Wholegrain Consumption and Risk Factors for Cardiorenal Metabolic Diseases in Chile: A Cross-Sectional Analysis of 2016-2017 Health National Survey

Abstract: Wholegrain (WG) consumption has been associated with reduced risk factors for cardiorenal metabolic diseases (CRMD). In Latin-America. WG intake is low and scarce studies on this subject have been found. We aimed to evaluate the association between WG consumption and risk factors for CRMD in the 2016-2017 Chilean-National Health Survey. This cross-sectional study included 3110 participants representative of a total population of 11,810,647 subjects > 18 y, not taking insulin and with complete data on CRMD risk factors. Outcomes were metabolic syndrome and its components, albuminuria, and impaired glomerular filtration rate (GFR). WG consumption was categorized as regular (≥every two days), sporadic (≥once a month), and non-consumers. Associations were analyzed by multivariable logistic regressions adjusted for confounders taking into account the complex sample design of the survey. Regular WG consumers showed a lower risk of high blood pressure (OR: 0.61, 95%CI: 0.41-0.91) compared to non-consumers in fully-adjusted models. Although inverse associations were noticed with other metabolic syndrome components and impaired GFR, none was statistically significant. The association between WG and BP remained robust in the sensitivity analysis. In conclusion regular WG consumption was associated with a 39% lower risk of high blood pressure in Chilean adults. Keywords: wholegrain; cardiovascular disease; metabolic syndrome; chronic kidney disease; Latin Americ

Descriptive analysis of dietary (poly)phenol intake in the subcohort MAX from DCH-NG: "Diet, Cancer and Health-Next Generations cohort"

Purpose (Poly)phenols are bioactive compounds widely distributed in plant-based foods. Currently, limited data exist on the intake distribution of (poly)phenols across meals. This study aimed to estimate dietary intakes of all individual (poly)phenols and total intake per class and subclass by meal event, and to identify their main food sources in the subcohort MAX from the Diet, Cancer and Health-Next Generations cohort (DCH-NG). Methods Dietary data were collected using three web-based 24-h dietary recalls over 1 year. In total, 676 participants completed at least one recall. The dietary data were linked to Phenol-Explorer database using standardized procedures and an in-house software. We categorized foods/drinks into five options of meal events selected by the participant: \u27Breakfast\u27, \u27Lunch\u27, \u27Evening\u27, \u27Snack\u27, and \u27Drink\u27. Results Adjusted total (poly)phenols mean intake by meal was the highest in the drink event (563 mg/day in men and 423 mg/day in women) and the lowest in the evening event (146 mg/day in men and 137 mg/day in women). The main overall (poly)phenol class contributor was phenolic acids (55.7-79.0%), except for evening and snack events where it was flavonoids (45.5-60%). The most consumed (poly)phenol subclasses were hydroxycinnamic acids and proanthocyanidins. Nonalcoholic beverages (coffee accounted for 66.4%), cocoa products, and cereals were the main food sources of total (poly)phenols. Conclusion This study provides data on the variability in the intake of classes and subclasses of (poly)phenols and their main food sources by meal event according to lifestyle data, age, and gender in a Danish population

Comparison of flavonoid intake assessment methods using USDA and phenol explorer databases: Subcohort diet, cancer and health-next generations—MAX study

Flavonoids are bioactive plant compounds that are widely present in the human diet. Estimating flavonoid intake with a high degree of certainty is challenging due to the inherent limitations of dietary questionnaires and food composition databases. This study aimed to evaluate the degree of reliability among flavonoid intakes estimated using four different approaches based on the two most comprehensive flavonoid databases, namely, United States Department of Agriculture (USDA) and Phenol Explorer (PE). In 678 individuals from the MAX study, a subcohort of the Diet, Cancer and Health-Next Generations cohort, dietary data were collected using three 24-h diet recalls over 1 year. Estimates of flavonoid intake were compared using flavonoid food content from PE as (1) aglycones (chromatography with hydrolysis), (2) aglycones transformed (converted from glycosides by chromatography without hydrolysis), (3) as they are in nature (glycosides, aglycones, and esters), and 4) using flavonoid content from USDA as aglycones (converted). Spearman\u27s intra-class correlation (ICC) coefficient and weighted kappa (K) coefficient were calculated for the reliability analysis. When comparing PE total aglycones to USDA total aglycones, there was a moderate reliability when a continuous variable was used [ICC: 0.73, 95% confidence interval (CI): 0.70–0.76] and an excellent reliability when flavonoid intake was modeled as a categorical variable (K: 0.89, 95% CI: 0.88–0.90). The degree of reliability among all methods of estimated flavonoid intakes was very similar, especially between database pairs, for the flavanol subclass, while larger differences were observed for flavone, flavonol, and isoflavone subclasses. Our findings indicate that caution should be taken when comparing the results of the associations between flavonoid intakes and health outcomes from studies, when flavonoid intakes were estimated using different methods, particularly for some subclasses

Dietary polyphenols, metabolic syndrome and cardiometabolic risk factors: An observational study based on the DCH-NG subcohort

