Felipe Poblete-Valderrama

Joint effect of physical activity and sedentary behaviour on cardiovascular risk factors in Chilean adults

BackgroundnTo investigate the associations between combined categories of moderate-to-vigorous physical activity (MVPA) and sedentary behaviour (SB) with markers of adiposity and cardiovascular risk in adults.nnnMethodsnOverall, 5040 participants (mean age 46.4 years and 59.3% women) from the cross-sectional Chilean National Health Survey 2009-2010 were included in this study. MVPA and SB were measured using the Global Physical Activity questionnaire. Four categories were computed using MVPA- and SB-specific cut-offs (High-SB & Active, Low-SB & Active, High-SB & Inactive and Low-SB & Inactive).nnnResultsnCompared to the reference group (High-SB & Inactive), those in High-SB & Active and Low-SB & Active were less likely to have an obese BMI (OR: 0.67 [0.54; 0.85], P = 0.0001 and 0.74 [0.59; 0.92] P = 0.0007, respectively) and less likely to have metabolic syndrome (OR: 0.63 [0.49; 0.82], P < 0.0001 and 0.72 [0.57; 0.91], P = 0.007), central obesity (OR: 0.79 [0.65; 0.96], P = 0.016 and 0.71 [0.59; 0.84], P < 0.0001), diabetes (OR: 0.45 [0.35; 0.59], P < 0.0001 and 0.44 [0.34; 0.56], P < 0.0001) and hypertension (OR: 0.52 [0.43; 0.63], P < 0.0001 and 0.60 [0.50; 0.72], P < 0.0001), respectively.nnnConclusionsnBeing physically active and spending less time in SBs was associated with lower adiposity and improvements in cardiovascular risk factors.

Higher levels of self-reported sitting time is associated with higher risk of type 2 diabetes independent of physical activity in Chile

BackgroundnSitting behaviours have increased markedly during the last two decades in Chile. However, their associations with health outcomes such as diabetes have not been reported. Therefore, the aim of this study was to investigate the independent association of self-reported sitting time with diabetes-related markers and diabetes prevalence in Chile.nnnMethodsnThis cross-sectional study included participants (aged ≥18 years) from the Chilean National Health Survey 2009-10 (n = 4457). Fasting glucose and haemoglobin A1c (HbA1c) were measured by standardized protocols. The prevalence of type 2 diabetes (T2D) was determined using WHO criteria. Physical activity (PA) and time spent sitting were determined using the Global Physical Activity Questionnaire (GPAQ).nnnResultsnThe odds ratio for T2D was 1.10 [95% CI: 1.04-1.16, P = 0.002] and 1.08 [1.02-1.14, P = 0.002] per 1 h increase in sitting time in men and women, respectively, independent of age, education, smoking, BMI and total PA. Overall, prevalence of T2D was 10.2 and 17.2% in individuals classified in the lowest and highest categories of sitting time, respectively. No significant associations were found between sitting time and glucose or HbA1c.nnnConclusionsnSitting time is positively associated with diabetes risk, independent of socio-demographic, obesity and PA levels, in the Chilean population.

Active commuting is associated with a lower risk of obesity, diabetes and metabolic syndrome in Chilean adults

BackgroundnThere is limited evidence on how active commuting is associated with health benefits in developing countries. The aim of this study therefore was to investigate the associations between active commuting and markers of adiposity and cardiometabolic risk in the Chilean adult population.nnnMethodsnIn total, 5157 participants from the Chilean National Health Survey 2009-10 were included in this cross-sectional study. Active commuting was measured using the Global Physical Activity Questionnaire (GPAQ v2). Body mass index (BMI) and waist circumference (WC) were measured and used to define obesity and central obesity. Type 2 diabetes (T2D) and metabolic syndrome were determined using WHO and updated ATPIII-NCEP criteria, respectively.nnnResultsnThe main finding of this study is that a 30 min increase in active commuting is associated with lower odds for BMI > 25.0 kg m-2 (0.93 [95% CI: 0.88-0.98, P = 0.010]). Similarly, the odds for central obesity was 0.87 [0.82-0.92, P < 0.0001]. Similar associations were found for T2D (0.81 [0.75-0.88], P < 0.0001) and metabolic syndrome (OR: 0.86 [0.80-0.92], P < 0.0001).nnnConclusionnOur findings show that active commuting is associated with lower adiposity and a healthier metabolic profile including lower risk for obesity, diabetes and metabolic syndrome.

Tiempo destinado a estar sentado y niveles de adiposidad ¿cuál es su efecto sobre el desarrollo de diabetes mellitus Tipo 2?

