Revista de la Facultad de Medicina Humana <p><span id="result_box" class="" lang="en" tabindex="-1"><span class=""><span style="vertical-align: inherit;"><span style="vertical-align: inherit;">The "Revista de la Facultad de Medicina Humana" of the Ricardo Palma University (Rev. Fac. Med. Hum.) is the organ of scientific diffusion of the faculty and a publication for the medical community as a whole. This comunity includes students, graduates, academics, researchers and national and international institutions. It covers current issues, with original and unpublished articles, related to the various specialties of the biomedical and Public Health area.</span></span></span></span></p> Universidad Ricardo Palma en-US Revista de la Facultad de Medicina Humana 1814-5469 <center> <p style="text-align: center;"><a href="" rel="license"><img style="border-width: 0;" src="" alt="Licencia Creative Commons"></a></p> <p><strong>This work is under a&nbsp;<a href="" rel="license">Creative Commons license Attribution 4.0 International (CC BY 4.0)</a>.</strong></p> </center> Lifestyle Medicine in Latin America <p>It is a pleasure to start the year 2022 with the special edition of the first issue of our journal dedicated to "Lifestyle Medicine in Latin America". The growth of this new medical discipline at a global level, considered as the seventh era of public health, with a level of scientific evidence that positions it as one of the areas of greatest production and publications at an international level. Only in PubMed there are more than 60 thousand indexed articles.</p> Jhony A. De La Cruz-Vargas Nahúm García Lujhon Flóres Gutiérrez Gabriel Lapman Fabiola Flores Monsivais Lucy E. Correa-Lopez Vania Assaly ##submission.copyrightStatement## 2021-12-27 2021-12-27 22 1 10.25176/RFMH.v22i1.4505 Lifestyle Medicine: The Time is Now <p>The time for lifestyle medicine is now. We need lifestyle medicine to help manage the ongoing outbreaks of lifestyle related chronic conditions like diabetes, obesity, dementia, and heart disease that continue to plague our world today, and we need lifestyle medicine to help handle the worldwide pandemic created by COVID-19.&nbsp; Mozafarrian and colleagues noted that among the 900,000 coronavirus disease hospitalizations in 2019 through November 18, 2020, 63.5% of them were estimated to be attributed to four cardiometabolic conditions:&nbsp; obesity, hypertension, diabetes, and heart failure.</p> Elizabet Frates David Katz ##submission.copyrightStatement## 2021-12-03 2021-12-03 22 1 10.25176/RFMH.v22i1.4390 Lifestyle Medicine: a field of medicine with deep roots and great potential for the future <p>Lifestyle Medicine - even though the term only recently started being broadly used – has its roots in ancient Greece, thousands of years ago. Hippocrates (460 – 370 B.C.) was the first one to use the term of Lifestyle Medicine, suggesting that in order for someone to have a good health, they should just “avoid eating excessive amounts of food and try to exercise even a bit”. So, he set the ground for what we call today, Lifestyle Medicine.</p> Ioannis Arkadianos ##submission.copyrightStatement## 2021-12-03 2021-12-03 22 1 10.25176/RFMH.v22i1.4389 The Future of the (European) Lifestyle Medicine Education <p>Since 2019 the European Lifestyle Medicine Organization (ELMO), in cooperation with the Belgian Lifestyle Medicine Organization, has offered an online English eight-week course, which issues a European Lifestyle Medicine Certificate (Certificate), after the participant passes a final exam. Almost 200 health professionals and others participated in this interactive European program, which offers a theoretical and especially practical skills to realistically implement lifestyle medicine principles.</p> Ioan Hanes ##submission.copyrightStatement## 2021-12-03 2021-12-03 22 1 10.25176/RFMH.v22i1.4388 Wellness application, effects, and evaluation from the cardiofood lifestyle program: a latin american experience <p><strong>Introduction:</strong>&nbsp;The changes in daily routines as a result of the mitigating measures implemented in the face of the COVID-19 pandemic represent a challenge for the Latin American population to preserve their general well-being.&nbsp;<strong>Objective:</strong>&nbsp;To evaluate the wellness assessment from the lifestyle medicine program Cardiofood Lifestyle in virtual modality in Latin American participants during the COVID-19 pandemic in 2020.&nbsp;<strong>Methods:</strong>&nbsp;Analytical, retrospective and descriptive study, with a quantitative approach; developed in virtual mode between May and December 2020. The population sample was 51 participants. A subjective assessment questionnaire and a self-authorship wellness score were applied and validated by a hypothesis test. The P value equal to zero is calculated.&nbsp;<strong>Results:</strong>&nbsp;Of 51 participants, 44 (86%) were women with a mean age of 45 and 7 (14%) were men with a mean age of 40 years. The mean of the evaluation test of the Cardiofood Lifestyle program was 4.71. 35 (68.62%) participants felt more energetic; 46 (90%) expressed feeling much more secure in choosing healthy foods; 36 (70.58%) felt much more lucid and 41 (80.40%) stated that they felt much healthier compared to the beginning of the program.&nbsp;<strong>Conclusions:</strong>&nbsp;There is a good subjective wellness assessment represented in Latin American participants of the Cardiofood Lifestyle medicine program in virtual mode during the COVID-19 pandemic in 2020, represented in better sensations of energy, lucidity, ability to make food choices and health.</p> Yael Alejandra Hasbani Gabriel H. Lapman Jonathan Eliel Hasbani ##submission.copyrightStatement## 2021-11-25 2021-11-25 22 1 10.25176/RFMH.v22i1.4118 Healthy lifestyle promotion and its effect on general practitioners at National Oncology Institute March – April 2021 <p><strong>Introduction:</strong>&nbsp;The medical population is considered a representation of integral health. Its work characteristics predispose each member to be complicit in an unconscious practice and promotion of an unhealthy lifestyle. The aim of this work was to describe the effects on lifestyle of an educational intervention in general practitioners in an active work environment.