Dr. Matus-Castillo, Carlos

La pandemia del COVID-19 modificó los estilos de vida de la población mundial, debido a las medidas de confinamiento para reducir la actividad social masiva. Esto aumentó los niveles de inactividad física y sus riesgos para la salud. Por ello, el Ministerio de Salud de Chile estableció una banda horaria exclusiva para la práctica de actividad física. Los objetivos del estudio fueron conocer las percepciones de los usuarios y las características de la actividad física realizada durante la banda horaria. Se empleó un enfoque interpretativo, de diseño cualitativo, mediante un estudio de caso, con una entrevista personal y presencial. El instrumento fue un guion semiestructurado, aplicado a once sujetos adultos de ambos sexos, con edades entre los 24 y 69 años, que realizaban actividad física en un parque de la ciudad de Concepción, Chile, durante el año 2021. Los resultados indican que las personas realizaban actividades físicas por placer, para cuidar la salud y socializar, y reportaron sentirse con energía durante el día. Manifestaron un alto nivel de satisfacción con esta medida y una alta motivación hacia la práctica de actividad física, pero sugirieron ampliar el horario de la mañana e introducir una nueva banda en la tarde. Por otro lado, realizaron actividades físicas preferiblemente grupales, de cuatro a siete veces por semana, y de una a dos horas de duración. En conclusión, las percepciones hacia la banda horaria fueron positivas, y las características de las prácticas físicas contribuyeron significativamente a mejorar la salud y el bienestar durante el confinamiento.

Antecedentes: la fragilidad se caracteriza por la pérdida de reservas biológicas y la vulnerabilidad a resultados adversos. Una intervención con efectos beneficiosos sobre la prevención y el manejo de la fragilidad es la práctica regular de actividad física (AF). Objetivo: caracterizar los niveles de AF y tiempo sedente en personas mayores con fragilidad. Metodología: se incluyó a 232 personas mayores de 60 años de la región metropolitana, participantes en la Encuesta Nacional de Salud 2016-2017. La fragilidad se evaluó en base a los criterios de la escala de fenotipos de Fried y el nivel de AF y tiempo sedentario con el cuestionario Global Physical Activity Questionnaire (GPAQ v2). Los niveles de AF según el fenotipo de fragilidad se determinaron con análisis de regresión lineal. Resultados y conclusiones: las personas mayores con fragilidad realizan menos AF total (β = -292,6 min/día [IC 95 %: 399,5; -185,7], p = 0,001), laboral (β = -5821,8 min/día [IC 95 %: 8680,8; -2962,8], p = 0,001), de transporte (β = -68,0 min/día [IC 95 %: -105,4;-30,62], p = 0,001). También se observó menor cantidad de AF moderada (β = -137,7 min/día [IC 95 %: -202,0; -73,5], p = 0,001); vigorosa (β = -43,4 min/día [IC 95 %: -81,6; -5,20], p = 0,026) y mayor tiempo sedente (β = 3,55 hora/día [IC 95 %: -1,97; 5,14 ], p = 0,001). Las personas mayores frágiles presentan niveles más bajos de AF en comparación con sus pares sin fragilidad. Considerando que la población chilena experimentará un aumento en el número de personas mayores, es imprescindible implementar medidas preventivas que permitan retrasar la aparición de la fragilidad, como fomentar la práctica de AF en todos sus niveles.

Background: Although the importance of walking for promoting a better cardiometabolic health is widely known (this includes both cardiovascular and metabolic/endocrine systems), there is little knowledge regarding its appropriate pace to provide adults with more cardiometabolic benefits. Aim: To analyze the associations between different walking pace categories and cardiometabolic health markers in the adult Chilean population. Methods: Cross-sectional study. A total of 5520 participants aged 15 to 90 years old from the Chilean National Health Survey (CNHS) 2016–2017 were included. Walking pace categories (slow, average, and brisk) were collected through self-reported methods. Glycaemia, glycosylated hemoglobin (HbA1c), gamma glutamyl transferase (GGT), vitamin D2, vitamin D3, systolic and diastolic blood pressure, and lipid profile (Total, HDL, LDL, VLDL, No HDL cholesterol and triglycerides) were determined using blood sample tests and measured with the standardized methods described in the CNHS 2016–2017. Results: People who had a brisk walking pace were associated with lower levels of glycaemia, HbA1c, GGT, systolic and diastolic blood pressure, and higher vitamin D3 levels compared with those with a slow walking pace. Moreover, people with a brisk walking pace had lower levels of VLDL cholesterol compared with those with a slow walking pace. However, after adjusting the model to include sociodemographic background, nutritional status, and lifestyle variables, the differences remained only for glycaemia, HbA1c and systolic blood pressure levels. Conclusions: A brisk walking pace was associated with better cardiometabolic health markers and lipid profile compared with a slow walking pace.

