RESUMO
BACKGROUND AND AIMS: Research into the relationship between an Energy-adjusted Diet-Inflammatory Index (E-DII) and a wider health-related biomarkers profile is limited. Much of the existing evidence centers on traditional metabolic biomarkers in populations with chronic diseases, with scarce data on healthy individuals. Thus, this study aims to investigate the association between an E-DII score and 30 biomarkers spanning metabolic health, endocrine, bone health, liver function, cardiovascular, and renal functions, in healthy individuals. METHODS AND RESULTS: 66,978 healthy UK Biobank participants, the overall mean age was 55.3 (7.9) years were included in this cross-sectional study. E-DII scores, based on 18 food parameters, were categorised as anti-inflammatory (E-DII < -1), neutral (-1 to 1), and pro-inflammatory (>1). Regression analyses, adjusted for confounding factors, were conducted to investigate the association of 30 biomarkers with E-DII. Compared to those with an anti-inflammatory diet, individuals with a pro-inflammatory diet had increased levels of 16 biomarkers, including six cardiometabolic, five liver, and four renal markers. The concentration difference ranged from 0.27 SD for creatinine to 0.03 SD for total cholesterol. Conversely, those on a pro-inflammatory diet had decreased concentrations in six biomarkers, including two for endocrine and cardiometabolic. The association range varied from -0.04 for IGF-1 to -0.23 for SHBG. CONCLUSION: This study highlighted that a pro-inflammatory diet was associated with an adverse profile of biomarkers linked to cardiometabolic health, endocrine, liver function, and renal health.
Assuntos
Biomarcadores , Mediadores da Inflamação , Inflamação , Rim , Fígado , Humanos , Estudos Transversais , Masculino , Pessoa de Meia-Idade , Biomarcadores/sangue , Feminino , Reino Unido/epidemiologia , Idoso , Rim/fisiopatologia , Inflamação/sangue , Inflamação/diagnóstico , Adulto , Mediadores da Inflamação/sangue , Fígado/metabolismo , Fatores de Risco Cardiometabólico , Dieta/efeitos adversos , Medição de Risco , Bancos de Espécimes Biológicos , Osso e Ossos/metabolismo , Biobanco do Reino UnidoRESUMO
Introducción: La alimentación se construye a partir de experiencias y significados adquiridos en el curso de la vida. Las personas mayores tienen un acervo importante que informa de valores y prácticas culturales aplicadas a la alimentación. El objetivo del estudio fue interpretar los significados que entregan personas mayores a la construcción de su alimentación en trayectorias del curso de vida. Métodos: La investigación utilizó un enfoque cualitativo de alcance exploratorio, utilizando el método de teoría fundamentada de Strauss y Corbin. Para la recolección de datos se aplicó una entrevista semiestructurada entre julio de 2021 y junio de 2022. El tipo de muestreo fue teórico y el análisis de los datos cualitativos respondió al proceso de codificación abierta, axial y selectiva. Resultados: Participaron 54 personas mayores (72% mujeres) con edad promedio de 68,6 años (6,9 años). Las personas mayores construyeron su alimentación con un alto significado a las comidas caseras, con influencia de género femenino durante la niñez y adolescencia. En la adultez, se reconstruye la alimentación al ingresar al mundo laboral. En la actualidad, cimentan la alimentación con un enfoque de cuidados para su salud. Reconocen transiciones y puntos de inflexión en la alimentación provocados por terremotos, pandemia por COVID-19, situación política en el país, embarazos o el diagnóstico de alguna enfermedad crónica. Discusión: Las personas mayores reconocen diversas vivencias en trayectorias vitales que han marcado sus patrones alimentarios. Estas experiencias de vida pueden ser la base de estrategias o acciones en la práctica clínica que aporten a su bienestar.
