RESUMO
BACKGROUND: Depression is a highly prevalent disease in Chilean adults. AIM: To identify sociodemographic, biomedical, and psychosocial factors related with depression in a representative sample of the Chilean adult population. MATERIAL AND METHODS: Analysis of data from the National Health Survey 2016-2017 which included 5,291 participants aged > 15 years. Depression was assessed using the Composite International Diagnostic Interview (CIDI-SF). Association between sociodemographic data, health and psychosocial variables and depression was analyzed using Poisson regression with robust error. RESULTS: The probability of depression was higher in women than in men (prevalence ratio (PR) = 2.13 [95% confidence intervals (CI): 1.65, 2.75]). In both genders, the probability was higher in people with frailty (women: PR = 10.0 [95% CI: 1.86, 18.1] and men: PR = 3.38 [95% CI: 2.72; 4.20]), severe chronic pain (women: PR = 2.84 [95% CI: 1.93, 4.18 and men: PR = 6.41 [95% CI: 3.59, 9.40]), presence of two or more diseases (women: PR = 4.15 [95% CI: 2.78, 6.20 and men: PR = 2.60 [95% CI: 1.39, 3.81]), perception of permanent stress (women: PR = 11.0 [95% CI: 6.13, 16.0], men: PR = 21.0 [95% CI: 10.2, 31.7]), financial stress (women: PR = 2.57 [95% CI: 1.87, 3.27] men: PR = 4.27 [95% CI: 2.48, 6.06] and poor or very poor perception of health (women: PR = 5.02 [95% CI: 1.92, 8.12], men: 2.09 [95% CI: 0.49, 3.69]). In men, the probability of depression was higher for widowers than married man (PR = 5.58 [95% CI: 2.5, 8.25]), presence of goiter (PR = 4.03 [95% CI: 1.99, 6.07]) and low social support (PR = 1.95 [95% CI: 1.18; 2.72]). CONCLUSIONS: The factors associated with a higher probability of depression are diverse in nature. Among these being women, frailty, chronic pain, multimorbidity and high perception of stress are important factors.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Depressão/epidemiologia , Chile/epidemiologia , Prevalência , Inquéritos EpidemiológicosRESUMO
ABSTRACT Objective: To study the association of SLC16A11 gene variants with obesity and metabolic markers in nondiabetic Chilean adults. Materials and methods: This cross-sectional study included 263 non-diabetic adults. The genotype of the rs75493593 polymorphism of SLC16A11 gene was performed by real-time PCR. It's association with adiposity markers (body weight, BMI, waist circumference and fat mass percentage), metabolic markers (glucose, insulin, HOMAIR, leptin, total cholesterol, LDLc, HDLc, triglycerides, ALT, GGT and hsCRP) and blood pressure was analyzed by linear regression. Results: The minor allele (T) of the SLC16A11 gene (rs75493593) has a frequency of 29.7% among Chileans. Risk genotypes (GT and TT) were associated with a significant 1.49 mU/l increase in plasmatic insulin for each copy of the minor allele (95% CI: 0.12, 2.87, p < 0.05). This association remained significant after adjusting for socio-demographic variables, physical activity and smoking (1.36 mU/l, 95% CI: 0.16, 2.58 p < 0.05), but was lost when BMI was included as a confounding factor. Higher BMI was also significantly associated with polymorphic genotypes in SLC16A11, independent of socio-demographic variables. Conclusion: The minor allele of the SLC16A11 gene (T) is highly prevalent among Chileans and is associated with increased insulin and BMI in nondiabetic individuals. These findings suggest that the genetic variant in SLC16A11 is not only associated with type 2 diabetes as previously shown in Mexicans, but is also related to early metabolic alterations in healthy subjects that may lead to type 2 diabetes.
Assuntos
Humanos , Adulto , Índice de Massa Corporal , Transportadores de Ácidos Monocarboxílicos/genética , Insulina/sangue , Chile , Estudos Transversais , Diabetes Mellitus Tipo 2 , Circunferência da CinturaRESUMO
Resumen: Introducción: La obesidad es una enfermedad inflamatoria donde la genética determina cierto nivel de riesgo. Aun cuando existen estudios que reportan asociación entre polimorfismos de FTO (fat-mass associated gene) y adiposidad, existe limitada evidencia en población infantil chilena. Objetivo: determinar la asociación entre el polimorfismo rs9939609 del FTO y marcadores de adiposidad en población in fantil chilena. Pacientes y Método: Estudio de corte transversal incluyó 361 participantes (de 6 a 11 años; 50% niñas). Los datos clínicos y la recolección de muestras de sangre se realizaron entre marzo y junio de 2008. El polimorfismo SNP (rs9939609), del gen FTO, se determinó utilizando ADN genómico extraído de leucocitos, utilizando el Mini Kit QIAamp DNA Blood (Qiagen GmbH, Hilden, Alemania). Los marcadores de adiposidad estudiados fueron, índice de masa corporal (IMC), masa grasa, perímetro de cintura (PC) y razón cintura/talla, y se compararon ajustados por sexo, edad y estadio de Tanner. La asociación entre el polimorfismo estudiado y los marcadores de obesidad se realizó mediante análisis de regresión lineal. Resultados: Al ajustar los marcadores por sexo, edad y estadío de Tanner se observó una asociación significativa entre el polimorfismo e indicadores de adi posidad. Por cada copia extra del alelo de riesgo se encontró un aumento de 2,47 kg de peso corporal, (IC 95%: 1,39-3,55); 1,06 kg/m2 de IMC, (IC 95%: 0,56-1,54); 2,55 cm de PC, (IC 95%: 1,26-3,85) y 1,98% de masa grasa, (IC 95%: 0,78-3,19). Al convertir los marcadores de adiposidad a z-score, la razón perímetro de cintura/talla arrojó la mayor asociación con el alelo de riesgo de FTO. Conclu sión: Este estudio indica asociación entre el polimorfismo rs9939609 del gen FTO con marcadores de adiposidad general y central en población infantil en Chile.