&nbsp;<strong>Methods:</strong>&nbsp;This study included 18 general practitioners working at the “Instituto Oncológico Nacional de Panamá”. It consisted of 10 virtual educational sessions delivered by trained professionals for 2 months.&nbsp;<strong>Results:</strong>&nbsp;Positive changes and improvement in all measured variables were reported, including increased frequency of exercise sessions, increased duration of each session, increased consumption of fruits, vegetables, legumes and seeds, increased hours of sleep, improvement in the perceived stress scale score and a decrease in the consumption of foods with low nutritional quality.&nbsp;<strong>Discussion:</strong>&nbsp;Truly little evidence exists regarding lifestyle promotion educational interventions aimed at health professionals. This population has a high predisposition to form a poor-quality lifestyle since the work environment in which the physician develops exposes him/her to adverse situations such as rotating schedules and long working hours with sleep deprivation.&nbsp;<strong>Conclusions:</strong>&nbsp;This practical and low-cost educational intervention achieved improvements in the lifestyle of physicians. For this reason, we recommend the replication of similar interventions and their documentation.</p> Irma A. Hernández Núñez Amin A. Valencia Leal ##submission.copyrightStatement## 2021-11-25 2021-11-25 22 1 10.25176/RFMH.v22i1.4123 Effects of two resistance exercise programs on the health-related fitness of obese women with pain symptoms in the knees <p><strong>Introduction:</strong>&nbsp;Overweight negatively impacts the cardiovascular system and osteomyoarticular, promoting pain in the joints of the lower limbs. Therefore, strategies have been applied to reduce overweight through lifestyle changes.&nbsp;<strong>Objective:</strong>&nbsp;to investigate the effects of two multidisciplinary intervention programs on the health-related physical fitness of obese women with pain symptoms in the knees.&nbsp;<strong>Methods:</strong>&nbsp;Women between 40 and 59 years of age with obesity (n=59) were evaluated in the pre- and post-intervention time regarding anthropometry, body composition, physical fitness, level of disability in the knee and hip, and health-related quality of life. A randomized clinical trial of parallel groups was conducted, using two resistance exercise programs and food re-education, for eight weeks. All participants received the same nutritional intervention content and for physical exercises were randomized into two groups, G1 being the "strength group" using machines (n=30), and G2 being the "functional training" group (n=29). Twenty-eight women (G1=18 + G2=10) were included in the final analyses. The groups and time were evaluated by two-way analysis of variance, with repeated measures. A p &lt; 0.05 was assumed for all analyses.&nbsp;<strong>Results:</strong>&nbsp;a time effect was identified, with higher values for maximum isometric lumbar-traction strength (MILTS), after the intervention period in both groups (p &lt; 0.05). However, for the other variables investigated, no significant differences were identified (p &gt; 0.05).&nbsp;<strong>Conclusion:</strong>&nbsp;The absence of significant results for all variables, except FIMTL, may be justified by the moderate adherence of the participants to interventions (~59% to 66%) since the study was conducted during the period of social isolation (COVID-19). However, it is believed that the intervention models were positive in maintaining the variables studied.</p> Ayanne Rodrigues Cambiriba Isabella Caroline Santos Déborah C. de Souza Marques Fabiano Mendes de Oliveira Sonia M. Marques Gomes Bertolini Cynthia G. Alves Araújo Vania Assaly Braulio Magnani Branco ##submission.copyrightStatement## 2021-11-25 2021-11-25 22 1 10.25176/RFMH.v22i1.4060 Diagnostic performance of lipid accumulation indices and triglyceride and glucose index for metabolic syndrome in a sample of Peruvian adult population <p><strong>Objectives:</strong>&nbsp;To determine the diagnostic performance of the lipid accumulation product (LAP), visceral adiposity index (VAI), triglyceride and glucose index (TyG) and body mass index (BMI) for metabolic syndrome (MetS) in a sample of Peruvian adults.&nbsp;<strong>Methodology:</strong>&nbsp;Study of diagnostic tests of the “National Survey on Nutritional, Biochemical, Socioeconomic, and Cultural Indicators related with Chronic Degenerative Diseases”. An analysis of ROC curves (Receptor Operation) was made, and their respective area under the curve (AUC) obtaining the different parameters such as sensitivity (Sens) and specificity (Spe). It was stratified according to sex and according to age. To choose the cut-off point, the Youden index was used.&nbsp;<strong>Results:</strong>&nbsp;The LAP had the highest AUC in both men (AUC = 0.929; cut-off value = 59.85; Sens = 91.6 and Spe = 84.5) and for women (AUC = 0.950; cut-off value = 53, 06; Sens = 92.4 and Spe = 86.4). The second place, in the case of men, was occupied by the VAI (AUC = 0.905; cut-off value = 2.36; Sens = 91.6 and Spe = 79.7), while in the case of women it was the TyG (AUC = 0.914; cut-off value = 8.70; Sens = 87.4 and Spe = 87.3). The LAP index showed significant differences with VAI to predict MetS (p &lt; 0.05), while no differences were shown with TyG.&nbsp;<strong>Conclusion:</strong>&nbsp;The LAP index had the best diagnostic performance for MetS, both for men and women, regardless of age.