Association between a lifestyle score and all-cause mortality: a prospective analysis of the Chilean National Health Survey 2009-2010

OBJECTIVE

To investigate the association between a lifestyle score and all-cause mortality in the Chilean population.

DESIGN

Prospective study.

SETTINGS

The score was based on seven modifiable behaviours: salt intake, fruit and vegetable intake, alcohol consumption, sleep duration, smoking, physical activity and sedentary behaviours. 1-point was assigned for each healthy recommendation. Points were summed to create an unweighted score from 0 (less healthy) to 7 (healthiest). According to their score, participants were then classified into: less healthy (0-2 points), moderately healthy (3-4 points) and the healthiest (5-7 points). Associations between the categories of lifestyle score and all-cause mortality were investigated using Cox proportional hazard models adjusted for confounders. Nonlinear associations were also investigated.

PARTICIPANTS

2706 participants from the Chilean National Health Survey 2009-2010.

RESULTS

After a median follow-up of 10·9 years, 286 (10·6 %) participants died. In the maximally adjusted model, and compared with the healthiest participants, those less healthy had 2·55 (95 % CI 1·75, 3·71) times higher mortality risk due to any cause. Similar trends were identified for the moderately healthy group. Moreover, there was a significant trend towards increasing the mortality risk when increasing unhealthy behaviours (hazard ratio model 3: 1·61 (95 % CI 1·34, 1·94)). There was no evidence of nonlinearity between the lifestyle score and all-cause mortality.

CONCLUSION

Individuals in the less healthy lifestyle category had higher mortality risk than the healthiest group. Therefore, public health strategies should be implemented to promote adherence to a healthy lifestyle across the Chilean population.

[Compliance with the Dietary Guidelines in Chilean adolescents: a cross-sectional study of the Chilean National Health Survey 2016-2017]

In Chile, compliance with the Food-Based Dietary Guidelines (GABA) ensures an adequate and ba lanced diet.

OBJECTIVE

To determine compliance with five GABA recommendations and their asso ciations with anthropometric, lifestyle, and metabolic variables, in adolescents aged between 15 and 19 years who participated in the Chilean National Health Survey 2016-2017.

SUBJECTS AND METHOD

Cross-sectional study including 355 adolescents. Participants were divided into four groups (fulfilled 0, 1, 2, or ≥ 3 recommendations) using five messages from the GABA (consumption of legumes, fish, dairy products, water, and fruits and vegetables). Associations between GABA and outcome variables (weight, body mass index, waist circumference, physical activity, sleep, and metabolic variables) were investigated using linear regression analyses adjusted by sociodemographic confounders.

RESULTS

5.6% of the adolescents met three or more GABA recommendations. Of the recommendations mea sured, the consumption of water (85%) and legumes (78.7%) presented greater compliance, showing differences between women and men regarding the consumption of legumes (58.6% vs. 86.4%), wa ter (69.6% vs. 91%), and dairy products (92.9% vs. 39.1%). Adolescents with higher compliance with GABA had a better concentration of lower glycemia (p = 0.025). There were no other significant asso ciations between lifestyle and anthropometric measurements.

CONCLUSIONS

Adolescents who partici pated in this study presented difficulties in adhering to GABA recommendations, thus compromising the maintenance of healthy lifestyles.

Association between bodyweight perception, nutritional status, and weight control practices: A cross-sectional analysis from the Chilean Health Survey 2016–2017

This research aimed (1) to examine the agreement between body mass index (BMI)-based nutritional status and perceived nutritional status overall and by socio-demographic factors and (2) to state the association between the accuracy of weight perception and weight control practices in the Chilean adult population. A population-based cross-sectional study was carried out with 5,192 Chilean adult participants from the Chilean National Health Survey 2016–2017. Agreement between BMI-based weight status and body weight perception for the total sample and across subgroups was determined using the weighted kappa coefficient. The agreement between BMI-based and perceived nutritional status of the total sample was fair (kappa = 0.38). A higher rate of weight perception accuracy was identified in women, younger respondents, and participants with higher education, a higher income, and from urban areas than their counterparts. Respondents with overweight or obesity tended to underestimate their nutritional status. Actions to lose weight were higher in those who had the right perception of their overweight/obesity condition and those who overestimated their body weight, regardless of their nutritional status. In all groups, weight loss behaviors were more related to the perceived than the BMI-based nutritional status. The consequences of accurate perception of the nutritional status are discussed including its effects on body weight and mental health.

