Obesity In Chile Research Articles

Overweight and obesity in Chile

Overweight and obesity in Chile

Metal exposure and obesity in Chile: a cross-sectional analysis of the National Health Survey 2017

Metal exposure and obesity in Chile: a cross-sectional analysis of the National Health Survey 2017

PCR21 Perception of Access to Healthcare of Patients with Obesity in Chile: A Patient Survey

In Chile, 34.4% of the population suffers from obesity, which is 15 percentage points higher than the OECD average. Despite its prevalence, no structured care for obesity is provided, but only for its comorbidities.

Assessment of massive open online courses for teaching nutrition and preventing obesity

A massive open online course (MOOC) is an online course aimed at unlimited participation and open access via the Web. To assess the MOOC experience for teaching nutrition, healthy food consumption, physical activity and health promotion to prevent obesity. 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. 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. 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.

Differences obesity at subnational levels in Chile and the potential for targeted interventions

Abstract Background Chile has a high prevalence of obesity (PO), and this has increased even more in recent years. Public health interventions have not impacted, probably because a geographic distribution of the cases at a lower level is unknown. We described the geographic distribution and change of obesity at a sub-regional level in Chile, and to identify targets areas/groups for interventions. Methods We did a secondary analysis of the latest two National Health Surveys (2009, 2016), using Regions and Health Service (HS) levels, which are the second and third administrative division of Chile, respectively. HSs were the smallest geographical unit possible to analyze with this data. Logistic regression models were fit to test differences between sex, age, number of children, family income, educational level, regions, and HS, using the lowest value of each variable as the reference group, adjusting by sex and age. Results At the national level, PO increased from 25% to 34% from 2009 to 2016. The southern regions have the highest PO in 2016 (Los Rios: 45%, Aysen:44%, Araucania:42%), and the lowest PO is even more than 30%. Although, the highest relative increase was in the north and central regions (Tarapacá:94%, Valparaíso:89%, Coquimbo:62%), as well as their HS. At HS level, in the Metropolitan Region, the PO varies from 21% to 46% in 2016 (OR = 3.3 IC95%1.4-7.9). Likewise, in the Valparaiso Region, it goes from 24% to 44% (OR = 2.9 IC95% 1.2-7). These differences in PO among HS levels in those regions were lower in 2009. Lower family income, educational level, and females with two or more children were associated with obesity in both surveys. Conclusions There is a high prevalence and increases in obesity in Chile at national and sub-national levels. The large variability in obesity observed among regions and Health Services suggests that lower geographical areas would be a potential target for effective interventions, complementarity to those at national levels. Key messages Analysis and intervention at a subnational level are required for preventing obesity in Chile. The high prevalence of obesity in Chile has a large variability among the subnational levels.

Weight Stigma, Chronic Stress, Unhealthy Diet, and Obesity in Chilean Adults.

Obesity is highly prevalent around the world, including in Chile. Although various psychological factors have been previously associated with obesity, there has been less attention on the role of weight stigma as a determinant of obesity in Chile. Therefore, the primary aim of this study was to examine the direct effect of weight stigma on obesity and determine whether chronic stress and unhealthy diet mediate the relationship between weight stigma and obesity. Faculty and staff from a Chilean university enrolled in the Chilean Study of Psychological Predictors of Obesity and Metabolic Syndrome and completed anthropometric measurements and measures of weight stigma, chronic stress, and unhealthy diet. Three-hundred and eighty-three participants (Mage = 45 years old; 58% female) were included in the present analysis. Structural equation model analyses demonstrated a direct effect of weight stigma on obesity, chronic stress, and unhealthy diet. However, chronic stress and unhealthy diet did not mediate the relationship between weight stigma and obesity. Weight stigma is an important determinant of obesity and is associated with high levels of chronic stress and unhealthy diet in Chilean adults. Our results provide further support for the multifactorial nature of obesity and can inform future interventions aimed promoting weight loss in people with overweight and obesity.

