Evidencias del efecto del grano integral en las enfermedades crónicas no transmisibles

Los cereales integrales son una categoría de alimentos fundamental para la dieta humana y representan una fuente invaluable de carbohidratos, proteínas, fibras, fitoquímicos, minerales y vitaminas. Muchos estudios han demostrado que el consumo de cereales integrales está relacionado con un menor riesgo de enfermedades crónicas no transmisibles. Sin embargo, varios de sus efectos positivos para la salud parecen desaparecer cuando se refinan los cereales. La pregunta de investigación es cuál sería el efecto de los cereales integrales en la prevención de enfermedades crónicas no transmisibles. Este artículo describe los efectos positivos del consumo de cereales integrales en la prevención de estas enfermedades. Para ello, se realiza una descripción narrativa que revisa los antecedentes disponibles sobre: a) situación epidemiológica en Chile y su relación con la alimentación; b) consumo de cereales integrales en el mundo y en Chile; y c) el efecto del consumo de cereales integrales en la reducción del riesgo de enfermedad cardiovascular. obesidad, diabetes tipo 2 y cáncer. Los antecedentes generales son muy alentadores sobre el efecto positivo del consumo de cereales integrales sobre determinadas enfermedades, especialmente las de origen metabólico. Sin embargo, la incertidumbre de algunas asociaciones negativas merece mayor atención.

Whole grains are a fundamental food category for the human diet and represent an invaluable source of carbohydrates, proteins, fibers, phytochemicals, minerals and vitamins. Many studies have shown that consumption of whole grains is linked to a lower risk of chronic non-communicable diseases. However, several of its positive health effects seem to disappear when grains are refined. The research question is what would be the effect of whole grains in the prevention of Chronic Non-Communicable Diseases. This article describes the positive effects of whole grain consumption in these diseases.To this end, a narrative description is made that reviews the available background on: a) epidemiological situation in Chile and its relationship with diet; b) consumption of whole grains in the world and in Chile; and c) the effect of whole grain consumption on reducing the risk of cardiovascular disease. obesity, type 2 diabetes, and cancer. The general background is very encouraging for a positive effect of whole grain consumption on certain diseases, especially those of metabolic origin. However, the uncertainty of some negative associations deserves further attention.

Analysis of the Chilean health promotion policy "Choose a Healthy Lifestyle".

BACKGROUND: Intersectoral health promotion initiatives in Chile to address obesity and non- communicable diseases have had a long history in Chile, but also a high degree of changes in their design, implementation, and financing. AIM: To analyze the "Choose a Healthy Lifestyle" enacted by Law 20,670 under Sabatier's "Advocacy Coalition Framework" (ACF), addressing the political discussion and its execution in the subsequent governing coalitions (2011-2022). MATERIAL AND METHODS: The ACF components are the following: external events, coalitions, policy subsystem (health promotion), and policy brokers. Policy change and learning occurs when a certain level of conflict exists between coalitions. We carried out a bibliographic and literature review, including history of the Law and notes in the media. RESULTS: We identified two coalitions. The first is pro-individual freedom and aims to solve the problem with education and health promotion. The second one defines the problem as structural and related to social determinants and health inequity. The first coalition launched the "Choose Healthy Liferstyle" program in 2011 when they were in executive power. After criticism from the opposition and the participation of policy brokers, the Program was institutionalized with an intersectoral vision. The lack of permanent financing affected the continuity of the policy, especially after a change in the governing coalition. CONCLUSIONS: Law 20,670 falls within the ACF. However, policy learning slowed down because the problem involved social aspects, conflict between deep beliefs of both coalitions, and lack of permanent funding, thus affecting the continuity of the policy.