[Legume consumption in chileans: findings from the 2016-2017 national health survey]

BACKGROUND

Legumes are low cost and high-quality nutritional foods. In Chile, a twice per week legume consumption is recommended to promote health and prevent disease.

AIM

To characterize the consumption of legumes according to sociodemographic and anthropometric variables in the Chilean adult population.

MATERIAL AND METHOD

Analysis of data from 5,473 participants of the 2016-2017 National Health Survey. The compliance with legume consumption was studied in population groups, according to sociodemographic and anthropometric characteristics, through logistic regression analyses.

RESULTS

Only 24% of all participants (51.4% of women) fulfilled legume intake recommendations. After adjusting for sociodemographic variables, the participants who were less likely to comply with the recommendation were widowers (Odds Ratio (OR): 0.58 [95% confidence intervals (CI): (0.40; 0.85]). On the contrary, people between 70-80 years (OR: 1.78 [95% CI: 1.11; 2.88]), those who resided in rural areas (OR: 1.62 [95% CI: 1.25; 2.10]) and those who resided in the Maule region (OR: 2.11 [95% CI: 1.37, 3.25]) had a higher likelihood of compliance.

CONCLUSIONS

One out of four Chileans complied with the recommendations of legume consumption. Even though the results differed when stratified by sex, it is highlighted that living in rural areas increased the probabilities of an adequate legume consumption.

Flavonoids as potential anti-platelet aggregation agents: from biochemistry to health promoting abilities

Cardiovascular ailments are the number one cause of mortalities throughout the globe with 17.9 million deaths per year. Platelet activation and aggregation play a crucial role in the pathogenesis of arterial diseases, including acute coronary syndrome, acute myocardial infarction, cerebrovascular transient ischemia, unstable angina, among others. Flavonoids-rich plant extracts are gaining interest for treating the heart-related problems due to safe nature of these herbal extracts. Consumption of plant-food-derived bioactives, particularly flavonoids, has shown antithrombotic, and cardiovascular protective effects due to its anti-platelet activity. Preclinical and clinical trials have proven that flavonoid-rich plant extracts are protective against the cardiac ailments through anti-platelet aggregation activity. This review aims to highlight the anti-platelet aggregation potential of flavonoids with a key emphasis on the therapeutic efficacy in humans. The mechanism of flavonoids in preventing and treating cardiovascular diseases is also highlighted based on preclinical and clinical experimental trials. Further studies are the need of time for exploring the exact molecular mechanism of flavonoids as anti-platelet aggregation agents for treating heart-related problems.

Ethnopharmacology, Phytochemistry and Biological Activities of Native Chilean Plants

The native flora of Chile has unique characteristics due to the geographical situation of the country, with the vast desert in the North, Patagonia in the South, the Andean Mountains on the east and the Pacific Ocean on the west. This exclusivity is reflected in high concentrations of phytochemicals in the fruits and leaves of its native plants. Some examples are Aristotelia chilensis (Molina), Stuntz (maqui), Berberis microphylla G. Forst. (calafate), Peumus boldus Molina (boldo), Ribes magellanicum Poir. (Magellan currant), Ugni molinae Turcz. (murtilla), Rubus geoides Sm. (miñe miñe), Drimys winteri J.R.Forst. & G.Forst. (canelo), Luma apiculata (DC.) Burret (arrayán) distributed throughout the entire Chilean territory. Some of these Chilean plants have been used for centuries in the country's traditional medicine. The most recent studies of phytochemical characterization of parts of Chilean plants show a wide spectrum of antioxidant compounds, phenolic components, terpenoids and alkaloids, which have shown biological activity in both in vitro and in vivo studies. This manuscript covers the entire Chilean territory characterizing the phytochemical profile and reporting some of its biological properties, focusing mainly on antioxidant, anti-inflammatory, antimicrobial, chemopreventive and cytotoxic activity, and potential against diabetes, metabolic syndrome and gastrointestinal disorders.

[Older people in Chile: the new social, economic and health challenge for the 21st century]

Ageing will be one of the most significant social transformations of the 21st century worldwide. In the last 40 years, Chile has tripled its older adult population. As a result, by 2050 the country will have the highest proportion of older adults in Latin America. This remarkable growth reinforces the need to identify their current situation and to revise what is the society doing to maintain older people as active members. In this context, this narrative revision aimed to describe the sociodemographic, epidemiologic and sociocultural profile of the older Chilean adults. Besides, programs and public policies focused on the improvement of their quality of life were identified.

