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Objectives: Evidence suggests that access to urban green spaces (UGS) may encourage physical exercise and impact nutritional status and health. Nevertheless, the quality of UGS is an understudied area. Novel digital tools allow the analysis of urban environments. This study aims to explore the quality of UGS and its association with obesity in Córdoba, Argentina, using Google Street View (GSV) images., Study Design: Population-based cross-sectional study., Methods: Lifestyle and sociodemographic data were collected in Córdoba, Argentina (n = 1322 adults) during 2020-2022. Anthropometric measurements were obtained. Buffers of 500m were established around dwellings to identify the presence of large-area UGS (≥1ha). The quality of 226 UGS was evaluated across specific dimensions using a multi-dimensional assessment tool adapted for remote monitoring through GSV. Two-level logistic regression models for obesity outcome (yes/no) were fitted using a random intercept to account for spatial variability. Odds ratios (OR) and their 95 % confidence intervals (95 % CI) were estimated as measures of association., Results: Obesity was present in 25.9 % of participants. The UGS quality dimensions that showed an inverse association with obesity were safety (OR = 0.33; 95 % CI 0.32-0.82), potential usage (OR = 0.42; 95 % CI 0.21-0.81), surroundings (OR = 0.54; 95 % CI 0.31-0.93), access (OR = 0.55; 95 % CI 0.31-0.97), aesthetics (OR = 0.55; 95 % CI 0.34-0.87) and amenities (OR = 0.62; 95 % CI 0.42-0.91). Proximity to UGS was not significantly associated with obesity., Conclusions: Rather than their proximity, the quality of the UGS might play a key role as a determinant of obesity. In urban areas, digital tools such as GSV are useful to explore these topics., (Copyright © 2024 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)

Background: Chronic kidney disease (CKD) increases cardiovascular risk, however, traditional cardiovascular risk factors cannot entirely explain it. A real-world investigation examined the concept that renal function decline is linked to carotid total plaque area progression, which strongly confirms cardiovascular risk. We analyzed CKD patients in stages 1-3 to find risk factor relationships before the onset of severe CKD., Methods: We monitored 328 patients for 16 ± 5 months. Participants were classified at baseline by estimated glomerular filtration rate (eGFR) stage: G1 (≥ 90), G2 (60-89), and G3 (30-59 ml/min/1.73m 2 ). Ultrasound-guided total plaque area tracked atherosclerosis. Age, sex, blood pressure, lipids, and HbA1c were covariates. Total plaque area and variables were measured on day 1 and at the conclusion of observation. We used a multilevel mixed effects model to assess biological and behavioral factors on total plaque area progression in the general population. For validation, this research was conducted on 73 CKD patients with optimal traditional cardiovascular risk factor management during 15 ± 5 months., Results: Multiple analyses showed an inverse relationship between eGFR decline and total plaque area progression [β-exponent = 0.99 (95% CI = 0.98-0.99)], regardless of age, lipid profile, blood pressure, smoking, diabetes, or hypertension. The correlation remained significant in the 73-patient sample with optimal traditional cardiovascular risk factor management (β-exponent = 0.99; 95% CI 0.97-0.99). Although traditional cardiovascular risk factor management was excellent, total plaque area increased considerably in G2-G3 patients compared to G1., Conclusions: CKD, total plaque area, and eGFR are inversely correlated, independent of traditional cardiovascular risk factors, suggesting that non-traditional mechanisms are responsible for resistant atherosclerosis. The combination of eGFR and total plaque area may be useful in identifying high-risk patients., Competing Interests: Declarations. Conflict of interests: JDS receives small royalties on a share of a patent on the measurement of carotid plaque by 3D ultrasound; JDS and LJA are officers of a dormant corporation, Vascularis Inc. The other authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Ethical approval: The Institutional Committee for Ethical Evaluation of Health Research, National Clinical Hospital (CIEIS HNC-FCM) N°: 119/12, approved the protocol.  Informed consent to participate: Informed consent was waived by the Ethics Committee. Human and animal rights statement: The Institutional Committee for Ethical Evaluation of Health Research, National Clinical Hospital (CIEIS HNC-FCM) N°: 119/12, approved the protocol., (© 2024. The Author(s) under exclusive licence to Italian Society of Nephrology.)

