Association of five diet scores with severe NAFLD incidence: A prospective study from UK Biobank.

AIM: This study aimed to contrast the associations of five common diet scores with severe non-alcoholic fatty liver disease (NAFLD) incidence. MATERIALS AND METHODS: In total, 162 999 UK Biobank participants were included in this prospective population-based study. Five international diet scores were included: the 14-Item Mediterranean Diet Adherence Screener (MEDAS-14), the Recommended Food Score (RFS), the Healthy Diet Indicator (HDI), the Mediterranean Diet Score and the Mediterranean-DASH Intervention for Neurodegenerative Delay score. As each score has different measurements and scales, all scores were standardized and categorized into quartiles. Cox proportional hazard models adjusted for confounder factors investigated associations between the standardized quartiles and severe NAFLD incidence. RESULTS: Over a median follow-up of 10.2 years, 1370 participants were diagnosed with severe NAFLD. When the analyses were fully adjusted, participants in quartile 4 using the MEDAS-14 and RFS scores, as well as those in quartiles 2 and 3 using the HDI score, had a significantly lower risk of severe incident NAFLD compared with those in quartile 1. The lowest risk was observed in quartile 4 for the MEDAS-14 score [hazard ratio (HR): 0.76 (95% confidence interval (CI): 0.62-0.94)] and the RFS score [HR: 0.82 (95% CI: 0.69-0.96)] and as well as in quartile 2 in the HDI score [HR: 0.80 (95% CI: 0.70-0.91)]. CONCLUSION: MEDAS-14, RFS and HDI scores were the strongest diet score predictors of severe NAFLD. A healthy diet might protect against NAFLD development irrespective of the specific approach used to assess diet. However, following these score recommendations could represent optimal dietary approaches to mitigate NAFLD risk.

Association of a dietary inflammatory index with cardiometabolic, endocrine, liver, renal and bones biomarkers: cross-sectional analysis of the UK Biobank study.

BACKGROUND AND AIMS: Research into the relationship between an Energy-adjusted Diet-Inflammatory Index (E-DII) and a wider health-related biomarkers profile is limited. Much of the existing evidence centers on traditional metabolic biomarkers in populations with chronic diseases, with scarce data on healthy individuals. Thus, this study aims to investigate the association between an E-DII score and 30 biomarkers spanning metabolic health, endocrine, bone health, liver function, cardiovascular, and renal functions, in healthy individuals. METHODS AND RESULTS: 66,978 healthy UK Biobank participants, the overall mean age was 55.3 (7.9) years were included in this cross-sectional study. E-DII scores, based on 18 food parameters, were categorised as anti-inflammatory (E-DII < -1), neutral (-1 to 1), and pro-inflammatory (>1). Regression analyses, adjusted for confounding factors, were conducted to investigate the association of 30 biomarkers with E-DII. Compared to those with an anti-inflammatory diet, individuals with a pro-inflammatory diet had increased levels of 16 biomarkers, including six cardiometabolic, five liver, and four renal markers. The concentration difference ranged from 0.27 SD for creatinine to 0.03 SD for total cholesterol. Conversely, those on a pro-inflammatory diet had decreased concentrations in six biomarkers, including two for endocrine and cardiometabolic. The association range varied from -0.04 for IGF-1 to -0.23 for SHBG. CONCLUSION: This study highlighted that a pro-inflammatory diet was associated with an adverse profile of biomarkers linked to cardiometabolic health, endocrine, liver function, and renal health.

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.

[Metabolic and cardiorespiratory fitness changes in women undergoing a physical exercise program assisted by a mobile application. A non-randomized controlled study]. / 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 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.

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

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.

Modificación de estilos de vida de adolescentes chilenos durante el primer confinamiento por COVID-19.

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.

Adherence to dietary recommendations by socioeconomic status in the United Kingdom biobank cohort study.

