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Many studies document the high prevalence of burnout among medical students. This syndrome may lead to depression, suicidal ideation, and increased academic dropout. However, there is a scarcity of evidence-based interventions to prevent it. The aim of this longitudinal study was to identify factors that may reduce students’ burnout and foster their well-being, and upon which effective interventions can be developed. A total of 1,117 medical students from eight Chilean universities were asked to complete a set of validated scales in 2015 and 2 years later, in 2017. The measures included distress, burnout, positive mental health, academic engagement, and dispositional mindfulness. Using logistic regressions and a two-wave latent change score model, the predictive power of these variables on burnout and flourishing (an optimal state of mental health) was studied, as well as their covariance across time. In total, 639 (57.2%) students answered the questionnaires in T1 and T2; 54.4% reported burnout in T1 and 56.2% in T2. Levels of dispositional mindfulness (the ability to pay attention to one’s sensations, thoughts, and emotions in everyday life) predicted lower probabilities of burning out at 2 years, whereas having experienced burnout in T1 doubled these odds. Dispositional mindfulness, academic engagement, and flourishing at T1 predicted greater odds of flourishing 2 years later, while depression decreased these odds. Dispositional mindfulness was the most powerful predictive factor of students’ burnout and flourishing. As dispositional mindfulness can be nurtured through practice, incorporating mindfulness training into undergraduate medical programs may help reduce burnout and promote students’ well-being as health professionals.

BACKGROUND An unhealthy diet ranks among the top contributors to the burden of noncommunicable chronic disease and death in the US, highlighting the importance of evaluating diet quality in population-based studies, such as the MIDUS (Midlife in the United States) cohort. OBJECTIVE 1) To develop a simple tool (MIDUS healthy eating index (MIDUS-HEI)) to evaluate diet quality more broadly and consistently in subjects enrolled at different time points of the MIDUS study, and 2) To use this score in assessing the cross-sectional association of the overall dietary pattern with sociodemographic and health variables in MIDUS participants. METHODS We used extant food intake data collected from participants in two biomarker sub-studies of the MIDUS Core and Refresher national samples to design, test, and validate the dietary score tool through its cross-sectional association with available sociodemographic and health variables. RESULTS Our results indicated that better dietary quality was observed among older adults as well as white subjects and those with a higher educational status. According to the MIDUS-HEI score, dietary quality improved over time in MIDUS Refresher cohort compared to the MIDUS Core cohort. However, race-based disparities in dietary quality increased between the two survey times. Regarding health variables, MIDUS-HEI score was inversely associated with the prevalence of metabolic syndrome (MetS) and most of its diagnostic criteria. CONCLUSIONS The MIDUS-HEI score is a useful indicator of quality of diet intake, exhibiting an inverse cross-sectional association with unhealthy diet-related biomarkers and MetS. Also, sociodemographic-dependent variations of this index were consistent with similar dietary pattern scores evident in other epidemiological studies. Thus, MIDUS-HEI represents a valuable tool for further analysis and discovery using the wide multidisciplinary scope of MIDUS.

Recommended hypoglycemia treatment in adults with T1D consists of 15 g of rapid absorption carbohydrates. We aimed to evaluate the response to fewer carbohydrates for treating hypoglycemia in patients with T1D on insulin pumps with predictive suspension technology (PLGS).T1D patients on insulin pumps with PLGS were randomized to receive 10 or 15 g of sucrose per hypoglycemia for two weeks (S10 and S15 groups, respectively) when capillary blood glucose (BG) was70 mg/dL, with crossover after two weeks. Evolution of capillary BG, active insulin, and suspension time were assessed.59 hypoglycemic episodes were analyzed, 33 in S10 and 26 in S15. Baseline BG in S10 was 54.3 ± 7.7 mg/dL versus 56.9 ± 8.8 in S15 (p = 0,239). Active insulin, present in 85% of the episodes, and PLGS suspension time were similar between groups. BG at 15 min was 77 mg/dL in S10 and 95 mg/dL in S15 (p = 0.0007). In S10, 21% of the episodes required to repeat the treatment after 15 min compared with none on S15, with a RR of 0,79 (95% CI 0.66, 0.940, p = 0,014) for successfully treating the episode. Sensor glucose was significantly different from BG at the moment of the hypoglycemia and control 15 min after treatment. No severe hypoglycemia and no rebound hyperglycemia occurred in neither group.A hypoglycemia treatment protocol with a lower dose of sucrose might be insufficient despite PLGS technology. Our data suggest that standard doses of sucrose should still be recommended.