Introduction: Food is intricately woven into the fabric of our experiences and the meanings accumulated throughout life. Older people possess a rich cultural heritage that shapes the values and practices surrounding food.The aim of the study was to interpret the meanings attributed to older people to the construction of their feeding in life course trajectories. Methods: The research employed a qualitative exploratory approach, utilizing the Grounded Theory method developed by Strauss and Corbin. Data collection took place through semi-structured interviews conducted between July 2021 and June 2022. The sampling method employed was theoretical, and the analysis of qualitative data followed the open, axial, and selective coding process. Results: A total of 54 older individuals (72% women), with an average age of 68.6 years (6,9 years), participated in the study. These individuals constructed their relationship with food, assigning significant value to homemade meals, influenced by gender roles during childhood and adolescence. In adulthood, the relationship with food transformed with entry into the workforce. Currently, their feeding are guided by a health-centric approach. They recognize transitions and turning pointsin food provoked by earthquakes, pandemic by COVID-19, political situation in the country, pregnancies or the diagnosis of a chronic disease. Discussion: Older people recognize a multitude of life experiences that have left imprints on their eating patterns. These life experiences can be the basis for strategies or actions in clinical practice that contribute to their well-being.
RESUMO
AIM: To investigate the joint associations of diabetes and obesity with all-cause and cardiovascular disease (CVD) mortality in the Mexico City Prospective Study. MATERIALS AND METHODS: In total, 154 128 participants (67.2% women) were included in this prospective analysis. Diabetes was self-reported, while body mass index was used to calculate obesity. Using diabetes and obesity classifications, six groups were created: (a) normal (no diabetes and normal weight); (b) normal weight and diabetes; (c) overweight but not diabetes (overweight); (d) overweight and diabetes (prediabesity); (e) obesity but not diabetes (obesity); and (f) obesity and diabetes (diabesity). Associations between these categories and outcomes were investigated using Cox proportional hazard models adjusted for confounder factors. RESULTS: During 18.3 years of follow-up, 27 197 (17.6%) participants died (28.5% because of CV causes). In the maximally adjusted model, participants those with the highest risk {hazard ratio (HR): 2.37 [95% confidence interval (CI): 2.24-2.51]}, followed by those with diabesity [HR: 2.04 (95% CI: 1.94-2.15)]. Similar trends of associations were observed for CVD mortality. The highest CV mortality risk was observed in individuals with diabesity [HR: 1.80 (95% CI: 1.63-1.99)], followed by normal weight and diabetic individuals [HR: 1.78 (95% CI: 1.60-1.98)]. CONCLUSION: This large prospective study identified that diabetes was the main driver of all-cause and CVD mortality in all the categories studied, with diabesity being the riskiest. Given the high prevalence of both conditions in Mexico, our results reinforce the importance of initiating prevention strategies from an early age.
Assuntos
Doenças Cardiovasculares , Obesidade , Humanos , Feminino , México/epidemiologia , Masculino , Doenças Cardiovasculares/mortalidade , Doenças Cardiovasculares/epidemiologia , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto , Obesidade/complicações , Obesidade/mortalidade , Obesidade/epidemiologia , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/mortalidade , Causas de Morte , Idoso , Fatores de Risco , Sobrepeso/mortalidade , Sobrepeso/complicações , Sobrepeso/epidemiologia , Índice de Massa Corporal , Modelos de Riscos Proporcionais , Estado Pré-Diabético/mortalidade , Estado Pré-Diabético/epidemiologia , Estado Pré-Diabético/complicaçõesRESUMO
AIM: We aimed to develop and assess a modified healthy aging index (HAI) among Chileans aged 60 years and older and compare its predictive ability for all-cause mortality risk with the frailty index (FI). METHODS: This prospective study analyzed data from the Chilean National Health Survey (CNHS) conducted in 2009-2010. We included 847 adults with complete data to construct the HAI and FI. The HAI comprised five indicators (lung function, systolic blood pressure, fasting glucose, cognitive status, and glomerular filtration rate), while the FI assessed frailty using a 36-item scale. HAI scores were calculated by summing the indicator scores, ranging from 0 to 10, with higher scores indicating poorer health. Receiver operating curves (ROC) and area under the curve (AUC) were used to assess predictive validity. Associations with all-cause mortality were assessed using Cox proportional hazard models adjusted by confounders. RESULTS: The mean HAI score was 4.06, while the FI score was 0.24. The AUC for mortality was higher for the HAI than the FI (0.640, 95% confidence interval (CI) 0.601 to 0.679 vs. 0.586, 95% CI 0.545 to 0.627). After adjusting for confounders, the FI showed a higher mortality risk compared to the HAI (2.63, 95% CI 1.76 to 3.51 vs. 1.16, 95% CI 1.08 to 1.26). CONCLUSION: The FI and HAI were valid predictors for all-cause mortality in the Chilean population. Integrating these indices into research and clinical practice can significantly enhance our capacity to identify at-risk individuals.
