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Gestational weight gain is an important indicator for monitoring nutritional status during pregnancy. However, there are no gestational weight gain references created for adolescents or national datasets to enable the construction of such graphs up to date. This manuscript aims to describe the creation of a Latin American dataset to construct gestational weight gain references for adolescents aged 10-19 years old. Gestational weight gain data from studies conducted in nine countries (Argentina, Brazil, Chile, Colombia, Mexico, Panama, Paraguay, Peru, and Uruguay) collected between 2003 and 2021 were harmonized. Data on height, weight, and gestational age in at least two gestational trimesters were included. Pregnant adolescents should be free of diseases that could affect weight, and newborns should weigh between 2,500-4,000 g and be free of congenital malformations. The final dataset included 6,414 individuals after data cleaning. Heterogeneity between the countries was assessed by calculating standardized site differences for GWG and z scores of height-for-age. Several imputation procedures were tested, and approximately 10% of the first-trimester weights were imputed. The prevalence of individuals with underweight (1.5%) and obesity (5.3%) was low, which may lead to problems when modeling the curves for such BMI categories. Maternal height and gestational weight gain did not show significant differences by country, according to the standardized site differences. A harmonized dataset of nine countries with imputed data in the first trimester of pregnancy was prepared to construct Latin American gestational weight gain curves for adolescents.

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Monitoring gestational weight gain (GWG) throughout pregnancy among adolescents is important for detecting individuals at risk and timely intervention. However, there are no specific tools or guidelines for GWG monitoring of this group. We aimed to construct GWG charts for pregnant adolescents (10-19 years old) according to pre-pregnancy body mass index (BMI) using a pooled dataset from nine Latin American countries. Datasets from Argentina, Brazil, Chile, Colombia, Mexico, Panama, Paraguay, Peru, and Uruguay collected between 2003 and 2021 were combined after data cleaning and harmonization. Adolescents free of diseases that could affect GWG and who gave birth to newborns weighing between 2,500-4,000 g and free of congenital malformations were included. Multiple imputation techniques were applied to increase the sample size available for underweight and obesity categories. Generalized Additive Models for Location, Scale, and Shape were used to construct the charts of GWG according to gestational age. Internal and external validation procedures were performed to ensure that models were not over-adjusted to the data. The cohort included 6,414 individuals and 29,414 measurements to construct the charts and 1,684 individuals and 8,879 measurements for external validation. The medians (and interquartile ranges) for GWG at 40 weeks according to pre-pregnancy BMI were: underweight, 14.9 (11.9-18.6); normal weight, 14.0 (10.6-17.7); overweight, 11.6 (7.7-15.6); obesity, 10.6 kg (6.7-14.3). Internal and external validation showed that the percentages above/below selected percentiles were close to those expected, except for underweight adolescents. These charts describe the GWG throughout pregnancy among Latin American adolescents and represent a significant contribution to the prenatal care of this group. GWG cut-offs based on values associated with lower risks of unfavorable outcomes for the mother-child binomial should be determined before implementing the charts in clinical practice.

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INTRODUCTION: To experience food insecurity determines negative consequences regarding nutrition, health and general wellness among older adults and their families. In Chile it practically doesn't exist any information related to it, despite this matter represents a major public health issue in other countries in the region. OBJECTIVES: To determine the prevalence of food insecurity and it's relation with socio-demographic, economic and nutritional factors among older adults residing in medium-low and low-income status districts, in the Great Santiago area. MATERIALS AND METHODS: A cross-sectional observational study in 344 older adults, between 65 and 74 year-old; a socioeconomic, demographic, nutritional and food-insecurity survey at the homes (HFIAS). A prevalence of food insecurity and it relation with the independent variables was determined, by means of multi-variety logistic regression models. RESULTS: The 40.4% of the sample presented food insecurity (95% IC 35.2-45.6%), predominantly of the mild type, with a higher proportion of women, at the limit of the statistic significance. The probability of perceiving food insecurity was significantly associated to low family income (OR 4.2 IC 2.1-8.6), with a greater number of members in the home (OR 2.4), malnutrition by deficit and/or excess (OR 2.0), not to be the owner of the house (OR 2.0), and low individual income (OR 1.8). CONCLUSIONS: There exists a high prevalence of food insecurity among this population, which is associated with socio-demographic, economic and nutritional status. The food security represents an important public health and nutritional issue in the country, which needs to be investigated further.

