[Sweetened beverages in young adults and its association to adiposity and metabolic risk]. / Bebidas endulzadas en adultos jóvenes y su asociación con adiposidad y riesgo metabólico.

OBJECTIVE: To estimate the association between sweetened beverages (SB) consumption with adiposity indicators and metabolic status among young Chilean adults. MATERIALS AND METHODS: We analyzed food frequency consumption, body mass index (BMC), waist circumference (WC), body fat percentage (BFP), glucose and triglycerides in 931 young adults randomly selected from Valparaiso Region using multivariate regression models controlling confusion and interactions factors. RESULTS: The median age was 24.9 years; (95%CI: 92.3-95.3) reported SB consumption, 33.1% received more than two portions (≥500 ml) daily what was associated with an increase in glycemia (ß=2.40; p=0.024) (both sexes), with BMI (ß=1.48, p=0.04), WC (ß= 4.50; p=0.009) and BFP (ß=3.02, p< 0.001) only in women. CONCLUSIONS: High consumption of SB increases glycemia in young adults and only in women, indicators of adiposity, relevant antecedents to formulate policies that decrease SB consumption and its consequences.

OBJECTIVE: Estimar la asociación entre consumo de bebidas endulzadas (BE) con indicadores de adiposidad y riesgo metabólico en adultos jóvenes. MATERIALS AND METHODS: Se analizó la frecuencia de consumo de alimentos, índice de masa corporal (IMC), circunferencia de cintura (CC), grasa corporal (PGC), glicemia y triglicéridos de 931 participantes seleccionados aleatoriamente (Región de Valparaíso, Chile), mediante modelos de regresión múltiple, controlando factores de confusión. RESULTS: La mediana de edad fue 24.9 años; 94% (IC95% :92.3-95.3) de los participantes consumía BE, 33.1% de ellos consumía más de dos porciones (≥500 ml) diarias, que se asoció con incremento en glicemia (ambos sexos) (ß=2.17; p=0.007) y con IMC (ß=1.48, p=0.04), CC(ß=4.50; p=0.009) y PGC (ß=3.02; p<0.001) sólo en mujeres. CONCLUSIONS: La alta ingesta de BE incrementa la glicemia en adultos jóvenes y los indicadores de adiposidad en mujeres, antecedentes relevantes para formular políticas que disminuyan el consumo de BE y sus consecuencias.

Changes in socio-economic level and their impact on nutritional status: a follow-up study among young Chilean adults.

OBJECTIVE: To verify the association between changes in socio-economic level (SEL) and nutritional status of Chilean adults over a 10-year period. DESIGN: Concurrent cohort study.Setting/SubjectsIndividuals born from 1974 to 1978 in the Valparaíso Region of Chile were evaluated between 2000 and 2002 (n 1232) and again between 2010 and 2012 (n 796). SEL was characterized according to the occupation and educational level of the head of household. Nutritional status was based on measurement of BMI and waist circumference (WC). RESULTS: Between the first and second evaluation there was a 13 % reduction in the number of individuals classified as poor and a 12 % increase in those classified in the medium high SEL. Increases in BMI were found among women who remained in the low SEL (ß=2·2, 95 % CI 0·16, 2·87) compared with women who maintained the same SEL (and whose SEL was above low over the 10-year period). Women who remained in the low SEL increased their WC (ß=4·10, 95 % CI 0·27, 7·93). There were no associations between nutritional status and SEL among males. CONCLUSIONS: In the period studied, the SEL of the study population improved between the third and fourth decade of life, but BMI and WC also increased among women, with the lowest socio-economic group experiencing the greatest changes. Meanwhile, among males we found no association between anthropometric measurements and changes in SEL.

[Pattern of smoking and socioeconomic status in two cohorts of young adults]. / Patrón de tabaquismo y nivel socioeconómico en dos cohortes de adultos jóvenes.