Assuntos
Fragilidade , Envelhecimento Saudável , Mortalidade , Idoso , Humanos , Pessoa de Meia-Idade , Idoso Fragilizado , Estudos Prospectivos , População da América do SulRESUMO
OBJECTIVES: The objective was to investigate the benefits of the 'weekend warrior' physical activity pattern in Latin America, where many people take part in high levels of non-exercise physical activity. METHODS: Participants in the Mexico City Prospective Study were surveyed from 1998 to 2004 and resurveyed from 2015 to 2019. Those who exercised up to once or twice per week were termed weekend warriors. Those who exercised more often were termed regularly active. Analyses were adjusted for potential confounders. RESULTS: The main analysis included 26 006 deaths in 154 882 adults (67% female) aged 52±13 years followed for 18±4 years (mean±SD). Compared with those who reported no exercise, the HR (95% CI) was 0.88 (0.83 to 0.93) in the weekend warriors and 0.88 (0.84 to 0.91) in the regularly active. Similar results were observed for cardiovascular disease and cancer mortality, but associations were weaker. Stratified analyses showed that substantial reductions in all-cause mortality risk only occurred when the duration of exercise sessions was at least 30-60 min. The repeated-measures analysis included 843 deaths in 10 023 adults followed for 20±2 years. Compared with being inactive or becoming inactive, the HR was 0.86 (95% CI 0.65 to 1.12) when being a weekend warrior or becoming a weekend warrior and 0.85 (95% CI 0.70 to 1.03) when being regularly active or becoming regularly active. CONCLUSIONS: This is the first prospective study to investigate the benefits of the weekend warrior physical activity pattern in Latin America. The results suggest that even busy adults could benefit from taking part in one or two sessions of exercise per week.
Assuntos
Doenças Cardiovasculares , Neoplasias , Adulto , Humanos , Feminino , Masculino , Doenças Cardiovasculares/prevenção & controle , Estudos Prospectivos , Exercício Físico , México/epidemiologia , Inquéritos e QuestionáriosRESUMO
BACKGROUND: We examined the association between individual lifestyle risk factors with all-cause and cause-specific mortality. METHODS: Prospective cohort study including 155,002 participants from the Mexico City Prospective Study. Cox regression models were used to estimate the association between individual lifestyle risk factors and all-cause and cause-specific mortality. Participants with prevalent diseases at baseline and participants who died during the first 2, 5, 10, and 15 years of follow-up were excluded to account for reverse causation. RESULTS: 27,469 people died during 18.3 years of follow-up years. Overweight and moderate alcohol consumption were inversely associated with all-cause mortality, while low physical activity and smoking were positively associated when all participants were included, regardless of prevalent disease or duration of follow-up. The direction of the association of overweight with all-cause mortality changed from inverse to positive after excluding the first 10 years of follow-up. Compared with normal weight, the hazard ratio (95 % confidence interval) was 1.17 (1.13,1.22) for obesity after excluding those who died in the first 5 years of follow-up and 1.71 (1.59,1.84) after excluding the first 15 years of follow-up. The magnitude of the association of alcohol intake, low physical activity, and smoking with mortality attenuated, whereas for fruits and vegetables increased, after excluding longer periods of follow-up. LIMITATIONS: The data were collected exclusively in Mexico City; lifestyle risk factors were self-reported and thus prone to misclassification bias. CONCLUSIONS: Reverse causation may influence both the magnitude and the direction of the associations between lifestyle risk factors and mortality.