Background and aims Polyphenol-rich foods have beneficial properties that may lower cardiometabolic risk. We aimed to prospectively investigate the relationship between intakes of dietary polyphenols, and metabolic syndrome (MetS) and its components, in 676 Danish residents from the MAX study, a subcohort of the Danish Diet, Cancer and Health–Next Generations (DCH-NG) cohort. Methods and results Dietary data were collected using web-based 24-h dietary recalls over one year (at baseline, and at 6 and 12 months). The Phenol-Explorer database was used to estimate dietary polyphenol intake. Clinical variables were also collected at the same time point. Generalized linear mixed models were used to investigate relationships between polyphenol intake and MetS. Participants had a mean age of 43.9y, a mean total polyphenol intake of 1368 mg/day, and 75 (11.6%) had MetS at baseline. Compared to individuals with MetS in Q1 and after adjusting for age, sex, lifestyle and dietary confounders, those in Q4 – for total polyphenols, flavonoids and phenolic acids–had a 50% [OR (95% CI): 0.50 (0.27, 0.91)], 51% [0.49 (0.26, 0.91)] and 45% [0.55 (0.30, 1.00)] lower odds of MetS, respectively. Higher total polyphenols, flavonoids and phenolic acids intakes as continuous variable were associated with lower risk for elevated systolic blood pressure (SBP) and low high-density lipoprotein cholesterol (HDL-c) (p < 0.05). Conclusions Total polyphenol, flavonoid and phenolic acid intakes were associated with lower odds of MetS. These intakes were also consistently and significantly associated with a lower risk for higher SBP and lower HDL-c concentrations

Dietary polyphenols, metabolic syndrome and cardiometabolic risk factors: An observational study based on the DCH-NG subcohort

Background and aims: Polyphenol-rich foods have beneficial properties that may lower cardiometabolic risk. We aimed to prospectively investigate the relationship between intakes of dietary polyphenols, and metabolic syndrome (MetS) and its components, in 676 Danish residents from the MAX study, a subcohort of the Danish Diet, Cancer and Health–Next Generations (DCH-NG) cohort. Methods and results: Dietary data were collected using web-based 24-h dietary recalls over one year (at baseline, and at 6 and 12 months). The Phenol-Explorer database was used to estimate dietary polyphenol intake. Clinical variables were also collected at the same time point. Generalized linear mixed models were used to investigate relationships between polyphenol intake and MetS. Participants had a mean age of 43.9y, a mean total polyphenol intake of 1368 mg/day, and 75 (11.6%) had MetS at baseline. Compared to individuals with MetS in Q1 and after adjusting for age, sex, lifestyle and dietary confounders, those in Q4 – for total polyphenols, flavonoids and phenolic acids–had a 50% [OR (95% CI): 0.50 (0.27, 0.91)], 51% [0.49 (0.26, 0.91)] and 45% [0.55 (0.30, 1.00)] lower odds of MetS, respectively. Higher total polyphenols, flavonoids and phenolic acids intakes as continuous variable were associated with lower risk for elevated systolic blood pressure (SBP) and low high-density lipoprotein cholesterol (HDL-c) (p &lt; 0.05). Conclusions: Total polyphenol, flavonoid and phenolic acid intakes were associated with lower odds of MetS. These intakes were also consistently and significantly associated with a lower risk for higher SBP and lower HDL-c concentrations

A healthy eating score is inversely associated with depression in older adults: results from the Chilean National Health Survey 2016-2017

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

Plasma metabolomic profiles of plant-based dietary indices reveal potential pathways for metabolic syndrome associations

Background and aims: Plant-based dietary patterns have been associated with improved health outcomes. This study aims to describe the metabolomic fingerprints of plant-based diet indices (PDI) and examine their association with metabolic syndrome (MetS) and its components in a Danish population. Methods: The MAX study comprised 676 participants (55% women, aged 18-67 y) from Copenhagen. Sociodemographic and dietary data were collected using questionnaires and three 24-h dietary recalls over one year (at baseline, and at 6 and 12 months). Mean dietary intakes were computed, as well as overall PDI, healthful (hPDI) and unhealthful (uPDI) scores, according to food groups for each plant-based index. Clinical variables were also collected at the same time points in a health examination that included complete blood tests. MetS was defined according to the International Diabetes Federation criteria. Plasma metabolites were measured using a targeted metabolomics approach. Metabolites associated with PDI were selected using random forest models and their relationships with PDIs and MetS were analyzed using generalized linear mixed models. Results: The mean prevalence of MetS was 10.8%. High, compared to low, hPDI and uPDI scores were associated with a lower and higher odd of MetS, respectively [odds ratio (95%CI); hPDI: 0.56 (0.43–0.74); uPDI: 1.61 (1.26–2.05)]. Out of 411 quantified plasma metabolites, machine-learning metabolomics fingerprinting revealed 13 metabolites, including food and food-related microbial metabolites, like hypaphorine, indolepropionic acid and lignan-derived enterolactones. These metabolites were associated with all PDIs and were inversely correlated with MetS components (p &lt; 0.05). Furthermore, they had an explainable contribution of 12% and 14% for the association between hPDI or uPDI, respectively, and MetS only among participants with overweight/obesity. Conclusions: Metabolites associated with PDIs were inversely associated with MetS and its components, and may partially explain the effects of plant-based diets on cardiometabolic risk factors

