La pandemia de COVID-19 y el cumplimiento de las guías alimentarias en una comunidad universitaria de Chile / COVID-19 pandemic and adherence to food- based dietary guidelines in a Chilean university community

Introducción. La pandemia de SARS-CoV-2/COVID-19 y las restricciones sanitarias afectaron la disponibilidad, acceso y consumo de alimentos, impactando la alimentación y el estado nutricional. Objetivo. Determinar el efecto de la pandemia SARS-CoV-2/COVID-19 sobre el cumplimiento de las Guías Alimentarias Basadas en Alimentos de Chile, en una comunidad universitaria, antes y durante la pandemia. Materiales y métodos. Estudio de cohorte retrospectiva con 427 participantes. Se aplicó una encuesta online con preguntas basadas en los mensajes de las GABA. La encuesta se validó por juicio de expertos y análisis psicométrico, evaluando la concordancia con el estadístico de Kappa (K=89,95) y la confiabilidad con el coeficiente Alfa de Cronbach (=0,97). Se fijó como período antes de la pandemia al tiempo anterior a marzo del año 2020, y durante la pandemia, entre marzo del 2020 y octubre del 2021. Para medir los cambios antes y durante la pandemia se aplicó el test de simetría considerando un p <0,05 con un intervalo de confianza del 95%, mediante el software estadístico STATA versión 16. Resultados. Se observaron cambios estadísticamente significativos antes y durante la pandemia en los mensajes relacionados con el estado nutricional (p=0,000), consumo semanal de: productos de pastelería (p=0,0040), cecinas y embutidos (p=0,0034), frituras (p=0,0070), legumbres (p=0,0000), aguas (p=0,0000) y lectura e información nutricional de los productos (p=0,0000). Conclusiones. La pandemia de SARS-CoV-2/COVID-19 generó cambios en la alimentación y estado nutricional respecto a los mensajes de las guías. Se precisan políticas alimentarias y estrategias educativas en alimentación y en nutrición para emergencias sanitarias(AU)

Introduction. The SARS-CoV-2/COVID-19 pandemic, as well as health restrictions, impacted food availability, access and consumption, affecting dietary habits and nutritional status. Objective. To determine the effect of the SARS-CoV-2/ COVID-19 pandemic on the adherence to Chilean Food-Based Dietary Guidelines, within a university community, both before and during the pandemic. Materials and methods. A retrospective cohort study involving 427 participants was conducted. An online survey was administered, with questions based on the FBDGs' messages. The survey was validated through expert judgment and psychometric analysis, and agreement was assessed using the Kappa statistic (K = 89.95) while reliability was determined using the Cronbach's Alpha coefficient ( = 0.97). The period before the pandemic was defined as the time prior to March 2020, and the pandemic period was set between March 2020 and October 2021. Changes before and during the pandemic were measured using the symmetry test, considering a p value of <0.05 and a 95% confidence level, using the STATA 16 statistical software. Results. Statistically significant changes were observed before and during the pandemic in messages related to nutritional status (p = 0.000), weekly consumption of bakery products (p = 0.0040), cold meats (p = 0.0034), fried foods (p = 0.0070), legumes (p = 0.0000), water (p = 0.0000), and messages related to reading and nutrition information of products (p = 0.0000). Conclusions. The pandemic led to dietary changes in relation to FBDGs messages. Food policies and food and nutrition education strategies are required to address health emergency contexts(AU)

Análisis cualitativo de los perfiles de egreso en procesos de aseguramiento de la calidad de carreras de Nutrición y Dietética en Chile