Assuntos
Estilo de Vida , Sobrepeso , Humanos , Estudos Prospectivos , Causas de Morte , México/epidemiologia , Sobrepeso/epidemiologia , Fatores de RiscoRESUMO
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.
Assuntos
Estilo de Vida Saudável , Estilo de Vida , Humanos , Estudos Prospectivos , Chile/epidemiologia , Inquéritos Epidemiológicos , Fatores de RiscoRESUMO
Research on morbidity and mortality often emphasizes individual diseases over the cumulative effects of multimorbidity, especially in low- and middle-income countries. This study aimed to analyze the association between multimorbidity and all-cause mortality in a representative sample of the Chilean population. This longitudinal study used data from 3701 subjects aged ≥15 years who participated in the Chilean National Health Survey conducted between 2009 and 2010. We included 16 self-reported highly prevalent morbidities. All-cause mortality data from an 11-year follow-up were collected from the Chilean Civil Registry. The Cox proportional hazard model, adjusted for confounders, determined the association between multimorbidity categories and all-cause mortality. Of the total sample, 24.3% reported no morbidity, while 50.4% two or more. After adjustment, participants with four or more morbidities had a 1.66 times higher mortality risk [95% confidence interval (CI): 1.03-2.67] than those without morbidities. The mortality risk increased by 10% for each additional morbidity [HR: 1.09 (CI: 1.04-1.16)]. Multimorbidity was common in the Chilean population and increased the mortality risk, which greatly challenges the health system to provide an integral and coordinated approach to healthcare.
Assuntos
Instalações de Saúde , Multimorbidade , Adulto , Humanos , Estudos Longitudinais , Chile/epidemiologiaRESUMO
Multimorbidity patterns can lead to differential risks for all-cause mortality. Within the Chilean context, research on morbidity and mortality predominantly emphasizes individual diseases or combinations thereof, rather than specific disease clusters. This study aimed to identify multimorbidity patterns, along with their associations with mortality, within a representative sample of the Chilean population. 3,701 participants aged ≥18 from the Chilean National Health Survey 2009-2010 were included in this prospective study. Multimorbidity patterns were identified from 16 chronic conditions and then classified using latent class analyses. All-cause mortality data were extracted from the Chilean Civil Registry. The association of classes with all-cause mortality was carried out using Cox proportional regression models, adjusting by sociodemographic and lifestyle variables. Three classes were identified: a) Class 1, the healthiest (72.1%); b) Class 2, the depression/cardiovascular disease/cancer class (17.5%); and c) Class 3, hypertension/chronic kidney disease class (10.4%). Classes 2 and 3 showed higher mortality risk than the healthiest class. After adjusting, Class 2 showed 45% higher mortality risk, and Class 3 98% higher mortality risk, compared with the healthiest class. Hypertension appeared to be a critical underlying factor of all-cause morbidity. Particular combinations of chronic diseases have a higher excess risk of mortality than others.
Assuntos
Doenças Cardiovasculares , Hipertensão , Adulto , Humanos , Estudos Prospectivos , Análise de Classes Latentes , Multimorbidade , Chile/epidemiologia , Doença Crônica , Hipertensão/epidemiologia , Doenças Cardiovasculares/epidemiologiaRESUMO
This study examined the association between folic acid supplements (FAs) during different periods of pregnancy and offspring telomere length (TL) at age four in 666 children from the INMA study. FAs were self-reported using food-structured questionnaires during three periods of pregnancy (the first three months of pregnancy, from month fourth onward, and the whole pregnancy). For each period, the average daily dosage of FAs was categorised into (i) <400 µg/d, (ii) ≥400 to 999 µg/d, (iii) ≥1000 to 4999 µg/d, and (iv) ≥5000 µg/d. Leucocyte TL at age four was measured using quantitative PCR methods. Multiple robust linear log-level regression models were used to report the % difference among FA categories. During the first period, and compared with children whose mothers were classified in the reference group (<400 µg/d), children whose mothers took higher dosages of FAs showed shorter TL at age four (≥5000 µg/d). When the first and the second periods were mutually adjusted, children whose mothers self-reported ≥5000 µg/d during the first period of pregnancy had a statistically significant shorter TL than their counterparts (% difference: -7.28% [95% CI: -14.42 to -0.13]). Similar trends were observed for the whole period of pregnancy. When the analysis was stratified by sex, the association was more evident in boys (% difference: -13.5% [95% CI: -23.0 to -4.04]), whereas no association was observed in girls. This study suggests that high dosages of FAs in the first pregnancy period may be associated with a shorter TL in children at age four, particularly among boys. Further studies should confirm these results.
