Asociación entre velocidad de marcha y deterioro cognitivo en personas mayores: resultados de la Encuesta Nacional de Salud 2016-2017

Antecedentes: La velocidad de la marcha podría considerarse un marcador temprano de riesgo de deterioro cognitivo en personas mayores. Objetivo: Determinar la asociación entre velocidad de la marcha y sospecha de deterioro cognitivo en población mayor chilena. Métodos: Se incluyeron 1788 personas mayores de la Encuesta Nacional de Salud (ENS) 2016-2017 que tenían información sobre velocidad de marcha y sospecha de deterioro cognitivo. La velocidad de la marcha fue autorreportada y categorizada como marca lenta, normal y rápida. Sospecha de deterioro cognitivo fue evaluado a través del cuestionario Mini Mental abreviado. La asociación entre marcha y deterioro cognitivo fue investigada mediante análisis de regresión logística. Resultados: En comparación a las personas mayores que reportaron una velocidad de marcha rápida, aquellas que reportaron una marcha lenta presentaron 2,67 veces mayor probabilidad de tener deterioro cognitivo (OR: 2,67 [95% IC:1,62; 4,42], p<0,001). Al ajustar los modelos por variables de confusión sociodemográficas, estilos de vida y salud, la asociación disminuyó, pero, permaneció significativa (OR: 1,78 [95% IC:1,15; 3,17], p=0,047). Mientras que las personas mayores que reportaron tener una velocidad de marcha normal no presentaron asociación con deterioro cognitivo. Conclusión: Personas mayores que reportan una velocidad de marcha lenta presentaron una mayor probabilidad de sospecha de deterioro cognitivo. Considerando que el deterioro cognitivo es un síndrome geriátrico con alta prevalencia en población mayor, existe la necesidad de enfatizar en estrategias para un diagnóstico temprano, por lo cual la velocidad de marcha podría ser un instrumento útil.

Background: Walking pace could be considered an early risk marker of cognitive impairment in older people. Objective: To determine the association between walking pace and cognitive impairment in older Chilean adults. Methods: 1,788 adults older than 60 years from the 2016-2017 Chilean National Health Survey with data available in the exposure and outcome were included in this cross-sectional study. Walking pace was self-reported and categorised as slow, average and brisk. Cognitive impairment was assessed using the Abbreviated Mini-Mental questionnaire. Logistic regression analyses were performed to investigate the association between walking pace and cognitive impairment, logistic regression analyses - adjusted for sociodemographic, lifestyle and health-related covariates. Results: In the minimally adjusted model and compared to older adults who self-reported a brisk walking pace, those in the slow walking pace category were 2.67 times more likely to have cognitive impairment (OR: 2.67 [95% CI: 1.62, 4.42]). When the analyses were adjusted, the association was attenuated but remained significant (OR: 1.78 [95% CI: 1.15 3.17]). No associations were found between average pace walkers and cognitive impairment. Conclusion: Older adults who self-reported a slow walking pace having a higher likelihood of cognitive impairment than their counterparts who had a brisk walking pace. Considering that cognitive impairment is a geriatric syndrome with a high prevalence in the elderly, there is a need to emphasise strategies for an early diagnosis. Therefore, walking pace may be a useful marker to identify individuals at high risk of cognitive impairment.

Asociación entre nivel educacional y sospecha de deterioro cognitivo en personas mayores chilenas: resultados de la Encuesta Nacional de Salud 2016-2017 / Association between educational level and suspicion of cognitive imparirment in Chilean older people

BACKGROUND: A low education level has been associated with cognitive impairment in older adults. AIM: To determine the association between educational attainment and suspicion of cognitive imparirment in older Chilean population. MATERIAL AND METHODS: Data from 2,005 adults aged ≥ 60 years assessed during 2016-2017 Chilean National Health Survey were included. Education was self-reported and categorized as primary: ≤ 8 years; secondary: 9 to 12 years and beyond secondary: > 12 years. suspicion of cognitive imparirment was assessed with the Mini-Mental questionnaire. RESULTS: Men and women with low education attainment had a higher prevalence of cognitive impairment (33% [95% confidence intervals (CI): 24; 41] and 27% [95% CI: 21; 33], respectively). Men who reported less schooling (≤ 8 years) were more likely to be at risk of suspicion of cognitive imparirment (Odds ratio (OR): 4.53 [95% CI: 1.10, 18.62]) compared to their peers. Women showed a substantially higher magnitude of association than men. The probability of suspicion of cognitive imparirment increased 9-times (OR: 9.96 [95% CI: 1.24; 79.6]) for 9-12 years and 18-times for ≤ 8 years of education (OR: 18.8 [95% CI: 2.42; 146.1]) compared to women with higher education. CONCLUSIONS: Older adults with low education attainment had an increased likelihood of developing suspicion of cognitive imparirment. However, the risk differs by sex, being higher in women than men.

