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

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

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

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.

Asociación entre la velocidad de marcha y obesidad en población chilena: Resultados de la Encuesta Nacional de Salud 2016-2017

Antecedentes: La velocidad de marcha es un marcador funcional, utilizado como predictor de enfermedades crónicas. Sin embargo, existe escasa evidencia de la asociación entre la velocidad de marcha y obesidad. Objetivo: Investigar la asociación entre la velocidad de marcha auto-reportada y obesidad en población chilena. Métodos: 6.183 participantes entre 15 a 98 años de la Encuesta Nacional de Salud 2016-2017 de Chile fueron incluidos en este estudio transversal. Peso corporal, talla, perímetro de cintura (PC), índice de masa corporal (IMC) e índice cintura/altura (ICA) fueron determinados. Auto-reporte de velocidad de la marcha (normal, lenta, rápida) fue la variable de exposición. La relación entre velocidad de marcha y marcadores de obesidad fue determinada mediante regresión lineal y regresión de Poisson y todos los análisis fueron ajustados en Modelos según factores sociodemográficos y estilos de vida. Resultados: En el modelo más ajustado, quienes reportaron una velocidad de marcha normal y rápida presentaron un menor IMC (p: -1,03, p = 0,017y -1,56p = 0,001, respectivamente), menor PC (p: -2,98, p = 0,004 y -3,64, p = 0,001) e ICA (3: -0,19, p = 0,004 y -0,26 p < 0,0001) respecto a quienes reportaron una marcha lenta. La velocidad de marcha rápida se asoció a una menor probabilidad de tener obesidad y obesidad central. Conclusión: La velocidad de marcha normal y rápida fueron asociadas con menor peso corporal, IMC, PC e ICA. La velocidad de marcha rápida se asoció a una menor probabilidad de obesidad y obesidad central, independiente de factores sociodemográficos y estilos de vida.

Background: Walking Pace is a functional marker, used as a predictor of chronic diseases. However, there is a lack of evidence on the association between walking pace and obesity. Aim: To investigate the association between-self-reported walking pace with obesity in the Chilean adult population. Methods: 6,183 Chilean participants (aged 15 to 98 years) from the Chilean National Health Survey 2016-2017 were included in this cross-sectional study. Weight, height, waist circumference (WC), body mass index (BMI) and waist to height ratio (WHtR) were the outcomes of interest. Self-reported walking pace (slow, average and brisk) was the exposure. The association between walking pace and obesity was determined by linear regression and Poisson regression and all analyses were adjusted in models according to sociodemographic and lifestyle factors. Results: In the most adjusted model, those who reported an average and brisk walking pace had a lower BMI (¡3: -1.03, p = 0.017 and-1.56 p = 0.001), lower WC (3: -2.98, p = 0.004 and -3.64, p = 0.001) and waist to height ratio (3: -0.19, p = 0.004 and -0.26 p < 0.0001) compared to people who reported a slow walking pace. A brisk walkingpace was associated with a lower probability of obesity and central obesity. Conclusion: the average and brisk walkingpace was associated with lower body weight, BMI, waist circumference and waist to height ratio and a brisk walking pace was associated with a lower probability of obesity and central obesity, independently of sociodemographic and lifestyle factors.

Índice de obesidad ABSI y su asociación con diabetes mellitus tipo 2 en adultos chilenos: un estudio transversal de la ENS 2016-2017

