Ricardo Uauy

Nevin Stewart Scrimshaw passed away peacefully 8 February 2013, having celebrated his 95th birthday only 2 wk earlier. Globally recognized as the Dean of International Nutritional Science and Policy, he held a PhD in biochemistry from Harvard University (1941), an MD from the University of Rochester (1945), and an MPH from the Harvard School of Public Health (HSPH⁶; 1959). A Fellow of the ASN, Nevin accumulated awards from the Society in each of its 3 domains of basic, medical, and international contributions, these in parallel to his respective academic degrees. On a broader stage, he was elected to the US National Academy of Science and to the Institute of Medicine, he won the World Hunger Prize in 1991, and he received the Prince Mahidol Award, and a knighthood, from the kingdom of Thailand in 2004.

Community acquired pneumonia (CAP) has a high mortality rate among older people. To increase its treatment efficiency, the Chilean Ministry of Health elaborated a clinical management guideline for CAP. To assess the degree of compliance with the clinical guidelines for CAP among professionals working at primary health care centers. A follow up of a cohort of 2,797 subjects aged 67 years or more, incorporated to a clinical study. All cases of bronchopneumonia or pneumonia diagnosed at primary health care centers between September 2005 and June 2008 were recorded. During the follow up period, 192 cases of CAP were diagnosed. A chest X-ray was requested in 81% of cases and a confirmation consultation was done in 58%. Amoxicillin/ Clavulanic acid was the most common antimicrobial prescription in 61% of cases, followed by Clarithromycin in 17% and Amoxicillin in 12%. The antimicrobial used was not registered in 5% of cases. The clinical guidelines improve the efficiency of CAP treatment and decrease complications. However, these guidelines must been complemented with an adequate training and supervision of health care teams.

Chile has experienced the nutritional transition due to both social and economic progress. As a consequence, higher rates of overweight and obesity have been observed in children. In western countries, researchers have tried to determine pathways by which parents influence their children's eating behavior; up to now findings have been inconsistent. The objective of this study was to evaluate the cross-sectional and retrospective relationship between maternal attitudes and child-feeding practices and children's weight status in children who had been subject of an obesity prevention intervention for two years. In 2006, for a cross-sectional study, a random sample of 232 children (125 girls, mean age 11.91 ± 1.56 y and 107 boys mean age 11.98 ± 1.51 y) was selected from three primary schools from a small city called Casablanca. Weight and height were determined to assess their nutritional status, using body mass index (BMI) z scores. Child-feeding practices and attitudes were determined cross-sectionally in 2006, using the Child Feeding Questionnaire (CFQ). To analyze the relationship between trends in weight change and child-feeding practices and attitudes, BMI z scores of all the 232 children in 2003 were used. Cross-sectionally, mothers of overweight children were significantly more concerned (P < 0.01) about their child's weight. Mothers of normal weight sons used significantly more pressure to eat (P < 0.05). Only in boys, the BMI z score was positively correlated with concern for child's weight (r = 0.28, P < 0.05) and negatively with pressure to eat (r = -0.21, P < 0.05). Retrospectively, the change in BMI z score between age 9 and 12 was positively correlated with concern for child's weight, but only in boys (r = 0.21, P < 0.05). Perceived child weight and concern for child's weight, explained 37% in boys and 45% in girls of the variance in BMI z score at age 12. Mothers of overweight children were more concerned with their children's weight; this indicated the Western negative attitude towards childhood overweight. None of the child-feeding practices were significantly correlated with a change in BMI z score.

A century ago, dietary fat was mainly seen as a source of energy. In 1929, George and Mildred Burr introduced the concept of essential fats: certain fats, i.e. linoleic acid and α-linolenic acid, need to be provided by the diet to prevent deficiencies. Although essential fats were initially considered of marginal nutritional importance for humans, clinical deficiency symptoms were recorded for the first time in the 1960s. Beyond the fact that essential fats can prevent deficiencies, research over the past decades has shown that they also play a major role in preventing chronic conditions such as cardiovascular diseases. This has resulted in an increased interest in the quality of the dietary lipid supply as a major determinant of long-term health and well-being, which is also reflected in recent diet guidelines. This paper will give an overview of key aspects of present recommendations on dietary fats.

A better understanding of the link between eating behavior and maternal feeding practices with childhood and maternal weight status is of great interest. To assess the association between childhood anthropometric measures with mothers' Body Mass Index (BMI) and their feeding practices toward preschool children in Chile. 1029 children (504 boys, 4.3 ± 0.3 years) and their mothers were selected from public nurseries located in low income neighborhoods in Santiago. Mothers' BMI, children's BMI and waist-to-height ratios were registered. Maternal feeding practices towards their children's nutritional habits were measured using an adapted version of the Child Feeding Questionnaire (CFQ). We found a direct correlation (p < 0.001) between children's BMI z-score and their mothers' BMI, both in boys (Spearman rho = 0.26) and girls (rho = 0.30). A direct association was also found between children's BMI z-score with scores of the subscale "concern for child's weight" (Spearman rho = 0.26 in boys and rho = 0.37 in girls; p < 0.001) and "food restriction" (rho = 0.19 in boys and rho = 0.27 in girls; p < 0.001). A reverse significant association was found between children's BMI z-score with scores of "pressure to eat" (rho = -0.30 in boys and rho = -0.36 in girls; p < 0.001). Analyses of the combined categories of childhood obesity and/or maternal obesity showed an important influence of children's weight status on CFQ scores. Mothers' BMI and children's BMI z-scores are highly correlated. We found significant associations between mothers' behaviour subscales and children's BMI z-score. It is not possible to establish a causal link between mother's CFQ scores and children's nutritional status, given the cross-sectional nature of this study and the bidirectional influences that exist between mothers and their children.