Estado afectivo, regulación emocional y estilos de alimentación en adultos en Chile

RESUMEN El comportamiento alimentario está intrínsecamente asociado al estado afectivo y las emociones dominantes. Esta investigación se propuso analizar la asociación entre afectividad, sintomatología ansiosa y depresiva, regulación emocional, estilos de alimentación desadaptativos: alimentación restrictiva, emocional y externa, y alimentación intuitiva. Se realizó un estudio transversal, de tipo correlacional, en el que participaron 648 adultos de ambos sexos, residentes en Chile. Se recogieron datos de las siguientes variables e instrumentos: afecto dominante con el Positive Affect and Negative Affect Schedule (PANAS); síntomas de depresión y ansiedad con dos preguntas de respuesta cerrada, dificultades de regulación emocional, con Difficulties in Emotion Regulation Scale (DERS); estilos de alimentación con el Dutch Eating Behaviour Questionnaire (DEBQ) y alimentación intuitiva con la Intuitive Eating Scale (IES-2). Se realizaron análisis de correlación y regresión lineal multivariada. Ser mujer y presencia de afecto negativo predijeron los estilos de alimentación desadaptativo emocional y restrictivo. El afecto positivo se asoció a un estilo de alimentación externo. Los tres estilos de alimentación desadaptativos evaluados se asociaron a dificultades de regulación emocional. Por el contrario, la alimentación intuitiva se asoció a ser hombre, afectividad positiva y ausencia de dificultades de regulación emocional. Se confirma la asociación entre la experiencia emocional y los estilos de alimentación y se enfatiza el rol de la regulación emocional como recurso psicológico relevante para prevenir el potencial efecto disfuncional de las emociones en el comportamiento alimentario.

ABSTRACT Eating behavior is intrinsically associated with the affective state and dominant emotions. This research set out to analyze the association between affectivity, anxious and depressive symptoms, emotional regulation, maladaptive eating styles, and intuitive eating. A cross-sectional, correlational study was carried out. Participants were 648 adults of both sexes, residents of Chile. Data were collected on the following variables and instruments: dominant affect with the Positive Affect and Negative Affect Schedule (PANAS); emotional regulation difficulties, with Difficulties in Emotion Regulation Scale (DERS); eating styles with the Dutch Eating Behavior Questionnaire (DEBQ) and intuitive eating with the Intuitive Eating Scale (IES-2). Correlation analysis and multivariate linear regression were performed. Being a woman and the presence of negative affect predicted emotional and restrictive eating styles. Positive affect was associated with an external eating style. The three maladaptive eating styles evaluated were associated with emotional regulation difficulties. On the contrary, intuitive eating was associated with being a man, positive affectivity, and the absence of emotional regulation difficulties. The association between emotional experience and eating styles was confirmed emphasizing the role of emotional regulation as a relevant psychological resource to prevent the potential dysfunctional effect of emotions on eating behavior.

Asociación entre autorregulación alimentaria, dieta, estado nutricional y bienestar subjetivo en adultos en Chile / Association between diet, eating self-regulation, nutritional status and subjective well-being of adults in Chile

Resumen Antecedentes La prevalencia de obesidad de la población mundial hace necesario profundizar en sus determinantes conductuales y cognitivos motivacionales. La autorregulación alimentaria emerge como un recurso individual que favorece mantener una dieta y estado nutricional saludable, lo que a su vez incidirá en la experiencia de bienestar de la población. Objetivo Establecer la asociación entre autorregulación alimentaria, dieta, estado nutricional y bienestar subjetivo en adultos. Método estudio descriptivo correlacional, en una muestra no probabilística de 528 adultos chilenos quienes respondieron un cuestionario sobre antecedentes sociodemográficos y de salud, cumplimiento de recomendaciones alimentarias y escalas de autorregulación alimentaria y bienestar subjetivo. Se realizó análisis descriptivo, correlación y regresión multivariada. Resultados Adultos normopeso presentaron mejores índices en todas las variables estudiadas. La autorregulación alimentaria predijo el cumplimiento de recomendaciones nutricionales (β = 0,085, Wald = 48,501, p<0,001) y el estado nutricional (β = -0,05, Wald = 16,02, p<0,001). El cumplimiento de recomendaciones nutricionales (β = 0,206, p <0,001) y el IMC (β = - 0,142, p = 0,001) predijeron el bienestar. Conclusiones En un contexto obesogénico, la autorregulación alimentaria emerge como un recurso clave que influye positivamente no solo en una dieta y estado nutricional saludable, sino que también en el bienestar.

Abstract Background The prevalence of obesity in the world population makes it necessary to explore into its behavioral and cognitive motivational determinants. Eating self-regulation emerges as an individual resource that favors maintaining a healthy diet and nutritional status, which in turn will affect the well-being of the population. Objective To establish the association between eating self-regulation, diet, nutritional status and subjective well-being in adults. Method descriptive correlational study, in a non-probabilistic sample of 528 Chilean adults who answered a questionnaire on sociodemographic and health history, compliance with dietary recommendations and scales of food self-regulation and subjective well-being. Descriptive analysis, correlation and multivariate regression were carried out. Results Normal weight adults presented better indices in all the variables studied. Eating self-regulation predicted compliance with nutritional recommendations (β = 0.085, Wald = 48.501, p <0.001) and nutritional status (β = -0.05, Wald = 16.02, p <0.001). Compliance with nutritional recommendations (β = 0.206, p <0.001) and BMI (β = - 0.142, p = 0.001) predicted well-being. Conclusions In an obesogenic context, eating self-regulation appears as a key resource that positively influences not only a healthy diet and nutritional status, but also subjective well-being.