From Farm to Fork: Assessing the Sustainability of Traditional Culinary Preparations to Promote Healthy and Sustainable Diets in Chile’s Metropolitan Region (P03-005-19)

ObjectivesThe high prevalences of ultra-processed foods and obesity in Chile, with increasing climate change, signal an urgent need for novel analyses to characterize sustainable diets. Therefore, the study objective was to describe the sustainability of 24 highly consumed and liked traditional Chilean culinary preparations (dishes) as perceived by those in the Metropolitan Region (RM). MethodsPre-existing methods on documenting traditional food systems were adapted, and combined with the FAO’s 5 criteria for sustainable diets (culture, nutrition, environment, physical, and economic access). In 2018, 40 individual semi-structured interviews were done by an ethnographer/anthropologist, 8 per age (25–45 y, 45–64 y, > 65 y) or ethnic (first nations or not) group. Each interview involved tasks about 24 traditional dishes (card sort exercises per sustainable diet criteria; and brief surveys to assess diet and taste preferences), was recorded, and transcribed. Based on the positive associations between a dish and the 5 sustainable diet criteria, an average sustainability score (0–100%) was calculated by dish. ATLAS.ti v. 8.3.1 was used to conduct the study analyses. ResultsThe traditional dishes identified as the most sustainable were: fruits (91%); salads (90%); scrambled eggs with tomato/onion (82%); vegetable soup (78%), and legumes (78%). With fish soup (52%), shredded beef (48%) and empanadas (39%) as the least sustainable. Of the 5 sustainable diet criteria, the environment dimension was the most difficult for participants to think about in relation to diet, and thus, verbally expound upon. Two-thirds of participants thought that no dish produced any environmental impact. Others erroneously confused environmental impact with health problems or with household contamination from cooking fried foods. The livestock and fishing industries were often cited as having negative environmental impacts. ConclusionsChileans in the RM can identify traditional dishes, largely based on primary agricultural products that are both healthy and sustainable. The finding that many lacked an understanding of how diet may be linked to the concept of sustainability; and more specifically, to environmental impacts signals an important need for more education and awareness regarding how sustainability relates to diet. Funding SourcesCONICYT-FONDECYT Initiation Project.

Economic development and inequality as factors associated with the prevalence of childhood obesity in Chile

El objetivo de este trabajo fue determinar los factores asociados a la prevalencia de la obesidad en parvulos a nivel nacional en el periodo 2001-2009 para una muestra de 553.044 parvulos. Se llevo a cabo un modelo de regresion multiple con introduccion por pasos. Como variable endogena, se ha utilizado la prevalencia de la obesidad en parvulos a nivel nacional. Como variables exogenas se han utilizado distintas variables macroeconomicas esto es; la escolaridad promedio de la poblacion (anos), el Indice de Desarrollo Humano (IDH), el indice GINI, el gasto publico en salud como porcentaje del PIB y el gasto en educacion como porcentaje del PIB. Los resultados mostraron que las variables asociadas a la prevalencia de la obesidad infantil son, el Indice de Desarrollo Humano (IDH) y el gasto publico en salud. Las conclusiones del trabajo son que a medida que aumenta el Indice de Desarrollo Humano (IDH), la prevalencia en la obesidad infantil disminuye. A medida que aumenta el gasto publico en salud por parte del Estado, la prevalencia de la obesidad disminuye. Los resultados del estudio se deduce la importancia que tiene el aumento del gasto publico en salud en prestaciones de servicios preventivos y curativos, y de actividades de planificacion familiar.

Impact of gaining or maintaining excessive weight in infancy on markers of metabolic homeostasis in young children: A longitudinal study in Chilean children.

Childhood obesity in Chile is one of the highest in the world. The objective of this study was to assess the impact of excessive weight gained or maintained over a 3-year period, on markers of metabolic homeostasis in young children. This is a longitudinal study which includes 243 children followed from 4 to 7 years. We assessed BMI, body fat percentage, waist circumference (WC), waist-hip ratio (WHR), waist-height (WH) and trunk fat as well as the following metabolic parameters: glucose, insulin, triglycerides, total cholesterol, LDL, HDL and metabolic risk score. Kruskal- Wallis was used to assess differences in metabolic markers by nutritional status and logistic regression to determine the effect of maintaining or gaining excess weight over the 3-year period, compared with children who maintained a normal weight. Children who were obese at both ages compared with those who were normal weight, had a significantly higher WC, serum concentrations of total fat, total cholesterol, triglycerides, LDL cholesterol and metabolic risk score (P < 0.05). Children who were overweight or obese at 4 and 7 years, had a greater risk of having a high WC (OR: 3.37; P = 0.03), total cholesterol (OR: 4.17; P < 0.003), triglycerides (OR: 1.96; P = 0.04); thus a higher metabolic risk score (OR: 3.21; P = 0.003). Excess weight maintained over time in early childhood, significantly increases the risk of having higher serum biomarkers of cardiovascular risk, which in turn determines the magnitude of cardiovascular and metabolic risks later in life.