The prevalence of obesity depends on biopsychosocial and environmental factors and represents a risk factor for communicable and non-communicable diseases. Objectives: To determine the association between demographic, socioeconomic and lifestyle characteristics and the presence of obesity and its metabolic comorbidities (MC) in adults in San Luis City, Argentina. Observational population-based cross-sectional study of 306 individuals aged 18-85 years from San Luis, Argentina, selected by multistage random sampling, with an overweight prevalence of 35% and a 0.05 margin of error. Socioeconomic, demographic, and lifestyle variables were assessed, and multiple logistic regression models were fitted with the presence of obesity and MC as outcomes and sociodemographic and lifestyle characteristics as covariates. Obesity was found in 17.3% of participants, diabetes in 3%, high blood pressure (HBP) in 11%, dyslipidemia in 3.3% and coronary ischemic complications (CIC) in 13%. The proportion of residents with at least one of these conditions was 26.8%. Low Educational level (EL) was positively associated with the presence of obesity (OR 3.58; IC95% 1.04-12.24; p=0,04), and its MC (OR 5.25; IC95% 1.05-26.23; p=0.04) with respect to high EL. Similarly, the possibility of presenting CIC was increased in people with medium EL (OR 5.8; IC95% 1.12-30.19; p=0.03). On the other hand, the possibility of presenting diabetes increased by 17% with increasing body mass index (BMI) (OR 1.17; IC95% 1.03-1.34; p=0.01). Finally, women were more likely to present HBP (OR 3.71; IC95% 1.01-13.72; p=0.04) and CIC (OR 3,43; IC95% 1,06-11,10; p=0,03). Conclusion: the increase in age, female sex and medium and low NI are factors and conditions of vulnerability that predispose an increase in the prevalence of MC in adults from San Luis, Argentina., (Universidad Nacional de Córdoba)

Background: The complex nature of obesity increasingly requires a comprehensive approach that includes the role of environmental factors. For understanding contextual determinants, the resources provided by technological advances could become a key factor in obesogenic environment research. This study aims to identify different sources of non-traditional data and their applications, considering the domains of obesogenic environments: physical, sociocultural, political and economic., Methods: We conducted a systematic search in PubMed, Scopus and LILACS databases by two independent groups of reviewers, from September to December 2021. We included those studies oriented to adult obesity research using non-traditional data sources, published in the last 5 years in English, Spanish or Portuguese. The overall reporting followed the PRISMA guidelines., Results: The initial search yielded 1583 articles, 94 articles were kept for full-text screening, and 53 studies met the eligibility criteria and were included. We extracted information about countries of origin, study design, observation units, obesity-related outcomes, environment variables, and non-traditional data sources used. Our results revealed that most of the studies originated from high-income countries (86.54%) and used geospatial data within a GIS (76.67%), social networks (16.67%), and digital devices (11.66%) as data sources. Geospatial data were the most utilised data source and mainly contributed to the study of the physical domains of obesogenic environments, followed by social networks providing data to the analysis of the sociocultural domain. A gap in the literature exploring the political domain of environments was also evident., Conclusion: The disparities between countries are noticeable. Geospatial and social network data sources contributed to studying the physical and sociocultural environments, which could be a valuable complement to those traditionally used in obesity research. We propose the use of information available on the Internet, addressed by artificial intelligence-based tools, to increase the knowledge on political and economic dimensions of the obesogenic environment., (© 2023. The Author(s), under exclusive licence to Springer Nature Limited.)

The obesity epidemic is a phenomenon that has been widely studied in recent decades but is still incompletely understood, and its control is far from the desirable level in view of the increasing prevalence figures observed worldwide. This paper conducts a narrative review with the aim of providing updated evidence on the global obesity epidemic, and particularly on the situation in Latin America and Argentina, identifying the main challenges and future directions for addressing this public health problem. It first describes the current burden and increasing trends in the prevalence of obesity, in the overall population and by population groups, and its possible association with genetic and epigenetic aspects. It also summarizes the direct and indirect socioeconomic consequences of this epidemic, as well as recent strategies and initiatives focused on obesity prevention, with special attention to those reported as the most efficient in the Latin American context. This review identified some pending challenges in the region, the integrated approach to the double burden of malnutrition and the growing childhood overweight; and it points out some emerging approaches, such as the syndemic approach, as potentially useful to understand and address this complex problem in the current context. In conclusion, it highlights the importance of implementing renewed, more efficient and evidence-based strategies to control the growing prevalence of obesity, which would also impact on the burden of related chronic diseases, and thus on the economy and well-being of Latin American societies.