BACKGROUND: One in five deaths that occur in Chile can be attributed to smoking whose prevalence remains high, despite interventions aimed at reducing it. AIM: To compare the prevalence of smoking and its intensity among young adults born 15 years apart and determine their association with socioeconomic status (SES). MATERIAL AND METHODS: Two cohorts of young adults living in the Valparaiso Region of Chile were evaluated in the third decade of life. Cohort 1 was evaluated between 2000 and 2002 (n = 1232) and cohort 2 between 2014 and 2017 (n = 1078). RESULTS: In cohort 1, 57.5% (95% Confidence Interval (CI) 54.6-58.7) of the subjects reported smoking, with a median of 3 (Interquartile range (ICR:1-6) cigarettes/day. This percentage fell to 40.2% (CI: 37.5-43.1) with a similar median in cohort 2. Analyzing cohort 2, the odds ratio (OR) for smoking was 2.24 (CI 1.48-3.38) in the medium SES, compared with the medium high SES. The figures for low medium and low SES were 2.72 (CI: 1.85-3.99) and 3.01 (1.85-4.88). Similarly, in this cohort there was a significantly higher risk of being a heavy smoker in lower SES. No associations between smoking or its intensity and SES were observed in cohort 1. CONCLUSIONS: Smoking behavior has decreased among young adults evaluated at the same age in two generational cohorts in the third decade of life. In the most recent cohort analyzed, smoking and its intensity increase along with a decrease in SES.

Indigenous and tribal peoples' health (The Lancet-Lowitja Institute Global Collaboration): a population study.

BACKGROUND: International studies of the health of Indigenous and tribal peoples provide important public health insights. Reliable data are required for the development of policy and health services. Previous studies document poorer outcomes for Indigenous peoples compared with benchmark populations, but have been restricted in their coverage of countries or the range of health indicators. Our objective is to describe the health and social status of Indigenous and tribal peoples relative to benchmark populations from a sample of countries. METHODS: Collaborators with expertise in Indigenous health data systems were identified for each country. Data were obtained for population, life expectancy at birth, infant mortality, low and high birthweight, maternal mortality, nutritional status, educational attainment, and economic status. Data sources consisted of governmental data, data from non-governmental organisations such as UNICEF, and other research. Absolute and relative differences were calculated. FINDINGS: Our data (23 countries, 28 populations) provide evidence of poorer health and social outcomes for Indigenous peoples than for non-Indigenous populations. However, this is not uniformly the case, and the size of the rate difference varies. We document poorer outcomes for Indigenous populations for: life expectancy at birth for 16 of 18 populations with a difference greater than 1 year in 15 populations; infant mortality rate for 18 of 19 populations with a rate difference greater than one per 1000 livebirths in 16 populations; maternal mortality in ten populations; low birthweight with the rate difference greater than 2% in three populations; high birthweight with the rate difference greater than 2% in one population; child malnutrition for ten of 16 populations with a difference greater than 10% in five populations; child obesity for eight of 12 populations with a difference greater than 5% in four populations; adult obesity for seven of 13 populations with a difference greater than 10% in four populations; educational attainment for 26 of 27 populations with a difference greater than 1% in 24 populations; and economic status for 15 of 18 populations with a difference greater than 1% in 14 populations. INTERPRETATION: We systematically collated data across a broader sample of countries and indicators than done in previous studies. Taking into account the UN Sustainable Development Goals, we recommend that national governments develop targeted policy responses to Indigenous health, improving access to health services, and Indigenous data within national surveillance systems. FUNDING: The Lowitja Institute.

Change in postmenarche anthropometric indicators in indigenous and nonindigenous adolescents from Chile.

OBJECTIVE: To analyze the change in anthropometric indicators between menarche and 36 months after menarche among indigenous and non-indigenous adolescents from the Araucanía Region of Chile. METHOD: This was a concurrent cohort study. Of 8,504 girls interviewed, 114 indigenous adolescents and 123 nonindigenous adolescents who had recently experienced menarche were selected. Body mass index (BMI), BMI by age (BMI z-score), waist circumference (WC) and body fat percentage (BF%) were evaluated at menarche and 6, 12, 18, 24, 30, and 36 months postmenarche. Linear models estimated with generalized estimating equations were used to quantify disparities adjusted for baseline anthropometric values, age at menarche, place of residence, and socioeconomic level. RESULTS: Indigenous girls presented menarche 4 months later than nonindigenous girls and had significantly higher BMI (1.5 kg/m2 ), BMI z-score (0.4), WC (2.9 cm), and BF% (1.7%) at menarche. Adjusted results did not show an association between being indigenous and post-menarche anthropometric variables: BMI = 0.1 kg/m2 (CI = -0.3; 0.5), BMI z-score = 0 (CI = -0.1; 0.1), WC = 0.7 cm (CI = -0.6; 2.0), and BF% = 0.5% (CI = -0.2; 1.3). It is important to mention that the mean BMI z-score of both groups were in the overweight category. CONCLUSION: At menarche, indigenous girls had higher values than nonindigenous girls for all anthropometric variables, and this trend remained after menarche, with no further change in ethnic disparity over the subsequent three years. This reinforces the need to implement interventions to prevent or control excess weight prior to menarche, with emphasis on indigenous girls.