Analysis of the Chilean health promotion policy "Choose a Healthy Lifestyle" / Análisis de la política de promoción de salud chilena "Elige Vivir Sano"

BACKGROUND: Intersectoral health promotion initiatives in Chile to address obesity and non- communicable diseases have had a long history in Chile, but also a high degree of changes in their design, implementation, and financing. AIM: To analyze the "Choose a Healthy Lifestyle" enacted by Law 20,670 under Sabatier's "Advocacy Coalition Framework" (ACF), addressing the political discussion and its execution in the subsequent governing coalitions (2011-2022). MATERIAL AND METHODS: The ACF components are the following: external events, coalitions, policy subsystem (health promotion), and policy brokers. Policy change and learning occurs when a certain level of conflict exists between coalitions. We carried out a bibliographic and literature review, including history of the Law and notes in the media. RESULTS: We identified two coalitions. The first is pro-individual freedom and aims to solve the problem with education and health promotion. The second one defines the problem as structural and related to social determinants and health inequity. The first coalition launched the "Choose Healthy Liferstyle" program in 2011 when they were in executive power. After criticism from the opposition and the participation of policy brokers, the Program was institutionalized with an intersectoral vision. The lack of permanent financing affected the continuity of the policy, especially after a change in the governing coalition. CONCLUSIONS: Law 20,670 falls within the ACF. However, policy learning slowed down because the problem involved social aspects, conflict between deep beliefs of both coalitions, and lack of permanent funding, thus affecting the continuity of the policy.

ANECEDENTES: Las iniciativas intersectoriales de promoción de salud en Chile han tenido una larga historia en el país, pero también un alto grado de cambios en su diseño, implementación y financiamiento. OBJETIVOS: Analizar el "Sistema Elige Vivir Sano" (Ley 20.670) bajo el marco de "Coaliciones de Causa" (ACF), abordando la discusión política y su ejecución durante cambios de coaliciones gobernantes (2011-2022). MATERIAL Y MÉTODOS: Los componentes de ACF incluyen eventos externos, coaliciones, subsistema de políticas (promoción de salud) e intermediarios de políticas. El cambio y aprendizaje de políticas ocurre cuando existe cierto nivel de conflicto entre coaliciones. Realizamos una revisión de literatura, incluyendo historia de la Ley y notas en los medios de comunicación. RESULTADOS: Identificamos dos coaliciones. La primera es pro-libertad individual y pretende resolver el problema con educación y promoción de la salud. La segunda es pro-determinantes sociales y define el problema como estructural. La primera coalición lanzó el programa "Elige Vivir Sano" en 2011 cuando estaban en el poder ejecutivo. Luego de las críticas de la oposición y la participación de intermediarios de políticas, el Programa se institucionalizó con una visión intersectorial. La falta de financiamiento permanente afecta la continuidad de la política, especialmente luego de un cambio en la coalición gobernante. CONCLUSIONES: La Ley 20.670 se enmarca dentro de la ACF. Sin embargo, el aprendizaje de políticas se ralentizó porque el problema involucra aspectos sociales, conflicto entre creencias profundas de ambas coaliciones y falta de financiamiento permanente, afectando la continuidad de la política.

Revisión sistemática con análisis de sesgo y calidad de intervenciones en el ambiente alimentario del lugar de trabajo y su impacto en el estado nutricional de los trabajadores / Systematic review with analysis of bias and quality of interventions in the food environment of the workplace and their impact on the nutritional status of workers

Introducción: la exposición de los trabajadores a una alimentación no saludable tiene relación con el aumento del sobrepeso y la obesidad. Objetivo: esta revisión sistemática tiene como objetivo analizar con análisis de sesgo y calidad el efecto de las intervenciones en el ambiente alimentario del lugar de trabajo en el estado nutricional de los trabajadores. Métodos: la búsqueda se realizó en tres bases de datos electrónicas de acuerdo a Colaboración Cochrane y fueron incluidos ocho estudios. Los datos se agruparon según tipo de intervención ambiental, se analizó la calidad metodológica y se evaluó la validez con el riesgo de sesgo. Resultados: de los ocho estudios, tres tuvieron efectos en la reducción del índice de masa corporal (IMC) y peso corporal, pero uno fue considerado como evidencia confiable de efectividad por tener bajo riesgo de sesgo. La mitad de los artículos incluidos fueron evaluados con alto riesgo de sesgo (3/8) y riesgo de sesgo poco claro (1/8) por errores en la selección y la realización y datos faltantes en los resultados. Conclusiones: se concluye que no hay suficiente evidencia para indicar que este tipo de intervenciones tienen efecto sobre el peso corporal. Para realizar intervenciones efectivas, el diseño de estos estudios tiene que evitar las fuentes potenciales de sesgo, que fueron analizadas en detalle en este estudio. Se debe considerar el entorno alimentario global de los trabajadores y no solo su lugar de trabajo, profundizando la interacción que existe entre factores socioeconómicos y ambientes alimentarios. (AU)