Introducción: El nuevo índice de obesidad basado en el volumen corporal (ABSI) ha sido asociado con enfermedades crónicas no transmisibles y mortalidad, independientemente de los valores del índice de masa corporal (IMC); sin embargo, se desconoce su asociación con diabetes mellitus tipo 2 (DMT2) en población chilena. Objetivo: determinar la asociación entre ABSI con glicemia, hemoglobina glicosilada (HbAc1) y DMT2 en población adulta chilena. Materiales y Métodos: Estudio transversal, incluyó a 4.874 participantes (edad media 43,3 años, 50,9% mujeres) de la Encuesta Nacional de Salud 2016-2017. ABSI fue calculado según la fórmula propuesta (basado en circunferencia de cintura, IMC y estatura. La Regresión de Poisson fue utilizada para investigar la asociación entre ABSI con DMT2 y regresión lineal para glicemia y HbAc1. Los análisis se ajustaron según factores sociodemográficos, de estilos de vida e IMC. Resultados: ABSI fue positivamente asociado con glicemia (p < 0,001), HbA1c (p < 0,001) y DMT2 (p < 0,001). En el modelo más ajustado, por cada 0.025 unidad de aumento de ABSI, la glicemia aumentó en 1,78 mg/dL (95% IC: 1,21; 2,35) y la HbAc1en un 0,92% (95% IC: 0,49; 1,35). En cuanto a DMT2, la razón de prevalencia fue de 1,14 (95% IC: 1,09; 1,20), independiente de factores sociodemográficos, estilos de vida e IMC. Conclusiones: ABSI se asoció de forma lineal con una mayor probabilidad de padecer DMT2, mayores niveles de glicemia y HbA1c en adultos chilenos. En este contexto, ABSI podría ser un índice complementario, independiente del IMC, para evaluar el riesgo de alteraciones metabólicas asociadas a obesidad.

Introduction: A Body Shape Index (ABSI) is a new obesity index based on body volume; this has been associated with chronic non-communicable diseases and mortality, independent of the values of the body mass index (BMI); however, its association with type 2 diabetes mellitus (T2DM) in the Chilean adult population is unknown. Objective: To determine the association between ABSI, glycemia, glycosylated hemoglobin (HbAc1), and self-reported T2DM in the Chilean adult population. Materials and Methods: In a cross-sectional study, 4,874 participants were included (mean age 43.3 years, 50.9% women) from the 2016-2017 National Health Survey. ABSI was calculated according to the proposed formula (based on waist circumference, BMI, and height). The Poisson regression was used to investigate the association between ABSI and T2DM, and linear regression was used to investigate the association between ABSI, glycemia, and HbAc1. Sociodemographic factors, lifestyle, and BMI adjusted the analyses. Results: ABSI was positively associated with glycemia (p < 0.001), HbA1c (p < 0.001), and DMT2 (p < 0.001). In the most adjusted model, for every 0.025 unit increase in ABSI, glycemia increased by 1.78 mg/dL (95% CI: 1.21, 2.35) and HbAc1 by 0.92% (95% CI: 0.49, 1.35). Regarding T2DM, the prevalence ratio was 1.14 (95% CI: 1.09, 1.20), independent of sociodemographic factors, lifestyles, and BMI. Conclusions: ABSI was linearly associated with a higher probability of suffering from T2DM and higher levels of glycemia and HbA1c in Chilean adults. In this context, ABSI could be a complementary index, independent of BMI, to assess the risk of metabolic disorders associated with obesity.

Asociación entre bajos niveles de vitamina D y deterioro cognitivo en personas mayores chilenas: Resultados de la Encuesta Nacional de Salud 2016-2017 / Association between low vitamin D levels and cognitive impairment in Chilean older adults: findings of the National Health Survey 2016-2017

INTRODUCTION: Recent studies have shown that low vitamin D levels constitute a potential risk factor for the development of cognitive impairment. The present study aimed to investigate the association between vitamin D levels and the suspicion of cognitive impairment in Chilean older adults. MATERIAL AND METHOD: We performed a cross-sectional study, including 1,287 participants ≥ 65 years (56.8% were women, age range 65 to 97 years) from the Chilean National Health Survey. Cognitive impairment was assessed using the Mini Mental State Examination (MMSE). Participants were classified into three groups according to their vitamin D levels (> 29 ng/ml sufficient, 12-29 ng/ml deficit, and < 12 ng/ml severe deficit). The association between vitamin D levels and cognitive impairment was explored using logistic regression analysis, adjusted for confounding factors. RESULTS: The prevalence of vitamin D deficit and vitamin D severe deficit was 37.7% and 21.0%, respectively. Compared to older adults with sufficient levels of vitamin D, those with severe deficits had a 94% (OR: 1.94 [95% IC: 1.27; 1.66], p = 0.002) higher odds of cognitive impairment (unadjusted model). Adjusting according to sociodemographic factors, lifestyle, adiposity, sunlight exposure, and multimorbidity slightly attenuated the association to 61% (OR: 1.61 [95%IC: 1.03; 2.19], p = 0.046), but remain significant. CONCLUSION: A severe deficit of vitamin D was associated with higher odds of cognitive impairment in Chilean older adults independent of major confounding factors. Future studies are needed to provide causal evidence between vitamin D and the suspicion of cognitive impairment.