Introducción: Experimentar inseguridad alimentaria determina consecuencias negativas en la nutrición, salud y bienestar general de los adultos mayores y sus familias. En Chile prácticamente no existe información al respecto, a pesar de ser un importante problema de salud pública en otros países de la región. Objetivos: Determinar la prevalencia de inseguridad alimentaria y su relación con factores sociodemográficos, económicos y nutricionales en Adultos Mayores residentes en comunas del nivel socioeconómico medio-bajo y bajo del Gran Santiago. Materiales y métodos: Estudio observacional transversal en 344 adultos mayores de 65 a 74 años; encuesta socioeconómica, demográfica, nutricional y de inseguridad alimentaria en el hogar (HFIAS). Se determinó prevalencia de inseguridad alimentaria y su relación con las variables independientes por modelos de regresión logística multivariados. Resultados: El 40,4% de muestra presentaba inseguridad alimentaria (95% IC 35,2-45,6%), predominantemente de tipo leve, con una proporción mayor en mujeres, en el límite de la significación estadística. La probabilidad de percibir inseguridad alimentaria se asoció significativamente con bajos ingresos familiares (OR 4,2 IC 2,1-8,6), con mayor número de personas en el hogar (OR 2,4), malnutrición por déficit o exceso (OR 2,0), no ser propietario de la vivienda (OR 2,0) y menores ingresos personales (OR 1,8). Conclusiones: Existe una alta prevalencia de inseguridad alimentaria en esta población, la que se asocia con variables sociodemográficas, económicas y nutricionales. La seguridad alimentaria es un importante tema de salud pública y nutrición en el país, que debe ser investigado en mayor profundidad.

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BACKGROUND: The development of enteral formulas (FE) is subject to various risks of contamination. The World Health Organization (WHO) and the Food and Agriculture Organization (FAO), have worried about alerting, recommendations and documents released to prevent contamination the FE, suggesting the standardization and protocols for all procedures involved. OBJETIVES: The study was aimed to evaluate compliance with the technical criteria contained in a Guideline for Good Practice of Manufacture in relation to the development, maintenance and administration of enteral nutrition in hospitals of Santiago, in the Metropolitan Area. MATERIAL AND METHODS: The verification criteria considered Physical Plant, Equipment and Implementation, Hygienic and Sanitary Standards, Human Resources, Organization and Management, Safety and Warranty Quality Assurance. 639 criteria were defined, 309 risk Type 1, by mayor risk of producing pollution. The study was conducted by observing Central Units Enteral Formulas and interview with the caregiver. Medium of compliance for each group of criteria risk 1 and overall, was analyzed. RESULTS: A total of 14 public hospitals were studied. The degree of compliance with the 639 reached a median of 33.2% (p25-75 31.6%-40.4%), with the lowest value for physical plant with 27.9% (p25-75 23.9%-38.2%) and the highest for human resources with 52.4% (p25-75 44.1%-52.4%). Median compliance for risk criteria Type 1 was only 31.8% (p25-75 27.5%-41.2%). CONCLUSION: Most of the units tested, meets less than half of the internationals recommendations, or the Ministry of Health of Chile. It should develop protocols and train staff to ensure quality and safety in the development of enteral formulas and reduce risk of infection.

Antecedentes: La Elaboración de fórmulas enterales está sujeta a diversos riesgos de contaminación. La Organización Mundial de la Salud (OMS) y la Organización para la Alimentación y la Agricultura (FAO) han emitido alertas y recomendaciones para su prevención, sugiriendo la estandarización y protocolización de todos los procedimientos involucrados. Objetivo: Elaborar y evaluar el cumplimiento de los criterios técnicos de una Pauta de Verificación de Buenas Prácticas de Manufactura, con relación a elaboración, conservación y administración de fórmulas enterales en hospitales de la provincia de Santiago. Material y métodos: Los criterios de verificación consideraron Planta Física, Equipamiento e Implementación, Normas Higiénicas y Sanitarias, Recurso Humano, Organización y Administración, Garantía de Inocuidad y Aseguramiento de la Calidad. Se definieron 639 criterios, 309 de Riesgo Tipo 1, por mayor riesgo de producir contaminación. El estudio se hizo por observación de las Unidades de Central de Fórmulas Enterales y entrevista con el profesional encargado. Se analizó la mediana de cumplimiento de cada grupo de criterios de riesgo tipo 1 y total. Resultados: Se evaluaron públicos 14 hospitales. El grado de cumplimiento de los 639 alcanzó una mediana de 33,2% (p25-75 31,6% -40,4%), con el valor más bajo para planta física con 27,9% (p25-75 23,9% -38,2%) y el mayor para recurso humano con 52,4% (p25-75 44,1%-52,4%). La mediana de grado de cumplimiento para Criterios Riesgo Tipo 1, fue sólo de 31,8% (p25-75 27,5% - 41,2%). Conclusión: La mayoría de las Unidades evaluadas, cumple con menos de la mitad de las recomendaciones internacionales o del Ministerio de Salud de Chile. Se deben elaborar protocolos y capacitar al personal para asegurar la calidad e inocuidad en la elaboración de fórmulas enterales y reducir los riesgos de infección.

