Publications

Citation

Fanny Petermann-Rocha; Marcela Carrasco G; Paula Margozzini. (2026). Sarcopenia in the Metropolitan Region of Chile: Cross-Sectional Findings from the Chilean National Health Survey 2016–2017. Revista médica de Chile, 154(3), 373-382. https://doi.org/10.4067/s0034-98872026000300373

Abstract

Aim To investigate sarcopenia in Chile, including its prevalence and association with sociodemographic and lifestyle factors. Methods 232 participants from the Metropolitan Region, representing 1,037,790 older adults, were included in this cross-sectional analysis. Sarcopenia was defined using the European Working Group on Sarcopenia in Older People 2019 statement. Age, sex, education, place of residency, marital status, smoking, self-perception of health, sleep, alcohol consumption, body mass index, waist circumference, physical activity, sedentary behaviour, and suspicion of cognitive impairment were the risk factors assessed. Poisson regression models were used to analyse the cross-sectional associations of sarcopenia by sociodemographic and lifestyle factors. All analyses accounted for the complex survey design and population expansion weights in Stata 18. Results 22.1% (95% CI: 15.5% to 30.3%) of the included participants exhibited sarcopenia. After adjusting, per each year of increment of age, the prevalence of sarcopenia increased by 4% (PR: 1.04 [95% CI: 1.01 to 1.08]). In addition, people with bad and regular self-reported health had 3.06 (95% CI: 1.34 to 6.98) and 1.88-times (95% CI: 1.03 to 3.41) higher prevalence of sarcopenia than people with a good perception. No other significant associations were identified. Conclusion Considering that sarcopenia is associated with higher risk of disability and reduction in quality of life and it could begin early in life, actions to address its risk are more urgent than ever.

Citation

Fanny Petermann-Rocha; Camilo Briones-Valdivieso. (2026). Diabetes en el embarazo y neurodesarrollo: Un llamado urgente a la acción. Revista médica de Chile, 154(1), 142-143. https://doi.org/10.4067/s0034-98872026000100142

Abstract availability

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Citation

Gary O’Donovan; Fanny Petermann-Rocha; Gerson Ferrari; Catalina Medina; Evelia Apolinar-Jiménez; Olga L. Sarmiento. (2026). Leisure-Time Physical Activity Is Associated With Reduced Risks of Mortality in Adults With General or Abdominal Obesity in Mexico. American Journal of Preventive Medicine, 70(6), 108302. https://doi.org/10.1016/j.amepre.2026.108302

Abstract summary

Prospective study of 153,060 adults in Mexico City, followed for approximately 18 years. Leisure-time physical activity was associated with lower mortality in people with general or abdominal obesity. In class II obesity, the relative risk of all-cause mortality was lower among those reporting moderate or high activity than among those reporting little activity, using inactive people of normal weight as the reference. Favourable associations were also observed for cardiovascular and cancer mortality. The observational design does not establish causality.

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Citation

Mariél de Aquino Goulart; Jorge Celis-Dooner; Fanny Petermann-Rocha; David I. Conway; Andrés Celis; Alex D. McMahon. (2026). Trends in Socioeconomic Inequalities of Dental Caries Experience among 12-Year-Olds in Chile: An Ecological Cohort Study. Caries Research, 1-11. https://doi.org/10.1159/000551081

Abstract

Introduction Socioeconomic inequalities in adolescent dental caries remain a major public health concern, even in countries with declining overall prevalence. Chile provides a unique setting to examine these inequalities nationally and assess the potential mitigating role of systemic fluoride delivery programmes. This study aimed to address these gaps by providing a national analysis of dental caries trends among 12-year-olds in Chile from 2009 to 2023 and investigate socioeconomic inequalities in dental caries experience between municipalities. Methods This ecological cohort study analysed 1,261,690 dental examinations of 12-year-olds across 325 Chilean municipalities from 2009 to 2023, representing 99.8% of eligible national records. Caries prevalence was modelled against area socioeconomic deprivation (IDSE deciles), adjusting for rurality and systemic fluoride delivery programmes, and weighting for number of total examinations by municipality/year. Inequality metrics included absolute rate difference (ARD), Slope Index of Inequality (SII), and Relative Index of Inequality (RII). Results During the study period, a strong and persistent socioeconomic gradient was observed: adolescents in the most deprived municipalities had a 17-percentage-point higher caries prevalence than those in the least deprived (β = -0.17, 95% confidence interval [95% CI]: -0.20, -0.14). This gradient followed a dose-response pattern and was confirmed by summary measures (ARD = 0.151; RRR = 1.234). Temporal analysis revealed peak inequality pre-2018 (SII = 0.17, 95% CI: -0.20, -0.14), followed by a steady decline post-2018, reaching statistically nonsignificant levels by 2023 (SII = 0.04, 95% CI: -0.15, 0.06). Fluoridation programmes modestly attenuated the deprivation gradient by 24% (β = -0.13), though they explained limited variance (ΔR2 = 0.04). Conclusion Socioeconomic inequalities in dental caries among Chilean adolescents remain substantial, despite national declines in prevalence. While systemic fluoridation contributes to modest reductions in inequality, structural determinants are the primary drivers of persistent inequalities.

Citation

Nicole Lasserre-Laso; Miquel Martorell; Roberto Candia; Fanny Petermann. (2026). ¿Cuál es la efectividad de una intervención basada en la dieta para modificar el perfil de lípidos séricos y el estado nutricional en mujeres con cáncer de mama? Un estudio piloto aleatorizado. Revista chilena de nutrición, 53(1), 61-70. https://doi.org/10.64159/rchnut-53-1-8

Abstract

Introduction: Women with breast cancer (BC) may experience metabolic changes, including increased body weight and altered serum lipid profiles, increasing the risk of recurrence and mortality. Objective: To evaluate the effectiveness of a diet-based pilot study on serum lipid profiles and nutritional status in women with breast cancer. Methods: Randomised pilot study: 16 women with BC (age 52.1 ± 3.3 years) were randomly assigned to an intervention group (n=8) or control group (n=8); 11 completed the study. The intervention group received a personalised diet with four months of follow-up. Anthropometric measurements (body weight, height, waist circumference and body fat), biochemical measurements (serum lipid profile) and dietary assessment were conducted. Results: At baseline, 54.5% had excess weight and body fat, and 72.7% had abdominal obesity. Total cholesterol was elevated in 34.6% and triglycerides in 45.5%. The intervention group significantly increased the dietary protein percentage (ANOVA 0.008), vegetable consumption (ANOVA 0.031) and fruit consumption (ANOVA 0.043), and reduced cereal intake (ANOVA 0.001). No significant between-group differences in nutritional status or lipid profile were found before and after intervention. Conclusion: A pilot dietary intervention improved diet quality in women with breast cancer. No significant differences in serum lipid profile or nutritional status were observed; further studies are needed to establish effects on these parameters.

Citation

GBD 2023 MASLD Collaborators. (2026). Global burden of metabolic dysfunction-associated steatotic liver disease, 1990–2023, and projections to 2050: a systematic analysis for the Global Burden of Disease Study 2023. The Lancet Gastroenterology & Hepatology, 11(6), 463-494. https://doi.org/10.1016/s2468-1253(26)00011-7

Abstract

Background Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease, is one of the most prevalent liver diseases globally, contributing to both economic and health-related challenges. We aimed to evaluate the global, regional, and national burden of MASLD from 1990 to 2023, quantify the contribution of identified modifiable risk factors, and project future prevalence up to the year 2050. Methods Estimates of MASLD prevalence and disability-adjusted life-years (DALYs) were produced by age, sex, region, Socio-demographic Index (SDI), and Healthcare Access and Quality (HAQ) index across 204 countries and territories from 1990 to 2023 as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023. The MASLD burden attributable to three risk factors (smoking, high BMI, and high fasting plasma glucose) was assessed as part of the GBD comparative risk assessment. As a secondary analysis, we used these estimates to forecast MASLD prevalence up to 2050 using fasting plasma glucose and mean BMI as predictors. Furthermore, to examine the relative contributions of population ageing, population growth, and changes in MASLD prevalence rate to the forecasted changes in case counts from 2023 to 2050, we conducted a decomposition analysis. Findings In 2023, approximately 1·3 billion (95% uncertainty interval [UI] 1·2 to 1·4) individuals were estimated to be living with MASLD (ie, 16·1% of the global population), with an age-standardised prevalence rate of 14 429·3 (95% UI 13 268·3 to 15 990·6) per 100 000 population, representing a percentage increase of 142·7% (95% UI 139·2 to 146·7) in crude numbers from 1990 (0·5 billion [0·5 to 0·6]) and of 28·6% (27·8 to 29·5) in the rate (11 217·2 [10 276·8 to 12 467·0] per 100 000 in 1990). An estimated 3·6 million (2·8 to 4·5) total DALYs were attributable to MASLD worldwide in 2023, corresponding to an age-standardised DALY rate of 39·6 (31·2 to 49·9) per 100 000 population. Despite a 116·3% (93·3 to 139·4) increase in crude DALYs (from 1·7 million [1·3 to 2·1] in 1990), its age-standardised estimate remained consistent (1·8% [-8·6 to 12·8]) from 1990 (38·9 [30·1 to 49·8] per 100 000) to 2023. There was substantial variation in age-standardised estimates across regions. North Africa and the Middle East had the highest prevalence rate (29 246·1 [26 848·3 to 32 048·7] per 100 000) and Andean Latin America showed the highest DALY rate (152·3 [114·1 to 194·7] per 100 000). By contrast, the high-income Asia Pacific region had the lowest prevalence rate (8653·5 [7923·7 to 9592·8] per 100 000) and east Asia had the lowest DALY rate (16·3 [13·5 to 19·9] per 100 000) among all GBD regions. North Africa and the Middle East showed disproportionately higher prevalence rates relative to other regions with similar SDIs. Lower SDIs and HAQs were associated with higher age-standardised DALY rates. The age-standardised prevalence rate was consistently higher in males (15 616·4 [14 349·2 to 17 263·3] per 100 000 people in 2023) than in females (13 245·2 [12 132·0 to 14 692·6] per 100 000 people), and peaked at age 80-84 years in both sexes. The number of MASLD prevalent cases was the highest in younger adults, peaking at age 35-39 years for males and age 55-59 years for females. Among the risk factors for MASLD, high fasting plasma glucose presented the largest contribution to the age-standardised DALY rate of total MASLD in 2023 (2·2 [95% UI 1·6 to 3·1] per 100 000 people), followed by high BMI (1·4 [0·6 to 2·4] per 100 000 people) and smoking (1·0 [0·3 to 1·8] per 100 000 people). Our forecasting model estimates that 1·8 billion (95% UI 1·6 to 2·0) individuals are likely to have MASLD by 2050, representing a 42·0% increase from 2023. The age-standardised prevalence rate is expected to increase to 15 774·9 (95% UI 14 613·9 to 17 336·2) per 100 000 people in 2050, representing an average annual percentage change of 0·3% (95% UI 0·3-0·3). According to our decomposition analysis, this change will be primarily due to population growth, particularly in sub-Saharan Africa and North Africa and Middle East, and less by population ageing or epidemiological change. Interpretation With a global prevalence of 16·1% and approximately 1·3 billion people already living with MASLD in 2023, the condition has and will continue to have substantial health and economic impacts worldwide. An inverse association between the HAQ Index and age-standardised DALY rates suggests that countries with lower health-care access and quality might be less well positioned to manage the growing MASLD burden, underscoring the need for strengthened health-system capacity in these settings. Funding Gates Foundation.

Citation

GBD 2023 IHD & Dietary Risk Factors Collaborators. (2026). Global, regional and national burden of ischemic heart disease attributable to suboptimal diet, 1990–2023: a Global Burden of Disease study. Nature Medicine, 32(4), 1454-1478. https://doi.org/10.1038/s41591-026-04250-8

Abstract summary

GBD 2023 analysis of ischaemic heart disease attributable to dietary risks in 204 countries. An estimated 4.06 million deaths and 96.84 million disability-adjusted life-years were associated with inadequate diets in 2023. Although age-standardised mortality rates declined since 1990, a substantial burden persisted, especially in countries with lower sociodemographic development. Low consumption of nuts, seeds, whole grains and fruit, together with excess sodium, stood out among modifiable factors.

