The influence of air pollution exposure on the short- and long-term health benefits associated with active mobility: A systematic review.

Active mobility (AM), defined as walking and cycling for transportation, can improve health through increasing regular physical activity. However, these health improvements could be outweighed by harm from inhaling traffic-related air pollutants during AM participation. The interaction of AM and air pollutants on health is complex physiologically, manifesting as acute changes in health indicators that may lead to poor long-term health consequences. The aim of this study was to systematically review the current evidence of effect modification by air pollution (AP) on associations between AM and health indicators. Studies were included if they examined associations between AM and health indicators being modified by AP or, conversely, associations between AP and health indicators being modified by AM. Thirty-three studies met eligibility criteria. The main AP indicators studied were particulate matter, ultrafine particles, and nitrogen oxides. Most health indicators studied were grouped into cardiovascular and respiratory indicators. There is evidence of a reduction by AP, mainly ultrafine particles and PM2.5, in the short-term health benefits of AM. Multiple studies suggest that long-term health benefits of AM are not negatively associated with levels of the single traffic-related pollutant NO2. However, other studies reveal reduced long-term health benefits of AM in areas affected by high levels of pollutant mixtures. We recommend that future studies adopt consistent and rigorous study designs and include reporting of interaction testing, to advance understanding of the complex relationships between AM, AP, and health indicators.

Relación entre el cumplimiento de las recomendaciones de actividad física y de sueño y el exceso de peso en escolares de la ciudad de Temuco, Chile / Relationship between physical activity and sleep recommendations compliance and excess weight among school children from Temuco, Chile

Introducción. Dada la importancia que la actividad física y el sueño han adquirido para la salud, se han propuesto diversas recomendaciones para la población infantil. El propósito de este estudio fue determinar cómo se asocia el cumplimiento de las recomendaciones de actividad física y de sueño con el exceso de peso. Población y métodos. Para la medición de la actividad física y el sueño, se utilizaron acelerómetros ActiGraph wGT3X-BT®. Se determinó el índice de masa corporal para las categorizaciones de ausencia (peso normal) o presencia (sobrepeso-obesidad) de exceso de peso. Resultados. Participaron 183 escolares (54,1 % eran niñas, edad M = 10,95 ± 1,07). El 85,4 % no cumple con las recomendaciones de actividad física, mientras que el 75,6 % no cumple con las recomendaciones de sueño. Los niños se diferencian significativamente de las niñas en tiempo de actividades físicas moderadas y vigorosas (p = 0,002), mas no así en cantidad de sueño. Los escolares con exceso de peso presentan menos tiempo de actividades de intensidad moderada y vigorosa (p = 0,004) y una menor cantidad de sueño (p = 0,010) que los escolares de peso normal. El no cumplir las recomendaciones de actividad física se asociaría con el exceso de peso (razón de momios [OR, por su sigla en inglés] = 8,178; intervalo de confianza del 95 % [IC95 %]: 1,465-45,635; p = 0,017), lo que no se observó en las recomendaciones de sueño. Conclusiones. Un alto porcentaje de escolares no cumplen con las recomendaciones de actividad física y cantidad de sueño. Se observaron asociaciones según el sexo y la presencia de exceso de peso. Es necesario desarrollar estrategias para fomentar el cumplimiento de estas recomendaciones en la población infantil.

Introduction. Given the importance of physical activity and sleep for health, different recommendations have been proposed for the pediatric population. The objective of this study was to determine the association between physical activity and sleep recommendations compliance and excess weight in school children from Temuco, Chile. Population and methods. Physical activity and sleep were measured using ActiGraph wGT3X-BT® accelerometers. Excess weight was categorized on two categories: absence (normal weight) or presence (overweight or obesity) based on body mass index. Results. A total of 183 school children participated (54.1 % were females; mean age = 10.95 ± 1.07). Of them, 85.4 % did not meet physical activity recommendations, whereas 75.6 % did not meet sleep recommendations. Significant differences were observed in favor of boys over girls in relation to moderate and vigorous physical activity (p = 0.002), but this was not the case for amount of sleep. School children with excess weight showed less time spent in moderate and vigorous activity (p = 0.004) and a lower amount of sleep (p = 0.010) than normal weight ones. Non-compliance with physical activity recommendations was associated with excess weight (odds ratio [OR] = 8.178; 95 % confidence interval [CI]: 1.465-45.635; p = 0.017), but this was not observed in relation to sleep recommendations.Conclusions. A high percentage of school children do not meet the recommendations for physical activity and sleep. Associations were observed by sex and presence of excess weight. Strategies are required to promote compliance with these recommendations in the pediatric population