</p> Jesús Enrique Talavera Jenny R. Torres-Malca ##submission.copyrightStatement## 2021-11-25 2021-11-25 22 1 10.25176/RFMH.v22i1.4104 Laughter: demographic levels and factors, in the context of COVID-19 <p><strong>Introduction:</strong>&nbsp;The pandemic does not stop, neither does the studies on it; This pandemic produces pain, sadness, despair and deaths, the numbers of which are incalculable. Faced with this difficult and painful situation, laughter raises its flag of hope.&nbsp;<strong>Objective:</strong>&nbsp;The study aims to describe the levels and demographic factors of laughter, in the context of COVID-19.&nbsp;<strong>Methods:</strong>&nbsp;The study corresponds to a quantitative, descriptive, cross-sectional approach. The data were obtained through a virtual survey, whose participants were 101, from the three regions.&nbsp;<strong>Results:</strong>&nbsp;Of the 101 participants, 87 (between 20 and 60 years old) are located in the high level and 14 in the medium level. Similarly, 14 (among single, married, divorced and cohabitants) in the medium level and 87 in the high level. Of the three regions (coast, mountains and jungle), 14 in the medium level and 87 in the high level. On the other hand, 6 men and 8 women are in the medium level, in the high 28 and 59, respectively. In the factor: religion, 14 (among Catholics, Adventists, Evangelicals and others) in the medium level, 87 in the high. According to the factor: educational level (primary, secondary and higher), 14 and 87 are located in the low and high level, respectively. In the family and friends circle, laughter is always experienced: 58.4% and 66.3%, respectively; for respondents it is easier to laugh, always, 54.5% and 66.3%, in the family environment and with friends, respectively. They declared that laughter prevents diseases, strengthens health, prevents covid-19, strengthens the immune system and limits the production of the hormone cortisol (responsible for stress), always 70.3%, 31.7%, 81.2; 31.7%, 71.3% and 83.2%, respectively.&nbsp;<strong>Conclusion:</strong>&nbsp;In the context of COVID-19, the most significant levels of laughter found in the study are two: medium and high; the most weighted demographic factors are: age, sex, religion, and employment status.</p> Salomón Vásquez Villanueva Salomón A. Vásquez-Campos Luis E. Barba Briceño Carlos A. Vásquez-Villanueva Lizardo Vásquez-Villanueva ##submission.copyrightStatement## 2021-07-26 2021-07-26 22 1 10.25176/RFMH.v22i1.3723 Lifestyle of chilean medical students during the covid-19 pandemic <p><strong>Objective:</strong><span style="font-weight: 400;"> To analyze the relationship of lifestyle and habits associated with health care and religiosity in Chilean Adventist medical students during the COVID-19 pandemic.</span></p> <p><strong>Methods: </strong><span style="font-weight: 400;">Analytical and cross-sectional, census, non-experimental design. The population consisted of 72 Adventist medical students who attended or are in any year of the career in 2020 and 2021. The FANTASTIC instrument was applied, in its validated version, and an evaluation of habits associated with health care and religiosity. The work was approved by an ethics committee.</span></p> <p><strong>Results:</strong><span style="font-weight: 400;"> 55.6% are female. The mean age is 22.64. 43.1% of the students have some type of diet associated with vegetarianism. Tobacco use was not evidenced. 66.7% study the Bible and pray always or almost always. 77.8% of the students have a very good or fantastic lifestyle. When performing the Spearman correlation between the variable habits associated with health care and religiosity versus the total score of the FANTASTICO instrument, a statistically significant relationship is presented at the 0.01 level (p &lt;0.00 r=0.48).</span></p> <p><strong>Conclusions:</strong><span style="font-weight: 400;"> Although some habits can be improved, in general most of the students have a very good lifestyle. It is appreciated that the scores of habits associated with health care and religiosity have a positive relationship with the scores obtained in the fantastic instrument.</span></p> Ana Belén Cáceres Codoceo Ismael Morales Ojeda ##submission.copyrightStatement## 2021-11-25 2021-11-25 22 1 10.25176/RFMH.v22i1.4125 Intervention program: integral diet and physical exercise in the reduction of anthropometric parameters in Salvador de Bahia-Brasil <p><strong>Introduction:</strong>&nbsp;High rates in anthropometric parameters such as excess weight, body fat, visceral fat, hypertension generate serious problems that affect the health of the general population.&nbsp;<strong>Objective:</strong>&nbsp;To identify the effects produced by the intervention program "integral diet and physical exercise" on anthropometric parameters and blood pressure in a community in Salvador de Bahia. Methodology: Experimental intervention study lasting 40 days in which 31 adults participated, carried out in a neighborhood of the municipality of Salvador (Bahia), Brazil. The study consisted of administering a comprehensive diet based on whole grains, oilseeds, legumes, fruits, vegetables and total abstinence from foods of animal origin, refined, industrialized flours, sugar, following the "Healthy Plate" and Physical Exercise model.&nbsp;<strong>Results:</strong>&nbsp;The participants who followed the program of integral diet and physical exercise, obtained significant changes in the anthropometric values (weight, BMI, waist contour, percentage of body fat, abdominal fat, biological age, and systolic and diastolic blood pressure, (p &lt;0.01), body mass did not show significant changes (p &lt;0.57).&nbsp;<strong>Conclusion:</strong>&nbsp;The intervention program with a comprehensive plant-based diet and physical exercise can reduce the rates of obesity, abdominal fat, anthropometric perimeters and blood pressure and contribute to reducing potential problems of chronic non-communicable diseases.