Antecedentes: La evaluación de los perfiles de egreso es uno de los aspectos centrales en la acreditación de carreras en Chile, por cuanto su formulación y aplicación en los procesos formativos influyen en sus niveles de pertinencia y calidad. Objetivo: Evidenciar las fortalezas y debilidades del diseño y aplicación de los perfiles de egreso de las carreras de Nutrición y Dietética en Chile, a partir de los resultados de sus procesos de acreditación. Materiales y métodos: Estudio transversal, descriptivo, cualitativo. Se identificaron, en las resoluciones de acreditación entre los años 2004 y 2016, las fortalezas y debilidades de los perfiles de egreso y las contradicciones entre lo declarado y lo ejecutado por los programas. Las carreras se ordenaron en dos grupos según el tiempo de acreditación: i) de dos a cuatro años y ii) de 5 o más años. Usando el software Atlas.ti 7.0 se determinaron los patrones y diferencias conceptuales en los juicios evaluativos de los perfiles de egreso. Resultados: Existe una alta variabilidad entre carreras en los contenidos y aplicación de los perfiles de egreso. Ella se asocia a las capacidades instaladas en las instituciones y a los tiempos de acreditación de la carrera. Existen carreras con déficit en el cumplimiento de competencias, conocimientos y habilidades. Conclusiones: Los contenidos y aplicación de perfiles de egreso son muy heterogéneos y su aplicación se asocia al tiempo de acreditación de la carrera. Es necesario limitar la alta dependencia a la demanda y estimular mayores compromisos institucionales.

Background: Assessment of the graduate profiles is one of the key aspects of program accreditation in Chile, therefore, their development and application in training processes have an impact on their relevance and quality. Objective: To demonstrate the strengths and weaknesses of the design and application of graduate profiles of Nutrition and Dietetics degree programs in Chile, on the basis of the outcomes of their accreditation processes. Materials and methods: Cross-sectional, descriptive, qualitative study. Strengths and weaknesses of graduate profiles, and inconsistencies between what was stated and what was actually implemented in the programs were identified in the accreditation resolutions issued between 2004 and 2016. Degree programs were classified in two groups, according to accreditation years: i) two to four years, and ii) five or more years The Atlas.ti 7.0 software was used to determine patterns and conceptual differences in the evaluative judgement of graduate profiles. Results: There was a high variability in the content and application of graduate profiles between degree programs. This was associated with the institutions' installed capacities and with accreditation years awarded to the program. Some programs were not compliant with the required competencies, knowledge and skills. Conclusions: The content and application of graduate profiles are highly heterogeneous, and its application is associated to accreditation years of the program. It is necessary to limit high dependency on demand to encourage stronger institutional commitments.

Análisis cualitativo de los procesos regulatorios de la calidad en los programas de Nutrición y Dietética en Chile

RESUMEN Introducción. El objetivo de este estudio es establecer patrones positivos y negativos de los resultados de los procesos de acreditación de las carreras. Asimismo, identificar desde una perspectiva cualitativa, variables relevantes y relaciones entre los criterios usados en su evaluación. Materiales y métodos. El estudio es transversal, descriptivo y cualitativo. Se analizaron veinte resoluciones de acreditación de las carreras de Nutrición y Dietética en Chile, emitidas entre los años 2004 y 2016 por la Comisión Nacional de Acreditación mediante el software ATLAS ti. Se consideraron las tres dimensiones; Propósitos e Institucionalidad; Condiciones de Operación y Resultados; y Capacidad de Autorregulación para establecer una matriz de relaciones con la identificación de patrones positivos y negativos entre criterios. Resultados. Se evidencian fuertes diferencias entre las carreras. Las relaciones positivas y negativas entre los códigos de los criterios perfil de egreso y plan de estudio indican que solo algunas de ellas proveen una formación adecuada. Del mismo modo, las relaciones entre la calificación del cuerpo docente y la investigación revelan casos de docentes sin niveles suficientes. Otros aspectos deficitarios son el nivel con que ingresan los estudiantes y el uso efectivo de diagnósticos y autoevaluaciones. Conclusiones. El estudio provee información relevante para la toma de decisiones y procesos de retroalimentación orientados al urgente mejoramiento y aseguramiento de la calidad de carreras, en particular de sus planes de estudio, calificación de docentes y efectividad de los procesos de aseguramiento de la calidad, dada la creciente importancia de estos profesionales en la salud pública.