Relationship between physical activity and sleep recommendations compliance and excess weight among school children from Temuco, Chile. / Relación entre el cumplimiento de las recomendaciones de actividad física y de sueño y el exceso de peso en escolares de la ciudad de Temuco, Chile.

Introduction: Given the importance of physical activity and sleep for health, different recommendations have been proposed for the pediatric population. The objective of this study was to determine the association between physical activity and sleep recommendations compliance and excess weight in school children from Temuco, Chile. Population and methods: Physical activity and sleep were measured using ActiGraph wGT3X-BT® accelerometers. Excess weight was categorized on two categories: absence (normal weight) or presence (overweight or obesity) based on body mass index. Results: A total of 183 school children participated (54.1 % were females; mean age = 10.95 ± 1.07). Of them, 85.4 % did not meet physical activity recommendations, whereas 75.6% did not meet sleep recommendations. Significant differences were observed in favor of boys over girls in relation to moderate and vigorous physical activity (p = 0.002), but this was not the case for amount of sleep. School children with excess weight showed less time spent in moderate and vigorous activity (p = 0.004) and a lower amount of sleep (p = 0.010) than normal weight ones. Non-compliance with physical activity recommendations was associated with excess weight (odds ratio [OR] = 8.178; 95 % confidence interval [CI]: 1.465-45.635; p = 0.017), but this was not observed in relation to sleep recommendations. Conclusions: A high percentage of school children do not meet the recommendations for physical activity and sleep. Associations were observed by sex and presence of excess weight. Strategies are required to promote compliance with these recommendations in the pediatric population.

Introducción. Dada la importancia que la actividad física y el sueño han adquirido para la salud, se han propuesto diversas recomendaciones para la población infantil. El propósito de este estudio fue determinar cómo se asocia el cumplimiento de las recomendaciones de actividad física y de sueño con el exceso de peso. Población y métodos. Para la medición de la actividad física y el sueño, se utilizaron acelerómetros ActiGraph wGT3X-BT®. Se determinó el índice de masa corporal para las categorizaciones de ausencia (peso normal) o presencia (sobrepeso-obesidad) de exceso de peso. Resultados. Participaron 183 escolares (54,1 % eran niñas, edad M = 10,95 ± 1,07). El 85,4 % no cumple con las recomendaciones de actividad física, mientras que el 75,6 % no cumple con las recomendaciones de sueño. Los niños se diferencian significativamente de las niñas en tiempo de actividades físicas moderadas y vigorosas (p = 0,002), mas no así en cantidad de sueño. Los escolares con exceso de peso presentan menos tiempo de actividades de intensidad moderada y vigorosa (p = 0,004) y una menor cantidad de sueño (p = 0,010) que los escolares de peso normal. El no cumplir las recomendaciones de actividad física se asociaría con el exceso de peso (razón de momios [OR, por su sigla en inglés] = 8,178; intervalo de confianza del 95 % [IC95 %]: 1,465-45,635; p = 0,017), lo que no se observó en las recomendaciones de sueño. Conclusiones. Un alto porcentaje de escolares no cumplen con las recomendaciones de actividad física y cantidad de sueño. Se observaron asociaciones según el sexo y la presencia de exceso de peso. Es necesario desarrollar estrategias para fomentar el cumplimiento de estas recomendaciones en la población infantil.

Individual and contextual factors associated with bicyclist injury severity in traffic incidents between bicyclists and motorists in Chile.