Abstract: Introduction: Obesity is considered a chronic inflammatory disease with an important genetic component. Although several studies have reported an association between the FTO (fat-mass associated gene) and adiposity in children, there is limited evidence in the Chilean population. Objective: To deter mine the association between the polymorphism rs9939609 of the FTO gene and markers of adipo sity in Chilean children. Patients and Method: Cross-sectional study which included 361 children aged between 6 and 11 years (50% were girls). Between March and June 2008, clinical data and blood sample collection was carried out. The rs9939609 single-nucleotide polymorphism (SNP) of the FTO gene, was determined using the genomic DNA extracted from leukocytes, using the QIAamp DNA Blood Mini Kit (Qiagen GmbH, Hilden, Germany).The adiposity markers included were body mass index (BMI), waist circumference (WC), body fat, and WC/H index; which were later compared adjusted by sex, age, and Tanner stage. Linear regression analyses were conducted to detect the association between the polymorphism and obesity markers. Results: After adjusting the models by age, sex, and Tanner stage, we found a significant association between the polymorphism and markers of adiposity. For each extra copy of the risk allele, we found an increase of 2.47 kg body weight (95% CI: 1.39-3.55); 1.06 kg/m2 BMI (95% CI: 0.56-1.54); 2.55 cm WC, (95% CI: 1.26-3.85); and 1.98% body fat (95% CI: 0.78-3.19). When converting adiposity markers to z-score, we found that WC/height index shows the strongest association with the risk allele FTO. Conclusion: This study supports the association between the rs9939609 SNP of the FTO gene and overall and central adiposity markers in Chilean children.
Assuntos
Humanos , Masculino , Feminino , Criança , Predisposição Genética para Doença , Polimorfismo de Nucleotídeo Único , Adiposidade/genética , Obesidade Infantil/genética , Dioxigenase FTO Dependente de alfa-Cetoglutarato/genética , Marcadores Genéticos , Modelos Lineares , Chile , Estudos Transversais , Obesidade Infantil/diagnóstico , Obesidade Infantil/patologiaRESUMO
Background: Sugar intake is a risk factor for the development of obesity. Aim: To investigate the association between total sugar intake and obesity markers in Chilean adults. Material and Methods: This cross-sectional study included 396 participants of the GENADIO study. Anthropometric measurements (body weight, body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio, and % body fat) were measured through standardized protocols. Total sugar intake was determined from a 7-days weighted food daily. Sugar intake expressed in g/day was categorized into quartiles. Results: Higher sugar intake was associated with a higher BMI, WC and HC but not with body fat %. One quartile increment in sugar intake was associated with 1.50 kg [95% confidence interval (CI): 0.49; 2.50] higher body weight, 0.34 kg/m2 [95% CI: 0.01; 0.69] higher BMI, 1.23 cm [95% CI: 0.11; 2.34] higher WC, 1.39 cm [95% CI: 0.28; 2.50] higher HC and 0.02 the waist-to-hip ratio [95% C: 0.01; 0.02]. Conclusions: Total sugar intake was associated with higher adiposity levels in these Chilean adults.
Assuntos
Humanos , Adulto , Açúcares da Dieta/efeitos adversos , Obesidade/epidemiologia , Chile/epidemiologia , Estudos TransversaisRESUMO
Actualmente los edulcorantes no nutritivos (ENN) son ampliamente usados para endulzar los alimentos en reemplazo de los azúcares simples, con la ventaja de no aportar energía. A pesar de que en general no presentan efectos tóxicos, los estudios epidemiológicos no han podido evidenciar que su uso contribuya a mejorar la pérdida de peso, sino por el contrario, han revelado que los ENN pueden inducir alteraciones metabólicas como intolerancia a la glucosa. Estudios in vivo e in vitro han mostrado que muchos ENN activan a receptores del sabor dulce no sólo en los botones gustativos, sino que también en los receptores presentes en tejidos como el adiposo y pancreático, interfiriendo con su función normal. Además, el consumo ENN se ha asociado a alteraciones de la composición de la microbiota intestinal que conducen a una respuesta inflamatoria de bajo grado. La nueva evidencia disponible sobre los ENN hace necesario evaluar el uso cada vez más intenso de los ENN en Chile. Debido a que el gusto exacerbado por el sabor dulce que cultivamos desde la infancia es un potente catalizador del uso de ENN, proponemos que una oportuna educación del sentido del gusto puede contribuir a mejorar las elecciones alimentarias.
