Background Cardiovascular disease is a major cause of death, and its mortality is increasing in Latin America. However, population-based data on cardiovascular disease risk factors are sparse in these countries. Methods A total of 7,524 men and women, aged 35 to 74 years old, were recruited between February 2010 and December 2011 from randomly selected samples in 4 cities (Bariloche and Marcos Paz, Argentina; Temuco, Chile; and Pando-Barros Blancos, Uruguay) in the Southern Cone of Latin America. Cardiovascular risk factors were measured using standard methods by trained and certified observers. Results Approximately 85.5% of adults ate less than five servings of fruit or vegetables per day, 35.2% engaged in low physical activity, and 29.7% currently smoked cigarettes. The prevalences of obesity, central obesity, hypertension, chronic kidney disease, dyslipidemia, diabetes, and metabolic syndrome were 35.7%, 52.9%, 40.8%, 2.0%, 58.4%, 12.4%, and 37.4%, respectively. The proportion of individuals with ≥3 cardiovascular risk factors, including low intake of fruit and vegetables, low physical activity, current cigarette smoking, obesity or central obesity, hypertension, chronic kidney disease, dyslipidemia, and diabetes, was 68.3%, and the proportion of individual with ≥3 cardiometabolic risk factors, including obesity or central obesity, hypertension, chronic kidney disease, dyslipidemia, and diabetes, was 22.9%. Conclusions Cardiovascular disease risk factors are highly prevalent in the general population in the Southern Cone of Latin America. These data suggest that national efforts on the prevention, treatment, and control of cardiovascular risk factors should be a public health priority in the Southern Cone of Latin America.
Objective: The purpose of the present study was to determine whether elevated dietary Na intake could be associated with CVD mortality. Design: We performed a systematic review and meta-analysis of prospective studies representing the general population. The adjusted relative risks and their 95 % confidence intervals were pooled by the inverse variance method using random-effects models. Heterogeneity, publication bias, subgroup and meta-regression analyses were performed. Settings: MEDLINE (since 1973), Embase (since 1975), the Cochrane Library (since 1976), ISI Web of Science, Google Scholar (until September 2013) and secondary referencing were searched for inclusion in the study. Subject: Eleven prospective studies with 229 785 participants and average followup period of 13·37 years (range 5·5-19 years). Results: Higher Na intake was significantly associated with higher CVD mortality (relative risk = 1·12; 95 % CI 1·06, 1·19). In the sensitivity analysis, the exclusion of studies with important relative weights did not significantly affect the results (relative risk = 1·08; 95 % CI 1·01, 1·15). The meta-regression analysis showed that for every increase of 10 mmol/d in Na intake, CVD mortality increased significantly by 1 % (P = 0·016). Age, hypertensive status and length of follow-up were also associated with increased CVD mortality. Conclusions: Higher Na intake was associated with higher CVD mortality in the general population; this result suggests a reduction in Na intake to prevent CVD mortality from any cause.
AimsTo determine the prevalence, treatment and control of diabetes mellitus (DM) and impaired fasting glucose (IFG) as well as associated factors in the adult population of four cities of the Southern Cone of Latin America (SCLA).MethodsThis is a cross-sectional population-based study that included 7407 adults between 35 and 74 years old in four cities of the SCLA: Temuco (Chile), Marcos Paz and Bariloche (Argentina), and Pando-Barros Blancos (Uruguay). DM was defined as fasting plasma glucose ≥126 mg/dL or self-reported history of diabetes. Awareness, treatment, and control of DM were defined as subjects self-reporting a DM previous diagnosis, the use of a prescription medication or nonpharmacological intervention for DM, and fasting plasma glucose <126 mg/dl, respectively.ResultsPrevalence of DM varied among cities, between 8.4% in Bariloche and 14.3% in Temuco. Prevalence of IFG varied at different sites, from 3.5% in Barros Blancos to 6.8% in Marcos Paz. Of the total number of people with diabetes, 20% were newly diagnosed at the time of the study. Overall, 79.8% of patients with diabetes were aware of their condition. The treatment and control rate were 58.8% and 46.2%, respectively. Older age, family history of diabetes, lower educational attainment, overweight, obesity, central obesity, low physical activity, hypertension, hypercholesterolemia and hypertriglyceridemia were all significantly associated with an increased risk of diabetes.ConclusionsThe prevalence of DM and IFG in the adult population of the SCLA is high and varies among cities. These conditions represent a public health challenge since the rates of awareness, treatment, and control are still low.
Objective: To assess the reproducibility and validity among adults in the Southern Cone of Latin America (Argentina, Chile and Uruguay) of a self-administered FFQ to be used in the CESCAS I Study, an ongoing observational prospective cohort study to detect and follow up CVD and their risk factors, as well as in other epidemiological studies. Design: Relative validity of the FFQ was evaluated by comparing nutrient and selected food group intakes with those from three 24 h recalls (24HR) administered over 6 months. The FFQ was administered at baseline (FFQ1) and again after 3 months (FFQ2). Setting: Primary-care centres in Argentina, Chile and Uruguay. Subjects: Adults (n 147) aged 21-74 years. Results: Reproducibility (FFQ1 v. FFQ2): the intra-class correlation coefficients for nutrients ranged from 0?52 (potassium) to 0?74 (fat). Validity (FFQ1 v. the average of three 24HR): the Pearson correlations for energy-adjusted nutrients ranged from 0?39 (thiamin and cholesterol) to 0?59 (carbohydrate). Joint classification: overall, 66 % of participants in the lowest 24HR quintile were in the lowest one or two FFQ1 quintiles, and 62 % of those in the highest 24HR quintile were in the highest one or two FFQ1 quintiles. On average, only 4 % were misclassified into extreme quintiles. Conclusions: The FFQ version for the Southern Cone seems to present moderate to acceptable relative validity and reliability for its use in the CESCAS I Study to measure dietary exposure.Keywords FFQ Validity Reproducibility Southern Cone of Latin America CVD are increasing throughout the world and cause 16?7 million deaths each year, 80 % of which occur in lowand middle-income countries. Most cardiovascular risk in the Southern Cone of Latin America (Argentina, Chile and Uruguay) could be explained by tobacco use, abnormal lipids, abdominal obesity and high blood pressure, as shown in the INTERHEART Latin American study that included 3125 cases and controls from different Latin American countries (1) . In Argentina, recent estimates have shown that there were more than 600 000 disabilityadjusted life years and almost 400 000 years of potential life lost due to CHD and stroke in 2005. Modifiable risk factors explained 75?0 % of fatal and non-fatal acute CHD and stroke events, 75?5 % of costs for acute events and 70?7 % of disability-adjusted life years lost (2) .Nutritional exposures are considered risk factors for CVD as well as other non-communicable and infectious diseases (3,4) . FFQ are often used in epidemiological studies to investigate the relationship between diet and disease because they are easy to administer, less expensive than other methods and can, at least theoretically, assess dietary intake over an extended period of time (5) . Usually FFQ are not considered an appropriate method of estimating actual nutrient intakes of individuals, but they can be used to rank people according to their intake. This information is useful to categorize nutritional exposures for epidemiological studies (6) .FFQ may be administered by tr...
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