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Berkowitz L, Mateo C, Salazar C, Samith B, Sara D, Pinto V, Martínez X, Calzada M, von Schultzendorff A, Pedrals N, Bitran M, Echeverría G, Ruini C, Ryff C, Rigotti A. Healthy Eating as Potential Mediator of Inverse Association between Purpose in Life and Waist Circumference: Emerging Evidence from US and Chilean Cohorts. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7099. [PMID: 38063529 PMCID: PMC10705882 DOI: 10.3390/ijerph20237099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 08/15/2023] [Accepted: 08/18/2023] [Indexed: 12/18/2023]
Abstract
High sense of purpose in life, a fundamental domain of eudaimonic well-being, has been consistently associated with lower risk for various obesity-related chronic diseases. Although this psychological feature correlates with some health behaviors as potential mediators, its association with healthy eating remains less explored. In addition, studies of these psycho-behavioral and health relationships in the South American population are lacking. This research sought to assess: (1) the cross-sectional association between self-reported purpose in life and overall healthy eating patterns, and (2) healthy food intake as a potential mediator of the inverse relationship between purpose in life and waist circumference. Data collected of 2060 US adults from the MIDUS study (5 ± 12 years, 55% women, mostly white people, and 42.5% obese) and 223 Chilean adults from the CHILEMED study (46.6 ± 9 years, 58.3% women, and 71.3% obese) were used. Anthropometric and sociodemographic variables were collected. Sense of purpose was assessed using the purpose in life subscale of the Ryff's psychological well-being questionnaire. Diet quality was evaluated using healthy eating or low-fat diet indexes, according to extant food intake data in each cohort. The relationship between these variables was estimated by bivariate and multivariate linear regressions with appropriate adjustments. To establish whether a better diet quality could mediate a link of purpose in life and improved nutritional status (assessed by waist circumference), the association between these three variables was tested by bootstrapping-based mediation analysis. Our results show significant associations of sense of purpose with healthy eating and low-fat dietary patterns in both US and Chilean cohorts, respectively, even after adjusting for sociodemographic variables. According to the mediation analysis, the relationship between sense of purpose and waist circumference, as an indicator of abdominal obesity, appears to be partially mediated by healthier food intake in both samples. In conclusion, our findings suggest a plausible mechanism underlying the favorable impact of this well-being dimension on physical health. Given its protective effects, interventions aimed at increasing purpose in life may facilitate adherence to better dietary patterns, which, in turn, will reduce the risk for obesity-related chronic diseases.
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Affiliation(s)
- Loni Berkowitz
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile; (L.B.); (B.S.); (M.C.); (N.P.); (G.E.)
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile; (C.M.); (C.S.); (D.S.); (V.P.); (X.M.); (A.v.S.); (M.B.)
| | - Camila Mateo
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile; (C.M.); (C.S.); (D.S.); (V.P.); (X.M.); (A.v.S.); (M.B.)
| | - Cristian Salazar
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile; (C.M.); (C.S.); (D.S.); (V.P.); (X.M.); (A.v.S.); (M.B.)
| | - Bárbara Samith
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile; (L.B.); (B.S.); (M.C.); (N.P.); (G.E.)
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile; (C.M.); (C.S.); (D.S.); (V.P.); (X.M.); (A.v.S.); (M.B.)
| | - Daniela Sara
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile; (C.M.); (C.S.); (D.S.); (V.P.); (X.M.); (A.v.S.); (M.B.)
| | - Victoria Pinto
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile; (C.M.); (C.S.); (D.S.); (V.P.); (X.M.); (A.v.S.); (M.B.)
- Carrera de Nutrición y Dietética and Centro de Nutrición Molecular y Enfermedades Crónicas, Facultad de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile
| | - Ximena Martínez
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile; (C.M.); (C.S.); (D.S.); (V.P.); (X.M.); (A.v.S.); (M.B.)
| | - Mariana Calzada
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile; (L.B.); (B.S.); (M.C.); (N.P.); (G.E.)
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile; (C.M.); (C.S.); (D.S.); (V.P.); (X.M.); (A.v.S.); (M.B.)
| | - Andrea von Schultzendorff
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile; (C.M.); (C.S.); (D.S.); (V.P.); (X.M.); (A.v.S.); (M.B.)
| | - Nuria Pedrals
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile; (L.B.); (B.S.); (M.C.); (N.P.); (G.E.)
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile; (C.M.); (C.S.); (D.S.); (V.P.); (X.M.); (A.v.S.); (M.B.)
| | - Marcela Bitran
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile; (C.M.); (C.S.); (D.S.); (V.P.); (X.M.); (A.v.S.); (M.B.)
| | - Guadalupe Echeverría
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile; (L.B.); (B.S.); (M.C.); (N.P.); (G.E.)
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile; (C.M.); (C.S.); (D.S.); (V.P.); (X.M.); (A.v.S.); (M.B.)
| | - Chiara Ruini
- Department for Life Qualities Studies, University of Bologna, 40126 Rimini, Italy;
| | - Carol Ryff
- Institute on Aging, University of Wisconsin-Madison, Madison, WI 53715-1149, USA;
| | - Attilio Rigotti
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile; (L.B.); (B.S.); (M.C.); (N.P.); (G.E.)
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile; (C.M.); (C.S.); (D.S.); (V.P.); (X.M.); (A.v.S.); (M.B.)
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Blanco E, Martinez SM, East P, Burrows R, Correa-Burrows P, Lozoff B, Gahagan S. Breastfeeding Duration and Timing of Bottle Supplementation: Associations with Body Mass Index from Childhood to Young-Adulthood. Nutrients 2023; 15:3121. [PMID: 37513539 PMCID: PMC10384694 DOI: 10.3390/nu15143121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/08/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
Evidence for the association between breastfeeding (BF) duration and later body mass index (BMI) is inconsistent. We explored how BF duration and BF type (exclusive or partial) related to BMI from childhood to young adulthood in a Chilean cohort. Infants were recruited at 6 months between 1994 and 1996 in Santiago, Chile (n = 821). Mothers reported date of first bottle and last BF; anthropometry was measured at 1, 5, 10, 16, and 23 years. We tested whether: (1) type of BF at 6 months (none, partial, exclusive) and (2) duration of exclusive BF (<1 month, 1 to <3 months, 3 to <6 months, and ≥6 months) related to BMI. At 6 months, 35% received both breastmilk and formula ("partial BF") and 38% were exclusively breastfed. We found some evidence of an association between longer BF and lower BMI z-scores at young ages but observed null effects for later BMI. Specifically, BF for 3 to <6 months compared to <1 month related to lower BMI z-scores at 1 and 5 years (both p < 0.05). Our results are in partial accordance with others who have not found a protective effect of longer BF for lower BMI.
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Affiliation(s)
- Estela Blanco
- Centro de Investigación en Sociedad y Salud y Núcleo Milenio de Sociomedicina, Las Condes, Santiago 7550000, Chile
| | - Suzanna M Martinez
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA 90095, USA
| | - Patricia East
- Department of Pediatrics, Division of Child Development and Community Health, University of California, San Diego, CA 92093, USA
| | - Raquel Burrows
- Institute of Nutrition and Food Technology, University of Chile, Macul, Santiago 7810000, Chile
| | - Paulina Correa-Burrows
- Institute of Nutrition and Food Technology, University of Chile, Macul, Santiago 7810000, Chile
| | - Betsy Lozoff
- Department of Pediatrics, University of Michigan, Ann Arbor, MI 48109, USA
| | - Sheila Gahagan
- Department of Pediatrics, Division of Child Development and Community Health, University of California, San Diego, CA 92093, USA
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Pemjean I, Mediano F, Ferrer P, Garmendia ML, Corvalán C. Food access, domestic environments, and dietary quality of low-middle income Chilean children during the COVID-19 pandemic. Front Public Health 2023; 11:1164357. [PMID: 37408742 PMCID: PMC10319070 DOI: 10.3389/fpubh.2023.1164357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 05/25/2023] [Indexed: 07/07/2023] Open
Abstract
Introduction Food access is associated with dietary quality; however, people living in similar physical environments can have different food access profiles. Domestic environments may also influence how food access relates to dietary quality. We studied food access profiles of 999 low-middle income Chilean families with children during the COVID-19 lockdown and how these profiles relate to dietary quality; secondarily, we also explore the role of the domestic environment in this relationship. Materials and methods Participants of two longitudinal studies conducted in the southeast of Santiago, Chile, answered online surveys at the beginning and end of the COVID-19 pandemic lockdown. Food access profiles were developed by a latent class analysis considering food outlets and government food transfers. Children's dietary quality was estimated by self-reported compliance with the Chilean Dietary Guidelines of Americans (DGA) and daily ultra-processed food (UPF) consumption. Logistic and linear regressions were used to assess the association between food access profiles and dietary quality. Domestic environment data (i.e., the sex of the person who buys food and cooks, meal frequency, cooking skills, etc.) were incorporated in the models to assess their influence on the relationship between food access and dietary quality. Results We have categorized three food access profiles: Classic (70.2%), Multiple (17.9%), and Supermarket-Restaurant (11.9%). Households led by women are concentrated in the Multiple profile, while families from higher income or education levels are focused on the Supermarket-Restaurant profile. On average, children presented poor dietary quality, with a high daily UPF consumption (median = 4.4; IQR: 3) and low compliance with national DGA recommendations (median = 1.2; IQR: 2). Except for the fish recommendation (OR = 1.77, 95% CI:1.00-3.12; p: 0.048 for the Supermarket-Restaurant profile), the food access profiles were poorly associated with children's dietary quality. However, further analyses showed that domestic environment variables related to routine and time use influenced the association between food access profiles and dietary quality. Conclusion In a sample of low-middle income Chilean families, we identified three different food access profiles that presented a socioeconomic gradient; however, these profiles did not significantly explain children's dietary quality. Studies diving deeper into household dynamics might give us some clues on intra-household behaviors and roles that could be influencing how food access relates to dietary quality.
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Affiliation(s)
- Isabel Pemjean
- Doctoral Program in Public Health, School of Public Health, University of Chile, Santiago, Chile
| | - Fernanda Mediano
- Carolina Population Center, University of North Carolina, Chapel Hill, NC, United States
| | - Pedro Ferrer
- Center for Research in Food Environments and Prevention of Nutrition-Related Diseases (CIAPEC), Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - María Luisa Garmendia
- Center for Research in Food Environments and Prevention of Nutrition-Related Diseases (CIAPEC), Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Camila Corvalán
- Center for Research in Food Environments and Prevention of Nutrition-Related Diseases (CIAPEC), Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
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Pfister F, Pozas C. The influence of Chile's food labeling and advertising law and other factors on dietary and physical activity behavior of elementary students in a peripheral region: a qualitative study. BMC Nutr 2023; 9:11. [PMID: 36631817 PMCID: PMC9832755 DOI: 10.1186/s40795-023-00671-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 01/05/2023] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND In 2016, Chile implemented the Food Labeling and Advertising Law to fight childhood obesity through front-of-package food labelling, marketing restrictions and school activities and programs. Nevertheless, little is known on its influence on key stakeholders in vulnerable peripheral regions of the country. This study aimed at identifying important influencing factors including the Food Labeling and Advertising Law on dietary habits and physical activity patterns of second graders in Chile, as perceived by school representatives and the children themselves. METHODS Semi-structured interviews with four school directors and 17 groups of three second graders, informal interviews with 9 key teachers and 4 food services staff complemented with documented observations were carried out in four primary schools of the Chilean city of Punta Arenas, in the Magallanes Punta Arenas region. The different sources allowed for triangulation of results. RESULTS FLAL seems to have a negligible influence on young children's diet and physical activity in the study region. Barriers are children's deeply rooted dietary habits, excessive screen-time, the parents' lacking problem awareness, limited time for parenting practices and bad role modeling. Environmental barriers are overloaded schools due to insufficient coordination between governmental entities, lacking funds for sound teacher training and unsafe neighborhoods limiting children's play. CONCLUSIONS Policy interventions aimed at reducing childhood obesity need to include and empower schools, families and local communities as active partners and consider their framework conditions for greater influence on dietary habits and physical activity.
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Affiliation(s)
- Franziska Pfister
- grid.424060.40000 0001 0688 6779School of Health Professions, Bern University of Applied Sciences, Murtenstrasse 10, 3008 Bern, Switzerland
| | - Claudia Pozas
- grid.424060.40000 0001 0688 6779School of Health Professions, Bern University of Applied Sciences, Murtenstrasse 10, 3008 Bern, Switzerland
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Ruedlinger J, Cid-Ossandón V, Huidobro A, Van De Wyngard V, Vargas C, Ferreccio C. Processed meat consumption and associated factors in Chile: A cross-sectional study nested in the MAUCO cohort. Front Public Health 2022; 10:960997. [PMID: 36062116 PMCID: PMC9436317 DOI: 10.3389/fpubh.2022.960997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 08/01/2022] [Indexed: 01/24/2023] Open
Abstract
Processed meat consumption is increasing in Latin America. While in developed countries processed meat consumption has been associated with cardiovascular diseases and cancer, our region lacks data associated to its consumption and health impact. We characterized processed meat intake and associated factors in a population-based cohort of a Chilean agricultural county, MAUCO. We analyzed baseline dietary data of 7,841 participants, 4,358 women and 3,483 men (38-77 years), who answered an adapted Mediterranean index food frequency questionnaire. Eight percent of the participants presented high processed meat consumption (≥5 times per week). We explored associations of processed meat consumption with participant characteristics using multinomial logistic regression models. Main factors associated with higher consumption were being men, younger and currently employed, and having a high intake (>4 times per week) of red meat (Odds ratio, 2.71, 95% CI 2.10-3.48), butter/cream (1.96, 1.60-2.41), whole-fat dairy products (1.32, 1.04-1.67) and a high intake (≥1 time per day) of sugary snacks/sweets (2.49, 2.04-3.03) and sugary drinks (1.97, 1.63-2.38). Processed meat consumption associated to chronic diseases, particularly cardiovascular disease (Prevalence ratio, 2.28, 95% CI 1.58-3.29). Obesity mediated this association in a proportion of 5.0%, whereas for diabetes the proportion was 13.9%. In this population, processed meat was associated with other unhealthy dietary and lifestyle factors, as well as with chronic diseases, particularly cardiovascular disease.