Introduction: workers' exposure to unhealthy eating is linked to the increase in overweight and obesity. Objective: this systematic review aims to analyze with bias and quality analysis the effect of interventions in the food environment of the workplace on the nutritional status of workers. Methods: the search was conducted in three electronic databases according to the Cochrane Collaboration and eight studies were included. Data were grouped according to type of environmental intervention, and methodological quality and validity with risk of bias was analyzed. Results: three studies had effects on reducing BMI and body weight, but one was judged to be reliable evidence of effectiveness, as they were at low risk of bias. Half of the included articles were assessed at high risk of bias (3/8) and unclear risk of bias (1/8), due to errors in selection and performance and missing data in the results. Conclusions: we conclude that there is not enough evidence to indicate that these types of interventions have an effect on body weight. To make effective interventions, the design of these studies has to avoid potential sources of bias, which were analyzed in detail in this study. The global food environment of workers and not just their workplace must be considered, deepening the interaction that exists between socioeconomic factors and food environments. (AU)

Evaluación de cursos en línea, masivos y abiertos de educación en salud y nutrición para prevenir la obesidad / Assessment of massive open online courses for teaching nutrition and preventing obesity

Background: A massive open online course (MOOC) is an online course aimed at unlimited participation and open access via the Web. Aim: To assess the MOOC experience for teaching nutrition, healthy food consumption, physical activity and health promotion to prevent obesity. Material and Methods: Two MOOC courses, (one with two versions), are described with the registration and evaluation instruments such as surveys carried out at the beginning and at the end of the courses. Effective participants in the three versions were 17.456, 11.121 in MOOC1, 2.351 in MOOC1 second version and 3.984 in MOOC2. Their median age was 31 years, 82% were women, 60% were professionals and 12% were foreigners. Results: In the final evaluation of the three courses, 85% to 99% qualified as "very good" or "good" all the surveyed topics. Thirty five percent of participants reported having lack of time, 11% reported problems with internet connectivity and 3.9%, personal or work problems. Conclusions: This is the first experience with MOOC in health and nutrition to prevent obesity in Chile. Considering the good results and positive evaluation of these courses, we estimate that they are an important tool to prevent obesity and chronic diseases in Chile, Latin America and other regions of the world.

[Assessment of massive open online courses for teaching nutrition and preventing obesity]. / Evaluación de cursos en línea, masivos y abiertos de educación en salud y nutrición para prevenir la obesidad.

BACKGROUND: A massive open online course (MOOC) is an online course aimed at unlimited participation and open access via the Web. AIM: To assess the MOOC experience for teaching nutrition, healthy food consumption, physical activity and health promotion to prevent obesity. MATERIAL AND METHODS: Two MOOC courses, (one with two versions), are described with the registration and evaluation instruments such as surveys carried out at the beginning and at the end of the courses. Effective participants in the three versions were 17.456, 11.121 in MOOC1, 2.351 in MOOC1 second version and 3.984 in MOOC2. Their median age was 31 years, 82% were women, 60% were professionals and 12% were foreigners. RESULTS: In the final evaluation of the three courses, 85% to 99% qualified as "very good" or "good" all the surveyed topics. Thirty five percent of participants reported having lack of time, 11% reported problems with internet connectivity and 3.9%, personal or work problems. CONCLUSIONS: This is the first experience with MOOC in health and nutrition to prevent obesity in Chile. Considering the good results and positive evaluation of these courses, we estimate that they are an important tool to prevent obesity and chronic diseases in Chile, Latin America and other regions of the world.

