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.

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.