RESUMEN Con la sanción de la Constitución Nacional en 1992 de la República del Paraguay, se declara en sus artículos 68 y 69 "que el Estado protegerá y promoverá el derecho a la salud como fundamental, proveyendo las condiciones dentro del Sistema Nacional de Salud, recursos, planes y políticas integradas al desarrollo". Este marco constitucional ha sido la base y el fundamento de la Ley 1.032/96, que crea el Sistema Nacional de Salud, el cual está compuesto por los subsectores públicos, mixtos y privados, caracterizado por un modelo segmentado y fragmentado, reglamentado por el Decreto Ley N°21.376 del año 1998 bajo la rectoría del Ministerio de Salud Pública y Bienestar Social, actualmente la salud paraguaya está fundamentada en los ejes estratégicos basados en la creación e implementación de unidades de salud familiar y se define con un enfoque basado en la atención primaria de la salud.

ABSTRACT With the enactment of the National Constitution of the Republic of Paraguay in 1992, articles 68 and 69 state that "the State will protect and promote the right to health as fundamental, providing the conditions within the National Health System, resources, plans and policies integrated to development". This constitutional framework has been the basis and foundation of Law 1.032/96, which creates the National Health System, which is composed of public, mixed and private subsectors, characterized by a segmented and fragmented model, regulated by the Decree Law No. 21,376 of 1998, under the Ministry of Public Health and Social Welfare, Paraguayan health is currently based on strategic axes based on the creation and implementation of family health units and is defined with an approach based on primary health care.

ABSTRACT Objective This study aims to estimate the epidemiological burden of excessive salt intake reduction and achieve the World Health Organization salt reduction target for 2025 in Paraguay, in 2019. Methods We used the Preventable Risk Integrated Model, a comparative risk assessment macro-simulation model, to estimate the averted deaths, disease incidence, and disability-adjusted life years from cardiovascular disease attributable to salt intake in the population of Paraguay for different salt reduction policy scenarios. Results As a result, in Paraguay, excessive salt intake (over 5 g/day) is responsible for approximately 2,656 cardiovascular disease deaths (95% Uncertainty Interval: 1,250-3,765), 4,816 cardiovascular disease cases (95% UI: 2,251-6,947), and 60,529 disability-adjusted life years (95% UI: 27,828-86,258) per year. By reducing salt consumption by 30%, as recommended by the World Health Organization until 2025, approximately 1,188 deaths (95% UI: 520 to 1,820), 2,100 incident cases (95% UI: 923-3,234), and 27,272 disability-adjusted life years (95% UI: 11,999-41,675) from cardiovascular disease could be averted every year. Conclusion In conclusion, the burden of cardiovascular disease attributable to excessive salt intake is significant and salt reduction policies must become a priority in Paraguay.

RESUMO Objetivo Este estudo visa estimar a carga epidemiológica do consumo excessivo de sal e o alcance da meta da Organização Mundial de Saúde para 2025 no Paraguai, em 2019. Métodos Foi usado um modelo de avaliação comparativa de risco (Preventable Risk Integrated Model) para análise comparativa de risco para estimar mortes, casos incidentes e anos de vida ajustados por incapacidade (DALYs) por doenças cardiovasculares atribuíveis ao consumo excessivo de sal na população paraguaia em diferentes cenários. Resultados No Paraguai, o consumo excessivo de sal é responsável por aproximadamente 2.656 mortes (Intervalo de Incerteza 95%: 1.250-3.765), 4.816 casos incidentes (95% II: 2.251-6.947) e 60.529 DALYs (95% II: 27.828-86.258) por doenças cardiovasculares por ano. Com uma redução de 30% no consumo de sal, como recomendado pela Organização Mundial de Saúde até 2025, aproximadamente 1.188 mortes (95% II: 520-1.820), 2.100 casos incidentes (95% II: 923-3.234) e 27.272 DALYs (95% II: 11.999-41.675) por doenças cardiovasculares poderiam ser prevenidos ou adiados por ano. Conclusão Concluiu-se que a carga de doenças cardiovasculares atribuível ao consumo excessivo de sal no Paraguai é significante e políticas de redução deveriam ser priorizadas no país.