ABSTRACT Introduction. The objective of this study is to establish positive and negative patterns based on the results of accreditation processes of degree programs. Similarly, its aim is to identify, from a qualitative perspective, relevant variables and relationships among the criteria used in their evaluation. Materials and methods. This is a cross-sectional, descriptive and qualitative study. Twenty accreditation resolutions of Chilean Nutrition and Dietetics degree programs were analyzed using the software ATLAS ti. Resolutions were issued between 2004 and 2016 by the National Accreditation Commission. Three dimensions were considered in order to establish a matrix of relationships associated with the identification of positive and negative patterns among criteria: Purpose and Institutionalism; Operating Conditions and Results; and Self-Regulatory Ability. Results. Major differences were found among the degree programs. Positive and negative relationships between criteria codes, graduate profile and curriculum, indicate that only some degree programs provide an appropriate training. In the same way, the relationship between the teaching staff qualification and research work revealed cases of teachers who were not sufficiently qualified. Other weak aspects were the level of knowledge that students have when they enter university and the effective use of diagnostics and self-assessment tests. Conclusions. This study provides relevant information for decision making and feedback processes oriented at the urgent improvement and quality assurance of degree programs, particularly of curricula, teaching staff qualifications, and effectiveness of the quality assurance processes, given the increasing importance of nutrition professionals in the public health area.

¿Qué pasa con la formación de nutricionistas en Chile? / What happening with nutritionist training in Chile?

RESUMEN El propósito de este artículo es analizar la evolución de las carreras y programas de Nutrición y Dietética en Chile. Se verifica un incremento sostenido de la oferta formativa, particularmente en los últimos veinte años, asociado a procesos de mercantilización de la Educación Superior. El aseguramiento de la calidad ha operado a través de la acreditación voluntaria y sus resultados son congruentes con el contexto nacional. La creciente importancia de la alimentación y nutrición en la salud pública del país exige formular cambios en la formación en Nutrición y Dietética, para lo cual se plantean diversas recomendaciones para lograr mayores niveles de pertinencia y el mejoramiento continuo de la calidad.

ABSTRACT The purpose of this article is to analyze the evolution of Nutrition and Dietetics degree programs and majors in Chile. This research demonstrated a sustained increase in the number of training programs, particularly during the last twenty years, due to the process of commodification of higher education. Quality assurance has been implemented by voluntary accreditation, which has shown results consistent with the national context. The growing importance given to food and nutrition in the national public health scenario requires changes in Nutrition and Dietetics academic programs. To this end, different recommendations are made in order to achieve improved relevance standards and continuous quality improvement.

Consumo de frutas, verduras y legumbres en universitarios chilenos / Consumption of fruits, vegetables and legumes among Chilean university students

RESUMEN Recomendaciones internacionales indican que se deben consumir diariamente 400 g/día o su equivalente a 5 porciones de frutas, verduras o legumbres. Nuestro objetivo fue determinar la frecuencia de consumo de frutas, verduras y legumbres en estudiantes universitarios chilenos. Materiales y Métodos: Estudio transversal. Fueron evaluados estudiantes universitarios (n= 1454) del norte, centro y sur de Chile. Ellos completaron una encuesta alimentaria que se utiliza para determinar hábitos alimentarios saludables (frutas, verduras y legumbres). El 78% era de sexo femenino. Al analizar la frecuencia de consumo de frutas, verduras y legumbres según universidad, sólo frutas y verduras mostraron de diferencia estadísticamente significativa (p< 0,01). El 70% de los estudiantes no cumple con la recomendación de consumo de frutas; 72% con la de verduras y 77% con la de legumbres. En mujeres, un 6,3% del total de la muestra cumple con la recomendación de frutas y en hombres el valor alcanza al 8,4%; en verduras se observa que la recomendación alcanza al 29,5% en mujeres y 21,3% en hombres, y en legumbres, es 2,4% en mujeres y 5% en hombres. Se observa un bajo consumo de frutas, verduras y legumbres en universitarios muy lejos de las recomendaciones internaciones.