Aplicación y efectividad de un modelo educativo en hábitos saludables con entrega de fruta y programa de actividad física en escolares

RESUMEN El objetivo fue evaluar una intervención educativa en hábitos de alimentación saludable basada en el programa Colación BKN en pre-escolares y escolares entre los años 2013-2018. Diseño longitudinal con comparación de cortes trasversales en escolares de prekínder a cuarto año básico durante 4 años en 14 escuelas de la Región Metropolitana de Chile. El programa consistió en entrega de fruta como colación, educación alimentaria, mejora de la actividad física y kioscos escolares, con participación de profesores y familias. Como resultado se observó una mejoría de los conocimientos en alimentación saludable de los niños, con una excelente satisfacción de usuarios. Sobrepeso y obesidad se mantuvieron el 2016 y 2018, pero aumentaron el 2015 y 2017. En escuelas similares no intervenidas el exceso de peso fue mayor con respecto a las del programa. Hubo una tendencia a disminuir el consumo de dulces y bebidas azucaradas en prekínder y kínder entre 2014 y 2017 y el consumo de 3 porciones al día de frutas y verduras en niños intervenidos fue superior al promedio nacional de 2 porciones al día.Conclusiones: Hubo un aumento exitoso en el consumo de frutas y verduras, educación alimentaria y actividad física para el cambio hacia hábitos más saludables.

ABSTRACT The objective was to evaluate an educational intervention for healthy eating habits based on the Colación BKN program, among preschool and schoolchildren, carried out in 2013-2018. We conducted a longitudinal study with cross-sectional data among preschool and school-age children (up to the fourth grade) over four years in 14 schools in the Metropolitan Region of Chile. The intervention program consisted of fruit delivery, nutrition education and improvements in physical activity and school food kiosks, with active participation of teachers and parents. There was an improvement in knowledge of healthy foods in children and excellent user satisfaction. Overweight and obesity did not increase during 2016 and 2018, but increased in 2015 and 2017. In similar not-intervened schools there was an increase of overweight and obesity compared with Colación BKN schools. For food consumption, there was a decrease in consumption of candy and soft drinks in preschool students and all children consumed more than three portions of fruits and vegetables per day, which is greater than the national average of two portions per day in the general population. Conclusions: There was a successful increase in fruit and vegetable consumption with nutrition education and promotion of healthy habits, such as physical activity and healthy food consumption.

Método Delphi para consensuar metodologías educativas para promover la alimentación saludable en adolescentes / Delphi method to reach consensus on education methods to promote healthy eating behaviors in adolescents

ANTECEDENTES: la adolescencia es un período importante para reforzar la educación sobre alimentación saludable. Para ello se requiere consensuar y establecer prioridades con expertos sobre las mejores metodologías para educar a los adolescentes en alimentación saludable. MÉTODOS: se escogió el método Delphi para obtener consenso a través de opiniones anónimas repetidas en dos rondas. Se seleccionaron expertos en nutrición (24), educación (14) y cocina (2) con los siguientes criterios de inclusión: carrera profesional relevante; mostrar interés en su área de conocimiento y experiencia en educación en alimentación saludable. Los 40 expertos de la primera ronda disminuyeron a 37 en la segunda ronda. El cuestionario enviado por correo en la primera ronda y sus resultados fueron reenviados para establecer prioridades. El análisis se efectuó con estadísticas descriptivas (%). Se consideró consenso el valor ≥ percentil 75. La consistencia interna se analizó con el coeficiente alfa de Cronbach (se considera buena si alfa es mayor de 0,7 y moderada si se sitúa entre 0,6 y 0,7). RESULTADOS: hubo más de un 90 % de consenso en las metodologías para hábitos alimentarios, habilidades culinarias y estrategias metodológicas. En los hábitos alimentarios se consideró como prioritario mejorar el acceso a la comida saludable y cambiar los currículos en la escuela. En las habilidades culinarias, la preparación de un desayuno saludable y colaciones saludables, y en las estrategias metodológicas, educar en hábitos alimentarios durante el desayuno y el almuerzo, y desarrollar actividades participativas tales como talleres de cocina. CONCLUSIONES: el método Delphi fue útil para obtener el consenso y las prioridades en cuanto a las metodologías para educar a los adolescentes en alimentación saludable