Comportamiento de la actividad física durante la pandemia por COVID-19 y su asociación con el bienestar subjetivo y salud mental en estudiantes universitarios en Chile / Behavior of physical activity during the COVID-19 pandemic and its association with subjective well-being and mental health in university students in Chile

Resumen Antecedentes La pandemia por COVID-19 ha impactado en la actividad física y salud psicológica de estudiantes universitarios. Objetivo Analizar el comportamiento de la actividad física durante la pandemia por COVID-19 y su asociación con el bienestar subjetivo y salud mental en estudiantes universitarios en Chile. Método Estudio transversal en una muestra de 469 estudiantes de diferentes universidades de Chile (67,4% mujeres, M= 21,7 DT= 2,45 años). Se midió el comportamiento de la actividad física, bienestar subjetivo y salud mental. Resultados Los estudiantes que mantuvieron un comportamiento físicamente activo antes y durante la pandemia presentaron mayor bienestar subjetivo (hombres: p = 0,020; y mujeres p <0,0001) que quienes se mantuvieron físicamente inactivos antes y durante la pandemia (mujeres M= 4,84, DE= 1,64; hombres M= 4,46, DT= 1,27). Las mujeres que se volvieron físicamente inactivas durante la pandemia tuvieron menos experiencias afectivas negativas que mujeres que eran inactivas antes de la pandemia ( F (3,293)=3,118; p =0,026). La sintomatología de salud mental se reportó con menor frecuencia en estudiantes físicamente activos que inactivos. Conclusión Estudiantes que se mantuvieron físicamente activos antes y durante la pandemia mostraron mejores indicadores de bienestar subjetivo y salud mental que quienes se mantuvieron físicamente inactivos o pasaron a ser físicamente inactivos durante la pandemia. La actividad física debe promoverse en la educación superior, debido a su potencial efecto protector en el manejo de consecuencias psicológicas durante una crisis pandémica.

Abstract Background The COVID-19 pandemic has impacted on the physical activity and psychological health of university students. Objective To analyze the physical activity during the COVID-19 pandemic and its association with subjective well-being and mental health in university students in Chile. Method Cross-sectional study in a sample of 469 students from different Chilean universities (67.4% women, M = 21.7 SD = 2.45 years). The physical activity, subjective well-being and mental health was measured. Results Students who maintained a physically active behavior before and during the pandemic presented higher subjective well-being (men: p = 0.020; and women p <0.0001) than those who were physically inactive before and during the pandemic (women M = 4 , 84, SD = 1.64; men M = 4.46, SD = 1.27). Women who became physically inactive during the pandemic had fewer negative affective experiences than women who were inactive before the pandemic (F (3,293) = 3.118, p = 0.026). Mental health symptoms were reported less frequently in physically active than inactive students. Conclusion Students who were physically active before and during the pandemic showed better indicators of subjective well-being and mental health than those who were physically inactive or became physically inactive during the pandemic. Physical activity should be promoted in higher education, due to its potential protective effect in managing psychological consequences during a pandemic crisis.

Cumplimiento de las Guías Alimentarias en personas mayores chilenas: Un estudio descriptivo de la Encuesta Nacional de Salud 2016-2017

RESUMEN Chile es uno de los países de Latinoamérica que exhibe un mayor envejecimiento poblacional, por lo que es necesario visualizar distintas herramientas que direccionen estilos de vida saludables en esta etapa de la trayectoria vital. Las Guías Alimentarias Basadas en Alimentos (GABA) entregan recomendaciones que permiten mejorar la calidad de vida de personas mayores. Por lo anterior, el objetivo del estudio fue determinar el nivel de cumplimiento de recomendaciones de las GABA y su asociación con variables antropométricas, metabólicas y de estilos de vida en 1.789 personas mayores de 60 años que participaron en la Encuesta Nacional de Salud 2016-2017. Se realizó un estudio descriptivo de corte transversal, en donde los participantes se subdividieron en cuatro grupos según cumplimiento de las GABA: no cumple, cumple con 1, 2 o a lo menos 3 recomendaciones de consumo de legumbres, frutas y verduras, lácteos, agua y pescado. Como resultado, el 43,8% de las personas mayores que participaron no cumplieron ninguna de las recomendaciones GABA evaluadas; estos últimos, realizaban menos actividad física y presentaban, además, una mayor probabilidad de pasar más tiempo sentados (p-tendencia: <0,001). Como conclusión, se destaca que cerca del 50% de las personas mayores en Chile no adhieren a las recomendaciones de las GABA, lo que podría repercutir en implicaciones en la salud y bienestar de la población mayor.

ABSTRACT Chile is one of the Latin American countries that exhibits the greatest increase in the aging population, thus it is necessary to visualize different tools that guide healthy lifestyles at this stage of life. Food-Based Dietary Guidelines (abbreviated as GABA, for initials in Spanish) provide recommendations that allow improving the quality of life in older people. This study aimed to determine the level of compliance with GABA recommendations and their association with anthropometric, metabolic and lifestyles factors in 1,789 people over 60 years who participated in the 2016-2017 National Health Survey. A descriptive cross-sectional study was carried out, in which participants were subdivided into four groups according to compliance with GABA: does not comply, complies with 1, 2 or at least 3 recommendations for consumption of legumes, fruits, vegetables, dairy, water and fish. As a result, 43.8% of older participants did not meet any of the GABA recommendations evaluated. These participants also performed less physical activity and had a longer sitting time (P-trend: <0.001). In conclusion, we highlight that close to 50% of elderly Chileans do not adhere to GABA recommendations, which could have implications for the health and well-being.