Bicyclists are vulnerable road users who risk incurring severe injuries from traffic incidents involving motorists. However, the prevalence of severe bicycle injuries varies across countries and is not well-documented in Latin American countries. Studies from developed countries outside of Latin America have shown that individual and contextual factors are associated with severe injuries incurred by bicyclists in road traffic incidents with motorists, but it is not clear whether these factors are the same as those incurred by Latin American bicyclists. Moreover, most studies on bicyclist-motorist traffic incidents have treated injury severity as a binary variable for analysis although injuries range widely in severity. The aims of this study were to determine the prevalence of bicycle injuries from incidents between motorists and bicyclists in Chile and examine the associations between individual and contextual factors and bicyclist injury severity, treated as an ordinal outcome variable, in these incidents. Data on road traffic incidents between bicyclists and motorists from the 2016 Traffic Accident of Bicycle Riders and Consequences database of the Chilean Transport Ministry were analysed. Multilevel mixed-effects ordinal regression models were used to examine associations. In total, 81.2 % of 4093 traffic incidents between bicyclists and motorists resulted in nonfatal injuries to bicyclists and another 2.3 % resulted in fatalities. Most incidents involved collisions (84.3 %), and most were due to a motorist being distracted while driving (50.4 %). Severe bicyclist injuries were more likely when the incident involved a stationary cyclist who was struck, a collision between a moving bicycle and a moving motor vehicle, or an overturning motor vehicle striking a bicyclist (p < 0.001). Other factors included the motorist driving under the influence of alcohol (p = 0.05), the incident taking place in a mid-size community (p = 0.04), the incident occurring between 7:00 pm and 4:59 am (p < 0.01), and the injured bicyclist being under 18 years or 45+ years of age (p < 0.05). These findings suggest the need for educational programs that promote safe driving behaviour in the presence of bicyclists, better enforcement of laws and higher penalties for distracted or drunk driving, and provision of high-quality exclusive bicyclist infrastructure to address the vulnerability of the youngest and oldest bicyclists on shared roads, particularly in mid-size communities, and to provide better lighting on bikeways for evening bicycling, to reduce the high incidence of severe bicyclist injuries in motorist-bicyclist incidents.

Comparison between self-reported and accelerometer-derived measurements for classifying children and adolescents as physically active in Chile.

The aim of this study was to compare self-reported with two accelerometer-derived methods to classify Chilean children and adolescents as physically active. In total, 247 students wore an accelerometer on their hips during 7 consecutive days to classify them as physically active based on (1) daily accumulation of ≥ 60 minutes of moderate-to-vigorous physical activity (MVPA) on each of the seven days, and (2) average MVPA ≥ 60 minutes/day. Also, participants were classified as physically active if they reported being active for at least 60 minutes in all seven days. When using the accelerometer data, 0.8% were active in all seven days, while 10.5% recorded ≥ 60 minutes MVPA per day on average. Based on self-report, 7.2% were physically active. The agreement between self-reported and accelerometer estimations were poor. Important differences were observed between the self-reported and device-derived methods for classifying children and adolescents as physically active. When comparing them, some considerations should be taken. The findings suggest that these methods are not interchangeable. Therefore, if possible, they should be used as complementary measurements.

Cultural adaptation, translation and validation of the Spanish version of Past-day Adults' Sedentary Time.

BACKGROUND: To better understand sedentary behaviour and favour international comparisons, more evidence from different countries are needed. However, there are a few tools available in Spanish to measure sedentary behaviour. This study aimed to culturally adapt, translate and validate the Past-day Adults' Sedentary Time (PAST) questionnaire in Chilean adults compared with the ActivPAL. METHOD: One hundred one workers wore an ActivPAL for 1 week and were asked to respond to the Spanish version of the PAST twice on different visits at a 7-day interval. The PAST assesses sedentary behaviour in several domains, including working time, during the previous day. Reliability was assessed with the intraclass correlation coefficient (ICC). Correlations and Bland-Altman methods were used to determine accuracy properties of the PAST compared with the ActivPAL. RESULTS: Seventy-seven participants provided valid data (51.0% male; age = 39.0 ± 12.39 years). The PAST showed moderate reliability (ICC = 0.63). For the total time in sedentary behavior per day, the PAST showed no correlation (r = 0.21, p = 0.07) and a mean bias of 54.9 min/day (LoA 95%: - 484.3, 594.2 min/day) with the ActivPAL. For the total time in SB at work, the PAST showed moderate reliability (ICC = 0.40), weak correlation (r = 0.37, p < 0.002), and mean bias was 33.8 min/day (LoA 95%: - 285.7, 353.3 min/day). CONCLUSIONS: The PAST performed better when estimating sedentary behaviour during working hours compared with the whole day. In this setting, accuracy properties were comparable with other self-report tools.