Frailty Index as a Predictor of Mortality in Middle-Aged and Older People: A Prospective Analysis of Chilean Adults.

We aimed to investigate the association between frailty status and all-cause mortality in middle-aged and older people. We included 2661 individuals aged ≥ 35 from the Chilean National Health Survey 2009−2010. Mortality was determined through linkage with the Chilean Civil Registry and Identification. A 36-item frailty index (FI) was used to assess the frailty status. Associations between frailty status and all-cause mortality were assessed using Kaplan−Meier and Cox proportional hazard models adjusted for sociodemographic and lifestyle factors. A non-linear association was investigated using penalized cubic splines fitted in the Cox models. During an 8.9 median follow-up (interquartile range of 8.6−9.0), 308 individuals died (11.5%). Lower survival rates were observed in frail individuals compared to pre-frail and robust people (log-rank < 0.001). Compared with robust individuals, frail people had a higher mortality risk (HR: 2.35 [95% CI: 1.57 to 3.51]). Frail middle-aged individuals had a higher risk of dying independently of major risk factors.

[ABSI obesity index and its association with type 2 diabetes mellitus in Chilean adults: a cross-sectional study of the ENS 2016-2017]. / Índice de obesidad ABSI y su asociación con diabetes mellitus tipo 2 en adultos chilenos: un estudio transversal de la ENS 2016-2017.

INTRODUCTION: A Body Shape Index (ABSI) is a new obesity index based on body volume; this has been associated with chronic non-communicable diseases and mortality, independent of the values of the body mass index (BMI); however, its association with type 2 diabetes mellitus (T2DM) in the Chilean adult population is unknown. OBJECTIVE: To determine the association between ABSI, glycemia, glycosylated hemoglobin (HbAc1), and self-reported T2DM in the Chilean adult population. MATERIALS AND METHODS: In a cross-sectional study, 4,874 participants were included (mean age 43.3 years, 50.9% women) from the 2016-2017 National Health Survey. ABSI was calculated according to the proposed formula (based on waist circumference, BMI, and height). The Poisson regression was used to investigate the association between ABSI and T2DM, and linear regression was used to investigate the association between ABSI, glycemia, and HbAc1. Sociodemographic factors, lifestyle, and BMI adjusted the analyses. RESULTS: ABSI was positively associated with glycemia (p < 0.001), HbA1c (p < 0.001), and DMT2 (p < 0.001). In the most adjusted model, for every 0.025 unit increase in ABSI, glycemia increased by 1.78 mg/dL (95% CI: 1.21, 2.35) and HbAc1 by 0.92% (95% CI: 0.49, 1.35). Regarding T2DM, the prevalence ratio was 1.14 (95% CI: 1.09, 1.20), independent of sociodemographic factors, lifestyles, and BMI. CONCLUSIONS: ABSI was linearly associated with a higher probability of suffering from T2DM and higher levels of glycemia and HbA1c in Chilean adults. In this context, ABSI could be a complementary index, independent of BMI, to assess the risk of metabolic disorders associated with obesity.

[Association between low vitamin D levels and cognitive impairment in Chilean older adults: findings of the National Health Survey 2016-2017]. / Asociación entre bajos niveles de vitamina D y deterioro cognitivo en personas mayores chilenas: Resultados de la Encuesta Nacional de Salud 2016-2017.