Embodiment of social roles and thinness as a form of capital: A qualitative approach towards understanding female obesity disparities in Chile

Obesity in Chile disproportionately affects women of low socioeconomic status (SES). Research has shown that ideals of body size and differences in perceived social pressure for being slim across socioeconomic strata contribute to the social stratification of body size among women in modern societies. Thinness is most valued by high SES women, following western standards of ideal body size.Aiming to understand the link between ideals of body size and SES, this qualitative study explored how 36 Chilean women construct their bodily ideals according to their social position. A purposive sample of women with different profiles with regard to educational attainment, nutritional status and body size (dis)satisfaction was defined, aiming to cover a diverse spectrum of bodily perceptions. Data were collected through semi-structured interviews and approached through a thematic and narrative analysis.Drawing on Bourdieu's concepts of habitus, field, capital and embodiment of the social context, this study explains how ideals of body size and appearance are strongly linked to class-dependent gender roles and social roles. The existing gender and class inequalities in the Chilean social structure have been literally embodied by these women through a ‘gendered class habitus’. Compliance with the thin ideal confers women different degrees of power according to their social position in different fields, such as in marriage and on the labour market, which turns thinness into an embodied form of capital.The societal dynamic behind obesity rates cannot be disregarded when approaching possible solutions. Promoting obesity-related lifestyle modification at an individual level might appear an over-simplistic and individualistic approach to a complex social issue. Context-oriented interventions that take cultural constructions of gender and social class into account might yield better results in the long term, while advocating for a more equitable society and social justice as a public health concern.

Smoking and obesity in Chile's Third National Health Survey: light and shade.

ABSTRACTThe Chilean Ministry of Health recently disclosed the first results of the 2016–2017 National Health Survey (Encuesta Nacional de Salud, ENS). The survey was cross-sectional and used a multistage stratified random sampling strategy resulting in a final sample of 6 233 persons ≥ 15 years old, with national, regional, and urban/rural representativeness. The survey results show consistent reductions in tobacco consumption compared to previous national health surveys (ENS 2003 and ENS 2009–2010), most likely due to stringent tobacco control policies enacted in the last 10 years. However, the results also show that there were alarming increases in obesity in the last 15 years. Stronger regulatory policies may be needed to curb the obesity epidemic that besets Chile, along the lines of what was done with tobacco use. The lesson learned seems to be that pushing for stronger policy measures leads to good results, as seems to be the case for tobacco use, while weak measures may not be sufficient for the scale of the health epidemics Chile is now facing, such as excess weight.

Effectiveness of sugar-sweetened beverages taxes to reduce obesity: evidence brief for policy

The high prevalence of obesity in Chile, along with the increasing consumption of sugary drinks in the country, has made apparent the need to propose fiscal measures, through taxes on specific foods, as a complementary alternative to approach this problem. Since 2014, an additional 5% increase in the tax on sugar-sweetened nonalcoholic beverages has been in effect in Chile, an amount that may be insufficient to produce an impact on obesity levels. The evidence of the effectiveness of fiscal measures upon sugary beverages, in terms of price modification, generally reflects a high transfer of the tax to the final consumers, which is variable according to local conditions. After the analysis of the literature, a sensitivity of the demand to the changes in prices of sugary drinks was evidenced, by means of negative elasticity close to -1, for different groups observed, besides a decrease in the consumption of these products. On the other hand, effects on body weight after the application of these taxes were analyzed by several simulation studies, reporting a decrease on prevalence of obesity between 0.99% and 2.4%. Within the acceptability of a fiscal measure of this nature, there were variable support figures between 36% and 60% among general population. Regarding possible negative effects on employment, an international study even evidenced a rise in the figures for employment in two locations following the application of a tax on sugary drinks. The research showed that there is evidence to support the implementation of a fiscal measure upon sugary beverages in Chile; however, there is a lack of local simulation studies to explore the possible effects and implications of a new tax of this kind in the country. Taxation measures upon foods seem to be both viable and effective alternatives to address the problem of obesity in Chile, but they should be considered as part of an overall strategy with the clear goal of reducing the prevalence of national obesity.