Autorregulación y autocompasión en conductas promotoras de salud y de riesgo en estudiantes universitarios

RESUMEN La Autorregulación (AR) y la Autocompasión (AC) emergen como recursos psicológicos efectivos para la promoción de salud. Objetivo: Describir conductas promotoras de salud y conductas de riesgo de universitarios en Chile y establecer su asociación con la AR y AC. Material y Método: Estudio de carácter correlacional descriptivo, de corte transversal. Una muestra de estudiantes universitarios chilenos de pregrado (n=544) respondió un cuestionario sobre conductas de salud y de riesgo, y las escalas Short Self-Regulation Questionnaire y Self-Compassion Scale. Resultados: Se observó baja frecuencia de conductas promotoras de salud y presencia de conductas de riesgo como consumo de tabaco (22,6%), de drogas (41,3%) y consumo problemático de alcohol (20,3%). El control de impulsos de la AR se asoció a mayor probabilidad de conducta alimentaria saludable (OR=1,56; IC 95%: 1,12-2,19; p< 0,01) y mejor calidad de sueño (OR=1,7; IC: 1,24-2,38; p<0,01). El mindfulness, componente de la AC, se asoció a menor actividad física regular (OR=0,69; IC:0,49-0,95; p<0,05) y menor consumo de medicamentos sin prescripción (OR=0,54; IC:0,32-0,91; p<0,05), y el autojuicio a mayor consumo de medicamentos sin prescripción (OR=1,83; IC: 1,03-3,28; p< 0,05). Conclusión: El control de impulsos se asocia a la regulación de la alimentación y sueño, ambos dominios alterados en la etapa universitaria; la AC se relaciona con menor probabilidad de consumo de medicamentos sin prescripción. Tanto la AR como la SC emergen como recursos potencialmente útiles hacia la promoción de hábitos saludables y prevención de conductas de riesgo para la salud.

ABSTRACT Self-regulation (SR) and Self-compassion (SC) emerge as effective psychological resources for promoting health. Objective: To describe health-promoting and risk-taking behaviors of university students in Chile and establish their relationship with SR and SC. Materials and Methods: Cross-sectional descriptive correlational study. A sample of Chilean undergraduate students (n=544) responded to a health questionnaire and the Short Self-Regulation Questionnaire and Self-Compassion Scale. Results: Low frequency of health-promoting behaviors and presence of risk-taking behaviors such as tobacco use (22.6%), drug use (41.3%) and problematic alcohol use (20.3%) were observed. SR impulse control was associated with a higher probability of healthy eating behavior (OR=1.56; CI 95%: 1.12-2.19; p <0.01) and better sleep quality (OR=1,7; CI: 1.24-2.38; p <0.01). Mindfulness, a component of SC, was associated with less regular physical activity (OR=0.69; CI: 0.49-0.95; p <0.05) and lower consumption of non-prescription drugs (OR=0.54; CI: 0.32-0.91; p <0.05), and self-judgment was related to a higher consumption of non-prescription drugs (OR=1.83; CI: 1.03-3.28; p <0.05). Conclusion: Impulse control influences both eating and sleep regulation, which are domains that tend to be altered among university students. SC is related to a lower probability of consuming non-prescription drugs. Both SR and SC emerge as potentially useful resources for promoting healthy habits and preventing risk behaviors.

RESUMO A Autorregulação (AR) e a Autocompaixão (AC) surgem como recursos psicológicos eficazes para a promoção da saúde. Objetivo: Descrever os comportamentos promotores da saúde e os comportamentos de risco de estudantes universitários no Chile e estabelecer sua relação com o AR e AC. Materiais e Método: Estudo correlacional descritivo transversal. Uma amostra de estudantes universitários chilenos (n = 544) respondeu a um questionário sobre saúde e aos Self-Regulation Questionnaire e Self-Compassion Scale. Resultados: Observou-se baixa frequência de comportamentos promotores de saúde e presença de comportamentos de risco como o consumo de tabaco (22,6%), uso de drogas (41,3%) e uso problemático de álcool (20,3%). O controle do impulso da AR foi associado a uma maior probabilidade de comportamento alimentar saudável (OR = 1,56; IC 95%: 1,12-2,19; p <0,01) e melhor qualidade do sono (OR = 1,7; IC: 1,24-2,38; p < 0,01). O componente mindfulness da AC foi associado a menor atividade física regular (OR = 0,69; IC: 0,49-0,95; p <0,05) e menor consumo de medicamentos não prescritos (OR = 0,54; IC: 0,32-0,91; p <0,05), e o autojulgamento foi relacionado a um maior consumo de medicamentos não controlados (OR=1,83; IC: 1,03-3,28; p <0,05). Conclusão: O controle dos impulsos influencia a regulação da alimentação e do sono, que são domínios que tendem a ser alterados na fase universitária. A AC está relacionada a uma menor probabilidade de consumir medicamentos sem receita médica. Tanto a AR como a AC surgem como recursos potencialmente úteis para a promoção de hábitos saudáveis e prevenção de comportamentos de risco para a saúde.