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Citation

GBD 2023 Child Growth Failure Collaborators. (2026). Quantifying the fatal and non-fatal burden of disease associated with child growth failure, 2000–2023: a systematic analysis from the Global Burden of Disease Study 2023. The Lancet Child & Adolescent Health, 10(1), 22-38. https://doi.org/10.1016/s2352-4642(25)00303-7

Abstract

BACKGROUND: Child growth failure (CGF), which includes underweight, wasting, and stunting, is among the factors most strongly associated with mortality and morbidity in children younger than 5 years worldwide. Poor height and bodyweight gain arise from a variety of biological and sociodemographic factors and are associated with increased vulnerability to infectious diseases. We used data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 to estimate CGF prevalence, the risk of infectious diseases associated with CGF, and the disease mortality, morbidity, and overall burden associated with CGF. METHODS: In this analysis we estimated the all-cause and cause-specific (diarrhoea, lower respiratory tract infections, malaria, and measles) disability-adjusted life-years (DALYs) lost and mortality associated with stunting, wasting, underweight, and CGF in aggregate. We combined the burden associated with mild, moderate, and severe forms of CGF: stunting was defined as height-for-age Z scores (HAZ) less than -1, underweight was defined as weight-for-age Z scores (WAZ) less than -1, and wasting was defined as weight-for-height Z scores (WHZ) less than -1, according to WHO Child Growth Standards. Population-level continuous distributions of HAZ, WAZ, and WHZ were estimated for 2000 to 2023 using data from surveys, literature, and individual-level study data. The risk of incidence of, and mortality due to, diarrhoea, lower respiratory infections, malaria, and measles was separately estimated in a meta-regression framework from longitudinal cohort data for Z scores less than -1. Finally, fatal outcomes associated with these diseases were estimated with vital registration, verbal autopsy, and case-fatality data, while non-fatal outcomes were estimated with surveys as well as health-care utilisation and case reporting data. The exposure prevalence and relative risk estimates were from continuous distributions, allowing for direct assessment of the attributable fractions for mild, moderate, and severe stunting, underweight, wasting, and the combined impact of child growth failure within populations. All estimates were age-specific, sex-specific, geography-specific, and year-specific. FINDINGS: We estimated that, in children younger than 5 years in 2023, CGF was associated with 79·4 million (95% uncertainty interval [UI] 47·0-106) DALYs lost and 880 000 (517 000-1 170 000) deaths. This represented 17·9% (10·6-23·8) of 444 million (434-457) total under-5 DALYs and 18·8% (11·1-25·0) of all 4·67 million (4·59-4·75) under-5 deaths. Compared to stunting (33·0 million [24·1-42·2] DALYs, 373 000 [272 000-477 000] deaths) and wasting (39·2 million [23·8-53·0] DALYs, 428 000 [256 000-583 000] deaths), childhood underweight was associated with the largest share of CGF-related disease burden: 52·2 million (21·9-75·1) DALYs and 573 000 (236 000-824 000) deaths in children younger than 5 years in 2023. INTERPRETATION: CGF remains a leading factor associated with death and disability in children younger than 5 years, despite global attention and focused interventions to reduce the prevalence of associated CGF indicators. Our findings underscore the need for policies, strategies, and interventions that focus on all indicators of CGF to reduce its associated health burden. FUNDING: Gates Foundation.

Citation

Fanny Petermann‐Rocha; Camilo Briones‐Valdivieso; Gabriela Nazar; Daniela Sugg; Daniel Reyes‐Molina; Carlos Celis‐Morales; Felipe Diaz‐Toro; Salil Deo. (2026). How would the use of Semaglutide impact the Chilean population? An estimated analysis following the SELECT trial approach. Diabetes, Obesity and Metabolism, 28(2), 1533-1536. https://doi.org/10.1111/dom.70260

Abstract availability

No standalone abstract was identified in the sources consulted.

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Citation

Fanny Petermann-Rocha; Evelia Apolinar-Jiménez; Gerson Ferrari; Catalina Medina; Gary O'Donovan. (2025). Leisure-Time Physical Activity and Obesity Risk in Adults in Mexico. American Journal of Preventive Medicine, 68(5), 989-997. https://doi.org/10.1016/j.amepre.2025.02.005

Abstract summary

Longitudinal analysis of 9,782 Mexican adults relating baseline leisure-time physical activity to obesity at a subsequent assessment. Moderate or high activity, compared with low or no activity, was associated with lower odds of abdominal and general obesity, with adjusted odds ratios of 0.86 and 0.85, respectively. Results were consistent across several sensitivity analyses and suggest a favourable association between leisure-time activity and long-term body weight.

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Fanny Petermann‐Rocha; Felipe Diaz‐Toro; Gabriela Nazar; Evelia Apolinar‐Jiménez; Catalina Medina; Salil Deo; Gary O'Donovan. (2025). Diabetes is one of the main drivers of mortality in Mexico: A latent class analysis of chronic diseases using the Mexico City Prospective Study. Diabetes, Obesity and Metabolism, 27(10), 5889-5898. https://doi.org/10.1111/dom.16644

Abstract summary

Latent class analysis of 154,369 Mexico City Prospective Study participants to identify chronic disease patterns and their relationship with mortality. Four groups were identified: relatively healthy, other chronic diseases, hypertension with some diabetes, and diabetes-dominated. Over a median of 20 years, the diabetes-dominated group had the highest mortality risk, with an adjusted hazard ratio of 2.60 compared with the healthy group. Risk was particularly high among men and people who did not reach the HbA1c target.

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Gary O'Donovan; Fanny Petermann-Rocha; Gerson Ferrari; Catalina Medina; Carolina Ochoa-Rosales; Olga L L Sarmiento; Agustín Ibáñez. (2025). Associations of the ‘weekend warrior’ physical activity pattern with mild dementia: findings from the Mexico City Prospective Study. British Journal of Sports Medicine, 59(5), 325-332. https://doi.org/10.1136/bjsports-2024-108460

Abstract summary

Among 10,033 Mexico City Prospective Study participants followed for approximately 16 years, exercising once or twice a week was associated with a lower risk of mild dementia than not exercising. The adjusted hazard ratio for this pattern was 0.75. Mild dementia was assessed using Mini Mental State Examination cut-offs. The results support investigating accessible physical activity patterns, although observational associations do not establish a causal preventive effect.

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Fanny Petermann-Rocha; Ziyi Zhou; John C. Mathers; Carlos Celis-Morales; David Raubenheimer; Naveed Sattar; Jill P. Pell; Ewan Forrest; Frederick K. Ho. (2024). Diet modifies the association between alcohol consumption and severe alcohol-related liver disease incidence. Nature Communications, 15(1), 6880. https://doi.org/10.1038/s41467-024-51314-9

Abstract

It is elusive why some heavy drinkers progress to severe alcohol-related liver disease (ALD) while others do not. This study aimed to investigate if the association between alcohol consumption and severe ALD is modified by diet. This prospective study included 303,269 UK Biobank participants. Alcohol consumption and diet were self-reported. The diet score was created from 4 items selected using LASSO. Cox proportional hazard model showed that the diet score was monotonically associated with severe ALD risk, adjusted for sociodemographics, lifestyle factors, and alcohol consumption. Relative excess risk due to interaction analysis indicated that having a higher ALD diet score and a higher alcohol consumption simultaneously confers to 2.44 times (95% CI: 1.06-3.83) higher risk than the sum of excess risk of each factor. In this work, we show that people who have a poor diet might be more susceptible to severe ALD due to alcohol consumption.

Citation

Fanny Petermann‐Rocha; Felipe Diaz‐Toro; Desirée Valera‐Gran; Eva‐María Navarrete‐Muñoz. (2024). Bibliometric analysis of research on sarcopenic obesity: a review of scientific literature. Obesity Reviews, 25(9), e13784. https://doi.org/10.1111/obr.13784

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Considering the current prevalence in obesity and sarcopenia globally, this study aimed to summarize the development of sarcopenic obesity research to establish the topic's past, present, and future research direction using a bibliometric analysis. A comprehensive search for publications on sarcopenia and obesity was conducted in the Web of Science (WoS) database until the 31st of December 2023. We performed a detailed descriptive analysis, considering metrics like sources, authors, and documents, along with analyzing conceptual and social structures to map sarcopenic obesity research. Between 1993 and 2023, there were 4978 publications on sarcopenic obesity, representing 22.6% of the whole sarcopenia research (22070). Most published articles were originals (74.6%), and one of the highest increments in the fields was seen after 2010. The most significant contribution in this research area falls under the categories of Nutrition & Dietetics, Gerontology, and Geriatrics & Gerontology. Among regions, scientific production was located in 93 different countries. The United States, China, and South Korea had the highest contributions. The most relevant keywords were sarcopenia, obesity, and body composition. Research on sarcopenic obesity primarily focuses on epidemiology and identifying risk factors and outcome predictors. Yet, there is a shortage of research addressing prevention, early detection, and treatments to enhance the health of individuals with sarcopenia.

Citation

Fanny Petermann-Rocha; Felipe Diaz-Toro; Claudia Troncoso-Pantoja; María Adela Martínez-Sanguinetti; Ana María Leiva-Ordoñez; Gabriela Nazar; Yeny Concha-Cisternas; Ximena Díaz Martínez; Fabian Lanuza; Fernanda Carrasco-Marín; Miquel Martorell; Karina Ramírez-Alarcón; Ana María Labraña; Solange Parra-Soto; Marcelo Villagran; Nicole Lasserre-Laso; Igor Cigarroa; Lorena Mardones; Jaime Vásquez-Gómez; Carlos A Celis-Morales. (2024). Association between a lifestyle score and all-cause mortality: a prospective analysis of the Chilean National Health Survey 2009–2010. Public Health Nutrition, 27(1), e9. https://doi.org/10.1017/s1368980023002598

Abstract

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.

Citation

Fanny Petermann‐Rocha; Fernanda Carrasco‐Marin; Jirapitcha Boonpor; Solange Parra‐Soto; Oliver Shannon; Fiona Malcomson; Nathan Phillips; Mahek Jain; Salil Deo; Katherine M. Livingstone; Sara E. Dingle; John C. Mathers; Ewan Forrest; Frederick K. Ho; Jill P. Pell; Carlos Celis‐Morales. (2024). Association of five diet scores with severe NAFLD incidence: A prospective study from UK Biobank. Diabetes, Obesity and Metabolism, 26(3), 860-870. https://doi.org/10.1111/dom.15378

Abstract

Aim This study aimed to contrast the associations of five common diet scores with severe non-alcoholic fatty liver disease (NAFLD) incidence. Materials and methods In total, 162 999 UK Biobank participants were included in this prospective population-based study. Five international diet scores were included: the 14-Item Mediterranean Diet Adherence Screener (MEDAS-14), the Recommended Food Score (RFS), the Healthy Diet Indicator (HDI), the Mediterranean Diet Score and the Mediterranean-DASH Intervention for Neurodegenerative Delay score. As each score has different measurements and scales, all scores were standardized and categorized into quartiles. Cox proportional hazard models adjusted for confounder factors investigated associations between the standardized quartiles and severe NAFLD incidence. Results Over a median follow-up of 10.2 years, 1370 participants were diagnosed with severe NAFLD. When the analyses were fully adjusted, participants in quartile 4 using the MEDAS-14 and RFS scores, as well as those in quartiles 2 and 3 using the HDI score, had a significantly lower risk of severe incident NAFLD compared with those in quartile 1. The lowest risk was observed in quartile 4 for the MEDAS-14 score [hazard ratio (HR): 0.76 (95% confidence interval (CI): 0.62-0.94)] and the RFS score [HR: 0.82 (95% CI: 0.69-0.96)] and as well as in quartile 2 in the HDI score [HR: 0.80 (95% CI: 0.70-0.91)]. Conclusion MEDAS-14, RFS and HDI scores were the strongest diet score predictors of severe NAFLD. A healthy diet might protect against NAFLD development irrespective of the specific approach used to assess diet. However, following these score recommendations could represent optimal dietary approaches to mitigate NAFLD risk.

Citation

Fanny Petermann‐Rocha; Evelia Apolinar; Gabriela Nazar; Felipe Diaz‐Toro; Andrés Celis; Salil Deo; Gerson Ferrari; Gary O'Donovan. (2024). Associations of diabesity with all‐cause and cardiovascular disease mortality: Findings from the Mexico City Prospective Study. Diabetes, Obesity and Metabolism, 26(6), 2199-2208. https://doi.org/10.1111/dom.15528

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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.

Citation

Fanny Petermann-Rocha; Amanda Pizarro; Sebastián Castro; Alonso Pizarro. (2024). Anthropometric evaluation through images: Findings from the SCANNER software package. Nutrition, 125, 112499. https://doi.org/10.1016/j.nut.2024.112499

Abstract

Objective To compare the waist-to-height ratio (WHtR) agreement between synthetic data and the Smart Computerized Anthropometric NavigatioN and Evaluation Resource (SCANNER) software package. Methods One hundred and ten 3D digital humans (55 for each sex) were created to obtain synthetic values. WHtR was obtained through the waist circumference and height division, both in centimeters. These data were programmed and obtained directly from the synthetic models. SCANNER v0.01 was coded by the researchers using Matlab. Differences between the objective WHtR and the one the SCANNER software package estimated were quantified using standard errors, Spearman's correlation and the Bland-Altman plot. Results Using the Spearman correlation, an agreement level of 0.982 was identified. Using the Bland-Altman plot, the agreement level was high, with a Rho value of 0.983 (95% CI: 0.977-0.988). Finally, when the standard errors were quantified, there was an overall error (between the synthetic data created and the computed one) of 0.49%, being higher in men (0.81%) than in women (0.18%). Conclusions The SCANNER software package is a straightforward tool that could facilitate the estimation of WHtR in distance participants or patients.

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Fanny Petermann-Rocha; Alonso Pizarro; Gabriela Nazar; Mauricio Zambrano-Bigiarini; Angela Plaza-Garrido; Felipe Díaz-Toro; Claudia Troncoso-Pantoja; Andrés Celis; Daniela Sugg; Carlos Celis-Morales. (2024). Disponibilidad y seguridad hídrica en el desarrollo de enfermedades crónicas no transmisibles ¿Nuevos factores de riesgo?. Revista médica de Chile, 152(5), 643-644. https://doi.org/10.4067/s0034-98872024000500643

Abstract availability

No standalone abstract was identified in the sources consulted.

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Frederick K. Ho; Fanny Petermann-Rocha. (2024). The Use of Life’s Essential 8 as a Prediction Model and Beyond. JACC: Advances, 3(6), 100944. https://doi.org/10.1016/j.jacadv.2024.100944

Abstract availability

No standalone abstract was identified in the sources consulted.

No standalone abstract

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Fanny Petermann-Rocha; Desirée Valera-Gran; Daniel Prieto-Botella; Dries S Martens; Sandra Gonzalez-Palacios; Isolina Riaño-Galán; Mario Murcia; Amaia Irizar; Jordi Julvez; Loreto Santa-Marina; Adonina Tardón; Jordi Sunyer; Jesús Vioque; Tim Nawrot; Eva-María Navarrete-Muñoz. (2023). Folic Acid Supplementation during Pregnancy and Its Association with Telomere Length in Children at Four Years: Results from the INMA Birth Cohort Study. Nutrients, 15(19), 4303. https://doi.org/10.3390/nu15194303

Abstract

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.

