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Browsing by Author "Pinheiro Fernandes, Anna"

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A description of Chilean food and nutrition health policies
(2021) Rodríguez-Osiac, Lorena; Pinheiro Fernandes, Anna; Mujica-Coopman, María; Caro-Moya, Patricia; Navarro-Rosenblatt, Deborah;
Background: Chile has implemented numerous successful food and nutrition initiatives since the early 20th century, aiming to address malnutritionin all its forms. Aim: To summarize the major nutrition and food-related policies, strategies, and programs implemented in Chile, using the NOURISHING Framework. Material and Methods: The NOURISHING framework proposes a methodology for reporting, monitoring, and categorizing actions to promote healthier eating in three main domains: food environment, food system and behavior change communication. The data collection was carried out reviewing the databases of the Chilean Ministries of Health, Education and Social Development, and the Parliament. Information about nutrition related public health policies, strategies or programs was obtained from peer reviewed articles, official reports, official State websites, as well as interviews with former and current stakeholders. Results: Chile has mandatory nutritional labeling that was updated to front-of-package warning labels about critical nutrients. In addition, the advertising of unhealthy foods and breast milk substitutes is restricted, among other food and nutrition policies. Nevertheless, strategies related to mass and social media communication campaigns, or periodic education and information interventions still need to be implemented. Conclusions: Using the NOURISHING framework, a comprehensive summary and description of nutrition and food public health policies implemented in Chile is described. An overview of the policy changes required according to the nutritional transition in Chile is provided.
Development and Validation of a Set of Instruments to Measure Food Environments
(2022) Araneda, Jacqueline; Oliva, Patricio; Quezada, Gladys; Lobos, Luz; Leyton, Barbára; Pinheiro Fernandes, Anna
Background: There is worldwide interest in measuring local food environments (FEs). The aim of this study was to develop and validate a set of instruments to evaluate FEs in Chile. Methods: Based on the development and validation of four instruments to measure FEs, a literature review, an evaluation by experts, and the implementation of a pilot tool in the FEs of schoolchildren from nine public schools in the commune of Chillán, Chile, were used. Results: A tool to evaluate FEs was provided, based on three dimensions: availability, variety, and advertising of healthy foods. A total of 1928 foods points of purchase were evaluated. The reliability was evaluated by Cronbach’s alpha. Some 74% of the foods’ points of purchase were store locations. The reliability of the four instruments was high to acceptable (store: 0.90; institution: 0.77; street food: 0.74; restaurant: 0.68). Unhealthy foods were highlighted by the scores obtained: store (6.08 ± 4.07; range: 0–13), restaurant (3.95 ± 1.75; range: 0–10), street food (1.18 ± 1.56; range: 0–7), and institution FEs (3.38 ± 2.78; range: 0–9). Conclusions: The results of this tool can provide information to governments for incorporatingb structural measures to ensure adequate availability, variety, and advertising of healthy foods in different FEs.
Evaluación de la precisión y exactitud de una encuesta alimentaria de registro con apoyo de imagen digital en tiempo real
(2018) Pinheiro Fernandes, Anna; Araneda, Jacqueline; Illanes, Kiyomi; Pedraza, Catherine
Introducción: las encuestas alimentarias son utilizadas para la determinación del consumo de alimentos y nutrientes a nivel poblacional y/o individual, aunque subestiman la ingesta en un 37% o más. La introducción de nuevas tecnologías como la imagen digital de la porción de consumo, podría contribuir a disminuir el error de estimación para calorías y determinados macronutrientes. Objetivo: evaluar la precisión y exactitud del método de registro apoyado con imagen digital en tiempo real en la estimación de ingesta de calorías y macronutrientes en adultos jóvenes, considerándose como método de referencia el registro por pesada (RPP). Método: se evaluó la ingesta del almuerzo sometido previamente a un RPP de 58 sujetos. Antes y después de la ingesta, cada participante capturó una imagen de sus porciones de consumo y completaron un registro de ingesta. Se determinó el estado nutricional de los sujetos. El análisis estadístico se realizó con medianas, Kruskal-Wallis y concordancia con Bland-Altman (p < 0,05). Resultados: la mayor proporción de los sujetos presentó estado nutricional normal (72%) y el 80% presentó riesgo cardiovascular promedio. Se encontraron diferencias significativas entre los tres métodos al estimar la ingesta en calorías, proteínas y lípidos. La subestimación de calorías y lípidos disminuye del 32% al 25,8% al utilizar una imagen digital como apoyo a la estimación de ingesta y lípidos de 47% al 24,4%. Conclusiones: el registro complementado con imagen digital de las porciones consumidas presenta mejor concordancia con el método de referencia (RPP) en estimación de calorías, proteínas y lípidos, mejorando la precisión y exactitud del método.
