La obesidad ha aumentado en años recientes en tasas que difieren según el nivel socioeconómico (NSE). El propósito de este estudio fue analizar la asociación entre NSE y estado nutricional de escolares de enseñanza básica en seis comunas con las mayores prevalencias de obesidad en Santiago, Chile. Se seleccionaron escuelas con diferentes prevalencias de obesidad en cada comuna y los escolares se escogieron aleatoriamente en cada escuela. Se evaluaron antropométricamente los escolares y a sus madres se les aplicó una encuesta sociodemográfica y del registro alimentario de 24 horas de sus hijos. Mediante la técnica de componentes principales se clasificó la muestra entre los que son de menor y mayor NSE. La prevalencia de exceso de peso fue de 51,1%, (24,7% tenía sobrepeso y 26,4% eran obesos) sin diferencias significativas entre NSE. Los de menor NSE presentaron menores valores de IMC, pliegues y circunferencia del brazo e ingesta alimentaria, sin embargo estas diferencias no fueron estadísticamente significativas. Hubo también una menor tendencia al sedentarismo en los de menor NSE, ya que usaban más lugares comunitarios [Odds Ratio (OR) 1,91; Intervalos de Confianza (IC) 1,05-3,48] y se iban y volvían al colegio caminando (OR 6,76; IC 2,75-16,67). En conclusión, aunque no hubo asociación significativa entre NSE e indicadores antropométricos e ingesta alimentaria, aunque los escolares de menor NSE tienen una tendencia a tener valores más bajos de estos índices y son más activos.

Resumen: Objetivo: Estimar la asociacion entre consumo de bebidas endulzadas (BE) con indicadores de adiposidad y riesgo metabolico en adultos jovenes. Material y metodos: Se analizo la frecuencia de consumo de alimentos, indice de masa corporal (IMC), circunferencia de cintura (CC), grasa corporal (PGC), glicemia y trigliceridos de 931 participantes seleccionados aleatoriamente (Region de Valparaiso, Chile), mediante modelos de regresion multiple, controlando factores de confusion. Resultados: La mediana de edad fue 24.9 anos; 94% (IC95% :92.3-95.3) de los participantes consumia BE, 33.1% de ellos consumia mas de dos porciones (≥500 ml) diarias, que se asocio con incremento en glicemia (ambos sexos) (β=2.17; p=0.007) y con IMC (β=1.48, p=0.04), CC (β=4.50; p=0.009) y PGC (β=3.02; p<0.001) solo en mujeres. Conclusion: La alta ingesta de BE incrementa la glicemia en adultos jovenes y los indicadores de adiposidad en mujeres, antecedentes relevantes para formular politicas que disminuyan el consumo de BE y sus consecuencias.

OBJECTIVE:To estimate the association between sweetened beverages (SB) consumption with adiposity indicators and metabolic status among young Chilean adults.MATERIALS AND METHODS:We analyzed food frequency consumption, body mass index (BMC), waist circumference (WC), body fat percentage (BFP), glucose and triglycerides in 931 young adults randomly selected from Valparaiso Region using multivariate regression models controlling confusion and interactions factors.RESULTS:The median age was 24.9 years; (95%CI: 92.3-95.3) reported SB consumption, 33.1% received more than two portions (≥500 ml) daily what was associated with an increase in glycemia (β=2.40; p=0.024) (both sexes), with BMI (β=1.48, p=0.04), WC (β= 4.50; p=0.009) and BFP (β=3.02, p< 0.001) only in women.CONCLUSIONS:High consumption of SB increases glycemia in young adults and only in women, indicators of adiposity, relevant antecedents to formulate policies that decrease SB consumption and its consequences.