Relación de la actividad física medida objetivamente con dislipidemias y factores de riesgo cardiovascular en escolares de la Región de La Araucanía / Relationship of objectively measured physical activity with dyslipidemias and cardiovascular risk factors in schoolchildren from Región de La Araucanía cases

INTRODUCCIÓN: Las dislipidemias favorecen la formación precoz de placas ateroscleróticas, aumentando el riesgo de enfermedades cardiovasculares (ECVs). La Actividad Física (AF) es un factor protector de ECVs, por lo que el objetivo de este trabajo fue evaluar la asociación entre AF medida objetivamente y dislipidemias en población pediátrica. METODOLOGÍA: La AF fue evaluada en 159 niños (9-13 años) de la Región de La Araucanía a través de acelerometría (ActiGraph GT3X+). Por este medio se estimó el porcentaje de AF moderada a vigorosa (AFMV) y el de conducta sedentaria (CS). Sujetos con ≥60 min de AFMV se consideraron físicamente activos según recomendación de la Organización Mundial de la Salud (OMS). Individuos con %CS>75° percentil fueron considerados sedentarios. El perfil lipídico fue determinado usando métodos convencionales. Fueron calculados índices de aterogenicidad TG/cHDL e índice de aterogenicidad del plasma (IAP). RESULTADOS: 37,1% presentó dislipidemia, 8% hipercolesterolemia, 19,5% hipertrigliceridemia, 6,3% cLDL elevado y 25,2% cHDL disminuido. Solo un 9,4% fueron considerados físicamente activos de acuerdo a la recomendación de la OMS. En los sujetos físicamente activos no hubo caso de dislipidemias (p= 0,032) y tampoco bajos niveles de cHDL (p= 0,013). El %AFMV estaba reducido en sujetos con cHDL bajo y se correlacionó positivamente con HDL-c (r= 0,157, p=0,048). Además, el %AFMV se correlacionó con menores valores de TG/cHDL (r= -0,193, p=0,015) e IAP (r= -0,214, p=0,006). Si bien el comportamiento sedentario no estuvo asociado con riesgo de dislipidemias, el %CS se correlacionó positivamente con niveles de glucosa (r= 0,159, p=0,044) y HOMA-IR (r= 0,178, p=0,037) y negativamente con Quicki (r= -0,160, p=0,044). CONCLUSIONES: Los hallazgos sugieren que la AF se correlaciona a menor frecuencia de dislipidemias y la práctica de AFMV aumentaría los valores de HDL-c y reduciría los índices aterogénicos, por lo que promoverla puede significar disminuir el riesgo de ECVs en nuestra población. Además, la CS se relaciona con un aumento en valores de glucosa e índices de resistencia insulínica en escolares de la Región de La Araucanía.