Objectives: Diet, one of the main risk factors for both metabolic syndrome (MetS) and non-communicable diseases (NCDs), is a multidimensional feature whose complexity relies on the individual and contextual characteristics of foods. The aim of this study was to build a "diet model" and estimate its relationship with MetS components in two Argentinian populations., Methods: This was a population-based cross-sectional study that assessed bio-socio-anthropometrical variables and dietary habits using food frequency questionnaires. Dietary patterns (DPs) were drawn out using exploratory factor analysis (EFA). A structural equation model (SEM) was used to explore and confirm theoretical and empirical relationships between DPs and the diet model. The association between individuals' adherence to DPs and MetS were assessed using a multiple logistic regression analysis. We selected two cities in central Argentina according to socio-eco-environmental characteristics. Participants included 493 men and women (1:1 ratio) from 35 to 65 y of age., Results: We identified four DPs: traditional Argentine (TA; processed meats, meats and eggs, fats, starchy vegetables), prudent (Pr; vegetables, fruits, milk, and yogurt), alcohol and snacks (AS), and sweets (S; candies and sodas). TA and AS DPs were associated with increased waist circumference. The S DP showed a strong effect on hypertension. Moderate adherence to the TA DP was positively associated with dyslipidemia but negatively with hypertension whenever individuals did not adhere to the AS DP. TA was positively correlated to AS and S, but inversely with Pr., Conclusion: This diet model integrated those food groups in an associative structure describing per se a synthesis of the Argentine dietary habits and their association with three of the five components of MetS., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Introduction: Demographic trends indicate that population aging is not exclusive to developed countries. Argentina reaches 15.5% of the elderly population. The Covid-19 pandemic has brought to the forefront the public health situation of this population, challenging health systems, with disproportionate impacts on this group, which has suffered more than 80% of the deaths in the country, mainly in those with comorbidities., Objective: To analyze the sociodemographic and environmental conditions involved in the process of development of health and nutrition profiles of the elderly people of Córdoba, Argentina 2020., Methodology: Epidemiological, cross-sectional, population-based study that included 221 elderly people (≥60 years old), through random sampling. Data on sociodemographic and environmental conditions, health and dietary profiles were collected through structured interviews., Results: The average age of the participants was 68 years. Eighty-five percent recognized neighborhood contamination, 38% of them being garbage dumps close to their homes. Eighty-nine percent reported at least one non-communicable disease (NCD) or associated risk factor and 66% were overweight (BMI≥25kg/m 2 ). The presence of obesity (BMI≥30kg/m 2 ) was associated (OR=2.05; CI 1.007-3.922) with the development of NCDs. Only 4% of the population complied with the daily fruit and vegetable consumption recommendation., Conclusion: The predominant characteristics of the health and dietary profiles associated with NCDs identified suggest the need to study in depth the social determinants that condition the aging process., (Copyright © 2022 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.)

Dietary patterns based on rich-carbohydrate foods were associated with breast cancer (BC) in Córdoba (Argentina). Nevertheless, the effect of dietary indicators of postprandial blood glucose or insulinemia on this cancer has not been studied. Thus, we hypothesize that higher dietary glycemic and insulinemic indices increase the risk of BC occurrence, with differential effects according to the presence/absence of overweight. A case-control study was conducted for BC (346/596 cases/controls) in Córdoba, Argentina, from 2008 to 2016. Multiple logistic regression models were used to assess the effect of glycemic index (GI), glycemic load, insulin index, and insulin load (IL) and the intake of high-GI foods (HGIF) on BC occurrence, adjusted by specific confounders and stratified by body mass index (BMI, <25 or ≥25 kg/m 2 ). The odds ratio (OR) for BC occurrence comparing the highest versus the lowest tertile of dietary GI was 1.77 (95% confidence interval [CI], 1.19-2.64). Additionally, a positive association between the weekly intake of HGIF and the dietary IL was found (OR, 1.71; 95% CI, 1.14-2.55 and OR, 1.50; 95% CI, 1.03-2.19, respectively). In normal-weight women, dietary GI and IL were associated with cancer occurrence, whereas in overweight women, only weekly intake of HGIF was associated. Our findings suggest that the BC risk related to hyperglycemic and hyperinsulinemic diet changed according to BMI. Furthermore, frequent exposure to HGIF has a relevant role in BC occurrence and its promoting effect is even higher in the presence of overweight., Competing Interests: Conflict of Interest None declared., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Seroepidemiological studies help identify the indirect distribution of diseases, detecting serological markers of immunity and demonstrating undiagnosed infections in the general population. The objectives were to estimate the seroprevalence of SARS-CoV-2 antibodies in Córdoba, Argentina, from December 2020 to January 2021 and to identify factors associated with the virus' contagiousness. A population-based cross-sectional observational study was performed in 3,225 individuals over two years of age living in Córdoba city, selected by multiple-stage random sampling proportional to distribution by gender, age group, and socioeconomic status in the city's population. Clinical characteristics, anthropometry, and comorbidities were collected by interview. Qualitative serological testing was performed for detection of SARS-CoV-2 nucleocapsid IgG antibodies (ARCHITECT, Abbott). SARS-CoV-2 seroprevalence was estimated for the total population and by age group, sex, socioeconomic status, and presence of target diseases. Prevalence ratios (PR) were estimated using a log-binomial regression model. SARS-CoV-2 seropositivity was 16.68% (95%CI: 15.41-18.01). Age 2 to 18 years, living in neighborhoods with low socioeconomic status, and obesity increased the odds of seropositivity (PR = 1.50; 95%CI: 1.10-2.04, PR = 1.91; 95%CI: 1.34-2.67 and PR = 1.39; 95%CI: 1.04-1.85). The results indicate that the city of Córdoba displays differential attributes that increase the likelihood of a positive SARS-CoV-2 antibody test. This allows targeting epidemiological surveillance strategies to reduce the spread of the virus.