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Affiliation(s)
- Jenny Ruedlinger
- Facultad de Medicina, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Advanced Center for Chronic Diseases, Universidad de Chile and Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Vicente Cid-Ossandón
- Facultad de Medicina, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Advanced Center for Chronic Diseases, Universidad de Chile and Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Andrea Huidobro
- Advanced Center for Chronic Diseases, Universidad de Chile and Pontificia Universidad Católica de Chile, Santiago, Chile
- Facultad de Medicina, School of Medicine, Universidad Católica del Maule, Talca, Chile
| | - Vanessa Van De Wyngard
- Facultad de Medicina, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Advanced Center for Chronic Diseases, Universidad de Chile and Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Claudio Vargas
- Advanced Center for Chronic Diseases, Universidad de Chile and Pontificia Universidad Católica de Chile, Santiago, Chile
- Departamento de Matemáticas y Ciencias de la Computación, Facultad de Ciencias, Universidad de Santiago de Chile, Santiago, Chile
| | - Catterina Ferreccio
- Facultad de Medicina, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Advanced Center for Chronic Diseases, Universidad de Chile and Pontificia Universidad Católica de Chile, Santiago, Chile
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Kim D, Justice AE, Chittoor G, Blanco E, Burrows R, Graff M, Howard AG, Wang Y, Rohde R, Buchanan VL, Voruganti VS, Almeida M, Peralta J, Lehman DM, Curran JE, Comuzzie AG, Duggirala R, Blangero J, Albala C, Santos JL, Angel B, Lozoff B, Gahagan S, North KE. Genetic determinants of metabolic biomarkers and their associations with cardiometabolic traits in Hispanic/Latino adolescents. Pediatr Res 2022; 92:563-571. [PMID: 34645953 PMCID: PMC9005573 DOI: 10.1038/s41390-021-01729-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 06/08/2021] [Accepted: 08/17/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND Metabolic regulation plays a significant role in energy homeostasis, and adolescence is a crucial life stage for the development of cardiometabolic disease (CMD). This study aims to investigate the genetic determinants of metabolic biomarkers-adiponectin, leptin, ghrelin, and orexin-and their associations with CMD risk factors. METHODS We characterized the genetic determinants of the biomarkers among Hispanic/Latino adolescents of the Santiago Longitudinal Study (SLS) and identified the cumulative effects of genetic variants on adiponectin and leptin using biomarker polygenic risk scores (PRS). We further investigated the direct and indirect effect of the biomarker PRS on downstream body fat percent (BF%) and glycemic traits using structural equation modeling. RESULTS We identified putatively novel genetic variants associated with the metabolic biomarkers. A substantial amount of biomarker variance was explained by SLS-specific PRS, and the prediction was improved by including the putatively novel loci. Fasting blood insulin and insulin resistance were associated with PRS for adiponectin, leptin, and ghrelin, and BF% was associated with PRS for adiponectin and leptin. We found evidence of substantial mediation of these associations by the biomarker levels. CONCLUSIONS The genetic underpinnings of metabolic biomarkers can affect the early development of CMD, partly mediated by the biomarkers. IMPACT This study characterized the genetic underpinnings of four metabolic hormones and investigated their potential influence on adiposity and insulin biology among Hispanic/Latino adolescents. Fasting blood insulin and insulin resistance were associated with polygenic risk score (PRS) for adiponectin, leptin, and ghrelin, with evidence of some degree of mediation by the biomarker levels. Body fat percent (BF%) was also associated with PRS for adiponectin and leptin. This provides important insight on biological mechanisms underlying early metabolic dysfunction and reveals candidates for prevention efforts. Our findings also highlight the importance of ancestrally diverse populations to facilitate valid studies of the genetic architecture of metabolic biomarker levels.
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Affiliation(s)
- Daeeun Kim
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Anne E. Justice
- Department of Population Health Sciences, Geisinger, Danville, PA
| | - Geetha Chittoor
- Department of Population Health Sciences, Geisinger, Danville, PA
| | - Estela Blanco
- Division of Academic General Pediatrics, Child Development and Community Health at the Center for Community Health, University of California at San Diego, San Diego, CA,Department of Public Health, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Raquel Burrows
- Department of Public Health Nutrition, Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Mariaelisa Graff
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Annie Green Howard
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Yujie Wang
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Rebecca Rohde
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Victoria L. Buchanan
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - V. Saroja Voruganti
- Department of Nutrition and Nutrition Research Institute, University of North Carolina at Chapel Hill, Kannapolis NC
| | - Marcio Almeida
- Department of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Brownsville, TX
| | - Juan Peralta
- Department of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Brownsville, TX
| | - Donna M. Lehman
- Departments of Medicine and Epidemiology and Biostatistics, University of Texas Health San Antonio, San Antonio, TX
| | - Joanne E. Curran
- Department of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Brownsville, TX
| | | | - Ravindranath Duggirala
- Department of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Brownsville, TX
| | - John Blangero
- Department of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Brownsville, TX
| | - Cecilia Albala
- Department of Public Health Nutrition, Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - José L. Santos
- Department of Nutrition, Diabetes and Metabolism, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Bárbara Angel
- Department of Public Health Nutrition, Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Betsy Lozoff
- Department of Pediatrics, University of Michigan, Ann Arbor, MI
| | - Sheila Gahagan
- Division of Academic General Pediatrics, Child Development and Community Health at the Center for Community Health, University of California at San Diego, San Diego, CA
| | - Kari E. North
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
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Effects of Developmental Failure of Swallowing Threshold on Obesity and Eating Behaviors in Children Aged 5-15 Years. Nutrients 2022; 14:nu14132614. [PMID: 35807794 PMCID: PMC9268440 DOI: 10.3390/nu14132614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/21/2022] [Accepted: 06/23/2022] [Indexed: 11/20/2022] Open
Abstract
Background: The aim of the present study was to identify factors related to developmental failure of swallowing threshold in children aged 5−15 years. Methods: A total of 83 children aged 5−15 years were included in this study. A self-administered lifestyle questionnaire was completed, along with hand grip strength and oral function tests. Swallowing threshold was determined based on the concentration of dissolved glucose obtained from gummy jellies when the participants signaled that they wanted to swallow the chewed gummy jellies. Developmental failure of swallowing threshold was defined as glucose concentrations in the lowest 20th percentile. After univariate analysis, multivariate binary logistic regression analysis was used to identify factors associated with developmental failure of swallowing threshold. Results: Hand grip strength was significantly correlated with masticatory performance (r = 0.611, p < 0.01). Logistic regression analysis revealed factors related to developmental failure of swallowing threshold, i.e., overweight/obesity (Odds ratio) (OR) = 5.343, p = 0.031, 95% CI = 1.168−24.437) and eating between meals at least once a day (OR = 4.934, p = 0.049, 95% CI = 1.004−24.244). Conclusions: Developmental failure of swallowing threshold was closely associated with childhood obesity in 5- to 15-year-old children.
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Social determinants of malnutrition in Chilean children aged up to five. BMC Public Health 2022; 22:44. [PMID: 34996396 PMCID: PMC8740415 DOI: 10.1186/s12889-021-12455-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 12/21/2021] [Indexed: 11/17/2022] Open
Abstract
Background This study aimed to ascertain the Social Determinants (SDs) of malnutrition (over and undernutrition) of Chilean children aged up to five. Methods The study was carried out using a sample of children from zero to five years old (n = 1,270,485; 52.2% female) from the National Socioeconomic Characterization Survey (CASEN) 2017. A multinomial logistic regression model was used, where the “child nutritional status” outcome variable assumed three possible values: normal nutrition, overnutrition, and undernutrition, while taking those variables reported in previous literature as independent variables. Results The model, by default, set normal nutrition as the reference group, Count R2 = 0.81. Results show a higher likelihood of both overnutrition and undernutrition among male children from the lowest quintiles, with native ethnic backgrounds, reporting health problems, having public health insurance, and who attend kindergarten. Additionally, higher probabilities of undernutrition in younger than two and living in the north of the country, while overnutrition is more likely in the south. Conclusions Socioeconomic variables are fundamentally related to both over and undernutrition; the current single schema program to prevent malnutrition should consider SDs such as ethnicity and geographical location, among others; moreover, successful nutritional programs—which focused on the lowest quintiles, need to be expanded to other vulnerable groups and pay more attention to overnutrition.
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Mardones F, Rosso P, Erazo Á, Farías M. Comparison of Three Gestational Weight Gain Guidelines Under Use in Latin America. Front Pediatr 2021; 9:744760. [PMID: 34722425 PMCID: PMC8550449 DOI: 10.3389/fped.2021.744760] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 09/15/2021] [Indexed: 12/03/2022] Open
Abstract
Presently, three guidelines are used in Latin America to assess adequacy of maternal body mass index (BMI) during pregnancy: (1) the chart proposed by the Institute of Medicine of the United States (IOM), (2) the Rosso-Mardones Chart (RM), and (3) a modified RM chart proposed by Atalah et al. (AEA). The aim of the present review was to explore available information on the sensitivity, specificity, and both positive (PPV) and negative predictive values (NPV) of these charts to detect women at risk of delivering babies with the following signs of abnormal fetal growth: (a) length at birth (BL) <50 cm; (b) birth weight (BW) <3,000 g; and (c) BW ≥ 4,000 or 4,250 g. Data from studies conducted in large samples of Chilean and Uruguayan women indicate that the RM chart has the greatest sensitivity to identify at risk cases. However, predictive values were similar for the three charts. Thus, the use of the RM chart should be preferred. The main limitation for using the IOM weight gain recommendations in Latin American women stems from the fact that their average height is approximately 20 cm lower than US women.
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Affiliation(s)
- Francisco Mardones
- Centro Latino Americano de Estudios Económicos y Sociales (Latin American Center for Economic and Social Studies), Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Pedro Rosso
- Department of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Álvaro Erazo
- Centro Latino Americano de Estudios Económicos y Sociales (Latin American Center for Economic and Social Studies), Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Marcelo Farías
- Department of Obstetrics and Gynecology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
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Vega-Salas MJ, Caro P, Johnson L, Papadaki A. Socio-economic inequalities in dietary intake in Chile: a systematic review. Public Health Nutr 2021; 25:1-16. [PMID: 34247696 PMCID: PMC9991770 DOI: 10.1017/s1368980021002937] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 06/02/2021] [Accepted: 07/07/2021] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Understanding the socio-economic inequalities in dietary intake is crucial when addressing the socio-economic gradient in obesity rates and non-communicable diseases. We aimed to systematically assess the association between socio-economic position (SEP) and dietary intake in Chile. DESIGN We searched for peer-reviewed and grey literature from inception until 31 December 2019 in PubMed, Scopus, PsycINFO, Web of Sciences and LILACS databases. Observational studies published in English and Spanish, reporting the comparison of at least one dietary factor between at least two groups of different SEP in the general Chilean population, were selected. Two researchers independently conducted data searches, screening and extraction and assessed study quality using an adaptation of the Newcastle Ottawa Quality Assessment Scale. RESULTS Twenty-one articles (from eighteen studies) were included. Study quality was considered low, medium and high for 24, 52 and 24 % of articles, respectively. Moderate-to-large associations indicated lower intake of fruit and vegetables, dairy products and fish/seafood and higher pulses consumption among adults of lower SEP. Variable evidence of association was found for energy intake and macronutrients, in both children and adults. CONCLUSIONS Our findings highlight some socio-economic inequalities in diets in Chile, evidencing an overall less healthy food consumption among the lower SEP groups. New policies to reduce these inequalities should tackle the unequal distribution of factors affecting healthy eating among the lower SEP groups. These findings also provide important insights for developing strategies to reduce dietary inequalities in Chile and other countries that have undergone similar nutritional transitions.
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Affiliation(s)
- María Jesús Vega-Salas
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Road, BristolBS8 1TZ, UK
| | - Paola Caro
- School for Policy Studies, University of Bristol, Bristol, UK
| | - Laura Johnson
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Road, BristolBS8 1TZ, UK
| | - Angeliki Papadaki
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Road, BristolBS8 1TZ, UK
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Feng Y, Li X, Mao Z, Huo W, Hou J, Wang C, Li W, Yu S. Heritability Estimation and Environmental Risk Assessment for Type 2 Diabetes Mellitus in a Rural Region in Henan, China: Family-Based and Case-Control Studies. Front Public Health 2021; 9:690889. [PMID: 34307284 PMCID: PMC8295650 DOI: 10.3389/fpubh.2021.690889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 06/08/2021] [Indexed: 11/15/2022] Open
Abstract
Objective: The prevalence of type 2 diabetes mellitus (T2DM) varies greatly in different regions and populations. This study aims to assess the heritability and environmental risk factors of T2DM among rural Chinese adults. Methods: Thousand five hundred thirty three participants from 499 extended families, which included 24 nuclear families, were recruited in the family-based study to assess the heritable risk of T2DM. Heritability of T2DM was estimated by the Falconer method. Using conditional logistic regression model, couple case-control study involving 127 couples were applied to assess the environmental risk factors of T2DM. Results: Compared with the Henan Rural Cohort, T2DM was significantly clustered in the nuclear families (OR: 8.389, 95% CI: 5.537–12.711, P < 0.001) and heritability was 0.74. No association between the heredity of T2DM and sex was observed between the extended families and the Henan Rural Cohort. Besides, results from the couple case-control study showed that physical activity (OR: 0.482, 95% CI: 0.261–0.893, P = 0.020) and fat intake (OR: 3.036, 95% CI: 1.070–8.610, P = 0.037) was associated with T2DM, and the proportion of offspring engaged in medium and high physical activity was higher than that of mothers in mother-offspring pairs. Conclusion: People with a family history of T2DM may have a higher risk of developing T2DM, however, there was no difference in genetic risk between males and females. Adherence to active physical activity and low fat intake can reduce the risk of T2DM.