Currently, non-nutritive sweeteners (NNS) are widely used to sweeten foods instead of simple sugars, as they possess the advantage of not contributing to energy intake. Although they do not present toxic effects in general, epidemiological studies have not been able to show benefits when they are used in weight loss programs. However, they could induce metabolic alterations such as glucose intolerance. In vivo and in vitro studies have shown that many NNSs activate sweet taste receptors not only in the taste buds, but also in receptors present in adipose and pancreatic tissues, interfering with their normal function. In addition, NNS consumption has been associated with an alteration in the composition of the gut microbiota that leads to a low-grade inflammatory response. Due to the wide use of NNS in Chile, it is necessary to evaluate the potential health effects of using NNS in the Chilean population. We propose that a timely education of the sense of taste can contribute to moderating the preference for higher levels of sweet taste that humans develop in childhood, which could help to improve food choices.
Assuntos
Humanos , Intolerância à Glucose/induzido quimicamente , Adoçantes não Calóricos/efeitos adversos , Chile , Saúde Global , Diabetes Mellitus/induzido quimicamente , ObesidadeRESUMO
RESUMEN Objetivos: Identificar las consecuencias psicosociales de la pandemia y definir propuestas para sobrellevar los efectos negativos de la pandemia y el confinamiento en la salud mental. Material y Método: Para el primer objetivo se realizó una búsqueda de artículos empíricos en inglés o español, indexados en las bases de datos Web of Science, publicados entre enero y mayo de 2020. Para el segundo objetivo se amplió la búsqueda, desde el año 2004 en adelante, a revisiones, encuestas nacionales, comunicaciones breves y reportes de organismos internacionales, tales como la OMS, el Centro de Control de Enfermedades de los Estados Unidos (CDC), y el Centro Europeo de Control de Enfermedades (ECDC). Resultados: Se analizaron 11 artículos científicos y 6 documentos. La experiencia emocional ante la pandemia es de amplia variabilidad individual, reportándose alta prevalencia de angustia psicológica y ansiedad. La severidad de los síntomas se relacionó con la duración del aislamiento, miedo a contraer la enfermedad, inestabilidad financiera y exposición a los medios de comunicación. Para el manejo de las consecuencias adversas, se propone cautelar la satisfacción de necesidades básicas, mantener vínculos sociales y recibir información veraz y no alarmista de parte de las autoridades y medios de comunicación. Conclusión: Las consecuencias de la pandemia incluyen malestar y respuestas de temor y ansiedad. En las personas en las que se conjugan situaciones de abandono y exclusión social, el confinamiento precariza aún más esta condición. Considerando que la pandemia se da en un contexto de alta heterogeneidad, la dimensión psicosocial debe constituir un eje de acción prioritario.
ABSTRACT Objective: To identify the psychosocial consequences of the pandemic and to define proposals for coping with the negative effects of the pandemic and confinement on mental health. Materials and Methods: For the first objective we searched for empirical articles in English or Spanish, published between January and May 2020, and indexed in the Web of Science data base. For the second objective, the search was expanded, from the year 2004 onwards, to reviews, national surveys, short communications and reports from international organizations such as the WHO, the United States Center for Disease Control (CDC), and the European Centre for Disease Control (ECDC). Results: 11 scientific articles and 6 documents were analyzed. The emotional experience related to the pandemic has a wide range of individual variability, with a high prevalence of psychological distress and anxiety reported. The severity of symptoms was related to the period of isolation, fear of contracting the disease, financial instability and media exposure. In order to manage adverse consequences, it is recommended to satisfy basic needs, maintain social ties and receive truthful and non-alarmist information from the authorities and the media. Conclusion: The consequences of the pandemic include discomfort and responses of fear and anxiety. For people who suffer abandonment and social exclusion, confinement makes this condition even more precarious. Considering that the pandemic occurs in a context of high heterogeneity, the psychosocial dimension should also be a priority.