Objective: To determine the effectiveness of vaccination against SARS-CoV-2 in preventing illness and death from COVID-19 in Córdoba, Argentina, during the period from January through June 2021., Methods: A retrospective cohort study was conducted among 1,139,458 residents of the province of Córdoba. Multiple logistic regression models were developed to describe the relationship between vaccination and the presence of SARS-CoV-2 or death from COVID-19, while taking account of comorbidities and chronic disease risk factors and adjusting for sex and age., Results: Among the general population, having received one or two doses of vaccine reduced the risk of illness by 98.8% and 99.3%, respectively, and the risk of dying by 83% and 96.5%, respectively. Among those who developed COVID-19, the probability of dying was reduced by 57% and 80%, respectively. Regarding probability of death, risk increased with age, with being male, and with obesity, arterial hypertension, and diabetes mellitus., Conclusion: Vaccination is effective and protects against the risk of getting COVID-19, developing severe disease, or dying. Having obesity, arterial hypertension, or diabetes mellitus, in descending order, increases the risk of death.

Objective: To assess the association of sociodemographic and environmental factors with the obesity occurrence in Argentina from a sex- and age-comparative perspective and a multilevel approach., Design: Cross-sectional study based on secondary data from the National Survey of Chronic Diseases Risk Factors (CDRF) 2018, Argentina. Two-level logistic regression models stratified by sex and age were used., Setting: The nationwide probabilistic sample of the CDRF survey and twenty-four geographical units., Participants: 16 410 adult people, living in Argentine towns of at least 5000 people, nested into 24 geographical units. Sex and age groups were defined as young (aged 18-44 years), middle-aged (45-64 years) and older (65 years and older) men and women., Results: Single men (all age groups) and divorced/widowed men (aged 45 years or older) had a lower obesity risk compared to married ones. In the middle-aged group, men with higher education showed a lower risk than men with incomplete primary education. In young women, a marked social gradient by educational level was observed. A low-income level coupled with highly urbanised contexts represents an unfavourable scenario for young and middle-aged women. Having a multi-person household was a risk factor for obesity (OR = 1·26, P = 0·038) in middle-aged women. Contextual factors linked to the availability of socially constructed recreational resources and green spaces were associated with obesity among young adults., Conclusions: Socio-environmental determinants of obesity seem to operate differently according to sex and age in Argentina. This entails the need to address the obesity epidemic considering gender inequalities and the socio-environmental context at each stage of life.

Background: In real life, nutrition goes beyond purely biological domains. Primary prevention is the most efficient approach for reducing the risk of mortality. We aimed to study the association of lifestyle, as measured by a modified World Cancer Research Fund/American Institute for Cancer Research (mWCRF/AICR) scoring system with all-cause, digestive system disease-related (DSD-related), cardiovascular disease-related (CVD-related), cancer-related and other cause-related mortality using data from two population-based cohort studies conducted in Southern Italy., Methods: A random sample of 5271 subjects aged 18 years or older was enrolled in 2005-2006 and followed up until 2020. Usual food intakes were estimated using a validated dietary questionnaire. Competing risks survival models were applied., Results: High adherence to the mWCRF/AICR score was found to be statistically significant and negatively associated with all-cause mortality (HR 0.56, 95%CI 0.39; 0.82), DSD-related mortality (SHR 0.38, 95%CI 0.15; 0.97) and cancer-related mortality (SHR 0.43, 95%CI 0.19; 0.97) in the male sub-cohort and other-cause mortality (SHR 0.43, 95%CI 0.21; 0.88) only in the female group., Conclusions: This mWCRF/AICR score can be seen as a simple, easy tool for use in clinical practice to evaluate both qualitative and quantitative aspects of the diet.

Non-Alcoholic Fatty Liver Disease (NAFLD) affects about 20-30% of the adult population in developed countries and is an increasingly important cause of hepatocellular carcinoma. Liver ultrasound (US) is widely used as a noninvasive method to diagnose NAFLD. However, the intensive use of US is not cost-effective and increases the burden on the healthcare system. Electronic medical records facilitate large-scale epidemiological studies and, existing NAFLD scores often require clinical and anthropometric parameters that may not be captured in those databases. Our goal was to develop and validate a simple Neural Network (NN)-based web app that could be used to predict NAFLD particularly its absence. The study included 2970 subjects; training and testing of the neural network using a train-test-split approach was done on 2869 of them. From another population consisting of 2301 subjects, a further 100 subjects were randomly extracted to test the web app. A search was made to find the best parameters for the NN and then this NN was exported for incorporation into a local web app. The percentage of accuracy, area under the ROC curve, confusion matrix, Positive (PPV) and Negative Predicted Value (NPV) values, precision, recall and f1-score were verified. After that, Explainability (XAI) was analyzed to understand the diagnostic reasoning of the NN. Finally, in the local web app, the specificity and sensitivity values were checked. The NN achieved a percentage of accuracy during testing of 77.0%, with an area under the ROC curve value of 0.82. Thus, in the web app the NN evidenced to achieve good results, with a specificity of 1.00 and sensitivity of 0.73. The described approach can be used to support NAFLD diagnosis, reducing healthcare costs. The NN-based web app is easy to apply and the required parameters are easily found in healthcare databases., (© 2021. The Author(s).)