Food Availability in Different Food Environments Surrounding Schools in a Vulnerable Urban Area of Santiago, Chile: Exploring Socioeconomic Determinants
(2022) Pinheiro Fernandes, Anna; Quintiliano-Scarpelli, Daiana; Araneda Flores, Jacqueline; Álvarez, Claudio; Suárez-Reyes, Mónica; Palacios, José Luis; Pizarro Quevedo, Tito; Marques de Oliveira, Maria Rita
The analysis of the food environment is used to identify areas with gaps in the availability of healthy foods and can be used as a public policy assessment tool. In recent decades, Chile has implemented several strategies and regulations to improve food environments, with encouraging results. Little is known about the scope of these measures in socially vulnerable environments. This study is part of a project that seeks to build an integrated intervention model for healthy school environments in a vulnerable area of Santiago, Chile. The objective of this study was to evaluate the availability of healthy and unhealthy foods around schools and the relationship between it and socioeconomic determinants of the school community in the Chilean context. A cross-sectional study to measure the food environment of informal markets (street food), formal markets (stores), and institutions (schools) was conducted in and around 12 schools (100 m surrounding schools) in a vulnerable urban area of Santiago, Chile. A lack of healthy foods was observed, which was related to some socio-economic determinants and the multidimensional poverty was the most relevant. The diagnosis of food environments around schools can represent an important target for governments to implement policies focused at improving the availability of healthy foods.
Food insecurity and its determinants in a vulnerable area of Santiago, Chile
(2022) Pinheiro Fernandes, Anna; Quintiliano, Daiana; Araneda, Jacqueline; De Oliveira, Rogerio; Pizarro, Tito; Suarez, Mónica; Marques, Maria
This study aims to identify the determinants associated to food insecurity in a group of households composed of schoolchildren and their mothers/caregivers, who lived in a low-to-medium community development index area of the city of Santiago, Chile with a high presence of migrant population. The non-probabilistic and convenience sample was made up of 646 people, who answered a series of surveys with the aim of characterizing this group in sociodemographic terms (sex, age, number of inhabitants in the household, place of food purchase, conditional or non-conditional state transfer program beneficiary status, persons in charge of purchasing food for the household, mothers/caregivers education level and basic knowledge of food and nutrition). To assess moderate-to-severe food insecurity and severe food insecurity, the Food Insecurity Experience Scale-FIES was applied between September and October 2021. Logistic regression analysis were used to carry out multivariate analyses, with the use of stepwise back-and-forward strategies for the selected variables and defining p < 0.05. These models were adjusted per number of inhabitants in the household. The results indicate that 25.4% of households presented moderate-to-severe food insecurity, and 6.4% severe food insecurity experience. The variables that presented significant odds of risk to food insecurity were being a migrant, low maternal education level, low performance on basic knowledge in nutrition and when the father was responsible for food purchases. Several public policies have been implemented in Chile during the most recent decades aimed at increasing access to healthier foods and the implementation of healthier food environments. Despite this, there are still social and economic health determinants that contribute to the risk of odds insecurity for the most vulnerable groups in the country, thus putting at risk the fulfillment of the human right to adequate food at risk.
Hábitos alimentarios y estado nutricional de niños y niñas que asisten a las Escuelas Deportivas Integrales del Instituto Nacional de Deporte, Región de Ñuble
(2020) Castillo, Pamela; Araneda, Jacqueline; Pinheiro Fernandes, Anna
La malnutrición por exceso se ha convertido en un problema de salud pública a través de todo el ciclo vital. El objetivo del estudio fue analizar los hábitos alimentarios y el estado nutricional de niños y niñas que asisten a las Escuelas Deportivas Integrales (EDI) del Instituto Nacional de Deporte en la comuna de Chillán. Se realizó evaluación antropométrica y aplicación de encuesta sobre hábitos alimentarios, que permitía medir alimentos consumidos de manera diaria, semanal y mensual de: frutas, verduras, lácteos, agua, carne, pescado, legumbres, golosinas dulces y saladas, productos fritos, comida rápida y embutidos. En los resultados, se confirma una alta prevalencia de malnutrición por exceso (58,7%). Para el cumplimiento de las Guías Alimentarias Basadas en Alimentos (GABAS) para la población chilena, se observó sólo un 59,2% en frutas, 71,4% para verduras, 13,8% en pescado, 39,3% en legumbres y 66,3% en lácteos. Diariamente, más del 65% consume golosinas dulces y/o saladas. Semanalmente, la comida rápida y productos fritos se ingieren en un 66% y 79% respectivamente. Se sugiere la necesidad de realizar intervenciones multidisciplinarias de prevención y promoción de la salud, orientadas a mejorar estilos de vida saludables en la población infantil y así contribuir a disminuir los índices de morbilidad infantil.