Dyslipidemias cause early formation of atherosclerotic plaque, increasing the risk of cardiovascular diseases (CVD). Physical Activity (PA) is a protective factor against CVDs. The aim of this study is to evaluate the association between objectively measured PA with dyslipidemias in a pediatric population. METHOD: The PA was evaluated in 159 children (9-13 years old) from Región de La Araucanía using accelerometry (ActiGraph GT3X +). The percentage of moderate to vigorous PA (MVPA) and sedentary behavior (SB) were estimated. Subjects with ≥60 min of MVPA were considered physically active according to the recommendation of the World Health Organization (WHO). Individuals with %SB >75th percentile were sedentary. The lipid profile was determined using conventional methods. TG/HDL-C ratio and atherogenic index of plasma (AIP) were calculated. RESULTS: 37.1% presented dyslipidemia, 8% hypercholesterolemia, 19.5% hypertriglyceridemia, 6.3% elevated LDL-C and 25.2% decreased HDL-C. Only 9.4% were physically active according to the WHO recommendation. In physically active subjects where no cases of dyslipidemias (p =0.032) and no low HDL-C (p = 0.013). The %MVPA was reduced in subjects with low HDL-C and positively correlated with HDL-c (r = 0.157, p = 0.048). In addition, %MVPA was correlated with lower TG / HDL-C values (r = -0.193, p = 0.015) and AIP (r = -0.214, p = 0.006). SB was not associated with risk of dyslipidemia, % SB was positively correlated with glucose levels (r = 0.159, p = 0.044) and HOMA-IR (r = 0.178, p = 0.037) and negatively with Quicki (r = -0.160, p = 0.044). CONCLUSIONS: Our results suggested that PA is it correlates to a lower frequency of dyslipidemia and the practice of MVPA would increase HDL-c values and reduce atherogenic index, promoting it may been reducing the risk of CVDs in our population. In addition, the SB is related to an increase in glucose values and insulin resistance index in schoolchildren in Región de La Araucanía.

Comparison between self-reported and accelerometer-derived measurements for classifying children and adolescents as physically active in Chile / Comparación entre medidas autoreportadas y provenientes de acelerómetro para clasificar a los niños, niñas y adolescentes como físicamente activos en Chile / Comparação de autorrelato e medidas derivadas de acelerômetro para classificar a atividade física em crianças e adolescentes chilenos

The aim of this study was to compare self-reported with two accelerometer-derived methods to classify Chilean children and adolescents as physically active. In total, 247 students wore an accelerometer on their hips during 7 consecutive days to classify them as physically active based on (1) daily accumulation of ≥ 60 minutes of moderate-to-vigorous physical activity (MVPA) on each of the seven days, and (2) average MVPA ≥ 60 minutes/day. Also, participants were classified as physically active if they reported being active for at least 60 minutes in all seven days. When using the accelerometer data, 0.8% were active in all seven days, while 10.5% recorded ≥ 60 minutes MVPA per day on average. Based on self-report, 7.2% were physically active. The agreement between self-reported and accelerometer estimations were poor. Important differences were observed between the self-reported and device-derived methods for classifying children and adolescents as physically active. When comparing them, some considerations should be taken. The findings suggest that these methods are not interchangeable. Therefore, if possible, they should be used as complementary measurements.

El objetivo fue comparar el autoreporte con dos métodos provenientes de acelerómetría para clasificar a niños, niñas y adolescentes chilenos como físicamente activos. Doscientos cuarenta y siete estudiantes llevaron un acelerómetro en la cintura durante siete días consecutivos y fueron clasificados como físicamente activos, basados en: (1) acumulación diaria de ≥ 60 minutos de actividad física de moderada a vigorosa (AFMV) en cada uno de los siete días, y (2) promedio de AFMV ≥ 60 minutos/día. Asimismo, los participantes fueron clasificados como físicamente activos si reportaron ser activos por al menos 60 minutos en cada uno de los siete días. Al usar los datos del acelerómetro, 0,8% fueron activos los siete días, mientras que un 10,5% registró ≥ 60 minutos AFMV por día promedio. Un 7,2% fue físicamente activos según el autoreporte. El acuerdo entre las estimaciones autoreportadas y el acelerómetro fue pobre. Se observaron importantes diferencias entre los autoreportes y los métodos derivados del dispositivo para clasificar niños, niñas y adolescentes como físicamente activos. Cuando se comparen datos derivados de los acelerómetros y autoreportes esto se debería considerar. Los resultados sugieren que estos métodos no son intercambiables. Por ello, en la medida de lo posible, se deberían usar como medidas complementarias.