Introduction: Understanding how socioeconomic markers interact could inform future policies aimed at increasing adherence to a healthy diet. Methods: This cross-sectional study included 437,860 participants from the UK Biobank. Dietary intake was self-reported. Were used as measures socioeconomic education level, income and Townsend deprivation index. A healthy diet score was defined using current dietary recommendations for nine food items and one point was assigned for meeting the recommendation for each. Good adherence to a healthy diet was defined as the top 75th percentile, while poor adherence was defined as the lowest 25th percentile. Poisson regression was used to investigate adherence to dietary recommendations. Results: There were significant trends whereby diet scores tended to be less healthy as deprivation markers increased. The diet score trends were greater for education compared to area deprivation and income. Compared to participants with the highest level of education, those with the lowest education were found to be 48% less likely to adhere to a healthy diet (95% Confidence Interval [CI]: 0.60-0.64). Additionally, participants with the lowest income level were 33% less likely to maintain a healthy diet (95% CI: 0.73-0.81), and those in the most deprived areas were 13% less likely (95% CI: 0.84-0.91). Discussion/conclussion: Among the three measured proxies of socioeconomic status - education, income, and area deprivation - low education emerged as the strongest factor associated with lower adherence to a healthy diet.

Low Sleep Hygiene Is Associated with Less Adherence to the Mediterranean Diet in Chilean Schoolchildren from Rural Public Schools-A Cross-Sectional Study.

The Mediterranean diet stands as a widely acknowledged and health-promoting dietary pattern, renowned for its notable linkage to the mitigation of noncommunicable chronic maladies. Nonetheless, the existing body of evidence concerning the potential interrelation between sleep hygiene and this dietary regimen remains circumscribed. The main objective was to determine the association between sleep hygiene and adherence to the Mediterranean diet in Chilean schoolchildren from rural public schools in southern Chile. A non-experimental study was carried out, with an analytical, cross-sectional design. A total of 265 students (56.6% women, mean age 13.5 ± 1.8) from a rural community in southern Chile were recruited. Sleep habits were evaluated using Section 6 of the Life Habits and Adolescence Questionnaire, Sleep and Rest, and adherence to the Mediterranean diet was assessed with the KIDMED Mediterranean Diet Adherence Questionnaire. The main results indicated that 52.8% of schoolchildren need to improve adherence to the Mediterranean diet and 16.6% have a low-quality Mediterranean diet. A high percentage of schoolchildren have behaviors related to poor sleep hygiene (going to bed late (46%), waking up tired and wanting to continue sleeping (63.8%), and having problems falling asleep (42.6%)). Schoolchildren who got up after 8:30 a.m., those who fell asleep after midnight, upon conducting a comparative analysis of the students based on their sleep patterns, those who woke up tired and those who had trouble falling asleep had a lower level of adherence to the Mediterranean diet compared to schoolchildren who got up earlier than 8:30 a.m., fell asleep before midnight, did not wake up tired, and those who did not find it difficult to fall asleep, respectively. In conclusion, having poor sleep patterns including difficulties in both awakening and falling asleep are associated with less adherence to the Mediterranean diet in schoolchildren from rural public schools in southern Chile. Monitoring these variables and promoting healthy lifestyle habits within the educational community are essential measures.

A Higher Skeletal Muscle Mass and Lower Adiposity Phenotype Is Associated with Better Cardiometabolic Control in Adults with Hip and Knee Osteoarthritis: Results from the Chilean National Health Survey 2016-2017.