Assuntos
Suplementos Nutricionais , Ácido Fólico , Masculino , Gravidez , Feminino , Humanos , Criança , Estudos de Coortes , Inquéritos e Questionários , TelômeroRESUMO
Introducción: La actividad física y el fitness cardiorrespiratorio (FCR) son factores protectores en el desarrollo de cáncer. Sin embargo, se desconoce el FCR en población chilena diagnosticada con cáncer. Objetivo: Evaluar la asociación que tuvo el FCR entre las personas con y sin diagnóstico de cáncer, y secundariamente comparar la tendencia del FCR según años de diagnóstico de cáncer en población chilena. Método: Se analizaron datos de 5.483 personas de la Encuesta Nacional de Salud 2016-2017 entre 15 y 98 años. El diagnóstico de cáncer (todos los disponibles) se determinó con preguntas estandarizadas, y el FCR se calculó con método abreviado (demografía, antropometría, estilos de vida). Se realizó análisis de regresión lineal ajustado por variables de confusión con el módulo de análisis de muestras complejas del programa STATA v.16 (95% IC, p < 0,05). Resultados: Las personas con algún tipo de diagnóstico de cáncer, versus aquellas sin cáncer, presentaron un menor nivel de FCR (fi: -1,23 [95% IC: -1,52; -0,94]). Al comparar los niveles de FCR según tipo de cáncer, se observaron resultados similares para cáncer colorrectal, de mama y útero (p < 0,001), pero no para cáncer de tiroides (p = 0,253). Hubo menor FCR desde el primer año de diagnóstico de todo tipo de cáncer hasta sobre diez años, aunque no significativo (p = 0,109). Conclusión: Los diagnosticados con cáncer presentaron menor FCR comparado a los no diagnosticados. Además, en las personas con cáncer el FCR disminuye al incrementar los años desde el primer diagnóstico. Sería importante evaluar e incrementar el FCR en pacientes oncológicos.
Introduction: Physical activity and cardiorespiratory fitness (CRF) are protective factors in cancer development. However, the CRF in the Chilean population diagnosed with cancer is unknown. This study aimed to evaluate the association that the CRF had between people with and without a cancer diagnosis and, secondarily, to compare the trend of the CRF according to years of cancer diagnosis in the Chilean population. Methods: Data from 5,483 people from the 2016-2017 National Health Survey between 15 and 98 years old were analyzed. Cancer diagnosis (all available) was determined with standardized questions, and CRF was calculated with an abbreviated method (demographics, anthropometry, lifestyles). Linear regression analysis adjusted for confounding variables was performed with the complex sample analysis module of the STATA v.16 program (95% CI, p < 0.05). Results: People with some cancer diagnosis versus those without cancer had a lower FCR level (ft: -1.23 [95% CI: -1.52; -0.94]). When comparing CRF levels according to cancer type, similar results were observed for colorectal, breast, and uterine cancer (p < 0.001) but not for thyroid cancer (p = 0.253). There was lower CRF from the first year of diagnosis of all types of cancer to over ten years, although not significant (p = 0.109). Conclusions: Those diagnosed with cancer presented lower CRF compared to those not diagnosed. In addition, in people with cancer, the CRF decreased with increasing years since the first diagnosis. It would be essential to evaluate and increase CRF in cancer patients.
RESUMO
The term "vegetarian" usually refers to individuals who exclude meat, fish, poultry and/or their derived products from their diet [...].