Dietary Sources of Anthocyanins and Their Association with Metabolome Biomarkers and Cardiometabolic Risk Factors in an Observational Study

Anthocyanins (ACNs) are (poly)phenols associated with reduced cardiometabolic risk. Associations between dietary intake, microbial metabolism, and cardiometabolic health benefits of ACNs have not been fully characterized. Our aims were to study the association between ACN intake, considering its dietary sources, and plasma metabolites, and to relate them with cardiometabolic risk factors in an observational study. A total of 1351 samples from 624 participants (55% female, mean age: 45 \ub1 12 years old) enrolled in the DCH-NG MAX study were studied using a targeted metabolomic analysis. Twenty-four-hour dietary recalls were used to collect dietary data at baseline, six, and twelve months. ACN content of foods was calculated using Phenol Explorer and foods were categorized into food groups. The median intake of total ACNs was 1.6mg/day. Using mixed graphical models, ACNs from different foods showed specific associations with plasma metabolome biomarkers. Combining these results with censored regression analysis, metabolites associated with ACNs intake were: salsolinol sulfate, 4-methylcatechol sulfate, linoleoyl carnitine, 3,4-dihydroxyphenylacetic acid, and one valerolactone. Salsolinol sulfate and 4-methylcatechol sulfate, both related to the intake of ACNs mainly from berries, were inversely associated with visceral adipose tissue. In conclusion, plasma metabolome biomarkers of dietary ACNs depended on the dietary source and some of them, such as salsolinol sulfate and 4-methylcatechol sulfate may link berry intake with cardiometabolic health benefits

Prevalencia de obesidad pre-sarcopénica en personas mayores chilenas: Resultados de la Encuesta Nacional de Salud 2016-2017

Introduction: There are no studies in Chile that quantify the prevalence of pre-sarcopenic obesity. Therefore, this study aimed to determine the prevalence of pre-sarcopenic obesity in Chilean elderly people. Methodology: 240 people ≥ 60 years from the Chilean National Health Survey 2016-2017 were included. Pre-sarcopenia was estimated with the handgrip test and obesity was defined using waist circumference. As a sensitivity analysis, obesity was classified in a subsample of 129 people using the BMI. Based on the obesity and muscle strength criteria, the participants were categorized as: normal; obese/ normal; normal/pre-sarcopenia and obesity/pre-sarcopenia. Results: 22.6% of the population presented obesity/pre-sarcopenia using waist circumference as a diagnostic parameter. The prevalence of pre-sarcopenic obesity was higher in women (22.9%), in older people (33.0%), with urban residence (22.8%), and lower educational levels (37.3%). By incorporating the BMI as an obesity criterion, a decrease in the prevalence of pre-sarcopenic obesity (12.2%) and a higher percentage of women with this phenotype were identified. Conclusions: The prevalence of pre-sarcopenic obesity was identified in 22.6% of the older Chilean population included. Considering the role of obesity and sarcopenia in the development of non-communicable diseases, its identification and early detection could allow the creation of interventions that favor the survival and health of the elderly.Introducción: No existen estudio en Chile que cuantifiquen la prevalencia de obesidad pre-sarcopénica. &nbsp;Por ende, el objetivo de este estudio fue determinar la prevalencia de obesidad pre-sarcopénica en personas mayores chilenas. Metodología: Se incluyeron 240 personas ≥ 60 años de la Encuesta Nacional de Salud (ENS) 2016-2017 de Chile. La pre-sarcopenia se estimó con la prueba de prensión manual y la obesidad fue definida utilizando la obesidad abdominal través de la medición del perímetro de cintura. Como análisis de sensibilidad, en una submuestra de 129 personas se clasificó la obesidad utilizando el IMC. En función de los criterios de obesidad y fuerza muscular los participantes fueron clasificados en 4 categorías: normal; obeso/ normal; normal/ pre-sarcopenia y obesidad/ pre-sarcopénica. Resultados: Un 22,6% de la población estudiada presentaba obesidad/pre-sarcopénica usando el perímetro de cintura como parámetro diagnóstico. Además, la prevalencia de obesidad pre-sarcopénica fue mayor en mujeres (22,9%), en personas con mayor edad (33,0%), con residencia urbana (22,8%), y menor nivel educacional (37,3%). Al incorporar el IMC como criterio de obesidad, se identificó una disminución de la prevalencia de obesidad pre-sarcopénica (12,2%) y un porcentaje mayor de mujeres con este fenotipo. Conclusiones: Se identificó una prevalencia de 22,6% de obesidad pre-sarcopénica en población mayor chilena. Considerando el rol de la obesidad y sarcopenia en el aumento de enfermedades crónicas no transmisibles, su identificación y detección temprana podría permitir la creación de intervenciones que favorezcan la supervivencia y la salud de las personas mayores