Background: The Mediterranean diet (MedDiet) is associated with good health. We aimed to estimate the effect of levels of adherence to the MedDiet on lifespan by performing treatment effects survival analysis., Methods: A sample of 5250 subjects aged ≥18 years were randomly selected from the electoral list of Castellana Grotte and Putignano (Apulian Region, Italy). Cohorts were enrolled in 2005-06 and followed-up until December 2018. The adherence to the MedDiet was measured by the relative Mediterranean score (rMED) and categorized as high, medium and low. Time-to-death (all-causes) as estimated by average treatment effect on the treated (ATET), potential outcome mean (POM) and relative efficiency of exposure were the outcomes., Results: A total of 4896 subjects were included. The median follow-up time was 12.82 (inter quartile range (IQR) 12.22-13.05), 12.91 (IQR 12.21-13.27) and 12.84 (IQR 12.19-13.03) years for high, medium and low rMED subjects respectively. By December 2018, 453 (9.25%) had died. There was a strong effect of medium and low rMED {ATET, -5.10 [95% confidence interval (CI) -9.39, -0.80] and -8.91 (95%CI -13.37, -4.45), respectively}. High rMED has an important effect on mean age at death [POM 90.16 (95% CI 86.06, 94.25)]. The relative effect size for medium and low rMED subjects was a lower lifespan of 5.62% (95% CI 1.01, 10.3) and 9.90% (95% CI 5.30, 5.30), respectively., Conclusions: We observed an important benefit in additional years of survival from adherence to MedDiet in this southern Italian cohort. Further investigation corroborating our findings in other population groups in other geographic regions will be an important contribution to promoting health and longevity., (© The Author(s) 2020; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.)

Background: PTP4A3 is a subclass of a protein tyrosine phosphatase super family and is expressed in a range of epithelial neoplasms. We evaluated PTP4A3 expression and its association with clinicopathological parameters in different types of functioning pituitary adenomas., Methods: A total of 34 functioning pituitary adenomas samples were evaluated in this observational study. PTP4A3 expression was examined by immunohistochemical staining, and, possible correlations between PTP4A3 and some clinicopathological variables were investigated., Results: PTP4A3 was expressed in 19 out of 34 tumours (55%), at the cytoplasmic level of tumorous cells. Moreover, there was significant association (p=0.042) between PTP4A3 expression and tumorous size., Conclusions: PTP4A3 was expressed in more than half of the tumours analysed, with there being a significant association with the tumorous size of functioning adenomas. This allows to speculate that PTP4A3 may regulate tumour growth, although further investigations are necessary to determine if this phosphatase can serve as a biomarker or used as a therapeutic target in pituitary macroadenomas., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: Food choices and nutritional requirements of women, which vary throughout their life cycle, are unknown for Argentinian women., Objective: To identify Argentinian women’s dietary patterns and their relation to socioeconomic and health characteristics, during puerperium., Method: The food intake of 249 puerperal women was assessed for a cross-sectional study. Dietary patterns were determined by factor analysis, whose adherence was associated with different variables through Spearman’s correlation and multivariate analyses., Results: Three patterns were revealed: macronutritional (MP), phytochemical (PP) and energetic (EP). Physical activity and family history of cardiometabolic diseases were positively associated to MP adherence (odds ratio [OR] = 2.69 and 2.68, respectively). Women without formal employment adhered less to PP (OR = 0.49). Low educational level increased adherence to EP (OR = 2.20). Body mass index correlated inversely to PP (rho = −0.16). Correspondence analysis revealed that high adherence to MP and PP were associated with formal employment, high educational level, adequate physical activity, normal body mass index and a diverse diet., Conclusion: Food choices were conditioned by family disease, physical activity, employment, and educational level. We identified three dietary patterns in postpartum women, which constitute an original contribution to future nutritional approaches.

Background: Non-Alcoholic Fatty Liver Disease (NAFLD) is the most common chronic liver disease worldwide, and lifestyle modification is the current standard treatment. The aim of the study was to estimate the effect of two different physical activity (PA) programs, a Low Glycemic Index Mediterranean Diet (LGIMD), and their combined effect on the NAFLD score as measured by FibroScan ® ., Methods: Moderate or severe NAFLD subjects ( n = 144) were randomly assigned to six intervention arms during three months. Interventions arms were a control diet, LGIMD, aerobic activity program (PA1), combined activity program (PA2), and LGIMD plus PA1 or LGIMD plus PA2. The data were compared at baseline, at 45 days, and at 90 days. Analysis of variance was performed under the intention-to-treat principle., Results: There was a statistically significant reduction in the NAFLD score after 45 days of treatment in every working arm except for Arm 1 (control diet). After 90 days, the best results were shown by the intervention arms in which LGIMD was associated with PA: LGIMD plus PA1 (-61.56 95% CI -89.61, -33.50) and LGIMD plus PA2 (-38.15 95% CI -64.53, -11.77)., Conclusion: All treatments were effective to reduce NAFLD scores, but LGIMD plus PA1 was the most efficient.