</p> Gloria Cari Huanca ##submission.copyrightStatement## 2021-11-25 2021-11-25 22 1 10.25176/RFMH.v22i1.4338 The lifestyle associated with the control of arterial hypertension and diabetes mellitus in a care center in Lima, during the covid-19 pandemic <p><strong>Introduction</strong><span style="font-weight: 400;">: Hypertension and diabetes mellitus 2 are prevalent diseases. The COVID-19 pandemic has changed lifestyle and disease control, potentially triggering serious complications. </span><strong>Objectives: </strong><span style="font-weight: 400;">To determine the association between lifestyle and the control of chronic non-communicable diseases: arterial hypertension and diabetes mellitus 2 during the COVID-19 pandemic in patients of an Urgent Care Center. </span><strong>Materials and methods:</strong><span style="font-weight: 400;"> Observational, cross-sectional, and analytical study. A sample of 158 patients, between 30 and 79 years old, was included. Control files and medical records were analyzed, anthropometric values ​​were measured, and lifestyle was evaluated through surveys. </span><strong>Results:</strong><span style="font-weight: 400;"> 51.3% were male, an average of 61 years, 57.6% with married marital status, and 51.9% with higher educational level. In the multivariate analysis of patients with arterial hypertension, a significant association between the lack of control of the hypertensive disease and an unhealthy lifestyle is evidenced (PR = 2.538; p = 0.000; 95% CI = 1.608-4.006). On the other hand, the diabetic population obtained a significant association between the lack of control of type 2 diabetes mellitus with an unhealthy lifestyle (PR = 5.498; p = 0.013; 95% CI = 1.440-20.995), in addition to the prevalence of glycemic lack of control in patients with abnormal abdominal girth it was 1.6 times more than in people with normal abdominal girth (PR = 2.623; p = 0.038; 95% CI = 1.057-6.508). </span><strong>Conclusions:</strong><span style="font-weight: 400;"> Lifestyle is significantly associated with the control of arterial hypertension and diabetes mellitus. There is a significant association between abdominal circumference and control of type 2 diabetes mellitus.</span></p> Mariana Callapiña-De Paz Yoshie Z. Cisneros-Núñez Norka R. Guillén-Ponce Jhony A. De La Cruz-Vargas ##submission.copyrightStatement## 2021-07-26 2021-07-26 22 1 10.25176/RFMH.v22i1.3759 Quality of life of students in Health Sciences from a private university in Nuevo Leon, Mexico <p><strong>Introduction: </strong><span style="font-weight: 400;">Knowing the quality of life allows taking action for its improvement.&nbsp;</span><strong>Objective: </strong><span style="font-weight: 400;">To describe the quality of life in students in the Health Sciences area of ​​a private university in Nuevo León.</span><strong> Methods: </strong><span style="font-weight: 400;">Quantitative, observational, descriptive, cross-sectional study. Population: health sciences students from a private university in Nuevo León, Mexico, during August-December 2018. Construct used: quality of life, was measured using the World Health Organization Quality of Life short version. Statistical analysis: IBM SPSS, performing student's t-test and one-way ANOVA. </span><strong>Results: </strong><span style="font-weight: 400;">Sample of 611 students, with age m = 20.53 years, SD ± 2.92 years, gender: 58.6% female (n = 358) and 41.4% male (n = 253). Nationality: 84% Mexican (n = 513) and 16% foreigners (n = 98). Place of origin: 74% urban area (n = 452) and 26% rural area (n = 159). 44.7% refer to their quality of life as fair (n = 273). There is a statistically significant difference in the quality of life of students according to the degree they are studying (F = 2.052 and p = 0.039) and according to their nationality, (t = 2.013, p = .045).</span><strong> Conclusions: </strong><span style="font-weight: 400;">Career, age and nationality directly influence the quality of life, for which comprehensive health promotion strategies should be considered, emphasizing psychological health and interpersonal relationships that allow students to obtain the necessary resources to face challenges, preserve and improve their quality of life.</span></p> Francys Marie Medina-Toro Jose Leonardo Jimenez-Ortiz Jason Aragón-Castillo Daniela Guadalupe Frutos-Najera Manuel Muñoz-Palomeque ##submission.copyrightStatement## 2021-11-25 2021-11-25 22 1 10.25176/RFMH.v22i1.4119 Characteristics related to lifestyle in elderly patients in a Health Center of the Andes in Peru <p><strong>Introduction:</strong>&nbsp;A correct lifestyle is vital in older adults to reduce their risk of diseases and loss of functionality.&nbsp;<strong>Objective:</strong>&nbsp;To determine the lifestyles of elderly patients in a Health Center in the Peruvian Andes. Method: Observational, descriptive study with elderly patients from a health center. We worked with a previously collected database. Descriptive statistics were used. The study was approved by the institutional ethics committee.&nbsp;<strong>Results:</strong>&nbsp;Of the 74 patients evaluated, the mean age was 75.4 years and 52% were females. The mean BMI was 24.8 kg / m2 and that of the abdominal circumference was 86.8 cm. 32.7% had a visual acuity of 70 in the right eye and 36.4% of 50 in the left eye. Glucose (mg / dL), hemoglobin (g / dL) and uric acid (mg / dL) had a median of 97, 15.4 and 7; respectively. Triglycerides and cholesterol had a mean of 182.2 mg / dL and 189.9 mg / dL; respectively. 5.4% of men had reactive PSA. 4% had diabetes, 21.6% hypertension, and 22.2% anemia; while 70.3% consumed alcohol, 6.8% smoked and 89.2% consumed soda.&nbsp;<strong>Conclusions:</strong>&nbsp;Some indicators of poor lifestyle were found, such as the consumption of alcohol and soft drinks, as well as indicators of conditions related to a poor lifestyle such as an average BMI close to being overweight, high triglycerides and cholesterol.