Citation

Fanny Petermann-Rocha; Salil Deo; Donald Lyall; Ariela R. Orkaby; Terence J. Quinn; Naveed Sattar; Carlos Celis-Morales; Jill P. Pell; Frederick K. Ho. (2023). Association Between the AHA Life's Essential 8 Score and Incident All-Cause Dementia: A Prospective Cohort Study from UK Biobank. Current Problems in Cardiology, 48(11), 101934. https://doi.org/10.1016/j.cpcardiol.2023.101934

Abstract

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.

Citation

Fanny Petermann-Rocha; Frederick K. Ho. (2023). Vegetarians: Past, Present, and Future Regarding Their Diet Quality and Nutritional Status. Nutrients, 15(16), 3587. https://doi.org/10.3390/nu15163587

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Citation

Fanny Petermann-Rocha; Michael D. Wirth; Jirapitcha Boonpor; Solange Parra-Soto; Ziyi Zhou; John C. Mathers; Katherine Livingstone; Ewan Forrest; Jill P. Pell; Frederick K. Ho; James R. Hébert; Carlos Celis-Morales. (2023). Associations between an inflammatory diet index and severe non-alcoholic fatty liver disease: a prospective study of 171,544 UK Biobank participants. BMC Medicine, 21(1), 123. https://doi.org/10.1186/s12916-023-02793-y

Abstract

Background Although non-alcoholic fatty liver disease (NAFLD) is linked to inflammation, whether an inflammatory diet increases the risk of NAFLD is unclear. This study aimed to examine the association between the Energy-adjusted Diet Inflammatory Index (E-DII) score and severe NAFLD using UK Biobank. Methods This prospective cohort study included 171,544 UK Biobank participants. The E-DII score was computed using 18 food parameters. Associations between the E-DII and incident severe NAFLD (defined as hospital admission or death) were first investigated by E-DII categories (very/moderately anti-inflammatory [E-DII 1]) using Cox proportional hazard models. Nonlinear associations were investigated using penalised cubic splines fitted into the Cox proportional hazard models. Analyses were adjusted for sociodemographic, lifestyle and health-related factors. Results Over a median follow-up of 10.2 years, 1489 participants developed severe NAFLD. After adjusting for confounders, individuals in the very/moderately pro-inflammatory category had a higher risk (HR: 1.19 [95% CI: 1.03 to 1.38]) of incident severe NAFLD compared with those in the very/moderately anti-inflammatory category. There was some evidence of nonlinearity between the E-DII score and severe NAFLD. Conclusions Pro-inflammatory diets were associated with a higher risk of severe NAFLD independent of confounders such as the components of the metabolic syndrome. Considering there is no recommended treatment for the disease, our findings suggest a potential means to lower the risk of NAFLD.

Citation

Fanny Petermann-Rocha; Solange Parra-Soto; Vicente Cid; Pia Venegas; Andrea Huidobro; Catterina Ferreccio; Carlos Celis-Morales. (2023). The association between walking pace and grip strength and all-cause mortality: A prospective analysis from the MAUCO cohort. Maturitas, 168, 37-43. https://doi.org/10.1016/j.maturitas.2022.11.004

Abstract summary

Prospective analysis of 8,813 participants in the Chilean MAUCO cohort. Slow walking pace and low grip strength were associated, separately and jointly, with higher all-cause mortality. Adjusted hazard ratios were 1.77 for slow walking and 2.40 for low strength. Associations persisted after excluding early events. The authors propose considering both measurements as clinical risk markers in middle-aged and older adults.

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Fanny Petermann-Rocha; Carlos Celis-Morales; Jill P. Pell; Frederick K. Ho. (2023). Do all vegetarians have a lower cardiovascular risk? A prospective study. Clinical Nutrition, 42(3), 269-276. https://doi.org/10.1016/j.clnu.2023.01.010

Abstract

Background Vegetarian diets are heterogeneous and their health benefits may vary. This study aimed to compare the cardiovascular risk among vegetarian diets that meet existing health guidelines, those that do not, and diets that include red meat. Methods 391,124 participants (55.5% women) from the UK Biobank prospective population-based study were included. Using data from a food frequency questionnaire, participants were categorised into lacto-vegetarian or meat-eaters. Then, both groups were dichotomised into a healthier and less healthy group using an unweighted score based on current UK guidelines. Ischaemic heart disease (IHD) and myocardial infarction (MI) incidence - both separately and as a composite of major adverse cardiovascular events (MACE) - were the outcomes included. Associations between types of diets and health outcomes were investigated using Cox proportional hazard models adjusted for confounder factors. Results After a median follow-up of 10.4 years, there were 40,048 MACE. When the analyses were adjusted for prevalent morbidity and lifestyle factors, people who followed healthier vegetarian and meat-eater diets had 18% (95% CI: 0.73 to 0.92) and 5% (95% CI: 0.93 to 0.97) lower risk of MACE than less healthy meat-eaters. Similar patterns were identified for the individual outcomes, with the strongest association observed for MI. The cardiovaculasr risk among less healthy vegetarians and less healthy meat-eaters were not significnatly different. Conclusions Vegetarian diets are heterogeneous and the cardiovascular risk varied accordingly. Future studies should consider the overall dietary patterns of vegetarians rather than just based on meat consumption. Guidelines advocating a plant-based diet need to stress the importance of overall diet quality in addition to the reduction of meat.

Citation

Fanny Petermann-Rocha; Salil Deo; Carlos Celis-Morales; Frederick K Ho; Pankaj Bahuguna; David McAllister; Naveed Sattar; Jill P Pell. (2023). An Opportunity for Prevention: Associations Between the Life's Essential 8 Score and Cardiovascular Incidence Using Prospective Data from UK Biobank. Current Problems in Cardiology, 48(4), 101540. https://doi.org/10.1016/j.cpcardiol.2022.101540

Abstract summary

Study of 250,825 UK Biobank participants examining a modified version of Life’s Essential 8 and incident cardiovascular disease. Over a median of 10.4 years, 25,068 major cardiovascular events occurred. The lowest-scoring quartile had approximately twice the risk of the healthiest quartile; the difference was particularly marked for heart failure. Simulations suggested that improving scores among those with the poorest cardiovascular health could have a greater impact than small uniform changes across the population.

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Fanny Petermann-Rocha; Claudia Troncoso-Pantoja; Amparo Gamero; Patricio Pérez-Armijo; Elena Carrillo-Alvarez; Rodrigo Daga; Manuel Reig García-Galbis; Alberto Pérez-López; Néstor Benítez Brito; Tania Fernández-Villa; Diego A. Bonilla; Macarena Lozano-Lorca; Malak Kouiti; Ashuin Kammar-García; Edna J. Nava-González; Rafael Almendra-Pegueros. (2023). Desafíos alimentarios para un mundo que envejece. Revista Española de Nutrición Humana y Dietética, 27(3), 179-181. https://doi.org/10.14306/renhyd.27.3.1975

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Citation

Fanny Petermann-Rocha; Nirmala Rao; Manya Bala; Monika Parshad-Asnani; Anthony Sifuna; Aisha Yousafzai; Frederick K. Ho; Patrick Ip. (2023). Hygiene Practices and Early Childhood Development in the East Asia-Pacific Region: A Cross-Sectional Analysis. International Journal of Environmental Research and Public Health, 20(4), 2798. https://doi.org/10.3390/ijerph20042798

Abstract

Poor hygiene might be a risk factor for early childhood development (ECD). This study investigated the associations of three hygiene practices ('wash hands before a meal,' 'wash hands after going to the toilet,' and 'brush teeth'), separately and combined, with ECD. Six thousand six hundred ninety-seven children (4 [0.8] years) from the East Asia-Pacific Early Child Development Scales validation study were included in this cross-sectional analysis. The hygiene variables were recoded to have comparable values as 'always,' 'sometimes,' and 'never.' These variables were then grouped to create combined categories. The binary outcome variables, poor ECD, were defined as a score p never : 1.67 [1.40-2.00]; PR rarely : 1.49 [1.30-1.71]; PR sometimes : 1.30 [1.14-1.49]). Children who did not always follow good hygiene practices had a higher likelihood of poor ECD independently of sociodemographic factors. Considering these findings, future hygiene practice interventions and trials should consider including ECD outcomes.

Citation

Fanny Petermann-Rocha; Frederick K. Ho; Jill P. Pell. (2023). Reply to: “Defining severe NAFLD based on ICD codes in large cohorts: Balancing feasibility and limitations”. Journal of Hepatology, 79(6), e233-e234. https://doi.org/10.1016/j.jhep.2023.08.014

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Claudia Nuñez; Fanny Petermann-Rocha. (2023). Reflexiones sobre la tuberculosis en Chile: avances y compromisos futuros. ARS MEDICA Revista de Ciencias Médicas, 48(4), 5-7. https://doi.org/10.11565/arsmed.v48i4.2022

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Camilo Briones-Valdivieso; Fanny Petermann Rocha. (2023). Contaminación por partículas en Chile: ¿Cuál es su asociación con enfermedades cardiovasculares?. Revista médica de Chile, 151(10), 1416-1418. https://doi.org/10.4067/s0034-98872023001001416

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Fanny Petermann-Rocha; Desirée Valera-Gran; Paula Fernández-Pires; Dries S. Martens; Jordi Júlvez; Cristina Rodríguez-Dehli; Ainara Andiarena; Manuel Lozano; Ana Fernández-Somoano; Aitana Lertxundi; Sabrina Llop; Mònica Guxens; Tim S. Nawrot; Eva-María Navarrete-Muñoz. (2023). Children who sleep more may have longer telomeres: evidence from a longitudinal population study in Spain. Pediatric Research, 93(5), 1419-1424. https://doi.org/10.1038/s41390-022-02255-w

Abstract

Background Inadequate sleep duration has been suggested as a chronic stressor associated with changes in telomere length (TL). This study aimed to explore the association between sleep duration and TL using the INMA birth cohort study data. Methods A total of 1014 children were included in this study (cross-sectional: 686; longitudinal: 872). Sleep duration (h/day) was reported by caregivers at 4 years and classified into tertiles (7-10 h/day; >10-11 h/day; >11-14 h/day). Leucocyte TL at 4 and 7-9 years were measured using quantitative PCR methods. Multiple robust linear regression models, through log-level regression models, were used to report the % of difference among tertiles of sleep duration. Results In comparison to children who slept between >10 and 11 h/day, those in the highest category (more than 11 h/day) had 8.5% (95% CI: 3.56-13.6) longer telomeres at 4 years. Longitudinal analysis showed no significant association between sleep duration at 4 years and TL at 7-9 years. Conclusion Children who slept more hours per day had longer TL at 4 years independently of a wide range of confounder factors. Environmental conditions, such as sleep duration, might have a major impact on TL during the first years of life. Impact Telomere length was longer in children with longer sleep duration (>11 h/day) independently of a wide range of confounder factors at age 4 and remained consistent by sex. Sleep routines are encouraged to promote positive child development, like the number of hours of sleep duration. Considering the complex biology of telomere length, future studies still need to elucidate which biological pathways might explain the association between sleep duration and telomere length.

Citation

Fanny Petermann-Rocha; Frederick K. Ho; Jill P. Pell. (2022). Reply to: “Associations of muscle mass and grip strength with severe NAFLD: A prospective study of 333,295 UK Biobank participants”. Journal of Hepatology, 77(5), 1454-1455. https://doi.org/10.1016/j.jhep.2022.07.023

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Citation

Fanny Petermann‐Rocha; Viktoria Balntzi; Stuart R. Gray; Jose Lara; Frederick K. Ho; Jill P. Pell; Carlos Celis‐Morales. (2022). Global prevalence of sarcopenia and severe sarcopenia: a systematic review and meta‐analysis. Journal of Cachexia, Sarcopenia and Muscle, 13(1), 86-99. https://doi.org/10.1002/jcsm.12783

Abstract

Background Sarcopenia is defined as the loss of muscle mass and strength. Despite the seriousness of this disease, a single diagnostic criterion has not yet been established. Few studies have reported the prevalence of sarcopenia globally, and there is a high level of heterogeneity between studies, stemmed from the diagnostic criteria of sarcopenia and the target population. The aims of this systematic review and meta-analysis were (i) to identify and summarize the diagnostic criteria used to define sarcopenia and severe sarcopenia and (ii) to estimate the global and region-specific prevalence of sarcopenia and severe sarcopenia by sociodemographic factors. Methods Embase, MEDLINE, and Web of Science Core Collections were searched using relevant MeSH terms. The inclusion criteria were cross-sectional or cohort studies in individuals aged ≥18 years, published in English, and with muscle mass measured using dual-energy x-ray absorptiometry, bioelectrical impedance, or computed tomography (CT) scan. For the meta-analysis, studies were stratified by diagnostic criteria (classifications), cut-off points, and instruments to assess muscle mass. If at least three studies reported the same classification, cut-off points, and instrument to measure muscle mass, they were considered suitable for meta-analysis. Following this approach, 6 classifications and 23 subgroups were created. Overall pooled estimates with inverse-variance weights obtained from a random-effects model were estimated using the metaprop command in Stata. Results Out of 19 320 studies, 263 were eligible for the narrative synthesis and 151 for meta-analysis (total n = 692 056, mean age: 68.5 years). Using different classifications and cut-off points, the prevalence of sarcopenia varied between 10% and 27% in the studies included for meta-analysis. The highest and lowest prevalence were observed in Oceania and Europe using the European Working Group on Sarcopenia in Older People (EWGSOP) and EWGSOP2, respectively. The prevalence ranged from 8% to 36% in individuals Conclusions The prevalence of sarcopenia and severe sarcopenia varied considerably according to the classification and cut-off point used. Considering the lack of a single diagnostic for sarcopenia, future studies should adhere to current guidelines, which would facilitate the comparison of results between studies and populations across the globe.

