Association between a lifestyle score and all-cause mortality: a prospective analysis of the Chilean National Health Survey 2009-2010.

OBJECTIVE: To investigate the association between a lifestyle score and all-cause mortality in the Chilean population. DESIGN: Prospective study. SETTINGS: The score was based on seven modifiable behaviours: salt intake, fruit and vegetable intake, alcohol consumption, sleep duration, smoking, physical activity and sedentary behaviours. 1-point was assigned for each healthy recommendation. Points were summed to create an unweighted score from 0 (less healthy) to 7 (healthiest). According to their score, participants were then classified into: less healthy (0-2 points), moderately healthy (3-4 points) and the healthiest (5-7 points). Associations between the categories of lifestyle score and all-cause mortality were investigated using Cox proportional hazard models adjusted for confounders. Nonlinear associations were also investigated. PARTICIPANTS: 2706 participants from the Chilean National Health Survey 2009-2010. RESULTS: After a median follow-up of 10·9 years, 286 (10·6 %) participants died. In the maximally adjusted model, and compared with the healthiest participants, those less healthy had 2·55 (95 % CI 1·75, 3·71) times higher mortality risk due to any cause. Similar trends were identified for the moderately healthy group. Moreover, there was a significant trend towards increasing the mortality risk when increasing unhealthy behaviours (hazard ratio model 3: 1·61 (95 % CI 1·34, 1·94)). There was no evidence of nonlinearity between the lifestyle score and all-cause mortality. CONCLUSION: Individuals in the less healthy lifestyle category had higher mortality risk than the healthiest group. Therefore, public health strategies should be implemented to promote adherence to a healthy lifestyle across the Chilean population.

Efecto del sedentarismo sobre la interacción entre el gen FTO y niveles de adiposidad en adultos chilenos - Resultados del Estudio GENADIO / Effect of Sedentary behaviors on the Interaction Between the FTO Gene and Adiposity Levels in Chilean Adults - Results from the GENADIO Study

ANTECEDENTES: Tanto el gen FTO (Fat-mass and obesity-associated-gene) y el tiempo sedente se asocian a obesidad, sin embargo, se desconoce si el tiempo sedente puede modificar la predisposición genética a la obesidad. Por ende, el objetivo de este estudio fue investigar si la asociación entre el polimorfismo rs9939609 del gen FTO y marcadores de adiposidad podrían ser modificados por el tiempo sedente. MÉTODOS: Este estudio de corte transversal incluye a 409 participantes del estudio GENADIO. Los marcadores de adiposidad estudiados fueron peso corporal, índice de masa corporal (IMC), perímetro de cintura (PC) y porcentaje masa grasa. El tiempo sedente se determinó mediante acelerometría de movimiento. La interacción entre el gen FTO (rs9939609) y el tiempo sedente sobre los marcadores de adiposidad se determinó mediante análisis de regresión múltiple. RESULTADOS: Tanto la variante de riesgo del gen FTO como el tiempo sedente se asociaron a mayor peso corporal, IMC, PC y masa grasa. Sin embargo, la asociación entre tiempo sedente y marcadores de adiposidad fue mayor en personas portadoras del alelo de riesgo del gen FTO. Por cada 1 hora de incremento en tiempo sedente, el peso corporal incrementa en 1,36 kg ([95% IC: 0,27; 2,46], p = 0,015) y 2,95 kg ([95% IC: 1,24; 4,65], p = 0,001) en personas con la variante protectora (TT) versus aquellos con la variante de riesgo (AA), respectivamente. Resultados similares se encontraron para (PC). CONCLUSIÓN: La asociación entre la variante de riesgo de FTO y mayor nivel de adiposidad es más acentuada en individuos que presentan mayores niveles de sedentarismo.

BACKGROUND: The Fat-mass and obesity-associated-gene (FTO gene) and sedentary behavior time are associated with obesity. However, whether sedentary behavior time can modify the genetic predisposition to obesity in the Chilean population is unknown. Therefore, this study investigated the association between sedentary behavior, adiposity markers, and the FTO gene. METHODS: This cross-sectional study included 409 participants from the Genes, Environment, Diabetes, and Obesity (GENADIO) study. Adiposity markers studied included body weight, body mass index (BMI), waist circumference (WC), and fat mass. Sedentary behaviors were measured using accelerometers. Using multiple regression, we evaluated the interaction between sedentary behaviors and the FTO gene (rs9939609) on adiposity markers. RESULTS: Sedentary behaviors and the FTO genotype were positively associated with higher body weight, BMI, WC, and fat mass. However, the association between time of sedentary behavior and adiposity markers was higher in carriers of the risk variant for the FTO gene. For each hour of increment in sedentary behaviors, body weight increases by 1.36 kg ([95% CI: 0.27; 2.46], p = 0.015) and 2.95 kg ([95%CI: 1.24; 4.65], p = 0.001) in non-risk carriers (TT) versus risk carriers (AA), respectively. We observed similar results for WC, BMI, and body fat, but the interaction was significant only for WC. CONCLUSION: The association between sedentary behaviors and adiposity markers, especially body weight and WC, is higher in individuals who carry the risk variant of the FTO gene.