Phytochemicals as Potential Epidrugs in Type 2 Diabetes Mellitus

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

Multivesicular Liposome (Depofoam) in Human Diseases

Drug development is a key point in the research of new therapeutic treatments for increasing maximum drug loading and prolonged drug effect. Encapsulation of drugs into multivesicular liposomes (DepoFoam) is a nanotechnology that allow delivery of the active constituent at a sufficient concentration during the entire treatment period. This guarantees the reduction of drug administration frequency, a very important factor in a prolonged treatment. Currently, diverse DepoFoam drugs are approved for clinical use against neurological diseases and for post-surgical pain management while other are under development for reducing surgical bleeding and for post-surgical analgesia. Also, on pre-clinical trials on cancer DepoFoam can improve bioavailability and stability of the drug molecules minimizing side effects by site-specific targeted delivery. In the current work, available literature on structure, preparation and pharmacokinetics of DepoFoam are reviewed. Moreover, we investigated approved DepoFoam formulations and preclinical studies with this nanotechnology.

Mushrooms-Rich Preparations on Wound Healing: From Nutritional to Medicinal Attributes

Mushrooms have a significant role in human diet as functional food and as a nutraceutical resource. The combination of its umami flavor, protein, vitamins, minerals and carbohydrates has meant that mushrooms could be considered a cheap food source for a long time in many countries. Moreover, mushrooms contain an excellent variety of bioactive metabolites that can be successful in both prevention and treatment of various human health hazards. In addition, extracts from medicinal mushrooms and their metabolites have been verified for wound treating with contribution to different mechanisms of the healing process. This review summarizes the nutritional value and composition of mushrooms, ethnobiology and ethnopharmacology, and wound healing potential.

[Comparison between self-reported and device measured physical activity according to nutritional status]

BACKGROUND

It is unknown if nutritional status could influence the accuracy of self-reported physical activity (PA) levels.

AIM

To compare PA measured using the international physical activity questionnaire (IPAQ) and by accelerometry (ActiGraph) according to nutritional status in Chilean adults.

MATERIAL AND METHODS

This is an observational cross-sectional study that used information from the GENADIO project carried out in Chile between 2009-2011. The sample consisted of 322 people. PA levels and sitting time were determined through the IPAQ self-report questionnaire and ActiGraph accelerometers (GTM1). The nutritional status was determined according to body mass index (BMI).

RESULTS

Compared with the measurement made with accelerometry, the IPAQ self-report questionnaire underestimated the levels of light PA, total PA and sedentary time in -171.5, -54.8 and -40.6 min / day, respectively. However, IPAQ overestimated the levels of moderate PA and vigorous PA in 91.0 and 47.3 min/day respectively, compared with accelerometry. Compared with normal weight, obese subjects reported higher levels of moderate PA (105.5 and 48.9 min/day, respectively) and vigorous PA (54.1 and 38.3 min/day respectively). Total PA had a greater delta of underestimation between IPAQ and accelerometer measurements in normal weight than in obese subjects (-122.1 vs -16.5 min/day, respectively).

CONCLUSIONS

The measurement of PA by means of a self-report questionnaire was discrepant with its objective measurement with an accelerometer. The discrepancy is even higher in obese people.

[Physical activity and sedentary behaviors among people with cancer]

BACKGROUND

One of the side effects of cancer treatment is a low level of physical activity (PA) due to fatigue and pain.

AIM

To quantify PA levels in Chilean people with cancer.

MATERIAL AND METHODS

Analysis of the National Health Survey 2016-2017 including 6,233 participants, comparing those with and without a self-report of cancer was conducted. Levels of PA and sitting time were assessed using the Global Physical Activity Questionnaire.

RESULTS

3% of participants [confidence intervals (CI): 2.6; 3.9] reported having cancer and 34% [95% CI: 22.7; 46.7] of these reported being physically inactive, compared to 25% [95% CI: 22.5; 27,3] of those without cancer. Participants with cancer performed 56 and 77 minutes/day lower vigorous and total PA than participants without cancer. No differences between groups were observed for commuting PA, moderate PA and sedentary time. Lower level of PA was independent of the years elapsed since the diagnosis of cancer.

CONCLUSIONS

People with cancer are less physically active than their counterparts without the disease.