RESUMO Objetivo: Identificar as consequências psicossociais da pandemia e definir propostas para lidar com os efeitos negativos da pandemia e o confinamiento na saúde mental. Material e método: Para o primeiro objetivo foi realizada uma busca de artigos empíricos em inglês ou espanhol, indexados no banco de dado Web of Science, publicados entre janeiro e maio de 2020. Para o segundo objetivo a busca foi ampliada, da partir de 2004, a revisões, pesquisas nacionais, breves comunicações e relatórios de organizações internacionais, tais como OMS, Centro de Controle e Prevenção de Doenças dos Estados Unidos (CDC), e o Centro Europeu de Controle de Doenças (ECDC). Resultados: 11 artigos científicos e 6 documentos foram analisados. A experiência emocional ante a pandemia é de grande variabilidade individual, relatando uma alta prevalência de sofrimento psíquico e ansiedade. A gravidade dos sintomas estava relacionada à duração do isolamento, medo de contrair a doença, instabilidade financeira e exposição à mídia. Para gerenciar as consequências adversas, propõe-se proteger a satisfação de necessidades básicas, manter laços sociais e receber informação verdadeira e não alarmista das autoridades e da mídia. Conclusão: As consequências da pandemia incluem desconforto e respostas de medo e ansiedade. Nas pessoas em situação de abandono e exclusão social, o confinamiento torna essa condição ainda mais precária. Considerando que a pandemia ocorre em um contexto de alta heterogeneidade, a dimensão psicossocial deve constituir um eixo prioritário de ação.
Assuntos
Humanos , Estresse Psicológico , Saúde Mental , Infecções por Coronavirus , Pandemias , Ansiedade , Pneumonia Viral , Qualidade de Vida , BetacoronavirusRESUMO
El objetivo del trabajo fue analizar el posible efecto protector de la lactancia materna respecto a la obesidad infantil versus fórmulas lácteas. Se consultaron las bases de datos PubMed, Web of Science y Scielo, considerándose los artículos más actualizados sobre el tema. La evidencia analizada señala que los menores alimentados con lactancia materna exclusiva reportan bajos niveles de sobrepeso y obesidad, a diferencia de los alimentados con fórmulas lácteas infantiles. Se concluye que la lactancia materna exclusiva, hasta el sexto mes de vida del lactante, y complementada con alimentación solida (no láctea) hasta los dos o más años, es recomendada y podría proteger contra la obesidad infantil y sus comorbilidades asociadas en la vida adulta.
The aim was to review the evidence supporting the possible health benefits for obesity of breastfeeding versus formula feeding in infants. The search for studies addressing this topic was conducted in PubMed, Web of Science and Scielo databases. "Breastfeeding", "formula feeding" and "obesity" were the keywords used in the search. Only studies with a full version of the manuscript were included. The evidence analyzed indicated that children fed exclusively through breastfeeding reported low levels of overweight and obesity in comparison to those fed by infant milk formulas. To conclude, exclusive breastfeeding until the sixth month of life, and supplementation with solid (non-dairy) food until two years and more, is the gold standard and could protect against childhood obesity and its associated comorbidities in adult life.
Assuntos
Humanos , Masculino , Feminino , Lactente , Aleitamento Materno , Laticínios , Fórmulas Infantis , Obesidade Infantil/prevenção & controleRESUMO
RESUMEN Cumplir las recomendaciones incluidas en las Guías Alimentarias permite un acercamiento hacia un estilo de vida saludable. El objetivo de este estudio fue caracterizar los estilos de vida de la población chilena y su asociación al cumplimiento de 5 recomendaciones de las Guías Alimentarias Basadas en Alimentos (GABA) chilenas. Se utilizaron datos de la Encuesta Nacional de Salud 2016-2017. Los participantes fueron divididos en 4 grupos: aquellos que no cumplieron con ninguna recomendación, los que cumplían una, los que cumplían con 2 y los que cumplían con 3 o más recomendaciones saludables, estableciendo a este último como grupo de referencia. El 43,3% de la muestra no cumplió ninguna de las recomendaciones incorporados en esta investigación. De los que cumplían a lo menos 3, el 35,9% presentó un estado nutricional normal, el 38,9% reportó nunca haber fumado y el 82% se auto percibía como saludable. Además, los que cumplían las recomendaciones, presentaron niveles más altos de actividad física. Personas que incorporan y aplican las recomendaciones de las GABA, tienden a presentar conductas de vida más saludable. Estrategias comunicacionales efectivas y formativas en educación alimentaria sobre estas recomendaciones son claves para prevenir el acelerado y temprano crecimiento de las patologías crónicas.
ABSTRACT Compliance with dietary guidelines is essential for adoopting a healthy lifestyle. This study aimed to characterise the lifestyles of the Chilean population according to the fulfilment of 5 recommendations of the Food-Based Dietary Guidelines (GABA in Spanish) established in Chile according to WHO definition. Data from the 2016-2017 National Health Survey were used. Participants were divided into four groups: those who did not meet any recommendations, those who met one, those who met two and those who met three or more (reference group) GABA health recommendations. 43.3% of the sample did not meet any of the recommendations incorporated into this study. Of those who fulfilled at least three recommendations, 35.9% had a normal nutritional status, 38.9% reported never having smoked, and 82% perceived themselves as healthy. In addition, those who fulfilled the recommendations presented higher levels of physical activity (1343.5 MET/min/day [95% CI: 1049.9 - 1637.2]). From the results, it is inferred that people who incorporate and apply GABA recommendations tend to present healthier life behaviours. Consequently, effective and formative communication strategies in food education on these recommendations are crucial to preventing a fast and early growth of chronic diseases.