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Affiliation(s)
- Yinhua Feng
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xing Li
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Zhenxing Mao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Wenqian Huo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Jian Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Wenjie Li
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Songcheng Yu
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, China
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Burrows R, Correa-Burrows P, Bunout D, Barrera G, Rogan J, Kim E, Blanco E, Gahagan S. Obesity and impairment of pancreatic β-cell function in early adulthood, independent of obesity age of onset: The Santiago Longitudinal Study. Diabetes Metab Res Rev 2021; 37:e3371. [PMID: 32562305 DOI: 10.1002/dmrr.3371] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 05/23/2020] [Accepted: 06/03/2020] [Indexed: 12/25/2022]
Abstract
AIM We investigated the relation of time of onset and length of obesity with biomarkers of β-cell function in early adulthood in an infancy cohort. MATERIAL AND METHODS In 1039 23-year-olds, body-mass index (BMI) was measured at multiple time-points from enrollment. BMI trajectories were interpolated with cubic polynomials. Fasting glucose, insulin and adiponectin were measured at 23 years. Homeostatic model assessment-insulin resistance (HOMA-IR), HOMA-S, HOMA-β, HOMA-adiponectin (AD) and disposition index (DI) were estimated. IR and non-alcoholic fatty liver (NAFL) were diagnosed. According to the BMI trajectory, five groups were defined: participants who were never obese (NOB); participants with obesity starting in adolescence and remained obese into adulthood (recent-onset obesity, ROB); participants who were obese in early childhood but transitioned to non-obesity as preadolescents (former obesity, FOB); participants who were obese in early childhood and remained obese into adulthood (persistent obesity, POB); participants with obesity starting in preadolescence and transitioned to non-obesity as adolescents (transient obesity; TOB). RESULTS Obesity was present in 47% of participants during at least one time-point. ROBs and POBs had higher insulin, HOMA-IR and HOMA-β, lower HOMA-S and DI, and higher prevalence of IR and NAFL at 23 years than NOBs, TOBs and FOBs. No differences were found in the β-cell functionality of NOBs, TOBs and FOBs. CONCLUSIONS Persistent and recent obesity are both related to IR, NAFL and a decline of β-cell function in emerging adulthood. Defeating obesity in childhood or adolescence allows reaching emerging adulthood with β-cell functioning similar to that of subjects who were NOB.
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Affiliation(s)
- Raquel Burrows
- Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Chile, Santiago, Chile
| | - Paulina Correa-Burrows
- Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Chile, Santiago, Chile
| | - Daniel Bunout
- Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Chile, Santiago, Chile
| | - Gladys Barrera
- Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Chile, Santiago, Chile
| | - José Rogan
- Departamento de Física, Facultad de Ciencias, Universidad de Chile, Santiago, Chile
- Línea de Simulaciones, Centro para la Nanociencia y la Nanotecnología (CEDENNA), Santiago, Chile
| | - Elissa Kim
- Division of Child Development and Community Health, University of California San Diego, La Jolla, California, USA
| | - Estela Blanco
- Division of Child Development and Community Health, University of California San Diego, La Jolla, California, USA
| | - Sheila Gahagan
- Division of Child Development and Community Health, University of California San Diego, La Jolla, California, USA
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Sensitive periods for psychosocial risk in childhood and adolescence and cardiometabolic outcomes in young adulthood. Dev Psychopathol 2021; 32:1864-1875. [PMID: 33427189 DOI: 10.1017/s0954579420001248] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Greater psychosocial risk in childhood and adolescence predicts poorer cardiometabolic outcomes in adulthood. We assessed whether the timing of psychosocial risk from infancy through adolescence predicts cardiometabolic outcomes in young adulthood. Young adults and their mothers participated in a longitudinal study beginning in infancy in Santiago, Chile (N = 1040). At infancy, 5 years, 10 years, and adolescence, mothers reported on depressive symptoms, stressful experiences, support for child development in the home, father absence, parental education, and socioeconomic status (SES) to create a psychosocial risk composite at each time point. Young adults (52.1% female; 21-27 years) provided fasting serum samples and participated in anthropometric and blood pressure (BP) assessments, including a dual-energy X-ray absorptiometry (DXA) scan for measuring body fat. Greater infant psychosocial risk was associated with a greater young adult metabolic syndrome score (β = 0.07, 95% confidence intervals (CI): 0.01 to 0.13, p = 0.02), a higher body mass index and waist circumference composite (β = 0.08, 95% CI: 0.03 to 0.13, p = 0.002), and a higher body fat (DXA) composite (β = 0.07, 95% CI: 0.01 to 0.12, p = 0.02). No psychosocial risk measure from any time point was associated with BP. Infant psychosocial risk predicted cardiometabolic outcomes in young adulthood better than psychosocial risk at 5 years, 10 years, or adolescence, mean of psychosocial risk from infancy through adolescence, and maximum of psychosocial risk at any one time. Consistent with the Developmental Origins of Health and Disease model, findings suggest that infancy is a sensitive period for psychosocial risk leading to poorer cardiometabolic outcomes in young adulthood.
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Consequences of Low Sleep Duration in Anthropometric and Body Composition Parameters of Chilean Preschoolers. CHILDREN-BASEL 2020; 8:children8010008. [PMID: 33375679 PMCID: PMC7823337 DOI: 10.3390/children8010008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 12/18/2020] [Accepted: 12/21/2020] [Indexed: 12/18/2022]
Abstract
Reduced sleep duration in schoolchildren has been associated with poor health outcomes at the scholar level; however, there is little information on the effects of sleep loss on Chilean preschoolers. The aim of this study was to describe and compare cardiometabolic outcomes according with the sleep duration in Chilean preschoolers. A second aim was to identify potential risk outcomes (i.e., in odds ratios) for suffering anthropometric and body composition alterations related with participants’ sleep duration. A total of 99 (n = 54 boys; n = 45 girls) preschoolers (mean age (95% CI) 3.1 (2.7, 3.4 years), mean weight 16.1 (15.5, 16.6 kg)) were included in this study. Sleep duration was assessed using standardized questionnaires with the parents. Socio-demographic parents’ information, as well as anthropometric, nutritional, and handgrip strength outcomes in preschoolers were distributed by tertiles (T1; < 10 h, T2; 10 to < 11 h, and T3; ≥ 11 h) of sleep time. Children in the lowest tertile of sleep duration had significantly higher body mass indices (p = 0.036), weight-for-height Z-scores (p < 0.0001), waist–hip ratios (p = 0.041), and body fat in percent (p = 0.035) and kg (p = 0.044) compared to those in the top tertile. Low sleep duration was associated with significantly greater risks of overweight/obesity (OR 1.3 (0.9, 1.8)), low height (OR 1.2 (0.8, 1.6)), and increased BMI (OR 1.5 (0.4, 1.4)), but not with reductions in grip strength. Chilean preschoolers with low sleep duration showed higher cardiometabolic markers (anthropometric/body composition) and were more likely to be classified as obese than youth with longer sleep duration.
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Kenny TA, Little M, Lemieux T, Griffin PJ, Wesche SD, Ota Y, Batal M, Chan HM, Lemire M. The Retail Food Sector and Indigenous Peoples in High-Income Countries: A Systematic Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238818. [PMID: 33261090 PMCID: PMC7730644 DOI: 10.3390/ijerph17238818] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/17/2020] [Accepted: 11/18/2020] [Indexed: 02/06/2023]
Abstract
Indigenous Peoples in high-income countries experience higher burdens of food insecurity, obesity, and diet-related health conditions compared to national averages. The objective of this systematic scoping review is to synthesize information from the published literature on the methods/approaches, findings, and scope for research and interventions on the retail food sector servicing Indigenous Peoples in high-income countries. A structured literature search in two major international databases yielded 139 relevant peer-reviewed articles from nine countries. Most research was conducted in Oceania and North America, and in rural and remote regions. Several convergent issues were identified across global regions including limited grocery store availability/access, heightened exposure to unhealthy food environments, inadequate market food supplies (i.e., high prices, limited availability, and poor quality), and common underlying structural factors including socio-economic inequality and colonialism. A list of actions that can modify the nature and structure of retailing systems to enhance the availability, accessibility, and quality of healthful foods is identified. While continuing to (re)align research with community priorities, international collaboration may foster enhanced opportunities to strengthen the evidence base for policy and practice and contribute to the amelioration of diet quality and health at the population level.
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Affiliation(s)
- Tiff-Annie Kenny
- Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Quebec, QC G1V 0A6, Canada;
- Centre de recherche du CHU de Québec, Université Laval, Axe santé des populations et pratiques optimales en santé, Quebec, QC G1E 6W2, Canada
- Correspondence: or
| | - Matthew Little
- School of Public Health and Social Policy, University of Victoria, Victoria, BC V8P 5C2, Canada;
| | - Tad Lemieux
- Department of English Language and Literature, Carleton University, Ottawa, ON K1S 5B6, Canada;
| | - P. Joshua Griffin
- School of Marine and Environmental Affairs, University of Washington, Seattle, WA 98105, USA; (P.J.G.); (Y.O.)
- Department of American Indian Studies, University of Washington, Seattle, WA 98195, USA
| | - Sonia D. Wesche
- Department of Geography, Environment and Geomatics, Faculty of Arts, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
| | - Yoshitaka Ota
- School of Marine and Environmental Affairs, University of Washington, Seattle, WA 98105, USA; (P.J.G.); (Y.O.)
- Nippon Foundation Ocean Nexus Center, EarthLab, University of Washington; Seattle, WA 98195, USA
| | - Malek Batal
- Département de nutrition, Faculté de médecine, Université de Montréal, Montreal, QC H3T 1J4, Canada;
- Centre de recherche en santé publique (CReSP), Montreal, Quebec, QC H3N 1X9, Canada
| | - Hing Man Chan
- Department of Biology, University of Ottawa, Ottawa, ON K1N 9A7, Canada;
| | - Melanie Lemire
- Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Quebec, QC G1V 0A6, Canada;
- Centre de recherche du CHU de Québec, Université Laval, Axe santé des populations et pratiques optimales en santé, Quebec, QC G1E 6W2, Canada
- Institut de biologie intégrative et des systèmes (IBIS), Université Laval, Quebec, QC G1V 0A6, Canada
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Flannagan K, Gahagan S, Das A, Burrows R, Lozoff B, Villamor E. Serum polyunsaturated fatty acids in infancy are associated with body composition in adolescence. Pediatr Obes 2020; 15:e12656. [PMID: 32426929 DOI: 10.1111/ijpo.12656] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 04/07/2020] [Accepted: 04/23/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Polyunsaturated fatty acids (PUFA) have been related to the development of adiposity. N-3 PUFA appears to be protective against obesity risk, while n-6 PUFA may be associated with greater adiposity. However, most studies have been conducted among adults. The role of PUFA in infancy is unknown. OBJECTIVE To examine associations of serum PUFA at age 1 year with age- and sex-adjusted body mass index Z score (BMIZ) change through age 16 years and body composition at 16 years. METHODS We quantified serum PUFA in 636 Chilean infants aged 1 year. We measured BMIZ at ages 1, 5, 10 and 16 years, and body composition by dual energy X-ray absorptiometry at 16 years. We estimated differences in 1- to 16-years BMIZ change between PUFA quartiles from multivariable linear mixed models with restricted cubic splines. At 16 years, we estimated differences in total fat mass (ToFM), truncal fat mass (TrFM), total lean mass (TLM), percent total fat mass (%ToFM) and percent truncal fat mass (%TrFM) between PUFA quartiles using linear regression. RESULTS PUFA were not associated with BMIZ change. Alpha-linolenic acid (ALA) was positively associated with TrFM (P = .03) and %TrFM (P < .0001) at 16 years while eicosapentaenoic acid (EPA) was inversely associated with %TrFM (P = .001). Docosapentaenoic acid (DPA) was positively associated with ToFM (P = .01), TrFM (P = .009), %ToFM (P = .02) and %TrFM (P = .02). Gamma-linolenic acid (GLA) and the Δ6-desaturase (D6D) activity index were each positively, linearly associated with ToFM, TrFM and %ToFM. The Δ5-desaturase (D5D) activity index was inversely associated with %TrFM (P = .04). CONCLUSIONS ALA, DPA, GLA and the D6D index at 1 year of age were positively associated with adiposity at age 16 years, while EPA and the D5D index were inversely associated with central adiposity. Our results related to EPA and desaturase indices are in agreement with limited prior studies.
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Affiliation(s)
- Kerry Flannagan
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Sheila Gahagan
- Division of Child Development and Community Health, University of California, San Diego, California, USA
| | - Arun Das
- Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Raquel Burrows
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Betsy Lozoff
- Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Eduardo Villamor
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
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Rezende LFM, Murata E, Giannichi B, Tomita LY, Wagner GA, Sanchez ZM, Celis-Morales C, Ferrari G. Cancer cases and deaths attributable to lifestyle risk factors in Chile. BMC Cancer 2020; 20:693. [PMID: 32711508 PMCID: PMC7382839 DOI: 10.1186/s12885-020-07187-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/16/2020] [Indexed: 01/10/2023] Open
Abstract
Background To identify modifiable risk factors that contribute to cancer holds important public health relevance for setting up prevention strategies. Therefore, the aim of this study was to estimate the proportion of cancer cases and deaths attributable to alcohol consumption, high body mass index (BMI), low fruits and vegetables consumption, lack of physical activity, tobacco smoking, and passive smoking in Chile in 2018. Methods We retrieved data from a national representative survey to describe the distribution of six lifestyle risk factors. Relative risks of each risk factor-cancer pair were obtained from published meta-analysis and pooled cohort studies. Cancer cases and deaths were obtained from the GLOBOCAN 2018. Results Nearly 30% of all cancer cases (15,097 out of 50,320 cases) and 36% of all cancer deaths (10,155 out of 28,010 deaths) in Chile in 2018 were attributable to lifestyle risk factors. Smoking and high BMI accounted for most of the cancer cases (9232 and 4394, respectively) and deaths (6868 and 2572). The cancer burden of other lifestyle risk factors varied by sex. In men, the proportion of all cancer cases attributed to alcohol were 3.7% compare to 2.0% for women. Cancers cases and deaths of the larynx, lung, oral/cavity, esophagus and bladder could be at least halved if lifestyle risk factors were eliminated. Conclusion Smoking and high BMI were the leading causes of preventable cancer cases and deaths within the six lifestyles factors considered. Cancer prevention strategies should consider evidence-based interventions and public policies to encourage the adoption of a healthier lifestyle.
