There is an increasing interest in having validated instruments that can classify food environments due to their influence on eating behavior and nutritional status. In Chile, it is not known how people perceive food environments and only a few studies have adapted instruments to the Chilean context, all of which use objective measures. The aim of this study is to present the adaptation and validation of the Perceived Nutrition Environment Measures Survey (NEMS-P-Ch) for Chile using a cross-sectional, non-probability study. First, the NEMS-P was adapted in 3 stages: cultural translation and adaptation, expert judgment (focus groups), and cognitive interviews with a population similar to the target audience. Then, the adapted questionnaire (NEMS-P for Chile, NEMS-P-Ch) was tested on people responsible for buying food in their homes in the Metropolitan Region, Chile, for statistical validation. After 200 people completed the questionnaire a final version of the NEMS-P-Ch was generated with 48 questions and seven sections that measure food environments: home, food supply, restaurants and street. NEMS-P-Ch had acceptable reliability in more than half of the questions analyzed, with Cronbach's alpha values between 0.44 and 0.82. Acceptable values were also obtained for most of the questions when the consistency of the instrument was evaluated after applying it for the second time (n= 167). The NEMS-P-Ch adapted to the Chilean context showed acceptable validity and reliability. Having instruments adapted and validated to the national reality will promote their use and adaptation in other countries of the region and thus deepen the study of food environments in various territories and populations.

Introduction In Chile, there is a high prevalence of obesity, and most people have an inadequate quality of food. Food environments can constitute barriers that prevent healthy food choices and lead to overweight and obesity, as well as diet-related non-communicable diseases. There are international instruments that allow the characterization of food environments. In Chile, there are no studies on the perception of food environments. This study aimed to characterize the perception of obesogenicity of food environments in the urban Chilean population using an instrument previously validated in Chile. Methods This is a cross-sectional study with probabilistic sampling. The "Perceived Nutrition Environment Measures Survey", based on the Chilean model of food environments, was applied to 256 participants from two urban communities of the Metropolitan Region. Scores were calculated for the instrument items, which allowed calculating scores by environments included in the Chilean model of Food Environments. Negative scores were related to a higher obesogenic level. Results The results show that the domestic food environment is perceived as less obesogenic (median of 15.8 points), with more than 90% of households having fruits, vegetables, and legumes, even though the supply food environment was negative (median -0.19 points). However, about 50% of households had ultra-processed foods. The street food environment was perceived as the most obesogenic (median -1.91 points), with more than 60% of the participants indicating difficulty finding healthy options. Conclusions According to the level of obesogenicity of the environments studied, it is necessary to have public policies that improve them and ensure the availability and physical and economic access to healthy food, particularly in the food supply and public road environments.

La migración internacional ha aumentado exponencialmente en Chile, lo que ha representado un desafío para el sistema de salud. El presente estudio transversal exploratorio, de metodología cualitativa y abordaje multidisciplinario, busca describir barreras y dificultades en la consulta nutricional a personas migradas, desde la perspectiva de profesionales nutricionistas de los centros de salud familiar de una comuna de la Región Metropolitana; dada la relevancia de la Atención Primaria en el sistema de salud nacional, y la particularidad de la alimentación, que conjuga valores nutricionales relacionadas con la salud, así como aspectos simbólicos significativos para las personas, posicionando a las nutricionistas en un escenario donde buscan mantener un estado nutricional óptimo en una población culturalmente diferente. Se realizaron once entrevistas a nutricionistas, las cuales fueron codificadas y analizadas temáticamente, identificando cuatro ejes narrativos de barreras y dificultades: escasez de recursos en la atención de una demanda poblacional creciente, problemas lingüísticos de comunicación (idiomáticos y dialectales), desconocimiento del funcionamiento del sistema sanitario chileno por parte de los/las usuarios/as migrados/as, y divergencia de prácticas y concepciones sanitarias entre migrados/as y nutricionistas. Del estudio se concluye que la atención nutricional con el usuario/a migrante internacional es compleja y se debe considerar abordar los temas antes mencionados al momento de generar respuestas institucionales de atención, programas y políticas enfocadas en la atención al usuario/a migrante internacional, de manera de lograr una promoción auténtica y pertinente de hábitos alimentarios saludables y el mantenimiento del Efecto Migrante Sano.