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La obesidad es una grave epidemia a nivel mundial y las estrategias aplicadas para su prevención han dado pobres resultados. Numerosos factores ambientales se han asociado al riesgo de obesidad y es importante que todos ellos sean considerados en las políticas de prevención. Se ha demostrado que existe un nexo entre la publicidad de alimentos en televisión con la obesidad infantil. La gran cantidad de anuncios publicitarios de alimentos poco saludables dirigidos a los niños a través de la televisión y las repercusiones que esto podría tener en la salud, ha llevado a algunos países a legislar al respecto. Sin embargo, falta definir a nivel internacional un marco conceptual de referencia que permita una legislación que logre un impacto real en la prevención de la obesidad infantil. Este trabajo revisa las evidencias científicas disponibles sobre la relación entre publicidad de alimentos y obesidad infantil como base para el desarrollo de políticas públicas de regulación del mercadeo de alimentos a través de la televisión.

Obesity is a serious global epidemic and the prevention strategies implemented have been insufficient. Numerous environmental factors have been associated with risk of obesity and their full consideration in prevention policies is important. The connection between food advertising on television and childhood obesity has been demonstrated. The large number of advertisements for unhealthy foods targeted at children through television and its possible impact on health has led some countries to legislate on this matter. However, a conceptual framework of reference enabling legislation must be internationally defined in order to achieve a real impact in preventing childhood obesity. This paper reviews scientific evidence on the relationship between food advertising and childhood obesity as a basis for developing public policies to regulate food marketing on television.

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En la actualidad, las enfermedades cardiovasculares son la primera causa de muerte en el mundo. La presión arterial elevada es uno de los factores más importantes para su desarrollo, la cual está fuertemente relacionada con el consumo de sal. A nivel mundial el consumo de sal actual sobrepasa en más del doble la ingesta recomendada, lo que se ha asociado con el desarrollo de enfermedades cardiovasculares y de algunos cánceres. Los efectos beneficiosos demostrados al reducir su consumo (menor morbi-mortalidad y menores gastos en salud) han servido de aliciente para desarrollar diversas estrategias nacionales para lograr este efecto. Dentro de las estrategias más utilizadas se encuentran campañas educativas y la disminución paulatina de la sal agregada en los alimentos industrializados. Chile, se ha sumado a estas iniciativas con un acuerdo entre los productores de pan y el Ministerio de Salud con el fin de disminuir progresivamente la concentración de sal en el pan a nivel nacional. El objetivo de esta revisión es aportar información actualizada sobre las recomendaciones de ingesta de sal, ingesta real, efectos nocivos del exceso de consumo, beneficios atribuidos a su disminución y analizar las estrategias globales para reducir el consumo de sal en la población.

Global strategies to reduce salt intake.

Currently, cardiovascular diseases (CVD) are the leading cause of death worldwide. High blood pressure is one of the main risk factors for the development of CVD and blood pressure levels are strongly associated with salt intake. Worldwide, salt consumptions accounts more than two fold the recommended daily intake, which has been described to be associated with CVD and some cancers. Benefits of decrease salt intake (reduction of morbidity, mortality and health related costs) have promoted several public health strategies to reduce salt consumption globally. Among the most commonly used strategies include educational campaigns and the gradual decrease of added salt in processed foods. Chile has joined these initiatives with an agreement between the producers of bread and the Ministry of Health to gradually decrease the concentration of salt in bread nationwide. The purpose of this review is to provide updated information regarding recommended intakes of salt, real intake, adverse effects of excess consumption, profits attributable to a decline and analyze the global strategies to reduce salt intake in the population.

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Currently, cardiovascular diseases (CVD) are the leading cause of death worldwide. High blood pressure is one of the main risk factors for the development of CVD and blood pressure levels are strongly associated with salt intake. Worldwide, salt consumptions accounts more than two fold the recommended daily intake, which has been described to be associated with CVD and some cancers. Benefits of decrease salt intake (reduction of morbidity, mortality and health related costs) have promoted several public health strategies to reduce salt consumption globally. Among the most commonly used strategies include educational campaigns and the gradual decrease of added salt in processed foods. Chile has joined these initiatives with an agreement between the producers of bread and the Ministry of Health to gradually decrease the concentration of salt in bread nationwide. The purpose of this review is to provide updated information regarding recommended intakes of salt, real intake, adverse effects of excess consumption, profits attributable to a decline and analyze the global strategies to reduce salt intake in the population.

