Ingesta de alimentos ultraprocesados y circunferencia de cintura según área de residencia en adultos peruanos / Ultra-processed food consumption and waist circumference by residence setting in Peruvian adults

Introducción. La circunferencia de cintura (CC) es indicador de obesidad abdominal y riesgo cardiovascular en adultos. En Perú, la obesidad ha aumentado a diferente magnitud por área de residencia y poco se sabe de la influencia del consumo de alimentos ultraprocesados (AUP) sobre este fenómeno en población adulta. Objetivo. Evaluar la asociación entre ingesta de AUP y circunferencia de cintura en adultos peruanos por área de residencia. Materiales y métodos. Estudio transversal de datos secundarios de 745 adultos con información de ingesta dietaria (un recordatorio de 24 horas) de la Encuesta Nacional Vigilancia Alimentaria y Nutricional por Etapas de Vida 2017-2018. Los AUP fueron caracterizados según la clasificación NOVA. La ingesta AUP como el porcentaje relativo de la ingesta energética total (%), dividida en terciles. La CC medida como punto medio entre última costilla y cresta iliaca. Se usó regresión lineal múltiple ponderada y análisis estratificado según área de residencia. Resultados. La edad promedio fue 37,2 años. La ingesta de AUP promedio fue 14,7% (IC95%: 14,2 ­ 15,3). Comparado con adultos en el menor tercil de ingesta de AUP, aquellos en tercil medio tuvieron mayor CC ( 0,73; IC95%: 0,22 ­ 1,24; valor p= 0,007). Al estratificar por área de residencia, adultos rurales del tercil medio tuvieron mayor CC en comparación con primer tercil ( : 1,85; IC95%: 1,17 ­ 2,53, valor p < 0,001). Conclusiones. En adultos peruanos, la ingesta de AUP se asoció a CC en áreas rurales, aunque no de forma lineal. Más estudios son necesarios para entender la naturaleza de esta asociación(AU)

Introduction. Waist circumference (WC) is an abdominal obesity and cardiovascular risk indicator among adults. In Peru, obesity prevalence has been increasing unequally between residence areas, and the influence of ultra- processed food (UPF) consumption on WC in Peruvian adults remains unclear. Objective. Evaluate the association between UPF consumption and waist circumference by residence setting among Peruvian adults. Materials and methods. A cross-sectional secondary analysis of dietary intake data (single 24-hour recall) from 745 adults aged 18 and 59 years old from the "Vigilancia Alimentaria y Nutricional por Etapas de Vida 2017-2018" National Surveys was performed. The NOVA system was used to characterize the UPFs, and the exposure was the percentage of total energy consumed from UPF per day (%), in quantiles. WC (cm) was assessed at the middle point between the last rib and the iliac crest. Weighted linear regression analysis stratified by residence areas were conducted. Results. The mean age was 37.2 years. The mean percent of total energy consumed from UPF was 14.7% (95%CI: 14.2 ­ 15.3). Those in the middle tertile of UPF consumption, had higher WC ( 0.73; 95%CI: 0.22 ­ 1.24; p-value = 0.007) compared with those in the lower tertile. In the stratified analysis, those in the second tertile in rural areas have more WC compared with the first tertile ( 1.85; 95%CI: 1.17 ­ 2.53, p-value< 0.001). Conclusions. In rural areas, UPF consumption was associated with waist circumference, but it does not follow a linear association. Further studies are needed to understand the rationale behind these results(AU)

Síndrome metabólico en el adulto mayor vinculado a los programas de actividad física comunitaria / Metabolic Syndrome in the Elderly Adult Involved in the Community Physical Activity Programs

Introducción: El síndrome metabólico es una situación clínica compleja que se asocia a un incremento de la morbilidad y mortalidad. Los elementos que lo componen aumentan el riesgo de diabetes mellitus tipo II y enfermedad cardiovascular. Objetivo: Determinar el comportamiento del síndrome metabólico en el adulto mayor vinculado a los programas de actividad física comunitaria del proyecto Lindo Amanecer del municipio Arroyo Naranjo. Métodos: Se realizó un estudio observacional descriptivo de corte transversal. El universo de estudio lo constituyeron 120 adultos mayores, de los que se entrevistaron a 106, en el período de abril a octubre de 2018. Se siguieron los criterios del Adult Treatment Panel III para el diagnóstico de síndrome metabólico. Las variables descriptivas se expresaron en porcientos y para la comparación de variables en estudio se utilizó el método estadístico de ji al cuadrado. Resultados: Los resultados obtenidos mostraron un 41,51 por ciento de personas con síndrome metabólico, predominaron las personas de 70 y más años de edad (54,54 por ciento y el sexo femenino (93,18 por ciento). El 100 por ciento tuvieron cifras de presión arterial ≥ 130/85 mmHg. El 100 por ciento de los pacientes desconocían su enfermedad. Conclusiones: Se encontró predominio en los pacientes con síndrome metabólico del sexo femenino y del grupo de edad de 70 y más años. El diagnóstico a nivel de la Atención Primaria de Salud es deficiente. Se asocia a la hipertensión arterial, obesidad abdominal y al riesgo de enfermedad cardiovascular(AU)

