Dr. Garrido-Méndez, Alex

Background: Housewives represent a important proportion of the Chilean population. However, there is limited evidence about their lifestyles. Aim: To characterize lifestyles and determine the level of compliance with healthy lifestyles guidelines of housewives in Chile. Material and Methods: Housewives from the 2009-2010 National Health Survey were included. The variables studied included levels of physical activity (PA), sedentary behavior, diet, hours of sleep and smoking. Compliance with healthy lifestyle behaviors was evaluated through logistic regression, granting a value of 1 for compliance and 0 for non-compliance. A healthy lifestyle was defined as meeting at least four healthy behaviors. Results: Housewives aged > 55 years had a higher BMI and waist circumference compared to those aged < 40 years. Housewives were also more likely to report moderate alcohol consumption and were more likely to meet a healthier lifestyle score (Odds ratio = 1.52 [95% confidence intervals: 1.09 to 2.11], p = 0.013). No significant age trends were observed for other lifestyle behaviors. Conclusions: Housewives had high levels of central obesity, excess body weight and high levels of salt intake but low alcohol intake. Their healthy lifestyles behaviors increased along with increasing age.

Background: Healthy lifestyles are associated with a better metabolic and cardiovascular health profile. Aim: To investigate the association between a lifestyle score and cardiovascular risk in Chilean adults. Material and Methods: A healthy lifestyle score was derived for 2,774 participants in the Chilean National Health Survey 2009-2010 and based on seven modifiable behaviors (salt intake, fruit and vegetable intake, alcohol consumption, sleep duration, smoking, physical activity and sedentary behaviors). A high score represented a healthier lifestyle whereas a low score represents an unhealthy lifestyle. The association between the lifestyle score and cardiovascular risk factors (obesity, hypertension, diabetes, dyslipidemia and metabolic syndrome), was explored using logistic regression models. Results: One quartile increment in the healthy lifestyle score was associated with a lower risk for obesity (Odds ratio (OR): 0.82 [95% confidence intervals (CI): 0.75 to 0.90], p < 0.01), central obesity (OR: 0.88 [95% CI: 0.81 to 0.96], p < 0.01), diabetes (OR: 0.84 [95% CI: 0.75 to 0.95], p < 0.04) and dyslipidemia (OR: 0.90 [95% CI: 0.83 to 0.98], p = 0.01). These results were independent of major confounding factors. Conclusions: The adherence to a healthy lifestyle is associated with lower cardiovascular risk.

The aim of this study was to investigate the association between physical activity (PA), both occupational (OPA) and during leisure time (LTPA), with obesity and cardiovascular risk factors in Chilean adults. 5,157 participants from the Chilean National Health Survey 2009–2010 were included in this study. OPA and LTPA levels were assessed using the Global Physical Activity Questionnaire. The association between both PA with obesity and cardiovascular risk factors was determined using logistic regression. Our findings showed a significant trend between higher LTPA and lower odds for obesity (OR 0.64 [95% CI: 0.53; 0.76], central obesity 0.52 [0.44; 0.61]) and other cardiovascular risk factors including diabetes (OR: 0.72 [0.55; 0.94]), hypertension (OR: 0.59 [0.50; 0.71]) and metabolic syndrome (OR: 0.62 [0.50; 0.78]). In contrast, OPA was only associated with lower odds of diabetes (OR: 0.79 [0.65; 0.98]) and hypertension (0.85 [0.74; 0.98]). In conclusion, LTPA was associated with a lower risk of all major cardiovascular risk factors, whereas OPA was only associated with a lower risk of diabetes and hypertension.

La Diabetes Mellitus Tipo 2 (DMT2) es una enfermedad multifactorial que ha incrementado en las últimas cuatro décadas, pasando de 153 millones de personas diabéticas en el mundo en el año 1980 a 382 millones de personas el año 20131,2, estimándose que su prevalencia aumentará a 552 millones para el año 20353. Su desarrollo se relaciona principalmente con el exceso de peso corporal, inactividad física y una alimentación no saludable prolongada4-6. Si bien hay estudios randomizados de intervención de alta calidad, realizados en personas pre-diabéticas que sugieren que el mejorar el estilo de vida (actividad física y alimentación) podría ser efectivo en prevenir o retrasar su aparición7, hasta la fecha no existían estudios de calidad y con un tamaño muestral adecuado que demostrasen que una intervención no farmacológica, es decir, mediante cambios en los estilos de vida orientados a la pérdida de peso corporal, es efectiva en revertir la DMT2 y sus complicaciones, en pacientes que ya estén con tratamiento farmacológico para esta enfermedad.

