To investigate the association between a lifestyle score and all-cause mortality in the Chilean population.

Prospective study.

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.

2706 participants from the Chilean National Health Survey 2009–2010.

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.

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.

Growing evidence suggests that individuals with anxiety disorder have an elevated risk of cardiovascular disease (CVD) but few studies have assessed this association independently of or jointly with depression.

We conducted a prospective cohort study using UK Biobank. Diagnoses of anxiety disorder, depression, and CVDs were ascertained through linked hospital admission and mortality data. Individual and joint associations between anxiety disorder and depression and CVD overall, as well as each of myocardial infarction, stroke/transient ischemic attack, and heart failure, were analyzed using Cox proportional hazard models and interaction tests.

Among the 431,973 participants, the risk of CVD was higher among those who had been diagnosed with anxiety disorder only (hazard ratio [HR] 1.72; 95% confidence interval [CI] 1.32–2.24), depression only (HR 2.07; 95% CI 1.79–2.40), and both conditions (HR 2.89; 95% CI 2.03–4.11) compared to those without these conditions, respectively. There was very little evidence of multiplicative or additive interaction. Results were similar for myocardial infarction, stroke/transient ischemic attack, and heart failure.

Having anxiety is associated with the same magnitude of increased risk of CVD among people who do not have depression and those who do. Anxiety disorder should be considered for inclusion in CVD risk prediction and stratification, in addition to depression.

To investigate the relationship of a healthy eating score with depression in Chilean older adults.

Cross-sectional study.

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).

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).

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 %).

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.

To identify sex-specific cut-off points for waist circumference (WC) in the definition of metabolic syndrome (MetS) for the Chilean adult population.

MetS was defined as the presence of at least two out of four of the following criteria: TAG ≥1·7 mmol/l; HDL-cholesterol: <1·3 mmol/l in women and <1·0 mmol/l in men; systolic blood pressure ≥130 mmHg and/or diastolic blood pressure ≥85 mmHg; and fasting glucose ≥ 5·6 mmol/l or current treatment for diabetes. The receiver operating characteristics curve and the AUC were computed to derive the specificity and sensitivity using bootstrapping (10 000 iterations restricted to have at least between 40 and 60 % of the original population). The optimal cut-off point for the Chilean population was computed by sex.

A representative sample of the Chilean population aged ≥15 years.

8182 participants (60 % women) from the three available Chilean National Health Surveys conducted in 2003, 2009–2010 and 2016–2017.

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.

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.

Newly available data from big scale studies conducted in the UK, such as the UK Biobank, offers the possibility to further explore the prospective association between a diet-quality score and health outcomes after accounting for the effect of important confounding factors. The aim of this work, therefore, was to investigate the association between a diet-quality score, with the incidence of cardiovascular diseases (CVDs), cancer and all-cause mortality.

This study includes 345,343 participants (age range: 39–73, 55.1% women) from the UK Biobank, a prospective population-based study. Using 21 standardised variables of diet (alcohol, bread, bread type, cereal, dried fruit, water, coffee, tea, cheese, oily fish, non-oily fish, salt added to food, spread type, fresh fruit, cooked vegetable, raw vegetables, milk type, poultry, beef, lamb, and pork) we created a diet-quality score (very healthy, healthy, unhealthy and very unhealthy) using principal-component factor analysis. Associations between the dietary-quality score (very unhealthy individuals were the reference group) and health outcomes (all-cause mortality, CVD and cancer incidence) were investigated using Cox-proportional hazard models. All analyses were performed using STATA 14 statistical software.

In comparison to individuals with a very unhealthy diet, those with a better diet-quality had a lower risk of all-cause mortality and cancer as well as incidence of CVD and cancer. For example, individuals classified in the very healthy group had a 12% lower risk of all-cause mortality (HR: 0.88 [95% CI: 0.82 to 0.95]), 12% lower risk of CVD incidence (HR: 0.88 [95% CI: 0.80 to 0.98]), 17% of all-cancer mortality (HR: 0.83 [95% CI: 0.75 to 0.93]), and 10% lower risk all-cancer incidence (HR: 0.90 [95% CI: 0.85 to 0.94]). Those in the healthy group had a 12% lower risk of all-cause (HR: 0.88 [95% CI: 0.83 to 0.93]) and 15% lower risk of all-cancer mortality (HR: 0.85 [95% CI: 0.78 to 0.93]). There was no significant association between CVD mortality and any diet-quality group. These findings were independent of major confounding factors including socio-demographic covariates, prevalent of diseases and lifestyle factors.

Our findings indicate that individuals with a healthy diet in the UK biobank cohort are associated with a lower risk of premature mortality, and incidence of CVDs and cancer independently of major confounding factors.

Obesity remains one of the biggest health challenges worldwide. Sarcopenia, a progressive loss of muscle strength, is associated with a higher risk of disability and lower quality of life. Both conditions can occur independently of each other; however, share a common inflammatory pathway, leading to serious health problems. Previous studies have shown a positive association between severe sarcopenia and respiratory disease incidence/mortality, however, it is unclear if this association is modified by obesity. The aim of this work, therefore, was to investigate the association of severe sarcopenia and severe sarcopenic-obesity with respiratory incidence and mortality in the UK Biobank cohort.