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Affiliation(s)
- Leandro F M Rezende
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina Preventive, Sao Paulo, SP, Brazil
| | - Eliana Murata
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina Preventive, Sao Paulo, SP, Brazil
| | - Beatriz Giannichi
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina Preventive, Sao Paulo, SP, Brazil
| | - Luciana Yuki Tomita
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina Preventive, Sao Paulo, SP, Brazil
| | - Gabriela Arantes Wagner
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina Preventive, Sao Paulo, SP, Brazil
| | - Zila M Sanchez
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina Preventive, Sao Paulo, SP, Brazil
| | - Carlos Celis-Morales
- Centro de Investigación en Fisiología del Ejercicio - CIFE, Universidad Mayor, Santiago, Chile.,Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.,Laboratorio de Rendimiento Humano, Grupo de Estudio en Educación, Actividad Física y Salud (GEEAFyS), Universidad Católica del Maule, Talca, Chile
| | - Gerson Ferrari
- Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Facultad de Ciencias Médicas, Universidad de Santiago de Chile - USACH, Estación Central, 7500618, Santiago, Chile.
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Changes in diet quality over 10 years of nutrition transition in Colombia: analysis of the 2005 and 2015 nationally representative cross-sectional surveys. Int J Public Health 2020; 65:547-558. [PMID: 32632458 DOI: 10.1007/s00038-020-01396-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 05/07/2020] [Accepted: 05/20/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES To describe the changes in diet quality in Colombians using nationally representative samples from the 2005 and 2015 nutrition surveys. METHODS Repeated cross-sectional analyses of the National Nutrition Surveys from 2005 and 2015. Children (4-17 y.o.) and adults (≥ 18 y.o.) were included. The Alternative Healthy-Eating Index (AHEI) was derived from 24-h recall questionnaires and used to examine diet quality. RESULTS A total of 33,971 participants (20,122 children, 13,849 adults) were included in 2005, and 26,445 participants (15,304 children, 11,141 adults) in 2015. Over the ten-year period, the AHEI decreased from 46.3 to 44.3 in children (Cohen's d = 0.19) and from 49.0 to 46.2 in adults. (Cohen's d = 0.25). On average, those in the highest socioeconomic level had the worst diet quality; however, the difference between the less and most affluent groups shrank by 4.0% over the observation period. CONCLUSIONS Between 2005 and 2015, there was a worsening in the diet quality of Colombian children and adults. Less affluent individuals had a greater worsening of diet quality compared to groups from higher socioeconomic levels.
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Mbogori T, Kimmel K, Zhang M, Kandiah J, Wang Y. Nutrition transition and double burden of malnutrition in Africa: A case study of four selected countries with different social economic development. AIMS Public Health 2020; 7:425-439. [PMID: 32968668 PMCID: PMC7505783 DOI: 10.3934/publichealth.2020035] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 06/22/2020] [Indexed: 01/12/2023] Open
Abstract
Background Disease and lifestyle patterns have been changing rapidly especially in Africa due to transformation in economic development and urbanization. Research on the magnitude and consequences of these transformations in Africa is limited. This study investigates the shifts in nutritional status in children and adults in four selected low-, middle- and high-income countries in Africa, identifies factors associated with the shifts, and provides recommendations for future studies. Methods Malawi, Kenya, Ghana, and South Africa were selected based on their Gross Domestic Product (GDP). Nationally representative data were obtained from the 2017 Global Nutrition Report, Demographic Health Surveys (DHSs), and the World Health Organization (WHO) database. Prevalence of underweight, overweight, and obesity were assessed and compared across the countries, gender, residence, and over time. Results: South Africa had the highest GDP and largest prevalence of overweight and obesity rates in children < 5 years old and adults > 18 (13.3% and 51.9%, respectively). Malawi, with the lowest GDP, had the highest stunting rate (37.0%). In all 4 countries, but most notably in South Africa, trends indicated that the increasing prevalence of overweight and obesity was much greater than the declining rate of underweight. Malawi, Kenya, and Ghana had a slight decline in overweight prevalence in children under 5 years. Conclusions Nutritional shifts are occurring in Africa and seem to be heavily influenced by economic development. The double-burden of malnutrition presents prioritization challenges for policymakers. Attention needs to be shifted towards prevention of obesity, at least in the higher income countries in Africa.
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Affiliation(s)
- Teresia Mbogori
- Department of Nutrition and Health Sciences, Ball State University, 2000 W University Avenue, Muncie, Indiana 47306, USA
| | - Kilee Kimmel
- Department of Nutrition and Health Sciences, Ball State University, 2000 W University Avenue, Muncie, Indiana 47306, USA
| | - Mengxi Zhang
- Department of Nutrition and Health Sciences, Ball State University, 2000 W University Avenue, Muncie, Indiana 47306, USA
| | - Jay Kandiah
- Department of Nutrition and Health Sciences, Ball State University, 2000 W University Avenue, Muncie, Indiana 47306, USA
| | - Youfa Wang
- Department of Nutrition and Health Sciences, Ball State University, 2000 W University Avenue, Muncie, Indiana 47306, USA.,Systems-Oriented Global Childhood Obesity Intervention Program, Fisher Institute of Health and Well-being, Ball State University, 2000 W University Avenue, Muncie Indiana 47306, USA
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Aguayo GA, Schritz A, Ruiz-Castell M, Villarroel L, Valdivia G, Fagherazzi G, Witte DR, Lawson A. Identifying hotspots of cardiometabolic outcomes based on a Bayesian approach: The example of Chile. PLoS One 2020; 15:e0235009. [PMID: 32569307 PMCID: PMC7307745 DOI: 10.1371/journal.pone.0235009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 06/06/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND There is a need to identify priority zones for cardiometabolic prevention. Disease mapping in countries with high heterogeneity in the geographic distribution of the population is challenging. Our goal was to map the cardiometabolic health and identify hotspots of disease using data from a national health survey. METHODS Using Chile as a case study, we applied a Bayesian hierarchical modelling. We performed a cross-sectional analysis of the 2009-2010 Chilean Health Survey. Outcomes were diabetes (all types), obesity, hypertension, and high LDL cholesterol. To estimate prevalence, we used individual and aggregated data by province. We identified hotspots defined as prevalence in provinces significantly greater than the national prevalence. Models were adjusted for age, sex, their interaction, and sampling weight. We imputed missing data. We applied a joint outcome modelling approach to capture the association between the four outcomes. RESULTS We analysed data from 4,780 participants (mean age (SD) 46 (19) years; 60% women). The national prevalence (percentage (95% credible intervals) for diabetes, obesity, hypertension and high LDL cholesterol were 10.9 (4.5, 19.2), 30.0 (17.7, 45.3), 36.4 (16.4, 57.6), and 13.7 (3.4, 32.2) respectively. Prevalence of diabetes was lower in the far south. Prevalence of obesity and hypertension increased from north to far south. Prevalence of high LDL cholesterol was higher in the north and south. A hotspot for diabetes was located in the centre. Hotspots for obesity were mainly situated in the south and far south, for hypertension in the centre, south and far south and for high LDL cholesterol in the far south. CONCLUSIONS The distribution of cardiometabolic risk factors in Chile has a characteristic pattern with a general trend to a north-south gradient. Our approach is reproducible and demonstrates that the Bayesian approach enables the accurate identification of hotspots and mapping of disease, allowing the identification of areas for cardiometabolic prevention.
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Affiliation(s)
- Gloria A. Aguayo
- Population Health Department, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Anna Schritz
- Competence Center for Methodology and Statistics, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Maria Ruiz-Castell
- Population Health Department, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Luis Villarroel
- Department of Public Health, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Gonzalo Valdivia
- Department of Public Health, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Guy Fagherazzi
- Population Health Department, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Daniel R. Witte
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Danish Diabetes Academy, Odense, Denmark
| | - Andrew Lawson
- Department of Public Health Sciences, Medical University of South Carolina, South Carolina, Charleston, United States of America
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Von Holle A, North KE, Gahagan S, Burrows RA, Blanco E, Lozoff B, Howard AG, Justice A, Graff M, Voruganti VS. Sociodemographic predictors of early postnatal growth: evidence from a Chilean infancy cohort. BMJ Open 2020; 10:e033695. [PMID: 32499257 PMCID: PMC7282289 DOI: 10.1136/bmjopen-2019-033695] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES Infant anthropometric growth varies across socioeconomic factors, including maternal education and income, and may serve as an indicator of environmental influences in early life with long-term health consequences. Previous research has identified sociodemographic gradients in growth with a focus on the first year and beyond, but estimates are sparse for growth before 6 months. Thus, our objective was to examine the relationship between sociodemographic factors and infant growth patterns between birth and 5 months of age. DESIGN Prospective cohort study. SETTINGS Low-income to middle-income neighbourhoods in Santiago, Chile (1991-1996). PARTICIPANTS 1412 participants from a randomised iron-deficiency anaemia preventive trial in healthy infants. MAIN OUTCOME MEASURES Longitudinal anthropometrics including monthly weight (kg), length (cm) and weight-for-length (WFL) values. For each measure, we estimated three individual-level growth parameters (size, timing and velocity) from SuperImposition by Translation and Rotation models. Size and timing changes represent vertical and horizontal growth curve shifts, respectively, and velocity change represents growth rate shifts. We estimated the linear association between growth parameters and gestational age, maternal age, education and socioeconomic position (SEP). RESULTS Lower SEP was associated with a slower linear (length) velocity growth parameter (-0.22, 95% CI -0.31 to -0.13)-outcome units are per cent change in velocity from the average growth curve. Lower SEP was associated with later WFL growth timing as demonstrated through the tempo growth parameter for females (0.25, 95% CI 0.05 to 0.42)-outcome units are shifts in days from the average growth curve. We found no evidence of associations between SEP and the weight size, timing or velocity growth rate parameters. CONCLUSION Previous research on growth in older infants and children shows associations between lower SEP with slower length velocity. We found evidence supporting this association in the first 5 months of life, which may inform age-specific prevention efforts aimed at infant length growth.
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Affiliation(s)
- Ann Von Holle
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kari E North
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Sheila Gahagan
- Division of Child Development and Community Health, University of California San Diego, La Jolla, California, USA
| | - Raquel A Burrows
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Estela Blanco
- Division of Child Development and Community Health, University of California San Diego, La Jolla, California, USA
| | - Betsy Lozoff
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
| | - Annie Green Howard
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Anne Justice
- Center for Biomedical and Translational Informatics, Geisinger Health, Danville, Pennsylvania, USA
| | - Misa Graff
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Venkata Saroja Voruganti
- Department of Nutrition and UNC Nutrition Research Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Socioeconomic determinants of excess weight and obesity among Indigenous women: findings from the First National Survey of Indigenous People's Health and Nutrition in Brazil. Public Health Nutr 2020; 24:1941-1951. [PMID: 32476634 PMCID: PMC8094432 DOI: 10.1017/s1368980020000610] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Objective: This article assesses the nutritional status of Indigenous women from 14 to 49 years of age in Brazil. Design: Sample size was calculated for each region considering a prevalence of 50 % for all disease outcomes, a relative error of 5 % and a CI of 95 %. In the initial data analysis, the prevalence of excess weight and obesity was calculated according to independent variables. Multivariate multilevel hierarchical analyses were conducted based on a theoretical model of two ranked blocks. Setting: The 2010 Indigenous population in Brazil was 896 000, with approximately 300 Indigenous ethnic groups, making Brazil one of the most ethnically diverse countries in the Americas and the world. Participants: Of the total target sample of 6722 women evaluated by the National Survey, thirty did not participate, 939 were not eligible for analyses due to pregnancy or unknown pregnancy status, and thirty-nine were excluded due to missing anthropometric data. Results: The evaluation of nutritional status was completed for 5714 non-pregnant women (99·3 % of eligible participants for this outcome). High prevalence rates were encountered for both excess weight (46·2 %) and obesity (15·8 %) among the sampled women. In the multivariate analyses, higher socioeconomic indicators, market-integrated living conditions and less reliance on local food production, as well as increased age and parity were associated with excess weight and obesity. Conclusion: Results point to distinct patterns of associations between socioeconomic indicators and the occurrence of excess weight and obesity among Indigenous women, which have potentially significant implications from a public policy perspective for Indigenous peoples in Brazil.
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Medina I, Petermann-Rocha F, Waddell H, Díaz-Martínez X, Matus-Castillo C, Cigarroa I, Concha-Cisternas Y, Salas-Bravo C, Martínez-Sanguinetti MA, Celis-Morales C. Association between Different Modes of Travelling and Adiposity in Chilean Population: Findings from the Chilean National Health Survey 2016-2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103731. [PMID: 32466197 PMCID: PMC7277509 DOI: 10.3390/ijerph17103731] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/19/2020] [Accepted: 05/22/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND Active travel has been suggested as a feasible way of increasing physical activity levels. Although international studies have demonstrated its effect over different health outcomes and adiposity, there is still limited evidence on this topic in developing countries, such as Chile. AIM To investigate the associations between different types of travelling and markers of obesity in the Chilean adult population. METHODS 5411 participants from the Chilean National Health Survey 2016-2017 (CNHS) were included in this study. Active travel was assessed using a questionnaire. Car commuters, public transport (PT), walking and cycling were the four forms of travelling assessed. Bodyweight, body mass index and waist circumference were used as markers of adiposity. RESULTS Compared to car travellers, body weight, WC and BMI levels were lower for PT walking and cycling travellers. The odds for obesity (Odds ratio (OR): 0.41 (95% CI: 0.28; 0.61 p ≤ 0.001) were lower for walking and the odds (OR: 0.56 (95%CI: 0.35; 0.89 p = 0.014) for central obesity were significantly lower for cyclist in comparison to car travellers. Additionally, participation in any form of active travel (walking or cycling) was low, with only 20.9% of the population reporting being active travellers. CONCLUSION Active travel, such as walking and cycling, was associated with lower adiposity levels in the Chilean adult population. Promoting active travel could be a feasible strategy to tackle the high prevalence of obesity and physical inactivity in the Chilean population.
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Affiliation(s)
- Ignacio Medina
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, UK; (I.M.); (F.P.-R.); (H.W.)
| | - Fanny Petermann-Rocha
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, UK; (I.M.); (F.P.-R.); (H.W.)
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
| | - Heather Waddell
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, UK; (I.M.); (F.P.-R.); (H.W.)
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
- Medical Research Council Centre for Inflammation Research, The Queen’s Medical Research Institute, The University of Edinburgh, Edinburgh EH16 4TJ, UK
| | - Ximena Díaz-Martínez
- Grupo de Investigación en Calidad de Vida, Departamento de Ciencias de la Educación, Facultad de Educación y Humanidades, Universidad del Biobío, Chillán 378000, Chile
| | - Carlos Matus-Castillo
- Departamento de Ciencias del Deporte y Acondicionamiento Físico, Universidad Católica de la Santísima Concepción, Concepción 4090541, Chile;
| | - Igor Cigarroa
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Santiago 8370003, Chile; (I.C.); (Y.C.-C.)
| | - Yeny Concha-Cisternas
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Santiago 8370003, Chile; (I.C.); (Y.C.-C.)