INTRODUCTION: Recent studies have shown that low vitamin D levels constitute a potential risk factor for the development of cognitive impairment. The present study aimed to investigate the association between vitamin D levels and the suspicion of cognitive impairment in Chilean older adults. MATERIAL AND METHOD: We performed a cross-sectional study, including 1,287 participants ≥ 65 years (56.8% were women, age range 65 to 97 years) from the Chilean National Health Survey. Cognitive impairment was assessed using the Mini Mental State Examination (MMSE). Participants were classified into three groups according to their vitamin D levels (> 29 ng/ml sufficient, 12-29 ng/ml deficit, and < 12 ng/ml severe deficit). The association between vitamin D levels and cognitive impairment was explored using logistic regression analysis, adjusted for confounding factors. RESULTS: The prevalence of vitamin D deficit and vitamin D severe deficit was 37.7% and 21.0%, respectively. Compared to older adults with sufficient levels of vitamin D, those with severe deficits had a 94% (OR: 1.94 [95% IC: 1.27; 1.66], p = 0.002) higher odds of cognitive impairment (unadjusted model). Adjusting according to sociodemographic factors, lifestyle, adiposity, sunlight exposure, and multimorbidity slightly attenuated the association to 61% (OR: 1.61 [95%IC: 1.03; 2.19], p = 0.046), but remain significant. CONCLUSION: A severe deficit of vitamin D was associated with higher odds of cognitive impairment in Chilean older adults independent of major confounding factors. Future studies are needed to provide causal evidence between vitamin D and the suspicion of cognitive impairment.

[Association between Walking Pace and obesity in Chilean Population: Findings from the Chilean National Health Survey 2016-2017]. / Asociación entre la velocidad de marcha y obesidad en población chilena: Resultados de la Encuesta Nacional de Salud 2016-2017.

BACKGROUND: Walking Pace is a functional marker, used as a predictor of chronic diseases. However, there is a lack of evidence on the association between walking pace and obesity. AIM: To investigate the association between-self-reported walking pace with obesity in the Chilean adult population. METHODS: 6,183 Chilean participants (aged 15 to 98 years) from the Chilean National Health Survey 2016-2017 were included in this cross-sectional study. Weight, height, waist circumference (WC), body mass index (BMI) and waist to height ratio (WHtR) were the outcomes of interest. Self-reported walking pace (slow, average and brisk) was the exposure. The association between walking pace and obesity was determined by linear regression and Poisson regression and all analyses were adjusted in models according to sociodemographic and lifestyle factors. RESULTS: In the most adjusted model, those who reported an average and brisk walking pace had a lower BMI (¡3: -1.03, p = 0.017 and-1.56 p = 0.001), lower WC (3: -2.98, p = 0.004 and -3.64, p = 0.001) and waist to height ratio (3: -0.19, p = 0.004 and -0.26 p < 0.0001) compared to people who reported a slow walking pace. A brisk walkingpace was associated with a lower probability of obesity and central obesity. CONCLUSION: the average and brisk walkingpace was associated with lower body weight, BMI, waist circumference and waist to height ratio and a brisk walking pace was associated with a lower probability of obesity and central obesity, independently of sociodemographic and lifestyle factors.

[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.

The rs483145 polymorphism of MC4R gene is not associated with obesity in the Chilean population: Results of GENADIO study.

INTRODUCTION: The melanocortin receptor 4 (MC4R) participates in the control of appetite at the level of the central nervous system, through the leptin-melanocortin pathway. An association between different polymorphisms of the MC4R gene and obesity has been reported. However, there are few studies of the rs483145 single nucleotide polymorphism (SNP) of this gene. OBJECTIVE: To investigate its prevalence and association with adiposity markers in Chilean adults. METHODS: The prevalence of SNP rs483145, of the MC4R gene, was determined in 259 participants of the GENADIO study (genes, environment, diabetes and obesity) by means of real-time polymerase chain reaction (PCR). The association between the risk allele of MC4R (A) and adiposity markers (body weight, body mass index, fat mass percentage, hip circumference, waist circumference, waist-to-hip ratio) was performed by linear regression analysis and adjusted for confusion variables (socio-demographic and physic activity) using three statistical models. RESULTS: It was determined that the prevalence of the risk allele (A) of the SNP rs483145 of the MC4R gene is 24.5% in the Chilean adult population included in this study, without finding an association with any of the adiposity markers studied, both in adjusted and unadjusted models. CONCLUSION: The presence of the risk allele of SNP rs483145 of the MC4R gene is not associated with adiposity markers in the Chilean adult population studied. New studies with a bigger sample size will be necessary to confirm these results.