</p> José M. Vela-Ruiz Katherine Medina-Rojas Andrea Machón-Cosme Delcy Turpo Luis A. Saenz-Vasquez Dante M. Quiñones-Laveriano ##submission.copyrightStatement## 2021-11-25 2021-11-25 22 1 10.25176/RFMH.v22i1.4081 Hypertriglyceridemic waist circumference and its association with arterial hypertension in a sample of Peruvian adult population <p><strong>Objective:</strong>&nbsp;To evaluate the prevalence of hypertriglyceridemic waist (HTGW) and its association with arterial hypertension (AHT) in Peruvian adults.&nbsp;<strong>Methodology:</strong>&nbsp;Cross-sectional analytical study of the secondary database from the "National Survey of Nutritional, Biochemical, Socioeconomic and Cultural Indicators related to Chronic-Degenerative Diseases". HTGW was measured according to the presence of hypertriglyceridemia (≥ 150 mg/dl) and increased abdominal waist, according to JIS (men ≥ 94 cm and women ≥ 80 cm) and ATPIII (men ≥ 102 cm and women ≥ 88 cm) criteria.&nbsp;<strong>Results:</strong>&nbsp;the prevalence of AHT was 12.48%, HTGW -JIS was 21.49%, and HTGW-ATPII was 13.96%. In multiple regression, HTGW-JIS showed that they had 1.35 higher frequency of having AHT versus those without HTGW (PR=1.35; CI95%: 1.13 - 1.61; p = 0.001) and HTGW-ATPIII showed that they had 1.38 higher frequency of having AHT versus those without HTGW (PR=1.38; CI95%: 1.14 - 1.67; p = 0.001), both adjusted for convenience variables.&nbsp;<strong>Conclusion:</strong>&nbsp;HTGW was positively associated with AHT.</p> Víctor J. Vera-Ponce Leyla Rodas Alvarado Fernanda Huaccha Chávez Fiorella E. Zuzunaga-Montoya ##submission.copyrightStatement## 2021-11-25 2021-11-25 22 1 10.25176/RFMH.v22i1.4116 Decrease of cardiovascular risk in obese patients who participated in a lifestyle medicine program <p><span style="font-weight: 400;">Lifestyle Medicine in the management of chronic diseases such as obesity is essential to reduce cardiovascular risk and to reverse the disease process </span><span style="font-weight: 400;">(1). </span><strong>Objective:</strong><span style="font-weight: 400;"> To determine if a Lifestyle Medicine program can reduce cardiovascular risk in obese adults in Colombia. </span><strong>Material and methods: </strong><span style="font-weight: 400;">Descriptive observational study cases series type followed for 6 months in a Lifestyle Medicine Clinic. 9 patients were included taking into account 2 measures of cardiovascular risk as a parameter to complete the program. The following measurements were taken: cardiovascular risk using the Pan American Health Organization (PAHO) calculator, Body Mass Index (BMI), lipid profile, history of smoking, history of diabetes, and systolic blood pressure. </span><strong>Results:</strong><span style="font-weight: 400;"> Of the 9 obese patients, 22% had an intermediate cardiovascular risk and 78% had a low risk at the beginning of the study. After 6 months, it was achieved that 100% of the participants had a low cardiovascular risk; Furthermore, 11% of the patients managed to normalize their blood pressure values ​​and 20% showed a decrease in high blood pressure values. In addition, 22% went from type 3 obesity to type 2 obesity. </span><span style="font-weight: 400;">Finally, through psychological consultation, it was possible to reduce anxiety levels from high to intermediate in at least 44% of the participants. </span><strong>Conclusions:</strong><span style="font-weight: 400;"> The Lifestyle Medicine program, in a group of obese patients, managed to achieve a low cardiovascular risk, the decrease and normalization of blood pressure figures and reduction in BMI in participants who completed the study.</span></p> <p>&nbsp;</p> Eymard Torres-Rodriguez Lucy Perla Gulliana Cedillo Ramírez ##submission.copyrightStatement## 2021-11-25 2021-11-25 22 1 10.25176/RFMH.v22i1.4095 Immersion program in Lifestyle Medicine and its effects on cardiovascular risk factors <p><strong>Introduction:</strong><span style="font-weight: 400;"> Cardiovascular diseases are the leading cause of death worldwide and are associated with increased morbidity and mortality by COVID-19. Lifestyle Medicine immersion programs consist of a residential internship that performs a multidisciplinary professional follow-up.&nbsp;</span></p> <p><strong>Objective:</strong><span style="font-weight: 400;"> To evaluate the effect of the residential lifestyle medicine program on risk factors for cardiovascular disease: weight, blood pressure and glycemia.</span></p> <p><strong>Methods:</strong><span style="font-weight: 400;"> Longitudinal, comparative study, with intervention of a Lifestyle Medicine Program. Retrospective data from 2019-2021 of patients who had completed the intervention for 14 days were used. This consisted of a comprehensive follow-up: medical, nutritional, psychological, physical and spiritual of the patients.</span></p> <p><strong>Results:</strong><span style="font-weight: 400;"> Of the 53 patients evaluated, 26 underwent the intervention before the pandemic, who were hospitalized with the main reason for weight loss 34.62%. Of the patients who underwent the intervention within the pandemic (N=27), the main reason for hospitalization was for treatment of chronic diseases 33.33%. Glycemia: Initial M=186.64, SD=81.73; Final M=119.93, SD=35.02. Mean reduction of 66.71 mg/dl, statistically significant (t=4.3460, p=0.0008). SBP: Initial M=127.76, SD=16.36; Final M=115.21, SD=14.87. Mean reduction of 12.55 mmHg, statistically significant (t=4.7048, p=0.0001).</span></p> <p><strong>Conclusions:</strong><span style="font-weight: 400;"> The effect of the intervention was significant in the cardiovascular risk factors evaluated: weight, glycemia and systolic blood pressure. It was possible to reduce the risk factors for cardiovascular disease with intensive lifestyle changes. In times of pandemic, the relevance of lifestyle medicine intervention is emphasized.