Introduction: Metabolic syndrome is a complex clinical situation associated with an increase in morbidity and mortality. The elements that mark it up increase the risk of type 2 diabetes mellitus and cardiovascular disease. Objective: To determine the behavior of metabolic syndrome in elderly adults involved in the community physical activity programs of the Lindo Amanecer project in the municipality of Arroyo Naranjo. Methods: A cross-sectional descriptive observational study was carried out. The study universe was made up of 120 elderly adults, 106 of which were interviewed in the period from April to October 2018. The Adult Treatment Panel III criteria for the diagnosis of metabolic syndrome were followed. The descriptive variables were expressed in percentages and, for the comparison of variables under study, the chi-square statistical method was used. Results: The obtained results showed 41.51percent of people with metabolic syndrome, with a predominance of people aged 70 years and older (54.54percent) and the female sex (93.18percent). One hundred percent had blood pressure values over or equal to 130/85 mmHg. One hundred percent of the patients did not have any knowledge of their disease. Conclusions: In patients with metabolic syndrome, the predominance corresponded to the female sex, as well as the age group of 70 years and older. Diagnosis at the primary healthcare level is deficient. It is associated with arterial hypertension, abdominal obesity and the risk of cardiovascular disease(AU)

Efeito de uma intervenção remota de atividade física no risco cardiovascular e na aptidão física / The effects of a remote physical activity intervention on cardiovascular risk and physical fitness

RESUMO Devido à pandemia da COVID-19, os projetos de orientação de atividade física (AF) tiveram que adaptar suas atuações para o formato remoto. O objetivo deste estudo foi avaliar os efeitos de uma intervenção remota de AF no risco cardiovascular e na aptidão física em participantes desses projetos. Para isso, 29 participantes do Projeto Exercício e Coração (66±5 anos) foram orientados a realizar, 2 caminhadas, 1 videoaula de exercícios aeróbicos e 2 videoaulas de exercícios de força muscular por semana, sendo cada atividade realizada por 30 min e em intensidade moderada. No início e após 8 semanas, foram medidos marcadores de risco cardiovascular e de aptidão física, que foram comparados por testes t-student ou Wilcoxon, considerando-se p≤0,05. Comparando-se as avaliações pré e pós-intervenção, houve redução da circunferência da cintura (95,9±11,3 vs. 94,7±11,3 cm, p=0,013) e aumento da capacidade cardiorrespiratória (117±21 vs. 123±23 passos, p=0,019), da força dos membros superiores (23±6 vs. 25±6 repetições, p=0,003), da resistência abdominal (20±9 vs. 22±10 repetições, p=0,002) e da aptidão física geral (-0,04±3,55 vs. 1,30±4,10, p=0,000). Em conclusão, a intervenção remota aumentou a aptidão física geral, aumentando a capacidade cardiorrespiratória, a força e a resistência muscular, além de reduzir a obesidade central.

ABSTRACT Due to the COVID-19 pandemic, the projects that offer guidance for physical activity (PA) had to be adapted to the remote format. This study aimed at assessing the effects of a remote PA intervention on the cardiovascular risk and physical fitness of the individuals engaged in these projects. Thus, 29 participants of the Brazilian project known as Projeto Exercício e Coração (Exercise and Heart Project) (66±5 years) were instructed to perform 2 walking sessions, 1 aerobic exercise video class and 2 muscle strength video classes per week with each activity lasting 30 min and performed at moderate intensity. At baseline (pre) and after 8 weeks (post), markers of cardiovascular risk and physical fitness were evaluated and compared by using paired t-tests or Wilcoxon signed rank tests considering p≤0.05. When comparing pre- and post-intervention evaluations, there was a significant reduction in waist circumference (95.9±11.3 vs. 94.7±11.3 cm, p=0.013) and significant increases in cardiorespiratory fitness (117±21 vs. 123±23 steps, p=0.019), upper limb strength (23±6 vs. 25±6 repetitions, p=0.003), abdominal endurance (20±9 vs. 22±10 repetitions, p= 0.002) and overall physical fitness (-0.04±3.55 vs. 1.30±4.10, p=0.000). In conclusion, the remote intervention improved general physical fitness, increasing cardiorespiratory fitness, muscle strength and endurance, in addition to reducing central obesity.

Factores del síndrome metabólico en el riesgo cardiovascular en pobladores peruanos / Factors of Metabolic Syndrome in Cardiovascular Risk among Peruvian Populations

Objetivo: Determinar la incidencia de los factores del síndrome metabólico en el riesgo cardiovascular en pobladores del distrito de Ayacucho en Perú. Método: Enfoque cuantitativo, diseño correlacional causal. La muestra fue de 140 pobladores mayores de 18 años a quienes se les realizó el dosaje serológico y se tomaron las medidas antropométricas necesarias mediante el uso de equipos biomédicos calibrados y específicos para cada parámetro. Se utilizó como instrumento la Tabla de cálculo de Síndrome Metabólico (ALAD) y la tabla de Framinghan. Resultados: Se determinó que el Síndrome Metabólico incide significativamente (0,000) en el Riesgo Cardiovascular con un J2= 15,432 (1) y una influencia de 16,8 por ciento enfatizado por el coeficiente de Pseudo-R2 Nagelkerke. Conclusión: Se concluye que el síndrome metabólico incide en el riesgo cardiovascular de los pobladores evaluados, debido a que presentaron niveles bajo de colesterol HDL, triglicéridos altos, un incremento de perímetro abdominal y hábitos de fumar, siendo estos factores determinantes para incrementar el riesgo cardiovascular (AU)

Objective: To determine the incidence of metabolic syndrome factors on cardiovascular risk in inhabitants of the district of Ayacucho in Peru. Methods: Quantitative approach, causal correlational design. The sample consisted of 140 inhabitants over 18 years of age who underwent serological dosage and the necessary anthropometric measurements were taken using calibrated and specific biomedical equipment for each parameter. The Metabolic Syndrome Calculation Table (ALAD) and the Framinghan table were used as instruments. Results: It was determined that the Metabolic Syndrome has a significant influence (0.000) on Cardiovascular Risk with a J2= 15.432 (1) and an influence of 16.8 percent emphasized by the Pseudo-R2 Nagelkerke coefficient. Conclusion: It is concluded that the metabolic syndrome has an impact on the cardiovascular risk of the population evaluated, because they presented low HDL cholesterol levels, high triglycerides, an increase in abdominal perimeter and smoking habits, these being determining factors to increase cardiovascular risk(AU)