Cumplimiento de las Guías Alimentarias en personas mayores chilenas: Un estudio descriptivo de la Encuesta Nacional de Salud 2016-2017

RESUMEN Chile es uno de los países de Latinoamérica que exhibe un mayor envejecimiento poblacional, por lo que es necesario visualizar distintas herramientas que direccionen estilos de vida saludables en esta etapa de la trayectoria vital. Las Guías Alimentarias Basadas en Alimentos (GABA) entregan recomendaciones que permiten mejorar la calidad de vida de personas mayores. Por lo anterior, el objetivo del estudio fue determinar el nivel de cumplimiento de recomendaciones de las GABA y su asociación con variables antropométricas, metabólicas y de estilos de vida en 1.789 personas mayores de 60 años que participaron en la Encuesta Nacional de Salud 2016-2017. Se realizó un estudio descriptivo de corte transversal, en donde los participantes se subdividieron en cuatro grupos según cumplimiento de las GABA: no cumple, cumple con 1, 2 o a lo menos 3 recomendaciones de consumo de legumbres, frutas y verduras, lácteos, agua y pescado. Como resultado, el 43,8% de las personas mayores que participaron no cumplieron ninguna de las recomendaciones GABA evaluadas; estos últimos, realizaban menos actividad física y presentaban, además, una mayor probabilidad de pasar más tiempo sentados (p-tendencia: <0,001). Como conclusión, se destaca que cerca del 50% de las personas mayores en Chile no adhieren a las recomendaciones de las GABA, lo que podría repercutir en implicaciones en la salud y bienestar de la población mayor.

ABSTRACT Chile is one of the Latin American countries that exhibits the greatest increase in the aging population, thus it is necessary to visualize different tools that guide healthy lifestyles at this stage of life. Food-Based Dietary Guidelines (abbreviated as GABA, for initials in Spanish) provide recommendations that allow improving the quality of life in older people. This study aimed to determine the level of compliance with GABA recommendations and their association with anthropometric, metabolic and lifestyles factors in 1,789 people over 60 years who participated in the 2016-2017 National Health Survey. A descriptive cross-sectional study was carried out, in which participants were subdivided into four groups according to compliance with GABA: does not comply, complies with 1, 2 or at least 3 recommendations for consumption of legumes, fruits, vegetables, dairy, water and fish. As a result, 43.8% of older participants did not meet any of the GABA recommendations evaluated. These participants also performed less physical activity and had a longer sitting time (P-trend: <0.001). In conclusion, we highlight that close to 50% of elderly Chileans do not adhere to GABA recommendations, which could have implications for the health and well-being.

[Compliance with the Dietary Guidelines in Chilean adolescents: a cross-sectional study of the Chilean National Health Survey 2016-2017]. / Cumplimiento de las Guías Alimentarias en adolescentes chilenos: un estudio transversal de la Encuesta Nacional de Salud 2016-2017.