Citation

Fanny Petermann-Rocha; Nirmala Rao; Jill P. Pell; Carlos Celis-Morales; Ian C. K. Wong; Frederick K. Ho; Patrick Ip. (2022). Weight-for-Height, Body Fat, and Development in Children in the East Asia and Pacific Region. JAMA Network Open, 5(1), e2142458. https://doi.org/10.1001/jamanetworkopen.2021.42458

Abstract

Importance Weight-for-height z score (WHZ) is a standard indicator of children's nutritional status even though it does not fully reflect body fat. Objective To examine the combined association of WHZ and body fat with early development in the East Asia and Pacific region. Design, setting, and participants Children from the East Asia-Pacific Early Child Development Scales validation study, with full data available regarding their nutritional status and outcomes, were included in this cross-sectional analysis. In brief, a multilevel stratified random sampling was used to select representative samples from each participating country in the study. WHZ and body fat were independently trichotomized using established references and were combined to form a 9-category exposure variable. Data collection was performed between 2012 and 2014, and the analyses were conducted in June 2021. Main outcomes and measures The binary outcome variable of not being developmentally on track (hereafter referred to as poor development) was defined as a score less than the 25th percentile in the following domains: cognitive, language, socioemotional, motor development, and total development score. Poisson regression models were used to analyze the associations between the combined categories and poor development, adjusted for sociodemographic factors. Results A total of 6815 children (mean [SD] age, 4.02 [0.8] years; 3434 girls [50.4%]) had full data available and were included in this study. Compared with children with normal weight and normal fat, those with wasting and low body fat had the highest likelihood of total poor development (prevalence ratio, 1.47; 95% CI, 1.28-1.70), followed by those with normal weight but low fat (prevalence ratio, 1.23; 95% CI, 1.11-1.36). Similar associations were found in language, cognitive, and socioemotional development, but not in motor development. Conclusions and relevance Poor development was more commonly found in children with low body fat independent of WHZ (wasted or normal weight). Early public health strategies may consider using a combination of WHZ and body fat as an indicator of poor development.

Citation

Fanny Petermann-Rocha; Stuart R. Gray; Ewan Forrest; Paul Welsh; Naveed Sattar; Carlos Celis-Morales; Frederick K. Ho; Jill P. Pell. (2022). Associations of muscle mass and grip strength with severe NAFLD: A prospective study of 333,295 UK Biobank participants. Journal of Hepatology, 76(5), 1021-1029. https://doi.org/10.1016/j.jhep.2022.01.010

Abstract

Background & aims Cross-sectional studies have reported that lower muscle mass and strength are risk factors for non-alcoholic fatty liver disease (NAFLD). However, the evidence from prospective studies is limited. This study examined both the strength and pattern of the associations between these 2 physical capability markers and severe NAFLD using data from the UK Biobank study. Methods A total of 333,295 participants were included in this prospective study. Grip strength was measured using a Jamar J00105 hydraulic hand dynamometer, and the Janssen equation was used to estimate skeletal muscle mass by bioelectrical impedance. Muscle mass was adjusted for body weight and all exposures were sex-standardised. Associations of muscle mass and strength with severe NAFLD (defined as hospital admission or death) were first investigated by tertile of each exposure using Cox proportional hazard models. Non-linear associations were investigated using penalised cubic splines fitted in the Cox proportional hazard models. Results After a median follow-up of 10 years (IQR 9.3 to 10.7 years), 3,311 individuals had severe NAFLD (3,277 hospitalisations and 34 deaths). Compared with the lowest tertile of muscle mass, the risk of severe NAFLD was lower in the middle (hazard ratio 0.76; 95% CI 0.70-0.83) and the highest tertile (hazard ratio 0.46; 95% CI 0.40-0.52). Tertiles of grip strength showed a similar pattern. Non-linearity was only identified for muscle mass (p Conclusions Lower muscle mass and grip strength were associated with higher risk of developing severe NAFLD. Interventions to improve physical capability may be protective, but this needs to be investigated in appropriately designed trials. Lay summary Lower muscle mass - both quantity and quality - were associated with a higher risk of severe non-alcoholic fatty liver disease. Therefore, improving muscle mass might be a protective factor against this increasing public health problem.

Citation

Yeny Concha-Cisternas; Fanny Petermann-Rocha; José Castro-Piñero; Solage Parra; Cecilia Albala; Vanessa Van De Wyngard; Jaime Vásquez; Igor Cigarroa; Carlos Celis-Morales. (2022). Fuerza de prensión manual. Un sencillo, pero fuerte predictor de salud en población adulta y personas mayores. Revista médica de Chile, 150(8), 1075-1086. https://doi.org/10.4067/s0034-98872022000801075

Abstract

Muscle strength can be measured through different methods and handgrip strength is one of the most used techniques in epidemiological studies. Given its easy application, high reliability, and low cost, it is considered an important health biomarker. Handgrip strength is associated with adverse health outcomes such as mortality and risk of developing chronic diseases, cardiovascular, respiratory, cancer and dementia. There is a paucity of evidence in Chile about the association of handgrip strength with these health outcomes limiting its visibility and implementation in clinical settings. Therefore, this narrative review summarizes the scientific evidence about the association of grip strength with non-communicable chronic diseases and mortality in middle age and older adults.

Citation

Juan F. Montiel; Fanny Petermann-Rocha; Alonzo Pizarro; Víctor Contreras. (2022). En búsqueda de una salud sostenible en Chile: rol de la investigación interdisciplinaria. Revista médica de Chile, 150(12), 1691-1692. https://doi.org/10.4067/s0034-98872022001201691

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Citation

Fernanda Carrasco-Marín; Fanny Petermann-Rocha; Miquel Martorell; Yenny Concha-Cisternas; Solange Parra-Soto; Rafael Zapata-Lamana; Javier Albornoz-Guerrero; Guillermo García-Pérez-de-Sevilla; Maria Antonia Parra-Rizo; Igor Cigarroa. (2022). Physical Fitness, Screen Time and Sleep Habits According to Obesity Levels in Schoolchildren: Findings from the Health Survey of the Extreme South of Chile. International Journal of Environmental Research and Public Health, 19(20), 13690. https://doi.org/10.3390/ijerph192013690

Abstract

Obesity is a worry because it is associated with a greater burden of disease, and it has been shown to be related to the health habits and physical condition of children and adolescents. Objective To associate physical fitness, screen time, and sleep habits with the different categories of obesity in schoolchildren from the extreme south of Chile. Methods 583 schoolchildren were included in this cross-sectional analysis. The screen time and sleep habits were measured with the Sleep Self-Report questionnaire, while the physical fitness was assessed with the Alpha Fitness test battery. The Body Mass Index/age (BMI/age) and the Waist-to-Height ratio (WtHr) were used to define adiposity using the following categories: healthy weight/low-risk waist-to-height ratio (H/LR), healthy weight/high-risk waist-to-height ratio (H/HR), overweight/low-risk waist to height ratio (O/LR), and overweight/high-risk waist to height ratio (O/HR). Results A considerable number of schoolchildren (23.2%) presented sleep problems, while the mean screen time was 9.3 (95% CI: 8.4; 10.1) hours/day. Schoolchildren classified as H/HR showed better physical fitness than the O/HR group but worse physical fitness than the H/LR group. Conclusions Significant differences were evidenced in the physical fitness between the adiposity categories, which could open future lines of research concerning the characterization of the healthy weight-obese adiposity categories in children.

Citation

Fabian Lanuza; Fanny Petermann-Rocha; Carlos Celis-Morales; Yeny Concha-Cisternas; Gabriela Nazar; Claudia Troncoso-Pantoja; Nicole Lassere-Laso; María Adela Martínez-Sanguinetti; Solange Parra-Soto; Raul Zamora-Ros; Cristina Andrés-Lacueva; Tomás Meroño. (2022). A healthy eating score is inversely associated with depression in older adults: results from the Chilean National Health Survey 2016–2017. Public Health Nutrition, 25(10), 2864-2875. https://doi.org/10.1017/s1368980021004869

Abstract

Objective To investigate the relationship of a healthy eating score with depression in Chilean older adults. Design Cross-sectional study. Setting Older adults from the Chilean National Health Survey 2016-2017. Associations were analysed using complex samples multivariable logistic regressions adjusted for age, sex, socio-demographic, lifestyles (physical activity, smoking, alcohol consumption and sleep duration), BMI and clinical conditions (hypertension, diabetes, hypercholesterolaemia and cardiovascular diseases). Participants The number of participants was 2031 (≥ 60 years). The Composite International Diagnostic Interview-Short Form was applied to establish the diagnosis of major depressive episode. Six healthy eating habits were considered to produce the healthy eating score (range: 0-12): consumption of seafood, whole grain, dairy, fruits, vegetables and legumes. Participants were categorised according to their final scores as healthy (≥ 9), average (5-8) and unhealthy (≤ 4). Results Participants with a healthy score had a higher educational level, physical activity and regular sleep hours than participants with an average and unhealthiest healthy eating score. Participants classified in the healthiest healthy eating score had an inverse association with depression (OR: 0·28, (95 % CI 0·10, 0·74)). Food items that contributed the most to this association were legumes (15·2 %) and seafood (12·7 %). Conclusion Older adults classified in the healthiest healthy eating score, characterised by a high consumption of legumes and seafood, showed a lower risk for depression in a representative sample of Chilean population.

Citation

Fanny Petermann-Rocha; Juan Montiel; Alfredo Pemjean. (2021). En busca de la armonización de datos en salud: una tarea pendiente. Revista médica de Chile, 149(11), 1679-1680. https://doi.org/10.4067/s0034-98872021001101679

Abstract availability

No standalone abstract was identified in the sources consulted.

No standalone abstract

Citation

Fanny Petermann‐Rocha; Lyn D. Ferguson; Stuart R. Gray; Irene Rodríguez‐Gómez; Naveed Sattar; Stefan Siebert; Frederick K. Ho; Jill P. Pell; Carlos Celis‐Morales. (2021). Association of sarcopenia with incident osteoporosis: a prospective study of 168,682 UK biobank participants. Journal of Cachexia, Sarcopenia and Muscle, 12(5), 1179-1188. https://doi.org/10.1002/jcsm.12757

Abstract

Background Sarcopenia often co-occurs with osteoporosis in cross-sectional studies. However, this association has rarely been studied in prospective studies. This study aimed to investigate the association between sarcopenia categories-along with its individual components-and incident osteoporosis in both middle-aged and older men and women from the UK Biobank study. Methods A total of 168,682 participants (48.8% women, aged 37 to 70 years at baseline) were included in this prospective study. Categories of sarcopenia (pre-sarcopenia and sarcopenia), and its individual components, were defined according to the EWGSOP2 criteria (2019). Associations with incident osteoporosis by sex were investigated using Cox-proportional hazard models adjusted for socio-demographic, lifestyle and health-related factors, and morbidity count. Associations between categories of sarcopenia and incident osteoporosis were also investigated by age-groups and subtype of osteoporosis (with and without pathological fractures). Results After a median follow-up of 7.4 years, 6296 participants were diagnosed with osteoporosis. When the analyses were adjusted for a range of relevant confounding factors, pre-sarcopenia was associated with 1.3-times higher risk of osteoporosis in men (HR: 1.30 [95% CI: 1.03 to 1.63]) but not in women, and sarcopenia was associated with 1.66-times increased osteoporosis risk in women (HR: 1.66 [95% CI: 1.33 to 2.08]) but not in men compared with people without sarcopenia or pre-sarcopenia. A similar magnitude of associations was found in osteoporosis without pathological fractures but weaker for those with pathological fractures. Within the individual components, low muscle mass (HR women : 1.36 [95% CI: 1.22 to 1.51] and HR men : 3.07 [95% CI: 1.68 to 5.59]), followed by slow gait speed (HR women : 1.30 [95% CI: 1.17 to 1.45] and HR men : 1.70 [95% CI: 1.43 to 2.02]), were associated with a higher risk of incident osteoporosis in both sexes. Low grip strength was associated with a higher risk of incident osteoporosis in men (HR: 1.38 [95% CI: 1.15 to 1.65]), but not in women. No significant interaction between the exposures and incident osteoporosis by age groups were identified. Conclusions Our findings demonstrated that pre-sarcopenic men and sarcopenic women had a higher risk of developing osteoporosis even after adjustment for a large range of potential confounders. Considering that sarcopenia could be prevented, health interventions to improve physical capability may delay or prevent the onset of osteoporosis.

Citation

Fanny Petermann-Rocha; Donald M. Lyall; Stuart R. Gray; Jason M. R. Gill; Naveed Sattar; Paul Welsh; Terence J. Quinn; William Stewart; Jill P. Pell; Frederick K. Ho; Carlos Celis-Morales. (2021). Dose-response association between device-measured physical activity and incident dementia: a prospective study from UK Biobank. BMC Medicine, 19(1), 305. https://doi.org/10.1186/s12916-021-02172-5

Abstract

Background Previous cohort studies have investigated the relationship between self-reported physical activity (PA) and dementia. Evidence from objective device-measured PA data is lacking. This study aimed to explore the association of device-measured PA with the risk of dementia incidence and common subtypes (Alzheimer's disease [AD] and vascular dementia) using the UK Biobank study. Methods 84,854 participants (55.8% women), invited to participate in the device-measured PA between 2013 and 2015, were included in this prospective cohort study. Wrist accelerometers were used to measure light, moderate, vigorous, moderate-to-vigorous PA (MVPA) and total PA intensity and duration (MET/min/week). Incident dementia (fatal and non-fatal) was extracted from hospital episodes records for incidence and death register for mortality. Incidence follow-up was carried out until the end of March 2021in England and Scotland and the end of March 2018 in Wales. Mortality data were available until February 2021. Nonlinear associations were first investigated using penalised cubic splines fitted in the Cox proportional hazard models. In addition, using MVPA, five categories were created. Associations of these categories with the outcomes were investigated using Cox proportional hazard models. Analyses were adjusted for sociodemographic, lifestyle and health-related factors. Results After a median follow-up of 6.3 years, 678 individuals were diagnosed with dementia. Evidence of nonlinearity was observed for all PA modes and all-cause dementia. For categories of MVPA, there was a significant trend towards a low risk of overall dementia when higher levels of MVPA were achieved (HR trend 0.66 [95% CI 0.62 to 0.70]. The lowest risk was identified in individuals who performed more than 1200 MET/min/week, those who had 84% (95% CI 0.12 to 0.21) lower risk of incident dementia compared to those who performed Conclusions Participants with higher PA levels had a lower risk of incident dementia than those less active, independently of sociodemographic, lifestyle factors and comorbidity. Considering that the majority of previous studies have reported this association using self-reported data, our findings highlight the strong inverse association between PA objectively measured and incident dementia.