O objetivo foi comparar o autorrelato com dois métodos derivados de acelerômetro para classificar crianças e adolescentes chilenos como fisicamente ativas ou inativas. Um total de 247 alunos usaram um acelerômetro no quadril durante sete dias consecutivos e foram classificados como fisicamente ativos com base em: (1) acúmulo diário de ≥ 60 minutos de atividade física de moderada a vigorosa intensidade (AFMV) em cada um dos sete dias e (2) AFMV média por dia de ≥ 60 minutos. Além disso, os participantes foram classificados como fisicamente ativos com base no autorrelato de ser ativo por pelo menos 60 minutos em todos os sete dias. Com o uso dos dados de acelerômetro, 0,8% foram classificados como ativos em todos os sete dias, enquanto 10,5% registravam ≥ 60 minutos de AFMV por dia em média e 7,2% eram fisicamente ativos com base no autorrelato. A concordância foi baixa entre o autorrelato e as estimativas por acelerômetro. Foram observadas diferenças importantes entre o autorrelato e os métodos baseados em dispositivos para classificar as crianças e adolescentes como fisicamente ativos. Algumas considerações são relevantes ao comparar estimativas baseadas em acelerômetro e o autorrelato de atividade física. Os achados sugerem que esses métodos não são intercambiáveis. Portanto, quando possível, devem ser usados como medidas complementares.

Compliance of the 24-Hour Movement Guidelines in 9- to 11-Year-Old Children From a Low-Income Town in Chile.

BACKGROUND: The purpose was to determine the proportion of 9- to 11-year-old children meeting the 24-hour movement guidelines (24-HMG) in a low-income town from Chile. METHODS: Physical activity, sedentary behavior (recreational screen), and sleep times were measured with both questionnaire and accelerometer in 258 children from third to sixth grade. Meeting the 24-HMG was defined as having ≥60 minutes per day of moderate to vigorous physical activity, ≤2 hour day of screen time, and 9 to 11 hours of sleep per night. Compliance rates were calculated as self-reported 24-HMG, with all estimations based on questionnaires, and mixed 24-HMG, in which physical activity and sleep were determined with an accelerometer and sedentary behavior was determined with a questionnaire. RESULTS: About 198 children (10.1 [0.8] y, range 9-11 y) provided valid data for estimating self-reported 24-HMG, and 141 for mixed 24-HMG. Only 3.2% and 0.7% met the 24-HMG when using the self-reported and mixed methods, respectively. When assessing individual recommendations, 13.1% and 3.7% of the sample were physically active based on the self-report and accelerometer, respectively. About a quarter met the sedentary behavior recommendations, while around 50% met the sleep recommendations with both self-reported and mixed methods. CONCLUSIONS: An extremely low percentage of the participants met the 24-HMG. Multicomponent initiatives must be implemented to promote healthy movement behaviors in Chilean children.

2018 Chilean Physical Activity Report Card for Children and Adolescents: Full Report and International Comparisons.

BACKGROUND: The study summarizes the findings of the 2018 Chilean Report Card (RC) on Physical Activity (PA) for Children and Adolescents and compares the results with the first Chilean RC and with other countries from the Global Matrix 3.0. METHODS: A Research Work Group using a standardized methodology from the Global Matrix 3.0 awarded grades for 13 PA-related indicators based on the percentage of compliance for defined benchmarks. Different public data sets, government reports, and papers informed the indicators. RESULTS: The grades assigned were for (1) "behaviors that contribute to overall PA levels": overall PA, D-; organized sport participation, D-; active play, INC; and active transportation, F; (2) "factors associated with cardiometabolic risk": sedentary behavior, C-; overweight and obesity, F; fitness, D; sleep, INC; and (3) "factors that influence PA": family and peers, F; school, D; inclusion, INC; community and built environment, B; government strategies and investments, B-. CONCLUSIONS: Chile's grades remained low compared with the first RC. On the positive side, Chile is advancing in environmental and policy aspects. Our findings indicate that the implementation of new strategies should be developed through collaboration between different sectors to maximize effective investments for increasing PA and decreasing sedentary time among children and adolescents in Chile.

The descriptive epidemiology of sitting in Chilean adults: Results from the National Health Survey 2009-2010.

