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Metabolic health and its association with lifestyle habits according to nutritional status in Chile: A cross-sectional study from the National Health Survey 2016-2017.

ABSTRACT: BACKGROUND:Lifestyle habits associate with metabolic health in overall populations. Whether such association is similar among subjects with a different nutritional status has been less studied. We aimed to (i) determine the prevalence of metabolic phenotypes in Chile, and (ii) determine the association between lifestyle habits and metabolic health according to the nutritional status. METHODS:The National Health Survey of Chile 2016-2017 was analyzed. A metabolically unhealthy phenotype was defined as manifesting ?3 of the following risk factors: elevated blood pressure, elevated triglycerides, elevated glucose, elevated waist circumference, or reduced high-density lipoprotein cholesterol. Individuals manifesting <2 risk factors were considered as healthy. The nutritional status was defined as normal weight (18.5 to <25 kg/m2), overweight (25 to <30 kg/m2) or obesity (?30 kg/m2). Questionnaires were used to estimate smoking habits, alcohol intake, sedentary behavior, moderate-vigorous physical activity, fruits/vegetables consumption, and fish/seafood consumption. The association (odds ratio [95%CI]) between lifestyle habits and metabolic health was determined within each nutritional status, adjusting for age, sex, BMI (in kg/m2), and education. RESULTS:The prevalence of a metabolically unhealthy phenotype was 36% in the overall sample. Such a prevalence was 7%, 33% and 58% among subjects with normal weight, overweight and obesity, respectively. In subjects with normal weight, the highest quartile of fruits/vegetables consumption was associated with reduced odds of having a metabolically unhealthy phenotype (0.09 [0.01-0.48]). In subjects with obesity, the highest quartile of moderate-vigorous physical activity was associated with reduced odds of having a metabolically unhealthy phenotype (0.29 [0.09-0.91]). CONCLUSION:One third of the Chilean population manifests an unhealthy phenotype. We identified associations between lifestyle habits and metabolic health that are specific to the nutritional status. Thus, emphasizing fruits/vegetables consumption in subjects with normal weight, and physical activity in subjects with obesity, may maximize the benefits of public health interventions.

SUBMITTER: Fernandez-Verdejo R

PROVIDER: S-EPMC7375524 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Metabolic health and its association with lifestyle habits according to nutritional status in Chile: A cross-sectional study from the National Health Survey 2016-2017.

Fernández-Verdejo Rodrigo R Moya-Osorio José Luis JL Fuentes-López Eduardo E Galgani Jose E JE

PloS one 20200722 7

<h4>Background</h4>Lifestyle habits associate with metabolic health in overall populations. Whether such association is similar among subjects with a different nutritional status has been less studied. We aimed to (i) determine the prevalence of metabolic phenotypes in Chile, and (ii) determine the association between lifestyle habits and metabolic health according to the nutritional status.<h4>Methods</h4>The National Health Survey of Chile 2016-2017 was analyzed. A metabolically unhealthy phen ...[more]

PMID: 32697789

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Project description:ObjectivesThis study estimates the prevalence of chronic kidney disease (CKD) among Chilean adults and examines its associations with sociodemographic characteristics, health behaviours and comorbidities.DesignAnalysis of cross-sectional data from the two most recent large nationally representative Chilean Health Surveys (Encuesta Nacional de Salud, ENS) 2009-2010 and 2016-2017.ParticipantsAdults aged 18+ years with serum creatine data (ENS 2009-2010: n=4583; ENS 2016-2017: n=5084).Primary and secondary outcome measuresReduced kidney function (CKD stages 3a-5) based on the estimated glomerular filtration rate (eGFR <60 mL/min/1.73 m2) was the primary outcome measure. Using the urine albumin-to-creatinine ratio (ACR ≥30 mg/g), increased albuminuria was ascertained among adults aged 40+ years with diabetes and/or hypertension. Both outcomes were analysed using logistic regression with results summarised using OR. CKD prevalence (stages 1-5) among adults aged 40+ years was estimated including participants with an eGFR of >60 mL/min/1.73 m2 but with increased albuminuria (stages 1-2).ResultsOverall, 3.2% (95% CI: 2.4% to 3.8%) of adults aged 18+ in ENS 2016-2017 had reduced kidney function. After full adjustment, participants with hypertension (OR: 2.37; 95% CI: 1.19 to 4.74) and those with diabetes (OR: 1.66; 95% CI: 1.03 to 2.66) had significantly higher odds of reduced kidney function. In ENS 2016-2017, 15.5% (13.5% to 17.8%) of adults aged 40+ years with diabetes and/or hypertension had increased albuminuria. Being obese versus normal-weight (OR: 1.66; 95% CI: 1.08 to 2.54) and having both diabetes and hypertension versus having diabetes alone (OR: 2.30; 95% CI: 1.34 to 3.95) were significantly associated with higher odds of increased albuminuria in fully-adjusted analyses. At least 15.4% of adults aged 40+ years in ENS 2016-2017 had CKD (stages 1-5), including the 9.6% of adults at CKD stages 1-2.ConclusionsPrevention strategies and Chilean guidelines should consider the high percentage of adults aged 40 years and older at CKD stages 1-2.

Project description:BACKGROUND:Trend data on hypertension prevalence and attainment indicators at each step of the care cascade (awareness, treatment, control) are required in Chile. This study aims to quantify trends (2003-2017) in prevalence and in the proportion of individuals with hypertension attaining each step of the care cascade among adults aged 17?years or older, and to assess the impact of lowering the blood pressure (BP) thresholds used to define elevated BP on these indicators. METHODS:We used data from 2003, 2010, and 2017 Chilean national health surveys. Each year we assessed levels of (1) mean systolic (SBP) and diastolic (DBP) blood pressure, (2) hypertension prevalence (BP???140/90?mmHg or use of antihypertensive treatment), and (3) awareness, treatment, and control. Logistic regression on pooled data was used to assess trends in binary outcomes; linear regression was used to assess trends in continuous SBP and DBP. We compared levels of hypertension prevalence using two sources to ascertain antihypertensive treatment (self-reported versus medicine inventory). The 2017 American College of Cardiology/American Heart Association (ACC/AHA) guidelines were used to re-define hypertension using lower thresholds (BP???130/80?mmHg). RESULTS:Hypertension prevalence was 34.0, 32.0 and 30.8% in 2003, 2010 and 2017, respectively. Levels of treated- and controlled-hypertension were significantly higher in 2017 than in 2003 (65% versus 41% for treatment, P?<?0.001; 34% versus 14% for control, P?<?0.001), while levels of awareness were stable (66% versus 59%, P?=?0.130). Awareness, treatment, and control levels were higher among females in 2003, 2010, and 2017 (P?<?0.001). Mean SBP and DBP decreased over the 15-year period, except for SBP among females on treatment. Adopting the 2017 ACC/AHA guidelines would increase hypertension prevalence by 17 and 55% in absolute and relative terms, respectively. CONCLUSIONS:Chile has experienced a positive population-wide lowering in blood pressure distribution which may be explained partly by a significant rise in levels of treated- and controlled-hypertension since 2003. Lowering the thresholds used to define elevated BP would substantially increase the financial public health challenge of further improving attainment levels at each step of the care cascade. Innovative and collaborative strategies are needed to improve hypertension management, especially among males.

Dataset Information

Metabolic health and its association with lifestyle habits according to nutritional status in Chile: A cross-sectional study from the National Health Survey 2016-2017.

Publications

Metabolic health and its association with lifestyle habits according to nutritional status in Chile: A cross-sectional study from the National Health Survey 2016-2017.

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