Citation

Fanny Petermann-Rocha; Frederick K. Ho; Hamish Foster; Jirapitcha Boopor; Solange Parra-Soto; Stuart R. Gray; John C. Mathers; Carlos Celis-Morales; Jill P. Pell. (2021). Nonlinear Associations Between Cumulative Dietary Risk Factors and Cardiovascular Diseases, Cancer, and All-Cause Mortality: A Prospective Cohort Study From UK Biobank. Mayo Clinic Proceedings, 96(9), 2418-2431. https://doi.org/10.1016/j.mayocp.2021.01.036

Abstract summary

Prospective study of 422,702 UK Biobank participants that constructed a cumulative score of nine dietary risks and examined its relationship with cardiovascular disease, cancer and mortality. A less favourable score was associated with higher incidence and mortality, particularly for heart failure and cardiovascular disease. The results support assessing several dietary components jointly, while recognising that calculated attributable fractions depend on assumptions and do not demonstrate causality.

Abstract summary

Open licence not confirmed; a summary or link is included.

Citation

Fanny Petermann-Rocha; Shuai Yang; Stuart R. Gray; Jill P. Pell; Carlos Celis-Morales; Frederick K. Ho. (2021). Sarcopenic obesity and its association with respiratory disease incidence and mortality – Authors’ reply. Clinical Nutrition, 40(5), 2520. https://doi.org/10.1016/j.clnu.2021.03.030

Abstract availability

No standalone abstract was identified in the sources consulted.

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Citation

Fanny Petermann-Rocha; Donald M Lyall; Terence J Quinn; Frederick K Ho; Jill P Pell; Carlos Celis-Morales. (2021). Associations between physical frailty and dementia incidence: a prospective study from UK Biobank – Authors' reply. The Lancet Healthy Longevity, 2(2), e68. https://doi.org/10.1016/s2666-7568(21)00008-8

Abstract availability

No standalone abstract was identified in the sources consulted.

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Citation

Fanny Petermann-Rocha; Jill P Pell; Carlos Celis-Morales; Frederick K Ho. (2022). Frailty, sarcopenia, cachexia and malnutrition as comorbid conditions and their associations with mortality: a prospective study from UK Biobank. Journal of Public Health, 44(2), e172-e180. https://doi.org/10.1093/pubmed/fdaa226

Abstract

Background Frailty, sarcopenia, cachexia and malnutrition are clinical conditions that share similar diagnostic criteria. This study aimed to investigate the clustering and mortality risk among these clinical conditions in middle- and older-aged adults. Methods 111 983 participants from UK Biobank were included. Sarcopenia was defined according to the EWGSOP 2019 while frailty using a modified version of the Fried criteria. Cachexia was defined using the Evans et al. classification and malnutrition using the Global Leadership Initiative on Malnutrition. The exposure variable was categorized as: no conditions; frailty only (one condition); frailty with sarcopenia (two conditions); frailty with ≥2 other conditions (three or four conditions). Its association with all-cause mortality was investigated using Cox-proportional hazard analysis. Results Frailty had the highest prevalence (45%) and was present in 92.1% of people with malnutrition and everyone with sarcopenia or cachexia. Compared with people with no conditions, those with frailty only and frailty with sarcopenia had higher risk of all-cause mortality. Individuals with frailty plus ≥2 other conditions had even higher risk (HR: 4.96 [95% CI: 2.73 to 9.01]). Conclusions The four clinical conditions investigated overlapped considerably, being frailty the most common. The risk of all-cause mortality increased with the increasing number of conditions in addition to frailty.

Citation

Fanny Petermann-Rocha; Solange Parra-Soto; Stuart Gray; Jana Anderson; Paul Welsh; Jason Gill; Naveed Sattar; Frederick K Ho; Carlos Celis-Morales; Jill P Pell. (2021). Vegetarians, fish, poultry, and meat-eaters: who has higher risk of cardiovascular disease incidence and mortality? A prospective study from UK Biobank. European Heart Journal, 42(12), 1136-1143. https://doi.org/10.1093/eurheartj/ehaa939

Abstract

Aims To compare the incidence and mortality risk for cardiovascular diseases (CVD) [CVD and also ischaemic heart disease (IHD), myocardial infarction (MI), stroke, and heart failure (HF)] among people with different types of diets-including vegetarians, fish eaters, fish and poultry eaters, and meat-eaters-using data from UK Biobank. Methods and results A total of 422 791 participants (55.4% women) were included in this prospective analysis. Using data from a food frequency questionnaire, four types of diets were derived. Associations between types of diets and health outcomes were investigated using Cox proportional hazard models. Meat-eaters comprised 94.7% of the cohort and were more likely to be obese than other diet groups. After a median follow-up of 8.5 years, fish eaters, compared with meat-eaters, had lower risks of incident CVD {hazard ratios (HR): 0.93 [95% confidence intervals (CI): 0.88-0.97]}, IHD [HR: 0.79 (95% CI: 0.70-0.88)], MI [HR: 0.70 (95% CI: 0.56-0.88)], stroke [HR: 0.79 (95% CI: 0.63-0.98)] and HF [HR: 0.78 (95% CI: 0.63-0.97)], after adjusting for confounders. Vegetarians had lower risk of CVD incidence [HR: 0.91 (95% CI: 0.86-0.96)] relative to meat-eaters. In contrast, the risk of adverse outcomes was not different in fish and poultry eaters compared with meat-eaters. No associations were identified between types of diets and CVD mortality. Conclusion Eating fish rather than meat or poultry was associated with a lower risk of a range of adverse cardiovascular outcomes. Vegetarianism was only associated with a lower risk of CVD incidence.

Citation

Fanny Petermann-Rocha; Peter Hanlon; Stuart R. Gray; Paul Welsh; Jason M. R. Gill; Hamish Foster; S. Vittal Katikireddi; Donald Lyall; Daniel F. Mackay; Catherine A. O’Donnell; Naveed Sattar; Barbara I. Nicholl; Jill P. Pell; Bhautesh D. Jani; Frederick K. Ho; Frances S. Mair; Carlos Celis-Morales. (2020). Comparison of two different frailty measurements and risk of hospitalisation or death from COVID-19: findings from UK Biobank. BMC Medicine, 18(1), 355. https://doi.org/10.1186/s12916-020-01822-4

Abstract

Background Frailty has been associated with worse prognosis following COVID-19 infection. While several studies have reported the association between frailty and COVID-19 mortality or length of hospital stay, there have been no community-based studies on the association between frailty and risk of severe infection. Considering that different definitions have been identified to assess frailty, this study aimed to compare the association between frailty and severe COVID-19 infection in UK Biobank using two frailty classifications: the frailty phenotype and the frailty index. Methods A total of 383,845 UK Biobank participants recruited 2006-2010 in England (211,310 [55.1%] women, baseline age 37-73 years) were included. COVID-19 test data were provided by Public Health England (available up to 28 June 2020). An adapted version of the frailty phenotype derived by Fried et al. was used to define frailty phenotype (robust, pre-frail, or frail). A previously validated frailty index was derived from 49 self-reported questionnaire items related to health, disease and disability, and mental wellbeing (robust, mild frailty, and moderate/severe frailty). Both classifications were derived from baseline data (2006-2010). Poisson regression models with robust standard errors were used to analyse the associations between both frailty classifications and severe COVID-19 infection (resulting in hospital admission or death), adjusted for sociodemographic and lifestyle factors. Results Of UK Biobank participants included, 802 were admitted to hospital with and/or died from COVID19 (323 deaths and 479 hospitalisations). After analyses were adjusted for sociodemographic and lifestyle factors, a higher risk of COVID-19 was observed for pre-frail (risk ratio (RR) 1.47 [95% CI 1.26; 1.71]) and frail (RR 2.66 [95% CI 2.04; 3.47]) individuals compared to those classified as robust using the frailty phenotype. Similar results were observed when the frailty index was used (RR mildly frail 1.46 [95% CI 1.26; 1.71] and RR moderate/severe frailty 2.43 [95% CI 1.91; 3.10]). Conclusions Frailty was associated with a higher risk of severe COVID-19 infection resulting in hospital admission or death, irrespective of how it was measured and independent of sociodemographic and lifestyle factors. Public health strategies need to consider the additional risk that COVID-19 poses in individuals with frailty, including which additional preventive measures might be required.

Citation

Fanny Petermann-Rocha; Stuart R. Gray; Jill P. Pell; Carlos Celis-Morales; Frederick K. Ho. (2020). Biomarkers Profile of People With Sarcopenia: A Cross-sectional Analysis From UK Biobank. Journal of the American Medical Directors Association, 21(12), 2017.e1-2017.e9. https://doi.org/10.1016/j.jamda.2020.05.005

Abstract

Objective This study aimed to characterize the biomarker profile of sarcopenic vs nonsarcopenic men and women, using the current European Working Group on Sarcopenia in Older People (EWGSOP2) definition in the UK Biobank study. Design Cross-sectional study. Setting and participants A total of 396,707 (68.8% women, age 38 to 73) participants from UK Biobank. Measures Thirty-three biomarkers, standardized to sex-specific z-scores, were included in the analysis. Associations between these biomarkers and sarcopenia, defined using EWGSOP2 criteria, were examined using multiple linear regression. Results Higher concentrations of rheumatoid factor, C-reactive protein, cystatin C, sex hormone-binding globulin, gamma-glutamyltransferase, alkaline phosphatase, and total protein, as well as lower concentrations of insulin-like growth factor-1, albumin, creatinine, sodium, and systolic blood pressure, were associated with sarcopenia in both men and women. However, some of the associations differed by sex. Sarcopenia was associated with higher concentrations of phosphate, lipoprotein A, and lower of diastolic blood pressure, HbA1c, urea, glucose, total bilirubin, and testosterone in women only, and with higher concentrations of high-density lipoprotein, aspartate aminotransferase, and direct bilirubin and lower values of apolipoprotein A, vitamin D, and apolipoprotein B in men only. Conclusions and implications Several biomarkers were associated with sarcopenia in men and women using the new EWGSOP2 statement. However, some of these associations and their magnitude differed between men and women. Considering the EWGSOP2 updated its statement on the definition of sarcopenia in 2019, this study enables us to update the study of the biomarkers profile of people with sarcopenia.

Citation

Fanny Petermann-Rocha; María Adela Martínez-Sanguinetti; Frederick K Ho; Carlos Celis-Morales; Alonso Pizarro. (2020). Optimal cut-off points for waist circumference in the definition of metabolic syndrome in Chile. Public Health Nutrition, 23(16), 2898-2903. https://doi.org/10.1017/s1368980020001469

Abstract

Objective To identify sex-specific cut-off points for waist circumference (WC) in the definition of metabolic syndrome (MetS) for the Chilean adult population. Design MetS was defined as the presence of at least two out of four of the following criteria: TAG ≥1·7 mmol/l; HDL-cholesterol: Setting A representative sample of the Chilean population aged ≥15 years. Participants 8182 participants (60 % women) from the three available Chilean National Health Surveys conducted in 2003, 2009-2010 and 2016-2017. Results WC had a good predictive ability for MetS (AUC for men 0·74 (95 % CI 0·72, 0·76); AUC for women 0·71 (95 % CI 0·68, 0·73)). The optimal cut-off points for WC, in the definition of MetS, were 92·3 cm (95 % CI 90·5, 94·4) and 87·6 cm (95 % CI 85·8, 92·1) for men and women, respectively. Conclusions The mentioned cut-off points should be used for WC in the definition of MetS in Chile. As a result, the current recommendation (WHO/International Diabetes Federation) for WC, in the identification of MetS, is not supported by these findings in a representative sample of the Chilean adult population.

Citation

Fanny Petermann-Rocha; Natalia Ulloa; María Adela Martínez-Sanguinetti; Ana María Leiva; Miquel Martorell; Marcelo Villagrán; Claudia Troncoso-Pantoja; Frederick K. Ho; Carlos Celis-Morales; Alonso Pizarro. (2020). Is waist-to-height ratio a better predictor of hypertension and type 2 diabetes than body mass index and waist circumference in the Chilean population?. Nutrition, 79-80, 110932. https://doi.org/10.1016/j.nut.2020.110932

Abstract

Objective The aim of this study was to identify which anthropometric measurement (body mass index [BMI], waist circumference [WC], or waist-to-height ratio [WHtR]) is a better predictor of type 2 diabetes and hypertension in the Chilean population. Methods The study included 13 044 participants (59.7% women) from the Chilean National Health Surveys conducted in 2003, 2009-2010, and 2016-2017. BMI, WC, and WHtR were the anthropometric measurements evaluated. Hypertension was defined as systolic blood pressure ≥140 mm Hg and diastolic blood pressure ≥90 mm Hg or on medication for hypertension. Diabetes was defined as fasting glucose ≥7 mmol/L or on medication for diabetes. The receiver operating characteristics (ROC) curve and the area under curve (AUC) were computed to derive the specificity and sensitivity using a bootstrapping approach. Results Compared with BMI and WC, WHtR was the anthropometric measurement with the highest AUC curve in both sexes for hypertension (AUC for women: 0.70; 95% confidence interval [CI], 0.67-0.73; AUC for men: 0.71; 95% CI, 0.69-0.74) and diabetes (AUC for women: 0.71; 95% CI, 0.66-0.77; AUC for men: 0.71; 95% CI, 0.67-0.76). The sex-specific cutoff points of WHtR to predict hypertension were 0.59 and 0.55 for women and men, respectively. Those used to predict diabetes were 0.60 and 0.58 for women and men, respectively. Conclusion WHtR was a better predictor of hypertension and diabetes than BMI and WC in Chile. The definition of cutoff points specific for the Chilean population could be implemented in future screening programs aiming to identify high-risk individuals.

