Dra. Troncoso-Pantoja, Claudia

El envejecimiento será una de las transformaciones sociales más importantes del siglo XXI en todo el mundo. En los últimos 40 años, Chile ha triplicado su población adulta mayor. Como resultado, para el 2050 el país tendrá la mayor proporción de adultos mayores en América Latina. Este notable crecimiento refuerza la necesidad de identificar su situación actual y revisar qué está haciendo la sociedad para mantener a las personas mayores como miembros activos. En este contexto, esta revisión narrativa tuvo como objetivo describir el perfil sociodemográfico, epidemiológico y sociocultural de los adultos mayores chilenos. Además, se identificaron programas y políticas públicas enfocadas a la mejora de su calidad de vida.

Objective: The aim of this study was to identify which anthropometric measurement (body mass index [BMI], waist circumference [WC], or waist-to-height ratio [WHtR]) is a better predictor of type 2 diabetes and hypertension in the Chilean population. Methods: The study included 13 044 participants (59.7% women) from the Chilean National Health Surveys conducted in 2003, 2009-2010, and 2016-2017. BMI, WC, and WHtR were the anthropometric measurements evaluated. Hypertension was defined as systolic blood pressure ≥140 mm Hg and diastolic blood pressure -90 mm Hg or on medication for hypertension. Diabetes was defined as fasting glucose -7 mmol/L or on medication for diabetes. The receiver operating characteristics (ROC) curve and the area under curve (AUC) were computed to derive the specificity and sensitivity using a bootstrapping approach. Results: Compared with BMI and WC, WHtR was the anthropometric measurement with the highest AUC curve in both sexes for hypertension (AUC for women: 0.70; 95% confidence interval [CI], 0.67-0.73; AUC for men: 0.71; 95% CI, 0.69-0.74) and diabetes (AUC for women: 0.71; 95% CI, 0.66-0.77; AUC for men: 0.71; 95% CI, 0.67-0.76). The sex-specific cutoff points of WHtR to predict hypertension were 0.59 and 0.55 for women and men, respectively. Those used to predict diabetes were 0.60 and 0.58 for women and men, respectively. Conclusion: WHtR was a better predictor of hypertension and diabetes than BMI and WC in Chile. The definition of cutoff points specific for the Chilean population could be implemented in future screening programs aiming to identify high-risk individuals.

Background: Genetic variants within the FTO gene have been associated with increased adiposity and metabolic markers; however, there is limited evidence regarding the association of FTO gene variants with physical activity-related variables. The authors aimed to investigate the association of the rs17817449 single-nucleotide polymorphism of FTO with physical activity, sedentary time, and cardiorespiratory fitness in Chilean adults. Methods: A total of 409 participants from the GENADIO study were included and genotyped for the rs17817449 single-nucleotide polymorphism of FTO in this cross-sectional study. Physical activity and sedentary time were measured with ActiGraph accelerometers. Cardiorespiratory fitness was assessed using the Chester step test. The associations were assessed by using multivariate regression analyses. Results: No associations were found for FTO variant with physical activity levels and cardiorespiratory fitness. The risk allele (G) of the FTO was found to be associated with sedentary time in the minimally adjusted model (β = 19.7 min/d; 95% confidence interval, 4.0 to 35.5, per each copy of the risk allele; P = .006), but the association was no longer significant when body mass index was included as a confounder (P = .211). Conclusion: The rs17817449 single-nucleotide polymorphism of the FTO gene was not associated with the level of physical activity, cardiorespiratory fitness, and sedentary behaviors in Chilean adults.

Certain countries have the privilege of diverse ecosystems that allow access to wide food availability. This fact carries an intrinsic diversity in bioactive compounds such as phytochemicals, especially polyphenols. The aim of this review is to summarize the advances in polyphenols research which have been conducted in Chile, with a focus on polyphenol-rich foods and health-related outcomes. In the first part, several studies that have analyzed food sources rich in polyphenols are presented. This is followed by a description of in vitro and in vivo studies from Chile that have evaluated the polyphenol compounds of Chilean foods or their extracts along with their biological activity or health effects. Most polyphenol studies in our search have an in vitro experimental design where mainly protective activities are tested. The antioxidant effect is remarkable in all studies. As well as discussing the future direction of dietary assessment and the approach to biomarkers in this field, currently, additional emphasis and research investment are necessary to explore more native foods with an added value.

The foodservice sector has grown rapidly due to the increase in meals out of home. Thanks to the enormous number of meals served daily, making changes to reduce the environmental footprint of their menus could have a positive impact on the sustainability of the food system. The objective of this study was to select indicators to evaluate and communicate the sustainability of culinary preparations offered by foodservices. A bibliographic search of indicators was carried out, which were subsequently subjected to validation regarding their relevance by a group of experts. The indicators finally selected, carbon footprint, water footprint, presence of meat and/or animal products, presence of local ingredients and generation of waste in processing, were applied to traditional Chilean recipes and the results were presented to two discussion groups of consumers to evaluate their understanding and usefulness. When these indicators were applied to 10 Chilean recipes, it was found that those containing meat as an ingredient were less sustainable. A group of consumers invited for validation found the way these indicators were communicated understandable and useful. It is expected that the validation of these indicators will be useful for communicating to services and consumers the sustainability of dishes in foodservices.