Changes in symptoms of asthma and rhinitis by sensitization status over ten years in a cohort of young Chilean adults.

BACKGROUND: We investigated the net changes in prevalence of symptoms of asthma and rhinitis over 10 years in a cohort of young by baseline sensitization status. METHODS: One thousand one hundred ninety three Chilean adults subjects aged 22-28 living in a semi-rural area of central Chile answered a lifestyle and the European Community Respiratory Health Survey (ECRHS) questionnaires. Bronchial hyper-responsiveness (BHR) and skin prick test (SPT) to eight allergens were measured at baseline in 2001. Ten years later, 772 participants completed the questionnaires again. Estimates of adjusted net changes in prevalence of symptoms by sensitization status at baseline and association between sensitization status at baseline and respiratory symptoms ten years later were assessed. RESULTS: A quarter of the participants were sensitized to at least one allergen in 2001. Prevalence of wheeze had a net change per year of -0.37 % (95 % Confidence Interval -0.71 to 0.02 %; p = 0.067). Self-reported nasal allergies in the last 12 months increased by 0.83 % per year (95 % CI 0.49 to 1.17 %; p < 0.001). Those sensitized to either cat fur (OR 1.76; CI 1.01 to 3.05), cockroach, (OR 2.09; 1.13 to 3.86) blend of grass and pollens (1.78; 95 % CI 1.08 to 2.92), or weeds (OR 1.77; 95 % CI 1.01 to 3.12) in 2001 were more likely to have wheeze in the last 12 months 10 years later. CONCLUSION: Symptoms of asthma remained stable or slightly changed over 10 years in adults, whilst rhinitis and nasal allergies greatly increased. Being sensitized to at least one allergen is a risk factor for persistent symptoms of asthma and rhinitis, but not for determining net changes of symptoms over time. The underlying causes for the contrasting trends between asthma and nasal allergy are unknown.

[Association of C reactive protein levels with metabolic syndrome in adults: a population-based study]. / Síndrome metabólico e inflamación en adultos: Un estudio poblacional.

BACKGROUND: Metabolic syndrome is highly prevalent among adults in Chile and represents a health risk. AIM: To determine the relationship between metabolic syndrome (MetS) and its components, with C reactive protein levels (CRP) as an inflammation marker. MATERIAL AND METHODS: The population studied consisted of 736 individuals born in a hospital from Valparaíso Region, aged between 32-38 years at the time of the study. MetS was identified according to the Adult Treatment Panel (ATP) III guidelines and inflammation was measured using ultra-sensitive CRP. This parameter was classified as normal for values from 0 to 3 mg/L, high for values from 3.01 to 10 mg/L and very high for values > 10 mg/L. RESULTS: Median CRP was in the normal range (1.9 mg/L, interquartile range 0.7-5.2) and was higher among women than men (2.2 and 1.4 mg/L respectively, p < 0.01). Twenty seven percent of participants had MetS. One-fourth had high blood glucose values, one-third had high triglyceride levels and 28% had blood pressure values over those established as normal in MetS. Elevated waist circumference (WC) and low HDL cholesterol were found among almost 50% of participants. A relationship between MetS and high CRP was only found among men with an Odds ratio (OR) of 2.04 (95% confidence intervals (CI): 1.11-3.73). The same association was observed for high triglyceride levels with an OR of 2.02 (CI: 1.17-3.49) and high WC with an OR of 3.89 (CI: 2.06-7.36). Among women, the only relationship observed was between abdominal obesity and very high CRP with an OR of 2. 65 (CI: 1.20-5.84). CONCLUSIONS: Metabolic syndrome, high triglyceride levels, and abdominal obesity were associated with inflammation only in men.

Postmenarche growth: cohort study among indigenous and non-indigenous Chilean adolescents.