Citation

Fanny Petermann-Rocha; Frederick K Ho; Paul Welsh; Daniel Mackay; Rosemary Brown; Jason M.R. Gill; Naveed Sattar; Stuart R Gray; Jill P Pell; Carlos A Celis-Morales. (2020). Physical capability markers used to define sarcopenia and their association with cardiovascular and respiratory outcomes and all-cause mortality: A prospective study from UK Biobank. Maturitas, 138, 69-75. https://doi.org/10.1016/j.maturitas.2020.04.017

Abstract

Introduction It is unclear what combinations of physical capability markers used to define sarcopenia have the strongest associations with health outcomes. Aim To compare the associations between different combinations of physical capability markers of sarcopenia with cardiovascular and respiratory outcomes and all-cause mortality. Study design 469,830 UK Biobank participants were included in this prospective study. Four groups were derived based on combinations of three physical capability markers used to define sarcopenia or severe sarcopenia: gait speed, grip strength and muscle mass. Outcomes studied were all-cause mortality, as well as incidence and mortality from cardiovascular disease (CVD), respiratory disease and chronic obstructive pulmonary disease (COPD). Results All combinations of physical capability markers used to define sarcopenia or severe sarcopenia identified individuals at increased risk of respiratory disease and all-cause mortality. However, the definition most strongly associated with a wide range of adverse health outcomes was the combination of slow gait speed plus low muscle mass, followed by severe sarcopenia, and the combination of slow gait speed plus low grip strength. The current definition of sarcopenia (low grip strength plus low muscle mass) had the weakest associations with all-cause (HR: 1.35 [95% CI: 1.07 to 1.71]) and respiratory mortality (HR: 1.88 [95% CI: 1.15 to 3.10]), as well as respiratory disease (HR: 1.38 [95% CI: 1.11 to 1.73]) and COPD incidence (HR: 2.08 [95% CI: 1.14 to 3.79]). Conclusions Associations of sarcopenia with adverse outcomes were strongest when sarcopenia was defined as slow gait speed plus low muscle mass, followed by severe sarcopenia, suggesting that this combination of physical capability markers should be still considered in the diagnosis of sarcopenia.

Citation

Fanny Petermann-Rocha; Shuai Yang; Stuart R. Gray; Jill P. Pell; Carlos Celis-Morales; Frederick K. Ho. (2020). Sarcopenic obesity and its association with respiratory disease incidence and mortality. Clinical Nutrition, 39(11), 3461-3466. https://doi.org/10.1016/j.clnu.2020.03.006

Abstract

Background Sarcopenic obesity is defined as a combination of sarcopenia and obesity. Previous studies have shown a positive association between sarcopenia and respiratory disease, while other studies have identified that obese individuals have a lower risk for respiratory diseases. This study aimed to investigate the association of obesity, sarcopenia and sarcopenic obesity with respiratory disease incidence and mortality. Methods Data from 170,083 participants from the prospective UK Biobank study were included. Sarcopenic obesity was defined as the combination of sarcopenia with one of the following obesity criteria: BMI ≥30 kg/m 2 , waist circumference (WC) ≥ 88 cm in women or ≥ 102 cm in men, or the two highest sex-specific quintiles of body fat. Respiratory disease incidence and mortality were the outcomes. Results The mean follow-up period was 7.0 years. 5459 (3.2%) participants developed respiratory diseases and 780 (0.5%) died from respiratory diseases. Compared to individuals without obesity or sarcopenia, those who were obese (Hazard Ratio (HR): 1.13 [95 CI: 1.03; 1.23]), sarcopenic (HR: 1.23 [95% CI: 1.10; 1.36]) or sarcopenic obese (based on BMI) (HR: 1.51 [95% CI: 1.30; 1.77]), had a higher risk of respiratory disease incidence. However, the risk of respiratory disease mortality was higher in sarcopenic individuals and lower in obese individuals. No associations were identified between sarcopenic obesity and respiratory mortality (HR: 1.12 [95% CI: 0.76; 1.63]). Similar patterns were found when obesity was defined using WC or body fat. Conclusion Obesity, sarcopenia and sarcopenic obesity were associated with a higher risk of respiratory disease incidence. However, while obesity was associated with lower, and sarcopenia with higher respiratory mortality risk, no associations between sarcopenic obesity and respiratory mortality were identified.

Citation

Fanny Petermann-Rocha; Minghao Chen; Stuart R. Gray; Frederick K. Ho; Jill P. Pell; Carlos Celis-Morales. (2020). Factors associated with sarcopenia: A cross-sectional analysis using UK Biobank. Maturitas, 133, 60-67. https://doi.org/10.1016/j.maturitas.2020.01.004

Abstract

Introduction The critical sociodemographic, lifestyle and diseases factors influencing sarcopenia, defined by the current European Working Group on Sarcopenia 2 (EWGSOP2) classification and cut-off points, have not yet been fully elucidated. This study aimed, therefore, to determine sociodemographic, anthropometric, lifestyle and health-related factors associated with sarcopenia using the new EWGSOP2 definition. Study design 396,283 participants (52.8 % women, age 38-73 years) were included in this cross-sectional study. The potential factors associated with sarcopenia were allocated to four categories: sociodemographic (sex, age, education, income and professional qualification), anthropometric (nutritional status, abdominal obesity, body fat and birth weight), lifestyle (physical activity, smoking, sleeping, sitting time, TV viewing, alcohol, and dietary intakes) and health status (self-reported prevalent diseases). P-values were corrected for multiple testing using the Bonferroni method. Results Age, women, lower education, higher deprivation, underweight, lower birth weight, and chronic diseases such as rheumatoid arthritis, chronic bronchitis and osteoporosis were associated with a higher likelihood of sarcopenia. Conversely, overweight, obesity, as well as a self-reported higher intake of energy, protein, vitamins (B12 and B9) and minerals (potassium, calcium and magnesium) were associated with lower odds of sarcopenia. Conclusion Women, people aged over 65 years, underweight people and those with rheumatoid arthritis were most likely to have sarcopenia. Considering the increase in the ageing population, sarcopenia is likely to become more prevalent. Identifying factors associated with sarcopenia could inform future strategies for early identification of individuals at high risk of sarcopenia and therefore the implementation of preventive strategies against the disease.

Citation

Fanny Petermann-Rocha; María Adela Martínez-Sanguinetti; Marcelo Villagrán; Natalia Ulloa; Gabriela Nazar; Claudia Troncoso-Pantoja; Alex Garrido-Méndez; Lorena Mardones; Fabián Lanuza; Ana María Leiva; Nicole Lasserre-Laso; Miquel Martorell; Carlos Celis-Morales. (2020). Desde una mirada global al contexto chileno: ¿Qué factores han repercutido en el desarrollo de obesidad en Chile? (Parte 1). Revista chilena de nutrición, 47(2), 299-306. https://doi.org/10.4067/s0717-75182020000200299

Abstract

Obesity is an inflammatory, chronic, recurrent, progressive disease of multifactorial aetiology affecting more than 650 million people worldwide. Its physical, emotional and economic burden relates not only to clinical manifestations but also to systemic and long-term effects. In Chile, economic growth, urbanisation and globalisation have profoundly changed lifestyles, favouring an obesogenic environment. What factors have influenced the development of obesity in Chile, and what role has each played in its increasing prevalence? Part 1 of this review discusses the main non-modifiable factors, from the country's epidemiological transition in the 1970s to related endocrine disorders.

Citation

Fanny Petermann-Rocha; Stuart R. Gray; Jill P. Pell; Frederick K. Ho; Carlos Celis-Morales. (2021). The joint association of sarcopenia and frailty with incidence and mortality health outcomes: A prospective study. Clinical Nutrition, 40(4), 2427-2434. https://doi.org/10.1016/j.clnu.2020.10.044

Abstract

Background Sarcopenia and frailty are strongly associated with disease incidence and mortality. However, there is limited evidence regarding their joint association with health outcomes. This study aimed to investigate the joint association of sarcopenia and frailty with cardiovascular disease (CVD), respiratory disease and cancer incidence and mortality as well as all-cause mortality in middle-aged and older adults in the UK Biobank study. Methods 316,980 UK Biobank participants were included in this prospective study (53.1% women). Sarcopenia was defined according to the EWGSOP2 2019. Frailty was defined using a modified version of the Fried criteria. Combined classifications of sarcopenia and frailty were generated with the following seven subgroups derived: i) normal, ii) non-sarcopenic/pre-frail, iii) non-sarcopenic/frail, iv) pre-sarcopenic/pre-frail, v) pre-sarcopenic/frail, vi) sarcopenic/pre-frail, and vii) sarcopenic/frail. No participants had (pre)sarcopenia but not frailty. Associations between these exposures and health outcomes (incidence and mortality from cardiovascular and respiratory diseases, cancer, as well as, all-cause mortality) were investigated using Cox-proportional hazard models. Results 51.7% of the participants were not sarcopenic nor frail (normal), 41.3% were pre-frail or frail, 6.5% pre-sarcopenia and frail (including pre-frail) and 0.5% as having both sarcopenia and frailty (including pre-frailty). The combination sarcopenic/frail showed the strongest association with CVD (HR: 1.68 [95% CI: 1.22 to 2.30]) and respiratory disease incidence (HR: 1.77 [95% CI: 1.40 to 2.24]) and for mortality from all-cause (HR: 2.27 [95% CI: 1.64 to 3.13]), respiratory disease (HR: 3.50 [95% CI: 1.97 to 6.23]), and cancer (HR: 1.92 [95% CI: 1.08 to 3.38]). Finally, when we investigated the associations between the outcomes and exposures by age groups (≥and Conclusion Our findings indicate that different combinations of sarcopenia and frailty were associated with adverse health outcomes, highlighting the joint association between both conditions. However, those individuals with sarcopenia and frailty showed the strongest associations with CVD and respiratory disease incidence and mortality for all-cause and respiratory disease and cancer.

Citation

Fanny Petermann-Rocha; Donald M Lyall; Stuart R Gray; Irene Esteban-Cornejo; Terence J Quinn; Frederick K Ho; Jill P Pell; Carlos Celis-Morales. (2020). Associations between physical frailty and dementia incidence: a prospective study from UK Biobank. The Lancet Healthy Longevity, 1(2), e58-e68. https://doi.org/10.1016/s2666-7568(20)30007-6

Abstract

BACKGROUND: Dementia is associated with a high burden of dependency and disability. Physical frailty (hereafter referred to as frailty) is a multisystem dysregulation that has been identified as a risk factor for dementia. The aim of this study was to examine the association of frailty and its individual components with all-cause dementia incidence in a cohort of UK adults. METHODS: Participants in UK Biobank with data available for dementia incidence and without any form of dementia at baseline were included in this prospective study. Frailty was defined using a modified version of the frailty phenotype based on five individual components (weight loss, tiredness, physical activity, gait speed, and grip strength), with participants classified as pre-frail if they fulfilled one or two criteria or frail if they fulfilled three or more. Associations between frailty and dementia incidence were investigated using Cox proportional hazard models adjusted for sociodemographic factors, lifestyle factors, and morbidity count. The population attributable fraction was also estimated. FINDINGS: Of 502 535 participants in UK Biobank, 143 215 met the inclusion criteria and were included in our analyses. 68 500 (47·8%) of the participants were pre-frail and 5565 (3·9%) were frail. During a median follow-up period of 5·4 years, 726 individuals developed dementia. Compared with non-frail individuals, the risk of dementia incidence was increased for individuals with pre-frailty (hazard ratio 1·21 [95% CI 1·04-1·42]) and frailty (1·98 [1·47-2·67]) in the fully adjusted model. Of the five components used to define frailty, weight loss (1·31 [1·09-1·58]), tiredness (1·48 [1·18-1·86]), low grip strength (1·38 [1·17-1·63]), and slow gait speed (1·55 [1·22-1·96]) were independently associated with incident dementia. Based on population attributable fraction analyses, in the study sample, pre-frailty and frailty accounted for 9·9% and 8·6% of dementia cases, respectively. INTERPRETATION: Individuals with pre-frailty and frailty were at a higher risk of dementia incidence even after adjusting for a wide range of confounding factors. Early detection and interventions for frailty could translate into prevention or delayed onset of dementia. FUNDING: None.

Citation

Frederick K. Ho; Fanny Petermann-Rocha; Stuart R. Gray; Bhautesh D. Jani; S. Vittal Katikireddi; Claire L. Niedzwiedz; Hamish Foster; Claire E. Hastie; Daniel F. Mackay; Jason M. R. Gill; Catherine O'Donnell; Paul Welsh; Frances Mair; Naveed Sattar; Carlos A. Celis-Morales; Jill P. Pell. (2020). Is older age associated with COVID-19 mortality in the absence of other risk factors? General population cohort study of 470,034 participants. PLOS ONE, 15(11), e0241824. https://doi.org/10.1371/journal.pone.0241824

Abstract

Introduction Older people have been reported to be at higher risk of COVID-19 mortality. This study explored the factors mediating this association and whether older age was associated with increased mortality risk in the absence of other risk factors. Methods In UK Biobank, a population cohort study, baseline data were linked to COVID-19 deaths. Poisson regression was used to study the association between current age and COVID-19 mortality. Results Among eligible participants, 438 (0.09%) died of COVID-19. Current age was associated exponentially with COVID-19 mortality. Overall, participants aged ≥75 years were at 13-fold (95% CI 9.13-17.85) mortality risk compared with those Conclusions Higher COVID-19 mortality among older adults was partially explained by other risk factors. 'Healthy' older adults were at much lower risk. Nonetheless, older age was an independent risk factor for COVID-19 mortality.