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The objective of this study was to compare the food consumption and nutrient intakes obtained through a 24-h dietary recall (DR) and a consumption tendency interview (CTI). Both instruments DR and CTI were applied simultaneously in groups of 264 schoolchildren and 272 adults. Information on age, sex, literacy, occupation, and head of family's social security system was also obtained. Body weight and height were measured and the body mass index BMI was calculated. Food portions and nutrient intakes were described and compared by using means, standard deviation. ANOVA, and product moment Pearson' correlation. No significant differences were detected between both methods with respect to mean consumption of cereals, fruits, meats and sugars. Dairy products and oil consumption were found to be larger according to CTI: 0.6 +/- 1.7 y 0.3 +/- 0.9 portions, respectively (p < 0.01). In terms of nutrient intakes, there were no differences in beta-carotene, vitamin A, vitamin C, iron, and zinc. Mean differences of energy and selected nutrients were lower than 10% of total intake, except by omega-3 fatty acid, cholesterol, vitamin E, and folate. Correlation coefficient between both methods was < 0.4 for most foods and nutrient intakes. Correlation was slightly higher in adults regarding cereals dairy and sugar (approximately 0.5). Both methods DR and CTI produce similar results when applied at the population level, but can be significant different on individuals. The suitability of each method will depend on the objectives of the study.

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Introducción: La incorporación de ácido graso docosahexaenoico (DHA) en los fosfolípidos del tejido nervioso del lactante depende principalmente del contenido en la leche como ácido graso preformado. Su concentración en la leche es variable y depende de la dieta materna. En nuestro país, el bajo consumo de alimentos marinos puede significar un bajo contenido de DHA en la leche materna. Objetivo: Determinar si la recomendación de consumir una mayor cantidad de alimentos marinos a las madres en lactancia es un medio efectivo para aumentar el consumo de DHA y su contenido en la leche materna. Metodología: estudio prospectivo observacional en 24 madres en lactancia. Al inicio y dos semanas después de recomendar un mayor consumo de alimentos marinos. Se determinó la ingesta materna de alimentos fuentes de ácidos grasos n-3 y n-6 y la composición lipídica de la leche por transesterificación directa de los lípidos. Se mantuvo contacto regular con las madres durante todo el estudio. Resultados: el consumo de alimentos marinos aumentó de 63 a 163 gr por semana (p < 0,01) y de DHA de 57 a 150 mg/día (p < 0,001). El mayor consumo de DHA no modificó significativamente el contenido de DHA en la leche. En madres con ingesta de DHA > de 200 mg/día hubo una correlación positiva entre el consumo y el contenido en la leche (r = 0,71, p < 0,05). Conclusiones: La intervención educativa triplicó el consumo de DHA en las nodrizas. Se observó aumento del DHA en la leche cuando la ingesta de éste ácido graso fue > de 200 mg/día. Incentivar el consumo de alimentos marinos y LC-PUFA n-3 es una intervención factible, de bajo costo y riesgo mínimo que puede contribuir a mejorar la salud infantil

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Antecedentes: El Ministerio de Salud mide cada tres años la prevalencia de lactancia materna a través deencuestas nacionales y paralelamente recoge información de los resúmenes estadísticos en forma semestral(RMS). Objetivo: Comparar la prevalencia de lactancia materna y la concordancia diagnóstica entre una encuesta de recordatorio y el registro en la ficha clínica. Material y método: Encuesta de prevalencia en 519 menores de 12 meses y análisis de las fichas clínicas de los mismos niños; clasificación y comparación del tipo de alimentación: lactancia materna exclusiva (LME), predominante (LMP), complementada (LMC),fórmula, etc. Resultados: Se obtuvo 73,4 por ciento de concordancia entre ambos registros con un valor Kappa de 0,62 (95 por ciento IC 0,57-0,67,p<0,001). El mayor porcentaje de acuerdo se obtuvo en LME (93,4 por ciento) y la menor en LMP (20,4 por ciento). La prevalencia de LME según RMC fue 8,5 y 10 puntos mayor que la obtenida a través de encuestas los años 1996 y 1999 respectivamente (p < 0,02). Conclusiones: La prevalencia de LME fue significativamente mayor según las fichas o los RMC (p < 0,01). Aunque existe un adecuado porcentaje de acuerdo entre los métodos, la metodología utilizada no permite determinar cul de ellos es más preciso. No obstente las encuestas estandarizadas son una herramienta útil, de bajo costo, fáciles de aplicar y procesar que entregn resultados oportunos para la toma de decisiones programáticas

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