Sex-related differential prevalence of central obesity in diabetes mellitus: a multi-centred survey in North-Central Nigeria

Contrary to the old dictum that central obesity is more common among men than women, recent reports have shown a gradual reversal of this trend, as suggested by some studies. Objective: To compare the prevalence of central obesity among men and women with Diabetes mellitus in NorthCentral Nigeria. Methods: This multi-centred, cross-sectional study was conducted across 20 hospitals in Abuja, Nasarawa State, and Niger State, involving 1040 participants. Some obesity indices (body mass index, waist circumference and waist-toheight ratio) were measured. Results: The prevalence of central obesity (waist circumference criterion) was significantly higher in the females compared to male participants (89.6% vs 51.6%, χ2 = 1231.37, p<0.001), similar to the prevalence determined by waistheight ratio criterion (female vs male, 88.8% vs 71.5%, χ2 = 58.83, p<0.001). Following correction for age, duration of diabetes mellitus, blood pressure, blood glucose, and glycated haemoglobin using logistic regression, female gender remained a significant determinant of central obesity (OR = 2.76, 95% CI 1.81-3.83, p = 0.004). Conclusion: The prevalence of central obesity was higher among women than men in a cross-section of patients with diabetes mellitus in North-Central Nigeria

Associations Between Insulin Resistance Indexes and Hyperuricemia in Hypertensive Population / 中国医学科学院学报

Objective To explore the relationship between insulin resistance (IR) indexes and hyperuricemia (HUA) among the people with hypertension. Methods From July to August in 2018,hypertension screening was carried out in Wuyuan county,Jiangxi province,and the data were collected through questionnaire survey,physical measurement,and biochemical test.Logistic regression was performed to analyze the relationship between HUA and IR indexes including metabolic score for IR (METS-IR),triglyceride-glucose (TyG) index,TyG-body mass index (BMI),TyG-waist circumference (WC),visceral adiposity index (VAI),triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C),and lipid accumulation product (LAP).The penalty spline method was used for the curve fitting between IR indexes and HUA.The area under the receiver operating characteristic curve (AUC) was employed to reveal the correlation between each index and HUA. Results The 14 220 hypertension patients included 6 713 males and 7 507 females,with the average age of (63.8±9.4) years old,the average uric acid level of (418.9±120.6) mmol/L,and the HUA detection rate of 44.4%.The HUA group had higher proportions of males,current drinking,current smoking,diabetes,and using antihypertensive drugs,older age,higher diastolic blood pressure,WC,BMI,homocysteine,total cholesterol,TG,low-density lipoprotein cholesterol,blood urea nitrogen,creatinine,aspartate aminotransferase,alanine aminotransferase,total protein,albumin,total bilirubin,direct bilirubin, METS-IR, TyG, TyG-BMI, TyG-WC, VAI, TG/HDL-C, and LAP, and lower systolic blood pressure and HDL-C than the normal uric acid group (all P<0.05).Multivariate Logistic regression showed that METS-IR (OR=1.049,95%CI=1.038-1.060, P<0.001), TyG (OR=1.639,95%CI=1.496-1.797, P<0.001), TyG-BMI (OR=1.008,95%CI=1.006-1.010, P<0.001), TyG-WC (OR=1.003,95%CI=1.002-1.004, P<0.001), lnVAI (OR=1.850, 95%CI=1.735-1.973, P<0.001), ln(TG/HDL-C) (OR=1.862,95%CI=1.692-2.048, P<0.001),and lnLAP (OR=1.503,95%CI=1.401-1.613,P<0.001) were associated with the risk of HUA.Curve fitting indicated that METS-IR,TyG,TYG-BMI,TYG-WC,lnVAI,ln(TG/HDL-C),and lnLAP were positively correlated with HUA (all P<0.001),and the AUC of TyG index was higher than that of other IR indexes (all P<0.05). Conclusion Increased IR indexes,especially TyG,were associated with the risk of HUA among people with hypertension.

Obesity is positively Associated with Depression in Older Adults: Role of Systemic Inflammation / 生物医学与环境科学（英文）

OBJECTIVE@#We aimed to explore the association between obesity and depression and the role of systemic inflammation in older adults.@*METHODS@#Adults ≥ 65 years old ( n = 1,973) were interviewed at baseline in 2018 and 1,459 were followed up in 2021. General and abdominal obesity were assessed, and serum C-reactive protein (CRP) levels were measured at baseline. Depression status was assessed at baseline and at follow-up. Logistic regression was used to analyze the relationship between obesity and the incidence of depression and worsening of depressive symptoms, as well as the relationship between obesity and CRP levels. The associations of CRP levels with the geriatric depression scale, as well as with its three dimensions, were investigated using multiple linear regressions.@*RESULTS@#General obesity was associated with worsening depression symptoms and incident depression, with an odds ratio ( OR) [95% confidence interval ( CI)] of 1.53 (1.13-2.12) and 1.80 (1.23-2.63), especially among old male subjects, with OR (95% CI) of 2.12 (1.25-3.58) and 2.24 (1.22-4.11), respectively; however, no significant relationship was observed between abdominal obesity and depression. In addition, general obesity was associated with high levels of CRP, with OR (95% CI) of 2.58 (1.75-3.81), especially in subjects free of depression at baseline, with OR (95% CI) of 3.15 (1.97-5.04), and CRP levels were positively correlated with a score of specific dimension (life satisfaction) of depression, P < 0.05.@*CONCLUSION@#General obesity, rather than abdominal obesity, was associated with worsening depressive symptoms and incident depression, which can be partly explained by the systemic inflammatory response, and the impact of obesity on depression should be taken more seriously in the older male population.