Introduction: The prevalence of overweight and obesity increases in university students as a consequence of the modification of their eating habits and their level of physical activity. The general objective of this work was to analyze the relationship between the nutritional status of Physical Education students and the level of physical activity, cardiovascular risk and eating habits, during the first three years of the degree., Method: Observational, descriptive and longitudinal section study. 67 students were studied. To assess nutritional status and cardiovascular risk, body mass index (BMI) and waist circumference (CC) were measured, respectively. To inquire about eating habits, a survey was used based on the recommendations of the dietary guidelines for the Argentine population. To estimate the level of physical activity, the IPAQ International Physical Activity Questionnaire, short format, Spanish version was used., Results: Students with obesity, obesity, and elevated cardiovascular risk increased during the course of the study. For their part, healthy eating behaviors and a high level of physical activity in women decreased. BMI showed a positive correlation with CC. Healthy food selection in males was correlated with BMI., Conclusions: The evolution of the course in Physical Education indicated a progressive increase in the factors associated with obesity. These results would allow directing and promoting legislative actions that update the curriculum of the Physical Education career, according to the social and health needs of this population., (Universidad Nacional de Córdoba.)

Background and Aims: Cardiovascular diseases (CVDis) are leading causes of morbidity and mortality. Even after the introduction of pharmacological therapy to lower Cholesterol, there is still a residual risk that may be ascribed to remnant cholesterol (RC). We aimed, by analyzing two prospective cohort studies, to estimate the effect of RC on risk and hazard of cardiovascular deaths (CVDs), while accounting for competing risks such as cancer (CDs) and other-causes deaths (OCDs)., Methods and Results: Cohorts were enrolled in 1992 and 2005. Personal data history was recorded. A fasting venous blood sample was obtained, and RC was calculated at baseline. Cause of Death was coded by using ICD-10th version. Follow-up ended on December 31, 2017. Flexible parametric competing-risks models were applied, with age at death as time-axis. In total, 5729 subjects were enrolled. There were 861 (15.1%) deaths: 234 CVDs (27.2%), 245 CDs (28.5%), 271 OCDs (31.5%) and 111 unknown causes of death (12.8%). RC exposure was a strong risk factor only for CVDs (Risk 2.54, 95% Confidence Interval 1.21; 5.34; Trend 1.26 (1.00; 1.58) for ≥1.29 mmol/L)., Conclusions: RC is a strong independent risk factor for cardiovascular mortality. Competing risk analysis is demonstrably a useful tool to disentangle associations among different competing events with a common risk factor., (Copyright © 2020 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)

Breast cancer (BC) is a multifactorial disease. Environmental factors, specifically, obesity and diet quality, have been linked with an increased risk of BC in women. This research was aimed at assessing the association of diet quality with BC risk, considering nutritional status, in Córdoba province (Argentina). A case-control study was conducted during the period 2008-2016 (346 cases/566 controls). A diet quality score was calculated for each woman based on fifteen dietary components related to low-grade inflammation. Dietary information was obtained through a validated questionnaire. A score (0, 0.5, or 1) was assigned to each variable depending on compliance with dietary recommendations. The higher the score, the higher the degree of adherence to a poor quality diet, which carries a potential inflammatory effect. A multiple logistic regression analysis was used to assess the association between BC occurrence and diet quality, adjusting by body mass index. The mean score of women was 6.86 (1.83). Of total women studied, 20% were obese. A 39% increase in BC risk was observed for each unit of increase in the score in this group (Odds Ratio: 1.39; 95% Confidence Interval: 1086-1796). Obese women with poorer quality diet have a greater risk of BC occurrence in Córdoba (Argentina).

Introduction: Introduction: the goal of this study was to evaluate whether an association exists between dietary components related to inflammation and oral squamous cell carcinoma (OSCC) in Argentina. Methods: a case-control study was carried out with 3 controls for each case and participants of both genders who were between 24 and 85 years of age, who were recruited at the outpatient clinic, Odontology School, Universidad Nacional de Córdoba, between 2012 and 2015. Dietary information was collected using a semi-quantitative food frequency questionnaire from which energy-adjusted Dietary Inflammatory Index (E-DIITM) scores were computed. Logistic regression models were fit to assess the association between E-DII and OSCC. Results: significantly higher intakes of macronutrients such as fat, protein and cholesterol, and of micronutrients such as iron, riboflavin, monounsaturated, polyunsaturated, omega-6 and omega-3 fatty acids, and vitamin B6 were observed in cases as compared to controls (all p < 0.05). We also observed a significant 69% increase in OSCC for each point on the E-DII scale (OR 1.69, 95% CI [1.18-2.43]) after adjusting for alcohol and tobacco consumption. Conclusion: we found an association between diet-associated inflammation, as represented by the E-DII, and risk of OSCC. Future research should be directed at deepening our understanding of this association in other populations, and should include studies utilizing prospective designs.