Objective:To analyse serum folate levels in women of childbearing age in the Metropolitan Region (MR) of Chile.Design:Cross-sectional design as part of the 2016–2017 National Health Survey (Encuesta Nacional de Salud, ENS 2016–2017), using a household-based multistage stratified random sample. Serum folate levels measured by electrochemiluminescence immunoassay in fasting venous blood samples were classified as deficient (20 ng/ml).Setting:The MR of Chile.Participants:Women of reproductive age (15–49 years, n 222) from the MR participated in the ENS 2016–2017.Results:The mean, median and range of serum folate were 14·2 (se 0·4), 13·9 and 2·1–32·2 ng/ml, respectively. Folate deficiency was detected in 0·9 % of women, while 7·0 % had supraphysiological levels of the vitamin. No significant effects of age, educational level, marital status, parity, smoking status or nutritional status on serum folate levels were detected by univariate or multivariate analyses. Intake of folic acid supplements showed a significant association with serum folate levels, but only 1·2 % of women used supplements.Conclusions:Folate deficiency in women of reproductive age living in the MR of Chile is almost inexistent according to the ENS 2016–2017, suggesting that the current population-wide mandatory folic acid fortification of flour is an effective and equitable measure to prevent folate deficiency. These results support the option of maintaining current folic acid fortification in Chile, particularly based on the low adherence to supplementation regimes evidenced in other populations.

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.

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.

Latin America is experiencing a significant epidemiological and nutritional transition, with a trend toward higher incidence of food-related chronic diseases. In this context, Lifestyle Medicine (LM) is a growing field focused on assisting individuals in adopting healthy behaviors for the prevention and treatment of these chronic diseases, including, among other pillars, a great emphasis on healthy eating. There is also a growing interest worldwide in environmental sustainability of dietary patterns, with increasing concern about their effects on planetary health. In this context, whole-food, plant-based diets -such as the Mediterranean diet (MD)- have emerged as a solution for both healthier eating and lowering environmental impact. Yet in order to be effective at these goals and achieve a high adherence to any nutritional prescription, the sociocultural reality of the community or population where we aim to practice must also be taken into account. In this review, we specifically highlight the plant-based MD as a LM-contextualized dietary pattern that is adaptable, applicable, and sustainable within the Chilean context and has the potential to address the current trend of chronic diseases in our country.

Vitamin E was identified as a lipophilic compound essential to maintain rat pregnancy. Low vitamin E intake during early pregnancy associates with congenital malformations and embryonic loss in animals and with miscarriage and intrauterine growth restriction in humans. Vitamin E protects cell membranes from lipoperoxidation and exerts non-antioxidant activities. Its function can be restored by vitamin C, thus, intake and circulating levels of both micronutrients are frequently analyzed together. Although substantial vitamin E inadequacy was reported worldwide, its consumption in Latin America (LatAm) is mostly unknown. Using data from the Latin American Study of Nutrition and Health (Estudio Latinoamericano de Nutrición y Salud, ELANS), we evaluated vitamin E and C intake in women of reproductive age (WRA) from eight LatAm countries and identified their main food sources. Two non-consecutive 24-h dietary recalls in 3704 women aged from 15 to 49 years and living in urban locations showed low average intake of vitamin E (7.9 mg/day vs. estimated average requirement (EAR) of 12 mg/day) and adequate overall vitamin C consumption (95.5 mg/day vs. EAR of 60 mg/day). The mean regional inadequacy was 89.6% for vitamin E and 36.3% for vitamin C. The primary food sources of vitamin E were fats and oils, as well as vegetables. Vitamin C intake was explained mainly by the consumption of fruit juices, fruits, and vegetables. Combined deficient intake of both vitamins was observed in 33.7% of LatAm women. Although the implications of low antioxidant vitamins’ consumption in WRA are still unclear, the combined deficient intake of both vitamins observed in one-third of ELANS participants underscores the need for further research on this topic.

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.

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.