Lactancia materna y su asociación con obesidad: Mecanismos que podrían explicar el rol protector en la infancia

RESUMEN Introducción: La lactancia materna (LM) es un factor protector contra la obesidad infantil; sin embargo, los mecanismos a través de los cuales ejerce este efecto aún no están claros. El objetivo fue describir los mecanismos asociados al efecto protector que ejerce la lactancia materna contra la obesidad infantil. Métodos: Se utilizaron los buscadores PUBMED, SCOPUS, Cochrane Library y Scielo para desarrollar una revisión descriptiva de la evidencia científica. Las palabras clave fueron: lactancia materna, obesidad, mecanismo y dieta. Se revisaron artículos en español e inglés, desde 1977 hasta el 2020. Resultados: El efecto protector de la LM contra la obesidad infantil está dado por una combinación de varios mecanismos, se destaca su composición nutricional y el aporte de sustancias bioactivas, algunas de ellas reguladoras de la ingesta energética. Los lactantes que reciben LM por más tiempo seleccionan alimentos más saludables en etapa preescolar, independiente de factores sociodemográficos. También han sido descritos efectos en la adiposidad, el control del peso corporal y la ingesta energética mediante regulación de la programación epigenética y de la microbiota intestinal. Conclusión: La LM es un proceso único, que interacciona de forma compleja con factores del crecimiento y desarrollo de los lactantes y preescolares. Su rol protector contra la obesidad ha sido asociado a diversos mecanismos. Sin embargo, se requiere de nuevas investigaciones para comprender los alcances que puede presentar la LM en la etapa pediátrica y su rol en la prevención de la obesidad.

ABSTRACT Background and aim: Breastfeeding (BF) is a protective factor against childhood obesity; however, the mechanisms associated with this effect have not yet been elucidated. This study aimed to describe the mechanisms related to the protective effect of breastfeeding against childhood obesity. Methods: A search on PUBMED, SCOPUS, Cochrane Library and SCIELO databases was carried out to develop a descriptive review of the scientific evidence. The key words were breastfeeding; obesity; mechanism and diet. Articles were reviewed in Spanish and English from 1977 to 2020. Results: The protective effect of BF against childhood obesity is given by a combination of several mechanism. Its nutritional composition and the contribution of bioactive substances stand out, some of them regulated by the energy intake. Infants who are breastfed choose healthier foods in preschool, regardless of sociodemographic factors. Effects on adiposity, control of body weight and energy intake have also been described by epigenetic regulation programming and the intestinal microbiota. Conclusion: BF is a unique process that interacts in a complex way with infants and preschoolers' growth and developmental factors Its protective role against childhood obesity has been associated with various mechanisms. New research is still required to understand the implications of BF in pediatric age and its role in preventing obesity.

Factores asociados a depresión en población chilena. Resultados Encuesta Nacional de Salud 2016-2017

Background: Depression is a highly prevalent disease in Chilean adults. Aim: To identify sociodemographic, biomedical, and psychosocial factors related with depression in a representative sample of the Chilean adult population. Material and Methods: Analysis of data from the National Health Survey 2016-2017 which included 5,291 participants aged > 15 years. Depression was assessed using the Composite International Diagnostic Interview (CIDI-SF). Association between sociodemographic data, health and psychosocial variables and depression was analyzed using Poisson regression with robust error. Results: The probability of depression was higher in women than in men (prevalence ratio (PR) = 2.13 [95% confidence intervals (CI): 1.65, 2.75]). In both genders, the probability was higher in people with frailty (women: PR = 10.0 [95% CI: 1.86, 18.1] and men: PR = 3.38 [95% CI: 2.72; 4.20]), severe chronic pain (women: PR = 2.84 [95% CI: 1.93, 4.18 and men: PR = 6.41 [95% CI: 3.59, 9.40]), presence of two or more diseases (women: PR = 4.15 [95% CI: 2.78, 6.20 and men: PR = 2.60 [95% CI: 1.39, 3.81]), perception of permanent stress (women: PR = 11.0 [95% CI: 6.13, 16.0], men: PR = 21.0 [95% CI: 10.2, 31.7]), financial stress (women: PR = 2.57 [95% CI: 1.87, 3.27] men: PR = 4.27 [95% CI: 2.48, 6.06] and poor or very poor perception of health (women: PR = 5.02 [95% CI: 1.92, 8.12], men: 2.09 [95% CI: 0.49, 3.69]). In men, the probability of depression was higher for widowers than married man (PR = 5.58 [95% CI: 2.5, 8.25]), presence of goiter (PR = 4.03 [95% CI: 1.99, 6.07]) and low social support (PR = 1.95 [95% CI: 1.18; 2.72]). Conclusions: The factors associated with a higher probability of depression are diverse in nature. Among these being women, frailty, chronic pain, multimorbidity and high perception of stress are important factors.

Nivel de actividad física en personas mayores chilenas que han sufrido caídas

RESUMEN Antecedentes: Las caídas limitan las actividades de la vida diaria. Actualmente se desconoce cómo los niveles de actividad física (AF) varían luego de sufrir una caída. Objetivo: investigar los niveles de práctica de actividad física de personas mayores que han reportado caídas en los últimos 12 meses. Métodos: Se incluyeron 1.254 participantes ≥ 60 años de Encuesta Nacional de Salud (ENS) 2009-2010. La prevalencia de caídas en los últimos 12 meses se determinó mediante auto reporte. Los niveles de AF y el tiempo sedente se determinaron a través del cuestionario Global Physical Activity Questionnaire (GPAQ). La asociación entre caídas y AF fue investigada mediante regresión lineal. Resultados: El 70,5% [95% IC: 68,0; 72,8] de las personas mayores no reportaron caídas, mientras que un 19,4% [95% IC: 17,4; 21,5] reportó haber sufrido entre 1-2 caídas y un 10% [95% IC: 8,4; 11,8] ≥3 caídas en los últimos 12 meses. En comparación al grupo que reportó no sufrir caídas, aquellos que sufrieron ≥3 caídas realizaban 79,2 minutos menos de AF total/día. Resultados similares fueron observados para AF de transporte y AF moderada. No se encontraron diferencias para tiempo sedente o AF vigorosa. Conclusión: Personas mayores que sufrieron caídas en los últimos 12 meses reportaron realizar menos actividad física que sus contrapartes que no experimentaron caídas. A mediano y largo plazo, estos cambios en la actividad física podrían contribuir a resultados de salud adversos en una población.