Risk factors for obesity: analysis of the 2009-2010 Chilean health survey

Background: Chile has one of the highest obesity rates in Latin America. However, the factors that could explain this high prevalence of obesity are unknown. Aim: To determine the main risk factors for the development of obesity in Chile. Material and methods: We included 1398 obese and 1478 normal weight participants of the National Health Survey 2009-2010. The risk factors considered were socioeconomic variables, diet, physical activity, comorbidities and general wellbeing. Results: The main factors associated with a higher risk of being obese were age, high salt consumption and high alcohol intake. Education, income and living in rural or urban zones were protective for women and risk factors for men. The probability of being obese increases in women that sleep less than seven hours per day or have a poor health. Sedentariness and lack of physical activity were risk factors among men. Conclusions: The identification of these risk factors may help to implement public health interventions to tackle obesity in Chile.

Using evidence-informed policies to tackle overweight and obesity in Chile

ABSTRACTOverweight and obesity are a global epidemic with rates having risen to alarming levels in both developed and developing countries. Chile has been no exemption, with sharp increases in obesity prevalence, especially among school-age children. This paper describes the policy actions and strategies implemented to tackle this major public health concern in Chile over the last 10 years, and highlights the main challenges and nuances of the process. Chile has taken policy action that includes front-of-package labelling, advertising regulations, and school-food restrictions. New policies focus on the social determinants of health as they relate to food environments and people’s behavior. These actions are not only suitable to the current context in Chile, but are also supported by the best available scientific evidence. Moreover, the implementation of these policies has produced a broad debate involving public institutions and the food industry, with discussions issues ranging from property rights to trade barriers. Despite some differences among stakeholders, a valuable political consensus has been achieved, and several international organizations are eager to evaluate the impact of these pioneer initiatives in Latin America.

Carga económica y epidemiológica de la obesidad en Chile – un estudio de simulación

Carga económica y epidemiológica de la obesidad en Chile – un estudio de simulación

PSY55 - The Health And Economic Burden of Obesity In Chile – An Epidemiological And Economic Simulation Model

This study address the policy question of what is the actual economic burden of obesity in Chile and its projections until the year 2030. The aim of such research question is to inform decision-makers on the magnitude and potential future trends if no actions are undertake. A transition state population level simulation model that incorporate the natural history of obesity and 16 related conditions had been development for the 2010-2030 period. Outcomes of the model consider annual number of cases, deaths, year of life lost (YLL) and direct cost associated with each condition. Epidemiological input data has estimated using DISMOD II® equations. Cost parameters are based on national representative data sources. Univariate and multivariate deterministic sensitivity analysis and second order Monte Carlo simulation for multivariate probabilistic analysis are performed. The model is programed in Excel (Microsoft ® Office Excel 15) with Visual Basic ® Macros. An average of 2,29% (CI95% 1,14%-2,75%) of the annual total health expenditure are attributed to obesity and its related conditions with a clearly increasing trend during the years of analysis, accounting for nearly 3% of the health expenditures in the year 2030. Both health and economic impact are greater in females than in males. Main drivers of those cost are the type 2 diabetes mellitus, the chronic kidney disease, bariatric surgery and some cancers that together contribute with more than half the health expenditures attributable to obesity within the country. Obesity represent a preventable condition that accounts for an important share of the total health expenditure of the Chilean health system. Increasing trends on the obesity prevalence and ageing are both important drivers of an expected future rise in the cost attributable to obesity in the country. Future works needs to address the potential impact of policy strategies to tackle this health problem.

CONSUMPTION OF READY-TO-EAT CEREAL IS INVERSELY ASSOCIATED WITH BODY MASS INDEX IN 6-13 YEARS OLD CHILEAN SCHOOLCHILDREN

childhood obesity in Chile is a serious problem with the prevalence continuing to increase over the last decade, despite all governmental efforts to diminish it. Studies indicate that the consumption of certain foods may help to control body weight. The objective of this study was to evaluate the relationship between ready-to-eat cereals (RTEC), body mass index and nutritional intake of macronutrients and micronutrients in school children from Santiago, Chile. the study included 1 477 children aged 6-13 years who were evaluated by trained nutritionists. Weight, height and waist circumference were measured and a 24-hour recall questionnaire was administered in which the hours spent watching TV were also recorded. Overall, 32% of boys and 28 % of girls were overweight but the difference between them was not significant. All children, regardless of sex, showed a significant inverse relationship between amounts of RTEC consumed and body mass index (BMI). Those girls that consumed higher amount of RTEC had a reduced waist circumference than those that had a lower intake. A high consumption of RTEC in all children was related to a higher intake of calories, proteins, carbohydrates, calcium and zinc and to a lower intake of calories from fat. RTEC consumption was also associated with lower risk of being overweight/obese. this study identifies RTEC intake as a potential indicator of a healthy diet. Controlled interventions are necessary to isolate the effect of RTEC consumption from other participating factors.