Assuntos
Humanos , Estado Nutricional , Alimentos , Estilo de Vida , Exercício Físico , Saúde , Doença CrônicaRESUMO
RESUMEN Introducción: si bien la conducta alimentaria depende de múltiples factores, existe acuerdo en la importancia de aspectos socio-ambientales en los que la familia tiene un rol central, especialmente en edades tempranas. Objetivo: sistematizar evidencia científica actualizada sobre la asociación entre actitudes y prácticas de alimentación infantil, conducta alimentaria y estado nutricional del niño. Método: revisión narrativa de 40 artículos empíricos publicados entre los años 2011 y 2019. Resultados: se identificó tendencia en los padres a subestimar el peso corporal en niños con sobrepeso, y asociación entre preocupación por el peso, presión para comer y estado nutricional del niño. La alimentación restrictiva y el uso de la alimentación para fines instrumentales y controlar emociones, no serían prácticas efectivas, posiblemente porque interfieren en la capacidad de autorregulación del niño. Prácticas positivas incluyeron monitoreo, modelado de patrones alimentarios saludables y creación de ambientes no obesogénicos. Conclusión: existen hallazgos consistentes respecto a que prácticas coercitivas pueden ejercer efectos negativos en la conducta alimentaria infantil y prácticas que promueven la estructuración en la alimentación y un entorno positivo, serían más funcionales. La evidencia internacional es consistente en la relevancia de padres y cuidadores en la promoción de una conducta alimentaria saludable y la condición nutricional de niños.
ABSTRACT Introduction: In the last years, there has been an exponential increase in childhood obesity rates worldwide. Although eating behavior depends on multiple factors, there is agreement on the impact of socio-environmental aspects in which the family has a central role. Identifying the influence of parents and caregivers on child eating behavior can help to generate effective strategies for controlling obesity, especially at early stages. Aim: To review recent scientific evidence on the association between parental feeding attitudes and practices, eating behavior and nutritional status of the child. Method: Narrative review of 40 empirical articles published between 2011 and 2019. Results: Parents tend to underestimate body weight in overweight children. Weight concern and pressure to eat are associated with the nutritional status of the child. Restrictive feeding and the use of food for instrumental purposes and as a mean of controlling emotions, would not be effective practices, possibly because they interfere with the child's ability to self-regulate intake. Positive practices included monitoring, modelling healthy eating patterns and creating non-obese environments. Conclusion: Consistent findings support the notion that coercive practices could have negative effects on child eating behavior. Moreover, practices that promote structured and a positive environment could be more functional. However, international evidence is consistent in the relevance of parents and caregivers in promoting healthy eating behavior and the nutritional status of children.
Assuntos
Criança , Adolescente , Emoções , Comportamento Alimentar , Dieta Saudável , Família , Sobrepeso , AlimentosRESUMO
Ageing will be one of the most significant social transformations of the 21st century worldwide. In the last 40 years, Chile has tripled its older adult population. As a result, by 2050 the country will have the highest proportion of older adults in Latin America. This remarkable growth reinforces the need to identify their current situation and to revise what is the society doing to maintain older people as active members. In this context, this narrative revision aimed to describe the sociodemographic, epidemiologic and sociocultural profile of the older Chilean adults. Besides, programs and public policies focused on the improvement of their quality of life were identified.
Assuntos
Humanos , Idoso , Idoso de 80 Anos ou mais , Qualidade de Vida , Política Pública , Envelhecimento , Chile/epidemiologia , Economia Médica , Serviços de Saúde , América LatinaRESUMO
Background: Depression has been previously associated with cognitive impairment in high income country populations. However, its association in the Chilean population has not been investigated. Aim: To investigate the association between depression and cognitive impairment. Material and Methods: Data from 1384 Chilean adults aged > 60 years, participating in the National Health Survey 2009-2010 was analyzed. Cognitive impairment was assessed using the Mini Mental Examination score. The medical diagnosis of depression was self-reported. The association between depression and cognitive impairment was assessed using a logistic regression. Results: Depression was positively associated with cognitive impairment. However, the magnitude of the association was higher in men (Odds ratio (OR) = 4.02 [95% confidence intervals (CI): 1.44; 6.61], p < 0.01]) than in women (OR = 2.23 [95%CI: 1.03; 3.43], p = 0.04). Older adults who were diagnosed for the first time with depression after 65 years of age, showed a stronger association with cognitive impairment (OR = 6.65 [95% CI: 2.39; 10.9], p < 0.01) than those diagnosed before 55 years. Conclusions: Our study confirms the association between depression and cognitive impairment. Further research is needed to elucidate the nature and potential mechanisms that link depression with cognitive impairment.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Depressão/epidemiologia , Disfunção Cognitiva/epidemiologia , Chile/epidemiologia , Inquéritos EpidemiológicosRESUMO
Chile tiene una de las tasas de obesidad más altas del mundo. Se estima que para el año 2030 las muertes atribuidas a esta enfermedad alcanzarían a 204 mil personas, incrementándose además los costos económicos asociados a esta patología. Las causas y los factores de riesgo asociados al desarrollo de obesidad son diversos. Sin embargo, existe consenso que una de las maneras más eficaces de prevenir y/o disminuir su prevalencia es abordando los factores de riesgo modificables, a través del fomento de hábitos de vida saludable con un enfoque integral, centrados en la alimentación saludable, práctica de actividad física, prevención del tabaquismo y consumo de alcohol, como también en el cuidado de la salud mental del individuo. No obstante, el desafío es cómo hacer realidad estos buenos propósitos. En este contexto, el objetivo de esta revisión, parte 2, fue investigar los principales factores modificables, con énfasis en los factores individuales, que han repercutido en el desarrollo de obesidad: desde una mirada global hasta el caso particular de Chile.