Accuracy and capability of tri-ponderal mass index in assessing cardio-metabolic risk factors in Chinese children and adolescents aged 3 to 17 years, compared with body mass index / 中华医学杂志(英文版)

BACKGROUND@#Tri-ponderal mass index (TMI) has been reported to be a more accurate estimate of body fat than body mass index (BMI). This study aims to compare the effectiveness of TMI and BMI in identifying hypertension, dyslipidemia, impaired fasting glucose (IFG), abdominal obesity, and clustered cardio-metabolic risk factors (CMRFs) in 3- to 17-year-old children.@*METHODS@#A total of 1587 children aged 3 to 17 years were included. Logistic regression was used to evaluate correlations between BMI and TMI. Area under the curves (AUCs) were used to compare discriminative capability among indicators. BMI was converted to BMI- z scores, and accuracy was compared by false-positive rate, false-negative rate, and total misclassification rate.@*RESULTS@#Among children aged 3 to 17 years, the mean TMI was 13.57 ± 2.50 kg/m 3 for boys and 13.3 ± 2.33 kg/m 3 for girls. Odds ratios (ORs) of TMI for hypertension, dyslipidemia, abdominal obesity, and clustered CMRFs ranged from 1.13 to 3.15, higher than BMI, whose ORs ranged from 1.08 to 2.98. AUCs showed similar ability of TMI (AUC: 0.83) and BMI (AUC: 0.85) in identifying clustered CMRFs. For abdominal obesity and hypertension, the AUC of TMI was 0.92 and 0.64, respectively, which was significantly better than that of BMI, 0.85 and 0.61. AUCs of TMI for dyslipidemia and IFG were 0.58 and 0.49. When 85th and 95th of TMI were set as thresholds, total misclassification rates of TMI for clustered CMRFs ranged from 6.5% to 16.4%, which was not significantly different from that of BMI- z scores standardized according to World Health Organization criteria.@*CONCLUSIONS@#TMI was found to have equal or even better effectiveness in comparison with BMI in identifying hypertension, abdominal obesity, and clustered CMRFs TMI was more stable than BMI in 3- to 17-year-old children, while it failed to identify dyslipidemia and IFG. It is worth considering the use of TMI for screening CMRFs in children and adolescents.

A case-control study on the association between a healthy lifestyle and obesity among adult twins in Shanghai / 中华流行病学杂志

Objective: To investigate the associations between the numbers of healthy lifestyles and overweight/obesity and abdominal obesity in adult twins in Shanghai. Methods: Based on the Shanghai Twin Registry System Phase Ⅱ survey data in 2017-2018, a case-control study was conducted to analyze the association between healthy lifestyles and obesity and further adjusted for confounders by a co-twin control study. Results: A total of 7 864 adult twins (3 932 pairs) were included. In the co-twin case-control analysis for monozygotic twins, compared with participants with 0 to 2 healthy lifestyles, those with 3 and 4 to 5 healthy lifestyles had a 49% (OR=0.51, 95%CI: 0.28-0.93) and 70% (OR=0.30, 95%CI: 0.13-0.69) lower risk of overweight/obesity, respectively, and a 17% (OR=0.83, 95%CI: 0.44-1.57) and 66% (OR=0.34, 95%CI: 0.14-0.80) lower risk of abdominal obesity, respectively. For each additional healthy lifestyle, the risk of developing overweight/obesity was reduced by 41% (OR=0.59, 95%CI: 0.42-0.85), and the risk of developing abdominal obesity was reduced by 37% (OR=0.63, 95%CI: 0.44-0.90). Conclusion: An increasing number of healthy lifestyles was associated with a marked decreased risk for both overweight/obesity and abdominal obesity.

Epidemiological characteristics of cardio-metabolic risk factors among children and adolescents aged 7-17 years in 4 provinces of China / 中华流行病学杂志