BACKGROUND: In Chile, indigenous and non-indigenous schoolchildren have the same stature when they begin school but indigenous adults are shorter, indicating the importance of analyzing growth during puberty. The aim of this study was to compare the growth of indigenous and non-indigenous girls during the 36 months after menarche in Chile's Araucanía Region. METHODS: A concurrent cohort study was conducted to compare growth in the two ethnic groups, which were comprised of 114 indigenous and 126 non-indigenous girls who recently experienced menarche and were randomly selected. Height was measured at menarche and at 6, 12, 18, 24 and 36 months post-menarche. General linear models were used to analyze growth and a generalized estimating equation model was used to compare height at 36 months post-menarche. RESULTS: At menarche, the Z-score of height/age was less for indigenous than non-indigenous girls (-0.01 vs. -0.61, p < 0.001). Indigenous girls grew at a slower rate than non-indigenous girls (6.5 vs. 7.2 cm, p = 0.02), and height at 36-months post-menarche reached -0.82 vs. -0.35 cm (p <0.001). In an adjusted model at 36 months post-menarche, indigenous girls were 1.6 cm shorter than non-indigenous girls (95% confidence interval: -3.13 to -0.04). CONCLUSIONS: The height of indigenous girls at menarche was lower than that of non-indigenous girls and they subsequently grew less, maintaining the gap between the two groups. At the end of the follow-up period, the indigenous girls were shorter than their non-indigenous peers.

[Intake of sugar-sweetened non-alcoholic beverages and body mass index: A national sample of Chilean school children]. / Ingesta de bebidas azucaradas analcohólicas e índice de masa corporal en escolares chilenos.

OBJECTIVE: To estimate the association between the intake of sugar-sweetened non-alcoholic beverages and body mass index (BMI) in Chilean school children. MATERIALS AND METHODS: Food consumption frequency data were analyzed for school children aged 6 to 18. The association between consumption of sugar-sweetened beverages and BMI was estimated by multivariate lineal regression models. RESULTS: Sugar-sweetened beverages are consumed on a daily basis by 92% (95%CI:90-94) of subjects with daily intake medians of 424 mL (p25-p75:212-707). Every extra daily portion of sugar-sweetened beverages consumed by school children aged 6 to 13 is associated with 0.13 BMI z-scores (95%CI:0.04-0.2;p=0.01). CONCLUSIONS: School children consume sugar-sweetened beverages daily with intake medians close to 0.5L. There is an association between sugar-sweetened beverage consumption and higher BMI in Chilean school children.

[Fruit and vegetable intake, and blood pressure. A population research]. / Consumo de frutas, verduras y presión arterial. Un estudio poblacional.

Consuming fruits and vegetables is known to lower blood pressure. However, it is unclear how much should be consumed in order to achieve this effect. The aim of this study was to analyze the association between fruit and vegetable consumption and blood pressure. A cross-sectional study was conducted among a random sample of 777 adults between the ages of 32 and 38 from the Region of Valparaiso, Chile. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured, and a survey was carried out to quantify consumption trends over the past month. The fruit and vegetable intake was divided into three groups: less than 200 g, 200-400 g, and more than 400 g. In the analysis, multiple linear regression models were used and were adjusted for sex, BMI, physical activity, socioeconomic status, smoking, and sodium intake. It was observed that increasing intake of fruits and vegetables lowers the systolic blood pressure (ß = -3.37 , 95% CI : -6.45 to -0.29; for consumption between 200 and 400 g ) (ß = -4.02, 95% CI: -7.06 to -0.98; for consumption great than 400 g), while an effect on diastolic pressure is only seen in those who meet the WHO recommendation of consuming more than 400 g per day (ß -2.87, CI = -5.17 to -0.57). In conclusion, consuming fruits and vegetables in amounts larger than 400 g per day, provides a protective effect against increases in both systolic and diastolic blood pressure.

[Secular variation of births, weight and length at birth: Local perspective]. / Variación secular de los nacimientos, peso y longitud al nacer: perspectiva local.

OBJECTIVE: To analyse the outcomes of births and anthropometric measurements at birth of children born between 1974 and 2011 at Limache Hospital (Valparaíso, Chile). PATIENTS AND METHOD: Times series were constructed of births, weight and length at birth, and low weight and length at birth. The trend was modelled with linear and logistical regressions using splines to represent breaks in the trend by decade. RESULTS: The series includes 17,574 births. There was an increase in births per year in the 1970s (30/year) and declines in them to 17 and 22 births/year in the 1980s and 1990s, respectively (P<.001), with no significant trend thereafter. Newborns from 2000 to 2011 weighed 266 grams more than those in the 1970s (P<.001), and have now reached a mean weight of 3,530 g. Low birthweight fell from 8% in the 1970s to 1.1% after 2000. Birth length increased by 1cm in the 37 years studied, with a reduction of low birth length from 7.6% to 2.1% during the period. CONCLUSION: Live births in the Limache Hospital declined, and anthropometric measurements at birth improved in the years analysed. This information is useful in developing interventions, taking into account the possible selection biases that could distort these estimates and their interpretation.

