Guadalupe Echeverría

Validación de cuestionario autoaplicable para un índice de alimentación mediterránea en Chile

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, the Chilean-MDI describes overall food intake in our population, showing demographic trends that are comparable to those obtained with similar indexes applied in other populations.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.

Deficient Vitamin E Uptake During Development Impairs Neural Tube Closure in Mice Lacking Lipoprotein Receptor SR-BI

SR-BI is the main receptor for high density lipoproteins (HDL) and mediates the bidirectional transport of lipids, such as cholesterol and vitamin E, between these particles and cells. During early development, SR-BI is expressed in extraembryonic tissue, specifically in trophoblast giant cells in the parietal yolk sac. We previously showed that approximately 50% of SR-BI−/− embryos fail to close the anterior neural tube and develop exencephaly, a perinatal lethal condition. Here, we evaluated the role of SR-BI in embryonic vitamin E uptake during murine neural tube closure. Our results showed that SR-BI−/− embryos had a very low vitamin E content in comparison to SR-BI+/+ embryos. Whereas SR-BI−/− embryos with closed neural tubes (nSR-BI−/−) had high levels of reactive oxygen species (ROS), intermediate ROS levels between SR-BI+/+ and nSR-BI−/− embryos were detected in SR-BI−/− with NTD (NTD SR-BI−/−). Reduced expression of Pax3, Alx1 and Alx3 genes was found in NTD SR-BI−/− embryos. Maternal α-tocopherol dietary supplementation prevented NTD almost completely (from 54% to 2%, p < 0.001) in SR-BI−/− embryos and normalized ROS and gene expression levels. In sum, our results suggest the involvement of SR-BI in the maternal provision of embryonic vitamin E to the mouse embryo during neural tube closure.

A Chilean Berry Concentrate Protects against Postprandial Oxidative Stress and Increases Plasma Antioxidant Activity in Healthy Humans.

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.

Inverse Associations between a Locally Validated Mediterranean Diet Index, Overweight/Obesity, and Metabolic Syndrome in Chilean Adults

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.

Evidencia actual sobre los beneficios de la dieta mediterránea en salud

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 (Prevencion con Dieta Mediterranea) 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.

Recursos psicosociales positivos y salud cardiovascular

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.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.

The Chilean Diet and the Omega-6/Omega-3 Balance

Continental Chile is a long and narrow country stretching north to south on the western coast of South America, with a northern border at latitude 17°30 South, to Cape Horn at 56° in the southern end. The Andes Mountains define the eastern border and the Pacific Ocean the western border. In front of the 4,300 km long coastline, Chile exerts exclusive maritime control 200 nautical miles from the coast, fishing rights included, with the responsibility of preserving natural resources. Different types of climate and ecosystems exist in this country, which harbors one of the five main Mediterranean ecosystems in the world [1]. Chile had 17.1 million inhabitants and a per capita GNP of USD 14,700 in 2009. Exports in 2009 reached USD 53 billion, 53.5% of which was from copper. Other key exports are forestry and wood products, fresh fruit and processed food, fishmeal and seafood, and wine. The food industry accounts for 15.4% of exports, with agricultural products and extractive fisheries representing 6.9% [2]. Canola oil, αlinolenic acid (ALA; omega3)rich oil, is produced in Chile but in variable amounts. Its production and human consumption depend mostly on availability and price, in competition with soy and sunflower oils which are imported from Argentina and Bolivia. Aquaculture, together with fishing, constitutes the third largest Chilean economic activity after mining and forestry; it exerts a strong demand for fishmeal and fish oil, as well as canola oil. Chile is the second largest fishmeal producer in the world after Peru. However, Chilean fishmeal and fish oil production has shown a downward trend over the last 10 years. The catch is progressively being used for products for human consumption, but unfortunately it is not reflected in the national consumption. The Chilean public health system continuously monitors the nutritional status of children under 6 years of age and in 2006 found stunting and obesity to be 2.8 and 7.4%, respectively, at the national level [3]. The prevalence of overweight and obesity progressively increases in the infantile and school populations. These studies also show a progressive increase in adolescents being overweight. In a sample of 1,732 children aged 9– 12 years, Liberona et al. [4] reported that the prevalence of overweight and obesity reached 40%, and was higher in boys and those in the lower socioeconomic groups. The findings of the first Chilean National Health Survey (ENS 2003) [5], showed that the prevalence of overweight and obesity reached 38

Increased statin eligibility based on ACC/AHA versus NCEP guidelines for high cholesterol management in Chile

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.

The Consumption of Beef Burgers Prepared with Wine Grape Pomace Flour Improves Fasting Glucose, Plasma Antioxidant Levels, and Oxidative Damage Markers in Humans: A Controlled Trial

Wine grape pomace flour (WGPF) is a fruit byproduct that is high in fiber and antioxidants. We tested whether WGPF consumption could affect blood biochemical parameters, including oxidative stress biomarkers. In a three-month intervention study, 27 male volunteers, each with some components of metabolic syndrome, consumed a beef burger supplemented with 7% WGPF containing 3.5% of fiber and 1.2 mg gallic equivalents (GE)/g of polyphenols (WGPF-burger), daily, during the first month. The volunteers consumed no burgers in the second month, and one control-burger daily in the third month. At baseline and after these periods, we evaluated the metabolic syndrome components, plasma antioxidant status (i.e., 2,2-diphenyl-1-picrylhydrazyl radical scavenging capacity (DPPH), vitamin E, vitamin C), and oxidative damage markers (i.e., advanced oxidation protein products (AOPPs), oxidized low-density lipoproteins (oxLDLs), malondialdehyde (MDA)). The WGPF-burger intake significantly reduced glycemia and homeostatic model assessment-based measurement of insulin resistance. Vitamin C increased and decreased during the consumption of the WGPF-burger and control-burger, respectively. The WGPF-burger intake significantly decreased AOPP and oxLDL levels. Vitamin E and MDA levels showed no significant changes. In conclusion, the consumption of beef burgers prepared with WGPF improved fasting glucose and insulin resistance, plasma antioxidant levels, and oxidative damage markers. Therefore, this functional ingredient has potential as a dietary supplement to manage chronic disease risk in humans.

Consumo de huevo y enfermedad cardiovascular: una revisión de la literatura científica

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.