Objective: This study aimed to investigate the epidemiological characteristics of cardio-metabolic risk factors among children and adolescents aged 7-17 years in (Hebei, Zhejiang, Shaanxi, Hunan) 4 provinces of China and the influence of demographic and economic characteristics on them. Methods: A total of 1 747 children and adolescents aged 7-17 from a Community-based Cohort Study on Nervous System Disease in 2018 were selected. High waist circumference, central obesity, elevated TG, elevated TC, elevated LDL-C, decreased HDL-C, elevated blood pressure, elevated blood glucose, and clustering of risk factors was analyzed. χ2 test was used for univariate analysis, multivariate logistic regression was used to analyze the correlation between demographic and economic factors and risk factors, and the Cochran-Armitage trend test was used for trend analysis. Results: The detection rates of high waist circumference, decreased HDL-C, elevated blood pressure, elevated TG, elevated blood glucose, central obesity, elevated TC, and elevated LDL-C were 29.08%, 15.28%, 13.17%, 13.05%, 11.79%, 7.33%, 6.53%, and 5.15%, respectively. The rate of clustering of risk factors was 18.37%. Multivariate logistic regression analysis showed that the risk of high waist circumference in girls was higher than that in boys (OR=1.67, 95%CI: 1.26-2.22), and the risk of elevated blood glucose and clustering of risk factors was lower than that in boys (OR=0.69, 95%CI: 0.49-0.99; OR=0.72, 95%CI: 0.53-0.99). The risk of high waist circumference, decreased HDL-C, and clustering of risk factors in 13-17 years old group was higher than that in the 7-year-olds group (OR=2.24, 95%CI: 1.65-3.04; OR=1.59, 95%CI: 1.20-2.11; OR=1.75, 95%CI: 1.26-2.44), but the risk of central obesity was lower (OR=0.54, 95%CI: 0.37-0.78). The risk of elevated TC, elevated TG, and decreased HDL-C in children and adolescents in southern was higher than that in northern parts of China (OR=1.88, 95%CI: 1.25-2.83; OR=1.61, 95%CI: 1.17-2.22; OR=1.55, 95%CI: 1.19-2.04), but the risk of high waist circumference and central obesity was lower than that in northern China (OR=0.57, 95%CI: 0.43-0.75; OR=0.62, 95%CI: 0.42-0.90). The risk of decreased HDL-C in rural children and adolescents was higher than in urban children and adolescents (OR=1.36, 95%CI: 1.02-1.83). The risk of multiple risk factors increased with the increase in average monthly household income per capita and BMI level. Conclusions: High waist circumference, decreased HDL-C and elevated blood pressure were prominent cardio-metabolic risk factors among children and adolescents aged 7-17 years in 4 provinces of China in 2018. The region, average monthly household income per capita, and BMI were the main influencing factors of cardio-metabolic risk factors.

Study on the relationship between indexes of different abnormal weight and dyslipidemia in adults in Beijing City / 中华预防医学杂志

Objective: To analyze the relationship and consistency between indexes of different abnormal weight and dyslipidemia in adults in Beijing City. Methods: From August to December of 2017, 4 975 residents aged 18 to 79 years old in 5 districts of Beijing were randomly selected as subjects by using a multi-stage stratified cluster sampling method. Questionnaire, physical examination and laboratory tests were conducted. The prevalence of overweight/obesity, high body fat rate, central obesity, and high waist-to-height ratio was calculated. Partial correlation was used to analyze the correlation of blood lipid with body mass index (BMI), body fat rate, waist circumference and waist-height ratio. Logistic regression analysis for complex sampling was used to analyze the relationship between indexes of different abnormal weight and dyslipidemia after controlling for relevant risk factors, including age, sex, smoking status, drinking, insufficiency intake of vegetable and fruit, physical inactivity. Kappa value was computed to analyze the consistency between indexes of different abnormal weight. Results: The weighted prevalence of dyslipidemia was 30.48%, and it was higher in men than that in women (40.16% vs. 20.52%, P<0.01). The weighted rate of overweight/obesity, high body fat rate, central obesity, and high waist-to-height ratio was 56.65%, 47.52%, 42.48% and 59.45%, respectively. BMI, body fat rate, waist circumference and waist-to-height ratio were positively correlated with the level of total cholesterol, triglyceride, low-density lipoprotein cholesterol, and non-high-density lipoprotein cholesterol, and negatively correlated with high-density lipoprotein cholesterol. Logistic regression analysis for complex sampling showed that the high body fat rate (OR=1.67, 95%CI: 1.35-2.07), overweight/obesity (OR=1.65, 95%CI: 1.26-2.14) and high waist-to-height ratio (OR=1.46, 95%CI: 1.09-1.96) were associated with dyslipidemias. Kappa values of high body fat rate with overweight/obesity, high waist-to-height ratio and central obesity were 0.65, 0.53 and 0.58, respectively (P<0.05). Conclusion: In 2017, the prevalence of dyslipidemia in adults in Beijing City is high, especially in men. Overweight/obesity, high body fat rate and high waist-to-height ratio are associated with dyslipidemia. The high body fat rate is most associated with dyslipidemia.

Estresse percebido em mulheres com síndrome metabólica: um estudo transversal / Perceived stress in women with metabolic syndrome: a cross-sectional study / Estrés percibido en mujeres con síndrome metabólico: un estudio transversal

Introdução: o estresse percebido foi sugerido como um fator de risco para o desenvolvimento da Síndrome Metabólica (SM). No entanto, pouco se sabe desta associação entre mulheres. Objetivo: avaliar o estresse percebido em mulheres com SM. Materiais e Métodos: estudo transversal, a partir do recorte de um ensaio clínico não-randomizado, com pacientes de um centro de saúde público (RBR-43K52N). A variável de desfecho foi a SM, utilizando os critérios do NCEP/ATPIII. Foram coletados dados sociodemográficos, antropométricos, bioquímicos, hemodinâmicos e aplicação da PSS. Resultados: A amostra constituiu-se de 75 mulheres acometidas por SM (47,69±8,15 anos de idade; 155,65±0,07 cm; 82,43±17,79 kg; IMC de 33,54±7,28). Encontrou-se valores elevados de RCQ entre as mulheres estressadas e não-estressadas. A pontuação média da PSS foi de 27,73±9,17. Nos agrupamentos, verificou-se diferença significativa para PSS entre as mulheres estressadas e não-estressadas (35,24±5,22 e 20,42±5,53, respectivamente; p=0,001). Observou-se também que mulheres estressadas tinham níveis mais elevados de triglicerídeos e níveis mais baixos de HDL-c quando comparadas com mulheres não estressadas, embora sem diferença estatística. Discussões: Os achados sugerem que as mulheres categorizadas como estressadas tinham maior pontuação da PSS, níveis mais elevados de triglicerídeos e níveis mais baixos de HDL-c quando comparadas com mulheres não estressadas. Conclusões: a pontuação da PSS foi significativamente maior entre mulheres com parâmetros lipídicos da SM alterados, com menores níveis de HDL- e aumento de triglicerídeos.