In Chile, compliance with the Food-Based Dietary Guidelines (GABA) ensures an adequate and ba lanced diet. OBJECTIVE: To determine compliance with five GABA recommendations and their asso ciations with anthropometric, lifestyle, and metabolic variables, in adolescents aged between 15 and 19 years who participated in the Chilean National Health Survey 2016-2017. SUBJECTS AND METHOD: Cross-sectional study including 355 adolescents. Participants were divided into four groups (fulfilled 0, 1, 2, or ≥ 3 recommendations) using five messages from the GABA (consumption of legumes, fish, dairy products, water, and fruits and vegetables). Associations between GABA and outcome variables (weight, body mass index, waist circumference, physical activity, sleep, and metabolic variables) were investigated using linear regression analyses adjusted by sociodemographic confounders. RESULTS: 5.6% of the adolescents met three or more GABA recommendations. Of the recommendations mea sured, the consumption of water (85%) and legumes (78.7%) presented greater compliance, showing differences between women and men regarding the consumption of legumes (58.6% vs. 86.4%), wa ter (69.6% vs. 91%), and dairy products (92.9% vs. 39.1%). Adolescents with higher compliance with GABA had a better concentration of lower glycemia (p = 0.025). There were no other significant asso ciations between lifestyle and anthropometric measurements. CONCLUSIONS: Adolescents who partici pated in this study presented difficulties in adhering to GABA recommendations, thus compromising the maintenance of healthy lifestyles.

Lactancia materna y su asociación con obesidad: Mecanismos que podrían explicar el rol protector en la infancia

RESUMEN Introducción: La lactancia materna (LM) es un factor protector contra la obesidad infantil; sin embargo, los mecanismos a través de los cuales ejerce este efecto aún no están claros. El objetivo fue describir los mecanismos asociados al efecto protector que ejerce la lactancia materna contra la obesidad infantil. Métodos: Se utilizaron los buscadores PUBMED, SCOPUS, Cochrane Library y Scielo para desarrollar una revisión descriptiva de la evidencia científica. Las palabras clave fueron: lactancia materna, obesidad, mecanismo y dieta. Se revisaron artículos en español e inglés, desde 1977 hasta el 2020. Resultados: El efecto protector de la LM contra la obesidad infantil está dado por una combinación de varios mecanismos, se destaca su composición nutricional y el aporte de sustancias bioactivas, algunas de ellas reguladoras de la ingesta energética. Los lactantes que reciben LM por más tiempo seleccionan alimentos más saludables en etapa preescolar, independiente de factores sociodemográficos. También han sido descritos efectos en la adiposidad, el control del peso corporal y la ingesta energética mediante regulación de la programación epigenética y de la microbiota intestinal. Conclusión: La LM es un proceso único, que interacciona de forma compleja con factores del crecimiento y desarrollo de los lactantes y preescolares. Su rol protector contra la obesidad ha sido asociado a diversos mecanismos. Sin embargo, se requiere de nuevas investigaciones para comprender los alcances que puede presentar la LM en la etapa pediátrica y su rol en la prevención de la obesidad.

ABSTRACT Background and aim: Breastfeeding (BF) is a protective factor against childhood obesity; however, the mechanisms associated with this effect have not yet been elucidated. This study aimed to describe the mechanisms related to the protective effect of breastfeeding against childhood obesity. Methods: A search on PUBMED, SCOPUS, Cochrane Library and SCIELO databases was carried out to develop a descriptive review of the scientific evidence. The key words were breastfeeding; obesity; mechanism and diet. Articles were reviewed in Spanish and English from 1977 to 2020. Results: The protective effect of BF against childhood obesity is given by a combination of several mechanism. Its nutritional composition and the contribution of bioactive substances stand out, some of them regulated by the energy intake. Infants who are breastfed choose healthier foods in preschool, regardless of sociodemographic factors. Effects on adiposity, control of body weight and energy intake have also been described by epigenetic regulation programming and the intestinal microbiota. Conclusion: BF is a unique process that interacts in a complex way with infants and preschoolers' growth and developmental factors Its protective role against childhood obesity has been associated with various mechanisms. New research is still required to understand the implications of BF in pediatric age and its role in preventing obesity.

Anxiety, Low Self-Esteem and a Low Happiness Index Are Associated with Poor School Performance in Chilean Adolescents: A Cross-Sectional Analysis.