Chile has one of the highest rates of obesity worldwide. Deaths attributed to obesity are likely to increase to 204,000 by 2030. There will be also a higher economic burden associated with this disease. There are many factors associated with obesity; however, it is known that one of the most effective strategies to decrease its prevalence is reducing modifiable risk factors, such as improving dietary patterns, performing physical activity, avoiding smoking and drinking alcohol as well as improving mental health. Nevertheless, how to make realize these changes is one of the biggest challenges. In this context, the aim of this literature review, chapter 2, was to investigate the main modifiable risk factors, with emphasis on individual factors, associated with the development of obesity in Chile: from a global view to the Chilean context.
Assuntos
Humanos , Obesidade/prevenção & controle , Obesidade/epidemiologia , Estresse Psicológico , Tabagismo , Consumo de Bebidas Alcoólicas , Exercício Físico , Chile/epidemiologia , Fatores de Risco , Higiene do Sono , Dieta SaudávelRESUMO
Background: Menopause exposes women to an increased cardiovascular risk. Aim: To determine the association between menopause and cardiovascular risk factors in Chilean adult women using data from the National Health Survey (NHS) 2016-2017. Material and Methods: Data from 2,139 women over 40 years of age participating in the NHS 2016-2017, with information about menopause and cardiovascular risk factors was used. Expansion factors were applied to this sample, obtaining an expanded sample of 3,733,191 participants. Laboratory values (blood glucose, triglycerides, HDL and total cholesterol) and anthropometric measurements (body weight, height and waist circumference) were analyzed. The presence of hypertension, diabetes, and metabolic syndrome (MetS) were also recorded. Results: Sixty seven percent of surveyed women were menopausal and had higher systolic blood pressure than non-menopausal participants. Menopause was significantly associated with hypertension (Odds ratio (OR): 2.43 [95% confidence intervals (CI): 1.71; 3.45], p < 0.01) and diabetes (OR: 2.05 [95% CI: 1.32; 3.19], p < 0.01). However, no association was observed with obesity, abdominal obesity or MetS. Conclusions: In these women, a positive association was identified between menopause and hypertension as well as diabetes.
Assuntos
Humanos , Feminino , Adulto , Doenças Cardiovasculares , Síndrome Metabólica , Pressão Sanguínea , Menopausa , Índice de Massa Corporal , Chile , Fatores de Risco , Inquéritos EpidemiológicosRESUMO
RESUMEN Introducción: La determinación del nivel de actividad física (AF) puede realizarse a través de acelerómetro o mediante cuestionario de auto-reporte. El objetivo de este estudio fue comparar los niveles de AF entre un cuestionario de auto-reporte y la medición con acelerómetro de movimiento según factores sociodemográficos en la población chilena. Métodos: Estudio de corte transversal que incluyó a 230 adultos chilenos participantes del proyecto Genes, Ambiente, Diabetes y Obesidad (GENADIO). Niveles de AF fueron medidos mediante el cuestionario Internacional Physical Activity Questionnaire (IPAQ) y acelerómetro de movimiento (ActiGraph). Resultados: IPAQ subestimó los niveles de AF total en comparación a la medición con acelerómetro (delta [IPAQ-Acel.]= −55,7 min/día). Según nivel educacional, se evidenció que el cuestionario IPAQ sobreestimó los niveles de AF total en personas con bajo nivel educacional (delta [IPAQ-Acel.]= 70,4 min/día), pero subestimó la AF total en personas con enseñanza media o técnico universitaria (delta [IPAQ-Acel.]= −67,9 y −135,6 min/día, respectivamente). Resultados similares fueron observados para los distintos niveles de ingreso socioeconómico (NSE). Conclusión: El cuestionario de auto-reporte IPAQ subestimó los niveles de AF total en comparación a la medición por acelerómetro; sin embargo, estas diferencias variaron según factores sociodemográficos.