Introduction: Perceived stress has been suggested as a risk factor for the development of Metabolic Syndrome (MS). However, little is known about this association among women. Objective: to evaluate perceived stress in women with Metabolic Syndrome (MS). Materials and Methods: cross-sectional study, based on a non-randomized clinical trial, with patients from a public health center (RBR-43K52N). The outcome variable was MS, using the NCEP/ATPIII criteria. Sociodemographic, anthropometric, biochemical, hemodynamic data and PSS application were collected. Results: The sample consisted of 75 women affected by MetS (47.69± 8.15 years old; 155.65±0.07 cm; 82.43±17.79 kg; BMI of 33.96±6 ,42). High WHR values were found among stressed and non-stressed women. The average PSS score was 27.73±9.17. In the groups, there was a significant difference for PSS between stressed and non-stressed women (35.24±5.22 and 20.42±5.53, respectively; p=0.001). It was also observed that stressed women had higher levels of triglycerides and lower levels of HDL-c when compared to non-stressed women, although without statistical difference. Discussions: The findings suggest that women categorized as stressed had higher PSS scores, higher levels of triglycerides and lower levels of HDL-c when compared to non-stressed women. Conclusions: the PSS score was significantly higher among women with altered MS lipid parameters, with lower levels of HDL- and increased triglycerides.

Introducción: El estrés percibido ha sido sugerido como un factor de riesgo para el desarrollo del Síndrome Metabólico (SM). Sin embargo, poco se sabe sobre esta asociación entre las mujeres. Objetivo: evaluar el estrés percibido en mujeres con Síndrome Metabólico (SM). Materiales y Métodos: estudio transversal, basado en un ensayo clínico no aleatorizado, con pacientes de un centro de salud pública (RBR-43K52N). La variable resultada fue SM, utilizando los criterios NCEP/ATPIII. Se recogieron datos sociodemográficos, antropométricos, bioquímicos, hemodinámicos y aplicación de PSS. Resultados: La muestra estuvo compuesta por 75 mujeres afectadas por SMet (47,69± 8,15 años; 155,65±0,07 cm; 82,43±17,79 kg; IMC de 33,96±6,42). Se encontraron valores altos de WHR entre mujeres estresadas y no estresadas. La puntuación media de PSS fue de 27,73±9,17. En los grupos, hubo una diferencia significativa para PSS entre mujeres estresadas y no estresadas (35,24±5,22 y 20,42±5,53, respectivamente; p=0,001). También se observó que las mujeres estresadas tenían niveles más altos de triglicéridos y niveles más bajos de HDL-c en comparación con las mujeres no estresadas, aunque sin diferencia estadística. Discusiones: Los hallazgos sugieren que las mujeres categorizadas como estresadas tenían puntajes PSS más altos, niveles más altos de triglicéridos y niveles más bajos de HDL-c en comparación con mujeres no estresadas. Conclusiones: la puntuación de PSS fue significativamente mayor entre las mujeres con parámetros lipídicos de SM alterados, con niveles de HDL más bajos y triglicéridos elevados.

Asociación del fitness cardiorrespiratorio con marcadores de adiposidad corporal: estudio de corte transversal de la Encuesta Nacional de Salud Chile 2016-2017 / Association of cardiorespiratory fitness with adiposity markers

BACKGROUND: Cardiorespiratory fitness (CRF) is inversely associated with metabolic diseases and adiposity markers. Aim: To assess the association of CRF with body mass index (BMI), waist circumference (WC) and obesity in a representative sample of the Chilean population. MATERIAL AND METHODS: Data from 5,958 participants in the Chilean National Health Survey 2016-1027 aged 15 years or above were analyzed. CRF was estimated by an equation that included sociodemographic, anthropometric and health-related data and expressed in metabolic equivalent units (METs). The association between CRF and adiposity was assessed using linear and Poisson regression models and the results were presented as Prevalence Ratio (PR). RESULTS: One MET increment in CRF was associated with a 3.27 kg/m2 (95% confidence intervals (CI): -3.35; -3.2) and 4.56 kg/m2 (95% CI: -4.67; -4.46) lower BMI in men and women, respectively. Waist circumference was 6.7 cm [95% CI: -6.98; -6.42] and 9 cm [95% CI: -9.33; -8.67] lower per 1-MET increment in CRF. With one MET increment, the probability of being obese was 34% (PR = 0.66 [95%CI: 0.63; 0.69]) and 36% (PR = 0.64 [95%CI: 0.61; 0.67]) lower in men and women, respectively. The probability of having a central obesity was 26% (PR = 0.74 [95%CI: 0.71; 0.77]) and 30% (PR = 0.70 [95%CI: 0.68; 0.73]) lower in men and women, respectively. Conclusions: A higher estimated CRF was associated with lower adiposity levels and a lower risk of being obese in both men and women. Public health policies aiming to increase physical activity are needed to increase the CRF of the Chilean population.