ABSTRACT Background: Falls among older adults are associated with important changes in lifestyle. However, there is no evidence about the physical activity levels of older adults who have experienced falls. The aim of this study, therefore, was to describe physical activity levels in older adults who have experienced falls in the last 12 months. Methods: 1,254 older adults (aged ≥60 years) from the National Health Survey 2009-2010 were included in this study. Number of falls during the last 12 months was self-reported and physical activity was measured using the Global Physical Activity Questionnaire (GPAQ). The association between falls and physical activity was investigated using regression analyses. Results: 70.5% [95% CI: 68.0; 72.8] of the older adults included in this study did not report any falls during the last 12 months. However, 19.4% [95% CI: 17.4; 21.5] reported 1-2 falls and 10% [95% CI: 8.4; 11.8] reported ≥3 falls in the last 12 months. In comparison to those who reported no falls, those who experienced ≥3 falls in the last 12 months did 79.2 fewer minutes/day of physical activity. Similar results were found for moderate and transport-related physical activity, but no associations were found for vigorous or sedentary behaviours. Conclusion: Older adults who suffered falls in the last 12 months reported doing less physical activity than their counterparts who did not experience any falls. In the middle and long term, these changes in physical activity could contribute to adverse health outcomes in an already frail population.

Caracterización del consumo de legumbres en población chilena: resultados de la Encuesta Nacional de Salud 2016-2017 / Legume consumption in chileans: findings from the 2016-2017 national health survey

Background: Legumes are low cost and high-quality nutritional foods. In Chile, a twice per week legume consumption is recommended to promote health and prevent disease. Aim: To characterize the consumption of legumes according to sociodemographic and anthropometric variables in the Chilean adult population. Material and Method: Analysis of data from 5,473 participants of the 2016-2017 National Health Survey. The compliance with legume consumption was studied in population groups, according to sociodemographic and anthropometric characteristics, through logistic regression analyses. Results: Only 24% of all participants (51.4% of women) fulfilled legume intake recommendations. After adjusting for sociodemographic variables, the participants who were less likely to comply with the recommendation were widowers (Odds Ratio (OR): 0.58 [95% confidence intervals (CI): (0.40; 0.85]). On the contrary, people between 70-80 years (OR: 1.78 [95% CI: 1.11; 2.88]), those who resided in rural areas (OR: 1.62 [95% CI: 1.25; 2.10]) and those who resided in the Maule region (OR: 2.11 [95% CI: 1.37, 3.25]) had a higher likelihood of compliance. Conclusions: One out of four Chileans complied with the recommendations of legume consumption. Even though the results differed when stratified by sex, it is highlighted that living in rural areas increased the probabilities of an adequate legume consumption.

Autocompasión como moderador entre apreciación corporal y estilos de alimentación en mujeres adultas emergentes / Self-compassion as a moderator between body appreciation and eating styles in emerging adult women

Resumen: Antecedentes: El ideal de belleza asociado a la delgadez es un factor relevante en la conformación de la imagen corporal y en la conducta alimentaria, lo que hace necesario identificar recursos psicológicos que promuevan conductas alimentarias sanas, particularmente en mujeres. Objetivo: examinar la relación entre apreciación corporal, alimentación intuitiva y estilos de alimentación maladaptativos (contextual, emocional y restrictivo), y el rol de la autocompasión en esas relaciones. Método: estudio descriptivo-correlacional en el que participaron 740 mujeres, entre 18 y 30 años, quienes respondieron las escalas de Apreciación Corporal (BAS-2), Alimentación Intuitiva (IES), Conducta Alimentaria (DEBQ) y Autocompasión (SCS). Se emplearon regresiones moderadas para examinar el rol de la autocompasión en la interacción de apreciación corporal con alimentación intuitiva y patrones de alimentación. Resultados: La apreciación corporal y la autocompasión se relacionaron positivamente con alimentación intuitiva y negativamente con la alimentación emocional y externa. La autocompasión tuvo un rol moderador en la interacción entre apreciación corporal y alimentación intuitiva (β=.006, ES=,0056), emocional (β=-,09, ES=,004), y externa (β=-,007, ES=,003), pero no con alimentación restrictiva (β=-,022, ES=,004). Conclusión: Estos hallazgos confirman el rol amortiguador de los recursos psicológicos, en específico, de la autocompasión, en la influencia que ejerce una baja apreciación corporal en los estilos de alimentación desadaptativos y también informan sobre la importancia de los recursos psicológicos para el manejo de las presiones sociales sobre la imagen corporal en las mujeres jóvenes.

