. Conclusions Volvamos Juntos met its proposed implementation objectives, despite several challenges. Reflections from this innovative social health program are relevant for the development of other interventions in times of crisis. Trial registration N/A.