OBJECTIVE: To analyze the relationship between anxiety, self-esteem, happiness index and primary school students' academic performance in Chilean adolescents from the Biobío province. METHODOLOGY: 733 (46.1% girls; 12 (1.3 years)) public primary school students that completed the 2018 Health and School Performance Survey carried out in the Biobío province were included in this cross-sectional analysis. The BECK Anxiety Inventory (BAI) was used to measure anxiety while happiness index and self-esteem were measured using the subjective happiness scale and the Rosenberg self-esteem scale, respectively. School performance was measured by grade point average (GPA) of language, math, physical education and cumulative GPA, and behavior associated with cognition in the school context was also considered. The relationship between mental health indicators and school performance was investigated using a one-way ANOVA and Pearson correlation. RESULTS: In comparison to students with low anxiety levels and high self-esteem and happiness levels, students with higher anxiety levels, lower self-esteem and happiness levels perceived themselves as having memory problems. They were also slower to solve math problems, had a shorter attention span in class and presented more difficulties in solving complex tasks, as well as being more nervous during testing. These students also got the lowest grade point average in math, language and physical education. CONCLUSIONS: High anxiety levels, low self-esteem and low happiness levels were associated with lower school performance and weaker behavior associated with cognition in Chilean adolescents. Implementing plans of emotional education and mental health could improve academic achievement.

Niveles de actividad física y tiempo sedente según ingreso económico en Chile: resultados de la Encuesta Nacional de Salud 2016-2017 / Association between physical activity and income levels in chilean adults

BACKGROUND: The Chilean population reports high levels of physical inactivity. The relationship between income level, physical activity (PA) and sedentary behaviors is not well known. AIM: To describe the levels of PA and sedentary time, according to income levels in the Chilean population. MATERIAL AND METHODS: Analysis of data from the Chilean National Health Survey 2016-2017, which included 5,130 participants (52.9% women). The levels of PA and sedentary time were measured by the Global Physical Activity Questionnaire. Income levels were established according to the self-reported income per capita of the households and presented as quintiles. PA levels according to income levels were estimated by linear regression analyses. RESULTS: Transport-related PA was higher in the lowest income quintiles (p = 0.039). There were no trends for income levels and PA domains including moderate, vigorous, total, occupational and leisure PA. The prevalence of leisure and occupational physical inactivities were higher in the lowest quintiles of income. Sitting time was higher in the higher income levels (p < 0.01). CONCLUSIONS: People in the lowest quintile for income spent more time in transport-related PA and less time sitting. However, physical inactivity prevalence during leisure and work time were higher in people with lower income.

The rs483145 polymorphism of MC4R gene is not associated with obesity in the Chilean population: Results of GENADIO study. / El polimorfismo rs483145 del gen MC4R no se asocia con obesidad en población chilena: resultados del estudio GENADIO.

INTRODUCTION: The melanocortin receptor 4 (MC4R) participates in the control of appetite at the level of the central nervous system, through the leptin-melanocortin pathway. An association between different polymorphisms of the MC4R gene and obesity has been reported. However, there are few studies of the rs483145 single nucleotide polymorphism (SNP) of this gene. OBJECTIVE: To investigate its prevalence and association with adiposity markers in Chilean adults. METHODS: The prevalence of SNP rs483145, of the MC4R gene, was determined in 259 participants of the GENADIO study (genes, environment, diabetes and obesity) by means of real-time polymerase chain reaction (PCR). The association between the risk allele of MC4R (A) and adiposity markers (body weight, body mass index, fat mass percentage, hip circumference, waist circumference, waist-to-hip ratio) was performed by linear regression analysis and adjusted for confusion variables (socio-demographic and physic activity) using three statistical models. RESULTS: It was determined that the prevalence of the risk allele (A) of the SNP rs483145 of the MC4R gene is 24.5% in the Chilean adult population included in this study, without finding an association with any of the adiposity markers studied, both in adjusted and unadjusted models. CONCLUSION: The presence of the risk allele of SNP rs483145 of the MC4R gene is not associated with adiposity markers in the Chilean adult population studied. New studies with a bigger sample size will be necessary to confirm these results.