El objetivo de este trabajo fue realizar una revisión de la situación de salud y nutrición del niño indígena chileno, específicamente del Mapuche, en lo publicado en las bases de datos de referencias bibliográficas y en investigaciones específicas que tienen base poblacional. Para este trabajo se buscó lo publicado en PubMed, LILACS, organismos nacionales e internacionales, durante los últimos 15 años. Desde el 2006 hasta el 2015 la proporción de pobres era mayor en los indígenas, con disminución de la brecha de 16% el 2006 a 7,7% el 2015 (p < 0,001). En la primera década de este siglo la mortalidad infantil en los niños indígenas tenía una tasa de 17,1/1.000 nacidos vivos, mientras en los no indígenas era de de 8,8/1.000 y, en el seguimiento de cinco años, la brecha se mantuvo (p < 0,001). Los recién nacidos con peso < 2,500g el año 2000 no superaban el 6% (5,6% en no indígenas y 5,2% en los indígenas). La talla baja al ingreso a la escuela era 8,4% en los escolares indígenas y 3,1% en los no indígenas, disminuyendo a 3,7 en los indígenas y 2,6% en los no indígenas el 2004, la obesidad en cambio aumentó más en los indígenas, llegando a 24,2 y 25,3% en los no indígenas (p < 0,001). La menarquia se presentó cuatro meses más tarde en las indígenas (12,7 años) y el índice de masa corporal, circunferencia de cintura y el porcentaje de grasa, fueron significativamente mayores en las indígenas en el momento de la telarquia, así como la frecuencia de exceso de peso (55% vs. 42% en las no indígenas). Los niños Mapuche presentan una condición de salud y nutrición favorable, comparada con los indígenas de otros países del continente, sin embargo, aun existe una brecha adversa -comparada con los no indígenas-, en que la desigualdad desfavorece al niño indígena y esta debe ser reconocida y corregida.

The aim of this study was to conduct a review of the health and nutritional status of Chilean indigenous children, specifically Mapuche children, as published in the literature and specific population-based studies. The searches were conducted in PubMed and LILACS in the last 15 years. From 2006 to 2015, the poverty rate was higher in the indigenous population, with a decrease in the gap from 16% in 2006 to 7.7% in 2015 (p < 0.001). In the first decade of this century, infant mortality in indigenous children was 17.1/1,000 live births, while in non-indigenous children it was 8.8/1,000, and the gap was maintained in the five-year follow-up (p < 0.001). Newborns with birthweight < 2,500g in the year 2000 did not reach 6% (5.6% in non-indigenous and 5.2% in indigenous children). Low height at first school enrollment was 8.4% in indigenous schoolchildren and 3.1% in non-indigenous children, decreasing to 3.7% in indigenous children and 2.6% in non-indigenous children in 2004, while obesity increased more in indigenous children, reaching 24.2% in indigenous and 25.3% in non-indigenous children (p < 0.001). Menarche appeared four months later on average in indigenous girls (12.7 years), and body mass index, waist circumference, and fat mass were significantly greater in indigenous girls at the time of thelarche, as was the overweight rate (55%, vs. 42% in non-indigenous). Mapuche children show favorable health and nutritional status compared to indigenous children elsewhere in Latin America, but there is still an adverse gap compared to non-indigenous Chilean children. This inequality affecting indigenous Chilean children should be acknowledged and corrected.

OBJECTIVE:To verify the association between changes in socio-economic level (SEL) and nutritional status of Chilean adults over a 10-year period. DESIGN:Concurrent cohort study.Setting/SubjectsIndividuals born from 1974 to 1978 in the Valparaíso Region of Chile were evaluated between 2000 and 2002 (n 1232) and again between 2010 and 2012 (n 796). SEL was characterized according to the occupation and educational level of the head of household. Nutritional status was based on measurement of BMI and waist circumference (WC). RESULTS:Between the first and second evaluation there was a 13 % reduction in the number of individuals classified as poor and a 12 % increase in those classified in the medium high SEL. Increases in BMI were found among women who remained in the low SEL (β=2·2, 95 % CI 0·16, 2·87) compared with women who maintained the same SEL (and whose SEL was above low over the 10-year period). Women who remained in the low SEL increased their WC (β=4·10, 95 % CI 0·27, 7·93). There were no associations between nutritional status and SEL among males. CONCLUSIONS:In the period studied, the SEL of the study population improved between the third and fourth decade of life, but BMI and WC also increased among women, with the lowest socio-economic group experiencing the greatest changes. Meanwhile, among males we found no association between anthropometric measurements and changes in SEL.

