RESUMO
Psychosocial status and lifestyle are key risk factors of non-communicable diseases (NCDs), which, in turn, are main drivers of healthcare costs and morbimortality worldwide, including Chile. Mediterranean diet (MedDiet) is one of the healthiest dietary patterns under study. However, its impact on high-risk conditions, such as metabolic syndrome (MetS), and NCDs outside the Mediterranean Basin remains mostly unexplored. Even though Central Chile has an environment, food production, and culinary traditions comparable to those present in Mediterranean countries, few studies -some with significant methodological limitations- have evaluated the effect of MedDiet on health and/or disease in Chilean subjects. Importantly, a Mediterranean lifestyle is a modus vivendi that integrates physical health with mental and social well-being. Psychological well-being (PWB) is associated with healthy behaviors, positive health outcomes, and longevity, thereby emerging as a novel healthcare goal. We report here an ongoing randomized controlled clinical trial in Chilean patients with MetS seeking to test whether (1) a PWB theory-based intervention facilitates induction to and increases long-term adherence to a locally adapted MedDiet, and (2) a MedDiet intervention -implemented alone or combined with well-being promotion- is more effective at reversing MetS compared to individuals following a low-fat diet without psychological support. The CHILEan MEDiterranean (CHILEMED) diet intervention study is a 1-year trial including patients with MetS living in Chile. Participants will be assigned randomly by a computer-generated random number sequence to one of the three intervention arms: a) low-fat diet as control group, b) MedDiet alone, and c) MedDiet plus well-being support. Patients will be followed-up by individual and/or group online nutritional sessions or phone cal as well as 6- and 12-month in-person re-assessment of medical history, medication use, food intake, PWB, anthropometrics/physical exam, and blood collection for laboratory analysis. The primary outcome of the trial will be the effect of the MedDiet -with or without PWB intervention- on overall reversal of MetS compared to low-fat diet alone. Based on a statistical superiority trial, expected impact, and patient loss, the estimated study sample is 339 subjects (113 individuals per arm in 3 equal-sized groups). Currently, we have enrolled 179 patients, predominantly women, evenly distributed by age (group means ranging from 45.7 to 48,9 years-old), 3/4 are obese with almost all of them showing abdominal obesity, 70% are hypertensive, whereas <10% exhibit diabetes. If findings turn out as expected (e.g., MedDiet -with or without PWB intervention- is better than the low-fat diet for reversion of MetS at 1-year follow-up), CHILEMED will provide further beneficial evidence of the MedDiet on NCD risk conditions beyond the Mediterranean region.
RESUMO
Background: In this study, we aimed to estimate the prevalence, tetracycline resistance and presence of Tet(O) in Campylobacter strains isolated from chicken in markets of Lima, Peru. Methods: A total of 250 chicken samples were obtained from traditional markets (skin, n = 120) and supermarkets (meat, n = 130). Samples were subjected to microbiological assays for identification of Campylobacter spp. according to ISO 10272-2017, and the isolates were then submitted to species identification by PCR. Phenotypic resistance to tetracyclines was assessed by the Kirby−Bauer test, and the presence of the Tet(O) gene was determined by PCR. Results: A significantly higher prevalence (p < 0.0001) of Campylobacter coli in skin samples from traditional markets (97.5%) than in meat samples from supermarkets (36.2%) was observed. On the other hand, Campylobacter jejuni was confirmed only in 3.1% of meat samples. All Campylobacter species isolated from skin and meat samples were phenotypically resistant to tetracyclines; however, the presence of the Tet(O) gene in C. coli was identified in 76.9% and 66.0% of skin and meat samples, no significant statistical difference (p = 0.1488) was found between these prevalence. All C. jejuni isolated from chicken meat samples from supermarkets were positive for Tet(O) gene. Conclusions: This study confirms the high prevalence of C. coli isolated from chicken sold in traditional markets and supermarkets in Lima, Peru, and in more than 70% of these strains, phenotypic resistance to tetracyclines could be linked with expression of the Tet(O) gene. It is necessary to evaluate other genes involved in resistance to tetracyclines and other groups of antibiotics in campylobacter strains isolated from chicken meat.