BACKGROUND: Although evidence on the health effects of sedentary behavior (SB) has grown systematically in recent years, few developing countries have reported population levels of SB, especially in South America. Our objective was to describe time spent sitting in a representative sample from Chile categorized by age, gender, educational level, and body mass index (BMI). METHODS: A national health survey was conducted in Chile in a nationally representative sample (n = 5411) in 2009-2010. Sitting time (ST) was measured with the Global Physical Activity Questionnaire Version 2. RESULTS: Data were from 5031 participants (43.26 ± 0.41 years, mean ± SE; 40.3% male). Overall, there were no gender differences in mean ST (men: 158.10 ± 5.80 min/day, women 143.45 ± 4.77 min/day; p = 0.05). ST was lower in those who lived in rural areas compared with urban areas (99.4 min/day vs. 160.0 min/day; p = 0.001). ST increased significantly with increasing BMI, but only in men (p = 0.009), and was positively related to years of education in both men and women (p < 0.0001). CONCLUSION: The findings were different from those reported in other countries and contexts, reinforcing the need for international surveillance and monitoring over time to inform policy makers. Differences in ST across different groups emphasize the need to develop tailored messages and interventions for reducing ST in different population subgroups.

Alta prevalencia de dislipidemias y riesgo aterogénico en una población infanto-juvenil / High prevalence of dyslipidemia and high atherogenic index of plasma in children and adolescents

Background: Dyslipidemias in childhood increase the risk of cardiovascular events in adult life. Aim: To evaluate the prevalence of dyslipidemia and risk of atherogenicity based in the atherogenic index of plasma (AIP) in a sample of school children and adolescents. Material and Methods: Cross-sectional study of 208 children aged 10.4 ± 1.0 years (107 women). Demographic data were obtained, and a clinical evaluation was conducted, including pubertal development according to Tanner and anthropometric parameters. A fasting blood sample was obtained to measure total cholesterol (CT), HDL cholesterol (cHDL) and triglycerides (TG), glucose and insulin. LDL cholesterol (cLDL), Non-HDL cholesterol and the indices CT/cHDL, cLDL/cHDL and AIP (log[TG/cHDL]) were calculated. Risk categories according to AIP for the pediatric population were also determined (low: AIP < 0.11, intermediate: AIP 0.11-0.21, high: AIP > 0.21). Results: Thirty eight percent of participants had dyslipidemia, without differences by gender and pubertal development. The frequency of dyslipidemia was significantly higher in children with obesity (54%, p < 0.01) and a waist circumference over percentile 90 (61%; p < 0.01). The later conditions had also higher CT/cHDL, cLDL/cHDL and AIP. According to AIP, 54% of children had a high atherogenicity risk along with alterations in anthropometric parameters and insulin resistance. All anthropometric and insulin resistance parameters were significantly correlated with the AIP. Conclusions: There is a high prevalence of dyslipidemia in the studied population, which is associated with an increased cardiometabolic risk. The indices of atherogenicity and particularly AIP are correlated with nutritional status, abdominal obesity and parameters of insulin resistance.

Alta prevalencia de trastornos nutricionales por exceso, resistencia insulínica y síndrome metabólico en escolares de la comuna de Carahue, Región de la Araucanía / High prevalence of overweight, obesity, insulin resistance and metabolic syndrome in rural children and adolescents

Background: Childhood and adolescent obesity is a major public health problem in Chile. Aim: To characterize cardiometabolic risk factors in a population of schoolchildren from Carahue, Chile. Material and Methods: Cross-sectional assessment of 208 children aged 10.4 ± 1.0 years (106 women). A clinical evaluation was carried out including pubertal development according to Tanner and anthropometric parameters. A fasting blood sample was obtained to measure glucose, insulin and lipid profile. HOMA-IR and Quicki indices were calculated. Insulin resistance (IR) was established according to Burrows criteria and Barja criteria, previously proposed for the Chilean pediatric population. The metabolic syndrome (MetS) was established using the modified Cook criteria. Results: Thirty eight percent of children had overweight and 33.1% obesity. MetS was only observed in obese subjects and the frequency in this subgroup was 38%. The prevalence of IR was 51% according to the Burrows criteria and 19% according to Barja criteria. It was more common in participants who were overweight, obese or had abdominal obesity. Children with insulin resistance according to Barja criteria, had worse anthropometric measures than their counterparts without resistance. When Burrows criteria was used, no differences in anthropometric measures were observed between participants with or without resistance. The frequency of MetS was 26 and 18% in children with insulin resistance according to Barja and Burrows criteria, respectively. Insulin levels and insulin sensitivity indexes were positively correlated with anthropometric parameters. Conclusions: There was a high prevalence of overweight, obesity and MetS in these participants. Our results suggest that the IR criteria according to Barja allows to identify cases with higher metabolic risk.