Citation

Yeny Concha-Cisternas; Igor Cigarroa; Carlos Matus-Castillo; Alex Garrido-Méndez; Ana María Leiva-Ordoñez; María Adela Martínez-Sanguinetti; Claudia Troncoso-Pantoja; Natalia Ulloa; María Fernanda Gabler; Fanny Petermann-Rocha; Solange Parra-Soto; Ximena Díaz; Carlos Celis-Morales. (2020). Prevalencia de debilidad muscular en personas mayores chilenas: resultados de la Encuesta Nacional de Salud 2016-2017. Revista médica de Chile, 148(11), 1598-1605. https://doi.org/10.4067/s0034-98872020001101598

Abstract

Background Handgrip strength is an indicator of frailty in older people. Aim To determine the prevalence of low handgrip strength in older Chilean adults. Material and methods A cross-sectional analysis of 244 individuals aged 60 years or more, participating in the 2016-2017 Chilean National Health Survey, was carried out. Handgrip strength was evaluated by a hand dynamometer and low grip strength was determined as a grip strength ≤ 15 kg and ≤ 27 kg for women and men, respectively. Results Twenty nine percent of participants had low grip strength. The average grip strength among 60-year-old men and women was 34.7 and 22.1 kg, respectively. These figures decreased to 28.8 kg and 17.2 kg among 90-year-old men and women, respectively. The prevalence of low grip strength in men and women aged 60 years was 18%. In 90-year-old men and women, these figures increased to 79% and 56.3%, respectively. Conclusions The prevalence of low grip strength increased substantially with age.

Citation

Jaime A. Vásquez-Gómez; Alex Garrido-Méndez; Carlos Matus-Castillo; Felipe Poblete-Valderrama; Ximena Díaz-Martínez; Yeny Concha-Cisternas; Igor Cigarroa; Miquel Martorell; María Adela Martínez-Sanguinetti; Ana María Leiva-Ordoñez; Fanny Petermann-Rocha; Carlos Celis-Morales. (2020). Fitness cardiorrespiratorio estimado mediante ecuación y su caracterización sociodemográfica en población chilena: Resultados de la Encuesta Nacional de Salud 2016-2017. Revista médica de Chile, 148(12), 1750-1758. https://doi.org/10.4067/s0034-98872020001201750

Abstract

Background Cardiorespiratory fitness is a strong predictor of mortality and chronic diseases. However, its estimation is costly and time consuming which may limit it broad use in population-based studies. Aim To estimate the cardiorespiratory fitness of the Chilean population by using equations and to characterize fitness levels of the Chilean population by sociodemographic factors. Material and methods This cross-sectional study included 5,958 adults from the Chilean Health Survey conducted between 2016 and 2017. Cardiorespiratory fitness was estimated from sex-specific equations for men and women and expressed as METs (Energy Metabolic Equivalent). Fitness levels were characterized by sociodemographics factors (age, sex, education, income and area of residency). Results Fitness levels were higher in men (9.01 METs) than in women (6.76 METs) and in average decrease by 0.59 and 0.34 METs per each year increment in age for men and women, respectively. Fitness levels were 12.7 METs and 7.8 METs for 20-year-old men and women, respectively. However, fitness levels decreased to 7.8 METs and 4.3 METs in 90-year-old men and women, respectively. Fitness levels were also higher in individuals living in urban setting, those with higher education or income levels and lean individuals. Conclusions This study reports fitness levels in a nationally representative sample of Chile. Fitness levels were higher in men than women however, its decline with age was more pronounce in men than women.

Citation

Solange Parra-Soto; María Adela Martínez-Sanguinetti; Ana María Leiva-Ordoñez; Fanny Petermann-Rocha; Nicole Lasserre-Laso; Carlos Celis-Morales. (2020). Una dieta antiinflamatoria disminuiría el riesgo de mortalidad por todas las causas. Revista médica de Chile, 148(12), 1863-1864. https://doi.org/10.4067/s0034-98872020001201863

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Citation

Fanny Petermann-Rocha; Minghao Chen; Stuart R Gray; Frederick K Ho; Jill P Pell; Carlos Celis-Morales. (2019). New versus old guidelines for sarcopenia classification: What is the impact on prevalence and health outcomes?. Age and Ageing, afz126. https://doi.org/10.1093/ageing/afz126

Abstract

Introduction recently, the European Working Group on Sarcopenia in Older People (EWGSOP) established a new operational definition and cut-off points for sarcopenia. The aim of this study was, therefore, to compare the prevalence of sarcopenia and its associations with different health outcomes using the old (EWGSOP1) and new (EWGSOP2) definitions of sarcopenia in the UK Biobank cohort. Methods sarcopenia was defined as low grip strength plus low muscle mass. Using both EWGSOP cut-off points, we created specific sarcopenia variables. Prevalence of sarcopenia derived using both EWGSOP definitions was calculated and compared as well as prospective health outcomes including all-cause mortality as well as incidence and mortality from cardiovascular disease (CVD), respiratory disease and chronic obstructive pulmonary disease (COPD). Results the prevalence of sarcopenia based on the EWGSOP1 and EWGSOP2 classifications were 8.14 and 0.36%, respectively. Sarcopenia defined by EWGSOP1 was associated with a higher risk of respiratory disease and COPD as well as mortality from all-cause, CVD and respiratory diseases. However, only respiratory incidence remained associated with sarcopenia when EWGSOP2 was used (HR: 1.32 [95% CI: 1.05-1.66]). Moreover, although individuals classified as sarcopenic using both classifications had the highest risk of all-cause mortality and respiratory disease, those with sarcopenia based on EWGSOP1 only experienced a more extensive range of poorer health outcomes. Conclusion in comparison with EWGSOP1, the new classification (EWGSOP2) produced a lower estimate of sarcopenia prevalence and fewer associations with adverse health outcomes. Although these associations were higher, many become non-significant.

Citation

Fanny Petermann-Rocha; Nicole Lasserre-Laso; Marcelo Villagrán; Lorena Mardones; María Adela Martínez; Ana María Leiva; Natalia Ulloa; Carlos Celis-Morales. (2019). Asociación del polimorfismo rs7903146, del gen TCF7L2, con marcadores de adiposidad y metabólicos en población chilena - resultados del estudio GENADIO. Revista médica de Chile, 147(8), 965-976. https://doi.org/10.4067/s0034-98872019000800965

Abstract

Background Type 2 diabetes etiology has a strong genetic component. More than 20 genetic variants have been associated with diabetes and other metabolic markers. However, the polymorphism rs7903146 of the TCF7L2 gene has shown the strongest association. Aim To investigate the association of TCF7L2 (rs7903146) genotype with adiposity and metabolic markers in the Chilean adult population. Material and methods The association of TCF7L2 (rs7093146) with adiposity and metabolic markers was studied in 301 participants. The outcomes of the study were adiposity markers (body weight, body mass index (BMI), fat mass and waist circumference) and metabolic markers (blood glucose, insulin, HOMA-IR, lipid profile, high sensitivity C-reactive protein (CRP), alanine aminotransferase (ALT), gamma glutamyl transpeptidase (GGT) and leptin). Results There was an association between the polymorphism TCF7L2 genotype and fasting blood glucose. The latter increased by 4.86 mg/dl per each copy of the risk allele [(95% confidence intervals (CI): 0.48; 9.24), p = 0.03] in the unadjusted adjusted model. However, this association was slightly attenuated in the fully adjusted model [4.38 mg/dl (95% IC: 0.16; 8.60), p = 0.04)]. There were no associations between the TCF7L2 genotype and any other metabolic or adiposity outcome. Conclusions These findings confirm the association between the TCF7L2 (rs7903146) and fasting glucose in the Chilean population. However, further studies are needed to confirm the association between the TCF7L2 and diabetes risk in the Chilean population.

Citation

Fanny Petermann-Rocha; Cristian Rocha; María Adela Martínez-Sanguinetti; Ana María Leiva; Claudia Troncoso-Pantoja; Marcelo Villagrán; Nicole Lasserre-Laso; Natalia Ulloa; Carlos Celis-Morales. (2019). ¿Existe asociación entre asma y adiposidad en la población adulta chilena?. Revista médica de Chile, 147(6), 733-740. https://doi.org/10.4067/s0034-98872019000600733

Abstract

Background In people with asthma, adiposity is associated with more symptoms and less control of the disease whereas on those without asthma adiposity is associated with a higher risk of developing the disease. Aim To investigate the association between asthma and adiposity markers in Chilean adults. Material and methods Data from 5,499 adults older than 15-years-old from the Chilean National Health Survey 20162017 were analyzed. Quintiles of body-mass index (BMI) and waist circumference (WC) were used as a proxy of adiposity. The association between asthma and quintiles of BMI and WC was determined by logistic regression. Results A higher BMI and WC was associated with a higher odds for asthma. This trend remained significant even after adjusting the models for socio-demographic factors, physical activity and smoking (Odds Ratio [OR] BMI: 1.13 [95% confidence intervals (CI): 1.04; 1.22], p Conclusions A higher BMI and WC were positively associated with asthma.

Citation

Fanny Petermann-Rocha; Rosemary E. Brown; Ximena Diaz-Martínez; Ana M. Leiva; María A. Martinez; Felipe Poblete-Valderrama; Alex Garrido-Méndez; Carlos Matus-Castillo; Cristian Luarte-Rocha; Carlos Salas-Bravo; Claudia Troncoso-Pantoja; Antonio García-Hermoso; Robinson Ramírez-Vélez; Jaime A. Vásquez-Gómez; Fernando Rodríguez-Rodríguez; Cristian Alvarez; Carlos Celis-Morales. (2019). Association of leisure time and occupational physical activity with obesity and cardiovascular risk factors in Chile. Journal of Sports Sciences, 37(22), 2549-2559. https://doi.org/10.1080/02640414.2019.1647738

Abstract

The aim of this study was to investigate the association between physical activity (PA), both occupational (OPA) and during leisure time (LTPA), with obesity and cardiovascular risk factors in Chilean adults. 5,157 participants from the Chilean National Health Survey 2009-2010 were included in this study. OPA and LTPA levels were assessed using the Global Physical Activity Questionnaire. The association between both PA with obesity and cardiovascular risk factors was determined using logistic regression. Our findings showed a significant trend between higher LTPA and lower odds for obesity (OR 0.64 [95% CI: 0.53; 0.76], central obesity 0.52 [0.44; 0.61]) and other cardiovascular risk factors including diabetes (OR: 0.72 [0.55; 0.94]), hypertension (OR: 0.59 [0.50; 0.71]) and metabolic syndrome (OR: 0.62 [0.50; 0.78]). In contrast, OPA was only associated with lower odds of diabetes (OR: 0.79 [0.65; 0.98]) and hypertension (0.85 [0.74; 0.98]). In conclusion, LTPA was associated with a lower risk of all major cardiovascular risk factors, whereas OPA was only associated with a lower risk of diabetes and hypertension.

Citation

Fanny Petermann-Rocha; Anne Sillars; Rosemary Brown; Lauren Sweeney; Claudia Troncoso; Antonio García-Hermoso; Ana María Leiva; María Adela Martínez; Ximena Diaz-Martínez; Felipe Poblete-Valderrama; Alex Garrido-Mendez; Ximena Cataldo; José Iturra Gonzalez; Carlos Salas; José Lara; Stuart R Gray; Carlos Celis-Morales. (2019). Sociodemographic patterns of urine sodium excretion and its association with hypertension in Chile: a cross-sectional analysis. Public Health Nutrition, 22(11), 2012-2021. https://doi.org/10.1017/s1368980018003889

Abstract

Objective The aim of the study was to determine the main factors (sociodemographic, anthropometric, lifestyle and health status) associated with high Na excretion in a representative population of Chile. Design Na excretion (g/d), a valid marker of Na intake, was determined by urine analysis and Tanaka's formulas. Blood pressure was measured by trained staff and derived from the mean of three readings recorded after 15 min rest. The associations of Na excretion with blood pressure and the primary correlates of high Na excretion were determined using logistic regression. Setting Chileans aged ≥15 years.ParticipantsParticipants (n 2913) from the Chilean National Health Survey 2009-2010. Results Individuals aged 25 years or over, those who were obese and those who had hypertension, diabetes or metabolic syndrome were more likely to have higher Na excretion. The odds for hypertension increased by 10·2 % per 0·4 g/d increment in Na excretion (OR=1·10; 95 % CI 1·06, 1·14; P < 0·0001). These findings were independent of major confounding factors. Conclusions Age, sex, adiposity, sitting behaviours and existing co-morbidities such as diabetes were associated with higher Na excretion levels in the Chilean population. These findings could help policy makers to implement public health strategies tailored towards individuals who are more likely to consume high levels of dietary salt.

Citation

Fanny Petermann-Rocha; Eliana Durán; Ana María Labraña; María Adela Martínez-Sanguinetti; Ana María Leiva; Alex Garrido-Méndez; Felipe Poblete-Valderrama; Ximena Díaz; Carlos Salas; Cristian Álvarez; Liliana Cuadra; Natalia Ulloa; Carlos Celis-Morales. (2019). ¿Cuál es la prevalencia de obesidad metabólicamente saludable en población chilena?. Revista chilena de nutrición, 46(3), 264-270. https://doi.org/10.4067/s0717-75182019000300264

Abstract

Obesity is a major cardiovascular risk factor. However, not all people with obesity have an altered metabolic profile, and not all people of normal weight have a normal profile. Objective: To determine the prevalence of metabolic phenotypes associated with nutritional status in Chile. Methods: The study included 1,733 participants from the 2009–2010 National Health Survey. Nutritional status (obesity or normal weight) was defined by BMI, and metabolic health by blood glucose, blood pressure, HDL cholesterol and triglycerides. These parameters defined four phenotypes, including metabolically unhealthy non-obese (MUNO) and metabolically healthy obese (MHO). Results: MHO prevalence was 3.3%, whereas 17.4% had MUNO. MHO prevalence decreased with age. The highest proportion of metabolically healthy individuals was in the high-income group with higher technical or university education. Conclusion: The Chilean population had a low prevalence of MHO and a high prevalence of MUNO. Future prevention should consider both nutritional status and metabolic health.

