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.

[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.

[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 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.

[Association of menopause with cardiovascular risk. Analysis of data from the 2016-17 Chilean national health survey]. / Menopausia y factores de riesgo cardiovascular en mujeres chilenas.

BACKGROUND: Menopause exposes women to an increased cardiovascular risk. AIM: To determine the association between menopause and cardiovascular risk factors in Chilean adult women using data from the National Health Survey (NHS) 2016-2017. MATERIAL AND METHODS: Data from 2,139 women over 40 years of age participating in the NHS 2016-2017, with information about menopause and cardiovascular risk factors was used. Expansion factors were applied to this sample, obtaining an expanded sample of 3,733,191 participants. Laboratory values (blood glucose, triglycerides, HDL and total cholesterol) and anthropometric measurements (body weight, height and waist circumference) were analyzed. The presence of hypertension, diabetes, and metabolic syndrome (MetS) were also recorded. RESULTS: Sixty seven percent of surveyed women were menopausal and had higher systolic blood pressure than non-menopausal participants. Menopause was significantly associated with hypertension (Odds ratio (OR): 2.43 [95% confidence intervals (CI): 1.71; 3.45], p < 0.01) and diabetes (OR: 2.05 [95% CI: 1.32; 3.19], p < 0.01). However, no association was observed with obesity, abdominal obesity or MetS. CONCLUSIONS: In these women, a positive association was identified between menopause and hypertension as well as diabetes.

[Association of the TCF7L2 (RS7903146) genotype with adiposity and metabolic markers in the Chilean adult population]. / Asociación del polimorfismo rs7903146, del gen TCF7L2, con marcadores de adiposidad y metabólicos en población chilena - resultados del estudio GENADIO.

BACKGROUND: Type 2 diabetes etiology has a strong genetic component. More than 20 genetic variants have been associated with diabetes and other metabolic markers. However, the polymorphism rs7903146 of the TCF7L2 gene has shown the strongest association. AIM: To investigate the association of TCF7L2 (rs7903146) genotype with adiposity and metabolic markers in the Chilean adult population. MATERIAL AND METHODS: The association of TCF7L2 (rs7093146) with adiposity and metabolic markers was studied in 301 participants. The outcomes of the study were adiposity markers (body weight, body mass index (BMI), fat mass and waist circumference) and metabolic markers (blood glucose, insulin, HOMA-IR, lipid profile, high sensitivity C-reactive protein (CRP), alanine aminotransferase (ALT), gamma glutamyl transpeptidase (GGT) and leptin). RESULTS: There was an association between the polymorphism TCF7L2 genotype and fasting blood glucose. The latter increased by 4.86 mg/dl per each copy of the risk allele [(95% confidence intervals (CI): 0.48; 9.24), p = 0.03] in the unadjusted adjusted model. However, this association was slightly attenuated in the fully adjusted model [4.38 mg/dl (95% IC: 0.16; 8.60), p = 0.04)]. There were no associations between the TCF7L2 genotype and any other metabolic or adiposity outcome. CONCLUSIONS: These findings confirm the association between the TCF7L2 (rs7903146) and fasting glucose in the Chilean population. However, further studies are needed to confirm the association between the TCF7L2 and diabetes risk in the Chilean population.

[Association between adiposity and asthma]. / ¿Existe asociación entre asma y adiposidad en la población adulta chilena?

BACKGROUND: In people with asthma, adiposity is associated with more symptoms and less control of the disease whereas on those without asthma adiposity is associated with a higher risk of developing the disease. AIM: To investigate the association between asthma and adiposity markers in Chilean adults. MATERIAL AND METHODS: Data from 5,499 adults older than 15-years-old from the Chilean National Health Survey 20162017 were analyzed. Quintiles of body-mass index (BMI) and waist circumference (WC) were used as a proxy of adiposity. The association between asthma and quintiles of BMI and WC was determined by logistic regression. RESULTS: A higher BMI and WC was associated with a higher odds for asthma. This trend remained significant even after adjusting the models for socio-demographic factors, physical activity and smoking (Odds Ratio [OR] BMI: 1.13 [95% confidence intervals (CI): 1.04; 1.22], p < 0.01 and OR WC: 1.15 [95% IC: 1.06; 1.25], p < 0.01). CONCLUSIONS: A higher BMI and WC were positively associated with asthma.

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.

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.

[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.

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.

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.

Association between Walking Pace and Diabetes: Findings from the Chilean National Health Survey 2016-2017.