RESUMEN Introducción: El consumo excesivo de sal contribuye al desarrollo de enfermedades crónicas no transmisibles como enfermedades renales, algunos tipos de cáncer y la hipertensión arterial (HTA); que, por otro lado, su excesivo consumo también actúa como principal factor de riesgo de muerte por enfermedades cardiovasculares. Objetivo: Describir las características de las prácticas alimentarias relacionadas con el consumo de sal durante el 2018. Metodología: Estudio observacional descriptivo transversal como instrumento se utilizó una encuesta virtual por Google Forms, se encuestó 269 personas de 20 años y más desde mayo y junio del 2018. Se excluyeron a cinco porque no cumplían criterios de inclusión. Resultados: Participaron 264 personas siendo el 73,1% del sexo femenino. El 31,4% tenía entre 25-29 años, 89,8% residía en el Departamento Central. El 44,7% prefiere preparaciones culinarias saladas. El 51,9% califica a la comida sin sal como saludable. El 64,4% prefiere informarse sobre temas de salud en sitios web. 72,3% cuando decide cuidar su salud con las comidas tiene en cuenta a las grasas y tipo de cocción frituras. 65,2% manifestó tener antecedentes de hipertensión arterial en el hogar y piensan que eleva la presión arterial en un 96.6%. Conclusión: Las principales características de las prácticas alimentarias relacionadas al consumo de sal de la población de estudio fueron su preferencia por las preparaciones culinarias saladas, la percepción la comida sin sal como saludable y no hallan diferencias entre el sabor de las comidas preparadas dentro y fuera de su hogar, ignoran el consumo de sal cuando deciden cuidarse con las comidas, aunque crean que la sal alimentaria eleva la presión arterial.

ABSTRACT Introduction: Excessive salt consumption contributes to the development of chronic non-communicable diseases such as kidney disease, some types of cancer and arterial hypertension (AHT); on the other hand, its excessive consumption also acts as the main risk factor for death from cardiovascular disease. Objective: To describe the characteristics of food practices related to dietary salt consumption during 2018. Methodology: Virtual cross-sectional descriptive observational survey by Google forms to 269 people aged 20 years and older from May and June 2018. Five were excluded because they did not meet inclusion criteria. Results: A total of 264 persons participated, 73.1% of whom were female. The 31.4% were between 25-29 years old, 89.8% resided in the Central Department. 44.7% preferred salty culinary preparations. 51.9% qualified food without salt as healthy. 64.4% prefer to get information about health issues on websites. 72.3%, when deciding to take care of their health with meals, consider fats and fried foods. 65.2% stated that they have a history of high blood pressure at home and think that it raises blood pressure in 96.6%. Conclusion: The main characteristics of the dietary practices related to salt consumption of the study population were their preference for salty culinary preparations, their perception of food without salt as healthy, and they found no difference between the taste of food prepared inside and outside the home, they ignore salt consumption when they decide to take care of themselves with their meals, even though they believe that dietary salt raises blood pressure.

ABSTRACT Introduction: Insufficient physical activity is one of the main public health problems globally. Teen behavior patterns and lifestyle may affect their physical and mental health. Objectives: The objective of this study was to know the patterns of physical activity and sedentary behaviors in the adolescent population nationwide. Materials and methods: A quantitative, observational, descriptive cross-sectional study, the questionnaire of the Global School Health Survey was applied in school adolescents of the eighth and ninth grades of the 3rd cycle of Basic School Education and the 1st, 2nd and 3rd year of Secondary Education in 49 schools and colleges in the country. 1,803 students aged 13 to 15 years were included in this study. Results. 27% of adolescents between the ages of 13 and 15 in Paraguay are active, being significantly higher in men than in women (p-value 0.000) and 22% are inactive more frequently in women than in men (p-value 0.000). It was observed that 33.5% of the adolescents had sedentary behavior, 43.4% of the adolescents did not use active displacement to attend school. Adolescents who did not participate in physical education classes at school accounted for 15.6%. Conclusion: Although 27% of adolescents between the ages of 13 and 15 are active, the large percentage of inactive adolescents with sedentary behavior is worrying.

RESUMEN Introducción: La actividad física insuficiente es uno de los principales problemas de salud pública a nivel global. Los patrones de conducta en los adolescentes, y el estilo de vida, podrían afectar su salud física y mental. Objetivos: El objetivo de este estudio fue conocer los patrones de actividad física y los comportamientos sedentarios en la población de adolescentes a nivel nacional. Materiales y métodos: Estudio cuantitativo, observacional, descriptivo de corte transverso, se aplicó el cuestionario de la Encuesta Global de Salud Escolar en adolescentes escolares del octavo y noveno grados del 3° ciclo de la Educación Escolar Básica y al 1°, 2° y 3° cursos de la Educación Media de 49 escuelas y colegios del país. En este estudio fueron incluidos 1.803 estudiantes de edades comprendidas entre 13 a 15 años. Resultados: El 27% de los adolescentes de 13 a 15 años de Paraguay son activos, siendo significativamente mayor en hombres que en mujeres (p-valor 0,000) y el 22% son inactivos con mayor frecuencia en mujeres que en hombres (p-valor 0,000). Se observo que el 33,5% de los adolescentes tenían comportamiento sedentario, el 43,4% de los adolescentes no utilizo el desplazamiento activo para asistir a la escuela. Los adolescentes que no participaron de las clases de educación física en la escuela representaron el15,6%. Conclusión: Si bien en un 27% los adolescentes de 13 a 15 años son activos, es preocupante el gran porcentaje de adolescentes inactivos y con comportamiento sedentario.