Poor Trunk Flexibility is Associated with Cardiovascular Risk Factors

Abstract Background: Poor flexibility is a predictor of reduced physical activity. The association between trunk flexibility and cardiovascular risk factors (CVRFs) is not well understood. Objective: To identify the prevalence of CVRFs and their association with trunk flexibility in individuals participating in a community-based health education program. Methods: Volunteers (51 men, 48 women) aged 20-85 years old, participants in a community-based health education program in the city of Santo Antônio de Goiás, Brazil, were selected for this study. Anthropometric measures including body mass, height, body mass index (BMI), waist circumference (WC) and waist/height ratio (WHtR) were evaluated. Physical activity level was evaluated based on leisure activity participation, and trunk flexibility was evaluated by the sit and reach test. Data distribution was assessed using the Shapiro-Wilk test; Pearson's chi-square or Fisher's exact and Student t tests were performed for comparisons. To analyze the association between trunk flexibility and concomitant CVRFs, Spearman's correlation test and linear regression were employed. Statistical significance was defined as p < 0.05. Results: 7.2% of the volunteers had no CVRF, 10.3% had only one CVRF and 82.5% had two or more CVRFs, with no differences between sexes. Increased abdominal adiposity, as assessed by WHtR (p = 0.0097), and systemic arterial hypertension (p = 0.0003) were the most prevalent CVRFs, with differences between age groups. A strong negative correlation was found between mean trunk flexibility and the number of concomitant CVRFs (r = -0.96, p < 0.0028). Conclusion: The strong negative correlation between trunk flexibility and concomitant CVRF indicates an increased risk for cardiovascular events. Therefore, trunk flexibility measurement may be an additional tool for health promotion and prevention of cardiovascular and associated diseases in community health programs.

Associação entre ingestão de bebida alcoólica e estado antropométrico de universitários / Association between alcohol consumption and anthropometric status of university students

Introdução: objetivamos avaliar associação entre ingestão de bebida alcoólica e estado antropométrico em estudantes que frequentam Restaurante Universitário. Metodologia: estudo transversal com 155 universitários em que foi avaliado o consumo de bebida alcoólica, frequência do consumo, tempo de consumo, quantidade e hábitos adotados enquanto bebiam. As medidas antropométricas realizadas foram estatura, peso, circunferência da cintura, circunferência do quadril e quatro dobras cutâneas (tricipital, bicipital, subescapular e suprailíaca). Para análise, realizamos estatística descritiva, o teste de qui-quadrado de independência para as proporções entre os grupos e a diferença entre as médias das medidas antropométricas de acordo a quantidade de bebida alcoólica consumida foi avaliada pelo teste ANOVA. Foram considerados significantes valores de p<0,05. Resultados: dos universitários, 63,87% eram bebedores, 23,2% dos bebedores estavam com excesso de peso, 21,2% apresentaram circunferência da cintura com risco elevado e percentual de gordura em excesso em ambos os grupos (77,8% vs. 73,2). Identificamos diferença estatisticamente para a circunferência da cintura entre o tempo de consumo (p=0,003) e entre o percentual de gordura corporal de acordo com a quantidade de bebida alcoólica consumida (p=0,001). Conclusão: o estado antropométrico dos universitários que consumiam bebida alcoólica apresentou alta frequência de excesso de peso e risco de complicações metabólicas associadas à obesidade, mesmo que sem significações estatísticas para as associações testadas.

Introduction: we aimed to evaluate the association between alcohol intake and anthropometric status in students who attend the University Restaurant. Methodology: cross-sectional study with 155 university students in which the consumption of alcoholic beverages, frequency of consumption, consumption time, quantity and habits adopted while drinking were evaluated. The anthropometric measurements taken were height, weight, waist circumference, hip circumference and four skinfolds (triceps, biceps, subscapular and suprailiac). For analysis, we performed descriptive statistics, the chi-square test of independence for proportions between groups and the difference between the means of anthropometric measures according to the amount of alcoholic beverage consumed was evaluated by the ANOVA test. Significant values of p<0.05 were considered. Results: of the college students, 63.87% were drinkers, 23.2% of the drinkers were overweight, 21.2% high risk waist dissipation and fat percentage in both groups (77.8% vs. 73 ,two). We identified a statistically significant difference for waist circumference between consumption time (p = 0.003) and between body fat percentage according to the amount of alcoholic beverage consumed (p = 0.001). Conclusion: the anthropometric status of college students who drank alcoholic beverages presented a high frequency of weight and risk of metabolic complications associated with obesity, even if without statistical significance for the tested associations.

Lifestyle Intervention in Reducing Cardiometabolic Risk Factors in Students with Dyslipidemia and Abdominal Obesity: A Randomized Study

Abstract Background The long incubation periods of cardiovascular diseases offer opportunities for controlling risk factors. In addition, preventive interventions in childhood are more likely to succeed because lifestyle habits become ingrained as they are repeated. Objective To investigate the effects of recreational physical activities, in combination or not with a qualitative nutritional counseling, in cardiometabolic risk factors of students with dyslipidemia and abdominal obesity. Methods Students (8-14 years old) were randomly divided into three groups (n=23 each): i ) Control; ii ) PANC, students undergoing Physical Activity and Nutritional Counseling, and iii ) PA, students submitted to Physical Activity, only. Blood samples (12-h fasting) were collected for biochemical analysis and anthropometric markers were also assessed. Two-Way RM-ANOVA and Holm-Sidak's test, and Friedman ANOVA on Ranks and Dunn's test were applied. P ≤ 0.05 was considered significant. Effect sizes were evaluated by Hedges' g and Cliff's δ for normal and non-Gaussian data, respectively. Results Compared to the control group and to baseline values, both interventions caused significant average reductions in total cholesterol (11%; p <0.001), LDL-c (19%; p=0.002), and non-HDL-c (19%; p=0.003). Furthermore, students in the PANC group also experienced a significant decrease in body fat compared to baseline (p=0.005) and to control (5.2%; g=0.541). Conclusions The proposed strategies were effective to reduce cardiometabolic risk factors in children and adolescents. The low cost of these interventions allows the implementation of health care programs in schools to improve the students' quality of life.