Fundamentos: La recopilación de los saberes y sabores de comidas tradicionales faculta la mantención de la identidad en las comunidades y los núcleos familiares, permitiendo ser un aporte para la alimentación saludable. Objetivo: Comprender el significado que representan las comidas tradicionales para un grupo de mujeres adultas mayores de la provincia de Concepción, Chile. Métodos: El estudio utilizó el paradigma cualitativo con enfoque fenomenológico interpretativo de Heidegger. Como estrategia de recolección de datos, se utilizó la entrevista semiestructurada. Las respuestas, se codificaron, reagruparon y analizaron a través de la técnica de análisis de contenido. Resultados: Las entrevistadas identifican recetas culinarias con características que son tradicionales para ellas, reconociendo ingredientes y formas de preparación que se han mantenido en el tiempo. Las materias primas utilizadas son las mismas que recuerdan desde su época de infancia, aunque se menciona una dificultad en la adquisición de estos productos, debido al acceso o el costo económico de su adquisición. Sin embrago, el cambio de ingredientes no es apreciado como una modificación mayor a la receta más clásica. Otro aspecto importante es la modificación de los sabores en las preparaciones. A lo anterior, los alimentos y preparaciones de antaño eran identificados como más naturales y por lo mismo, reconocidos como más saludable. Conclusiones: Las comidas tradicionales permiten entrecruzar simbolismos y significados en mujeres adultas mayores, que favorecen la valoración de la alimentación desde los sabores, formas de preparar e ingredientes utilizados, percibiéndose como una alternativa para la alimentación saludable.

Research on morbidity and mortality often emphasizes individual diseases over the cumulative effects of multimorbidity, especially in low- and middle-income countries. This study aimed to analyze the association between multimorbidity and all-cause mortality in a representative sample of the Chilean population. This longitudinal study used data from 3701 subjects aged ≥15 years who participated in the Chilean National Health Survey conducted between 2009 and 2010. We included 16 self-reported highly prevalent morbidities. All-cause mortality data from an 11-year follow-up were collected from the Chilean Civil Registry. The Cox proportional hazard model, adjusted for confounders, determined the association between multimorbidity categories and all-cause mortality. Of the total sample, 24.3% reported no morbidity, while 50.4% two or more. After adjustment, participants with four or more morbidities had a 1.66 times higher mortality risk [95% confidence interval (CI): 1.03–2.67] than those without morbidities. The mortality risk increased by 10% for each additional morbidity [HR: 1.09 (CI: 1.04–1.16)]. Multimorbidity was common in the Chilean population and increased the mortality risk, which greatly challenges the health system to provide an integral and coordinated approach to healthcare.

Objetivo principal: Interpretar el significado que se le asigna a las estrategias de enseñanza-aprendizaje en el área de salud destinada a personas mayores. Método: Estudio cualitativo de carácter exploratorio. Participaron personas mayores de 60 años y profesionales del área gerontológica con experiencia en la planificación y ejecución de educación en salud. La información fue recolectada a través de entrevista semiestructurada, y los datos fueron analizados a través de análisis de contenido. Resultados principales: Las personas mayores reconocen el realizar talleres y la educación individual como las mejores estrategias para recibir educación. Al triangular la información, los profesionales gerontológicos coinciden con la apreciación positiva de los talleres, pero acompañados de un adecuado diagnóstico participativo y desde la experiencia del participante. Conclusión principal: Los talleres se reconocen como la mejor estrategia de enseñanza-aprendizaje para personas mayores. Esta debe aplicarse considerando un diagnóstico participativo, con la experiencia de la persona mayor y ser mantenido en el tiempo.

Background: The Frailty Index (FI) is used to quantify and summarize vulnerability status in people. In Chile, no development and assessment of a FI have been explored. Objective: To develop and evaluate a FI using representative data from Chilean adults aged 40 years and older stratified by sex. Design: Cross-sectional study. Setting: National representative data from the Chilean National Health Survey 2016–2017 (CNHS 2016–2017). Participants: 3,036 participants older than 40 years with complete data for all variables. Measurements: A 49-item FI was developed and evaluated. This FI included deficits from comorbidities, functional limitations, mental health status, physical activity, anthropometry, medications, and falls. A score between 0 and 1 was calculated for each person. Descriptive statistics and linear regression models were employed to evaluate the FI’s performance in the population. Comparative analyses were carried out to evaluate the FI score by age (<60 and ≥ 60 years). Results: The mean FI score was 0.15 (SD:0.09), with a 99% upper limit of 0.46. Scores were greater in women than men (0.17 [SD:0.09]) vs. 0.12 [0.08]); in people older than 80 years (0.22 [0.11]), and in people with ≤8 years of education (0.18 [0.10]) compared with those with >12 years (0.12 [0.08]). The average age-related increase in the FI was 2.3%. When a cut-off point ≥ 0.25 was applied, the prevalence of frail individuals was 11.8% (95% CI: 10.0 to 13.8) in the general population. The prevalence was higher in women 15.9% [95% CI: 13.3 to 18.9] than men 7.4% [95% CI: 5.3 to 10.1]. In a comparative analysis by age, higher FI mean scores and prevalence of frail were observed in people ≥ 60 than younger than 60. Conclusions: The mean FI score and frailty prevalence were higher in women than men, in people with fewer years of formal education, and incremented markedly with age. This FI can be used for early detection of frailty status focusing on women and middle-aged people as a strategy to delay or prevent frailty-related consequences.