Carrera de Nutrición y Dietética, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Carrera de Fonoaudiología, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
PLoS One. 2020 Jul 22;15(7):e0236451. doi: 10.1371/journal.pone.0236451. eCollection 2020.
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.
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.
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]).
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.
生活方式习惯与整体人群的代谢健康有关。但不同营养状况人群之间的这种关联研究较少。本研究旨在：（i）确定智利代谢表型的流行率；（ii）根据营养状况确定生活方式习惯与代谢健康之间的关系。
分析了 2016-2017 年智利国家健康调查。代谢不健康表型定义为存在≥3 个以下风险因素：血压升高、甘油三酯升高、血糖升高、腰围增大或高密度脂蛋白胆固醇降低。表现出<2 个风险因素的个体被认为是健康的。营养状况定义为正常体重（18.5 至<25 kg/m2）、超重（25 至<30 kg/m2）或肥胖（≥30 kg/m2）。使用问卷估计吸烟习惯、饮酒量、久坐行为、中高强度体力活动、水果/蔬菜摄入量和鱼/海鲜摄入量。在每个营养状况下，根据年龄、性别、BMI（kg/m2）和教育程度调整后，确定生活方式习惯与代谢健康之间的关联（比值比[95%CI]）。
整体样本中代谢不健康表型的流行率为 36%。在正常体重、超重和肥胖的个体中，这种流行率分别为 7%、33%和 58%。在正常体重的个体中，水果/蔬菜摄入量最高四分位数与代谢不健康表型的发生几率降低相关（0.09 [0.01-0.48]）。在肥胖个体中，中高强度体力活动最高四分位数与代谢不健康表型的发生几率降低相关（0.29 [0.09-0.91]）。
智利三分之一的人口表现出不健康的表型。我们发现了生活方式习惯与代谢健康之间与营养状况相关的特定关联。因此，在正常体重的个体中强调水果/蔬菜的摄入，在肥胖个体中强调体力活动，可能会最大限度地提高公共卫生干预措施的效益。