[Association of menopause with cardiovascular risk. Analysis of data from the 2016-17 Chilean national health survey]

BACKGROUND

Menopause exposes women to an increased cardiovascular risk.

AIM

To determine the association between menopause and cardiovascular risk factors in Chilean adult women using data from the National Health Survey (NHS) 2016-2017.

MATERIAL AND METHODS

Data from 2,139 women over 40 years of age participating in the NHS 2016-2017, with information about menopause and cardiovascular risk factors was used. Expansion factors were applied to this sample, obtaining an expanded sample of 3,733,191 participants. Laboratory values (blood glucose, triglycerides, HDL and total cholesterol) and anthropometric measurements (body weight, height and waist circumference) were analyzed. The presence of hypertension, diabetes, and metabolic syndrome (MetS) were also recorded.

RESULTS

Sixty seven percent of surveyed women were menopausal and had higher systolic blood pressure than non-menopausal participants. Menopause was significantly associated with hypertension (Odds ratio (OR): 2.43 [95% confidence intervals (CI): 1.71; 3.45], p < 0.01) and diabetes (OR: 2.05 [95% CI: 1.32; 3.19], p < 0.01). However, no association was observed with obesity, abdominal obesity or MetS.

CONCLUSIONS

In these women, a positive association was identified between menopause and hypertension as well as diabetes.

Phytochemical screening of Alstonia venenata leaf and bark extracts and their antimicrobial activities

Alstonia venenata is a plant commonly found in South India and used in traditional medicine. The aim of this study was to characterize the phytochemicals present in A. venenata leaf and bark extracts and study their antimicrobial activities. Solvent extractions with Soxhlet apparatus of leaves and bark were obtained using hexane, benzene, isopropanol, methanol, and water. The crude extracts were concentrated and screened for qualitative phytochemical content and analyzed by thin layer chromatography. The antibacterial, antifungal and antiviral activities of crude extracts were measured by in vitro methods. Alkaloids, carbohydrates, tannins, phenolic compounds, terpenoids, cardiac glycosides and amino acids were found in the different crude extracts analyzed. Isopropanol extracts showed antifungal activity and it was more pronounced in the bark extract than the leaf extract. Moreover, the isopropanol extract exhibited antibacterial and antiviral activity. In conclusion, the leaves and bark of A. venenata have antimicrobial components which are more present in the isopropanol fraction.

Phytochemical screening of Alstonia scholaris leaf and bark extracts and their antimicrobial activities

Alstonia sholaris is an evergreen tree commonly found in South East Asia. In traditional medicine pharmacological activities are attributed to the leaves and bark of this plant. The aim of this study is characterizing the chemicals present in A. sholaris leaves and bark extracts and study their antimicrobial activities. Solvent extractions with Soxhlet apparatus of leaves and bark were obtained using hexane, benzene, isopropanol, methanol, and water. The crude extracts were concentrated and screened for qualitative phytochemical analysis and thin layer chromatography, and the antibacterial, antifungal an antiviral activity of crude extracts were measured by in vitro methods. Isopropanol and methanol extracts showed significant antibacterial activity and it was more pronounced against Gram positive than against Gram negative bacteria. Hexane, benzene, isopropanol and methanol fractions of A. scholaris bark and leaf showed activity against Enterobacter cloacae. Isopropanol extract showed maximum activity against selected human pathogenic fungus. In conclusion, the leaves and bark of A. scholaris are rich in phytochemicals with antimicrobial activities against human pathogens, being the isopropanol fraction the one with the highest antibacterial, antifungal, antiviral and anti-mycobacterial activities.

Phytochemical screening of Moringa oleifera leaf extracts and their antimicrobial activities

Moringa oleifera is a tree native to tropical and subtropical regions of South India and used in traditional medicine. The aim of this study was characterize the phytochemicals present in M. oleifera leaf extracts and study their antimicrobial activities. Solvent extractions with Soxhlet apparatus of leaves were obtained using hexane, benzene, isopropanol, methanol, and water. The crude extracts were concentrated and screened for qualitative phytochemical analysis, and the antibacterial, antifungal and antiviral activities of crude extracts were measured by in vitro methods. Alkaloids, carbohydrates, tannins, phenolic compounds, terpenoids, cardiac glycosides, amino acids, oils and fats were found in the different crude extracts analyzed. Water and methanol extracts showed antibacterial activity against all selected bacteria, hexane and benzene extracts showed antifungal activity against all fungi tested, and hexane, benzene and isopropanol extracts showed activity against Hepatitis B virus. In conclusion, the leaves of M. oleifera have antimicrobial phytochemicals.

