Effects of an Educational Intervention Program on Positional Cranial Deformity in Premature Infants.

Positional cranial deformities are associated with prematurity evolving during the first 2 years of life due to the malleable characteristics of the skull, the first year being the main/primary therapeutic window for intervention. The objectives were (a) to describe health characteristics, peri- and postnatal pathologies, and positional cranial deformities in infants enrolled in an early intervention program and (b) to analyze the effects of a parent education-based intervention program on positional cranial deformity in premature infants. A quantitative, analytical, longitudinal study was conducted. It included 103 premature infants enrolled in an early intervention program (EIP) during the year 2017, all under 4 months of corrected age, to whom a parent education-based intervention program was applied. Cranial circumference, cranial width, diagonals, and anteroposterior diameter were measured, and the cranial asymmetry index (CAI) and cephalic index (CI) were calculated at baseline and during two subsequent evaluations separated by a 3-month period. The main results showed that 75.7% of the infants belonged to a very premature gestational age category, and 57.3% had an adequate weight for gestational age. The most frequent pathologies were premature jaundice, premature anemia, and hyaline membrane disease. The most frequent positional cranial deformity was plagiocephaly. The parent education-based intervention program resulted in (1) a significant decrease in the CAI and a significant increase in the IC, (2) plagiocephalies: an increase in the mild category and a decrease in the moderate + severe categories, (3) brachycephalies: a decrease in the absence category and an increase in the moderate + severe category, and (4) dolichocephalies: an increase in the absence category and a decrease in the mild category. In conclusion, the recommended first line of intervention was not enough for this population, and future studies should support the development of national clinical guidelines, where education is complemented with other therapeutic measures.

Limitaciones y oportunidades para la adopción de la dieta mediterránea en adultos chilenos con elementos diagnósticos del síndrome metabólico / Limitations and opportunities for the appropriation of the Mediterranean diet in Chilean adults with diagnostic elements of metabolic syndrome

Antecedentes: un estilo de alimentación saludable, específicamente la dieta mediterránea (DMed), es un factor asociado a bajo riesgo, menorprevalencia y mejor manejo de las enfermedades crónicas. Sin embargo, existe información limitada respecto a cómo los pacientes incorporanpropuestas de este patrón alimentario en su vida cotidiana.Objetivo: identificar factores y condiciones que pueden influir en la adherencia a la DMed en Chile.Métodos: estudio cualitativo exploratorio en 17 pacientes de ambos sexos de entre 35 y 65 años que presentaban algún criterio diagnósticode síndrome metabólico (SMet). Mediante entrevistas en profundidad y grupos focales se indagaron el conocimiento, la valoración, las actitudesy las prácticas asociadas a cambios y mantenimiento de alimentación con énfasis en la DMed. El análisis de la información se realizó bajo elenfoque de teoría fundada usando el softwar e ATLAS.ti.Resultados: los participantes reconocieron el valor de una alimentación saludable tipo DMed, pero declararon bajo conocimiento (identificaciónde algunos alimentos aislados) de ella, junto con facilitadores (variedad de ingredientes) y limitantes (sabor, disponibilidad/costo de algunosalimentos) para su adopción rutinaria. Además, el cambio de hábitos alimentarios genera alta carga cognitiva y emocional inicial que requiereesfuerzo no solo individual sino también relacional, pues implica modificaciones de prácticas familiares y colectivas.Conclusiones: la información obtenida sobre barreras y oportunidades para adherir a una alimentación saludable como la DMed resulta clavepara diseñar e implementar intervenciones nutricionales basadas en este patrón alimentario y que puedan ser sostenibles en el tiempo para elenfrentamiento de las enfermedades crónicas en Chile.(AU)

Background: a healthy food intake pattern, specifically the Mediterranean diet (MedDiet), is a factor associated with reduced risk, lowerprevalence, and better management of chronic diseases. However, there is limited information regarding how patients integrate proposals foradherence to this food pattern in their daily lives.Objective: to identify factors and conditions that influence adherence to the MedDiet in Chile.Methods: an exploratory qualitative study was applied in 35 to 65-year-old patients of both sexes who presented at least one diagnostic criterionof metabolic syndrome (MetS). Through in-depth interviews and focal groups, knowledge, assessment, attitudes, and practices associated withchanges and maintenance of healthy eating habits, with emphasis on the MedDiet, were investigated. Information analysis was carried out underthe grounded theory approach using the ATLAS.ti software.Results: participants recognized the value of healthy eating, including the MedDiet, but declared low knowledge (identification of single foodsitems) together with facilitators (variety of ingredients) and limiting factors (taste, availability/cost of some items, family dynamics) for its routineadoption. In addition, change in eating habits generates a high initial cognitive and emotional load that requires not only individual but alsorelational effort as it implies modifications of family and collective practices.Conclusions: information obtained on barriers and opportunities to adhere to healthy eating such as the MedDiet is key to design and implementnutritional interventions based on this food pattern and that can be sustainable in time for chronic disease management in Chile.(AU)