Background: Food environments are crucial for promoting healthy and sustainable eating and preventing obesity. However, existing food environment frameworks assume an already installed causality and do not explain how associations in food environments are established or articulated, especially from an integrative and transdisciplinary approach. This research attempts to bridge these gaps through the use of Actor-Network Theory, which traces the relationship network between human (and nonhuman) actors in order to describe how these interact and what agencies (direct or remote) are involved. Objective: This study aims to explain the practices and interactions of actors in food environments in order to approach the problem of unhealthy eating with a transdisciplinary approach. Methods: This is a nonexperimental, cross-sectional study. Due to the complexity of the study phenomena, a mixed methods approach with 4 consecutive phases will be developed in Chile. Phase 1 involves a systematic literature review of food environment evidence since 2015, following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocol; phase 2 involves the application of a shortened version of the Nutrition Environment Measure Scale—Perceptions adapted to Chile (NEMS-P-Ch) in 2 neighborhoods with different socioeconomic levels; in phase 3, six focus groups in each neighborhood will be conducted to address social determinants such as gender, employment status, and migration; and in phase 4, participant observation and in-depth interviews will be used to analyze the direct and empirical exploration of the actors in their daily interaction with food environments. The triangulation and complementarity of the data will allow us to create a practical model about the practices and interactions of actors in their food environments, which reflects the complexity and transdisciplinary nature of the study. Results: We have advanced in phases 1-3 of the study. In phase 1, a total of 109 manuscripts are being revised for data extraction. In phase 2, we applied the NEMS-P-Ch to 785 people, 49.4% (388/785) of whom belong to a low socioeconomic neighborhood. Participants from phase 2 are being contacted to participate in the focus groups (phase 3). By the end of July, we have conducted 6 focus groups with 5-11 participants. Conclusions: This study will provide a comprehensive understanding of how individuals interact with their food environments, offering deep insights into the factors influencing their food-related decisions. In addition, the study aims to develop a model that more accurately reflects reality by examining not only the food environments themselves but also the interactions among various stakeholders within these environments and their daily practices. The findings of this study will offer evidence-based insights to inform public policies tailored to the specific territories and communities under investigation or those with similar characteristics. International Registered Report Identifier (IRRID): DERR1-10.2196/62765

Background/Objectives: Addressing the global syndemic of obesity, undernutrition, and climate change requires a shift toward healthy and sustainable diets. This study examines the feasibility and cost implications of implementing a Healthy and Sustainable Basic Food Basket in Chile that aligns with the EAT–Lancet diet recommendations, through its comparison with the current Basic Food Basket used for the poverty line definition. Methods: The Healthy and Sustainable Basic Food Basket was constructed based on the EAT–Lancet dietary model and was uniquely adapted to reflect the observed consumption patterns of Chile’s lowest income quintile, allowing for a more realistic affordability assessment for vulnerable populations. Food prices from the National Institute of Statistics were analyzed over a 10-year period (2014–2023). Results: This study found that the Healthy and Sustainable Basic Food Basket provides 2001 kcal per day with a balanced macronutrient distribution. However, its average cost was 13.9% higher than the Basic Food Basket, posing a significant economic barrier for low-income populations. The cost gap varied seasonally, peaking in October (21.1% higher) and narrowing in December (4.6% higher). Long-term trends showed increasing costs for both baskets, with the Healthy and Sustainable Basic Food Basket reaching its highest price in 2023, further limiting affordability. Conclusions: These findings highlight the limitations of current poverty measurement frameworks in Chile, which prioritize caloric sufficiency over nutritional quality and sustainability. This suggests a need for policy revisions to incorporate the cost of healthy and sustainable diets into poverty assessments and social protection programs. Key policy recommendations include promoting healthier diets and improved food nutrition, supporting low-carbon foods, regulating local food production and supply systems, and encouraging seasonal, local consumption. This study underscores the need for structural interventions to ensure equitable access to sustainable diets, addressing both public health and environmental concerns.

Obesogenic food environments disproportionately affect low-socioeconomic-status (LSE) populations. Since 2016, Chile has categorized food environments into five domains: home, supply, street, organizational, and restaurant. However, no study has simultaneously assessed all five domains or compared their obesogenic levels across socioeconomic statuses. This study compared the obesogenicity of the five food environments in two neighborhoods in Chile with different socioeconomic statuses. A cross-sectional design was employed, enrolling adults aged 18 or older who were responsible for household food shopping. Participants were randomly selected within neighborhoods and completed the shortened Chilean version of the NEMS-P. Weighted scores, divided into quintiles, assessed obesogenicity, with lower scores indicating more obesogenic environments. There were 388 participants from an LSE neighborhood and 397 from a high-socioeconomic-status (HSE) neighborhood. Perceptions of the home and supply environments differed significantly. The HSE neighborhood had a higher median score for the home environment (8.3 vs. 6.9, p = 0.0007), with 23.2 % of participants in the highest quintile, compared to 23.7 % and 23.5 % of LSE participants in the lowest quintiles. For the supply environment, the HSE neighborhood scored higher (5.8 vs. 2.2, p = 0.0001), with over 50 % of HSE participants in higher quintiles versus 52.8 % of LSE participants in lower ones. The LSE neighborhood exhibited more obesogenic food environments. These findings underscore the urgent need for public policies to transform food environments to reduce disparities in healthy food availability and access, particularly for vulnerable populations.