Citation

Fanny Petermann R; Claudia Troncoso-Pantoja; María Adela Martínez S; Ana María Leiva O; Natalia Ulloa M; Carlos Celis-Morales. (2019). Los problemas auditivos aumentan el riesgo de deterioro cognitivo en adultos mayores chilenos. Revista de otorrinolaringología y cirugía de cabeza y cuello, 79(1), 9-17. https://doi.org/10.4067/s0718-48162019000100009

Abstract

Introduction: Hearing loss has been associated with accelerated cognitive impairment during ageing, but this association had not been investigated in older Chilean adults. Aim: To investigate the association between hearing impairment and suspected cognitive impairment using the abridged Mini-Mental State Examination (MMSE). Materials and methods: The study included 1,384 adults aged ≥60 years from the 2009–2010 Chilean National Health Survey. An MMSE score below 13 indicated suspected cognitive impairment. Hearing impairment was assessed using a three-question self-report screening questionnaire. Associations were investigated using logistic regression. Results: Abnormal MMSE results were significantly associated with each hearing impairment studied. As hearing impairments increased, the odds of cognitive impairment increased by 59% (OR: 1.59; 95% CI: 1.38–1.82; p < 0.0001). Conclusion: Reduced hearing perception is a risk factor for cognitive impairment and subsequent dementia. Public policies focused on early screening in at-risk populations could help prevent associated consequences. Keywords: Ageing; mental status and dementia tests; hearing loss; cognitive impairment.

Citation

Fanny Petermann; Claudia Troncoso-Pantoja; María Adela Martínez; Ana María Leiva; Rodrigo Ramírez-Campillo; Felipe Poblete-Valderrama; Alex Garrido-Méndez; Ximena Díaz-Martínez; Natalia Ulloa; Yeny Concha; Carlos Celis-Morales. (2018). Asociación entre diabetes mellitus tipo 2, historia familiar de diabetes y deterioro cognitivo en adultos mayores chilenos. Revista médica de Chile, 146(8), 872-881. https://doi.org/10.4067/s0034-98872018000800872

Abstract

Background Although cardiovascular risk factors are associated with an impaired cognitive function, the impact of diabetes on cognitive function in Chilean adults is unknown. Aim To investigate the association of diabetes or family history of the disease with cognitive impairment in older adults. Materials and methods Data from the 2009-2010 Chilean National Health Survey including 1,384 participants aged ≥ 60 years were included in this study. A score below 13 points for the Mini Mental State Examination (MMSE) was considered an indication of cognitive impairment. Logistic regression analyses were performed to assess the association between MMSE, diabetes and family history of the disease. Results Cognitive impairment increased with age (Odds ratio (OR): 1.83 [95% confidence intervals (CI): 1.53; 2.19], p Conclusions Older adults with diabetes are more susceptible to develop cognitive impairment.

Citation

Fanny Petermann; Ana Leiva; María Adela Martínez; Eliana Durán; Ana María Labraña; Alex Garrido-Méndez; Carlos Celis-Morales. (2018). Consumo de carnes rojas y su asociación con mortalidad. Revista chilena de nutrición, 45(3), 293-295. https://doi.org/10.4067/s0717-75182018000400293

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Citation

Fanny Petermann; Marcelo Villagrán; Claudia Troncoso; Lorena Mardones; Ana María Leiva; María Adela Martínez; Alex Garrido-Méndez; Felipe Poblete-Valderrama; Carlos Salas-Bravo; Robinson Ramírez-Vélez; Natalia Ulloa; Francisco Pérez-Bravo; Carlos Celis-Morales. (2018). Asociación entre el polimorfismo rs9939609 del gen FTO y marcadores de adiposidad en población adulta chilena. Revista médica de Chile, 146(6), 717-726. https://doi.org/10.4067/s0034-98872018000600717

Abstract

Background Numerous studies have identified the role of Fat-mass-associated-gene (FTO) in the development of obesity. Aim To investigate the association of FTO gene with adiposity markers in Chilean adults. Material and methods 409 participants were included in this cross-sectional study. The association between FTO (rs9939609) genotype and adiposity markers was determined using linear regression analyses. Adiposity markers included were: body weight, body mass index, fat mass, waist circumference, hip circumference and waist/hip ratio. Results A fully adjusted model showed a significant association between FTO genotype and body weight (2.16 kg per each extra copy of the risk allele [95% confidence intervals (CI): 0.45 to 3.87], p = 0.014), body mass index (0.61 kg.m-2 [95% CI: 0.12 to 1.20], p = 0.050) and fat mass (1.14% [95% CI: 0.39 to 1.89], p = 0.010). The greater magnitude of association was found between the FTO gene and fat mass when the outcomes were standardized to z-score. Conclusions This study confirms an association between the FTO gene and adiposity markers in Chilean adults, which is independent of major confounding factors.

Citation

Fanny Petermann; Alex Garrido-Méndez; Ximena Díaz-Martínez; Ana María Leiva; Maríaadela Martínez; Felipe Poblete-Valderrama; Carlos Salas; Carlos Cristi-Montero; Carlos Celis-Morales. (2018). Tiempo destinado a estar sentado y niveles de adiposidad ¿Cuál es su efecto sobre el desarrollo de diabetes mellitus tipo 2?. Revista médica de Chile, 146(4), 433-441. https://doi.org/10.4067/s0034-98872018000400433

Abstract

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

Citation

Fanny Petermann; Ana María Leiva; María Adela Martínez; Carlos Salas; Alex Garrido-Méndez; Cristián Luarte-Rocha; Carlos Celis-Morales. (2018). EL TRANSPORTE ACTIVO: podría reducir hasta en un 40% el riesgo de desarollar cáncer, enfermedades cardiovasculares y mortalidad prematura. Revista Médica Clínica Las Condes, 29(1), 101-102. https://doi.org/10.1016/j.rmclc.2017.10.013

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Fanny Petermann; Ximena Díaz-Martínez; Álex Garrido-Méndez; Ana María Leiva; María Adela Martínez; Carlos Salas; Felipe Poblete-Valderrama; Carlos Celis-Morales. (2018). Asociación entre diabetes mellitus tipo 2 y actividad física en personas con antecedentes familiares de diabetes. Gaceta Sanitaria, 32(3), 230-235. https://doi.org/10.1016/j.gaceta.2017.09.008

Abstract

Objective To investigate whether the association between type 2 diabetes (T2D) and family history of diabetes is modified by the levels of physical activity in the Chilean population. Method In this study were included 5129 participants from the cross-sectional 2009-2010 National Health Survey. Physical activity level was assessed using the Global Physical Activity Questionnaire and family history of T2D, through self-reporting. The association between diabetes, family history of diabetes and physical activity was determined using logistic regression. Results The odds of developing T2D in people with family history of this pathology is high, independent of their levels of physical activity and adiposity. Both men and women with family history of T2D have a higher probability of developing T2D. The odds ratio for having T2D was 5,49 (95%CI: 3,85-7,84; p Conclusion Given the elevated risk of developing T2D presented by individuals with a family history of this pathology, and the effect of physical activity in reducing such risk, people with family history of diabetes may need higher levels of physical activity to attenuate their susceptibility to T2D.

Citation

Fanny Petermann; Ana María Labraña; Eliana Duran; Ana María Leiva; María Martínez; Carlos Salas; Alex Garrido-Méndez; Carlos Celis-Morales. (2018). El consumo de frutas y verduras se asocia a menor mortalidad: 5 porciones al día es bueno, ¡pero 10 serían mejor!. Revista chilena de nutrición, 45(2), 183-185. https://doi.org/10.4067/s0717-75182018000300183

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Fanny Petermann; Ana María Labraña; Eliana Durán; María Adela Martínez; Ana Leiva; Alex Garrido-Méndez; Carlos Celis-Morales. (2018). Repetido, pero cierto: Una alimentación saludable es la clave para una mejor salud. Revista chilena de nutrición, 45(1), 89-90. https://doi.org/10.4067/s0717-75182018000100089

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Fanny Petermann; Ana María Leiva; María Adela Martínez; Carlos Salas; Alex Garrido-Méndez; Cristian Luarte-Rocha; Ximena Díaz; Cristóbal Cuadrado; Carlos Celis-Morales. (2018). Inactividad física y obesidad ¿cuál es su repercusión en el gasto económico de diabetes mellitus 2 en Chile?. Revista chilena de nutrición, 45(1), 91-92. https://doi.org/10.4067/s0717-75182018000100091

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No standalone abstract was identified in the sources consulted.

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Citation

Fanny Petermann; Eliana Durán; Ana María Labraña; María Adela Martínez; Ana María Leiva; Alex Garrido-Méndez; Felipe Poblete-Valderrama; Ximena Díaz-Martínez; Carlos Salas; Carlos Celis-Morales. (2017). Factores de riesgo asociados al desarrollo de hipertensión arterial en Chile. Revista médica de Chile, 145(8), 996-1004. https://doi.org/10.4067/s0034-98872017000800996

Abstract

Background High blood pressure is one of the major risk factors for the development of cardiovascular disease, affecting 27% of the Chilean population in 2010. Aim To determine the risk factors associated with the development of hypertension. Material and methods Analysis of the database of the 2009-2010 National Health Survey in which 4,901 participants were included. Socio-demographic factors, physical activity, eating habits, well-being and comorbidities were analyzed. Results Women had a lower risk of developing hypertension than men (Odds ratio (OR): 0.69, 95% confidence intervals (CI): 0.59-0.81, p Conclusions Identifying the risk factors associated with hypertension allows public health policies to be tailored to its prevention.

Citation

Fanny Petermann; Eliana Durán; Ana María Labraña; María Adela Martínez; Ana María Leiva; Alex Garrido-Méndez; Felipe Poblete-Valderrama; Ximena Díaz-Martínez; Carlos Salas; Carlos Celis-Morales. (2017). Factores asociados al desarrollo de obesidad en Chile: resultados de la Encuesta Nacional de Salud 2009-2010. Revista médica de Chile, 145(6), 716-722. https://doi.org/10.4067/s0034-98872017000600716

Abstract

Background: Chile has one of the highest obesity rates in Latin America.However, the factors that could explain this high prevalence of obesity are unknown.Aim: To determine the main risk factors for the development of obesity in Chile.Material and Methods: We included 1,398 obese and 1,478 normal weight participants of the National Health Survey 2009-2010.The risk factors considered were socioeconomic variables, diet, physical activity, comorbidities and general wellbeing.Results: The main factors associated with a higher risk of being obese were age, high salt consumption and high alcohol intake.Education, income and living in rural settings were protective for women and risk factors for men.The probability of being obese increases in women that sleep less than seven hours per day or have a poor health.Sedentariness and lack of physical activity were risk factors among men.Conclusions: The identification of these risk factors may help to implement public health interventions to tackle obesity in Chile.

Citation

C A Celis-Morales; D M Lyall; S R Gray; L Steell; J Anderson; S Iliodromiti; P Welsh; Y Guo; F Petermann; D F Mackay; M E S Bailey; J P Pell; J M R Gill; N Sattar. (2017). Dietary fat and total energy intake modifies the association of genetic profile risk score on obesity: evidence from 48 170 UK Biobank participants. International Journal of Obesity, 41(12), 1761-1768. https://doi.org/10.1038/ijo.2017.169

Abstract summary

Cross-sectional analysis of 48,170 UK Biobank adults on genetic predisposition to obesity and macronutrient intake. The association between a 93-variant genetic score and body mass index was stronger among people consuming more total fat, saturated fat or energy. Equivalent interactions were not found for protein, carbohydrate or fibre. Similar patterns were observed for waist circumference. The findings suggest that dietary context may modify the expression of genetic risk, without establishing causality because of the cross-sectional design.

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Citation

Fanny Petermann Rocha; Eliana Durán Fernández; Ana María Labraña Torres; Carlos Celis-Morales. (2017). Efecto de una consulta nutricional protocolizada sobre el estado nutricional y hábitos alimentarios de adultos con sobrepeso y obesidad. Revista chilena de nutrición, 44(4), 341-349. https://doi.org/10.4067/s0717-75182017000400341

Abstract

Overweight and obesity affect 67% of the Chilean population. Various strategies have been used to address this situation, including nutritional consultations. However, these consultations have not yet been standardised, and whether doing so could reduce excess body weight is unknown. This study assessed the effect of a standardised nutritional consultation on nutritional status and eating habits in adults with overweight or obesity at a family health centre. A three-month pre–post intervention study included 30 participants. Changes in nutritional status were assessed anthropometrically, and changes in eating habits using dietary assessment. The consultation significantly reduced body weight, BMI, waist circumference and body fat percentage, and improved the eating habits studied. A total of 92% of participants incorporated a mid-morning snack and a daily portion of skimmed dairy. Despite these positive effects, longer studies with a representative group of participants are needed to confirm the benefits.

Citation

Fanny Petermann; Ana María Leiva; María Adela Martínez; Carlos Salas; Alex Garrido-Méndez; Carlos Celis-Morales. (2017). Consumo de bebidas azúcaradas ayer y hoy: ¿cuál es el escenario para la población chilena?. Revista chilena de nutrición, 44(4), 400-401. https://doi.org/10.4067/s0717-75182017000400400

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No standalone abstract was identified in the sources consulted.

No standalone abstract