[Limitations and opportunities for the appropriation of the Mediterranean diet in Chilean adults with diagnostic elements of metabolic syndrome]. / Limitaciones y oportunidades para la adopción de la dieta mediterránea en adultos chilenos con elementos diagnósticos del síndrome metabólico.

Introduction: Background: a healthy food intake pattern, specifically the Mediterranean diet (MedDiet), is a factor associated with reduced risk, lower prevalence, and better management of chronic diseases. However, there is limited information regarding how patients integrate proposals for adherence to this food pattern in their daily lives. Objective: to identify factors and conditions that influence adherence to the MedDiet in Chile. Methods: an exploratory qualitative study was applied in 35 to 65-year-old patients of both sexes who presented at least one diagnostic criterion of metabolic syndrome (MetS). Through in-depth interviews and focal groups, knowledge, assessment, attitudes, and practices associated with changes and maintenance of healthy eating habits, with emphasis on the MedDiet, were investigated. Information analysis was carried out under the grounded theory approach using the ATLAS.ti software. Results: participants recognized the value of healthy eating, including the MedDiet, but declared low knowledge (identification of single foods items) together with facilitators (variety of ingredients) and limiting factors (taste, availability/cost of some items, family dynamics) for its routine adoption. In addition, change in eating habits generates a high initial cognitive and emotional load that requires not only individual but also relational effort as it implies modifications of family and collective practices. Conclusions: information obtained on barriers and opportunities to adhere to healthy eating such as the MedDiet is key to design and implement nutritional interventions based on this food pattern and that can be sustainable in time for chronic disease management in Chile.

Introducción: Antecedentes: un estilo de alimentación saludable, específicamente la dieta mediterránea (DMed), es un factor asociado a bajo riesgo, menor prevalencia y mejor manejo de las enfermedades crónicas. Sin embargo, existe información limitada respecto a cómo los pacientes incorporan propuestas de este patrón alimentario en su vida cotidiana. Objetivo: identificar factores y condiciones que pueden influir en la adherencia a la DMed en Chile. Métodos: estudio cualitativo exploratorio en 17 pacientes de ambos sexos de entre 35 y 65 años que presentaban algún criterio diagnóstico de síndrome metabólico (SMet). Mediante entrevistas en profundidad y grupos focales se indagaron el conocimiento, la valoración, las actitudes y las prácticas asociadas a cambios y mantenimiento de alimentación con énfasis en la DMed. El análisis de la información se realizó bajo el enfoque de teoría fundada usando el software ATLAS.ti. Resultados: los participantes reconocieron el valor de una alimentación saludable tipo DMed, pero declararon bajo conocimiento (identificación de algunos alimentos aislados, dinámica familiar) de ella, junto con facilitadores (variedad de ingredientes) y limitantes (sabor, disponibilidad/costo de algunos alimentos) para su adopción rutinaria. Además, el cambio de hábitos alimentarios genera alta carga cognitiva y emocional inicial que requiere esfuerzo no solo individual sino también relacional, pues implica modificaciones de prácticas familiares y colectivas. Conclusiones: la información obtenida sobre barreras y oportunidades para adherir a una alimentación saludable como la DMed resulta clave para diseñar e implementar intervenciones nutricionales basadas en este patrón alimentario y que puedan ser sostenibles en el tiempo para el enfrentamiento de las enfermedades crónicas en Chile.

Association of Stair Use With Risk of Major Chronic Diseases.