Assuntos
Dieta , Estado Nutricional , Animais , Humanos , Carne , VegetarianosRESUMO
ANTECEDENTES: Tanto el gen FTO (Fat-mass and obesity-associated-gene) y el tiempo sedente se asocian a obesidad, sin embargo, se desconoce si el tiempo sedente puede modificar la predisposición genética a la obesidad. Por ende, el objetivo de este estudio fue investigar si la asociación entre el polimorfismo rs9939609 del gen FTO y marcadores de adiposidad podrían ser modificados por el tiempo sedente. MÉTODOS: Este estudio de corte transversal incluye a 409 participantes del estudio GENADIO. Los marcadores de adiposidad estudiados fueron peso corporal, índice de masa corporal (IMC), perímetro de cintura (PC) y porcentaje masa grasa. El tiempo sedente se determinó mediante acelerometría de movimiento. La interacción entre el gen FTO (rs9939609) y el tiempo sedente sobre los marcadores de adiposidad se determinó mediante análisis de regresión múltiple. RESULTADOS: Tanto la variante de riesgo del gen FTO como el tiempo sedente se asociaron a mayor peso corporal, IMC, PC y masa grasa. Sin embargo, la asociación entre tiempo sedente y marcadores de adiposidad fue mayor en personas portadoras del alelo de riesgo del gen FTO. Por cada 1 hora de incremento en tiempo sedente, el peso corporal incrementa en 1,36 kg ([95% IC: 0,27; 2,46], p = 0,015) y 2,95 kg ([95% IC: 1,24; 4,65], p = 0,001) en personas con la variante protectora (TT) versus aquellos con la variante de riesgo (AA), respectivamente. Resultados similares se encontraron para (PC). CONCLUSIÓN: La asociación entre la variante de riesgo de FTO y mayor nivel de adiposidad es más acentuada en individuos que presentan mayores niveles de sedentarismo.
BACKGROUND: The Fat-mass and obesity-associated-gene (FTO gene) and sedentary behavior time are associated with obesity. However, whether sedentary behavior time can modify the genetic predisposition to obesity in the Chilean population is unknown. Therefore, this study investigated the association between sedentary behavior, adiposity markers, and the FTO gene. METHODS: This cross-sectional study included 409 participants from the Genes, Environment, Diabetes, and Obesity (GENADIO) study. Adiposity markers studied included body weight, body mass index (BMI), waist circumference (WC), and fat mass. Sedentary behaviors were measured using accelerometers. Using multiple regression, we evaluated the interaction between sedentary behaviors and the FTO gene (rs9939609) on adiposity markers. RESULTS: Sedentary behaviors and the FTO genotype were positively associated with higher body weight, BMI, WC, and fat mass. However, the association between time of sedentary behavior and adiposity markers was higher in carriers of the risk variant for the FTO gene. For each hour of increment in sedentary behaviors, body weight increases by 1.36 kg ([95% CI: 0.27; 2.46], p = 0.015) and 2.95 kg ([95%CI: 1.24; 4.65], p = 0.001) in non-risk carriers (TT) versus risk carriers (AA), respectively. We observed similar results for WC, BMI, and body fat, but the interaction was significant only for WC. CONCLUSION: The association between sedentary behaviors and adiposity markers, especially body weight and WC, is higher in individuals who carry the risk variant of the FTO gene.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Índice de Massa Corporal , Predisposição Genética para Doença/genética , Adiposidade/genética , Circunferência da Cintura/genética , Comportamento Sedentário , Dioxigenase FTO Dependente de alfa-Cetoglutarato/genética , Obesidade/genética , Chile , Estudos Transversais , Fatores de Risco , Polimorfismo de Nucleotídeo Único/genética , GenótipoRESUMO
This study aimed to investigate the association between the Life's Essential 8 (LE8) score and incident all-cause dementia (including Alzheimer's disease [AD] and vascular dementia) in UK Biobank. A total of 259,718 participants were included in this prospective study. Smoking, non-HDL cholesterol, blood pressure, body mass index, HbA1c, physical activity, diet, and sleep were used to create the Life's Essential 8 (LE8) score. Associations between the score (both continuous and as quartiles) and outcomes were investigated using adjusted Cox proportional hazard models. The potential impact fractions of 2 scenarios and the rate advancement periods were also calculated. Over a median follow-up of 10.6 years, 4958 participants were diagnosed with any dementia. Higher LE8 scores were associated with lower risk of all-cause and vascular dementia in an exponential decay pattern. Compared with individuals in the healthiest quartile, those in the least healthy quartile had a higher risk of all-cause dementia (HR: 1.50 [95% CI: 1.37-1.65] and vascular dementia (HR: 1.86 [1.44-2.42]). A targeted intervention that increased the score by 10-points among individuals in the lowest quartile could have prevented 6.8% of all-cause dementia cases. Individuals in the least healthy LE8 quartile might develop all-cause dementia 2.45 years earlier than their counterparts. In conclusion, individuals with higher LE8 scores had lower risk of all-cause and vascular dementia. Because of nonlinear associations, interventions targeted at the least healthy individuals might produce greater population-level benefits.