Ventilatory function and cardiovascular disease risk factors: a cross-sectional study in young adults.

BACKGROUND: The association between impaired lung function and cardiovascular disease (CVD) risk factors has been shown in adults. However, there is little evidence of such an association in young adults, particularly from South America, where the burden of CVD and chronic obstructive pulmonary disease (COPD) is as high as that observed in more developed countries. We therefore investigated the relation between CVD risk factors including metabolic syndrome (MS), and lung function status in young adults from Chile. METHODS: 970 subjects from a sample of 998 adults born between 1974 and 1978 in Limache, Chile, were studied. A Spanish translation of the European Community Respiratory Health Survey (ECRHS) questionnaire was used. Forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) were measured. Weight, height, waist circumference (WC), blood pressure, Homeostatic model assessment (HOMA-IR), triglycerides, high density lipoprotein (HDL), glycaemia, and metabolic syndrome (MS) were also assessed. RESULTS: The prevalence of MS was 11.8%. A lower FEV1 and lower FVC were associated with having MS (ß-coefficient -0.13; 95% Confidence Interval [CI] -0.21 to -0.05, and ß-coefficient -0.18; 95% CI -0.27 to -0.09, respectively). Both spirometric measures were also negatively associated with having an elevated HOMA-IR (ß-coefficient for FEV1 -0.08; 95% CI -0.13 to -0.03, and ß-coefficient for FVC -0.11; 95% CI -0.17 to -0.05). In males only, a lower FEV1 and FVC were associated with having elevated triglycerides (ß-coefficient highest vs. lowest tertile -0.13, 95% CI -0.24 to -0.03, and ß-coefficient -0.13, 95% CI -0.25 to -0.01, respectively). In women, a higher FEV1 and FVC were statistically significantly related to having higher levels of HDL. Ventilatory function was unrelated to hypertension or WC in this population. CONCLUSION: In this population-based study of young adults, a poorer ventilatory function was associated with many CVD risk factors. Endeavours to understand better causality issues of such associations are warranted.

[Evolution of the metabolic syndrome and its components in a follow up of 10 years in adults from Valparaíso region]. / Evolución del síndrome metabólico y de sus componentes en un seguimiento de 10 años en adultos de la Región de Valparaíso.

BACKGROUND: Metabolic syndrome is a risk factor for cardiovascular diseases and cancer. Its frequency is increasing steadily Aim: To evaluate the prevalence of metabolic syndrome (MS) and its components in a 10-year tracking study of young adults. MATERIAL AND METHODS: Concurrent cohort study of subjects born between 1974 and 1978. They were evaluated between 2000 and 2002 and between 2010 and 2012 to determine the frequency of MS and its components (high blood glucose, waist circumference [WC], triglycerides, blood pressure and low HDL cholesterol), according to ATP III criteria. Attrition was handled using the reciprocal of the probability of remaining in the study. RESULT: During the first evaluation, the prevalence of metabolic syndrome was 9.3%, confidence interval (CI): 7.5-11.1), with no gender differences. Ten years later, the prevalence of MS increased significantly to 27.6% (CI: 24.7-29.9) and was more common in women than men (30.4 and 23.8% respectively, p < 0.014). The components of MS also increased from one period to another: hyperglycemia, from 5.2% (CI: 4-7) to 24.4% (CI: 22-27); high triglyceride levels from 17.6% (CI: 15-20) to 35.3% (CI: 32-38); high blood pressure from 14.7 (CI: 13-18) to 30.2% (IC: 28-33) and high WC: 16.9% (CI: 15-19) to 41.5% (CI: 39-45). In both evaluations, there was a greater frequency of high triglycerides and high blood pressure among men, and greater frequency of low HDL and high WC among women. Hyperglycemia only showed differences by gender in the second measurement, and was greater among men. CONCLUSIONS: There was a marked increase in metabolic syndrome and its components in a 10-year interval, which is a warning sign of future cardiovascular risk.