INTRODUCTION: Physical inactivity is associated with a higher risk of chronic diseases. Regular stair use can contribute to increasing physical activity in the population. This study aimed to investigate the association between flights of stairs used daily at home and all-cause mortality and cause-specific incidence and mortality. METHODS: Of the 502,628 UK Biobank participants recruited between 2007 and 2010, 442,027 (mean age, 56±8 years) had available data and were included in the analyses conducted in 2023. Participants were categorized on the basis of flights of stairs climbed daily (1-5, 6-10, 11-15, >15). The disease-specific outcomes were cardiovascular disease, respiratory disease, cancer, type 2 diabetes, and all-cause dementia. Cox proportional hazard models, adjusted for sociodemographic, lifestyle, and health-related confounding factors, were used to analyze the associations between stair use frequency and health outcomes. RESULTS: Participants were followed up for a median of 10.9 years. Climbing stairs >15 times per day was associated with a lower risk of 8 of the 9 outcomes analyzed than not using stairs. The magnitude of association ranged from 3% (95% CI=0.94, 0.99) lower risk for all-cause cancer to 51% (95% CI=0.39, 0.60) lower risk of chronic obstructive pulmonary disease. Findings were similar for mortality outcomes, with the hazard ratios ranging from 0.82 (95% CI=0.77, 0.87) for all-cause cancer to 0.46 (95% CI=0.23, 0.92) for chronic obstructive pulmonary disease mortality. CONCLUSIONS: Stair use was associated with a lower risk of all-cause mortality and cause-specific incidence and mortality independent of confounding factors, including adiposity and multimorbidity.

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.

Healthy Eating as Potential Mediator of Inverse Association between Purpose in Life and Waist Circumference: Emerging Evidence from US and Chilean Cohorts.

High sense of purpose in life, a fundamental domain of eudaimonic well-being, has been consistently associated with lower risk for various obesity-related chronic diseases. Although this psychological feature correlates with some health behaviors as potential mediators, its association with healthy eating remains less explored. In addition, studies of these psycho-behavioral and health relationships in the South American population are lacking. This research sought to assess: (1) the cross-sectional association between self-reported purpose in life and overall healthy eating patterns, and (2) healthy food intake as a potential mediator of the inverse relationship between purpose in life and waist circumference. Data collected of 2060 US adults from the MIDUS study (5 ± 12 years, 55% women, mostly white people, and 42.5% obese) and 223 Chilean adults from the CHILEMED study (46.6 ± 9 years, 58.3% women, and 71.3% obese) were used. Anthropometric and sociodemographic variables were collected. Sense of purpose was assessed using the purpose in life subscale of the Ryff's psychological well-being questionnaire. Diet quality was evaluated using healthy eating or low-fat diet indexes, according to extant food intake data in each cohort. The relationship between these variables was estimated by bivariate and multivariate linear regressions with appropriate adjustments. To establish whether a better diet quality could mediate a link of purpose in life and improved nutritional status (assessed by waist circumference), the association between these three variables was tested by bootstrapping-based mediation analysis. Our results show significant associations of sense of purpose with healthy eating and low-fat dietary patterns in both US and Chilean cohorts, respectively, even after adjusting for sociodemographic variables. According to the mediation analysis, the relationship between sense of purpose and waist circumference, as an indicator of abdominal obesity, appears to be partially mediated by healthier food intake in both samples. In conclusion, our findings suggest a plausible mechanism underlying the favorable impact of this well-being dimension on physical health. Given its protective effects, interventions aimed at increasing purpose in life may facilitate adherence to better dietary patterns, which, in turn, will reduce the risk for obesity-related chronic diseases.

Association of Sitting Time With All-Cause and Cardiovascular Mortality: How Does Frailty Modify This Association?

To investigate how frailty modifies the association of sitting time with all-cause and cardiovascular mortality in Chilean adults. This prospective study included 2,604 participants aged ≥35 from the Chilean National Health Survey 2009-2010. Sitting time was self-reported, while frailty was assessed using a 36-item Frailty Index. Sitting time was categorized as low, medium, and high. Cox proportional hazard models were used to estimate the risk of mortality stratified for the sitting time categories. Over a median follow-up of 8.9 years, 311 participants died, 28% of them due to cardiovascular events. Frail people with prolonged sitting time were at higher risk of all-cause and cardiovascular mortality (hazard ratio 3.13; 95% confidence interval [2.06, 4.71] and hazard ratio 2.41; 95% confidence interval [1.50, 3.64], respectively). The observed risk was higher in women than men. Public health and individual strategies should be implemented to decrease sitting time across the population, with special attention on frail people.

Mediterranean diet and psychological well-being intervention to reverse metabolic syndrome in Chile (CHILEMED trial).