Association between Deep Subcutaneous Adipose Tissue Estimated by DAAT Index and Dietary Intake in Patients with Acute Coronary Syndrome

Abstract Background: Abdominal obesity has been associated with cardiovascular disease and may be modulated by dietary intake. The deep abdominal subcutaneous adipose tissue (dSAT) is a body fat compartment that can be estimated by using mathematical formulas. Objectives: To evaluate the association between dSAT estimated by the Deep-Abdominal-Adipose-Tissue (DAAT) index and dietary intake in patients with acute coronary syndrome (ACS). Methods: This is a cross-sectional study conducted with patients ≥ 18 years of age admitted to a tertiary hospital. Sociodemographic, clinical, and anthropometric (body weight [kg], height [m], waist, hip and neck circumferences [cm]) data were evaluated. A food frequency questionnaire was applied to identify each patient's nutrient intake. The DAAT index was calculated according to specific formulas for men and women. Possible association between food intake and the DAAT index was evaluated by multiple linear regression. The level of significance adopted was 0.05. Results: This study evaluated 138 patients, with a mean age of 61.2±10.8 years. Prevalence of obesity was 29.4% in men and 37.7% in women. Regarding waist circumference, 83% of the women showed values considered to be very high. The DAAT index was significantly higher in men when compared to woman (P < 0.0001) and proved to be positively correlated with proteins (r= 0.22, P= 0.01) and monounsaturated fatty acid (r= 0.18, P= 0.04) intake in the entire sample. After adjustment for sex, alcohol consumption, and levels of physical activity, the DAAT index was associated with the female sex (B= −129.84, P <0.001) and a sedentary lifestyle (B= 57.99, P <0.001). Conclusion: dSAT estimated by the DAAT index was not associated with dietary intake in patients with ACS.

Anthropometric markers of abdominal adiposity and its relation to dyslipidemia and insulin resistance among overweight/obese schoolchildren and adolescents / Marcadores antropométricos de adiposidade abdominal e sua relação com dislipidemia e resistência à insulina em escolares e adolescentes com sobrepeso/obesidade

ABSTRACT: Objective: to assess the relationship between anthropometric indicators and laboratorial markers of cardiovascular risk in overweight/obese children and adolescents, in order to verify whether any anthropometric indicator has a better potential for use in screening cardiovascular risk in the population. Method: retrospective cross-sectional study enrolling 237 individuals aged 7 to 18 years. Body mass index (BMI), waist circumference (WC), waist circumference/height index (WC/H), glucose, HOMA-IR, total cholesterol (TC), LDL, HDL, triglycerides and TC/HDL and LDL/HDL indexes were obtained. Associations between anthropometric and laboratory markers were tested in contingency tables using the chi-square test. Correlations were tested by Spearman's correlation. Results: higher WC (Freedman cutoffs) was associated with lower levels of HDL and higher score in the TC/HDL and LDL/HDL indexes, but, using +2 z-scores as the cutoff, there were associations with low HDL and higher HOMA-IR. WC/H indicator (0.5 cutoff) was not associated with any of the outcomes, but, using +2 z-scores, an association was found with HOMA-IR. Z-scores of WC, WC/H and BMI showed positive correlation with HOMA-IR, TC/HDL and HOMA-IR, respectively. Negative correlations were found between WC and WC/H z-scores with HDL. WC and WC/H z-score were related to changes in HDL and HOMA-IR. Conclusions: there seems to be an advantage in using WC alone as a possible predictor of dyslipidemia and insulin resistance in children and adolescents. It is not possible to state that WC, WC/H or BMI measurements differ in their abilities to identify Brazilian children and adolescents with risk factors for cardiovascular diseases. (AU)

RESUMO:Objetivo: avaliar a relação entre indicadores antropométricos e marcadores laboratoriais de risco cardiovascular em crianças e adolescentes com sobrepeso / obesidade, a fim de verificar se algum indicador antropométrico tem melhor potencial para uso no rastreamento de risco cardiovascular na população. Método: estudo transversal retrospectivo com 237 indivíduos com idades entre 7 e 18 anos. Índice de massa corporal (IMC), circunferência da cintura (CC), índice de circunferência da cintura / altura (CC / H), glicose, HOMA-IR, colesterol total (CT), LDL, HDL, triglicerídeos e índices CT/HDL e LDL/HDL foram obtidos. As associações entre marcadores antropométricos e laboratoriais foram testadas em tabelas de contingência por meio do teste do qui-quadrado. As correlações foram testadas pela correlação de Spearman. Resultados: CC mais elevado (pontos de corte de Freedman) foi associado a níveis mais baixos de HDL e maior pontuação nos índices TC/HDL e LDL/HDL, mas, usando +2 escores z como ponto de corte, houve associações com HDL baixo e HOMA-IR mais alto. O indicador CC/H (0,5 ponto de corte) não foi associado a nenhum dos desfechos, mas, usando +2 escores z, foi encontrada associação com o HOMA-IR. Os escores Z de CC, CC/E e IMC mostraram correlação positiva com HOMA-IR, TC/HDL e HOMA-IR, respectivamente. Correlações negativas foram encontradas entre CC e escores z de CC/H com HDL. CC e escore z de CC/H foram relacionados a mudanças em HDL e HOMA-IR. Conclusões: parece haver vantagem em usar a CC isoladamente como possível preditor de dislipidemia e resistência à insulina em crianças e adolescentes. Não é possível afirmar que as medidas de CC, CC/E ou IMC diferem na capacidade de identificar crianças e adolescentes brasileiros com fatores de risco para doenças cardiovasculares. (AU)