Background: Obesity and sedentary behavior are risk factors acting independently in the development of type 2 diabetes. Aim: To investigate whether the association between diabetes and obesity is modified by the levels of sitting time (ST) in the Chilean population. Material and Methods: We included 4,611 participants from the cross-sectional 2009-2010 Chilean National Health Survey in this study. Diabetes was determined as fasting glucose levels ≥126 mg/dl. Body mass index (BMI) and waist circumference (WC) were measured using standardized protocols. Sitting time was assessed using the Global Physical Activity Questionnaire. The association among diabetes, obesity and ST was determined using logistic regression. Results: The odds for diabetes increased by 3.1-fold in people with high levels of ST and obesity in comparison to those with low levels of ST and normal BMI (Odds ratio (OR): 4.17 [95% confidence intervals (CI): 2.87 to 6.05], P < 0.01). The odds for diabetes increased by 2.7fold in highly sedentary subjects with central obesity (OR: 3.73 [95% IC: 2.61 to 5.33], P < 0.01) in comparison to those with low levels of ST and normal WC. Conclusions: Elevated levels of sitting time and obesity are associated with a higher odds of developing diabetes. (Rev Med Chile 2018; 146: 433-441)

No cumplir con las recomendaciones de actividad física se asocia a mayores niveles de obesidad, diabetes, hipertensión y síndrome metabólico en población chilena

BACKGROUNDnPhysical inactivity is an important cardiovascular risk factor.nnnAIMnTo investigate the association of physical inactivity with obesity, metabolic markers, type 2 diabetes mellitus, hypertension and metabolic syndrome in Chilean adults.nnnMATERIAL AND METHODSnParticipants from the National Health Survey 2009-10 (n = 5,157) were included in this study. Body mass index, waist circumference, metabolic markers (blood glucose, glycosylated hemoglobin and lipid profile) were the outcomes. Type 2 diabetes, hypertension and metabolic syndrome were determined using international criteria. Physical activity levels were determined using the Global Physical Activity Questionnaire and physical inactivity was defined as < 600 METs/minutes/week.nnnRESULTSnCompared to their physically active peers, inactive men and women had a higher odds ratio (OR) for obesity (OR: 1.77 [95% confidence intervals (CI): 1.29-2.42], p < 0.01 and 1.25 [95% CI: 102-1.54], p < 0.035, respectively), diabetes (OR: 2.47 [1.80-3.38], p < 0.01 and 1.72 [1.35-2.19], p = 0.002, respectively) and hypertension (OR: 1.66 [1.31-2.09], p < 0.01 and 1.83 [1.54-2.18] respectively. An association of physical inactivity with central obesity and metabolic syndrome was observed only in men (OR: 1.92 [1.42- 2.58], p < 0.01 and 1.74 [1.23-2.47], p < 0.01, respectively).nnnCONCLUSIONSnNot meeting the physical activity recommendations is associated with obesity, diabetes, hypertension and metabolic syndrome, which are important cardiovascular risk factors.

Asociación entre el polimorfismo rs9939609 del gen FTO y marcadores de adiposidad en población adulta chilena.

BACKGROUNDnNumerous studies have identified the role of Fat-mass-associated-gene (FTO) in the development of obesity.nnnAIMnTo investigate the association of FTO gene with adiposity markers in Chilean adults.nnnMATERIAL AND METHODSn409 participants were included in this cross-sectional study. The association between FTO (rs9939609) genotype and adiposity markers was determined using linear regression analyses. Adiposity markers included were: body weight, body mass index, fat mass, waist circumference, hip circumference and waist/hip ratio.nnnRESULTSnA fully adjusted model showed a significant association between FTO genotype and body weight (2.16 kg per each extra copy of the risk allele [95% confidence intervals (CI): 0.45 to 3.87], p = 0.014), body mass index (0.61 kg.m-2 [95% CI: 0.12 to 1.20], p = 0.050) and fat mass (1.14% [95% CI: 0.39 to 1.89], p = 0.010). The greater magnitude of association was found between the FTO gene and fat mass when the outcomes were standardized to z-score.nnnCONCLUSIONSnThis study confirms an association between the FTO gene and adiposity markers in Chilean adults, which is independent of major confounding factors.

Factores asociados al desarrollo de diabetes mellitus tipo 2 en Chile

BACKGROUNDnworldwide, prevalence of type 2 diabetes has doubled in the last years, mainly due to unhealthy lifestyle behaviours. They are many risk factors associated with diabetes, however, which factors are associated with diabetes in the Chilean population remains unknown. Therefore, the aim was to determine what risk factors are associated with the development of diabetes in Chile.nnnMETHODSnfour thousand and seven hundred participants from the cross-sectional 2009-2010 National Health Survey were included in this study (4,162 normal; 538 diabetics). Risk factors assessed were socio-demographic, anthropometric, lifestyle, well-being and comorbidities. The association between diabetes and risk factors was examined using logistic regression.nnnRESULTSnthe main non-modifiable risk factors associated with diabetes were age ≥ 45 year, female and family history of diabetes; whereas the main modifiable risk factors were hypertension, overweight, obesity, central obesity, physical inactivity and higher levels of sitting time.nnnCONCLUSIONnthe identification of modifiable risk factors for DMT2 is key to control and decrease the prevalence of this pathology and to improve the quality of life of the population.