This study formulated and characterized an antioxidant-rich concentrate of berries (BPC-350) produced in Chile, which was used to perform a crossover study aimed at determining the effect of the berries on the modulation of plasma postprandial oxidative stress and antioxidant status. Healthy male volunteers (N=11) were randomly assigned to three experimental meals: (1) 250 g of ground turkey burger (GTB) + 500 mL of water; (2) 250 g of GTB + 500 mL of 5% BPC-350; (3) 250 g of GTB prepared with 6% BPC-350 + 500 mL of 5% BPC-350. Venous blood samples were collected prior to meal intake and every hour for six hours after intake. Malondialdehyde (MDA), carbonyls in proteins, and DPPH (2,2-diphenyl-1-picrylhydrazyl) antioxidant capacity were quantified in plasma. Significant differences indicated that BPC-350 decreases MDA plasma concentration and protein carbonyls (p<0.05). Additionally, a significant increase in the DPPH antioxidant capacity was observed in Meals 2 and 3 when compared to Meal 1 (p<0.05). The results are discussed in terms of oxidative reactions that occur during digestion at the stomach level and the important effect of oxidative reactions that occur during the thermal processing of red meat.

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.

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.

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 (p0.01). 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.

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.To identify the burnout risk and protection factors of students at different medical schools.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.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.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.

Increasing scientific evidence shows that the Mediterranean lifestyle -including a characteristic dietary pattern as well as psychosocial and cultural features- has beneficial effects on human health. However, production and use of some of the distinctive components (e.g., olive oil, red wine, nuts, legumes, fish and seafood) of the Mediterranean diet (MedDiet) are not exclusively confined to the Mediterranean Basin, but are also found in other world regions, including California, Southwestern Australia, South Africa, and Chile. Central Chile exhibits a Mediterranean climate and Chilean agriculture and culinary traditions show striking similarities to Mediterranean countries. Using a MedDiet index adapted to food habits in Chile, we found that only 10% of the adult population displays this healthy eating behavior. Furthermore, high scores in the MedDiet index correlate with lower prevalence of overweight, obesity, and metabolic syndrome in Chilean adults. High adherence to a Mediterranean-like diet is also associated with better psychological wellbeing. Finally, a pilot study investigating the effects of a Mediterranean diet in Chile -as part of a 'food-at-work intervention'- showed a significant improvement in diet quality which was associated with a 35% reduction in the prevalence of the metabolic syndrome. Increased appreciation and application of a Mediterranean-like dietary pattern may therefore improve health and quality of life in the population of Chile, where non-communicable chronic diseases are increasingly common.

Irarrazaval, Sebastian, Claudio Allard, Juan Campodonico, Druso Perez, Pablo Strobel, Luis Vasquez, Ines Urquiaga, Guadalupe Echeverria, and Federico Leighton. Oxidative stress in acute hypobaric hypoxia. High Alt Med Biol. 18:128–134, 2017.—The effects of acute hypobaric hypoxia endured by mountaineers were studied, specifically as evidenced by acute mountain sickness (AMS) and oxidative stress damage. Ten male volunteers were exposed to acute hypobaric hypoxia, and AMS was evaluated through arterial oxygen saturation (SaO2), cardiac rate, and the Lake Louise Score (LLS). Oxidative stress was determined through blood profile tests performed 24 hours before and after high-altitude exposure, assessing the oxidative damage and antioxidant profiles. Dietary habits were assessed using the Chilean Mediterranean Diet Index. During ascent (i.e., first 8 hours), all volunteers presented AMS (LLS ≥3 points), as manifested by a median LLS increment of four points, a 15 bpm cardiac rate, and 17% decrease in...

Context Grape pomace maybe useful in broiler diets as a source of low cost antioxidants. Aims The objective of this work was to determine the effect of including high concentrations of wine-grape pomace flour (WGPF) in broiler chicken diets on productive parameters and antioxidant capacity of the meat. Methods WGPF of white (WGPF-W) and red (WGPF-R) grape varieties were nutritionally and chemically characterised. Then, 120 broiler chickens were allocated to three isoenergetic and isoproteic feeding treatments: 0% WGPF (Control), 20% WGPF-W and 20% WGPF-R. Key results WGPF-W had no effect on bodyweight, daily weight gain, feed intake or feed conversion ratio (FCR). However, FCR was higher for WGPF-R treatment at the end of the study (Day 42). Meanwhile, breast meat from WGPF-R treatment had the highest content of ether extract (P < 0,05), followed by WGPF-W and by control treatment, due to the addition of higher amounts of soy oil to those diets with WGPF to ensure an isoenergetic composition. Breast and leg meat, respectively, showed greater antioxidant capacity (µM Trolox Eq/g) when WGPF-W (16.7 and 16.4) was fed, than the antioxidant capacity obtained for control (13.8 and 13.8) and WGPF-R (11.9 and 14.2) treatments. Conclusions Inclusion of 20% of WGPF-W increased antioxidant capacity of chicken meat by 17%, without decreasing productive parameters, provided the diets were made isoenergetic and isoproteic by adding soy oil. Implications The grape pomace flour could be useful in the diet of other animals.