[High prevalence of dyslipidemia and high atherogenic index of plasma in children and adolescents]. / Alta prevalencia de dislipidemias y riesgo aterogénico en una población infanto-juvenil.

BACKGROUND: Dyslipidemias in childhood increase the risk of cardiovascular events in adult life. AIM: To evaluate the prevalence of dyslipidemia and risk of atherogenicity based in the atherogenic index of plasma (AIP) in a sample of school children and adolescents. MATERIAL AND METHODS: Cross-sectional study of 208 children aged 10.4 ± 1.0 years (107 women). Demographic data were obtained, and a clinical evaluation was conducted, including pubertal development according to Tanner and anthropometric parameters. A fasting blood sample was obtained to measure total cholesterol (CT), HDL cholesterol (cHDL) and triglycerides (TG), glucose and insulin. LDL cholesterol (cLDL), Non-HDL cholesterol and the indices CT/cHDL, cLDL/cHDL and AIP (log[TG/cHDL]) were calculated. Risk categories according to AIP for the pediatric population were also determined (low: AIP < 0.11, intermediate: AIP 0.11-0.21, high: AIP > 0.21). RESULTS: Thirty eight percent of participants had dyslipidemia, without differences by gender and pubertal development. The frequency of dyslipidemia was significantly higher in children with obesity (54%, p < 0.01) and a waist circumference over percentile 90 (61%; p < 0.01). The later conditions had also higher CT/cHDL, cLDL/cHDL and AIP. According to AIP, 54% of children had a high atherogenicity risk along with alterations in anthropometric parameters and insulin resistance. All anthropometric and insulin resistance parameters were significantly correlated with the AIP. CONCLUSIONS: There is a high prevalence of dyslipidemia in the studied population, which is associated with an increased cardiometabolic risk. The indices of atherogenicity and particularly AIP are correlated with nutritional status, abdominal obesity and parameters of insulin resistance.

[High prevalence of overweight, obesity, insulin resistance and metabolic syndrome in rural children and adolescents]. / Alta prevalencia de trastornos nutricionales por exceso, resistencia insulínica y síndrome metabólico en escolares de la comuna de Carahue, Región de la Araucanía.

BACKGROUND: Childhood and adolescent obesity is a major public health problem in Chile. AIM: To characterize cardiometabolic risk factors in a population of schoolchildren from Carahue, Chile. MATERIAL AND METHODS: Cross-sectional assessment of 208 children aged 10.4 ± 1.0 years (106 women). A clinical evaluation was carried out including pubertal development according to Tanner and anthropometric parameters. A fasting blood sample was obtained to measure glucose, insulin and lipid profile. HOMA-IR and Quicki indices were calculated. Insulin resistance (IR) was established according to Burrows criteria and Barja criteria, previously proposed for the Chilean pediatric population. The metabolic syndrome (MetS) was established using the modified Cook criteria. RESULTS: Thirty eight percent of children had overweight and 33.1% obesity. MetS was only observed in obese subjects and the frequency in this subgroup was 38%. The prevalence of IR was 51% according to the Burrows criteria and 19% according to Barja criteria. It was more common in participants who were overweight, obese or had abdominal obesity. Children with insulin resistance according to Barja criteria, had worse anthropometric measures than their counterparts without resistance. When Burrows criteria was used, no differences in anthropometric measures were observed between participants with or without resistance. The frequency of MetS was 26 and 18% in children with insulin resistance according to Barja and Burrows criteria, respectively. Insulin levels and insulin sensitivity indexes were positively correlated with anthropometric parameters. CONCLUSIONS: There was a high prevalence of overweight, obesity and MetS in these participants. Our results suggest that the IR criteria according to Barja allows to identify cases with higher metabolic risk.