Epigenetics, Maternal Diet and Metabolic Programming

Background:

The maternal environment influences embryonic and fetal life. Nutritional deficits or excesses alter the trajectory of fetus/offspring’s development. The concept of “developmental programming” and “developmental origins of health and disease” consists of the idea that maternal diet may remodel the genome and lead to epigenetic changes. These changes are induced during early life, permanently altering the phenotype in the posterior adult stage, favoring the development of metabolic diseases such as obesity, dyslipidemia, hypertension, hyperinsulinemia, and metabolic syndrome. In this review, it is aimed to overview epigenetics, maternal diet and metabolic programming factors and determine which of these might affect future generations.

Scope and Approach:

Nutrients interfere with the epigenome by influencing the supply and use of methyl groups through DNA transmethylation and demethylation mechanisms. They also influence the remodeling of chromatin and arginine or lysine residues at the N-terminal tails of histone, thus altering miRNA expression. Fats, proteins, B vitamins and folates act as important cofactors in methylation processes. The metabolism of carbon in the methyl groups of choline, folic acid and methionine to S-Adenosyl Methionine (SAM), acts as methyl donors to methyl DNA, RNA, and proteins. B-complex vitamins are important since they act as coenzymes during this process.

Key Findings and Conclusion:

Nutrients, during pregnancy, potentially influence susceptibility to diseases in adulthood. Additionally, the deficit or excess of nutrients alter the epigenetic machinery, affecting genes and influencing the genome of the offspring and therefore, predisposing the development of chronic diseases in adults.

Antidiabetic Potential of Medicinal Plants and Their Active Components

Diabetes mellitus is one of the major health problems in the world, the incidence and associated mortality are increasing. Inadequate regulation of the blood sugar imposes serious consequences for health. Conventional antidiabetic drugs are effective, however, also with unavoidable side effects. On the other hand, medicinal plants may act as an alternative source of antidiabetic agents. Examples of medicinal plants with antidiabetic potential are described, with focuses on preclinical and clinical studies. The beneficial potential of each plant matrix is given by the combined and concerted action of their profile of biologically active compounds.

Plant-Derived Bioactives in Oral Mucosal Lesions: A Key Emphasis to Curcumin, Lycopene, Chamomile, Aloe vera, Green Tea and Coffee Properties

Oral mucosal lesions have many etiologies, including viral or bacterial infections, local trauma or irritation, systemic disorders, and even excessive alcohol and tobacco consumption. Folk knowledge on medicinal plants and phytochemicals in the treatment of oral mucosal lesions has gained special attention among the scientific community. Thus, this review aims to provide a brief overview on the traditional knowledge of plants in the treatment of oral mucosal lesions. This review was carried out consulting reports between 2008 and 2018 of PubMed (Medline), Web of Science, Embase, Scopus, Cochrane Database, Science Direct, and Google Scholar. The chosen keywords were plant, phytochemical, oral mucosa, leukoplakia, oral lichen planus and oral health. A special emphasis was given to certain plants (e.g., chamomile, Aloe vera, green tea, and coffea) and plant-derived bioactives (e.g., curcumin, lycopene) with anti-oral mucosal lesion activity. Finally, preclinical (in vitro and in vivo) and clinical studies examining both the safety and efficacy of medicinal plants and their derived phytochemicals were also carefully addressed.

Potential Phytopharmacy and Food Applications of Capsicum spp.: A Comprehensive Review

Capsicum genus (Solanaceae) is native to the Americas. Today, it is an important agricultural crop cultivated around the world, not only due to its economic importance, but also for the nutritional value of the fruits. Among their phytochemical constituents, capsaicinoids are characteristic and responsible of the pungency of sharp-tasting cultivars. Moreover, Capsicum and capsaicinoids (mainly, capsaicin) have been largely studied because of their health benefits. Thus, this study reviews the scientific knowledge about Capsicum spp. and their phytochemicals against cancer, diabetes, gastrointestinal diseases, pain, and metabolic syndrome, as well as their antioxidant and antimicrobial activity. These bioactivities can be the basis of the formulation of functional ingredients and natural preservatives containing Capsicum extracts or isolated compounds.