The objective of this cross-sectional study of 735 adults 32 to 38 years old born in Limache Hospital in the Valparaiso region of Chile was to analyze the relationship between consumption of certain sugar-sweetened beverages (SBs) and metabolic syndrome (MS). The association with sweetened soft drinks (SDs) as part of SBs was also studied. No relationship was observed between total consumption of SBs and MS; 89% of the adults consumed SBs, with a daily median of 179 mL. However, consumption of greater than 400 mL SBs per day was associated with 1 component of MS: a high waist circumference (odds ratio [OR], 2.17; 95% confidence interval [CI], 1.16–2.51). The median consumption of SDs was 163 mL (p25–75 = 71.4–386). An association between SD consumption and MS was found. Consumption of less than 200 mL had an OR of 1.59 (95% CI, 1.01–2.51); between 200 and 400 mL, an OR of 2.06 (95% CI, 1.20–2.51); and greater than 400 mL, an OR of 2.07 (95% CI, 1.18–3.63), compared with those who did not consume them. Although there was no association between SB intake and MS, consuming SBs in high quantities (>400 mL/d) was associated with increased waist circumference. Greater consumption of SDs was associated with MS.

Our purpose was to study the prevalence of mental disorders with an emphasis on somatic symptoms and their association with social support in a Chilean semi-rural area. We studied a sample of 796 adults born between 1974 and 1978 in Limache, Chile. The Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7, the Patient Health Questionnaire-15 and the Medical Outcomes Study Social Support Scale test were used to assess depression, anxiety, somatic symptoms and social support, respectively. We found that the prevalence of psychosomatic symptoms was 63.8% in women (most of them in the severe range) and 34.1% in men. The rates of depression and anxiety were 17.7 and 21.7%, respectively. Psychosomatic symptoms were strongly associated with depression (male OR:10.33, CI 95%:2.91–34.54; female OR:6.19, CI 95%:2.64–14.52) and anxiety (male OR:2.63, CI 95%:1.04–6.63; female OR:3.97, CI 95%:2.02–7.78). The association between psychosomatic symptoms and functional impairment was mainly due to symptoms of depression and anxiety. Mental disorders were inversely associated with social support. We conclude that psychosomatic symptoms were the norm, especially in women. Social support is marginally lower in those with a mental disorder, but still perceived as high. Physical complains in these communities are frequently the expression of depression and anxiety.

Background Latin American and Caribbean populations include three main ethnic groups: indigenous people, people of African descent, and people of European descent. We investigated ethnic inequalities among these groups in population coverage with reproductive, maternal, newborn, and child health interventions. Methods We analysed 16 standardised, nationally representative surveys carried out from 2004 to 2015 in Latin America and the Caribbean that provided information on ethnicity or a proxy indicator (household language or skin colour) and on coverage of reproductive, maternal, newborn, and child health interventions. We selected four outcomes: coverage with modern contraception, antenatal care coverage (defined as four or more antenatal visits), and skilled attendants at birth for women aged 15-49 years; and coverage with three doses of diphtheria-pertussis-tetanus (DPT3) vaccine among children aged 12-23 months. We classified women and children as indigenous, of African descent, or other ancestry (reference group) on the basis of their self-reported ethnicity or language. Mediating variables included wealth quintiles (based on household asset indices), woman's education, and urban-rural residence. We calculated crude and adjusted coverage ratios using Poisson regression. Findings Ethnic gaps in coverage varied substantially from country to country. In most countries, coverage with modern contraception (median coverage ratio 0.82, IQR 0.66-0.92), antenatal care (0.86, 0.75-0.94), and skilled birth attendants (0.75, 0.68-0.92) was lower among indigenous women than in the reference group. Only three countries (Nicaragua, Panama, and Paraguay) showed significant gaps in DPT3 coverage between the indigenous and the reference groups. The differences were attenuated but persisted after adjustment for wealth, education, and residence. Women and children of African descent showed similar coverage to the reference group in most countries. Interpretation The lower coverage levels for indigenous women are pervasive, and cannot be explained solely by differences in wealth, education, or residence. Interventions delivered at community level-such as vaccines-show less inequality than those requiring access to services, such as birth attendance. Regular monitoring of ethnic inequalities is essential to evaluate existing initiatives aimed at the inclusion of minorities and to plan effective multisectoral policies and programmes. Copyright (C) 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.