</span></p> Abigail Ballone ##submission.copyrightStatement## 2021-11-25 2021-11-25 22 1 10.25176/RFMH.v22i1.4337 Exploration of the Relationship of Sleep Quality in Patients with Diabetic Retinopathy, Villahermosa Tabasco. <p><strong>Introduction</strong>: In recent decades, there has been growing evidence suggesting that too little or too much sleep is associated with adverse health outcomes, including type 2 diabetes. There is a close association between diabetes and diabetic retinopathy (DR), so it is reasonable to assume that sleep may also have associations with DR.&nbsp;<strong>Objective</strong>: To explore the relationship between the perception of sleep quality and the degree of diabetic retinopathy in patients with type 2 Diabetes Mellitus treated at a 3rd level dophthalmological care service.&nbsp;<strong>Results</strong>: Significant correlations were found in: diastolic and systolic blood pressure (0.429), triglycerides and total cholesterol (0.707), glycosylated hemoglobin (HbA1c) and glycemia (0.561), Epworth sleepiness scale (ESS Score) and age (0.394) , ESS Score and weight (0.365), extended STOP questionnaire (Stop Bang) and age (0.317), Stop Bang and weight (0.579), Stop Bang and ESS Score (0.452), insomnia severity index (ISI Score) and Stop Bang (0.460). Although the reduced sample size limited the results in the associations by subgroups in the study, a trend towards an elevation of the ESS score can be seen in the subgroup of patients who reported sleeping 8 hours or more.&nbsp;<strong>Conclusions</strong>: Although the trends are not statistically significant, the authors consider that this finding is congruent with the state of the art on the subject of sleep and metabolic condition of retinopathic diabetic patients (increased trend of ESS score reported in the subgroup of 8 or more hours sleep), it will be necessary to explore this phenomenon in more detail and in a larger number of patients.</p> Tirsa A. Espinoza-Anguiano GJ Avilés-Rodriguez José Ricardo Espinoza-Vargas ##submission.copyrightStatement## 2021-11-25 2021-11-25 22 1 10.25176/RFMH.v22i1.4333 Scheme of intermittent fasting and reduction of anthropometric measures, lipid profile, blood pressure and cardiovascular risk <p><strong>Introduction:</strong>&nbsp;Lifestyle is a fundamental role in the risk of cardiovascular diseases and chronic diseases.&nbsp;<strong>Objective:</strong>&nbsp;To evaluate the effect of the 16/8 intermittent fasting scheme against anthropometric measurements, lipid profile values, blood pressure ​​and cardiovascular risk.&nbsp;<strong>Method:</strong>&nbsp;Longitudinal analytical study with intervention. Fifteen patients treated in the nutrition area in a private center between January and October 2020 submitted to the 16/8 intermittent fasting scheme for four months, seeking to reduce anthropometric measurements, lipid profile, blood pressure and / or cardiovascular risk. Variables: body weight, body mass index (BMI), waist-hip index (WHI), abdominal circumference, lipid profile, cardiovascular risk according to Framingham (Framingham AMR B table), total cholesterol / HDL and LDL / HDL indices.&nbsp;<strong>Results:</strong>&nbsp;The average age was 47.1 years, the average height was 1.66 m., The average body weight was 84.3 Kg., The average of the BMI was 30.46, the average of the WHI was 0.94, the average of the abdominal circumference was 99.87, the mean total cholesterol, HDL and LDL were 240.06, 43.73 and 153.2 respectively, the mean cardiovascular risk according to Framingham was 0.11% and the mean total cholesterol / HDL and LDL / HDL indices were 5.88 and 3.69. The evaluation of averages before and after found significant differences (p &lt;0.05) at 3 and 4 months of evaluation.&nbsp;<strong>Conclusions:</strong>&nbsp;The intermittent fasting scheme showed a significant reduction in anthropometric measurements, lipid profile and cardiovascular risk. Additionally, an increase in HDL was observed.</p> Javier Wong–Gonzales José A. Quispe-Palacios ##submission.copyrightStatement## 2021-12-20 2021-12-20 22 1 10.25176/RFMH.v22i1.4383 Clinical profile of patients before and after a diabetes reversal program in Ecuador <p><strong>Introduction.</strong> Chronic non-communicable diseases (NCDs) are the main cause of death in Ecuador and the world, and within them diabetes mellitus is one of the fastest growing morbidity and mortality. <strong>Objective</strong>. To determine if there are differences between the clinical characteristics before and after a diabetes reversal program in Ecuador. <strong>Methods</strong>. Comparative study before and after in the same individual. Patients who voluntarily entered an outpatient clinical program based on Lifestyle Medicine were followed for 8 weeks, measures were taken at the beginning and at the end of this period, which included plant-based nutrition, physical exercise and psychological support. <strong>Results.</strong> Eight patients were analyzed between 40 and 74 years (3 women and 5 men) The comparative analysis before and after the intervention showed significant differences for: Weight (p = 0.007), BMI (p: 0.004), Glucose (p = 0, 04), glycosylated hemoglobin (p = 0.007), triglycerides (p = 0.04), urea (p = 0.004), and TGP (p = 0.023). <strong>Conclusions.</strong> There is an improvement in the variables measured after having carried out the “Lifestyle Medicine” reversal program compared to the initial measurements.</p> <p>&nbsp;</p> Marco Albuja Chaves David Vera Alcívar ##submission.copyrightStatement## 2021-11-25 2021-11-25 22 1 10.25176/RFMH.v22i1.4339 Lifestyle Situation and Noncommunicable Diseases of chilean workers treated at Mutual de Seguridad (Pilot Study) <p><strong>Objective:</strong>&nbsp;To learn the lifestyle and NCDs of a group of workers who had occupational health evaluations performed in a branch of a mutuality: the Centro de Evaluación del Trabajo (CET), of Mutual de Seguridad.&nbsp;<strong>Methods:</strong>&nbsp;The sample included 30 workers who went in for occupational health evaluations. Blood tests and, vital signs were taken and finally, during the medical evaluation, they were given a survey. All data were collected and included in a database for analysis.