Abstract: Background: The ideal of beauty associated with thinness challenges body image and eating behavior, particularly in young women, thus to identify psychological resources that promote healthy eating behavior can be helpful. Objective: to examine the relationship between body appreciation, intuitive eating and maladaptive eating styles (contextual, emotional and restrictive), and the role of self-compassion in these relationships. Method: descriptive-correlational study in which 740 women, between 18 and 30 years old, answered the Body Appreciation Scale (BAS-2), Intuitive Eating (IES-2), the Dutch Eating Behavior Questionnaire (DEBQ) and Self-Compassion Scale (SCS). Regressions and Moderation Analyses were used to examine the role of self-compassion in the interaction of body appreciation, intuitive eating and eating behaviors. Results: Body appreciation and self-compassion were positively related to intuitive eating and negatively to emotional and external eating. Self-compassion played a moderating role in the interaction between body appreciation and intuitive eating (β = ,006, ES = ,0056), emotional (β = -,09, ES = ,004), and external (β = -,007, ES = ,003), but not with restrictive eating (β = -,022, ES = ,004). Conclusion: These findings confirm the buffering role of psychological resources, specifically, self-compassion, in the influence that low body appreciation exerts on maladaptive eating styles, and also shed light of the importance of psychological resources to manage social pressures to the body image in young women.

Estilos de alimentación y su asociación con apreciación corporal, internalización del sesgo del peso y autocompasión / Eating styles and their association with body appreciation, weight bias internalization and self-compassion

Resumen Antecedentes: La valoración de la delgadez y sesgo hacia las personas con sobrepeso, pueden promover menor valoración del cuerpo y estilos de alimentación desadaptativos; la autocompasión podría actuar mitigando estas relaciones. Objetivo: comprender la asociación entre apreciación corporal, internalización del sesgo del peso y estilos de alimentación (EA), así como el rol que cumple una actitud autocompasiva en la apreciación corporal. Método: Estudio correlacional, transversal, en el que participaron 837 adultos residentes en Chile. En el análisis de datos se empleó regresión múltiple y análisis de mediación. Resultados: La apreciación corporal y la internalización del sesgo del peso predijeron EA emocional (β = -,126; p <,001 y β = ,146 p <,001, respectivamente), EA externo (β = -,095; p <,001 y β = ,064 p <,001, respectivamente) y EA restrictivo (β = ,134; p <,001 y β = ,258; p <,001, respectivamente). La autocompasión medió la relación entre internalización del sesgo del peso y apreciación corporal (β = -,133; IC:[-,157; −0,11]). Conclusiones: La valoración del cuerpo y la internalización del sesgo del peso influyen en los EA, y una actitud compasiva hacia sí mismo media en el efecto del sesgo del peso sobre la devaluación hacia el propio cuerpo.

Abstract Background: The assessment of thinness and bias towards overweight people can promote body appreciation and maladaptive eating styles; self-compassion could act mitigating these relationships. Objective: to understand the association between body appreciation, weight bias internalization and eating styles (ES), as well as the role of a self-compassionate attitude in body appreciation. Method: Correlational, cross-sectional study, with 837 adults living in Chile. In the data analysis, multiple regression and mediation analysis were used. Results: Body appreciation and internalization of weight bias predicted emotional ES (β = -.126; p < .001 and β = .146; p < .001, respectively), external ES (β = -.095; p < .001 and β = .064; p < .001, respectively) and restrictive ES (β = -.134; p < 001 and β = .258; p < .001, respectively). Self-compassion mediated the relationship between internalization of weight bias and body appreciation (β = -.133, CI: [- .157, -.11]). Conclusions: The assessment of the body and the weight bias internalization influence eating styles, and a compassionate attitude towards oneself intervenes in the effect of the weight bias on the devaluation towards the own body.

Caracterización del consumo de agua en población chilena: resultados de la Encuesta Nacional de Salud 2016-2017 / Water intake in the Chilean population: findings from the 2016-17 National Health Survey

Background: Water is an essential nutrient for cellular homeostasis and life. Drinking ≥ 6 glasses (1.5 L/day) is the recommendation of daily water intake (RIAD). Aim: To characterize water intake, according to sociodemographic, anthropometric and lifestyles variables, in the Chilean adult population. Material and Methods: Analysis of data from 5,520 participants of the 2016-17 National Health Survey. Compliance with RIAD by population groups according to sociodemographic, anthropometric and lifestyle characteristics was studied through logistic regression analyses. Results: Only 27.8% of the national population met the RIAD. Women, people over than 56 years of age, housewives, retired people, widowers, and non-smokers were less likely to meet the RIAD. The likelihood of not complying with RIAD in these segments of the population ranged from 28% to 62%. Conversely, participants who presented a higher likelihood of meeting RIAD were those who co-habiting, had a medium and higher educational level, followed a diet plan, and those who reported a good health and well-being. The likelihood of meeting with the RIAD for these population groups ranged from 47% to 116%. Conclusions: The likelihood of meeting the RIAD varied according to different sociodemographic, anthropometric, and lifestyle variables. Therefore, public policies for promoting water consumption should be focused on all age groups, but especially in those groups with the highest risk of underconsumption.

Prevalencia de fragilidad en personas mayores de Chile: resultados de la Encuesta Nacional de Salud 2016-2017

Background: The assessment of frailty among older people could help to reduce its social and health burden. Aim: To determine and characterize the prevalence of frailty in Chilean older adults. Material and Methods: We studied 233 participants, aged > 60 years, participating in the Chilean National Health Survey 2016-2017. Frailty was assessed using modified Fried criteria. Thus, people classified as frail should meet at least 3 out of the 5 criteria (low strength, low physical activity, low body mass index, slow walking pace and tiredness). Results: The prevalence of frailty was 10.9% (7.7% for men and 14.1% for women). The prevalence of pre-frailty was 59.0% whereas 30.1% of participants were classified as robust. At the age of 80 years 58 and 62% of men and women were frail, respectively. These figures increased to 90 and 87% at the age of 90 years. The prevalence of pre-frailty increased from 43 to 92.1% among men and from 76% and 78% among women from the ages of 60 to 90 years, respectively. Conclusions: The prevalence of frailty increased markedly with age. It is important to implement prevention strategies to allow an early identification of high-risk individuals.