[Experience of a research Ethics Committee and the challenges of the new Chilean legislation on research in human beings]. / Experiencia del Comité de Ética de Investigación en Seres Humanos de la Facultad de Medicina de la Universidad de Chile y los desafíos que impone la nueva legislación chilena en la investigación médica.

The welfare of research participants must be guaranteed by international ethical standards. This article communicates the procedures of the Research Ethics Committee of the School of Medicine, University of Chile (CEISH). The new Chilean legislation on research in human beings is also discussed. Law 20.120: "On scientific research in human beings, its genome and forbidding human cloning" establishes the ethical principles that must be accomplished in every research involving human beings. Article 28 of the Law 20.584 "Regulation of the rights and duties of health care users", forbids the participation of handicapped people who cannot express their will in scientific research. Article 13 states that people not related directly with patient care cannot have access to his clinical records (with the exception of people with notarial authorization by the patient). CEISH proposes that, in case of people with intellectual deficiency, the decision to approve a scientific research should be analyzed on an individual basis. If the person is capable of expressing his or her will or has stated his or her consent beforehand, the research can be authorized. If the person cannot express his or her will, the scientific research cannot take place. In prospective studies, a consent from the patient and an authorization of the health authority should be required to access clinical records. In retrospective studies, consent should be obtained from the patient when personal information is going to be used. If the information is nameless, the consent can be disregarded.

Is waist circumference a better predictor of blood pressure, insulin resistance and blood lipids than body mass index in young Chilean adults?

BACKGROUND: It has been reported that waist circumference (WC) is a better predictor of cardiovascular risk factors than body mass index (BMI), although the findings have not been consistent. The aim of this study was to assess which measurement, BMI or WC, is more strongly associated with blood pressure, homeostatic model assessment (HOMA) and blood lipids in young Chilean adults. METHODS: 999 subjects aged 22 to 28 years were randomly selected from a registry of individuals born between 1974 and 1978 at the Hospital of Limache, Chile. Weight, height, WC, blood pressure, HOMA and lipoproteins were assessed in a cross-sectional study. RESULTS: In multivariable regressions BMI and WC were associated with blood pressure, HOMA and lipoproteins at similar level of explained variation (R2 between 1.6 % for Low Density Lipoproteins (LDL) and 15.6 %, the highest for HOMA and triglycerides) and similarly OR in standardised logistic regressions between 1.1 (95 % CI: 0.9 and 1.4) for LDL and 2.9 (95 % CI: 2.4 and 3.4) for elevated HOMA. When both WC and BMI were included in the model collinearity was high and only for HOMA was there a small independent contribution of each index (R2 = 1 %); for other outcomes the pattern was inconsistent. CONCLUSION: The strength of the associations of WC and BMI for any cardiovascular risk factors was similar, but highest for HOMA and triglycerides. WC and BMI are equally useful for monitoring the consequences of obesity in young adults.

[Age at menarche and indigenous ancestry: a population study in Chile]. / Edad de menarquia y ascendencia indígena: un estudio poblacional en Chile.

BACKGROUND: The age at menarche may influence decisively health and disease in women. It also indicates the beginning of the reproductive period and, as a consequence, the possibility of biological continuity for the human species. Genetic and environmental determinants define the age of menarche and can explain differences found among different populations. AIM: To determine the age at menarche among adolescents with different levels of indigenous descent (parental indigenous surnames), considering the effect of socioeconomic and demographic factors. MATERIAL AND METHODS: An observational study of historic cohorts of 8.624 girls from the Araucanía Region (central-southern Chile) was carried out. Data were collected by health professionals using a previously validated questionnaire. Occurrence of menarche was estimated through survival analysis and compared between groups (according to indigenous parental surnames) adjusted for parents' income and educational level and provenance (rural/urban). RESULTS: Estimated median age of menarche was 151 months (95% Cl: 150-151). In female with four indigenous surnames, menarche occurred two months later than girls without indigenous surnames and with two indigenous surnames (p < 0,001). In girls whose parents had lowest level of schooling, the difference increased to eight months later (p < 0,005). CONCLUSIONS: Age at menarche in the group with higher indigenous descent is later even if socio-economic conditions remain stable. Genetic factors might play an important role, however conditions of vulnerability can influence and further delay the onset of reproductive competency.

[What kind of intervention has the best results to reduce the weight in overweighted or obese adults?]. / Qué tipo de intervención tiene mejores resultados en la disminución de peso en adultos con sobrepeso u obesidad? Revisión sistemática y metaanálisis.