Background: Nutrition labeling is a tool that helps people to make healthy choices when choosing foods and drinks for consumption. Easy to understand information promotes rational choices. However the implementation of this information by industry and their proper use by consumers is complex. A key aspect is the existence of appropriate laws and regulations. Fortunately, Chile has a mandatory guideline for labeling packed food products. Though, the correctness of the information appearing in the label is essential. Aim: To evaluate the veracity of nutritional information appearing on food labels in our country. Material and Methods: We tabulated the information on the labels of over 1,000 packed products and analyzed it using globally accepted tables as reference. We included cereals, vegetables, fruits and juices, nuts, legumes, dairy, fish and shellfish, meat, oils and fats and sweets. Results: Ninety percent of the information appearing in the labels of analyzed products was presumably correct. However, there were great variations among food groups. Conclusions: This information allowed evaluate the application of the Food Health Regulations reform implemented in 2006, specifically Article 115. The possible improvements to achieve the original aims of the initiative are discussed.

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.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.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.s-MHC-SF is a valid questionnaire for the evaluation of personal well-being in Spanish-speaking populations.

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.

Eggs are a highly nutritive food. They contain high quality protein and several nutrients with potential health benefi ts. Nevertheless, the appearance of cardiovascular disease as an important public health issue, with high morbidity and mortality rates worldwide, along with the identifi cation 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.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.

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.To adapt a self-applicable Mediterranean Dietary Index in Chile (Chilean-MDI).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.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.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.

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.

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.

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.we analyzed data of 2 561 adults (≥ 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.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 HDS3 points was associated with an increased risk of MS (OR HDS3 / HDS ≥ 3 = 3.69; 95% CI 1.884-7.225, p0.001).Chilean adult population exhibits a high prevalence of MS linked to a poor diet quality.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 IDS3 puntos se asoció con un mayor riesgo de síndrome metabólico (OR IDS3 / IDS ≥ 3 = 3,69 95% IC:1,884- 7,225, p0,001). Conclusión: la población adulta chilena presenta una elevada prevalencia de síndrome metabólico asociado al consumo de una alimentación de mala calidad.

Background In 2013, the American College of Cardiology and the American Heart Association (ACC/AHA) jointly released new guidelines for cardiovascular risk assessment and cholesterol management that substantially modified the previous recommendations proposed by the National Cholesterol Education Program (NCEP) in 2001. The relative impact of these new guidelines on potential statin use has not been estimated in Latin American populations. Objective To estimate and compare eligibility for statin therapy based on ACC/AHA and NCEP guidelines in adult Chilean population. Methods Using data from the last National Health Survey (2009–2010 NHS), we conducted a cross-sectional analysis in a ​representative sample of the Chilean adult population and calculated the proportion of individuals that would receive statins under each set of guidelines. Results According to ACC/AHA guidelines, the population eligible for statin treatment increased from 21.7% (NCEP guidelines) to 33.2% (overall 53% increase). This effect was more pronounced among women (29.6% under ACC/AHA vs 15.6% under NCEP) and with those of advanced age (75% of the subjects >60 years of age compared with 46% under NCEP). The newly eligible group included more women and older subjects and individuals with lower LDL cholesterol levels. Conclusion Compared with NCEP recommendations, the new ACC/AHA guidelines significantly increased the number of Chilean adults eligible for statin therapy. Full implementation of the new recommendations may have important public health implications in Chile and other Latin American countries, as more women and older subjects without cardiovascular disease would qualify for statin treatment.