Nivel de actividad física en personas mayores chilenas que han sufrido caídas

RESUMEN Antecedentes: Las caídas limitan las actividades de la vida diaria. Actualmente se desconoce cómo los niveles de actividad física (AF) varían luego de sufrir una caída. Objetivo: investigar los niveles de práctica de actividad física de personas mayores que han reportado caídas en los últimos 12 meses. Métodos: Se incluyeron 1.254 participantes ≥ 60 años de Encuesta Nacional de Salud (ENS) 2009-2010. La prevalencia de caídas en los últimos 12 meses se determinó mediante auto reporte. Los niveles de AF y el tiempo sedente se determinaron a través del cuestionario Global Physical Activity Questionnaire (GPAQ). La asociación entre caídas y AF fue investigada mediante regresión lineal. Resultados: El 70,5% [95% IC: 68,0; 72,8] de las personas mayores no reportaron caídas, mientras que un 19,4% [95% IC: 17,4; 21,5] reportó haber sufrido entre 1-2 caídas y un 10% [95% IC: 8,4; 11,8] ≥3 caídas en los últimos 12 meses. En comparación al grupo que reportó no sufrir caídas, aquellos que sufrieron ≥3 caídas realizaban 79,2 minutos menos de AF total/día. Resultados similares fueron observados para AF de transporte y AF moderada. No se encontraron diferencias para tiempo sedente o AF vigorosa. Conclusión: Personas mayores que sufrieron caídas en los últimos 12 meses reportaron realizar menos actividad física que sus contrapartes que no experimentaron caídas. A mediano y largo plazo, estos cambios en la actividad física podrían contribuir a resultados de salud adversos en una población.

ABSTRACT Background: Falls among older adults are associated with important changes in lifestyle. However, there is no evidence about the physical activity levels of older adults who have experienced falls. The aim of this study, therefore, was to describe physical activity levels in older adults who have experienced falls in the last 12 months. Methods: 1,254 older adults (aged ≥60 years) from the National Health Survey 2009-2010 were included in this study. Number of falls during the last 12 months was self-reported and physical activity was measured using the Global Physical Activity Questionnaire (GPAQ). The association between falls and physical activity was investigated using regression analyses. Results: 70.5% [95% CI: 68.0; 72.8] of the older adults included in this study did not report any falls during the last 12 months. However, 19.4% [95% CI: 17.4; 21.5] reported 1-2 falls and 10% [95% CI: 8.4; 11.8] reported ≥3 falls in the last 12 months. In comparison to those who reported no falls, those who experienced ≥3 falls in the last 12 months did 79.2 fewer minutes/day of physical activity. Similar results were found for moderate and transport-related physical activity, but no associations were found for vigorous or sedentary behaviours. Conclusion: Older adults who suffered falls in the last 12 months reported doing less physical activity than their counterparts who did not experience any falls. In the middle and long term, these changes in physical activity could contribute to adverse health outcomes in an already frail population.

[Association between physical activity and income levels in chilean adults]. / Niveles de actividad física y tiempo sedente según ingreso económico en Chile: resultados de la Encuesta Nacional de Salud 2016-2017.

BACKGROUND: The Chilean population reports high levels of physical inactivity. The relationship between income level, physical activity (PA) and sedentary behaviors is not well known. AIM: To describe the levels of PA and sedentary time, according to income levels in the Chilean population. MATERIAL AND METHODS: Analysis of data from the Chilean National Health Survey 2016-2017, which included 5,130 participants (52.9% women). The levels of PA and sedentary time were measured by the Global Physical Activity Questionnaire. Income levels were established according to the self-reported income per capita of the households and presented as quintiles. PA levels according to income levels were estimated by linear regression analyses. RESULTS: Transport-related PA was higher in the lowest income quintiles (p = 0.039). There were no trends for income levels and PA domains including moderate, vigorous, total, occupational and leisure PA. The prevalence of leisure and occupational physical inactivities were higher in the lowest quintiles of income. Sitting time was higher in the higher income levels (p < 0.01). CONCLUSIONS: People in the lowest quintile for income spent more time in transport-related PA and less time sitting. However, physical inactivity prevalence during leisure and work time were higher in people with lower income.