Impacto de los mensajes frontales de advertencia en el patrón de compra de alimentos en Chile
(2021) Quintiliano-Scarpelli, Daiana; Gomes Ramires, Tatiana; Araneda Flores, Jacqueline; Pinheiro Fernandes, Anna
.Objetivo: analizar el impacto de los mensajes frontales de advertencia (MFA) en los patrones de compra de alimentos de familias chilenas con menores de 14 años después de la ley que regula el etiquetado nutricional en Chile. Métodos: estudio transversal que entrevistó a 468 apoderados de 11 establecimientos educacionales de Santiago. La encuesta pesquisó la percepción de los apoderados con respecto a los MFA, los patrones de compra y la influencia de los hijos en la compra de los alimentos adquiridos por la familia. Resultados: la madre es principalmente la responsable de las compras de alimentos del hogar (62.0 %). Los apoderados con escolaridad más alta presentaron mayor conocimiento de la regulación ((p < 0,05). El 66,3 % no consideraban la información presente en el rótulo antes de la ley. El MFA considerado más importante fue “Alto en azúcares” (18,0 %). El 49,5 % dejaron de comprar algún alimento debido a la presencia de MFA. El 75,0 % de los apoderados indicó que sus hijos los acompañan en el momento de la compra. Se observó una menor probabilidad de cambio en el patrón de compra de alimentos en las familias que no consideraban importante los MFA (OR: 5,85; p < 0,001), que no entendían los MFA (OR: 2,99; p = 0,020), que no tenían el hábito de leer el etiquetado antes de la ley (OR: 2,63; p < 0,001) y en las que el niño solicitaba algún alimento en el momento de la compra (OR: 2,91; p = 0,009). Conclusión: los factores asociados a la compra de alimentos con MFA fueron: no considerarlos importante, no entenderlos, no tener el hábito de leer el etiquetado y la solicitud de alimentos por los hijos en el momento de la compra.
Ingesta de alimentos proteicos en adolescentes de la ciudad de Chillán, Chile
(2019) Araneda, Jacqueline; González, Daniela; Mella, Viviana; Pérez, Karen; Quezada, Gladys; Pinheiro Fernandes, Anna
El objetivo del estudio fue analizar la ingesta de alimentos proteicos distintos de los lácteos y sus derivados, en adolescentes que asisten a un establecimiento educacional subvencionado en la comuna de Chillán. Se realizó un estudio analítico de corte transversal, con una muestra de 154 adolescentes de edades entre 14 y 17 años. Se evaluó estado nutricional según IMC e ingesta alimentaria mediante encuesta de frecuencia de consumo cuantificado, con énfasis en la ingesta de alimentos de origen proteico distinto de los lácteos. El 90% de los encuestados, independiente del sexo, consumió semanalmente legumbres, carnes, pescados y mariscos. Las medianas de consumo de carnes, alcanzó los 275 g en hombres y 191 g en mujeres (p<0,01). Los hombres consumieron 1,5 veces más embutidos que las mujeres (148 g v/s 89 g; p=0,02). Al comparar la ingesta de los alimentos proteicos estudiados, con la Guía Alimentaria para los adolescentes, el 60% presentó un bajo cumplimiento de ingesta semanal en carnes, huevos, pescados y mariscos, por lo que es imperativo implementar estrategias tendientes a mejorar el consumo de alimentos con proteínas de alto valor biológico que les permitan un adecuado desarrollo.
Inseguridad alimentaria y hábitos alimentarios durante la pandemia de COVID-19 en hogares chilenos
(2021) Araneda, Jacqueline; Pinheiro Fernandes, Anna
Background: The coronavirus 2 pandemic (COVID-19) has caused intense changes in lifestyles, feeding, and nutrition habits. Aim: To analyze food insecurity and eating habits during the period of quarantine in a group of Chilean individuals. Material and Methods: An online survey was conducted in 2,767 households with questions about the sociodemographic composition of the household, household food purchasing habits in the quarantine period for COVID-19, and perception of food insecurity. Results: More than 60% of households (p < 0.01) were worried about not having enough food, especially when children under 18 years of age lived in them. This perception increased in urban households (p<0.01) and those located in the Central-Southern and Southern regions (p < 0.01). During the pandemic, the consumption of healthy products such as milk increased in 50% of households, legumes in 72%, eggs in 79%, fruits in 54%, vegetables in 67% and water in 81%. There was also a lower consumption of unhealthy and ultra-processed foods such as hot-dogs in 90% of households, sausages in 73%, sugary drinks in 79% and ice cream in 83%. Conclusions: The COVID-19 pandemic in Chile increased the perception of food insecurity in households with vulnerable conditions. However, the consumption of healthier foods increased.