- Pedagogía en Educación Física, Facultad de Educación, Universidad Autónoma de Chile, Talca 3467987, Chile
| | - Carlos Salas-Bravo
- Departamento de Educación Física, Facultad de Educación, Universidad de Concepción, Concepción 4070386, Chile
| | | | - Carlos Celis-Morales
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, UK; (I.M.); (F.P.-R.); (H.W.)
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
- Centro de Investigación en Fisiología del Ejercicio (CIFE), Universidad Mayor, Santiago 7510041, Chile
- Laboratorio de Rendimiento Humano, Grupo de Estudio en Educación, Actividad Física y Salud (GEEAFyS), Universidad Católica del Maule, Talca 3480112, Chile
- Correspondence: ; Tel.: +562-2518-9701
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Fernández CI. Nutrition Transition and Health Outcomes Among Indigenous Populations of Chile. Curr Dev Nutr 2020; 4:nzaa070. [PMID: 32352043 PMCID: PMC7180001 DOI: 10.1093/cdn/nzaa070] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 03/02/2020] [Accepted: 03/26/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Over the past several decades, rural and indigenous populations in Latin America have experienced abrupt and profound transformations in their lifestyles and economies, many having remarkable health consequences. Yet, these changes have had heterogeneous effects on the population's biology in different local contexts. OBJECTIVES The primary goal was to characterize the nutrition transition and biomarkers of noncommunicable diseases (NCD) risk in 2 Chilean indigenous populations that have had divergent histories of subsistence strategies (agropastoralism compared with hunter-gathering) in the last few millennia and live in contrasting environments, and to identify context-specific factors driving the nutrition and epidemiological transitions. METHODS One-hundred-and-ninety (90 Pehuenche and 100 Atacameño) participants aged 18-87 y completed demographic, food-frequency, and physical activity questionnaires as well as measurements of some NCD risk biomarkers: blood pressure, weight, height, body fat percentage, waist circumference, blood total cholesterol, HDL cholesterol, triglycerides, and glucose. Framingham risk scores (FRSs) were calculated based on age, sex, total cholesterol, HDL cholesterol, systolic blood pressure, smoking, diabetes status, and hypertension medication. RESULTS Few differences in dietary composition and physical activity patterns were observed between the 2 populations. Multivariate analyses showed no differences between the 2 populations in any of the individual NCD risk biomarkers or FRSs after adjusting for age, sex, time since last meal, food insecurity in childhood, ultraprocessed food consumption, and physical activity. CONCLUSIONS Despite contrasting ecological and historical contexts, the 2 groups are converging into similar processes of market and wage-labor integration and transitioning to a Western diet high in processed and nonlocal foods, although some aspects of their "traditional" foodways are still in practice. The frequency of individuals exhibiting NCD biomarkers "at-risk" is relatively high and corresponds to other populations that have gone through nutrition transition. Furthermore, none of these biomarkers or FRSs differed between the 2 populations, suggesting a homogenization in the NCD risk factors.
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Garmendia ML, Mondschein S, Montiel B, Kusanovic JP. Trends and predictors of gestational diabetes mellitus in Chile. Int J Gynaecol Obstet 2019; 148:210-218. [PMID: 31671205 DOI: 10.1002/ijgo.13023] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 09/04/2019] [Accepted: 10/30/2019] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To examine the temporal trends in gestational diabetes mellitus (GDM) prevalence in Chile, and to determine the main predictors of GDM. METHODS A secondary analysis was conducted of all birth records at Hospital Dr. Sótero del Río, Chile, from January 1, 2002, to December 31, 2015. We excluded those women with pre-existing type 2 diabetes, those with missing data, and those with unlikely data. GDM was defined as fasting glucose levels >5.55 mmol/L [>100 mg/dL] or >7.77 mmol/L [>140 mg/dL] 2 hours after glucose load in the oral glucose tolerance test. Potential predictors were selected based on prior research and ease of evaluation. RESULTS From the original database of 100 758 records, 86 362 women were included in the final cohort. The mean GDM prevalence was 7.6% (95% CI [confidence interval] 7.5%-7.8%), increasing from 4.4% (95% CI 4.0%-4.9%) in 2002 to 13.0% (95% CI 12.0%-13.9%) in 2015. Age, education, marital status, parity, family history of type 2 diabetes, personal history of GDM, hypertension and pre-eclampsia, alcohol consumption, smoking, and pre-gestational nutritional status performed well in the prediction of GDM. CONCLUSION One out of eight Chilean pregnant women of medium- to low socio-economic status were found to develop GDM. We identified a set of easy-to-capture predictors in the primary health care system that may allow for the early identification of women at high-risk for the development of GDM.
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Affiliation(s)
- María L Garmendia
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Susana Mondschein
- School of Engineering and Sciences, Adolfo Ibáñez University, Santiago, Chile
| | - Braulio Montiel
- School of Engineering and Sciences, Adolfo Ibáñez University, Santiago, Chile
| | - Juan P Kusanovic
- High Risk Pregnancy Unit, Center for Research and Innovation in Maternal-Fetal Medicine (CIMAF), Hospital Dr. Sótero del Río, Santiago, Chile.,Division of Obstetrics and Gynecology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
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Variation in dietary intake and body fatness by socioeconomic status among women in the context of Costa Rican nutrition transitions. J Biosoc Sci 2019; 52:230-247. [PMID: 31218982 DOI: 10.1017/s0021932019000403] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The Nutrition Transition model posits that vegetable oils, animal source foods (ASFs) and caloric sweeteners contribute to increases in adiposity and hence body mass index. Body mass index (BMI) is increasing more rapidly among Latin American populations of low versus high socioeconomic status (SES). The objectives of this study among Costa Rican women were to: (1) compare indicators of adiposity and dietary intake by SES and (2) evaluate the relationship between intake of foods high in vegetable oils, ASFs or caloric sweeteners and body fatness. This cross-sectional study, conducted in 2014-2015, included 128 low-, middle- and high-SES non-pregnant, non-lactating women aged between 25 and 45 years with 1-4 live births. Anthropometry was used to assess BMI, body composition and body fat distribution. Dietary recalls (n = 379) were used to assess dietary intake. Percentage body fat was greater in low- versus high-SES women (31.5 ± 3.9 vs 28.2 ± 4.7%). Skinfold measurements at four sites on the upper and lower body were greater in low- versus high-SES women. Body mass index did not vary in low- versus high-SES women. Intake frequency of foods high in vegetable oils was greater in low- and middle- (1.8 and 1.8 times/day, respectively) versus high- (1.1 times/day) SES women. For individual foods, intake frequency varied significantly by SES for high-fat condiments, fried vegetables, dairy, sweetened coffee/tea and pastries and desserts. Intake frequency of Nutrition Transition food categories was not associated with percentage body fat after adjustment for energy intake. Indicators of body composition provide additional information beyond BMI that are useful in understanding SES-adiposity associations in Latin America. Approaches to understanding diet and adiposity in Latin America that focus on vegetable oils, ASFs and caloric sweeteners should consider within-country variation in the pace of the Nutrition Transition, especially when explaining variation in adiposity by SES.
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Doom JR, Reid BM, Blanco E, Burrows R, Lozoff B, Gahagan S. Infant Psychosocial Environment Predicts Adolescent Cardiometabolic Risk: A Prospective Study. J Pediatr 2019; 209:85-91.e1. [PMID: 30876752 PMCID: PMC6535359 DOI: 10.1016/j.jpeds.2019.01.058] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 01/29/2019] [Accepted: 01/31/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To prospectively assess whether the infant psychosocial environment was associated with cardiometabolic risk as early as adolescence. STUDY DESIGN Participants were recruited in Santiago, Chile, and have been followed from infancy. Inclusion criteria included healthy infants with birth weight ≥3 kg and a stable caregiver. The psychosocial environment, including depressive symptoms, stressful life events, poor support for child development, father absence, and socioeconomic status, was reported by mothers at 6-12 months. Body mass index (BMI) z score was assessed at 5 and 10 years. BMI z score, waist-to-hip ratio, systolic and diastolic blood pressure, fat mass and body fat percentage, fasting glucose, total and high-density lipoprotein cholesterol, and homeostatic model of insulin resistance were tested in adolescence. RESULTS Adolescents ranged from 16 to 18 years of age (n = 588; 48.1% female). A poorer infant psychosocial environment was associated with BMI z score at 10 years (β = 0.10, 95% CI = 0.00-0.19) and in adolescence (β = 0.15, 95% CI = 0.06-0.24) but not at 5 years. A poorer infant psychosocial environment was associated with higher blood pressure (β = 0.15, 95% CI = 0.05-0.24), greater anthropometric risk (β = 0.13, 95% CI = 0.03-0.22), greater biomarker (triglycerides, homeostatic model assessment of insulin resistance, total cholesterol) risk (β = 0.12, 95% CI = 0.02-0.22), and a higher likelihood of metabolic syndrome in adolescence (aOR = 1.50; 95% CI = 1.06-2.12). CONCLUSIONS These findings demonstrate that a poorer infant psychosocial environment was associated with greater adolescent cardiometabolic risk. The results support screening for infants' psychosocial environments and further research into causality, mechanisms, prevention, and intervention.
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Affiliation(s)
- Jenalee R. Doom
- University of Michigan, Center for Human Growth & Development,University of Michigan, Department of Pediatrics
| | - Brie M. Reid
- University of Minnesota, Institute of Child Development
| | - Estela Blanco
- University of California San Diego, Department of Pediatrics,Doctoral Program in Public Health, School of Public Health, Universidad de Chile
| | - Raquel Burrows
- Universidad de Chile, Instituto de Nutrición y Tecnología de los Alimentos
| | - Betsy Lozoff
- University of Michigan, Center for Human Growth & Development,University of Michigan, Department of Pediatrics
| | - Sheila Gahagan
- University of Michigan, Center for Human Growth & Development,University of California San Diego, Department of Pediatrics
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Abstract
AbstractObjectiveThe present study aimed to identify nutrition transition (NT) profiles in Argentina (2005–2013) and assess their association with obesity in the adult population.DesignA large cross-sectional study was performed considering data sets of nationally representative surveys. A multiple correspondence analysis coupled with hierarchical clustering was conducted to detect geographical clusters of association among sociodemographic and NT indicators. Multilevel logistic regression models were used to assess the effect of NT profile (proxy variable of contextual order) on obesity occurrence.SettingFirst, we used geographically aggregated data about the adult and child populations in Argentina. Second, we defined the population of adults who participated in the National Survey of Chronic Disease Risk Factors (2013) as the study population.ParticipantsTwenty-four geographical units that make up the territory of Argentina and 32 365 individuals over 18 years old living in towns of at least 5000 people.ResultsThree NT profiles were identified: ‘Socionutritional lag’ (characterized by undernutrition and socio-economically disadvantaged conditions; profile 1); ‘Double burden of malnutrition’ (undernutrition and overweight in highly urbanized scenarios; profile 2); and ‘Incipient socionutritional improvement’ (low prevalence of malnutrition and more favourable poverty indicator values; profile 3). Profiles 1 and 2 were significantly associated (OR; 95 % CI) with a higher risk of obesity occurrence in adults (1·17; 1·02, 1·32 and 1·44; 1·26, 1·64, respectively) compared with profile 3.ConclusionsArgentina is facing different NT processes, where sociodemographic factors play a major role in shaping diverse NT profiles. Most of the identified profiles were linked to obesity burden in adults.
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Justice AE, Chittoor G, Blanco E, Graff M, Wang Y, Albala C, Santos JL, Angel B, Lozoff B, Voruganti VS, North KE, Gahagan S. Genetic determinants of BMI from early childhood to adolescence: the Santiago Longitudinal Study. Pediatr Obes 2019; 14:e12479. [PMID: 30515969 PMCID: PMC6696926 DOI: 10.1111/ijpo.12479] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 08/24/2018] [Accepted: 09/13/2018] [Indexed: 01/05/2023]
Abstract
BACKGROUND While the genetic contribution to obesity is well established, few studies have examined how genetic variants influence standardized body mass index Z-score (BMIz) in Hispanics/Latinos, especially across childhood and adolescence. OBJECTIVES We estimated the effect of established BMIz loci in Chilean children of the Santiago Longitudinal Study (SLS). METHODS We examined associations with BMIz at age 10 for 15 loci previously identified in European children. For significant loci, we performed association analyses at ages 5 and 16 years, for which we have smaller sample sizes. We tested associations of unweighted genetic risk scores (GRSs) for previously identified tag variants (GRS_EUR) and from the most significant variants in SLS at each locus (GRS_SLS). RESULTS We generalized five variants at age 10 (P < 0.05 and directionally consistent), including rs543874 that reached Bonferroni-corrected significance. The effect on BMIz was greatest at age 10 for all significant loci, except FTO, which exhibited an increase in effect from ages 5 to 16. Both GRSs were associated with BMIz (P < 0.0001), but GRS_SLS explained a much greater proportion of the variation (13.63%). CONCLUSION Our results underscore the importance of conducting genetic investigations across life stages and selecting ancestry appropriate tag variants in future studies for disease prediction and clinical evaluation.