ABSTRACT Introduction: Determining level of physical activitY (PA) can be done with objective measurement, through accelerometer, or by subjective measurement through self-report questionnaire. The aim of this study was to compare PA measurements derived from a self-reported questionnaire and accelerometer according to sociodemographic factors in the Chilean population. Methods: This was a cross-sectional study which included 230 Chilean adults participating in the GENADIO study (Genes, Environment, Diabetes and Obesity). PA levels were measured through the International Physical Activity Questionnaire (IPAQ) and GT1M accelerometer (ActiTrainer, ActiGraph). Results: IPAQ questionnaire underestimated the total PA levels compared to the accelerometer measurement (delta[IPAQ-Acel.]= −55.7 min/day). According to educational level, IPAQ questionnaire overestimated PA level in people with low educational level (delta[IPAQ-Accel.]= 70.4 min/day), but underestimated total PA in people with secondary education or university technician (delta[IPAQ-Accel.]=-67.9 and-135.6 min/day, respectively). Similar results were observed for the different levels of socioeconomic income. Conclusion: The IPAQ questionnaire underestimated total PA levels compared to accelerometer; however, these differences varied according to sociodemographic factors.
Assuntos
Adulto , Exercício Físico , Obesidade , População , Doença Crônica , Ensino Fundamental e Médio , Meio Ambiente , GenesRESUMO
Background: It is unknown if nutritional status could influence the accuracy of self-reported physical activity (PA) levels. Aim: To compare PA measured using the international physical activity questionnaire (IPAQ) and by accelerometry (ActiGraph) according to nutritional status in Chilean adults. Material and Methods: This is an observational cross-sectional study that used information from the GENADIO project carried out in Chile between 2009-2011. The sample consisted of 322 people. PA levels and sitting time were determined through the IPAQ self-report questionnaire and ActiGraph accelerometers (GTM1). The nutritional status was determined according to body mass index (BMI). Results: Compared with the measurement made with accelerometry, the IPAQ self-report questionnaire underestimated the levels of light PA, total PA and sedentary time in −171.5, −54.8 and −40.6 min / day, respectively. However, IPAQ overestimated the levels of moderate PA and vigorous PA in 91.0 and 47.3 min/day respectively, compared with accelerometry. Compared with normal weight, obese subjects reported higher levels of moderate PA (105.5 and 48.9 min/day, respectively) and vigorous PA (54.1 and 38.3 min/day respectively). Total PA had a greater delta of underestimation between IPAQ and accelerometer measurements in normal weight than in obese subjects (-122.1 vs −16.5 min/day, respectively). Conclusions: The measurement of PA by means of a self-report questionnaire was discrepant with its objective measurement with an accelerometer. The discrepancy is even higher in obese people.
Assuntos
Humanos , Exercício Físico , Estado Nutricional , Chile , Estudos Transversais , Inquéritos e Questionários , Autorrelato , Atividade MotoraRESUMO
Background: One of the side effects of cancer treatment is a low level of physical activity (PA) due to fatigue and pain. Aim: To quantify PA levels in Chilean people with cancer. Material and Methods: Analysis of the National Health Survey 2016-2017 including 6,233 participants, comparing those with and without a self-report of cancer was conducted. Levels of PA and sitting time were assessed using the Global Physical Activity Questionnaire. Results: 3% of participants [confidence intervals (CI): 2.6; 3.9] reported having cancer and 34% [95% CI: 22.7; 46.7] of these reported being physically inactive, compared to 25% [95% CI: 22.5; 27,3] of those without cancer. Participants with cancer performed 56 and 77 minutes/day lower vigorous and total PA than participants without cancer. No differences between groups were observed for commuting PA, moderate PA and sedentary time. Lower level of PA was independent of the years elapsed since the diagnosis of cancer. Conclusions: People with cancer are less physically active than their counterparts without the disease.
Assuntos
Humanos , Comportamento Sedentário , Neoplasias , Exercício Físico , Chile , Inquéritos e Questionários , Inquéritos EpidemiológicosRESUMO
BACKGROUND: Triclosan (TCS) is an antimicrobial agent widely used in health care and consumer products. This compound is present in sludge of wastewater treatment plants (WWTPs), and because of its bactericidal characteristics, it can inhibit the methanogenic activity in anaerobic digestion (AD) technology. The aim of this study was to evaluate the toxic effects of TCS on the methanogenic activity. RESULTS: Batch anaerobic reactors were used with TCS concentrations of 7.8, 15.7, 23.5, and 31.4 mg/L. These assays consisted in three successive feedings (I, II, and III), wherein the sludge was exposed to each TCS concentration and volatile fatty acid (VFA) substrate. For evaluation of the residual sludge activity during feeding III, only VFA was used. The results showed that the increase in TCS concentrations correlated with the reduction in methane (CH4) production. In this case, the minimum values were achieved for TCS concentration of 31.4 mg/L with CH4 levels between 101.9 and 245.3 during feedings I, II, and III. Regarding the effect of TCS on VFA consumption, an inhibitory effect was detected for TCS concentrations of 23.5 and 31.4 mg/L, with concentrations of acetic, butyric, and propionic acids at the end of the assay (37 d) between 153.6 and 206.8, 62.5 and 60.1, and 93.4 and 110 mg/L, respectively. Regarding the removal of TCS during AD, these values were above 47%. Conclusion: TCS is an inhibitor of methanogenic activity with a decrease between 63 and 70% during the different feedings. The CH4 production was not recovered during feeding III, with inhibition percentages of 2172%.