Cambios metabólicos y de aptitud cardiorrespiratoria en mujeres intervenidas con un programa de ejercicio físico asistido con una aplicación móvil: un estudio controlado no randomizado / Metabolic and cardiorespiratory fitness changes in women undergoing a physical exercise program assisted by a mobile application. A non-randomized controlled study

El síndrome metabólico (SMet) es prevalente en nuestra población. El propósito de este estudio es evaluar el efecto del ejercicio físico, asistido con una aplicación móvil (m-Health), sobre la aptitud-cardiorrespiratoria (ACR) e indicadores de riesgo cardiovascular en mujeres con alteraciones metabólicas propias del SMet, y compararlo con el efecto de ejercicio monitoreado de forma presencial en mujeres de similares características. MATERIALES Y MÉTODOS: Estudio controlado no-randomizado con dos brazos. Se reclutaron 41 mujeres con alteraciones metabólicas, 14 completaron el estudio y conformaron por conveniencia el grupo de intervención con m-Health o el control con el Programa Vida Sana, ejecutados durante 10 semanas. Se evaluó la ACR, composición corporal, antropometría, presión arterial (PA); pre y post-intervención. RESULTADOS: El 95% de las mujeres presentaron baja y muy baja ACR basal. El grupo intervenido con m-Health luego de 10 semanas, aumentó el VO2max (% cambio: + 44,4; p = 0,035) y disminuyó el perímetro de cintura (% cam- bio:-2,6; p = 0,022) y la PAD (% cambio:-14,1; p = 0,036). En tanto, el grupo control disminuyó el perímetro de cintura (% cambio:-6,5; p = 0.015) y la PAD (% cambio:-12,2; p = 0,05), pero no modificó el VO2max. Las comparaciones entre grupos no arrojaron diferencias. CONCLUSIONES: Un programa de ejercicio físico vía m-Health mejoró la ACR y parámetros antropométricos en mujeres con alteraciones cardiometabólicas.

Metabolic syndrome (MetS) is prevalent in our population. The purpose of this study is to evaluate the effect of physical exercise, assisted by a mobile application (m-Health), on cardiorespiratory fitness (ACR) and cardiovascular risk markers in women with metabolic disorders typical of MetS, and to compare it with the effect of exercise monitored face to face in women with similar characteristics. MATERIALS AND METHODS: Controlled experimental study with two arms. Forty-one women with metabolic disorders were recruited; 14 completed the study and, for convenience, formed the intervention group with m-Health or the control group with the Vida Sana Program, both carried out for ten weeks. ACR, body composition, anthropometry, and blood pressure (BP) were evaluated before and after the intervention. RESULTS: 95% of the women presented low and very low basal ACR. The group treated with m-Health after 10 weeks increased VO2max (% change: + 44.4; p = 0.035) and decreased waist circumference (% change: -2.6; p = 0.022) and DBP (% change: -14.1; p = 0.036). Meanwhile, the control group decreased waist circumference (% change: -6.5; p = 0.015) and DBP (% change: -12.2; p = 0.05) but did not change VO2 max. Comparisons between groups did not show differences. Conclusions: A physical exercise program via m-Health improved ACR and anthropometric parameters in women with cardiometabolic disorders.

Modificación de estilos de vida de adolescentes chilenos durante el primer confinamiento por COVID-19 / Lifestyle modifications of chilean adolescents during the first COVID-19 confinement

ABSTRACT BACKGROUND: Confinement is an effective measure to control COVID-19, but it can have repercussions on lifestyle-related behaviors, especially among adolescents. Poor quality diet and low physical activity could trigger weight gain and the appearance of chronic non-communicable diseases at an early age. AIM: To investigate the changes in eating and physical activity patterns before and during the first COVID-19 confinement in Chilean adolescents. MATERIAL AND METHODS: Chilean adolescents aged between 10 and 19 years were invited to answer an online survey with 47 questions about dietary habits and physical activity. RESULTS: The survey was answered by 420 participants and only four adolescents declined to answer it. Changes in eating patterns were evidenced, such as an increase in lunch consumption from 54.1 to 83%, and a decrease in the consumption of both healthy and unhealthy foods. Also, significant changes were observed in physical activity patterns, and an increase in the time spent sitting, from 4.7 to 5.8 hours during confinement. CONCLUSIONS: The first confinement for COVID-19 modified eating and physical activity patterns in Chilean adolescents towards unhealthy habits, which if maintained, could negatively affect their health and quality of life.