Psychosocial status and lifestyle are key risk factors of non-communicable diseases (NCDs), which, in turn, are main drivers of healthcare costs and morbimortality worldwide, including Chile. Mediterranean diet (MedDiet) is one of the healthiest dietary patterns under study. However, its impact on high-risk conditions, such as metabolic syndrome (MetS), and NCDs outside the Mediterranean Basin remains mostly unexplored. Even though Central Chile has an environment, food production, and culinary traditions comparable to those present in Mediterranean countries, few studies -some with significant methodological limitations- have evaluated the effect of MedDiet on health and/or disease in Chilean subjects. Importantly, a Mediterranean lifestyle is a modus vivendi that integrates physical health with mental and social well-being. Psychological well-being (PWB) is associated with healthy behaviors, positive health outcomes, and longevity, thereby emerging as a novel healthcare goal. We report here an ongoing randomized controlled clinical trial in Chilean patients with MetS seeking to test whether (1) a PWB theory-based intervention facilitates induction to and increases long-term adherence to a locally adapted MedDiet, and (2) a MedDiet intervention -implemented alone or combined with well-being promotion- is more effective at reversing MetS compared to individuals following a low-fat diet without psychological support. The CHILEan MEDiterranean (CHILEMED) diet intervention study is a 1-year trial including patients with MetS living in Chile. Participants will be assigned randomly by a computer-generated random number sequence to one of the three intervention arms: a) low-fat diet as control group, b) MedDiet alone, and c) MedDiet plus well-being support. Patients will be followed-up by individual and/or group online nutritional sessions or phone cal as well as 6- and 12-month in-person re-assessment of medical history, medication use, food intake, PWB, anthropometrics/physical exam, and blood collection for laboratory analysis. The primary outcome of the trial will be the effect of the MedDiet -with or without PWB intervention- on overall reversal of MetS compared to low-fat diet alone. Based on a statistical superiority trial, expected impact, and patient loss, the estimated study sample is 339 subjects (113 individuals per arm in 3 equal-sized groups). Currently, we have enrolled 179 patients, predominantly women, evenly distributed by age (group means ranging from 45.7 to 48,9 years-old), 3/4 are obese with almost all of them showing abdominal obesity, 70% are hypertensive, whereas <10% exhibit diabetes. If findings turn out as expected (e.g., MedDiet -with or without PWB intervention- is better than the low-fat diet for reversion of MetS at 1-year follow-up), CHILEMED will provide further beneficial evidence of the MedDiet on NCD risk conditions beyond the Mediterranean region.

Valores de referencia y factores de riesgo de la condición física en personas mayores chilenas físicamente activas / Reference values and risk factors in the deterioration of the physical fitness of physically active older chilean adults

BACKGROUND: Physical fitness assessment of older adults is essential because it is a key component of functional independence and healthy aging. AIM: To establish physical fitness reference values for physically active older Chilean adults of both sexes and identify the variables associated with the deterioration of their physical condition. MATERIAL AND METHODS: Cross-sectional study that included 342 older adults aged 60 and over. Their physical fitness was assessed with the Senior Fitness Test (SFT). The timed up and go (TUG), chair stand (CS), arm curl (AC), and aerobic resistance (2 min) tests were evaluated. RESULTS: Performance in the physical fitness tests by age group decreased in all tests as older adults advanced in age. Scores for men were more evenly distributed across the different age groups. The main risk factors for the deterioration of physical fitness were age, sex, and body mass index (BMI) (p-value < 0.05). The primary risk factor for men was age and for women age and BMI. CONCLUSIONS: Performance of both men and women in the different SFT tests decreased as older adults aged. Age, sex, and BMI were the main risk factors for the deterioration of the physical fitness of physically active older adults.

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.

[Reference values and risk factors in the deterioration of the physical fitness of physically active older chilean adults]. / Valores de referencia y factores de riesgo de la condición física en personas mayores chilenas físicamente activas.