OBJECTIVE: This study aimed to (1) characterize cardiometabolic factors in self-reported hip and knee osteoarthritis (OAD) across four body composition phenotypes defined by muscle mass and adiposity, and (2) associate risk factors with diabetes and hypertension (HTN). METHODS: A cross-sectional analysis of the Chilean National Health Survey 2016-17 (n = 4996) stratified participants into four groups: low skeletal muscle mass/high waist circumference (Low-SMM/High-WC), low SMM/low WC (Low-SMM/Low-WC), high SMM/high WC (High-SMM/High-WC), and high SMM/low WC (reference group). Each group was further divided into subgroups with or without diagnosed hip or knee OAD. The main outcomes were fasting plasma glucose, systolic (SBP)/diastolic (DBP) blood pressure (continuous outcomes), and other secondary factors such as cardiovascular risk (CVR). RESULTS: In the hip OAD subgroup, the Low-SMM/High-WC groups had significantly higher SBP versus the reference value (145 vs. 127 mmHg, p < 0.0001, diff +18 mmHg). In the knee OAD subgroup, the Low-SMM/High-WC groups had significantly higher SBP versus the reference value (141 vs. 134 mmHg, p < 0.0001, diff +7 mmHg). The SBP showed a significant interaction between the group and OAD diagnosis (p = 0.007 hip OAD; p < 0.0001 knee OAD). CONCLUSIONS: Hip and knee OAD associates with elevated SBP/DBP in older adults. OAD groups showed an OR above 2 for diabetes, 2.7 for HTN, 4.5 for metabolic syndrome, and over 2 for moderate-to-high cardiovascular risk. OAD interacts substantially with cardiometabolic factors, especially in low muscle mass/high adiposity phenotypes. Lifestyle optimization of physical activity and nutrition to preserve muscle mass and mitigate adiposity is essential for cardiometabolic health promotion in OAD patients.

Associations and predictive performance of 11 anthropometric measures with incident type 2 diabetes: A prospective cohort study from the UK Biobank.

OBJECTIVE: The study aim was to investigate associations of 11 anthropometric measures with incident type 2 diabetes and compare their predictive performance. METHODS: This prospective cohort study included 161,127 White European UK Biobank participants who were free of diabetes at baseline. Anthropometric measures included height, weight, BMI, A Body Shape Index, waist circumference, waist to hip ratio, waist to height ratio (WHtR), hip circumference, visceral adiposity index, hip index, and anthropometric risk index. The associations were examined using Cox proportional hazard models. The differences in C-index were used to compare predictive performance between BMI and other anthropometric measures. RESULTS: The median follow-up was 10.0 (interquartile range: 9.3-10.8) years, during which 6315 participants developed type 2 diabetes. All markers except height and hip index were positively associated with incident type 2 diabetes. The strongest associations were found for WHtR (hazard ratio per 1-SD increment: 2.27 [95% CI 2.19-2.35] in women; 1.96 [95% CI 1.90-2.01] in men). Compared with BMI, WHtR and anthropometric risk index had significantly better type 2 diabetes risk discrimination. CONCLUSIONS: Although most adiposity markers were associated with type 2 diabetes, the magnitude of the associations differed. WHtR had the strongest associations and predictive ability for type 2 diabetes and thus could be a more suitable marker for clinical use.

Physical Fitness, Screen Time and Sleep Habits According to Obesity Levels in Schoolchildren: Findings from the Health Survey of the Extreme South of Chile.

Obesity is a worry because it is associated with a greater burden of disease, and it has been shown to be related to the health habits and physical condition of children and adolescents. OBJECTIVE: To associate physical fitness, screen time, and sleep habits with the different categories of obesity in schoolchildren from the extreme south of Chile. METHODS: 583 schoolchildren were included in this cross-sectional analysis. The screen time and sleep habits were measured with the Sleep Self-Report questionnaire, while the physical fitness was assessed with the Alpha Fitness test battery. The Body Mass Index/age (BMI/age) and the Waist-to-Height ratio (WtHr) were used to define adiposity using the following categories: healthy weight/low-risk waist-to-height ratio (H/LR), healthy weight/high-risk waist-to-height ratio (H/HR), overweight/low-risk waist to height ratio (O/LR), and overweight/high-risk waist to height ratio (O/HR). RESULTS: A considerable number of schoolchildren (23.2%) presented sleep problems, while the mean screen time was 9.3 (95% CI: 8.4; 10.1) hours/day. Schoolchildren classified as H/HR showed better physical fitness than the O/HR group but worse physical fitness than the H/LR group. CONCLUSIONS: Significant differences were evidenced in the physical fitness between the adiposity categories, which could open future lines of research concerning the characterization of the healthy weight-obese adiposity categories in children.

Association of Physical Fitness, Screen Time, and Sleep Hygiene According to the Waist-to-Height Ratio in Children and Adolescents from the Extreme South of Chile.