Changes of Physical Activity and Ultra-Processed Food Consumption in Adolescents from Different Countries during Covid-19 Pandemic: An Observational Study.

AIM: to describe physical activity and ultra-processed foods consumption, their changes and sociodemographic predictors among adolescents from countries in Europe (Italy and Spain) and Latin America (Brazil, Chile, and Colombia) during the SARS-CoV-2-pandemic period. METHODS: Cross-sectional study via web survey. International Physical Activity Questionnaire (IPAQ) and weekly ultra-processed food consumption data were used. To compare the frequencies of physical activity status with sociodemographic variables, a multinomial logistic and a multiple logistic regression for habitual ultra-processed foods was performed. In final models, p < 0.05 was considered significant. RESULTS: Sample of 726 adolescents, mostly females (59.6%) aged 16-19 years old (54.3%). Adolescents from Latin America presented odds ratio (OR) 2.98 (CI 95% 1.80-4.94) of being inactive and those whose mothers had higher level of education were less active during lockdown [OR 0.40 (CI 95% 0.20-0.84)]. The habitual ultra-processed consumption was also high during this period in all countries, and more prevalent in Latin America. CONCLUSION: A higher prevalence of inactivity was observed in this population, but reductions of physical activity and habitual ultra-processed consumption during the pandemic were more pronounced in Latin America. Our findings reinforce the importance of promoting a healthy lifestyle, i.e., exercise and diet, during periods of social isolation.

[Questionnaire for measuring risk eating behaviors for excess malnutrition in adolescents]. / Cuestionario para medir conductas alimentarias de riesgo de malnutrición por exceso en adolescentes.

INTRODUCTION: Introduction: there are behavioral factors that predispose to the development of excess malnutrition, and which can be key to the promotion of healthy habits. The purpose of this study was to construct and validate a questionnaire to identify risky eating behaviors in adolescents. Objective: to evaluate the psychometric properties of a questionnaire to measure risky eating behaviors related to excess malnutrition in adolescents in the province of Concepción, Chile. Materials and methods: quantitative psychometric research with correlational scope; non-experimental, cross-sectional design. The population was composed by adolescents aged 10 to 15 years in the province of Concepción, from different socio-economic levels. A total of 303 students, chosen by non-probabilistic sampling, responded to the Questionnaire on Alimentary Malnutrition Risk Behaviors, CARME. A subsample of 115 students also answered a body image questionnaire, and 80 were assessed anthropometrically. Exploratory factor analyses and correlation evaluations were performed. Results: four factors were identified for the CARME: response to food, feeding without control, consumption of highly caloric foods, and emotional feeding, with reliability between α = 0.64 and α = 0.87. Scores showed differences by sex, and relationships with perceived body image (p < 0.05), but not with nutritional status. Conclusions: the evidence supports the construct validity, reliability and criteria validity of CARME. The questionnaire would be appropriate to measure dietary risk behaviors for overweight and obesity in adolescents. However, no associations were found between nutritional status and questionnaire dimensions.

INTRODUCCIÓN: Introducción: existen conductas que predisponen al desarrollo de malnutrición por exceso cuya detección es clave para la promoción de hábitos saludables. Esto hace necesario contar con instrumentos con evidencia de validez y confiabilidad que permitan diagnosticar e investigar este fenómeno oportunamente. Objetivo: construir y evaluar las propiedades psicométricas de un cuestionario que evalúa las conductas alimentarias de riesgo de malnutrición por exceso en adolescentes chilenos. Material y métodos: se realizó una investigación cuantitativa, psicométrica, analítico-relacional por encuesta. La población estuvo compuesta por adolescentes de 11 a 18 años de la provincia de Concepción, Chile. De esta, 303 estudiantes, elegidos por muestreo no probabilístico por cuotas, respondieron el Cuestionario de Conductas Alimentarias de Riesgo de Malnutrición por Exceso (CARME). Una submuestra respondió además a un cuestionario de imagen corporal y fue evaluada antropométricamente. Se realizó un análisis factorial exploratorio del CARME, se analizó su confiabilidad y se evaluó su relación con otras variables para evaluar su validez de criterio. Resultados: los ítems del CARME se organizaron en cuatro factores: respuesta frente a alimentos, alimentación sin control, consumo de alimentos altamente calóricos y alimentación emocional. Sus confiabilidades fueron de cuestionables (α = 0,64) a muy buenas (α = 0,87). Al evaluar su asociación con otras variables se encontraron relaciones con la percepción de la imagen corporal (p < 0,05), pero no con el estado nutricional. Conclusiones: la evidencia apoya la validez de constructo, la confiabilidad y la validez de criterio del CARME. El cuestionario sería adecuado para medir conductas alimentarias de riesgo de sobrepeso y obesidad en adolescentes.