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Vacarezza C, Araneda J, Gonzalez P, Arteaga O, Marcelain K, Castellon EA, Periera A, Khoury M, Müller B, Lecaros JA, Salas SP, Riquelme A, Corvalan AH, de la Jara JJ, Ferreccio C, Goic C, Nervi B, Roa JC, Owen GI. A snapshot of cancer in Chile II: an update on research, strategies and analytical frameworks for equity, innovation and national development. Biol Res 2024; 57:95. [PMID: 39696714 DOI: 10.1186/s40659-024-00574-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Accepted: 11/18/2024] [Indexed: 12/20/2024] Open
Abstract
INTRODUCTION Chile has achieved developed nation status and boasts a life expectancy of 81 + years; however, the healthcare and research systems are unprepared for the social and economic burden of cancer. One decade ago, the authors put forward a comprehensive analysis of cancer infrastructure, together with a series of suggestions on research orientated political policy. OBJECTIVES Provide an update and comment on policy, infrastructure, gender equality, stakeholder participation and new challenges in national oncology. Assess the funding and distribution of cancer investigation. Present actions for the development of oncology research, innovation and patient care. METHODS Triangulating objective system metrics of economic, epidemiological, private and public sector resources together with policy analysis, we assessed cancer burden, infrastructure, and investigation. We analyzed governmental and private-sector cancer databases, complemented by interviews with cancer stakeholders. RESULTS Governmental policy and patient advocacy have led to the recognition of cancer burden, a cancer law, and a national cancer plan. Cancer has become the leading cause of death in Chile (59,876 cases and 31,440 cancer deaths in 2022), yet only 0.36% gross domestic product (GDP) is directed to research and development. Inequalities in treatment regimens persist. Prevention policy has lowered tobacco consumption, sugar intake via soft drinks and offered a high coverage of HPV vaccines. A high-quality cancer research community is expanding, and internationally sponsored clinical oncology trials are increasing. CONCLUSIONS The cancer law has facilitated advancement in policy. Prevention policies have impacted tobacco and sugar intake, while gender equality and care inequality have entered the public forum. Cancer research is stagnated by the lack of investment. Implementation of a cancer registry and biobanking, reinforcement of prevention strategies, development of human resources, promotion of clinical trial infrastructure and investment in new technologies must be placed as a priority to permit advancements in innovation and equitable cancer care.
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Affiliation(s)
- Cristóbal Vacarezza
- Medical Public Health Residency Program, School of Public Health Dr. Salvador Allende, Faculty of Medicine, Universidad de Chile, Independencia 939, Santiago, Chile
- Servicio de Salud del Reloncavi, Esmeralda 269, Puerto Montt, Chile
| | - Julieta Araneda
- Public Health Program, School of Public Health Dr. Salvador Allende, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Faculty of Health and Odontology, Universidad Diego Portales, Santiago, Chile
| | - Pamela Gonzalez
- Faculty of Biological Sciences, Pontificia Universidad Católica de Chile, Alameda 340, 8331150, Santiago, Chile
- Millennium Institute on Immunology and Immunotherapy, 8331150, Santiago, Chile
| | - Oscar Arteaga
- School of Public Health Dr. Salvador Allende, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Center for Cancer Prevention and Control (FONDAP-CECAN), Pontificia Universidad Católica de Chile and Universidad de Chile, Santiago, Chile
| | - Katherine Marcelain
- Center for Cancer Prevention and Control (FONDAP-CECAN), Pontificia Universidad Católica de Chile and Universidad de Chile, Santiago, Chile
- Department Basic and Clinical Oncology, Faculty of Medicine, Universidad de Chile University of Chile, Santiago, Chile
| | - Enrique A Castellon
- Center for Cancer Prevention and Control (FONDAP-CECAN), Pontificia Universidad Católica de Chile and Universidad de Chile, Santiago, Chile
- Department Basic and Clinical Oncology, Faculty of Medicine, Universidad de Chile University of Chile, Santiago, Chile
| | - Ana Periera
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Maroun Khoury
- Laboratory of Nano-Regenerative Medicine, Faculty of Medicine, Universidad de Los Andes, Santiago, Chile
- IMPACT- Center of Interventional Medicine for Precision and Advanced Cellular Therapy, Universidad de Los Andes, Santiago, Chile
| | - Bettina Müller
- Center for Cancer Prevention and Control (FONDAP-CECAN), Pontificia Universidad Católica de Chile and Universidad de Chile, Santiago, Chile
- Center for Bioethics, Faculty of Medicine, Clinica Alemana, Universidad del Desarrollo Santiago, Santiago, Chile
- Chilean Cooperative Group for Oncological Research (GOCCHI), Santiago, Chile
- National Cancer Institute, Santiago, Chile