&nbsp;<strong>Results:</strong>&nbsp;93.3% of those enrolled were men; 66.6% were overweight or obese; 43.3% presented blood pressure in the high-normal range; 80% presented at least one altered parameter in their lipid profile; 50% indicated that they performed the minimum suggested amount of exercise per week; 83.3% indicated that they consume foods high in fat during the day; less than half (43.3%) indicated sleeping between 7-9 hours a day; 36.5% of the participants reported smoking at least once a day; 63.3% believe that they should make a change in relation to their lifestyle and are interested in being contacted in the future to participate in an intervention.&nbsp;<strong>Conclusion:</strong>&nbsp;There are many lifestyle factors that need to be improved. Information should be delivered, and knowledge updated regarding lifestyle medicine in the type of population studied, taking into consideration that there is a willingness to make changes.</p> Romina Riquelme Cruz ##submission.copyrightStatement## 2021-12-20 2021-12-20 22 1 10.25176/RFMH.v22i1.4331 Whole food plant based diet: its mechanisms for the prevention and treatment of obesity <p>Obesity is a metabolic condition with a continuous increasing rate, being considered today a “pandemic”. Due to this and the vast number of diseases it is associated with, there is a need for a treatment of this condition that is both effective and healthy in a comprehensive way. In this context, the concepts of lifestyle medicine and plant-based diets have emerged in medicine and in scientific research, and the latter have demonstrated benefits in all these areas and are being part of several scientific association’s recommendations today. In this article, a plant-based diet is briefly defined, and the mechanisms by which this type of diet provides benefits for the control of body weight are explored, including the satiety it generates and its characteristic low caloric density, the higher thermic effect of foods, the positive modulation of the gut microbiota, its effects on the insulin sensitivity, the absence of animal protein and how this affects the body weight, and the effects it has on the leptin hormone. Plant-based diets has been studied both in observational and interventional studies and positioned as a great alternative for the prevention and treatment of obesity, in addition to being a safe and health dietary pattern. We hope that in the future, more health professionals consider this evidence and incorporate it as part of their therapeutic tools.</p> Francisca Soto-Aguilar Javier Webar Ismael Palacios ##submission.copyrightStatement## 2021-07-26 2021-07-26 22 1 10.25176/RFMH.v22i1.3616 Impact of moderate physical exercise on sleep disorders in patients with fibromyalgia <p><strong>Introduction:</strong> Fibromyalgia (FM) or Fibromyalgia Syndrome (FMS) is currently defined as a chronic condition of unknown cause characterized by generalized pain, among other symptoms, in the absence of a specific organic disease. Sleep disorders are recognized as one of the main symptoms in fibromyalgia patients, and performing various types of physical activity in this group of patients could improve sleep quality and other sleep disorders. <strong>Objective: </strong>To determine if the performance of moderate physical exercise has a positive impact on sleep disorders in patients with fibromyalgia. <strong>Methods:</strong> A PubMed search was carried out, where 2616 articles were found in the last 5 years, after applying the inclusion and exclusion criteria, and in a first search of 616 articles, 12 useful articles were obtained; using other search engines such as Google Scholar, SciELO, the number of articles obtained was 2; adding a total of 14 articles. <strong>Results:</strong> The 14 studies reviewed showed that moderate physical exercise reduces sleep disorders in patients with fibromyalgia, 02 suggest individualized treatment, 02 mention that sedentary lifestyle aggravates symptoms, 04 found benefits in complementing exercise with yoga or balneotherapy, and 01 additionally, supports high intensity interval training. <strong>Conclusion:</strong> The conclusion of this review article was that the performance of moderate physical activity in patients with fibromyalgia has a beneficial impact on regulating and even modifying sleep disorders.</p> Sylvia G. Alfaro-Castro ##submission.copyrightStatement## 2021-12-10 2021-12-10 22 1 10.25176/RFMH.v22i1.4398 Exercise as a protagonist in muscle plasticity and in the muscle as an endocrine organ: implications in chronic diseases <p>The active skeletal muscle and the maintenance of muscle mass are essential for good health, wellness and disease prevention and treatment. The muscle as an endocrine organ capable of synthesizing&nbsp;&nbsp; myokines, has been documented recently. These peptides are secreted as a response to muscular contractions induced by exercise, and can develop molecular communication with other tissues, improving cardiovascular, metabolic, and mental health.</p> <p>The endocrine function of a muscle continues to be in a constant investigation; however, knowledge up to date urge us to continue promoting physical activity. Additionally, the extended knowledge of myokins is useful to prescribe individualized physical exercise programs to each patient.</p> Amelia Vargas-Pacheco Lucy E Correa-López ##submission.copyrightStatement## 2021-12-26 2021-12-26 22 1 10.25176/RFMH.v22i1.4129 Lifestyle medicine intervention in neurodevelopmental disorders. Case Report. <p>Neurodevelopmental disorders are conditions generated by dysfunction or interruption of brain development during childhood. In this group, attention deficit hyperactivity disorder and autism spectrum disorder stand out due to their prevalence and association between them. Studies suggest that these patients, due to their behavioral dysfunctions, develop unhealthy lifestyles, and that, in turn, these same habits could exacerbate these behaviors. We present a case of a 5 year old female with diagnoses of grade 1 autism spectrum disorder and attention deficit hyperactivity disorder, under pharmacological and non-pharmacological treatment without behavioral improvement. A lifestyle medicine approach was carried out with an emphasis on eating patterns, transitioning to a plant based diet, incorporating physical activity and sleep hygiene measures. At four months there is evident improvement in hyperactivity, attention and socialization.