Lifestyle Habits and Health Indicators in Migrants and Native Schoolchildren in Chile
(2021) Suárez-Reyes, Mónica; Pinheiro Fernandes, Anna; Cofré-Bolados, Cristian; Pizarro, Tito; Quintiliano-Scarpelli, Daiana
In Chile, the migrant population has increased in the last years. Migrants adopt behaviors of this new culture, which can have an effect on their health. Contradictory results regarding differences between migrant and native children have been reported. The aim of this study was to explore the associations between nationality with health indicator and lifestyle habits among schoolchildren in Chile. A cross-sectional and observational study with a non-probabilistic sample was conducted in 1033 children (86.4% Chilean and 13.6% migrant) from second to fourth grade of seven public schools from low-income municipalities from the Metropolitan Region, Chile. Anthropometric measurements (weight, height, waist circumference, triceps and subscapular folds), handgrip strength, and standing long jump measurements, physical activity, self-esteem and food guidelines accomplishments were determined. Migrant children presented lower body mass index (BMI), Z-BMI, body fat% and waist circumference values; and higher handgrip strength, standing long jump, and more satisfactory compliance with food guidelines than natives (p < 0.05). No significant difference for physical activity and self-esteem was observed. In the adjusted models, migrants presented lower odds for overweight/obesity, risk of abdominal obesity, low handgrip strength and unsatisfactory food guidelines accomplishment in all models (p < 0.05). The nutritional and muscular fitness of migrant children was better than that of the Chilean ones.
Manual de evaluación nutricional :
(Universidad del Desarrollo. Facultad de Medicina. Escuela de Nutrición, 2018) Pinheiro Fernandes, Anna; Quintiliano-Scarpelli, Daiana; Masferrer Riquelme, Dominique Andrea
Nutrient declaration after the food labeling and advertising law in Chile: A Longitudinal Approach
(Facultad de Medicina, Clínica Alemana Universidad del Desarrollo,, 2020) Quintiliano-Scarpelli, Daiana; Pinheiro Fernandes, Anna; Rodríguez, Lorena; Pizarro, Tito
Chile has implemented several strategies to decrease the burden of obesity and chronic diseases. The Food Labeling and Advertising Law (Law 20.606) requires a front-of-package "high in" warning label when energy and nutrients of concern (ENC) (total sugar, saturated fats, sodium) exceed established limits. This study aims to evaluate the impact of Law 20.606 on the ENC declaration of packaged foods in Chile, before and after the law implementation. We analyzed food nutritional labeling declarations from 70% of the most consumed packaged foods in Chile. Data collection was conducted in 2013 and 2019 in Santiago. Pictures from all sides of the package were taken from 476 products, classified into 16 food groups. All food groups had changes in the ENC declaration during the study period. Total sugar content showed the highest reduction (-15.0%; p = 0.001). Dairy, confitures and similar and sugary beverages had the greatest reduction in energy and total sugar content (p < 0.01). Energy, total sugar and sodium front of package "high in" simulation was significantly reduced in dairy, sugary beverages, flour-based foods, confitures and similar, fish and seafoods, fats and oils, spices, condiments and sauces and sugars (p < 0.05). We observed that companies reformulated products to adapt to the new regulation.
Propuesta de un modelo de planificaciones docentes en las asignaturas Lenguaje y Comunicación, Matemáticas, Historia, Geografía y Ciencias sociales, segundo a quinto básico. Alimentos, nutrición y actividad física
(2022) Pinheiro Fernandes, Anna; Salas, Trinidad; Scarpelli, Daiana; Suárez, Mónica; Soto, María; Grez, Francesca; López, Ana; Ríos, Trinidad
En cada una de las asignaturas entre 2° a 5° básico, encontrarán modelos de actividades orientadas a promover estilos de vida saludables con un enfoque creativo, innovador y muy fácil de realizar en las aulas de los establecimientos educacionales de Chile. En cada actividad podrán visibilizar el objetivo pedagógico y la base curricular que le corresponde, así como la información necesaria para realizar en forma completa cada sesión con su respectivo contenido a desarrollar. La comunidad educativa, integrada por Profesores, Facilitadores de la educación, Estudiantes y Apoderados, irán progresivamente adquiriendo y experimentando nuevos conocimientos temáticos de las asignaturas y asimismo incorporando la experiencia de conocer, entender y sumarse a la alimentación saludable y a la práctica del ejercicio como hábitos de vida y base del bienestar individual y comunitario. Utilizarán las matemáticas, el lenguaje, el conocimiento de la historia, la geografía y las ciencias sociales para alimentarse y moverse, como asimismo experimentarán el bienestar derivado de la vida sana.

Browsing by Author "Pinheiro Fernandes, Anna"

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