Assuntos
Demência Vascular , Humanos , Estudos Prospectivos , Fatores de Risco , Demência Vascular/diagnóstico , Demência Vascular/epidemiologia , Demência Vascular/etiologia , Bancos de Espécimes BiológicosRESUMO
RESEARCH QUESTION: What was the utilization, effectiveness and safety of assisted reproductive technology (ART) in Latin America during 2020? DESIGN: Retrospective collection of multinational data on ART performed by 188 institutions in 16 countries. RESULTS: Overall, 87,732 initiated cycles resulted in 12,778 deliveries and 14,582 births. The major contributors were Brazil (46.0%), Mexico (17.0%) and Argentina (16.8%). However, the highest utilization (cycles/million inhabitants) was Uruguay with 558, followed by Argentina with 490 and Panama with 425 cycles/million. Globally, women aged ≥40 years increased to 34% while women ≤34 dropped to 24.7%. After removing freeze-all cycles, the delivery rate per oocyte retrieval was 14.8% for intracytoplasmic sperm injection and 15.6% for IVF. Single-embryo transfer (SET) represented 38.3% of all fresh transfers, with delivery rate per transfer of 20.0%; this increased to 32.4% for elective SET (eSET) and 34.2% for blastocyst eSET, compared with blastocyst elective double embryo transfer (eDET) of 37.9%. However, multiple births increased from 1% in eSET to 30.5% in eDET. Perinatal mortality increased from 7.7 in singletons to 24.4 in twins and 64.0 in triplets. Frozen embryo transfer (FET) represented 66.6% of all transfers, with a delivery rate/transfer of 29.0%, significantly higher than 23.9% after fresh transfers at all ages (p<0.0001). Preimplantation genetic testing, reported in 8920 cycles, significantly improved delivery rate and decreased miscarriage rates at all ages (p≤0.041), including oocyte donation (p=0.002). Endometriosis was diagnosed in 28.3% of cases. The delivery rate in 5779 women after removal of peritoneal endometriosis was significantly better than tubal and endocrine factors in women aged 35-39 (p=0.0004) and women aged ≥40 (p=0.0353). CONCLUSIONS: Systematic collection and analysis of big data in a south-south cooperation model allow regional growth by implementing evidence-based reproductive decisions.
Assuntos
Endometriose , Resultado da Gravidez , Gravidez , Masculino , Humanos , Feminino , Resultado da Gravidez/epidemiologia , América Latina/epidemiologia , Estudos Retrospectivos , Sêmen , Técnicas de Reprodução Assistida , Sistema de RegistrosRESUMO
Atherosclerosis, chronic non-communicable diseases, and metabolic syndrome are highly interconnected and collectively contribute to global health concerns that reduce life expectancy and quality of life. These conditions arise from multiple risk factors, including inflammation, insulin resistance, impaired blood lipid profile, endothelial dysfunction, and increased cardiovascular risk. Adopting a plant-based diet has gained popularity as a viable alternative to promote health and mitigate the incidence of, and risk factors associated with, these three health conditions. Understanding the potential benefits of a plant-based diet for human health is crucial, particularly in the face of the rising prevalence of chronic diseases like diabetes, hypertension, dyslipidemia, atherosclerosis, and cancer. Thus, this review focused on the plausible advantages of consuming a type of food pattern for the prevention and/or treatment of chronic diseases, emphasizing the dietary aspects that contribute to these conditions and the evidence supporting the benefits of a plant-based diet for human health. To facilitate a more in-depth analysis, we present separate evidence for each of these three concepts, acknowledging their intrinsic connection while providing a specific focus on each one. This review underscores the potential of a plant-based diet to target the underlying causes of these chronic diseases and enhance health outcomes for individuals and populations.