BACKGROUND: Physical fitness assessment of older adults is essential because it is a key component of functional independence and healthy aging. AIM: To establish physical fitness reference values for physically active older Chilean adults of both sexes and identify the variables associated with the deterioration of their physical condition. MATERIAL AND METHODS: Cross-sectional study that included 342 older adults aged 60 and over. Their physical fitness was assessed with the Senior Fitness Test (SFT). The timed up and go (TUG), chair stand (CS), arm curl (AC), and aerobic resistance (2 min) tests were evaluated. RESULTS: Performance in the physical fitness tests by age group decreased in all tests as older adults advanced in age. Scores for men were more evenly distributed across the different age groups. The main risk factors for the deterioration of physical fitness were age, sex, and body mass index (BMI) (p-value < 0.05). The primary risk factor for men was age and for women age and BMI. CONCLUSIONS: Performance of both men and women in the different SFT tests decreased as older adults aged. Age, sex, and BMI were the main risk factors for the deterioration of the physical fitness of physically active older adults.

Asociación entre velocidad de marcha y deterioro cognitivo en personas mayores: resultados de la Encuesta Nacional de Salud 2016-2017

Antecedentes: La velocidad de la marcha podría considerarse un marcador temprano de riesgo de deterioro cognitivo en personas mayores. Objetivo: Determinar la asociación entre velocidad de la marcha y sospecha de deterioro cognitivo en población mayor chilena. Métodos: Se incluyeron 1788 personas mayores de la Encuesta Nacional de Salud (ENS) 2016-2017 que tenían información sobre velocidad de marcha y sospecha de deterioro cognitivo. La velocidad de la marcha fue autorreportada y categorizada como marca lenta, normal y rápida. Sospecha de deterioro cognitivo fue evaluado a través del cuestionario Mini Mental abreviado. La asociación entre marcha y deterioro cognitivo fue investigada mediante análisis de regresión logística. Resultados: En comparación a las personas mayores que reportaron una velocidad de marcha rápida, aquellas que reportaron una marcha lenta presentaron 2,67 veces mayor probabilidad de tener deterioro cognitivo (OR: 2,67 [95% IC:1,62; 4,42], p<0,001). Al ajustar los modelos por variables de confusión sociodemográficas, estilos de vida y salud, la asociación disminuyó, pero, permaneció significativa (OR: 1,78 [95% IC:1,15; 3,17], p=0,047). Mientras que las personas mayores que reportaron tener una velocidad de marcha normal no presentaron asociación con deterioro cognitivo. Conclusión: Personas mayores que reportan una velocidad de marcha lenta presentaron una mayor probabilidad de sospecha de deterioro cognitivo. Considerando que el deterioro cognitivo es un síndrome geriátrico con alta prevalencia en población mayor, existe la necesidad de enfatizar en estrategias para un diagnóstico temprano, por lo cual la velocidad de marcha podría ser un instrumento útil.

Background: Walking pace could be considered an early risk marker of cognitive impairment in older people. Objective: To determine the association between walking pace and cognitive impairment in older Chilean adults. Methods: 1,788 adults older than 60 years from the 2016-2017 Chilean National Health Survey with data available in the exposure and outcome were included in this cross-sectional study. Walking pace was self-reported and categorised as slow, average and brisk. Cognitive impairment was assessed using the Abbreviated Mini-Mental questionnaire. Logistic regression analyses were performed to investigate the association between walking pace and cognitive impairment, logistic regression analyses - adjusted for sociodemographic, lifestyle and health-related covariates. Results: In the minimally adjusted model and compared to older adults who self-reported a brisk walking pace, those in the slow walking pace category were 2.67 times more likely to have cognitive impairment (OR: 2.67 [95% CI: 1.62, 4.42]). When the analyses were adjusted, the association was attenuated but remained significant (OR: 1.78 [95% CI: 1.15 3.17]). No associations were found between average pace walkers and cognitive impairment. Conclusion: Older adults who self-reported a slow walking pace having a higher likelihood of cognitive impairment than their counterparts who had a brisk walking pace. Considering that cognitive impairment is a geriatric syndrome with a high prevalence in the elderly, there is a need to emphasise strategies for an early diagnosis. Therefore, walking pace may be a useful marker to identify individuals at high risk of cognitive impairment.

Predictors of the Level of Physical Activity in Physically Active Older People.

There has not been much study of risk profiles in older people according to different levels of practice in physical activity. For this reason, the aim of this research was to evaluate whether the elements that influence the quality of life and factors such as gender and education can predict the level of physical activity in the physically active elderly population. The Fernández−Ballesteros quality of life questionnaire and the WHO International Physical Activity Questionnaire were applied to a sample of 397 people with a mean age of 69.65 years (SD = 4.71). The results revealed the following predictive factors of practicing a low level of physical activity (p < 0.05): being a woman; having a low educational level; and low scores in activity and leisure and in functional skills. In conclusion, gender, education, functional skills, activity and leisure, and health are elements of quality of life that predict the level of physical activity performed by the elderly, where it is necessary to use leisure activities (visiting friends, playing games, running errands) as an indirect way to increase participation in physical activity.