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Affiliation(s)
- Anne E. Justice
- Biomedical and Translational Informatics, Geisinger, Danville, PA, USA,Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel
Hill, Chapel Hill, NC, USA
| | - Geetha Chittoor
- Biomedical and Translational Informatics, Geisinger, Danville, PA, USA,Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel
Hill, Chapel Hill, NC, USA
| | - Estela Blanco
- Division of Academic General Pediatrics, Child Development and Community Health at the Center for Community
Health, University of California at San Diego, San Diego, CA, USA
| | - Mariaelisa Graff
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel
Hill, Chapel Hill, NC, USA
| | - Yujie Wang
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel
Hill, Chapel Hill, NC, USA
| | - Cecilia Albala
- Department of Public Health Nutrition, Institute of Nutrition and Food Technology (INTA), University of
Chile, Santiago, Chile
| | - José L. Santos
- Department of Nutrition, Diabetes and Metabolism, School of Medicine, Pontificia Universidad Católica
de Chile, Santiago, Chile
| | - Bárbara Angel
- Department of Public Health Nutrition, Institute of Nutrition and Food Technology (INTA), University of
Chile, Santiago, Chile
| | - Betsy Lozoff
- Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI, USA
| | - V. Saroja Voruganti
- Department of Nutrition and Nutrition Research Institute, University of North Carolina at Chapel Hill,
Kannapolis NC 28081, USA
| | - Kari E. North
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel
Hill, Chapel Hill, NC, USA
| | - Sheila Gahagan
- Division of Academic General Pediatrics, Child Development and Community Health at the Center for Community
Health, University of California at San Diego, San Diego, CA, USA
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Changes in socio-economic status and lipoproteins in Chilean adolescents: a 16-year longitudinal study. Public Health Nutr 2018; 22:344-353. [PMID: 30472968 DOI: 10.1017/s1368980018003087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The present longitudinal study assessed whether changes in socio-economic status (SES) from infancy to adolescence were associated with plasma lipoprotein concentrations in adolescence, of which low HDL-cholesterol (HDL-C) and high LDL-cholesterol (LDL-C), TAG and total cholesterol (TC) concentrations are associated with higher cardiovascular risk. DESIGN SES, assessed using the modified Graffar Index, was calculated at 1, 5, 10 and 16 years. Principal components factor analysis with varimax rotation extracted two orthogonal SES factors, termed 'environmental capital' and 'social capital'. Generalized linear models were used to analyse associations between environmental and social capital at 1 and 16 years and outcomes (HDL-C, LDL-C, TAG, TC) at 16 years, as well as changes in environmental and social capital from 1-5, 5-10, 10-16 and 1-16 years, and outcomes at 16 years. SETTING Santiago, Chile.ParticipantsWe evaluated 665 participants from the Santiago Longitudinal Study enrolled at infancy in Fe-deficiency anaemia studies and examined every 5 years to age 16 years. RESULTS Social capital in infancy was associated with higher HDL-C in adolescence. Environmental capital in adolescence was associated with higher LDL-C and TC during adolescence. Changing environmental capital from 1-16 years was associated with higher LDL-C. Changing environmental capital from 1-5 and 1-16 years was associated with higher TC. CONCLUSIONS Improvements in environmental capital throughout childhood were associated with less healthy LDL-C and TC concentrations in adolescence. We found no evidence of associations between changing environmental capital and HDL-C or TAG, or changing social capital and HDL-C, LDL-C, TAG or TC.
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Trends of weight gain and prevalence of overweight and obesity from birth to three years of age. Obes Res Clin Pract 2018; 13:6-11. [PMID: 30424971 DOI: 10.1016/j.orcp.2018.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 10/25/2018] [Accepted: 10/28/2018] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To examine the changes in children's weight-for-height at six monthly intervals between birth and three years old (3yo) from different counties across Chile and to determine if children had overweight or obesity, and if so, whether it was a transient or persistent change. SUBJECTS AND METHODS Longitudinal data were obtained from routine medical check-ups and 8,373 children were selected from nine counties in Chile through a non-randomised sample design. Weight-for-height z-scores (WHZ) were generated and categorized as wasted, normal, overweight, and obese using WHO standards. Repeated-measures ANOVA were used to analyse the changes in WHZ over the seven measurements as well as based on having normal, overweight, or obese WHZ at 3yo. The number of times having overweight or obesity was counted (from 0 to 7 times). The timing of having overweight and obesity was computed as well as all combinations of the patterns. RESULTS Mean WHZ significantly increased up to 18months of age and declined thereafter (p<<0.001). Overall mean WHZ was 0.743, prevalence of overweight 31.2% and prevalence of obesity 10.0%. Children categorised with overweight or obesity at 3yo showed significantly higher and sustained pattern of weight gain compared with children with normal WHZ. Once a child had overweight or obesity they tended to remain with it and did not return to a weight-for-height in the normal range. CONCLUSION The increasing prevalence of overweight and obesity in Chilean children is of concern. There is a need for greater healthcare promotion and prevention of this disease from infancy.
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Yu AYL, López-Olmedo N, Popkin BM. Analysis of dietary trends in Chinese adolescents from 1991 to 2011. Asia Pac J Clin Nutr 2018; 27:1106-1119. [PMID: 30272859 PMCID: PMC6298787 DOI: 10.6133/apjcn.042018.02] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND OBJECTIVES To examine temporal trends in dietary energy, fat, carbohydrate, protein, sodium and potassium intake of Chinese adolescents aged 12 - 17 years by sex and urbanicity, using data from the China Health and Nutrition Survey. METHODS AND STUDY DESIGN Individual level, consecutive 3 - day 24-hour recalls were analyzed from survey years 1991 (n=504), 2000 (n=665), and 2011 (n=267) from nine provinces representing a range of geography, economic development, and health indicators in China. Linear multivariable regression models were conducted to predict mean intakes of energy, macronutrients, sodium, and potassium. Models were adjusted for age, per capita income, parental education, region, and family size. RESULTS From 1991 to 2011, total energy consumption decreased among both sexes and all urbanicity groups (p<0.05). Sodium intake decreased in all sex and urbanicity groups except the high urbanicity group, which was the only group to show significant change in potassium intake (p<0.05). Sodium-potassium ratios decreased overall and across both sexes (p<0.05). However, the major observed shift was a structural change from carbohydrates to fat and protein. Both sexes showed decrease in carbohydrate-derived energy (p<0.05). Proportion of fat-derived energy increased in female adolescents. Proportion of protein-derived energy increased in male adolescents, as well as in the low and high urbanicity groups (p<0.01). CONCLUSIONS This suggests Chinese adolescents are transitioning to a low carbohydrate diet. Urbanicity appears to play a role in sodium, potassium and protein intake. Improvements of sodiumpotassium ratios are primarily due to decreased sodium intake and require further reduction efforts.
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Affiliation(s)
- Alice Yunzi L Yu
- Department of Nutrition, University of North Carolina at Chapel Hill, USA
| | - Nancy López-Olmedo
- Department of Nutrition, University of North Carolina at Chapel Hill, USA
| | - Barry M Popkin
- Department of Nutrition, University of North Carolina at Chapel Hill, USA.
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Popkin BM, Reardon T. Obesity and the food system transformation in Latin America. Obes Rev 2018; 19:1028-1064. [PMID: 29691969 PMCID: PMC6103889 DOI: 10.1111/obr.12694] [Citation(s) in RCA: 240] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 03/01/2018] [Accepted: 03/16/2018] [Indexed: 02/06/2023]
Abstract
The Latin America and the Caribbean (LAC) region faces a major diet-related health problem accompanied by enormous economic and social costs. The shifts in diet are profound: major shifts in intake of less-healthful low-nutrient-density foods and sugary beverages, changes in away-from-home eating and snacking and rapid shifts towards very high levels of overweight and obesity among all ages along with, in some countries, high burdens of stunting. Diet changes have occurred in parallel to, and in two-way causality with, changes in the broad food system - the set of supply chains from farms, through midstream segments of processing, wholesale and logistics, to downstream segments of retail and food service (restaurants and fast food chains). An essential contribution of this piece is to marry and integrate the nutrition transition literature with the literature on the economics of food system transformation. These two literatures and debates have been to date largely 'two ships passing in the night'. This review documents in-depth the recent history of rapid growth and transformation of that broad food system in LAC, with the rapid rise of supermarkets, large processors, fast food chains and food logistics firms. The transformation is the story of a 'double-edged sword', showing its links to various negative diet side trends, e.g. the rise of consumption of fast food and highly processed food, as well as in parallel, to various positive trends, e.g. the reduction of the cost of food, de-seasonalization, increase of convenience of food preparation reducing women's time associated with that and increase of availability of some nutritious foods like meat and dairy. We view the transformation of the food system, as well as certain aspects of diet change linked to long-run changes in employment and demographics (e.g. the quest for convenience), as broad parameters that will endure for the next decades without truly major regulatory and fiscal changes. We then focus in on what are the steps that are being and can be taken to curb the negative effects on diet of these changes. We show that countries in LAC are already among the global leaders in initiating demand-related solutions via taxation and marketing controls. But we also show that this is only a small step forward. To shift LAC's food supply towards prices that incentivize consumption of healthier diets and demand away from the less healthy component is not simple and will not happen immediately. We must be cognizant that ultimately, food industry firms must be incentivized to market the components of healthy diets. This will primarily need to be via selective taxes and subsidies, marketing controls, as well as food quality regulations, consumer education and, in the medium term, consumers' desires to combine healthier foods with their ongoing quest for convenience in the face of busy lives. In the end, the food industry in LAC will orient itself towards profitable solutions, ie those demanded by the broad mass of consumers.
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Affiliation(s)
- B M Popkin
- Department of Nutrition, Gillings School of Global Public Health, Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - T Reardon
- Department of Agricultural, Food, and Resource Economics, Michigan State University, East Lansing, MI, USA
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Retamal R, Mascie-Taylor CGN. Regional variation in weight-for-height z
-scores and surface area/body mass ratio of Chilean children from birth to 3 years of age. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2018; 167:72-83. [DOI: 10.1002/ajpa.23605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 04/17/2018] [Accepted: 04/18/2018] [Indexed: 12/21/2022]
Affiliation(s)
- Rodrigo Retamal
- Departamento de Antropología, Facultad de Ciencias Sociales; Universidad de Chile; Santiago Chile
| | - C. G. Nicholas Mascie-Taylor
- Division of Biological Anthropology, Department of Archaeology and Anthropology; University of Cambridge; Cambridge United Kingdom
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Doom JR, Richards B, Caballero G, Delva J, Gahagan S, Lozoff B. Infant Iron Deficiency and Iron Supplementation Predict Adolescent Internalizing, Externalizing, and Social Problems. J Pediatr 2018; 195:199-205.e2. [PMID: 29395182 PMCID: PMC5869133 DOI: 10.1016/j.jpeds.2017.12.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 10/25/2017] [Accepted: 12/01/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To evaluate associations between iron supplementation and iron deficiency in infancy and internalizing, externalizing, and social problems in adolescence. STUDY DESIGN The study is a follow-up of infants as adolescents from working-class communities around Santiago, Chile who participated in a preventive trial of iron supplementation at 6 months of age. Inclusionary criteria included birth weight ≥3.0 kg, healthy singleton term birth, vaginal delivery, and a stable caregiver. Iron status was assessed at 12 and 18 months of age. At 11-17 years of age, internalizing, externalizing, and social problems were reported by 1018 adolescents with the Youth Self Report and by parents with the Child Behavior Checklist. RESULTS Adolescents who received iron supplementation in infancy had greater self-reported attention-deficit/hyperactivity disorder but lower parent-reported conduct disorder symptoms than those who did not (Ps < .05). Iron deficiency with or without anemia at 12 or 18 months of age predicted greater adolescent behavior problems compared with iron sufficiency: more adolescent-reported anxiety and social problems, and parent-reported social, post-traumatic stress disorder, attention-deficit/hyperactivity disorder, oppositional defiant, conduct, aggression, and rule breaking problems (Ps < .05). The threshold was iron deficiency with or without anemia for each of these outcomes. CONCLUSIONS Iron deficiency with or without anemia in infancy was associated with increased internalizing, externalizing, and social problems in adolescence.
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Affiliation(s)
- Jenalee R. Doom
- Center for Human Growth and Development, University of Michigan
| | - Blair Richards
- Center for Human Growth and Development, University of Michigan
| | | | - Jorge Delva
- School of Social Work, University of Michigan
| | - Sheila Gahagan
- Division of Child Development and Community Health, University of California, San Diego
| | - Betsy Lozoff
- Center for Human Growth and Development, University of Michigan,Department of Pediatrics and Communicable Diseases, Medical School, University of Michigan
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Dietary sources of energy and nutrients in the contemporary diet of Inuit adults: results from the 2007–08 Inuit Health Survey. Public Health Nutr 2018; 21:1319-1331. [DOI: 10.1017/s1368980017003810] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectiveTo characterize the major components of the contemporary Inuit diet and identify the primary sources of energy and essential nutrients.DesignDietary data were derived from the 24 h recall collected by the Inuit Health Survey (IHS) from 2007 to 2008. The population proportion method was used to determine the percentage contribution of each group. Unique food items/preparations (ninety-three country foods and 1591 market foods) were classified into eight country food groups and forty-one market food groups. Nutrient composition of each food item was obtained from the Canadian Nutrient File.SettingThirty-six communities across three Inuit regions of northern Canada.SubjectsA representative sample (n2095) of non-pregnant Inuit adults (≥18 years), selected through stratified random sampling.ResultsDespite their modest contribution to total energy intake (6·4–19·6 %, by region) country foods represented a major source of protein (23–52 %), Fe (28–54 %), niacin (24–52 %) and vitamins D (up to 73 %), B6(18–55 %) and B12(50–82 %). By contrast, the three most popular energy-yielding market foods (i.e. sweetened beverages, added sugar and bread) collectively contributed approximately 20 % of total energy, while contributing minimally to most micronutrients. A notable exception was the contribution of these foods to Ca (13–21 %) and vitamins E (17–35 %) and C (as much as 50 %). Solid fruits were consumed by less than 25 % of participants while vegetables were reported by 38–59 % of respondents.ConclusionsCountry foods remain a critical dimension of the contemporary Inuit diet.