Estilos de vida y cumplimiento de las Guías Alimentarias Chilenas: resultados de la ENS 2016-2017 / Lifestyles and adherence to the Chilean Dietary Guidelines: results of the Chilean National Health 2016-2017 Survey

RESUMEN Cumplir las recomendaciones incluidas en las Guías Alimentarias permite un acercamiento hacia un estilo de vida saludable. El objetivo de este estudio fue caracterizar los estilos de vida de la población chilena y su asociación al cumplimiento de 5 recomendaciones de las Guías Alimentarias Basadas en Alimentos (GABA) chilenas. Se utilizaron datos de la Encuesta Nacional de Salud 2016-2017. Los participantes fueron divididos en 4 grupos: aquellos que no cumplieron con ninguna recomendación, los que cumplían una, los que cumplían con 2 y los que cumplían con 3 o más recomendaciones saludables, estableciendo a este último como grupo de referencia. El 43,3% de la muestra no cumplió ninguna de las recomendaciones incorporados en esta investigación. De los que cumplían a lo menos 3, el 35,9% presentó un estado nutricional normal, el 38,9% reportó nunca haber fumado y el 82% se auto percibía como saludable. Además, los que cumplían las recomendaciones, presentaron niveles más altos de actividad física. Personas que incorporan y aplican las recomendaciones de las GABA, tienden a presentar conductas de vida más saludable. Estrategias comunicacionales efectivas y formativas en educación alimentaria sobre estas recomendaciones son claves para prevenir el acelerado y temprano crecimiento de las patologías crónicas.

ABSTRACT Compliance with dietary guidelines is essential for adoopting a healthy lifestyle. This study aimed to characterise the lifestyles of the Chilean population according to the fulfilment of 5 recommendations of the Food-Based Dietary Guidelines (GABA in Spanish) established in Chile according to WHO definition. Data from the 2016-2017 National Health Survey were used. Participants were divided into four groups: those who did not meet any recommendations, those who met one, those who met two and those who met three or more (reference group) GABA health recommendations. 43.3% of the sample did not meet any of the recommendations incorporated into this study. Of those who fulfilled at least three recommendations, 35.9% had a normal nutritional status, 38.9% reported never having smoked, and 82% perceived themselves as healthy. In addition, those who fulfilled the recommendations presented higher levels of physical activity (1343.5 MET/min/day [95% CI: 1049.9 - 1637.2]). From the results, it is inferred that people who incorporate and apply GABA recommendations tend to present healthier life behaviours. Consequently, effective and formative communication strategies in food education on these recommendations are crucial to preventing a fast and early growth of chronic diseases.

Actitudes y prácticas parentales de alimentación infantil: Una revisión de la literatura / Parental attitudes and feeding practices: A scoping review

RESUMEN Introducción: si bien la conducta alimentaria depende de múltiples factores, existe acuerdo en la importancia de aspectos socio-ambientales en los que la familia tiene un rol central, especialmente en edades tempranas. Objetivo: sistematizar evidencia científica actualizada sobre la asociación entre actitudes y prácticas de alimentación infantil, conducta alimentaria y estado nutricional del niño. Método: revisión narrativa de 40 artículos empíricos publicados entre los años 2011 y 2019. Resultados: se identificó tendencia en los padres a subestimar el peso corporal en niños con sobrepeso, y asociación entre preocupación por el peso, presión para comer y estado nutricional del niño. La alimentación restrictiva y el uso de la alimentación para fines instrumentales y controlar emociones, no serían prácticas efectivas, posiblemente porque interfieren en la capacidad de autorregulación del niño. Prácticas positivas incluyeron monitoreo, modelado de patrones alimentarios saludables y creación de ambientes no obesogénicos. Conclusión: existen hallazgos consistentes respecto a que prácticas coercitivas pueden ejercer efectos negativos en la conducta alimentaria infantil y prácticas que promueven la estructuración en la alimentación y un entorno positivo, serían más funcionales. La evidencia internacional es consistente en la relevancia de padres y cuidadores en la promoción de una conducta alimentaria saludable y la condición nutricional de niños.

ABSTRACT Introduction: In the last years, there has been an exponential increase in childhood obesity rates worldwide. Although eating behavior depends on multiple factors, there is agreement on the impact of socio-environmental aspects in which the family has a central role. Identifying the influence of parents and caregivers on child eating behavior can help to generate effective strategies for controlling obesity, especially at early stages. Aim: To review recent scientific evidence on the association between parental feeding attitudes and practices, eating behavior and nutritional status of the child. Method: Narrative review of 40 empirical articles published between 2011 and 2019. Results: Parents tend to underestimate body weight in overweight children. Weight concern and pressure to eat are associated with the nutritional status of the child. Restrictive feeding and the use of food for instrumental purposes and as a mean of controlling emotions, would not be effective practices, possibly because they interfere with the child's ability to self-regulate intake. Positive practices included monitoring, modelling healthy eating patterns and creating non-obese environments. Conclusion: Consistent findings support the notion that coercive practices could have negative effects on child eating behavior. Moreover, practices that promote structured and a positive environment could be more functional. However, international evidence is consistent in the relevance of parents and caregivers in promoting healthy eating behavior and the nutritional status of children.