Asociación del fitness cardiorrespiratorio con marcadores de adiposidad corporal: estudio de corte transversal de la Encuesta Nacional de Salud Chile 2016-2017 / Association of cardiorespiratory fitness with adiposity markers

BACKGROUND: Cardiorespiratory fitness (CRF) is inversely associated with metabolic diseases and adiposity markers. Aim: To assess the association of CRF with body mass index (BMI), waist circumference (WC) and obesity in a representative sample of the Chilean population. MATERIAL AND METHODS: Data from 5,958 participants in the Chilean National Health Survey 2016-1027 aged 15 years or above were analyzed. CRF was estimated by an equation that included sociodemographic, anthropometric and health-related data and expressed in metabolic equivalent units (METs). The association between CRF and adiposity was assessed using linear and Poisson regression models and the results were presented as Prevalence Ratio (PR). RESULTS: One MET increment in CRF was associated with a 3.27 kg/m2 (95% confidence intervals (CI): -3.35; -3.2) and 4.56 kg/m2 (95% CI: -4.67; -4.46) lower BMI in men and women, respectively. Waist circumference was 6.7 cm [95% CI: -6.98; -6.42] and 9 cm [95% CI: -9.33; -8.67] lower per 1-MET increment in CRF. With one MET increment, the probability of being obese was 34% (PR = 0.66 [95%CI: 0.63; 0.69]) and 36% (PR = 0.64 [95%CI: 0.61; 0.67]) lower in men and women, respectively. The probability of having a central obesity was 26% (PR = 0.74 [95%CI: 0.71; 0.77]) and 30% (PR = 0.70 [95%CI: 0.68; 0.73]) lower in men and women, respectively. Conclusions: A higher estimated CRF was associated with lower adiposity levels and a lower risk of being obese in both men and women. Public health policies aiming to increase physical activity are needed to increase the CRF of the Chilean population.

[Effects of a telehealth-based physical exercise program on functional capacity in patients with osteoarthritis]. / Efectos en la capacidad funcional de un programa de ejercicio físico terapéutico basado en telesalud en personas con diagnóstico de osteoartritis de rodilla y cadera.

BACKGROUND: Telehealth is a novel therapeutic alternative. AIM: To determine the effects of a remote therapeutic physical exercise program (TPEP), based on telehealth, on functional physical capacity in people with knee or hip osteoarthritis. PATIENTS AND METHODS: An eight-week TPEP was undertaken by 36 participants with a mean age of 68 years. The control group received printed exercise instructions, while the experimental group received the same instructions plus TPEP using tutorial videos and voice messaging via WhatsApp. Both groups were evaluated at baseline and the end of the intervention with the Lower Extremity Functional Scale (LEFS), Barthel index (BI), Short Physical Performance Battery (SPPB), senior fitness test and with the Visual Analog Scale for pain (VAS). RESULTS: The experimental group decreased the VAS score and improved tandem balance, three-meter walk, sit and stand 5 times, sit and stand in 30 seconds, push-ups in 30 seconds, two minutes' walk, join the right hand behind the back and SPPB general score. The control group increased the BI score and improved the three meters walking test, sitting, and standing 5 times, sit and stand 30 seconds chair test, 2 minutes walking test and the SPPB general score. No differences between groups were observed for the LEFS scale, BI, VAS and functional capacity. CONCLUSIONS: A TPEP based on telehealth has similar effectiveness than a TPEP based on traditional paper-based intervention to improve functional physical capacity in patients with OA. (Rev Med Chile 2022; 150: 33-45).