ABSTRACT International recommendations indicate that 400 g/ day or its equivalent to 5 servings of fruits, vegetables or legumes should be consumed daily. Our aim was to determine patterns of consumption of fruits, vegetables and legumes among Chilean university students. Materials and Methods: Cross-sectional study. University students (n= 1454) from the north, center and south of Chile were evaluated. A self-assessment survey was used to evaluate healthy eating habits (fruits, vegetables and legumes). Seventy-eight percent of participants were women. When analyzing the consumption frequency of fruits, vegetables and legumes according to different universities, only fruits and vegetables showed a statistically significant difference (p< 0.01). Seventy percent of students do not meet recommended amounts for fruit consumption; 72% for vegetables and 77% for legumes. Among women, 6.3% of the total sample met the recommendation for fruit, while, for men, the value was 8.4%; for vegetables, we observed that 29.5 and 21.3% of women and men, respectively, met the recommendation; for legumes, 2.4% of women and 5% of men met the recommendation. There was a low consumption of fruits, vegetables and legumes among university students, with levels far from the international recommendations.

Caracterización del estado nutricional, hábitos alimentarios y estilos de vida de estudiantes universitarios chilenos: estudio multicéntrico / Lifestyles, body mass index and sleep patterns among university students

Background Health surveys in Chile show a worrisome high prevalence of unhealthy lifestyles among adults. Aim To characterize the nutritional status, food intake and sleep patterns in university students of both genders. Material and Methods Cross sectional study in seven Chilean universities. Students from six universities answered a feeding habits survey, the Pittsburgh Sleep Quality Index, Insomnia Severity Index and Epworth Sleepiness Scale. All were weighed and their height was measured. Results A total of 1,418 students aged 21 ± 3 years (22% males) were evaluated. Three percent were classified as underweight, 68% as normal weight, 24% as overweight and 4% as obese. Thirty three percent of males and 28% of females smoked. Twenty six percent consumed at least one glass of alcoholic beverages on the weekend, and only 18% of males and 5% of females were physically active. Men consumed unhealthy foods with a significantly higher frequency than females. Twenty seven percent had mild daytime somnolence, 24% had moderate daytime somnolence, 50% had subclinical insomnia, 19% moderate insomnia, and 1.4% had severe insomnia. Conclusions In this group of students a high frequency of unhealthy lifestyles and malnutrition caused by excess was observed. Also a high prevalence of insomnia, daytime somnolence, and inadequate sleep amounts were recorded.

Reflexiones sobre las recomendaciones en salud pública para la prevención del cáncer dadas por el fondo mundial para la investigación sobre cáncer (FMIC) y la situación de Chile / Analysis of the recommendations for cancer prevention given by the global fund for research on cancer (FMIC) and the situation in Chile

El cáncer representa el 13% de causas de muerte anuales a nivel mundial y es la segunda causa en las Américas con 1,2 millones de muerte en el 2008. En Chile represento el 25,6 % del total de muertes en el 2007. La obesidad se relaciona con un tercio de todos los cánceres, y está asociada con la grasa corporal, grasa abdominal, aumento de peso en la edad adulta, todos factores modificables a través de un patrón saludable de dieta y actividad física. El objetivo fue analizar las recomendaciones de Salud Pública, emitidas por el Fondo Internacional para la Investigación del Cáncer (WCRF) y el Instituto Americano de Investigación del Cáncer (AICR) en el año 2007 para la prevención del cáncer. Comparar las recomendaciones del informe Alimentación, Nutrición y actividad física y la prevención del cáncer: una perspectiva mundial“, con la situación nacional en relación a estas recomendaciones. Luego, se proponen recomendaciones nacionales en concordancia con las propuestas del WCRF. El análisis revela que Chile a nivel poblacional presenta riesgos de cáncer asociados con estilos de vida; dieta, Indice de Masa Corporal y sedentarismo. El patrón de consumo alimentario y el perfil nutricional y las conductas asociadas a los estilos de vida de la población no reflejan las recomendaciones de organismos internacionales, sobre los consumos de productos protectores (legumbres, hortalizas, frutas altos en antioxidantes, fibra) y de los de alto riesgo (bebidas y jugos azucarados, procesados altos en sodio, grasas totales). Se requiere educar a la población sobre alimentación saludable y estilos de vida que mantengan la salud.