BACKGROUND: adolescence is a relevant period to educate in healthy eating behaviors. For this purpose it is necessary to obtain expert opinions and reach consensus and prioritize the best methodologies available to educate adolescents on healthy eating. METHODS: the Delphi method was chosen to get consensus through repeated iterations of anonymous opinions in two rounds. Participants were experts in nutrition (24), education (14), and cooking (2), selected with the following inclusion criteria: outstanding professional career; interest shown in their knowledge area, and expertise in healthy eating education. The 40 experts in the first round were reduced to 37 in the second round. The questionnaire was mailed in the first round and the results were sent to establish priorities in the second round. The analysis was done with descriptive statistics (%). Consensus was reached if ≥ 75th percentile. Cronbach's alpha coefficient was used to analyze internal consistency, which was considered good for an alpha value higher than 0.7, and moderate for values between 0.6 and 0.7. RESULTS: there was 90 % consensus for food habits, culinary skills, and methodologies. In food habits experts prioritized improving access to healthy food and curricular changes at school. In culinary skills they agreed on healthy breakfast and healthy snack preparations; in methodologies the consensus was to educate in healthy eating at breakfast and lunch at school, and on participative activities such as cooking workshops. CONCLUSIONS: the Delphi method was useful to obtain consensus and priorities on the methodologies to educate adolescents in healthy eating

Descripción de la progresión de la obesidad y enfermedades relacionadas en Chile / Increasing frequency of obesity in Chile

Background: An explosive increase in overweight and obesity occurred in Chile since the 90's, without an integrative national policy. Aim: To describe the current obesity situation in Chile and its consequences. Material and Methods: Analysis of the available anthropometric data obtained by an annual census of anthropometry for students (Nutritional Map) collected by the Ministry of Education, and three National Health Surveys (2003, 2009-2010 y 2016-2017) performed by the Ministry of Health in adults. Results: According to the Nutritional Map the prevalence of obesity in 1987 was 7.5% among children of six years of age and increased to 24% in 2018 (8% with severe obesity). At 14 years of age, the frequency of obesity increased from 8 to 15% from 2011 to 2018. In children older than 15 years, overweight and obesity increased from 61 to 74% from 2003 to 2016. In the same period, total obesity increased from 23 to 34% and the frequency of diabetes duplicated from 6 to 12%. The frequency of hypertension did not change, but its prevalence is 45 and 73% after 45 and 65 years of age, respectively. Conclusions: The frequency of obesity will continue to increase, producing severe health risks for the population. Public policies addressing both structural and individual aspects are recommended.

[Increasing frequency of obesity in Chile]. / Descripción de la progresión de la obesidad y enfermedades relacionadas en Chile.

BACKGROUND: An explosive increase in overweight and obesity occurred in Chile since the 90's, without an integrative national policy. AIM: To describe the current obesity situation in Chile and its consequences. MATERIAL AND METHODS: Analysis of the available anthropometric data obtained by an annual census of anthropometry for students (Nutritional Map) collected by the Ministry of Education, and three National Health Surveys (2003, 2009-2010 y 2016-2017) performed by the Ministry of Health in adults. RESULTS: According to the Nutritional Map the prevalence of obesity in 1987 was 7.5% among children of six years of age and increased to 24% in 2018 (8% with severe obesity). At 14 years of age, the frequency of obesity increased from 8 to 15% from 2011 to 2018. In children older than 15 years, overweight and obesity increased from 61 to 74% from 2003 to 2016. In the same period, total obesity increased from 23 to 34% and the frequency of diabetes duplicated from 6 to 12%. The frequency of hypertension did not change, but its prevalence is 45 and 73% after 45 and 65 years of age, respectively. CONCLUSIONS: The frequency of obesity will continue to increase, producing severe health risks for the population. Public policies addressing both structural and individual aspects are recommended.

Teachers' self-perception of their dietary behavior and needs to teach healthy eating habits in the school.

Through focus groups, we explored 22 third- to fifth-grade teachers' perceptions about their eating habits, including barriers and facilitators to healthy eating. It also explored teachers' thoughts about how to teach students healthy eating habits. The information was transcribed and treated using the content analysis technique. Results were evaluated using the concept of majority and minority group and presented in a sequential way: teachers' perceptions about eating habits, barriers to healthy eating, teacher's culinary habits, abilities to teach students healthy eating habits through Information and Communication Technologies, and cooking activities. Teachers' eating habits were poor, with lack of time, money, and will to improve. They had culinary habits skills and the desire to instruct and guide their students in eating healthier food. They need a program with Information and Communication Technologies and cooking workshops to apply in the classroom.