OBJECTIVE: To analyze the perception of physical fitness, screen time, and self-reported sleep hygiene in children and adolescents (CA) from the extreme south of Chile and its associations with waist-to-height ratio (WtHr). MATERIAL AND METHODS: An observational cross-sectional study was conducted in a sample of 594 schoolchildren from 5th to 8th grade of primary education, belonging to municipal educational establishments in the Magallanes region, Chile. Cardiorespiratory fitness was assessed through the 20-m shuttle run test, muscle strength through handgrip and the standing broad jump test, physical fitness perception through the International Fitness Scale, and central obesity through the waist-to-height index. In addition, sleep hygiene and screen time were measured. RESULTS: More than 92% of CA spent more than two hours a day watching or using screens. In addition, CA with excess central adiposity had a lower perception of physical fitness, and lower muscle strength and cardiorespiratory fitness compared to CA with normal values of adiposity. CONCLUSIONS: CA of the present study spent a high number of hours watching or using screens and had poor sleep quality. In addition, excessive central adiposity was associated with lower physical fitness.

Accuracy of the Resting Energy Expenditure Estimation Equations for Healthy Women.

BACKGROUND: There exist several prediction equations for the estimation of resting energy expenditure (REE). However, none of these equations have been validated in the Chilean female population yet. The aims of this study are (1) to determine the accuracy of existing equations for prediction of REE and (2) to develop new equations in a sample of healthy Chilean women. METHODS: A cross-sectional descriptive study was carried out on 620 Chilean women. The sample showed an age range between 18 and 73 years, a body mass index average of 28.5 ± 5.2 kg/m2, and a prevalence of overweight and obesity of 41% and 33.2%, respectively. REE was measured by indirect calorimetry (REEIC), which was used as the gold standard to determine the accuracy of twelve available REE prediction equations and to calculate alternative formulas for estimation of REE. Paired t-tests and Bland-Altman plots were used to know the accuracy of the estimation equations with REEIC. At the same time, multiple linear regressions were performed to propose possible alternative equations. The analyses were carried out by age groups and according to nutritional status. RESULTS: All the equations showed a tendency to overestimate REE, regardless of age or nutritional status. Overall, the Ireton-Jones equation achieved the highest mean percentage difference from REEIC at 67.1 ± 31%. The alternative new equations, containing variables of body composition, reached a higher percentage of classification within ± 10% of REEIC. CONCLUSIONS: The available equations do not adequately estimate REE in this sample of Chilean women. Although they must be validated, the new formulas proposed show better adaptation to this Chilean sample.

[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.

Covid-19 Confinement and Changes of Adolescent's Dietary Trends in Italy, Spain, Chile, Colombia and Brazil.

Confinement due to the COVID-19 pandemic can influence dietary profiles, especially those of adolescents, who are highly susceptible to acquiring bad eating habits. Adolescents' poor dietary habits increase their subsequent risk of degenerative diseases such as obesity, diabetes, cardiovascular pathologies, etc. Our aim was to study nutritional modifications during COVID-19 confinement in adolescents aged 10 to 19 years, compare them with their usual diet and dietary guidelines, and identify variables that may have influenced changes. Data were collected by an anonymous online questionnaire on food intake among 820 adolescents from Spain, Italy, Brazil, Colombia, and Chile. The results show that COVID-19 confinement did influence their dietary habits. In particular, we recorded modified consumption of fried food, sweet food, legumes, vegetables, and fruits. Moreover, gender, family members at home, watching TV during mealtime, country of residence, and maternal education were diversely correlated with adequate nutrition during COVID-19 confinement. Understanding the adolescents' nutrition behavior during COVID-19 lockdown will help public health authorities reshape future policies on their nutritional recommendations, in preparation for future pandemics.

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.

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

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.

Efecto del sedentarismo sobre la interacción entre el gen FTO y niveles de adiposidad en adultos chilenos - Resultados del Estudio GENADIO

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.

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.

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

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 (a = 0,64) a muy buenas (a = 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

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 a = 0.64 and a = 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