Dr. Villagran-Orellana, Marcelo

Objective: The aim of this study was to identify which anthropometric measurement (body mass index [BMI], waist circumference [WC], or waist-to-height ratio [WHtR]) is a better predictor of type 2 diabetes and hypertension in the Chilean population. Methods: The study included 13 044 participants (59.7% women) from the Chilean National Health Surveys conducted in 2003, 2009-2010, and 2016-2017. BMI, WC, and WHtR were the anthropometric measurements evaluated. Hypertension was defined as systolic blood pressure ≥140 mm Hg and diastolic blood pressure -90 mm Hg or on medication for hypertension. Diabetes was defined as fasting glucose -7 mmol/L or on medication for diabetes. The receiver operating characteristics (ROC) curve and the area under curve (AUC) were computed to derive the specificity and sensitivity using a bootstrapping approach. Results: Compared with BMI and WC, WHtR was the anthropometric measurement with the highest AUC curve in both sexes for hypertension (AUC for women: 0.70; 95% confidence interval [CI], 0.67-0.73; AUC for men: 0.71; 95% CI, 0.69-0.74) and diabetes (AUC for women: 0.71; 95% CI, 0.66-0.77; AUC for men: 0.71; 95% CI, 0.67-0.76). The sex-specific cutoff points of WHtR to predict hypertension were 0.59 and 0.55 for women and men, respectively. Those used to predict diabetes were 0.60 and 0.58 for women and men, respectively. Conclusion: WHtR was a better predictor of hypertension and diabetes than BMI and WC in Chile. The definition of cutoff points specific for the Chilean population could be implemented in future screening programs aiming to identify high-risk individuals.

La obesidad es una enfermedad inflamatoria, crónica, recurrente, progresiva y de etiología multifactorial, que afecta a más 650 millones de personas en el mundo. La carga física, emocional y económica que genera la obesidad no solo guarda relación con sus manifestaciones clínicas, sino también por su impacto a nivel sistémico y a largo plazo. En Chile, el crecimiento económico, la urbanización y la globalización han modificado profundamente el modo de vivir de la población lo que ha favorecido un ambiente obesogénico. Sin embargo, ¿qué factores han repercutido en el desarrollo de obesidad en Chile? ¿cuál ha sido el rol de cada uno de estos factores en el aumento de la prevalencia de esta patología? En la parte 1 de esta revisión discutiremos los principales factores no modificables que han repercutido en su desarrollo, desde la transición epidemiológica que vivió el país en la década de los 70, hasta las patologías endocrinas relacionadas.

Vitamin C is a water-soluble antioxidant associated with the prevention of the common cold and is also a cofactor of hydrolases that participate in the synthesis of collagen and catecholamines, and in the regulation of gene expression. In cancer, vitamin C is associated with prevention, progression, and treatment, due to its general properties or its role as a pro-oxidant at high concentration. This review explores the role of vitamin C in cancer clinical trials and the aspects to consider in future studies, such as plasmatic vitamin C and metabolite excretion recording, and metabolism and transport of vitamin C into cancer cells. The reviewed studies show that vitamin C intake from natural sources can prevent the development of pulmonary and breast cancer, and that vitamin C synergizes with gemcitabine and erlotinib in pancreatic cancer. In vitro assays reveal that vitamin C synergizes with DNA-methyl transferase inhibitors. However, vitamin C was not associated with cancer prevention in a Mendelian randomized study. In conclusion, the role of vitamin C in the prevention and treatment of cancer is still an ongoing area of research. It is necessary that new phase II and III clinical trials be performed to collect stronger evidence of the therapeutic role of vitamin C in cancer.

Background: Sugar intake is a risk factor for the development of obesity. Aim: To investigate the association between total sugar intake and obesity markers in Chilean adults. Material and Methods: This cross-sectional study included 396 participants of the GENADIO study. Anthropometric measurements (body weight, body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio, and % body fat) were measured through standardized protocols. Total sugar intake was determined from a 7-days weighted food daily. Sugar intake expressed in g/day was categorized into quartiles. Results: Higher sugar intake was associated with a higher BMI, WC and HC but not with body fat %. One quartile increment in sugar intake was associated with 1.50 kg [95% confidence interval (CI): 0.49; 2.50] higher body weight, 0.34 kg/m2 [95% CI: 0.01; 0.69] higher BMI, 1.23 cm [95% CI: 0.11; 2.34] higher WC, 1.39 cm [95% CI: 0.28; 2.50] higher HC and 0.02 the waist-to-hip ratio [95% C: 0.01; 0.02]. Conclusions: Total sugar intake was associated with higher adiposity levels in these Chilean adults.