| | - Juan Alberto Lecaros
- Bioethics and Law Observatory, Institute of Sciences and Innovation in Medicine, Universidad del Desarrollo, Santiago, Chile
| | - Sofia P Salas
- Center for Bioethics, Faculty of Medicine, Clinica Alemana, Universidad del Desarrollo Santiago, Santiago, Chile
| | - Arnoldo Riquelme
- Center for Cancer Prevention and Control (FONDAP-CECAN), Pontificia Universidad Católica de Chile and Universidad de Chile, Santiago, Chile
- Department of Gastroenterology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Alejandro H Corvalan
- Department of Hematology and Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Advanced Center for Chronic Diseases (FONDAP-ACCDiS), Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jorge Jiménez de la Jara
- Center for Cancer Prevention and Control (FONDAP-CECAN), Pontificia Universidad Católica de Chile and Universidad de Chile, Santiago, Chile
- School of Public Health, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Catterina Ferreccio
- Center for Cancer Prevention and Control (FONDAP-CECAN), Pontificia Universidad Católica de Chile and Universidad de Chile, Santiago, Chile
- School of Public Health, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Carolina Goic
- Center for Cancer Prevention and Control (FONDAP-CECAN), Pontificia Universidad Católica de Chile and Universidad de Chile, Santiago, Chile
- Department of Hematology and Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- National Cancer Commission, Santiago, Chile
| | - Bruno Nervi
- Center for Cancer Prevention and Control (FONDAP-CECAN), Pontificia Universidad Católica de Chile and Universidad de Chile, Santiago, Chile
- Department of Hematology and Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- National Cancer Commission, Santiago, Chile
| | - Juan Carlos Roa
- Millennium Institute on Immunology and Immunotherapy, 8331150, Santiago, Chile
- Center for Cancer Prevention and Control (FONDAP-CECAN), Pontificia Universidad Católica de Chile and Universidad de Chile, Santiago, Chile
- National Cancer Commission, Santiago, Chile
- Department of Pathology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Gareth I Owen
- Faculty of Biological Sciences, Pontificia Universidad Católica de Chile, Alameda 340, 8331150, Santiago, Chile.
- Millennium Institute on Immunology and Immunotherapy, 8331150, Santiago, Chile.
- Center for Cancer Prevention and Control (FONDAP-CECAN), Pontificia Universidad Católica de Chile and Universidad de Chile, Santiago, Chile.
- Chilean Cooperative Group for Oncological Research (GOCCHI), Santiago, Chile.
- Department of Hematology and Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
- Advanced Center for Chronic Diseases (FONDAP-ACCDiS), Pontificia Universidad Católica de Chile, Santiago, Chile.
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Lopes de Andrade V, Pinto P. Fluctuations in Mediterranean Diet Adherence Pre- and Post-Pandemic: A Study of Portuguese Cohorts 2019-2024. Nutrients 2024; 16:3372. [PMID: 39408339 PMCID: PMC11478962 DOI: 10.3390/nu16193372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2024] [Revised: 09/30/2024] [Accepted: 10/01/2024] [Indexed: 10/20/2024] Open
Abstract
BACKGROUND/OBJECTIVES The Mediterranean Diet (MD) is a lifestyle offering numerous health benefits. Nevertheless, the adherence to the MD is moderate even in Mediterranean countries. While sociodemographic factors influence MD adherence, additional impacts occurred due to the COVID-19 pandemic. This cross-sectional longitudinal study with three cohorts of Portuguese adults analyzes MD adherence before, during, and after the COVID-19 pandemic, and explores the effect of sociodemographic variables. METHODS Sociodemographic factors, lifestyle habits, and MD adherence were assessed in the years 2019, 2021, and 2024 with an online self-filled questionnaire. MD adherence was measured with the Mediterranean Diet Adherence Screener (MEDAS). RESULTS MEDAS score increased significantly (p < 0.05) from 2019 to 2021 (6.2 ± 0.7 to 7.7 ± 0.1), followed by a significant (p < 0.05) decrease in 2024 (7.2 ± 0.1) relative to 2019, which was more pronounced in participants with higher income. Accordingly, a trend in healthier food choices was observed followed by a decline in 2024. Of note is the significant increase in red meat consumption (p < 0.05) in 2024 relative to 2021. Respondents who consumed more red meat were mostly men, employed, or in a stable relationship. Most respondents practiced sport "Never or occasionally" in 2019 and 2021 (59.4 and 55.2%, respectively); in 2024, this category was significantly (p < 0.05) reduced (40.9%); men or higher-income participants were more likely to meet the recommended activity levels. CONCLUSIONS This study reveals that the improvements in MD lifestyle during the pandemic were not sustained in 2024, as healthier habits formed during confinement were not fully integrated into long-term behavior. These findings strengthen the need for targeted public health interventions to promote the MD.