Cancer is one of the most important causes of death in the world corresponding to 63% annually, is the second in the Americas with 1.2 million deaths in 2008 and Chile in 2007 representing 25.6% of all deaths. Obesity is associated with a third of all cancers and is associated with body fat, abdominal fat, weight gain in adulthood, all modifiable factors through a healthy diet pattern and physical activity. The aim was to analyze the recommendations of Public Health issued by the International Fund for Cancer Research (WCRF) and American Institute for Cancer Research (AICR) in 2007 to prevent cancer. Compare the recommendations of the report Food, Nutrition and physical activity and cancer prevention: a global perspective, "with the national situation regarding these recommendations. Then, we propose national recommendations in accordance with the proposals of WCRF. The analysis reveals that Chile has a population level cancer risks associated with lifestyle, diet, body mass index and physical inactivity. The pattern of food consumption and nutritional profile and behaviors associated with the lifestyles of the population does not reflect the recommendations of international organizations, on the consumption of protective (vegetables, fruits high in antioxidants, fiber) and high risk (sugary drinks and juices, processed, high in sodium, total fat). Is required to educate people about healthy eating and lifestyles to maintain health.

Recomendaciones para la prevención del cáncer dadas por el Fondo Mundial para la Investigación sobre Cáncer (FMIC): análisis de la situación en Chile / Recommendations for cancer prevention of World Cancer Research Fund (WCRF): situational analysis for Chile

The main diet-related cancers include colorectal, lung, breast in (postmenopausal) women, stomach, esophagus, prostate and pancreas. After tobacco, obesity is the leading cause of cancer; it accounts for one third of all cancers. Cancer is associated with high total body fat, abdominal fat and weight gain in adult life. These are all potentially modifiable risk factors. Consumption of a "healthy diet" and living an "active life" can significantly reduce the risk of cancer. The aim of this study was to analyze the recommendations published by the World Cancer Research Fund (WCRF) and American Institute for Cancer Research (AICR) for the prevention of cancer in 2007. We compared the recommendations of Food, Nutrition and Physical Activity and the Prevention of Cancer: a global perspective", with the national situation in Chile, analyzing the national report on the prevalence of risk factors. Our main finding was that the pattern of consumption and lifestyles differ markedly from the WCRF recommendations: we observed an over consumption of sugary drinks and high intake of processed foods high in sodium and total fat and low consumption of legumes, vegetables, fruits high in antioxidants and fiber that protect from cancer. Chile has an increased cancer prevalence which is associated with poor quality diets, rising mean body mass index and a sedentary behavior. We recommend the strengthening programs to promote healthy diets and active living, in order to reduce cancer risk.

Evolución del gasto en alimentos procesados en la población del Gran Santiago en los últimos 20 años / Changes in processed food expenditure in the population of Metropolitan Santiago in the last twenty years

Background: During recent decades household incomes have increased steadily, leading to changes in dietary habits and food expenditure. Aim: To report changes in household food expenditure focusing on trends in processed food across income quintiles in Metropolitan Santiago. Material and Methods: Information obtained from the Fourth (1986-1987), Fifth (1996-1997) and Sixth National Institute of Statistics (INE) Surveys (2006-2007) were used. Food expenditure data over the study periods was extracted from household expenditure surveys (HES) after verifying and adjusting food prices registered by the INE to current 2007prices. Results: Absolute food expenditure over the study period increased for all groups; the largest increase was found in lowest income quintiles; however, the proportion of total family budget spent on food decreased in all groups. The largest increases in food expenditure corresponded to sweetened beverages, processed fruit juices, alcoholic drinks, ready meals and "eating out". Expenditure on fish rose slightly whereas the absolute spending on legumes, eggs and oils decreased. Expenditure in processed food as percentage of total food expenditure increased from 42% to 57% of total for mean household. For the 2nd quintile it rose from 31% to 48% and for the lowest quintile increased from 53% to 68% over the three decades (1987-2007). Changes were greatest in energy rich processed foods such as bread, pastries, confectioneries and granulated sugar. These particular foods are of high energy density and contain high amounts of saturated fat, sodium and added sugars. Conclusions: These results confirm that food consumption patterns over the past decades have progressively departed from the recommended dietary guidelines given by national and international health organizations.