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Badillo P, Salgado P, Bravo P, Guevara K, Acurio J, Gonzalez MA, Oyarzun C, San Martin R, Escudero C. High plasma adenosine levels in overweight/obese pregnant women. Purinergic Signal 2017; 13:479-488. [PMID: 28721552 PMCID: PMC5714837 DOI: 10.1007/s11302-017-9574-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Accepted: 07/06/2017] [Indexed: 10/19/2022] Open
Abstract
We aim to investigate whether overweight/obese pregnant women have elevated plasma levels of adenosine associated with increased consumption of high-calorie food. Sixty women were included. They were divided into lean (n = 23 and n = 12) or overweight/obese (n = 7 and n = 18) non-pregnant and pregnant women, respectively. Clinical records and maternal blood samples were collected after informed consent. A self-reported dietary questionnaire was also completed. Plasma adenosine levels were determined with high-performance liquid chromatography. Biochemical parameters, including glucose, total protein, and lipid profile, were determined using standard colorimetric assays. Adenosine levels were higher in pregnant women than in non-pregnant women (18.7 ± 1.6 vs 10.8 ± 1.3 nM/μg protein, respectively, p < 0.0001). Overweight/obese pregnant women (21.9 ± 2.5 nM/μg protein) exhibited higher adenosine levels than lean pregnant (14.5 ± 1.0 nM/μg protein, p = 0.04) or non-pregnant women (11.7 ± 1.5 nM/μg protein, p = 0.0005). Also, pregnant women with elevated weight gain exhibited higher (26.2 ± 3.7 nM/μg protein) adenosine levels than those with adequate weight gain (14.9 ± 1.4 nM/μg protein, p = 0.03). These differences were not statistically significant compared with those of pregnant women with reduced weight gain (17.4 ± 2.1 nM/μg protein, p = 0.053). Body mass index and adenosine only in pregnant women were positively correlated (r = 0.39, p = 0.02). While, polyunsaturated fatty acid (PUFA) consumption was negatively correlated with plasma adenosine levels only in non-pregnant women (r = -0.33, p = 0.03). Pregnancy is associated with high plasma adenosine levels, which are further elevated in pregnant women who are overweight/obese. High PUFA intake might reduce plasma adenosine levels in non-pregnant women.
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Affiliation(s)
- Priscila Badillo
- Vascular Physiology Laboratory, Group of Investigation in Tumor Angiogenesis (LFV-GIANT), University of Bío-Bío, Chillán, Chile
| | - Paola Salgado
- Vascular Physiology Laboratory, Group of Investigation in Tumor Angiogenesis (LFV-GIANT), University of Bío-Bío, Chillán, Chile
| | - Patricia Bravo
- Vascular Physiology Laboratory, Group of Investigation in Tumor Angiogenesis (LFV-GIANT), University of Bío-Bío, Chillán, Chile
| | - Katherine Guevara
- Vascular Physiology Laboratory, Group of Investigation in Tumor Angiogenesis (LFV-GIANT), University of Bío-Bío, Chillán, Chile
| | - Jesenia Acurio
- Vascular Physiology Laboratory, Group of Investigation in Tumor Angiogenesis (LFV-GIANT), University of Bío-Bío, Chillán, Chile
- Group of Research and Innovation in Vascular Health (GRIVAS Health), University of Bío-Bío, Chillán, Chile
- Department of Basic Sciences, University of Bío-Bío, Chillán, Chile
| | - Maria Angelica Gonzalez
- Department of Nutrition, Health and Food Sciences Faculty, University of Bío-Bío, Chillán, Chile
| | - Carlos Oyarzun
- Laboratorio de Patologia Molecular, Instituto de Bioquimica y Microbiologia, Facultad de Ciencias, Universidad Austral de Chile, Campus Isla Teja, P.O. Box 567, Valdivia, Chile
| | - Rody San Martin
- Laboratorio de Patologia Molecular, Instituto de Bioquimica y Microbiologia, Facultad de Ciencias, Universidad Austral de Chile, Campus Isla Teja, P.O. Box 567, Valdivia, Chile
| | - Carlos Escudero
- Vascular Physiology Laboratory, Group of Investigation in Tumor Angiogenesis (LFV-GIANT), University of Bío-Bío, Chillán, Chile.
- Group of Research and Innovation in Vascular Health (GRIVAS Health), University of Bío-Bío, Chillán, Chile.
- Department of Basic Sciences, University of Bío-Bío, Chillán, Chile.
- Department of Nutrition, Health and Food Sciences Faculty, University of Bío-Bío, Chillán, Chile.
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Abstract
AbstractOut-of-home foods (takeaway, take-out and fast foods) have become increasingly popular in recent decades and are thought to be a key driver in increasing levels of overweight and obesity due to their unfavourable nutritional content. Individual food choices and eating behaviours are influenced by many interrelated factors which affect the results of nutrition-related public health interventions. While the majority of research based on out-of-home foods comes from Australia, the UK and USA, the same issues (poor dietary habits and increased prevalence of non-communicable disease) are of equal concern for urban centres in developing economies undergoing ‘nutrition transition’ at a global scale. The present narrative review documents key facets, which may influence out-of-home food consumption, drawn from biological, societal, environmental, demographic and psychological spheres. Literature searches were performed and references from relevant papers were used to find supplementary studies. Findings suggest that the strongest determinants of out-of-home food availability are density of food outlets and deprivation within the built environment; however, the association between socio-economic status and out-of-home food consumption has been challenged. In addition, the biological and psychological drives combined with a culture where overweight and obesity are becoming the norm makes it ‘fashionable’ to consume out-of-home food. Other factors, including age group, ethnicity and gender demonstrate contrasting effects and a lack of consensus. It is concluded that further consideration of the determinants of out-of-home food consumption within specific populations is crucial to inform the development of targeted interventions to reduce the impact of out-of-home foods on public health.
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Fujio-Vejar S, Vasquez Y, Morales P, Magne F, Vera-Wolf P, Ugalde JA, Navarrete P, Gotteland M. The Gut Microbiota of Healthy Chilean Subjects Reveals a High Abundance of the Phylum Verrucomicrobia. Front Microbiol 2017; 8:1221. [PMID: 28713349 PMCID: PMC5491548 DOI: 10.3389/fmicb.2017.01221] [Citation(s) in RCA: 176] [Impact Index Per Article: 25.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 06/16/2017] [Indexed: 12/31/2022] Open
Abstract
The gut microbiota is currently recognized as an important factor regulating the homeostasis of the gastrointestinal tract and influencing the energetic metabolism of the host as well as its immune and central nervous systems. Determining the gut microbiota composition of healthy subjects is therefore necessary to establish a baseline allowing the detection of microbiota alterations in pathologic conditions. Accordingly, the aim of this study was to characterize the gut microbiota of healthy Chilean subjects using 16S rRNA gene sequencing. Fecal samples were collected from 41 young, asymptomatic, normal weight volunteers (age: 25 ± 4 years; ♀:48.8%; BMI: 22.5 ± 1.6 kg/m2) with low levels of plasma (IL6 and hsCRP) and colonic (fecal calprotectin) inflammatory markers. The V3-V4 region of the 16S rRNA gene of bacterial DNA was amplified and sequenced using MiSeq Illumina system. 109,180 ± 13,148 sequences/sample were obtained, with an α-diversity of 3.86 ± 0.37. The dominant phyla were Firmicutes (43.6 ± 9.2%) and Bacteroidetes (41.6 ± 13.1%), followed by Verrucomicrobia (8.5 ± 10.4%), Proteobacteria (2.8 ± 4.8%), Actinobacteria (1.8 ± 3.9%) and Euryarchaeota (1.4 ± 2.7%). The core microbiota representing the genera present in all the subjects included Bacteroides, Prevotella, Parabacteroides (phylum Bacteroidetes), Phascolarctobacterium, Faecalibacterium, Ruminococcus, Lachnospira, Oscillospira, Blautia, Dorea, Roseburia, Coprococcus, Clostridium, Streptococcus (phylum Firmicutes), Akkermansia (phylum Verrucomicrobia), and Collinsella (phylum Actinobacteria). Butyrate-producing genera including Faecalibacterium, Roseburia, Coprococcus, and Oscillospira were detected. The family Methanobacteriaceae was reported in 83% of the subjects and Desulfovibrio, the most representative sulfate-reducing genus, in 76%. The microbiota of the Chilean individuals significantly differed from those of Papua New Guinea and the Matses ethnic group and was closer to that of the Argentinians and sub-populations from the United States. Interestingly, the microbiota of the Chilean subjects stands out for its richness in Verrucomicrobia; the mucus-degrading bacterium Akkermansia muciniphila is the only identified member of this phylum. This is an important finding considering that this microorganism has been recently proposed as a hallmark of healthy gut due to its anti-inflammatory and immunostimulant properties and its ability to improve gut barrier function, insulin sensitivity and endotoxinemia. These results constitute an important baseline that will facilitate the characterization of dysbiosis in the main diseases affecting the Chilean population.
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Affiliation(s)
- Sayaka Fujio-Vejar
- Laboratory of Microbiology and Probiotics, Institute of Nutrition and Food Technology, University of ChileSantiago, Chile.,Department of Nutrition, Faculty of Medicine, University of ChileSantiago, Chile
| | - Yessenia Vasquez
- Centro de Genética y Genómica, Facultad de Medicina, Clínica Alemana Universidad del DesarrolloSantiago, Chile
| | - Pamela Morales
- Department of Nutrition, Faculty of Medicine, University of ChileSantiago, Chile
| | - Fabien Magne
- Microbiology and Mycology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of ChileSantiago, Chile
| | - Patricia Vera-Wolf
- Centro de Genética y Genómica, Facultad de Medicina, Clínica Alemana Universidad del DesarrolloSantiago, Chile
| | - Juan A Ugalde
- Centro de Genética y Genómica, Facultad de Medicina, Clínica Alemana Universidad del DesarrolloSantiago, Chile
| | - Paola Navarrete
- Laboratory of Microbiology and Probiotics, Institute of Nutrition and Food Technology, University of ChileSantiago, Chile
| | - Martin Gotteland
- Laboratory of Microbiology and Probiotics, Institute of Nutrition and Food Technology, University of ChileSantiago, Chile.,Department of Nutrition, Faculty of Medicine, University of ChileSantiago, Chile
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Araya BM, Díaz M, Paredes D, Ortiz J. Association between preterm birth and its subtypes and maternal sociodemographic characteristics during the post-transitional phase in a developing country with a very high human development index. Public Health 2017; 147:39-46. [PMID: 28404494 DOI: 10.1016/j.puhe.2017.01.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 11/28/2016] [Accepted: 01/27/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Chile is a post-transitional country evolving towards a stationary population pyramid, which may be associated with increasing preterm birth (PTB) rates. This study aimed to compare maternal sociodemographic characteristics between the start of the post-transition phase (1994) and an established stage (2013) and to evaluate associations between these characteristics and PTB. STUDY DESIGN An observational analytic design was conducted using national birth records (n = 4,956,311). METHODS Variables analysed in the 20 birth cohorts from 1994 to 2013 were: length of gestation (preterm <37 weeks) subdivided by gestational age (extreme, moderate/severe and late); maternal age (≤19, 20-35 and >35 years); education level (<8, 8-12 and >12 years of education); employment; marital status; area of residence; and type of birth (singleton, twins, and triplets or higher order). The prevalence of PTB was expressed as a percentage, and associations between PTB and predictor variables were analysed using logistic regression models. RESULTS Education level, age >35 years, maternal employment, unmarried status, twin delivery and urban residency rates increased between 1994 and 2013. According to the adjusted models, age >35 years and delivery of more than two foetuses were risk factors for all PTB subtypes. Maternal employment was a risk factor for moderate/severe, late and total PTB, and a low level of education was a risk factor for late and total PTB. On the other hand, age ≤19 years was protective against all PTB subtypes. CONCLUSIONS All maternal characteristics changed between 1994 and 2013. Furthermore, the prevalence of PTB increased for all predictor variables studied over this period.
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Affiliation(s)
- B M Araya
- Department of Women and Newborn Health Promotion, Faculty of Medicine, University of Chile, Santiago, Chile.
| | - M Díaz
- Department of Women and Newborn Health Promotion, Faculty of Medicine, University of Chile, Santiago, Chile
| | - D Paredes
- Department of Women and Newborn Health Promotion, Faculty of Medicine, University of Chile, Santiago, Chile
| | - J Ortiz
- Department of Women and Newborn Health Promotion, Faculty of Medicine, University of Chile, Santiago, Chile
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Temporal Trends in Dietary Macronutrient Intakes among Adults in Rural China from 1991 to 2011: Findings from the CHNS. Nutrients 2017; 9:nu9030227. [PMID: 28273878 PMCID: PMC5372890 DOI: 10.3390/nu9030227] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 02/16/2017] [Accepted: 02/18/2017] [Indexed: 12/11/2022] Open
Abstract
Few studies have examined nutrition transitions among the rural population of China, even though half of the Chinese population (about 700 million) is living in rural China. To fill this research gap, we examined temporal trends in dietary macronutrient intakes in members of the Chinese rural population aged 18-60 years. The analysis used data from consecutive three-day dietary recalls, collected from the China Health and Nutrition Surveys (CHNS). Mixed-effect models were constructed to obtain adjusted means and to examine temporal trends after adjusting for intra-class correlation within clusters and covariates, including age, sex, geographical region, urbanicity, and income. From 1991 to 2011, a downward trend in daily energy, protein, and carbohydrate intakes was seen in all categories, with a significant reduction among all rural people (p < 0.0001). In contrast, a significant increment in daily fat intake, the proportion of energy from fat, and the proportion of rural people consuming a diet with more than 30% of energy from fat, were observed in the present study (p < 0.0001). These results suggest that adults in rural China have been undergoing a rapid nutrition transition towards a high-fat diet. Therefore, more emphasis should be placed on the quality of fat and maintaining a balanced diet during the process of nutritional education.
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ASSOCIATION BETWEEN BODY COMPOSITION, SOMATOTYPE AND SOCIOECONOMIC STATUS IN CHILEAN CHILDREN AND ADOLESCENTS AT DIFFERENT SCHOOL LEVELS. J Biosoc Sci 2017; 50:53-69. [PMID: 28238292 DOI: 10.1017/s0021932017000025] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This study examined the association between body composition, somatotype and socioeconomic status (SES) in Chilean children and adolescents by sex and school level (grade). The cross-sectional study was conducted on 1168 schoolchildren aged 6-18 years (572 males) from Valparaíso, Chile. Body composition, as assessed by percentage body fat (BF%) and somatotype, was evaluated using Ellis equations and the Heath-Carter method, respectively. The socioeconomic status of respondents was assessed using the ESOMAR survey. Obesity was defined as BF% ≥25 for boys and ≥30 for girls; 'high endomorph' somatotype was defined as a somatotype endomorph component (EC) of at least 5.5. Logistic regression analysis was used to assess the relationship between high adiposity and SES, potential confounding factors and school level. In females, the results indicated that the groups with lower SES had higher EC. At the 1st (youngest) school level (1-4th grades), males exhibited similar trends in their BF% and EC. High adiposity was associated with the female sex (BF%: OR=3.39; 95% CI 2.60, 4.41; high EC: OR=2.31; 95% CI 1.80, 2.98). In addition, low SES increased the risk of high adiposity compared with high SES (BF%: OR=2.25; 95% CI 1.40, 3.61; high EC: OR=2.19; 95% CI 1.37, 3.47). An association was observed between increased adiposity and lower SES, mainly in females, which indicates that females with low SES might be at greater risk of obesity.