BACKGROUND: Walking pace is a well-known indicator of physical capability, but it is also a strong predictor of type 2 diabetes (T2D). However, there is a lack of evidence on the association between walking pace and T2D, specifically, within developing countries such as Chile. AIM: To investigate the association between self-reported walking pace and T2D in the Chilean adult population. METHODS: 5520 Chilean participants (aged 15 to 90 years, 52.1% women) from the Chilean National Health Survey 2016-2017 were included in this cross-sectional study. Both walking pace (slow, average, and brisk) and diabetes data were collected through self-reported methods. Fasting blood glucose (reported in mg/dl) and glycosylated haemoglobin A (HbA1c) scores were determined via blood exams. RESULTS: In the unadjusted model, and compared to people who reported a slow walking pace, those with average and brisk walking pace had lower blood glucose levels (ß = -7.74 mg/dL (95% CI: -11.08 to -4.40) and ß = -11.05 mg/dL (95% CI: -14.36 to -7.75), respectively) and lower HbA1c (ß = -0.34% (95% CI: -0.57 to -0.11) and ß= -0.72% (95% CI: -0.94 to -0.49)), respectively. After adjusting for sociodemographic, Body Mass Index and lifestyle factors, the association between glycaemia and HbA1c remained only for brisk walkers. Both the average and brisk walker categories had lower odds of T2D (OR: 0.59 (95% CI: 0.41 to 0.84) and (OR 0.48 (95% CI: 0.30 to 0.79), respectively). CONCLUSION: Brisk walkers were associated with lower blood glucose and HbA1c levels. Moreover, average to brisk walking pace also showed a lower risk for T2D.

[Association of rs3751812 polymorphism of the FTO gene with adiposity and metabolic markers in Chilean population. Results of the GENADIO study]. / Asociación del polimorfismo rs3751812 del gen FTO con marcadores de adiposidad y metabólicos en población chilena. Resultados del estudio GENADIO.

INTRODUCTION: Background: genetic variants of the FTO gene confer the highest risk of obesity identified so far. Associations between the FTO gene and alterations in metabolic markers have been reported in different populations but not in Chileans. The aim of this study was therefore to investigate the association of rs3751812 gene polymorphism with adiposity and metabolic markers in the Chilean adult population. Methods: genotype of the FTO gene was determined in 409 participants from the GENADIO study. Adiposity markers (body weight, BMI, % fat mass and waist circumference), metabolic markers (glycemia, insulin, HOMAIR, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, leptin, ALT, GGT, PCRhs) and blood pressure were measured. The association between the FTO genotype and the different markers was determined using linear regression analyses. Results: there was an association between the polymorphism and all adiposity markers as well as insulin, HOMAIR, leptin and HDL cholesterol (p < 0.05) in the fully adjusted model. For total cholesterol, triglycerides, LDL cholesterol, ALT, GGT and PCRhs, the association disappeared after adjustment by body mass index. Conclusion: our findings verify the association between the FTO rs3751812 polymorphism with obesity, hyperinsulinemia, hyperleptinemia and lower levels of HDL cholesterol in the Chilean population. These alterations could increase the risk of diabetes mellitus type II and metabolic syndrome.

INTRODUCCIÓN: Antecedentes: el gen FTO presenta las variantes genéticas que confieren el mayor riesgo de obesidad hasta ahora identificado. Se han reportado asociaciones de polimorfismos del gen FTO y alteraciones de marcadores metabólicos en diversas poblaciones, pero no en chilenos. El objetivo de este estudio fue investigar la asociación del polimorfismo rs3751812 con marcadores de adiposidad y metabólicos en adultos chilenos. Métodos: se determinó el genotipo del FTO en 409 participantes del estudio GENADIO. Se evaluaron marcadores de adiposidad (peso corporal, índice de masa corporal [IMC], % de masa grasa y perímetro de cintura), marcadores metabólicos (glicemia, insulina, HOMAIR, colesterol total, colesterol LDL, colesterol HDL, triglicéridos, leptina, ALT, GGT, PCRus) y presión arterial. La asociación entre el genotipo FTO y los distintos marcadores se realizó mediante análisis de regresión lineal. Resultados: tras ajustar los marcadores por las variables de confusión, se evidenció una asociación significativa de los genotipos de riesgo con todos los marcadores de adiposidad estudiados y con los marcadores metabólicos: insulina, HOMAIR, leptina y colesterol HDL (p < 0,05). Para colesterol total, triglicéridos, colesterol LDL, ALT, GGT y PCRus, la asociación perdió significancia al ajustar por IMC. Conclusión: este estudio revela que existe una asociación entre el polimorfismo rs3751812 del gen FTO con obesidad, hiperinsulinemia, hiperleptinemia y bajos niveles de colesterol HDL en la población chilena, lo que podría aumentar el riesgo de desarrollar diabetes mellitus tipo II y síndrome metabólico.

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.

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.

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.

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.