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: Adiposity and education are two independent risk factors for type 2 diabetes (T2D). However, there is limited evidence whether both education and adiposity are associated with T2D in an additive manner in the Chilean population. Aim: To investigate the joint association between adiposity and education with T2D in the Chilean adult population. Material and Methods: Analysis of data of the Chilean National Health Survey 2016-2017, which included 5,033 participants with a mean age of 43 years, (51% women). Poisson regression analyses with robust standard error were used to investigate the joint association of the education level and general and central adiposity with T2D. The results were reported as Prevalence Ratio and their 95% confidence intervals (PR, 95% CI). Results: Obesity was associated with a higher probability of having T2D in men than in women, however central adiposity was associated with a higher probability of having T2D in women than in men. Compared with men who had higher education (> 12 years) and had normal body weight, those with the same educational level and who were obese had 2.3-times higher probability of having T2D (PR: 2.35 [95% CI: 1.02; 5.39]). For women, having a low education and being obese was associated with 4.4-times higher probability of having T2D compared to those with higher education and normal body mass index (BMI) (PR: 4.47 [95% IC: 2.12; 9.24]). Similar results were observed when waist circumference was used as a marker of obesity rather than BMI. Conclusions: Women and men with higher BMI and low education had a higher risk of T2D. However, this risk was higher in women than in men.

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.

Introducción: La determinación del nivel de actividad física (AF) puede realizarse a través de acelerómetro o mediante cuestionario de auto-reporte. El objetivo de este estudio fue comparar los niveles de AF entre un cuestionario de auto-reporte y la medición con acelerómetro de movimiento según factores sociodemográficos en la población chilena. Métodos: Estudio de corte transversal que incluyó a 230 adultos chilenos participantes del proyecto Genes, Ambiente, Diabetes y Obesidad (GENADIO). Niveles de AF fueron medidos mediante el cuestionario Internacional Physical Activity Questionnaire (IPAQ) y acelerómetro de movimiento (ActiGraph). Resultados: IPAQ subestimó los niveles de AF total en comparación a la medición con acelerómetro (delta [IPAQ-Acel.]= -55,7 min/día). Según nivel educacional, se evidenció que el cuestionario IPAQ sobreestimó los niveles de AF total en personas con bajo nivel educacional (delta [IPAQ-Acel.]= 70,4 min/día), pero subestimó la AF total en personas con enseñanza media o técnico universitaria (delta [IPAQ-Acel.]= -67,9 y -135,6 min/día, respectivamente). Resultados similares fueron observados para los distintos niveles de ingreso socioeconómico (NSE). Conclusión: El cuestionario de auto-reporte IPAQ subestimó los niveles de AF total en comparación a la medición por acelerómetro; sin embargo, estas diferencias variaron según factores sociodemográficos.

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 (β = −7.74 mg/dL (95% CI: −11.08 to −4.40) and β = −11.05 mg/dL (95% CI: −14.36 to −7.75), respectively) and lower HbA1c (β = −0.34% (95% CI: −0.57 to −0.11) and β= −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.

Background: One of the side effects of cancer treatment is a low level of physical activity (PA) due to fatigue and pain. Aim: To quantify PA levels in Chilean people with cancer. Material and Methods: Analysis of the National Health Survey 2016-2017 including 6,233 participants, comparing those with and without a self-report of cancer was conducted. Levels of PA and sitting time were assessed using the Global Physical Activity Questionnaire. Results: 3% of participants [confidence intervals (CI): 2.6; 3.9] reported having cancer and 34% [95% CI: 22.7; 46.7] of these reported being physically inactive, compared to 25% [95% CI: 22.5; 27,3] of those without cancer. Participants with cancer performed 56 and 77 minutes/day lower vigorous and total PA than participants without cancer. No differences between groups were observed for commuting PA, moderate PA and sedentary time. Lower level of PA was independent of the years elapsed since the diagnosis of cancer. Conclusions: People with cancer are less physically active than their counterparts without the disease.

Background: Walking speed is a strong predictor of non-communicable diseases and mortality. Aim: To investigate the association of self-reported walking pace with adiposity, metabolic and cardiovascular markers in the Chilean population. Material and Methods: Analysis of data from 5,077 participants of the 2009-2010 National Health Survey (ENS 2009-2010). Walking speed was self-reported as average or slow pace. Body mass index (BMI), waist circumference (WC), blood pressure, blood glucose, glycosylated hemoglobin and lipid profile were the outcome. Results: In Chile, 11% (95% confidence intervals [CI]: 10.0; 12.7) of the population reported a slow walking pace. Compared with average walking people, those reporting a slow pace had a higher body weight (difference (∆) 5.65 kg [95% CI: 3.22; 8.09], p < 0.01), BMI (D 2.48 kg/m 2 [95% CI: 1.53; 3.44], p < 0.01), WC (D 6.23 cm [95% CI: 4.12; 8.34], p < 0.01), serum triglycerides (D 30,9 mg/dl [95% CI: 5,31; 57,5], p = 0.018), and lower HDL cholesterol (D -2.32 mg/dl [95% CI: -4,24; -0,34], p = 0.022). Those reporting a slow pace had also a higher odd of being obese (odds ratio (OR): 2.46 [95% CI: 1.82; 3.33], p < 0.01), being diabetic (OR: 1.54 [95% CI: 1.02; 2.40], p = 0.018) and having metabolic syndrome (OR: 2.03 [95% CI: 1.30; 3.18], p = 0.002). Conclusions: In Chilean adults, slow walking pace is associated with and unfavorable adiposity and lipid profile, including a higher probability of being obese, diabetic and having metabolic syndrome.