Evidence has shown that interventions which involve changes in a person's lifestyle, such as diet and physical activity, lead to weight loss and thus reduce the risk factors of cardiovascular disease. However, the effectiveness and necessary duration of specific interventions are unclear. The purpose of this research was to evaluate and compare the effect on weight of interventions based on diet, exercise and a combination of both. The research subjects were overweight and obese adults, at six and twelve months after the beginning of the intervention. First a systematic review was carried out, followed by a meta-analysis. Initially, 24 studies were selected which met the established criteria for inclusion; twelve of these demonstrated the required level of quality. The diet-based interventions resulted in reductions of-6.66 kilograms (95% confidence interval (CI): -9.04 to -4.28) and -3.80 kilograms (CI: -5.50 to -2.10) at six and twelve months, respectively. Those who engaged in exercise showed a loss of -2.21 kilograms (CI: -4.62 to -0.21) and -2.00 kilograms (CI: -5.70 to -1.70) at six and twelve months, respectively, while those who changed their diets and engaged in exercise showed a loss of -10.86 kilograms (CI: -13.22 to -8.49) and -6.50 kilograms (CI: -8.09 to -4.90) at six and twelve months. The combination of diet and exercise showed the best effect in reducing weight among overweight and obese people, followed by diet alone while exercise alone didn't reach significant results. The effect of these interventions was greater during the first six months of intervention.

Absence of disparities in anthropometric measures among Chilean indigenous and non-indigenous newborns.

BACKGROUND: Studies throughout North America and Europe have documented adverse perinatal outcomes for racial/ethnic minorities. Nonetheless, the contrast in newborn characteristics between indigenous and non-indigenous populations in Latin America has been poorly characterized. This is due to many challenges, including a lack of vital registration information on ethnicity. The objective of this study was to analyze trends in anthropometric measures at birth in Chilean indigenous (Mapuche) and non-indigenous children over a 5-year period. METHODS: We examined weight and length at birth using information available through a national data base of all birth records for the years 2000 through 2004 (n = 1,166.513). Newborns were classified ethnically according to the origins of the parents' last names. RESULT: The average birthweight was stable over the 5 year period with variations of less than 20 g in each group, and with mean values trivially higher in indigenous newborns. The proportion weighing less than 2500 g at birth increased modestly from 5.2% to 5.6% in non-indigenous newborns whereas the indigenous births remained constant at 5.2%. In multiple regression analyses, adjusting flexibly for gestational age and maternal characteristics, the occurrence of an indigenous surname added only 14 g to an average infant's birthweight while holding other factors constant. Results for length at birth were similar, and adjusted time trend variation in both outcomes was trivially small after adjustment. Anthropometric indexes at birth in Chile are quite favorable by international standards. CONCLUSION: There is only a trivial degree of ethnic disparity in these values, in contrast to conditions for ethnic minorities in other countries. Moreover, these values remained roughly constant over the 5 years of observation in this study.

Age of menarche and nutritional status of indigenous and non-indigenous adolescents in the Araucanía Region of Chile.

BACKGROUND: Early onset of menarche has been linked to prevalence of obesity; however, this may differ for indigenous females. OBJECTIVE: To analyse the relationship between age of menarche and nutritional status among indigenous and non-indigenous girls. METHOD: The design of this study was cross-sectional. Date of menarche was determined through interviews, and all responses were confirmed by the girls' mothers. A total of 8504 adolescents were screened for recent menarche. One hundred and thirty-one girls of Mapuche (indigenous) and 143 girls of Chilean-Spanish background were identified and evaluated by anthropometric measurements. RESULTS: Median age of menarche was 150 months, interquartile range (IR) 143-157 in indigenous, and 145.5 months, IR 139-153 in non-indigenous girls (p = 0.04). The indigenous females showed a higher prevalence of overweight (36.4% vs 23.1%), although the frequency of obesity was similar (16.8% vs 16.3%). For indigenous girls, age of menarche was delayed by 2.69 months (confidence intervals (CI) -0.38 to 5.77). It was observed that girls with overweight experienced age of menarche 7.59 months earlier than those with normal weight, CI -10.78 to -4.41. In the analysis of obesity, the effect on age of menarche was similar, with onset 7.53 months earlier than for the normal weight, CI -11.34 to -3.72. CONCLUSION: Age of menarche is younger than has been previously reported and occurs earlier in girls with overweight and obesity, while being indigenous was not related.