Assuntos
Triclosan/toxicidade , Digestão Anaeróbia , Metano/metabolismo , Anti-Infecciosos/toxicidade , Esgotos , Estações de Tratamento de Águas Residuárias , Cromatografia Líquida de Alta Pressão , Ácidos Graxos Voláteis , AnaerobioseRESUMO
Background: A decrease in functional capacity due to ageing is one of the main risk factors for falls in older people. Aim: To investigate factors associated with falls in Chilean older adults. Material and Methods: We analyzed the self-reports of falls of 1,334 people aged ≥ 60 years who answered the National Health Survey 2009-2010. Falls during the last 12 months were recorded. Lifestyle, socio-demographic and health status were analyzed. A Poisson regression with robust variance estimates was performed to identify factors associated with falls. Results: Falls during the preceding year were reported by 37% of respondents (95% confidence intervals (CI): 32-42]. Fall frequency was higher in women (Prevalence ratio (PR):1.30 [95% CI:1.11; 1.53], p < 0.01) and those aged ≥ 75 years (PR:1.29 [95% CI:1.04; 1.61], p = 0.02). Hearing impairment (PR: 1.31 [95% CI: 1.07; 1.61], p < 0.01), impaired vision (PR:1.46 [95% CI:1.20; 1.77], p < 0.01), low self-reported wellbeing (PR: 1.41 [95% CI: 1.03; 1.94], p = 0.03) and disability (PR: 1.54 [95% CI:1.32; 1.79], p < 0.01) were associated with falls. However, multimorbidity (having ≥ 3 diseases) was negatively associated with falls (PR: 0.79 [95% CI: 0.63; 0.99], p = 0.04). Conclusions: Among older people, female sex, being aged > 75 years and having disability, hearing or vision impairment are risk factors for falls.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Acidentes por Quedas/estatística & dados numéricos , Fatores Socioeconômicos , Distribuição de Poisson , Chile/epidemiologia , Prevalência , Fatores de Risco , Inquéritos Epidemiológicos , AutorrelatoRESUMO
Background: Type 2 diabetes etiology has a strong genetic component. More than 20 genetic variants have been associated with diabetes and other metabolic markers. However, the polymorphism rs7903146 of the TCF7L2 gene has shown the strongest association. Aim: To investigate the association of TCF7L2 (rs7903146) genotype with adiposity and metabolic markers in the Chilean adult population. Material and Methods: The association of TCF7L2 (rs7093146) with adiposity and metabolic markers was studied in 301 participants. The outcomes of the study were adiposity markers (body weight, body mass index (BMI), fat mass and waist circumference) and metabolic markers (blood glucose, insulin, HOMA-IR, lipid profile, high sensitivity C-reactive protein (CRP), alanine aminotransferase (ALT), gamma glutamyl transpeptidase (GGT) and leptin). Results: There was an association between the polymorphism TCF7L2 genotype and fasting blood glucose. The latter increased by 4.86 mg/dl per each copy of the risk allele [(95% confidence intervals (CI): 0.48; 9.24), p = 0.03] in the unadjusted adjusted model. However, this association was slightly attenuated in the fully adjusted model [4.38 mg/dl (95% IC: 0.16; 8.60), p = 0.04)]. There were no associations between the TCF7L2 genotype and any other metabolic or adiposity outcome. Conclusions: These findings confirm the association between the TCF7L2 (rs7903146) and fasting glucose in the Chilean population. However, further studies are needed to confirm the association between the TCF7L2 and diabetes risk in the Chilean population.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Polimorfismo de Nucleotídeo Único , Diabetes Mellitus Tipo 2/genética , Adiposidade/genética , Proteína 2 Semelhante ao Fator 7 de Transcrição/genética , Valores de Referência , Glicemia/genética , Marcadores Genéticos , Modelos Lineares , Chile , Antropometria , Estado Nutricional , Estudos Transversais , Fatores de Risco , Diabetes Mellitus Tipo 2/metabolismo , Alelos , Adiposidade/etnologia , Estudos de Associação Genética , Frequência do Gene , GenótipoRESUMO
Background: In people with asthma, adiposity is associated with more symptoms and less control of the disease whereas on those without asthma adiposity is associated with a higher risk of developing the disease. Aim: To investigate the association between asthma and adiposity markers in Chilean adults. Material and Methods: Data from 5,499 adults older than 15-years-old from the Chilean National Health Survey 20162017 were analyzed. Quintiles of body-mass index (BMI) and waist circumference (WC) were used as a proxy of adiposity. The association between asthma and quintiles of BMI and WC was determined by logistic regression. Results: A higher BMI and WC was associated with a higher odds for asthma. This trend remained significant even after adjusting the models for socio-demographic factors, physical activity and smoking (Odds Ratio [OR] BMI: 1.13 [95% confidence intervals (CI): 1.04; 1.22], p < 0.01 and OR WC: 1.15 [95% IC: 1.06; 1.25], p < 0.01). Conclusions: A higher BMI and WC were positively associated with asthma.