Ximena Díaz-Martínez

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

Background Sitting 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. Methods This 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). Results The 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. Conclusions Sitting 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

Background There 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. Methods In 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. Results The 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). Conclusion Our 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

BACKGROUND Physical inactivity is an important cardiovascular risk factor. AIM To investigate the association of physical inactivity with obesity, metabolic markers, type 2 diabetes mellitus, hypertension and metabolic syndrome in Chilean adults. MATERIAL AND METHODS Participants 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. RESULTS Compared 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). CONCLUSIONS Not meeting the physical activity recommendations is associated with obesity, diabetes, hypertension and metabolic syndrome, which are important cardiovascular risk factors.

Factores asociados al desarrollo de diabetes mellitus tipo 2 en Chile

BACKGROUND worldwide, 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. METHODS four 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. RESULTS the 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. CONCLUSION the 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.

Factores asociados al desarrollo de obesidad en Chile: resultados de la Encuesta Nacional de Salud 2009-2010

Background: Chile has one of the highest obesity rates in Latin America. However, the factors that could explain this high prevalence of obesity are unknown. Aim: To determine the main risk factors for the development of obesity in Chile. Material and methods: We included 1398 obese and 1478 normal weight participants of the National Health Survey 2009-2010. The risk factors considered were socioeconomic variables, diet, physical activity, comorbidities and general wellbeing. Results: The main factors associated with a higher risk of being obese were age, high salt consumption and high alcohol intake. Education, income and living in rural or urban zones were protective for women and risk factors for men. The probability of being obese increases in women that sleep less than seven hours per day or have a poor health. Sedentariness and lack of physical activity were risk factors among men. Conclusions: The identification of these risk factors may help to implement public health interventions to tackle obesity in Chile.

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: Physical inactivity and obesity are major risk factors for type 2 diabetes (T2D). Aim: To investigate whether if the association between obesity and diabetes is modified by levels of physical activity in the Chilean population. Material and Methods: Cross-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. Results: Compare 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. Conclusions: Individuals who are physically inactive and have a high adiposity level have an increased risk for T2D compared to active individuals with normal BMI.

Factores de riesgo asociados al desarrollo de hipertensión arterial en Chile.

BACKGROUND High blood pressure is one of the major risk factors for the development of cardiovascular disease, affecting 27% of the Chilean population in 2010. AIM To determine the risk factors associated with the development of hypertension. MATERIAL AND METHODS Analysis of the database of the 2009-2010 National Health Survey in which 4,901 participants were included. Socio-demographic factors, physical activity, eating habits, well-being and comorbidities were analyzed. RESULTS Women had a lower risk of developing hypertension than men (Odds ratio (OR): 0.69, 95% confidence intervals (CI): 0.59-0.81, p < 0.01). In both men and women, the risk is greater over the age of 25 years (OR: 2.90, 95% CI: 1.55-5.43, p < 0.01). The risk is greater in subjects who were overweight (OR: 1.61, 95% CI: 1.31-1.98, p < 0.01), obese (OR: 3.18, 95% CI: 2.56-3.95, p < 0.01), or had central obesity (OR: 2.25, 95% CI: 1.85-2.72, p < 0.01). Subjects with a family history of hypertension and diabetes also have a higher risk. CONCLUSIONS Identifying the risk factors associated with hypertension allows public health policies to be tailored to its prevention.

Factores asociados a inactividad física en Chile: resultados de la Encuesta Nacional de Salud 2009-2010 = Correlates of physical inactivity: Findings from the Chilean National Health Survey 2009-2010

Background: Physical inactivity is an important risk factor for cardiovascular diseases. Aim: To identify factors associated with physical inactivity in Chilean adults. Material and Methods: Participants from the Chilean Health Survey (5,133 individuals) were included in this study. Physical activity was measured using the Global physical activity questionnaire (GPAQ). Physical inactivity was defined as < 600 MET. min.week−1 of moderate to vigorous intensity physical activity. Logistic regression was used to identify correlates of physical inactivity. Results: The main finding of this study were that women (odds ratio (OR): 1.51 [95% confidence intervals (CI): 1.32-1.72]) were more likely to be inactive compared to men and that older adults were more likely to be inactive than their younger or middle age counterparts (OR: 3.06 [95% CI: 2.45-3.82]). Other correlates of physical inactivity were individuals with obesity (OR: 1.43 [95% CI: 1.20-1.70]), diabetes (OR: 1.96 [95% CI: 1.61-2.38]), hypertension (OR: 1.72 [95% CI: 1.50-1.97]), metabolic syndrome (OR: 1.42 [95% IC: 1.18-1.70]), a low education level (OR: 1.26 [95% CI: 1.06-1.49]) and higher levels of sedentary behavior (OR: 2.77 [95% CI: 2.36-3.25]). Conclusions: Women, older people and sedentary subjects with chronic non-transmissible conditions are at higher risk of being physically inactive.Background: Physical inactivity is an important risk factor for cardiovascular diseases. Aim: To identify factors associated with physical inactivity in Chilean adults. Material and methods: Participants from the Chilean Health Survey (5,133 individuals) were included in this study. Physical activity was measured using the Global physical activity questionnaire (GPAQ). Physical inactivity was defined as <600 MET.min.week-1 of moderate to vigorous intensity physical activity. Logistic regression was used to identify correlates of physical inactivity. Results: The main finding of this study were that women (odds ratio (OR): 1.51 [95% confidence intervals (CI): 1.32-1.72]) were more likely to be inactive compared to men and that older adults were more likely to be inactive than their younger or middle age counterparts (OR: 3.06 [95% CI: 2.45-3.82]). Other correlates of physical inactivity were individuals with obesity (OR: 1.43 [95% CI: 1.20-1.70]), diabetes (OR: 1.96 [95% CI: 1.61-2.38]), hypertension (OR: 1.72 [95% CI: 1.50-1.97]), metabolic syndrome (OR: 1.42 [95% IC: 1.18-1.70]), a low education level (OR: 1.26 [95% CI: 1.06-1.49]) and higher levels of sedentary behavior (OR: 2.77 [95% CI: 2.36-3.25]). Conclusions: Women, older people and sedentary subjects with chronic non-transmissible conditions are at higher risk of being physically inactive.