Background: Fat-mass-associated-gene (FTO) is associated with higher energy intake and specific food preferences. Aim: To investigate the association of the FTO genotype with energy intake, macronutrient and alcohol consumption. Material and Methods: Four hundred and nine participants of the GENADIO (Genes, Environment, Diabetes and Obesity) study were included. Energy intake, macronutrient and alcohol consumption were the outcomes of interest. The association of FTO (rs9939609) genotype with these outcomes was investigated using linear regression analyses, adjusting for confounding variables. Results: After adjusting for socio-demographic factors, being a carrier of the risk allele for the FTO gene was associated with a higher energy intake (173 kcal per each extra copy of the risk variant [95% confidence intervals (CI): 45; 301], (P = 0.008). After adjusting for lifestyle factors and body mass index, the association was slightly attenuated but remained significant (144 kcal [95% CI: 14; 274], p = 0.030). Conclusions: The FTO genotype is associated with a higher energy intake. (Rev Med Chile 2018; 146: 1252-1260)

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 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.

A pesar de que la actividad física (AF) es un factor protector contra las enfermedades crónicas no transmisibles, un gran porcentaje de la población no cumple los niveles mínimos recomendados. El objetivo fue investigar como varían los niveles de práctica de AF entre los diferentes grupos etarios en la población chilena. Se incluyeron 5.133 participantes de la Encuesta Nacional de Salud 2009-2010. La AF fue determinada utilizando el cuestionario GPAQ. La inactividad física fue definida como <600 MET/min/ semana de AF moderada a vigorosa. La asociación entre AF y edad fue investigada por sexo mediante regresión logística. Las mujeres presentaron una mayor probabilidad de ser físicamente inactivas en comparación a los hombres (p<0,0001). Al analizar la prevalencia de inactividad física por sexo y grupo etario, esta cambió ligeramente entre los 20 a 59 años, pero a partir de los 60 se observó un incremento importante en la prevalencia llegando a 63% y 56% para mujeres y hombres >80 años, respectivamente. Los resultados obtenidos confirman la necesidad de seguir fomentando la práctica regular de AF física a través de todo el ciclo vital, pero en especial sobre los 60 años, ya que este grupo presenta una mayor probabilidad de ser físicamente inactivo.

Background: Although cardiovascular risk factors are associated with an impaired cognitive function, the impact of diabetes on cognitive function in Chilean adults is unknown. Aim: To investigate the association of diabetes or family history of the disease with cognitive impairment in older adults. Materials and Methods: Data from the 2009-2010 Chilean National Health Survey including 1,384 participants aged ≥ 60 years were included in this study. A score below 13 points for the Mini Mental State Examination (MMSE) was considered an indication of cognitive impairment. Logistic regression analyses were performed to assess the association between MMSE, diabetes and family history of the disease. Results: Cognitive impairment increased with age (Odds ratio (OR): 1.83 [95% confidence intervals (CI): 1.53; 2.19], p < 0.01, per 5 years increment in age). This trend was greater in individuals with diabetes (OR: 2.37 [95% CI: 1.68; 3.35], p < 0.01) compared to those without the disease. A similar trend was identified among individuals with a family history of diabetes compared to those without. Conclusions: Older adults with diabetes are more susceptible to develop cognitive impairment.

La práctica regular de actividad física (AF) se asocia a un número importante de beneficios sobre la salud, incluyendo la reducción de enfermedades cardiovasculares, diabetes mellitus tipo 2, hipertensión arterial, depresión, demencia y algunos tipos de cáncer, como de colon y mamas (Figura 1). Se estima que el 9% de mortalidad prematura por cualquier causa (equivalente a 5.3 millones de muertes por año), se podrían prevenir si la población cumpliera con las recomendaciones de AF, es decir, realizara al menos 150 minutos de AF de intensidad moderada o >75 minutos de AF de intensidad vigorosa por semana.