Impacto de un programa nacional de tratamiento en mujeres adultas con exceso de peso en centros de atención primaria

Abstract

Background: Chile has a high prevalence of overweight and obesity and is important to implement and evaluate treatment and control strategies that are effective. Objectives: To evaluate changes in nutritional status and fasting glucose in overweight women, pre-diabetic and/or pre-hypertension in primary care centers of public health sector. Material and methods: A retrospective cohort of the universe of women admitted to the program in the participating primary care centers for 18 months was studied. Intervention includes consultations and workshops with doctors, nutritionists, psychologists and physical therapists for 4 months, in primary heath center, promoting healthy eating and increased physical activity, not using drugs. Analysis of causes of admission, dropout, participation in scheduled activities and changes in baseline nutritional status and fasting glucose after 4 months of intervention. Results: 1,528 women 18 to 65 years old, with initial BMI between 25 and 40 were studied and 1,222 completed treatment (71.6%). The median weight change was -3.9% (CI -4.1 to 3.7) of initial weight and -2.0 mg/dl (CI -2.0 to 1.0) of blood glucose. 36.8% of patient decreased ≥ 5% of initial weight, 12.5% of overweight and about one third of obese partly improved or normalized their nutritional status. There was significant reduction in the prevalence of pre-diabetes (16.6 to 8.8%, p < 0.001). Conclusion: The intervention was effective for good adhesion and impact in reducing cardiovascular risk factors as BMI, waist circumference and high fasting glucose. One challenge is to keep track of this population to ascertain the impact in the medium and long term.