Does obesity increase early postoperative complications after laparoscopic colorectal surgery? Results from a single center

Laparoscopic colorectal surgery (LCRS) has several advantages over open surgery, but LCRS has been associated with a higher rate of postoperative complications (POCs) among obese patients [body mass index (BMI), ≥30 kg/m(2)]. The prevalence of obesity in Chile is increasing, up to 25.1% in 2010, suggesting that a higher percentage of patients undergoing LCRS will be obese. This study compared POC rates between obese and nonobese patients undergoing LCRS. This study included case and control patients in a prospectively maintained LCRS database who underwent LCRS between July 2007 and June 2012 at Clinica Las Condes, Santiago, Chile. Obese and nonobese (BMI <30 kg/m(2)) patients were paired by gender, age, American Society of Anesthesiologists class, preoperative diagnosis, and type of surgery. Intraoperative complications and POCs were documented up to 30 days. The severity of each POC was classified by Clavien-Dindo score. In this study, 449 patients who underwent LCRS during the study period were identified. The study paired 53 obese patients (mean BMI 33.1 kg/m(2)) with 53 nonobese patients (mean BMI 25.9 kg/m(2)). The median age was 55 years in the obese group and 57 years in the nonobese group, and 60% of the patients in both groups were men. The findings showed POCs in 13 obese (24.5%) and 15 nonobese (28.3%) patients (p = 0.66). Stratified by severity of POCs, the two groups were similar (p = 0.62). The two groups did not differ in terms of the median time to the first feeding (1 day each) or the hospital length of stay (4 days each). Similar percentages of patients in the two groups required reoperation (p = 0.4), intensive care unit (ICU) admission (p = 0.77), and readmission to the hospital (p = 0.65) because of POCs. The frequency of POCs after LCRS was no higher among the obese patients than among the nonobese patients.

Association between eating behavior scores and obesity in Chilean children

BackgroundInadequate eating behavior and physical inactivity contribute to the current epidemic of childhood obesity. The aim of this study was to assess the association between eating behavior scores and childhood obesity in Chilean children.Design and methodsWe recruited 126 obese, 44 overweight and 124 normal-weight Chilean children (6-12 years-old; both genders) according to the International Obesity Task Force (IOTF) criteria. Eating behavior scores were calculated using the Child Eating Behavior Questionnaire (CEBQ). Factorial analysis in the culturally-adapted questionnaire for Chilean population was used to confirm the original eight-factor structure of CEBQ. The Cronbach's alpha statistic (>0.7 in most subscales) was used to assess internal consistency. Non-parametric methods were used to assess case-control associations.ResultsEating behavior scores were strongly associated with childhood obesity in Chilean children. Childhood obesity was directly associated with high scores in the subscales "enjoyment of food" (P < 0.0001), "emotional overeating" (P < 0.001) and "food responsiveness" (P < 0.0001). Food-avoidant subscales "satiety responsiveness" and "slowness in eating" were inversely associated with childhood obesity (P < 0.001). There was a graded relation between the magnitude of these eating behavior scores across groups of normal-weight, overweight and obesity groups.ConclusionOur study shows a strong and graded association between specific eating behavior scores and childhood obesity in Chile.

Validación de ecuaciones antropométricas para evaluar composición corporal en niños preescolares chilenos

Validated equations to measure body composition in Chilean preschool children are lacking, since the only international equation available was developed in obese, and undernourished Caucasian children. Due to the increase in overweight and obesity in Chile, it is essential to have simple and reliable instruments to assess children.To design and validate anthropometric equations to estimate body fat (BF) and total body water (TBW) to be applicable in children aged 3 to 5 years, using deuterated water dilution as a reference method.Weight, height, circumferences and skinfold thickness were evaluated in 238 children aged 3 to 5 years, attending Junta Nacional de Jardines Infantiles (JUNJI). Several equations were developed using multiple regression models to estimate body water and fat. The proposed equations were validated against a sample of 77 children previously evaluated, using Bland and Alunan agreement analysis, that compares average differences of both methods with the average of predicted and estimated values.New equations for TBW and BF were obtained, accounting for 86% and 72% in estimated variability. The agreement analysis showed a mean difference 0.001 +/- 0.32 and 0.07 +/- 0.56 kg, for TBW and BF, respectively, confirming the validity of the equations.The new validated equations in Chilean children aged 3 to 5 years, have an adequate and predictive capacity, especially useful for evaluating TBW and BF change in cohorts.