Efecto de una intervención educativa nutricional en un entorno laboral / Effect of a nutrition educational intervention in a work environment

El objetivo fue evaluar el efecto de una intervención educativa nutricional en un entorno laboral. Para ello se realizó un estudio cuasi-experimental, longitudinal, con una intervención educacional de cuatro meses de duración. Participaron 90 trabajadores, 44 mujeres y 46 hombres, edad promedio 29,3 ± 5,4 años, de una empresa de telefonía celular de Asunción-Paraguay. Se efectuaron encuestas de datos clínicos, hábitos alimentarios, actividad física y mediciones antropométricas al inicio y final de la intervención. Para hábitos alimentarios se utilizaron el cuestionario de frecuencia de consumo cuantificado y el registro de consumo alimentario de una semana, ambos previamente validados y utilizados en otras investigaciones. La actividad física se estimó con el Cuestionario Internacional de Actividad Física IPAQ que divide a la misma en tres categorías (baja, moderada y alta). La antropometría incluyó peso, talla, IMC y circunferencia de cintura. La educación nutricional consistió en consultas de consejería individual, concurso para bajar de peso, acciones colectivas de apoyo e intervenciones del entorno del lugar de trabajo. La ingesta de frutas y verduras fue significativamente mayor (p<0,001 y p=0,001); el consumo de pan disminuyó en un 56% (p=0,001); mejoró el estado nutricional (p<0,001) y disminuyó la circunferencia de cintura (p<0,001) al final del estudio. Los niveles de actividad física moderado y alto aumentaron de 43,4% a 59%. Esta intervención integral en el lugar de trabajo, con un concurso para bajar de peso, mejoró el estado nutricional e impactó positivamente en el estilo de vida de los empleados(AU)

The objective is to evaluate a nutrition educational intervention in a work place. This is a quasi-experimental and four- month longitudinal study in 90 participants (44 women and 46 men), average age 29.3 ± 5.4 years, from a telephone company in Asunción, Paraguay. Anthropometry, nutritional assessment and physical activity evaluation were carried out at the beginning and at the end of the intervention. For food habits, a food frequency questionnaire and one-week food consumption registration system were applied, both validated and used previously in other studies. The level of physical activity was measured using the International Physical Activity Questionnaire (IPAQ) which divides physical intensity in three levels (low, moderate and high). Anthropometry included weight, height and waist circumference. Nutrition education consisted in individual lifestyle counseling, a contest to lose weight, collective support actions and environmental intervention at the work place. A significant increase of intakes of fruits and vegetables (p<0.001 y p= 0.001 respectively); a 56% reduction in bread consumption (p= 0.001); significantly (p<0.001) improvement of nutritional status, and waist circumference reduction (p<0.001) were observed al the end of the study. High and moderate physical activity improved from 43.4% to 59%. This integral nutrition intervention at the work place with a weight loss contest improved the nutritional status and had a positive impact in the workers life styles(AU)

The contribution of distance education to health promotion in Chile.

The objective of this paper is to present the distance education's contribution to developing health promotion in Chile, through evaluation of a postgraduate certificate program for professionals, and a training course for nurse technicians working in primary healthcare, with an 8-month follow-up after program completion. The program methodology was participatory, interactive and reflective, with mentoring support, exercises, group work and discussions as well as content pertinent to the needs of practice. The evaluation was quali-quantitative with an analysis of the student profile, the implementation process, outcomes at the end of the training and impacts on workplace changes. The results showed a high rate of student approval (87 and 76%), good academic performance and a high level of satisfaction with the methodology and knowledge delivered. The participants' final projects were adapted to local work places realities and were implemented by 62.6% of technicians and 43% of professionals, in addition to changes in work practices that favor health promotion. The level of fulfillment of participants' expectations was very high and the most frequent barriers to implementing the final project were lack of time and personnel, along with minimal support from management and low prioritization of health promotion. This study shows the effectiveness of a distance training model for professionals and technicians that can reach the most remote parts of the country, where there is no access to presencial training, with an educational program centered on work activities and current health challenges.

[Not Available]. / Método DELPHI para buscar consenso sobre metodologías educativas en alimentación saludable para alumnos de tercero a quinto año básico, sus familias y profesores.