The glycaemic index (GI) and glycaemic load (GL) are involved in the aetiology of different diseases, and they could be related to the development of colorectal cancer (CRC). The aim of this study was to evaluate the association between the quality and quantity indicators of carbohydrates consumed by the population of Córdoba (Argentina) and the odds of developing CRC in 2008-2016 period. A case-control study was conducted with 492 participants (161/331 cases/controls), interviewed through a validated FFQ. Multilevel logistic regression models were used to assess the effect of GI, GL and the quantity or weekly intake of high-GI foods on CRC occurrence, following adjustment for individual/first-level covariates, and using level of urbanisation as the contextual variable. The models were stratified by sex. Participants in the highest v. lowest tertile of dietary GL and weekly intake of high-GI foods had increased odds of CRC presence in the entire sample (OR 1·64, 95 % CI 1·16, 2·34 and OR 1·11, 95 % CI 1·09, 1·14, respectively) and in women (OR 1·98, 95 % CI 1·24, 3·18 and OR 1·41, 95 % CI 1·09, 1·83, respectively). In men, the second tertile of GL and weekly intake of high-GI foods were associated with CRC (OR 1·44, 95 % CI 1·04, 1·99 and OR 1·48, 95 % CI 1·32, 1·65, respectively). Also, GI was associated with CRC in women (highest v. lowest tertile OR 2·12, 95 % CI 1·38, 3·27). In addition to the quantity and quality of carbohydrates intake, it is important to consider the frequency of consumption of high-GI foods in CRC prevention.

Objective: The present study aimed to identify nutrition transition (NT) profiles in Argentina (2005-2013) and assess their association with obesity in the adult population., Design: A large cross-sectional study was performed considering data sets of nationally representative surveys. A multiple correspondence analysis coupled with hierarchical clustering was conducted to detect geographical clusters of association among sociodemographic and NT indicators. Multilevel logistic regression models were used to assess the effect of NT profile (proxy variable of contextual order) on obesity occurrence., Setting: First, we used geographically aggregated data about the adult and child populations in Argentina. Second, we defined the population of adults who participated in the National Survey of Chronic Disease Risk Factors (2013) as the study population.ParticipantsTwenty-four geographical units that make up the territory of Argentina and 32 365 individuals over 18 years old living in towns of at least 5000 people., Results: Three NT profiles were identified: 'Socionutritional lag' (characterized by undernutrition and socio-economically disadvantaged conditions; profile 1); 'Double burden of malnutrition' (undernutrition and overweight in highly urbanized scenarios; profile 2); and 'Incipient socionutritional improvement' (low prevalence of malnutrition and more favourable poverty indicator values; profile 3). Profiles 1 and 2 were significantly associated (OR; 95 % CI) with a higher risk of obesity occurrence in adults (1·17; 1·02, 1·32 and 1·44; 1·26, 1·64, respectively) compared with profile 3., Conclusions: Argentina is facing different NT processes, where sociodemographic factors play a major role in shaping diverse NT profiles. Most of the identified profiles were linked to obesity burden in adults.

Background: Diverse environmental exposures, as well as dietary and lifestyle factors, are associated with prostate cancer (PC) etiology; however little is known about joint interactive influences. The aim of this study was to analyse effects of diet combined with arsenic in drinking water and agricultural occupation on PC risk. Methods: A case-control study was conducted in Córdoba, Argentina (period 2008-2015) including 147 cases of PC and 300 controls. All subjects were interviewed about food consumption, socio-demographic and lifestyle characteristics. A sample of drinking water was taken to determine arsenic concentrations. Adherence scores to the Traditional Dietary Pattern were estimated, based on a principal component factor analysis. A two-level logistic regression model was fitted in order to assess effects of the Traditional Pattern, occupation and arsenic exposure on the occurrence of PC (outcome). Family history of PC was considered as a clustering variable. Results: PC risk was greatest in subjects with high adherence to the Traditional Pattern (OR 2.18; 95%IC 1.097–4.344). Subjects exposed to arsenic in drinking water above 0.01mg/l who simultaneously performed agricultural activities showed a markedly elevated PC risk (OR 5.07; 95%IC 2.074-12.404). Variance of the random effect of family history of PC was significant. conclusion: Diet, arsenic and occupation in agriculture exert significant effects on PC risk. Further efforts are necessary to analyse risk factors integrally, in order to achieve a better understanding of the complex causal network for PC in this multiple-exposure population., (Creative Commons Attribution License)