</p> Jonathan Velásquez Toro ##submission.copyrightStatement## 2021-11-02 2021-11-02 22 1 10.25176/RFMH.v22i1.4134 Lifestyle intervention for the management of chronic noncommunicable diseases: hypertension, dyslipidemia, insulin resistance and overweight in a male patient. Case Report <p>Chronic noncommunicable diseases (NCDs) are defined as diseases of long duration, slow progression, that do not resolve spontaneously and that rarely achieve complete cure&nbsp;<sup>(<a href="">1</a>)</sup>. Cardiovascular diseases (CVD), cancer, chronic respiratory diseases and diabetes stand out. NCDs cause 41 million deaths each year (71% of the world total). Cardiovascular disease accounts for the majority of these deaths (17.9 million per year)&nbsp;<sup>(<a href="">2</a>)</sup>. In addition to causing premature deaths, these diseases lead to complications and disabilities, limit productivity, and drug treatments are expensive, so early detection and timely treatment should be a priority&nbsp;<sup>(<a href="">2</a>)</sup>. Lifestyle medicine (MEV) has gained relevance in the prevention, treatment and reversal of most NCDs, directly addressing their causes&nbsp;<sup>(<a href="">3</a>)</sup>. We will present the case of a young man with multiple risk factors and a diagnosis of arterial hypertension, dyslipidemia and insulin resistance. We carry out an intervention through the MEV to improve the patient's condition and health. At the 6-month follow-up, significant changes in habits and laboratory parameters were achieved.</p> Natalia Delorenzo Ch ##submission.copyrightStatement## 2021-11-27 2021-11-27 22 1 10.25176/RFMH.v22i1.4354 Diabetic foot and lifestyle: Case Report <p>Diabetes is still the leading cause of non-traumatic amputation in most Western countries, epidemiological reports indicate that more than a million amputations are performed in people with diabetes each year, this is equivalent to an amputation for diabetes somewhere in the world every 30 seconds, most of these amputations are preceded by ulcers.</p> <p>We present a case of a 39-year-old male patient suffering from diabetes mellitus and uncontrolled hypertension, with late complications, chronic kidney disease, anemia, retinopathy, and ischemic and neuropathic diabetic foot, with indication for amputation. Healthy lifestyles are used, controlling glycemia, hypertension, without requiring medication and reducing proteinuria. There were no adverse effects. With favorable evolution since then.</p> <p>Conclution: A healthy lifestyle is an intervention that the earlier it is used, the greater its benefits, without the risk of adverse effects or unnecessary costs, but even in late stages it has shown benefits in glycemic, hypertensive and renal control.</p> Danitza Adriana Rojo García Rubén López Flores Fernando Carballo Ordoñez ##submission.copyrightStatement## 2021-11-05 2021-11-05 22 1 10.25176/RFMH.v22i1.4137 Lifestyle medicine applied to late complications of diabetes mellitus. Case report <p>Diabetes mellitus is the main cause of progression of chronic kidney disease and dialysis. The therapeutic intervention considers an HbA1C level that avoids adverse effects associated with hypoglycemic therapy, as occurs in patients with chronic kidney disease, despite not reaching normoglycemia. The present case describes an intervention based on Lifestyle Medicine in a patient with diabetic nephropathy and chronic kidney disease, whose biomarkers showed improvement in kidney damage due to reduction of proteinuria or reduction of HbA1C, LDL and triglycerides in its metabolic control. The intervention with lifestyle medicine requires a multidisciplinary approach and the time of intervention does not discriminate a degree of chronic kidney disease that limits its intervention</p> Edwin Castillo Velarde ##submission.copyrightStatement## 2021-11-27 2021-11-27 22 1 10.25176/RFMH.v22i1.4355 Diabetes treatment and control using lifestyle intervention in outpatient setting: Case Series and Update <p>The prevalence of diabetes demands the identification of more efficient long-term methods to achieve good patient control. This paper reports the progress of 4 patients diagnosed with previously poorly controlled diabetes and prediabetes with comorbidities that were attended in an outpatient clinic, they received orientation regarding lifestyle change and were instructed to increase consumption of dietary fiber and physical activity. Body composition and biochemical markers were followed and changes were reported. In a 5 month period Patient 1 achieved criterion for controlled diabetes and was able to suspend oral hypoglycemic agents, reducing his body weight by 10%. Within a 8 week period Patient 2 experienced a 50% decrease of HOMA IR and was able to achieve criteria of controlled diabetes. Furthermore a 3 kg increase in lean body mass and a 4 kg body weight decrease were documented. These findings were accompanied by a 23% and 38% decrease in total cholesterol and triglycerides respectively. Patient 3 achieved criteria for type 2 diabetes remission within a 18 month time span(Inicial HBA1C 11.4% Final HBA1C 5.3). Patient 4 progressed to remission of prediabetes and a decrease of 5.9% in total body weight in a 3 month period.</p> Amin Amilcar Valencia Leal Lujhon Guillermo Flórez Gutiérrez Evy Nohemi Perez Ana Vanessa Valencia Leal ##submission.copyrightStatement## 2021-11-05 2021-11-05 22 1 10.25176/RFMH.v22i1.4139