Objetivo: mediante la técnica de consenso Delphi, conocer la opinión de un grupo de expertos en nutrición, educación y gastronomía para buscar consenso sobre metodologías educativas en alimentación saludable, alumnos de tercero a quinto año básico, sus familias y profesores.Métodos: con los resultados de encuestas y grupos focales realizados previamente a niños, padres y profesores, se elaboró un cuestionario que fue enviado a 51 expertos en nutrición, educación y gastronomía en una primera ronda. Los resultados fueron analizados y reenviados en una segunda ronda con las preguntas no consensuadas, obteniendo 38 respuestas.Resultados: hubo consenso en que se pueden cambiar hábitos en escuelas mediante talleres de cocina con chefs o monitores, educación activo-participativa y huertos escolares. Padres y profesores deben tener habilidades culinarias saludables para educar a los niños. Estos deben hacer uso racional del dinero en la escuela. Para ello es necesario cambiar la oferta del kiosko hacia alimentos saludables, o suprimirlo si no es saludable. Los profesores deben capacitarse con talleres de autocuidado y vida sana para educar en alimentación saludable a los niños en horarios de clase con material educativo, talleres de cocina con recetas y aprovechar horarios de desayuno y almuerzo para actividades educativas. Los padres deben participar en talleres para escoger alimentos saludables en lugares de venta y preparar menús saludables. Los niños deben aprender habilidades culinarias simples, preparando y degustando alimentos saludables. Conclusiones: estos resultados son fundamentales para diseñar materiales educativos en alimentación saludable que cambien los malos hábitos alimentarios actuales.

Método Delphi para buscar consenso sobre metodologías educativas en alimentación saludable para alumnos de tercero a quinto año básico, sus familias y profesores / Delphi method to get consensus about education methodologies in healthy eating for third to fifth school-age children, their parents and teachers

Objetivo: mediante la técnica de consenso Delphi, conocer la opinión de un grupo de expertos en nutrición, educación y gastronomía para buscar consenso sobre metodologías educativas en alimentación saludable en alumnos de tercero a quinto año básico, sus familias y profesores. Métodos: con los resultados de encuestas y grupos focales realizados previamente a niños, padres y profesores, se elaboró un cuestionario que fue enviado a 51 expertos en nutrición, educación y gastronomía en una primera ronda. Los resultados fueron analizados y reenviados en una segunda ronda con las preguntas no consensuadas, obteniendo 38 respuestas. Resultados: hubo consenso en que se pueden cambiar hábitos en escuelas mediante talleres de cocina con chefs o monitores, educación activo-participativa y huertos escolares. Padres y profesores deben tener habilidades culinarias saludables para educar a los niños. Estos deben hacer uso racional del dinero en la escuela. Para ello es necesario cambiar la oferta del kiosko hacia alimentos saludables, o suprimirlo si no es saludable. Los profesores deben capacitarse con talleres de autocuidado y vida sana para educar en alimentación saludable a los niños en horarios de clase con material educativo, talleres de cocina con recetas y aprovechar horarios de desayuno y almuerzo para actividades educativas. Los padres deben participar en talleres para escoger alimentos saludables en lugares de venta y preparar menús saludables. Los niños deben aprender habilidades culinarias simples, preparando y degustando alimentos saludables. Conclusiones: estos resultados son fundamentales para diseñar materiales educativos en alimentación saludable que cambien los malos hábitos alimentarios actuales (AU)

Objective: To know nutrition, education and gastronomic expert opinion to get consensus about education methodologies in healthy food topics for third to fi fth school-age children, their parents and teachers, with the Delphi method. Methods: A questionnaire was developed with the results of surveys and focus groups in children, parents and teachers made previously. The questionnaire was mailed to 51 experts in nutrition, education and gastronomic in a first round. The results were analyzed and forwarded in a second round with the subjects without consensus, with 38 experts answering the questionnaire. Results: Food habits can be modified at school with cooking workshops with chefs or monitors in an experiential learning and with school gardens. Parents and teachers should have cooking skills to educate children in healthy food. Children should do a rational management of their money at school buying healthy food. For this purpose it is necessary to change the food offered by the kiosk or remove the kiosk if is non healthy. Teachers should be trained in self-care and healthy lifestyles and they should educate children with education materials, cooking workshops with recipes, taking advantage of breakfast and lunch time for education activities. Parents should participate in workshops learning about healthy food choices and how to prepare healthy menus. Children should learn very simple culinary skills, preparing and tasting healthy food. Conclusions: These results are critical to design educational materials on healthy eating plans to change current eating habits (AU)