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San Martin R, Brito J, Siques P, León-Velarde F. Obesity as a Conditioning Factor for High-Altitude Diseases. Obes Facts 2017; 10:363-372. [PMID: 28810235 PMCID: PMC5644942 DOI: 10.1159/000477461] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 05/10/2017] [Indexed: 12/19/2022] Open
Abstract
Obesity, a worldwide epidemic, has become a major health burden because it is usually accompanied by an increased risk for insulin resistance, diabetes, hypertension, cardiovascular diseases, and even some kinds of cancer. It also results in associated increases in healthcare expenditures and labor and economic consequences. There are also other fields of medicine and biology where obesity or being overweight play a major role, such as high-altitude illnesses (acute mountain sickness, hypoxic pulmonary hypertension, and chronic mountain sickness), where an increasing relationship among these two morbid statuses has been demonstrated. This association could be rooted in the interactions between obesity-related metabolic alterations and critical ventilation impairments due to obesity, which would aggravate hypobaric hypoxia at high altitudes, leading to hypoxemia, which is a trigger for developing high-altitude diseases. This review examines the current literature to support the idea that obesity or overweight could be major conditioning factors at high altitude.
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Affiliation(s)
- Rocío San Martin
- Institute of Health Studies, Universidad Arturo Prat, Iquique, Chile
| | - Julio Brito
- Institute of Health Studies, Universidad Arturo Prat, Iquique, Chile
- *Julio Brito, Institute of Health Studies, Universidad Arturo Prat, Avda. Arturo Prat 2120, Iquique, 1110939, Chile,
| | - Patricia Siques
- Institute of Health Studies, Universidad Arturo Prat, Iquique, Chile
| | - Fabiola León-Velarde
- Department of Biological and Physiological Sciences. Facultad de Ciencias y Filosofía/ IIA, Universidad Peruana Cayetano Heredia, Lima, Perú
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Kagawa RMC, Fernald LCH, Behrman JR. Weight Status and Behavioral Problems among Very Young Children in Chile. PLoS One 2016; 11:e0161380. [PMID: 27583678 PMCID: PMC5008787 DOI: 10.1371/journal.pone.0161380] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 08/04/2016] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND/OBJECTIVES Our objective was to explore the association between weight status and behavioral problems in children before school age. We examined whether the association between weight status and behavioral problems varied by age and sex. SUBJECTS/METHODS This study used cross-sectional data from a nationally-representative sample of children and their families in Chile (N = 11,207). These children were selected using a cluster-stratified random sampling strategy. Data collection for this study took place in 2012 when the children were 1.5-6 years of age. We used multivariable analyses to examine the association between weight status and behavioral problems (assessed using the Child Behavior Checklist), while controlling for child's sex, indigenous status, birth weight, and months breastfed; primary caregiver's BMI and education level; and household wealth. RESULTS Approximately 24% of our sample was overweight or obese. Overweight or obese girls showed more behavioral problems than normal weight girls at age 6 (β = 0.270 SD, 95% CI = 0.047, 0.493, P = 0.018). Among boys age 1 to 5 years, overweight/obesity was associated with a small reduction in internalizing behaviors (β = -0.09 SD, 95% CI = -0.163, -0.006, P = 0.034). CONCLUSIONS Our data suggest that the associations between weight status and behavioral problems vary across age and sex.
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Affiliation(s)
- Rose M. C. Kagawa
- School of Public Health, University of California, Berkeley, CA, United States of America
| | - Lia C. H. Fernald
- School of Public Health, University of California, Berkeley, CA, United States of America
| | - Jere R. Behrman
- Department of Economics, University of Pennsylvania, Philadelphia, PA, United States of America
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Changes in Food Intake in Australia: Comparing the 1995 and 2011 National Nutrition Survey Results Disaggregated into Basic Foods. Foods 2016; 5:foods5020040. [PMID: 28231135 PMCID: PMC5302341 DOI: 10.3390/foods5020040] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 05/20/2016] [Accepted: 05/23/2016] [Indexed: 12/30/2022] Open
Abstract
As nations seek to address obesity and diet-related chronic disease, understanding shifts in food intake over time is an imperative. However, quantifying intake of basic foods is not straightforward because of the diversity of raw and cooked wholefoods, processed foods and mixed dishes actually consumed. In this study, data from the Australian national nutrition surveys of 1995 and 2011, each involving more than 12,000 individuals and covering more than 4500 separate foods, were coherently disaggregated into basic foods, with cooking and processing factors applied where necessary. Although Australians are generally not eating in a manner consistent with national dietary guidelines, there have been several positive changes. Australians are eating more whole fruit, a greater diversity of vegetables, more beans, peas and pulses, less refined sugar, and they have increased their preference for brown and wholegrain cereals. Adult Australians have also increased their intake of nuts and seeds. Fruit juice consumption markedly declined, especially for younger Australians. Cocoa consumption increased and shifts in dairy product intake were mixed, reflecting one of several important differences between age and gender cohorts. This study sets the context for more detailed research at the level of specific foods to understand individual and household differences.
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Albala C, Angel B, Lera L, Sanchez H, Marquez C, Fuentes P. Low Leptin Availability as a Risk Factor for Dementia in Chilean Older People. Dement Geriatr Cogn Dis Extra 2016; 6:295-302. [PMID: 27504118 PMCID: PMC4965539 DOI: 10.1159/000447447] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE The aim was to study the role of leptin in the development of dementia. METHODS Follow-up of the ALEXANDROS cohorts, with baseline measurements in 2000. From 1,136 available subjects free of dementia at baseline, 667 subjects had frozen baseline blood samples for measuring leptin and soluble leptin receptor (sOB-R). The free leptin index (FLI) was calculated as the ratio of leptin to sOB-R. Dementia was defined as an MMSE score <22 and a score >5 in the Pfeffer Activities Questionnaire. RESULTS After 15 years of follow-up, 42 incident cases of dementia were identified. No difference in serum leptin was observed between people with and without dementia, but sOB-R was higher in demented than in nondemented subjects (sOB-R: 44.94 ± 23.97 vs. 33.73 ± 21.13 ng/ml). The adjusted risk for dementia increased, the higher the log sOB (hazard ratio = 3.58; 95% CI 1.72-7.45, p = 0.001). CONCLUSION Lower availability of free leptin was found in demented than in nondemented people, suggesting a role of leptin in cognition.
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Affiliation(s)
| | | | - Lydia Lera
- INTA, University of Chile, Santiago, Chile
| | | | | | - Patricio Fuentes
- Department of Neurology, Clinic Hospital, University of Chile, Santiago, Chile
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Smith MR, Micha R, Golden CD, Mozaffarian D, Myers SS. Global Expanded Nutrient Supply (GENuS) Model: A New Method for Estimating the Global Dietary Supply of Nutrients. PLoS One 2016; 11:e0146976. [PMID: 26807571 PMCID: PMC4726504 DOI: 10.1371/journal.pone.0146976] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 12/23/2015] [Indexed: 11/18/2022] Open
Abstract
Insufficient data exist for accurate estimation of global nutrient supplies. Commonly used global datasets contain key weaknesses: 1) data with global coverage, such as the FAO food balance sheets, lack specific information about many individual foods and no information on micronutrient supplies nor heterogeneity among subnational populations, while 2) household surveys provide a closer approximation of consumption, but are often not nationally representative, do not commonly capture many foods consumed outside of the home, and only provide adequate information for a few select populations. Here, we attempt to improve upon these datasets by constructing a new model--the Global Expanded Nutrient Supply (GENuS) model--to estimate nutrient availabilities for 23 individual nutrients across 225 food categories for thirty-four age-sex groups in nearly all countries. Furthermore, the model provides historical trends in dietary nutritional supplies at the national level using data from 1961-2011. We determine supplies of edible food by expanding the food balance sheet data using FAO production and trade data to increase food supply estimates from 98 to 221 food groups, and then estimate the proportion of major cereals being processed to flours to increase to 225. Next, we estimate intake among twenty-six demographic groups (ages 20+, both sexes) in each country by using data taken from the Global Dietary Database, which uses nationally representative surveys to relate national averages of food consumption to individual age and sex-groups; for children and adolescents where GDD data does not yet exist, average calorie-adjusted amounts are assumed. Finally, we match food supplies with nutrient densities from regional food composition tables to estimate nutrient supplies, running Monte Carlo simulations to find the range of potential nutrient supplies provided by the diet. To validate our new method, we compare the GENuS estimates of nutrient supplies against independent estimates by the USDA for historical US nutrition and find very good agreement for 21 of 23 nutrients, though sodium and dietary fiber will require further improvement.
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Affiliation(s)
- Matthew R. Smith
- Department of Environmental Health, Harvard T H Chan School of Public Health, Boston, Massachusetts, United States of America
- * E-mail:
| | - Renata Micha
- Friedman School of Nutrition Science & Policy, Tufts University, Boston, Massachusetts, United States of America
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Athens, Greece
| | - Christopher D. Golden
- Center for Health and the Global Environment, Harvard T H Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science & Policy, Tufts University, Boston, Massachusetts, United States of America
| | - Samuel S. Myers
- Department of Environmental Health, Harvard T H Chan School of Public Health, Boston, Massachusetts, United States of America
- Harvard University Center for the Environment, Cambridge, Massachusetts, United States of America
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Cossio-Bolaños M, Vilchez-Avaca C, Contreras-Mellado V, Andruske CL, Gómez-Campos R. Changes in abdominal obesity in Chilean university students stratified by body mass index. BMC Public Health 2016; 16:33. [PMID: 26762642 PMCID: PMC4712471 DOI: 10.1186/s12889-015-2587-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 12/09/2015] [Indexed: 11/10/2022] Open
Abstract
Background Studies based on Body Mass Index (BMI) and waist circumference (WC) are generally used to examine the prevalence and tendency of overweight and obesity. These studies help determine the socioeconomic development of a country and improve public health policies. Therefore, the goal of this research was to determine the trend of change in abdominal obesity of Chilean university students according to the Body Mass Index (BMI) measured in intervals of three and six years. Methods For this study, a total of 1598 students of both sexes ranging in age from 18 to 26 from a Chilean university were evaluated. Students were assessed commencing in 2007 (372 males and 315 females), 2010 (250 males and 330 females), and ending in 2013 (153 males and 178 females). During the three transversal assessments, weight, height, and waist circumference were evaluated. BMI was calculated for both sexes. Results No significant differences were found in age and BMI during the three years evaluated (2007, 2010, and 2013). In 2013, waist circumference (WC) increased significantly (p < 0.001 for both sexes). Moreover, in 2013, in all the percentiles evaluated, high values of WC were compared in relation to previous years. Furthermore, in 2013, in all four BMI categories (underweight, normal, overweight, and obese), the university students showed significant increases in WC (Females: p = 0.004; Males: p = 0.035) whereas in 2007 and 2010, the values remained relatively stable. Conclusions BMI remained constant during 2007, 2010, and 2013. However, the university students of both sexes showed greater risk of abdominal obesity as a result of increased WC in 2013.
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Affiliation(s)
- Marco Cossio-Bolaños
- Department of Physical Activity Sciences, Catholic University of Maule, Talca, Chile. .,Faculty of Physical Education, State University of Campinas, São Paulo, Brazil. .,Red Iberoamericana Biological Research in Human Development, Arequipa, Peru. .,, Av. San Miguel s/n., Talca, Chile.
| | - Catalina Vilchez-Avaca
- Red Iberoamericana Biological Research in Human Development, Arequipa, Peru.,Program of sports and physical activity, Universidad de Talca, Talca, Chile
| | - Victor Contreras-Mellado
- Red Iberoamericana Biological Research in Human Development, Arequipa, Peru.,Program of sports and physical activity, Universidad de Talca, Talca, Chile
| | | | - Rossana Gómez-Campos
- Faculty of Physical Education, State University of Campinas, São Paulo, Brazil.,Universidad Autonoma de Chile, Talca, Chile.,Universidad Científica del Sur, Lima, Peru
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The case for aflatoxins in the causal chain of gallbladder cancer. Med Hypotheses 2016; 86:47-52. [DOI: 10.1016/j.mehy.2015.11.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Accepted: 11/25/2015] [Indexed: 12/24/2022]
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Lera L, Sánchez H, Ángel B, Albala C. Mini Nutritional Assessment Short-Form: Validation in Five Latin American Cities. SABE Study. J Nutr Health Aging 2016; 20:797-805. [PMID: 27709228 DOI: 10.1007/s12603-016-0696-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To validate the short-form of the MNA (MNA-SF) and the cut-off point of 31 cm for calf circumference (CC) in older people in Latin America. METHODS A cross-sectional study was conducted with 5,722 community-dwelling older subjects (range: 60-102 years) in Latin America´s five main cities: Sao Paulo (Brazil), Santiago (Chile), Havana (Cuba), Mexico DF (Mexico) and Montevideo (Uruguay). All participants underwent an interview, which included anthropometric measurements, completing the MNA and obtaining socio-demographic, nutrition and health information. The short-form of the MNA consists of only six questions from the original 18. It has two versions: one using body mass index (BMI) and the second using CC as a surrogate. Cohen's Kappa was calculated to assess the agreement between the MNA and the MNA-SF; diagnostic tests were performed, and Receiver-operating characteristic (ROC) curves were developed. Criterion-related validity was assessed in the Chilean sample. RESULTS Both version of the MNA-SF showed high sensitivity and specificity with the MNA, showing good accuracy (0.88), although higher values were estimated for malnutrition and risk of malnutrition in the total sample by sex. The cut-off point of 31 cm for CC showed high sensitivity (74.6-94.4%), specificity (72.6-100%) and good area under the ROC curve (0.87-0.95) when compared with BMI. There was good agreement between MNA and both version of MNA-SF for identifying persons with malnutrition or a risk of malnutrition in the five cities (Kappa coefficient: 0.6193-0.7852). CONCLUSION Both versions of the MNA-SF are population-screening tools of easy and fast application, with good accuracy for assessing malnutrition and risk of malnutrition in Latin American older people.
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Affiliation(s)
- L Lera
- Dr. Lydia Lera, Public Health Nutrition Unit, Institute of Nutrition and Food Technology (INTA) - University of Chile, Santiago de Chile, Chile,
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