El sistema inmune juega un rol fundamental en el mantenimiento de nuestra salud. Sin embargo, hay aspectos esenciales de nuestros estilos de vida que podrían ayudar a fortalecer la respuesta inmune frente a infecciones, tales como una buena alimentación y la práctica regular de actividad física. Mantener nuestro sistema inmune en un estado óptimo podría ser vital en situaciones de riesgo, como lo es la actual pandemia de COVID-19 que se desencadena a nivel mundial. Por ende, el objetivo de esta revisión narrativa de la literatura fue describir los beneficios inmunológicos asociados a la alimentación y actividad física con un enfoque especial al actual desafío sanitario del COVID-19. Particularmente, se ha abordado el efecto de la malnutrición por déficit y exceso, el rol de los macro y micronutrientes, la suplementación de micronutrientes, probióticos y patrones alimentarios sobre la funcionalidad del sistema inmune. En cuanto a la modulación inmunológica por la actividad física, hemos revisado la literatura científica con relación al efecto de la actividad física aeróbica y de los ejercicios de resistencia muscular sobre la respuesta inmunológica la relación entre la actividad física, función pulmonar e infección por COVID-19, la interacción de la vacunación con actividad física y el riesgo de infección asociado a realizar actividad física en espacios cerrados.

Actualmente los edulcorantes no nutritivos (ENN) son ampliamente usados para endulzar los alimentos en reemplazo de los azúcares simples, con la ventaja de no aportar energía. A pesar de que en general no presentan efectos tóxicos, los estudios epidemiológicos no han podido evidenciar que su uso contribuya a mejorar la pérdida de peso, sino por el contrario, han revelado que los ENN pueden inducir alteraciones metabólicas como intolerancia a la glucosa. Estudios in vivo e in vitro han mostrado que muchos ENN activan a receptores del sabor dulce no sólo en los botones gustativos, sino que también en los receptores presentes en tejidos como el adiposo y pancreático, interfiriendo con su función normal. Además, el consumo ENN se ha asociado a alteraciones de la composición de la microbiota intestinal que conducen a una respuesta inflamatoria de bajo grado. La nueva evidencia disponible sobre los ENN hace necesario evaluar el uso cada vez más intenso de los ENN en Chile. Debido a que el gusto exacerbado por el sabor dulce que cultivamos desde la infancia es un potente catalizador del uso de ENN, proponemos que una oportuna educación del sentido del gusto puede contribuir a mejorar las elecciones alimentarias.

Type 2 diabetes Mellitus (T2DM) prevalence has significantly increased worldwide in recent years due to population age, obesity, and modern sedentary lifestyles. The projections estimate that 439 million people will be diabetic in 2030. T2DM is characterized by an impaired β-pancreatic cell function and insulin secretion, hyperglycemia and insulin resistance, and recently the epigenetic regulation of β-pancreatic cells differentiation has been underlined as being involved. It is currently known that several bioactive molecules, widely abundant in plants used as food or infusions, have a key role in histone modification and DNA methylation, and constituted potential epidrugs candidates against T2DM. In this sense, in this review the epigenetic mechanisms involved in T2DM and protein targets are reviewed, with special focus in studies addressing the potential use of phytochemicals as epidrugs that prevent and/or control T2DM in vivo and in vitro. As main findings, and although some controversial results have been found, bioactive molecules with epigenetic regulatory function, appear to be a potential replacement/complementary therapy of pharmacological hypoglycemic drugs, with minimal side effects. Indeed, natural epidrugs have shown to prevent or delay the T2DM development and the morbidity associated to dysfunction of blood vessels, eyes and kidneys due to sustained hyperglycemia in T2DM patients.

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 (β = 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.

Alternariol is a toxic metabolite of Alternaria fungi and studies have shown multiple potential pharmacological effects. To outline the anticancer effects and mechanisms of alternariol and its derivatives based on database reports, an updated search of PubMed/MedLine, ScienceDirect, Web of Science, and Scopus databases was performed with relevant keywords for published articles. The studies found to suggest that this mycotoxin and/or its derivatives have potential anticancer effects in many pharmacological preclinical test systems. Scientific reports indicate that alternariol and/or its derivatives exhibit anticancer through several pathways, including cytotoxic, reactive oxygen species leading to oxidative stress and mitochondrial dysfunction-linked cytotoxic effect, anti- inflammatory, cell cycle arrest, apoptotic cell death, genotoxic and mutagenic, anti-proliferative, autophagy, and estrogenic and clastogenic mechanisms. In light of these results, alternariol may be one of the hopeful chemotherapeutic agents.