Background: One in five deaths that occur in Chile can be attributed to smoking whose prevalence remains high, despite interventions aimed at reducing it.

BACKGROUND:One in five deaths that occur in Chile can be attributed to smoking whose prevalence remains high, despite interventions aimed at reducing it.AIM:To compare the prevalence of smoking and its intensity among young adults born 15 years apart and determine their association with socioeconomic status (SES).MATERIAL AND METHODS:Two cohorts of young adults living in the Valparaiso Region of Chile were evaluated in the third decade of life. Cohort 1 was evaluated between 2000 and 2002 (n = 1232) and cohort 2 between 2014 and 2017 (n = 1078).RESULTS:In cohort 1, 57.5% (95% Confidence Interval (CI) 54.6-58.7) of the subjects reported smoking, with a median of 3 (Interquartile range (ICR:1-6) cigarettes/day. This percentage fell to 40.2% (CI: 37.5-43.1) with a similar median in cohort 2. Analyzing cohort 2, the odds ratio (OR) for smoking was 2.24 (CI 1.48-3.38) in the medium SES, compared with the medium high SES. The figures for low medium and low SES were 2.72 (CI: 1.85-3.99) and 3.01 (1.85-4.88). Similarly, in this cohort there was a significantly higher risk of being a heavy smoker in lower SES. No associations between smoking or its intensity and SES were observed in cohort 1.CONCLUSIONS:Smoking behavior has decreased among young adults evaluated at the same age in two generational cohorts in the third decade of life. In the most recent cohort analyzed, smoking and its intensity increase along with a decrease in SES.

Cardiovascular risk factors have increased along with economic development, but it is not clear if this tendency differs by education. The aim of this study was to analyze the effect of education on blood lipid levels while income increases over a decade in Chilean adults.

OBJECTIVE:To analyze the change in anthropometric indicators between menarche and 36 months after menarche among indigenous and non-indigenous adolescents from the Araucanía Region of Chile.METHOD:This was a concurrent cohort study. Of 8,504 girls interviewed, 114 indigenous adolescents and 123 nonindigenous adolescents who had recently experienced menarche were selected. Body mass index (BMI), BMI by age (BMI z-score), waist circumference (WC) and body fat percentage (BF%) were evaluated at menarche and 6, 12, 18, 24, 30, and 36 months postmenarche. Linear models estimated with generalized estimating equations were used to quantify disparities adjusted for baseline anthropometric values, age at menarche, place of residence, and socioeconomic level.RESULTS:Indigenous girls presented menarche 4 months later than nonindigenous girls and had significantly higher BMI (1.5 kg/m2 ), BMI z-score (0.4), WC (2.9 cm), and BF% (1.7%) at menarche. Adjusted results did not show an association between being indigenous and post-menarche anthropometric variables: BMI = 0.1 kg/m2 (CI = -0.3; 0.5), BMI z-score = 0 (CI = -0.1; 0.1), WC = 0.7 cm (CI = -0.6; 2.0), and BF% = 0.5% (CI = -0.2; 1.3). It is important to mention that the mean BMI z-score of both groups were in the overweight category.CONCLUSION:At menarche, indigenous girls had higher values than nonindigenous girls for all anthropometric variables, and this trend remained after menarche, with no further change in ethnic disparity over the subsequent three years. This reinforces the need to implement interventions to prevent or control excess weight prior to menarche, with emphasis on indigenous girls.