242,572 white participants from the UK biobank study were included. Severe sarcopenia was defined as the combination of low muscle mass, low grip strength and slow gait speed. Severe sarcopenic-obesity was defined, using 3 different criteria. The combination of severe sarcopenia plus at least one of the following criteria: BMI ≥ 30 kg/m2, waist circumference (WC) > 88 cm in women and > 102 cm in men, or the two highest quintiles of body fat (60%). Associations between severe sarcopenic and severe sarcopenic-obesity and respiratory incidence and mortality were investigated using Cox-proportional hazard models.

In people without sarcopenia, high BMI, WC and body fat were associated with a reduced risk of respiratory disease mortality (HR: 0.70 [0.52; 0.85], HR: 0.74 [95%CI: 062: 088] and HR: 0.74 [95%CI: 0.63; 0.88], respectively). In comparison to people without sarcopenia or obesity, those with severe sarcopenia had three times higher risk of respiratory disease incidence (HR: 3.13 [95%CI: 2.25; 4.35]) and five times higher risk of mortality (HR: 5.37 [95%CI: 2.96: 9.74]). However, sarcopenic-obesity, based on WC and body fat, was only associated with a moderately increased respiratory disease incidence (HR 1.60 [95%CI: 1.04; 2.46] and HR: 1.52 [1.04: 2.22], respectively). There were no associations between respiratory mortality and sarcopenic-obesity.

Higher levels of adiposity may be a protective factor against respiratory mortality and could reduce the effect of severe sarcopenia over this disease. However, the mechanism behind this association needs to elucidate.

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.

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.

Chileans aged ≥15 years.

Participants (n 2913) from the Chilean National Health Survey 2009–2010.

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.

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.

To characterise clusters of individuals based on adherence to dietary recommendations and to determine whether changes in Healthy Eating Index (HEI) scores in response to a personalised nutrition (PN) intervention varied between clusters.

Food4Me study participants were clustered according to whether their baseline dietary intakes met European dietary recommendations. Changes in HEI scores between baseline and month 6 were compared between clusters and stratified by whether individuals received generalised or PN advice.

Pan-European, Internet-based, 6-month randomised controlled trial.

Adults aged 18–79 years (n 1480).

Individuals in cluster 1 (C1) met all recommended intakes except for red meat, those in cluster 2 (C2) met two recommendations, and those in cluster 3 (C3) and cluster 4 (C4) met one recommendation each. C1 had higher intakes of white fish, beans and lentils and low-fat dairy products and lower percentage energy intake from SFA (P<0·05). C2 consumed less chips and pizza and fried foods than C3 and C4 (P<0·05). C1 were lighter, had lower BMI and waist circumference than C3 and were more physically active than C4 (P<0·05). More individuals in C4 were smokers and wanted to lose weight than in C1 (P<0·05). Individuals who received PN advice in C4 reported greater improvements in HEI compared with C3 and C1 (P<0·05).

The cluster where the fewest recommendations were met (C4) reported greater improvements in HEI following a 6-month trial of PN whereas there was no difference between clusters for those randomised to the Control, non-personalised dietary intervention.

To characterise participants who dropped out of the Food4Me Proof-of-Principle study.

The Food4Me study was an Internet-based, 6-month, four-arm, randomised controlled trial. The control group received generalised dietary and lifestyle recommendations, whereas participants randomised to three different levels of personalised nutrition (PN) received advice based on dietary, phenotypic and/or genotypic data, respectively (with either more or less frequent feedback).

Seven recruitment sites: UK, Ireland, The Netherlands, Germany, Spain, Poland and Greece.

Adults aged 18–79 years (n 1607).

A total of 337 (21 %) participants dropped out during the intervention. At baseline, dropouts had higher BMI (0·5 kg/m2; P<0·001). Attrition did not differ significantly between individuals receiving generalised dietary guidelines (Control) and those randomised to PN. Participants were more likely to drop out (OR; 95 % CI) if they received more frequent feedback (1·81; 1·36, 2·41; P<0·001), were female (1·38; 1·06, 1·78; P=0·015), less than 45 years old (2·57; 1·95, 3·39; P<0·001) and obese (2·25; 1·47, 3·43; P<0·001). Attrition was more likely in participants who reported an interest in losing weight (1·53; 1·19, 1·97; P<0·001) or skipping meals (1·75; 1·16, 2·65; P=0·008), and less likely if participants claimed to eat healthily frequently (0·62; 0·45, 0·86; P=0·003).

Attrition did not differ between participants receiving generalised or PN advice but more frequent feedback was related to attrition for those randomised to PN interventions. Better strategies are required to minimise dropouts among younger and obese individuals participating in PN interventions and more frequent feedback may be an unnecessary burden.