Assuntos
Aterosclerose , Síndrome Metabólica , Humanos , Síndrome Metabólica/prevenção & controle , Qualidade de Vida , Promoção da Saúde , Aterosclerose/prevenção & controle , Dieta Vegetariana , Doença CrônicaRESUMO
Antecedentes: La velocidad de marcha es un marcador funcional, utilizado como predictor de enfermedades crónicas. Sin embargo, existe escasa evidencia de la asociación entre la velocidad de marcha y obesidad. Objetivo: Investigar la asociación entre la velocidad de marcha auto-reportada y obesidad en población chilena. Métodos: 6.183 participantes entre 15 a 98 años de la Encuesta Nacional de Salud 2016-2017 de Chile fueron incluidos en este estudio transversal. Peso corporal, talla, perímetro de cintura (PC), índice de masa corporal (IMC) e índice cintura/altura (ICA) fueron determinados. Auto-reporte de velocidad de la marcha (normal, lenta, rápida) fue la variable de exposición. La relación entre velocidad de marcha y marcadores de obesidad fue determinada mediante regresión lineal y regresión de Poisson y todos los análisis fueron ajustados en Modelos según factores sociodemográficos y estilos de vida. Resultados: En el modelo más ajustado, quienes reportaron una velocidad de marcha normal y rápida presentaron un menor IMC (p: -1,03, p = 0,017y -1,56p = 0,001, respectivamente), menor PC (p: -2,98, p = 0,004 y -3,64, p = 0,001) e ICA (3: -0,19, p = 0,004 y -0,26 p < 0,0001) respecto a quienes reportaron una marcha lenta. La velocidad de marcha rápida se asoció a una menor probabilidad de tener obesidad y obesidad central. Conclusión: La velocidad de marcha normal y rápida fueron asociadas con menor peso corporal, IMC, PC e ICA. La velocidad de marcha rápida se asoció a una menor probabilidad de obesidad y obesidad central, independiente de factores sociodemográficos y estilos de vida.
Background: Walking Pace is a functional marker, used as a predictor of chronic diseases. However, there is a lack of evidence on the association between walking pace and obesity. Aim: To investigate the association between-self-reported walking pace with obesity in the Chilean adult population. Methods: 6,183 Chilean participants (aged 15 to 98 years) from the Chilean National Health Survey 2016-2017 were included in this cross-sectional study. Weight, height, waist circumference (WC), body mass index (BMI) and waist to height ratio (WHtR) were the outcomes of interest. Self-reported walking pace (slow, average and brisk) was the exposure. The association between walking pace and obesity was determined by linear regression and Poisson regression and all analyses were adjusted in models according to sociodemographic and lifestyle factors. Results: In the most adjusted model, those who reported an average and brisk walking pace had a lower BMI (¡3: -1.03, p = 0.017 and-1.56 p = 0.001), lower WC (3: -2.98, p = 0.004 and -3.64, p = 0.001) and waist to height ratio (3: -0.19, p = 0.004 and -0.26 p < 0.0001) compared to people who reported a slow walking pace. A brisk walkingpace was associated with a lower probability of obesity and central obesity. Conclusion: the average and brisk walkingpace was associated with lower body weight, BMI, waist circumference and waist to height ratio and a brisk walking pace was associated with a lower probability of obesity and central obesity, independently of sociodemographic and lifestyle factors.