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Affiliation(s)
- Vanda Lopes de Andrade
- Agriculture School, Polytechnic University of Santarem, 2001-904 Santarem, Portugal;
- Research Centre for Natural Resources, Environment and Society (CERNAS), 2001-904 Santarem, Portugal
- Life Quality Research Centre (CIEQV), 2040-413 Rio Maior, Portugal
- Research Institute for Medicines (iMed. ULisboa), Faculty of Pharmacy, Universidade de Lisboa, 1649-003 Lisboa, Portugal
| | - Paula Pinto
- Agriculture School, Polytechnic University of Santarem, 2001-904 Santarem, Portugal;
- Research Centre for Natural Resources, Environment and Society (CERNAS), 2001-904 Santarem, Portugal
- Life Quality Research Centre (CIEQV), 2040-413 Rio Maior, Portugal
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Manninen S, Tilles-Tirkkonen T, Aittola K, Männikkö R, Karhunen L, Kolehmainen M, Schwab U, Lindström J, Lakka T, Pihlajamäki J. Associations of Lifestyle Patterns with Glucose and Lipid Metabolism in Finnish Adults at Increased Risk of Type 2 Diabetes. Mol Nutr Food Res 2024; 68:e2300338. [PMID: 38308150 DOI: 10.1002/mnfr.202300338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 10/18/2023] [Indexed: 02/04/2024]
Abstract
SCOPE Various lifestyle and sociodemographic factors have been associated with risk factors for type 2 diabetes (T2D). However, their combined associations with T2D risk factors have been studied much less. MATERIALS AND RESULTS This study investigates cross-sectional associations of lifestyle patterns with T2D risk factors among 2925 adults at increased risk participating in the Stop Diabetes study. Lifestyle patterns are determined using principal component analysis (PCA) with several lifestyle and sociodemographic factors. The associations of lifestyle patterns with measures of glucose and lipid metabolism and serum metabolites analyzed by nuclear magnetic resonance (NMR) spectroscopy are studied using linear regression analysis. "Healthy eating" pattern is associated with better glucose and insulin metabolism, more favorable lipoprotein and fatty acid profiles and lower serum concentrations of metabolites related to inflammation, insulin resistance, and T2D. "High socioeconomic status and low physical activity" pattern is associated with increased serum concentrations of branched-chain amino acids, as are "Meat and poultry" and "Sleeping hours" patterns. "Snacks" pattern is associated with lower serum concentrations of ketone bodies. CONCLUSIONS Our results show, in large scale primary care setting, that healthy eating is associated with better glucose and lipid metabolism and reveal novel associations of lifestyle patterns with metabolites related to glucose metabolism.
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Affiliation(s)
- Suvi Manninen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, 70211, Finland
| | - Tanja Tilles-Tirkkonen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, 70211, Finland
| | - Kirsikka Aittola
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, 70211, Finland
| | - Reija Männikkö
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, 70211, Finland
| | - Leila Karhunen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, 70211, Finland
| | - Marjukka Kolehmainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, 70211, Finland
| | - Ursula Schwab
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, 70211, Finland
- Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, KYS, 70029, Finland
| | - Jaana Lindström
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, 00271, Finland
| | - Timo Lakka
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, 70211, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, KYS, 70029, Finland
- Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, 70100, Finland
| | - Jussi Pihlajamäki
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, 70211, Finland
- Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, KYS, 70029, Finland
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