Obesity and metabolic syndrome (MetS) are key risk factors for chronic disease. Dietary patterns are critical in the incidence and persistence of obesity and MetS, yet there is few data linking diet to obesity and MetS in Chile. Our objective was to use a locally validated diet index to evaluate adherence to a Mediterranean dietary pattern and its correlations with overweight/obesity (OW/O) and MetS prevalence in Chilean adults. We conducted a nationwide, cross-sectional online survey of Chilean adults with complete self-reported diet and body mass index data (n = 24,882). A subsample of 4348 users (17.5%) had valid MetS data. An inverse association was observed between adherence to Mediterranean diet and OW/O and MetS prevalence. As diet quality decreased from healthy, to moderately-healthy, to unhealthy, prevalence increased from 44.8, 51.1, to 60.9% for OW/O and from 13.4, 18.5, to 28.9% for MetS (p-values < 0.001). Adjusted odds ratios for OW/O and MetS were significantly higher in moderately-healthy (OR = 1.58 and 1.54) and unhealthy (OR = 2.20 and 2.49, respectively) diet groups in comparison to the healthy diet group. This study represents the first report on the relationship between Mediterranean diet and chronic disease risk in Chile. It suggests that the Mediterranean diet may be applied to manage chronic disease risk beyond the Mediterranean basin.

Nutrition labeling is a tool that helps people to make healthy choices when choosing foods and drinks for consumption. Easy to understand information promotes rational choices. However the implementation of this information by industry and their proper use by consumers is complex. A key aspect is the existence of appropriate laws and regulations. Fortunately, Chile has a mandatory guideline for labeling packed food products. Though, the correctness of the information appearing in the label is essential.To evaluate the veracity of nutritional information appearing on food labels in our country.We tabulated the information on the labels of over 1,000 packed products and analyzed it using globally accepted tables as reference. We included cereals, vegetables, fruits and juices, nuts, legumes, dairy, fish and shellfish, meat, oils and fats and sweets.Ninety percent of the information appearing in the labels of analyzed products was presumably correct. However, there were great variations among food groups.This information allowed evaluate the application of the Food Health Regulations reform implemented in 2006, specifically Article 115. The possible improvements to achieve the original aims of the initiative are discussed.

Health is defined as a state of complete physical, mental and social wellbeing and not merely as the absence of disease. Thus, medical practice must not only deal with diagnosis and treatment of pathological conditions and solve physical ailments, but also promote a comprehensive wellbeing state -including the psychological domain- to achieve positive health. Therefore, it is necessary to scientifically identify the psychological and social determinants that contribute more effectively to prevent disease and achieve optimal health. This article reviews the most recent evidence showing the importance of positive psychological and social resources on cardiovascular disease, the leading cause of morbidity and mortality as well as health care costs worldwide. Evidence is summarized regarding the role of positive psychosocial factors as health promoters and protectors against cardiovascular risk, the possible mechanisms that explain this association, and the practical implications and future research arising from this perspective. The development of interdisciplinary research in this field, incorporating the area of psychological wellbeing, should help to generate and test new strategies aimed at more effective cardiovascular disease prevention and treatment.

ObjectiveTo evaluate the feasibility of diet mediterranisation, in a food-at-work context, and its consequence on metabolic syndrome in a mid-age unselected healthy male population group.DesignOne-year longitudinal intervention study. Physical exercise was not modified.SettingAll workers of the Santiago division of ‘Maestranza Diesel’, a metal-mechanic company servicing the mining industry, were invited to participate.SubjectsInitially, 145 workers of a total of 171, of average age 39 years, accepted to participate (sixteen women and 129 men). A subgroup of ninety-six men fully completed the controls programmed for the intervention study. Losses from the original group correspond to missing one control (sixteen), leaving the company (eleven) or blood sampling discomfort (six). The women and sixteen male workers, hired post study initiation, did participate but were excluded from this 12-month analysis.ResultsDiet mediterranisation was successful, reflected in the daily food consumption at the canteen and the evolution of the Mediterranean diet score (MDS) from 4·8 ± 1·4 to 7·4 ± 1·5 (limits 0–14). Some metabolic syndrome components showed statistically significant improvement and also statistically significant correlation with the MDS: waist circumference, HDL-cholesterol, systolic and diastolic blood pressure. After 12 months, the reversion rate for metabolic syndrome was 48 % (12/23) with an incidence rate of 4·1 % for new cases (3/73). In total, metabolic syndrome decreased from 24·0 % to 15·6 % (23/96 to 15/96) (P = 0·029).ConclusionsDiet mediterranisation is feasible in a food-at-work intervention, affecting lunch consumption at the workers canteen and overall consumption evaluated with MDS, together with a significant reduction in metabolic syndrome.