Efectos en la capacidad funcional de un programa de ejercicio físico terapéutico basado en telesalud en personas con diagnóstico de osteoartritis de rodilla y cadera / Effects of a telehealth-based physical exercise program on functional capacity in patients with osteoarthritis

BACKGROUND: Telehealth is a novel therapeutic alternative. Aim: To determine the effects of a remote therapeutic physical exercise program (TPEP), based on telehealth, on functional physical capacity in people with knee or hip osteoarthritis. PATIENTS AND METHODS: An eight-week TPEP was undertaken by 36 participants with a mean age of 68 years. The control group received printed exercise instructions, while the experimental group received the same instructions plus TPEP using tutorial videos and voice messaging via WhatsApp. Both groups were evaluated at baseline and the end of the intervention with the Lower Extremity Functional Scale (LEFS), Barthel index (BI), Short Physical Performance Battery (SPPB), senior fitness test and with the Visual Analog Scale for pain (VAS). RESULTS: The experimental group decreased the VAS score and improved tandem balance, three-meter walk, sit and stand 5 times, sit and stand in 30 seconds, push-ups in 30 seconds, two minutes' walk, join the right hand behind the back and SPPB general score. The control group increased the BI score and improved the three meters walking test, sitting, and standing 5 times, sit and stand 30 seconds chair test, 2 minutes walking test and the SPPB general score. No differences between groups were observed for the LEFS scale, BI, VAS and functional capacity. CONCLUSIONS: A TPEP based on telehealth has similar effectiveness than a TPEP based on traditional paper-based intervention to improve functional physical capacity in patients with OA. (Rev Med Chile 2022; 150: 33-45)

[Association of cardiorespiratory fitness with adiposity markers]. / Asociación del fitness cardiorrespiratorio con marcadores de adiposidad corporal: estudio de corte transversal de la Encuesta Nacional de Salud Chile 2016-2017.

BACKGROUND: Cardiorespiratory fitness (CRF) is inversely associated with metabolic diseases and adiposity markers. AIM: To assess the association of CRF with body mass index (BMI), waist circumference (WC) and obesity in a representative sample of the Chilean population. MATERIAL AND METHODS: Data from 5,958 participants in the Chilean National Health Survey 2016-1027 aged 15 years or above were analyzed. CRF was estimated by an equation that included sociodemographic, anthropometric and health-related data and expressed in metabolic equivalent units (METs). The association between CRF and adiposity was assessed using linear and Poisson regression models and the results were presented as Prevalence Ratio (PR). RESULTS: One MET increment in CRF was associated with a 3.27 kg/m2 (95% confidence intervals (CI): -3.35; -3.2) and 4.56 kg/m2 (95% CI: -4.67; -4.46) lower BMI in men and women, respectively. Waist circumference was 6.7 cm [95% CI: -6.98; -6.42] and 9 cm [95% CI: -9.33; -8.67] lower per 1-MET increment in CRF. With one MET increment, the probability of being obese was 34% (PR = 0.66 [95%CI: 0.63; 0.69]) and 36% (PR = 0.64 [95%CI: 0.61; 0.67]) lower in men and women, respectively. The probability of having a central obesity was 26% (PR = 0.74 [95%CI: 0.71; 0.77]) and 30% (PR = 0.70 [95%CI: 0.68; 0.73]) lower in men and women, respectively. CONCLUSIONS: A higher estimated CRF was associated with lower adiposity levels and a lower risk of being obese in both men and women. Public health policies aiming to increase physical activity are needed to increase the CRF of the Chilean population.

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.

The FTO rs17817449 Polymorphism is Not Associated With Sedentary Time, Physical Activity, or Cardiorespiratory Fitness: Findings From the GENADIO Cross-Sectional Study.

BACKGROUND: Genetic variants within the FTO gene have been associated with increased adiposity and metabolic markers; however, there is limited evidence regarding the association of FTO gene variants with physical activity-related variables. The authors aimed to investigate the association of the rs17817449 single-nucleotide polymorphism of FTO with physical activity, sedentary time, and cardiorespiratory fitness in Chilean adults. METHODS: A total of 409 participants from the GENADIO study were included and genotyped for the rs17817449 single-nucleotide polymorphism of FTO in this cross-sectional study. Physical activity and sedentary time were measured with ActiGraph accelerometers. Cardiorespiratory fitness was assessed using the Chester step test. The associations were assessed by using multivariate regression analyses. RESULTS: No associations were found for FTO variant with physical activity levels and cardiorespiratory fitness. The risk allele (G) of the FTO was found to be associated with sedentary time in the minimally adjusted model (ß = 19.7 min/d; 95% confidence interval, 4.0 to 35.5, per each copy of the risk allele; P = .006), but the association was no longer significant when body mass index was included as a confounder (P = .211). CONCLUSION: The rs17817449 single-nucleotide polymorphism of the FTO gene was not associated with the level of physical activity, cardiorespiratory fitness, and sedentary behaviors in Chilean adults.