Cambios en el consumo aparente de nutrientes en el Gran Santiago 1988-1997 en hogares según ingreso y su probable relación con patrón de enfermedades crónicas no transmisibles / Changes in household food and nutrient consumption in Metropolitan Santiago 1988-97 by income

Background: The rise in the prevalence of obesity, diabetes, and other risk factors for cardiovascular diseases and cancer observed in Chile over the past decades may be related to changes in dietary patterns of the population. Aim: To report changes in household apparent food-nutrients consumption (HAFNC) for Metropolitan Santiago-Chile 1988-97. Material and Methods: The analysis is based on data from household expenditure surveys conducted by the Instituto Nacional de Estadísticas (INE) on a representative sample of the population to define changes in food prices. Information on food and drink purchases were grouped by specific items and expen-ditures standardized across the two surveys. HAFNC was determined based on unit consumed at home and out of home by the total group and by income quintile using national food composition tables. Results: Apparent energy consumption increased over the study period by 25 percent, this was mainly explained by increased consumption of meat and dairy (rich in saturated fats of animal origin) and of processed foods (fat spreads, sweets and pastries) and foods rich in added sugars (sugary drinks and juices). Dietary fiber derived from whole grains, legumes and cereals decreased. The HAFNC of items protective against nutrition related chronic diseases, such as vegetables, fruits and other fiber rich foods remained stable or frankly decreased (legumes and non-starchy vegetables) Fish and other marine foods rich in omega- 3 fats remained low. Conclusions: The changes in apparent food consumption patterns can be characterized by an increase in energy dense, fat and sugar rich foods with a low consumption of fi sh, whole grains, legumes, vegetables and fruits.

Cambios en la disponibilidad de alimentos en el Gran Santiago por quintiles de ingreso 1988-1997 / Changes in food availability in metropolitan Santiago Chile according to income (quintiles) 1988-1997

Se presentan los cambios en la disponibilidad de alimentos en hogares del Gran Santiago 1988-1997, obtenidos por muestra representativa y se analiza posible relación con los cambios en el perfil epidemeológico nacional. Se evaluó el ítem gasto de alimentos/bebidas de la IV y V Encuesta de Presupuestos Familiares, realizada por INE cada 10 años para calcular el Indice de Precios al Consumidor (IPC). Se ordenaron los alimentos por grupo homologando el gasto en alimentos entre ambas encuestas; asignando precios según productos; se determinaron las unidades físicas de alimentos consumidos dentro y fuera del hogar. El gasto en alimentos aumentó, determinando una mayor disponibilidad de alimentos para el total hogares y quintiles de ingreso, incrementándose más en quintiles más pobres. Se eleva el consumo aparente de cereales procesados, productos de pastalería, carnes de ave y cerdo, lácteos procesados, jugos preparados y bebidas, cremas, mayonesa, comidas preparadas para llevar al hogar y comidas fuera del hogar. Pescados, verduras y frutas aumentan levemente con una gran disminución de las legumbres. El perfil alimentario actual se caracteriza por mayor disponibilidad de productos de origen animal y alimentos procesados; aumentando la densidad energética, calorías grasas, grasas saturadas, azúcares simples de alto índice glicémico; baja la disponibilidad de alimentos aportadores de antioxidantes, fitoquímicos, fibra dietaria y ácidos grasos omega 3. Estos cambios probablemente han impactado notablemente el perfil epidemeológico y nutricional del país, manifestándose por aumento epidémico de la obesidad, y las enfermedades crónicas relacionadas con la dieta y la inactividad física.