Patterns of healthy lifestyle behaviours in older adults: Findings from the Chilean National Health Survey 2009–2010

&NA; The purpose of this study was to investigate healthy lifestyle behaviours across age categories in the older population in Chile. Data from 1390 older adults (≥60 years), in the 2009–2010 Chilean National Health Survey were analyzed. We derived the following age categories: 60–65, 66–70, 71–75, 76–80 and >80 years. The associations between age and compliance with healthy lifestyle behaviours (smoking, sitting time, physical activity, sleep duration and intake of salt, alcohol, fruit and vegetables) were investigated using logistic regression. The probability of meeting the guidelines for alcohol intake (OR trend: 1.35 [95% CI: 1.11; 1.64], p = 0.001) and smoking (OR trend: 1.23 [95% CI: 1.13; 1.33], p < 0.0001) increased with age, whereas spending <4 h per day sitting time or engaging in at least 150 min of physical activity per week or sleep on average between 7 and 9 h per day were less likely to be met with increasing age (OR trend: 0.77 [95% CI: 0.71; 0.83], p < 0.000; OR trend: 0.73 [95% CI: 0.67; 0.79], p < 0.0001, and OR trend: 0.89 [95% CI: 0.82; 0.96], p = 0.002, respectively). No significant trend across age categories was observed for fruit and vegetables, and salt intake. The probability of meeting at least 3 out of 7 healthy lifestyle behaviours across the age categories was also lower in older age categories compared to those aged 60 to 65 years. Overall, in older adults the probability of having the healthy lifestyle behaviours of physical activity, sitting time and sleeping behaviours was low but not for smoking or alcohol consumption. With an increasingly ageing population, these findings could inform stakeholders on which lifestyle behaviours could be targeted in the older adults and therefore which interventions should take place to promote healthy ageing.

Aumento del índice de masa corporal durante las últimas cuatro décadas en la población chilena: de la desnutrición a la obesidad = Increase in body mass index during the last four decades in Chile: from undernutrition to obesity

Sr. Editor nLa obesidad es un importante factor de riesgo para el desarrollo de enfermedades cardiovasculares, diabetes mellitus tipo 2, cancer, problemas musculo-esqueleticos, y otras enfermedades cronicas no transmisibles [1, 2]. La preocupacion mundial por la obesidad y su impacto economico en la salud, ha llevado a la Organizacion Mundial de la Salud (OMS) a incluir esta en la lista de los objetivos sanitarios globales para enfermedades no transmisibles (Global Non-comunicable diseases (Global-NCD)). Dentro de los nuevos objetivos de esta iniciativa esta el detener el aumento de la obesidad (0% de incremento) para el ano 2025 [2]; sin embargo, se desconoce si tales objetivos sanitarios seran alcanzados en el plazo propuesto. nUn reciente estudio liderado por el grupo de investigacion en Factores de Riesgo para Enfermedades No-transmisibles (NCD Risk Factor Collaboration (NCD-RiskC)) [3], reporto la tendencia de los cambios en indice de masa corporal (IMC) entre 1975 y 2014 en un total de 19,2 millones de personas en 200 paises del mundo. A nivel mundial, el IMC habria aumentado de 21,7 a 24,2 kg/m2 en hombres y de 22,1 a 24,4 kg/m2 en mujeres durante el periodo estudiado. Este incremento es equivalente a 6,6 y 6,3 kg de peso corporal para hombres y mujeres, respectivamente, con una estatura de 1,63 metros. La prevalencia de la obesidad a nivel mundial se incremento de 3,2% a 10,8% en hombres y de 6,4% a 14,9% en mujeres de acuerdo a este estudio[3]. Estos resultados alertan a que si esta tendencia al incremento del IMC continua, no sera posible cumplir con los objetivos sanitarios propuestos por el Global-NCD y la OMS. nLeer mas...

Efectos de la actividad física sobre la asociación entre obesidad y diabetes mellitus Tipo 2: resultados de la Encuesta Nacional de Salud 2009-2010

Background: n nPhysical inactivity and obesity are major risk factors for type 2 diabetes (T2D). n nAim: n nTo investigate whether if the association between obesity and diabetes is modified by levels of physical activity in the Chilean population. n nMaterial and Methods: n nCross-sectional study including 4,712 participants from the 2009-2010 National Health Survey. Diabetes was determined when participants referred having the disease or had a fasting glucose ≥ 126 mg/dl. Physical activity level was assessed using the Global Physical Activity Questionnaire. The association between diabetes, obesity and physical activity was determined using logistic regression analysis. n nResults: n nCompare to active and normal weight subjects (reference group), the risk for T2D was higher in active individuals with overweight (Odds ratio (OR): 2.85 [95% confidence intervals (CI): 1.76- 4.61] p < 0.01). The risk among inactive but normal weight participants (OR: 2.12 [95% CI: 1.49- 3.01], p < 0.01) was of lower magnitude and was even higher among inactive and overweight individuals (OR: 3.22 [95% CI: 2.10 – 4.93], p < 0.01). Similar results were found for obesity and central obesity. n nConclusions: n nIndividuals who are physically inactive and have a high adiposity level have an increased risk for T2D compared to active individuals with normal BMI.