Introduction: Celiac disease (CD) causes intestinal damage, inability to absorb nutrients, and progressive malnutrition. Iron deficiency is one of the predominant nutritional problems. A strict gluten-free diet (GF) allows for an optimal quality of life., Objective: To assess the nutritional situation of iron in school-aged celiac children by determining biochemical parameters, their relation to the consumption of the mineral and adherence to gluten-free diets in San Luis., Methods: Observational, analytical and cross-sectional study. We included 44 children with CD, from 6-10 years of age, with diagnosis of celiac disease and registered in public and private entities of San Luis (Argentina) during 2011-2012. A qualitative-quantitative survey was used to determine dietary habits and sociodemographic characteristics. Iron levels and adherence to a GF diet were evaluated. Generalized linear regression models were constructed to verify the association of ferritin with iron consumption and adherence to diet., Results: Most families had low socioeconomic status and were large families. Current feeding did not prevent iron deficiency anemia. Most children had normal immune system, and normal antiendomysial and antitransglutaminase antibodies; 7% of the children showed low levels of iron. Under adequate iron consumption conditions, ferritin was associated to predictor antibodies and the presence of both parents in the home., Conclusion: Under adequate conditions of iron consumption, the levels of iron in blood were related to adherence to gluten-free diets.

Objective: To associate the intake of flavonoids and carotenoids with the breast milk level of superoxide anion, as an oxidative stress marker., Materials and Methods: 100 women from Cordoba (Argentina), who breastfed within the first postpartum 6 months, were studied during the 2013-2015 period, by evaluating their sanitary data, food intake and anion level in milk with multiple logistic regression., Results: The intake of flavonoids, provitamin A carotenoids and non-provitamin carotenoids was 72 (61) mg/d, 1813 (1 657) µg/d y 5427 (3 664) µg/d, respectively. The anion was associated with the intake of flavanols (OR=1.081; CI95 1.001-1.167) y flavanones (OR=1.025; CI95 1.001-1.048). This effect was not seen with other flavonoids and carotenoids., Conclusions: Intake of flavanols and flavanones increases milk oxidation risk, which is relevant to develop diet recommendations.

Background/objectives: In Argentina, obesity prevalence rose from 14.6% in 2005 to 20.8% in 2013. Although the number of studies on noncommunicable diseases and dietary patterns as a unique dietary exposure measure has increased, information on this topic remains scarce in developing countries. This is the first population-based study investigating the association between diet and obesity using a dietary pattern approach in Argentina. We aimed (a) to identify current dietary patterns of the population of Córdoba city, (b) to investigate its association with obesity prevalence, and (c) to identify and describe dietary patterns from the subgroup of people with obesity., Subjects/methods: The Córdoba Obesity and Diet Study (CODIES) was conducted in Córdoba city by using a random sample of n = 4,327 subjects between 2005 and 2012. Empirically derived dietary patterns were identified through principal component factor analysis. A multiple logistic regression analysis was used to investigate the association of dietary patterns with obesity., Results: Four dietary patterns were identified, called " Starchy-Sugar ", " Prudent ", " Western ", and " Sugary drinks ". High scores for the " Western " pattern (with strongest factor loading on meats/eggs, processed meats, and alcohol) showed a positive association with obesity (OR: 1.33, 95% CI: 1.06-1.67, for third versus first tertile of factor score). " Meats/Cheeses " and " Snacks/Alcohol " patterns emerged in people with obesity., Conclusions: The findings suggest that high adherence to the " Western " pattern promoted obesity in this urban population. In addition, people with obesity showed characteristic dietary patterns that differ from those identified in the overall population., Competing Interests: The authors declare no potential conflicts of interests.

Introduction: Obesity is a chronic, heterogeneous, multifactorial disease, which has sharply increased in prevalence in both developed and developing countries. This study aimed to estimate the prevalence of obesity and to identify socio-demographic risk factors associated with it, with special emphasis on diet., Methods: Nutritional status, demographic characteristics, lifestyle habits, and food consumption patterns derived from a Food Frequency Questionnaire were investigated. Exhaustive exploratory analyses were performed in order to describe dietary patterns, and logistic regression models were used for odds ratio estimation., Results: The study included 4328 subjects, over 18 years old and resident in Cordoba city. The prevalence of overweight and obesity was 34 and 17 %, respectively, with 60 % in men and 45 % in women of BMI ≥ 25. Obesity risk factors were high intake of sodium, refined grains, starchy vegetables, and snacks. A lower risk of overweight and obesity was associated with an adequate, moderate intake of meats, eggs, alcoholic beverages, sugar and sweets, milk, yogurt, and pulses., Conclusions: A high intake of snacks, refined grains, starchy vegetables and sodium and low intake of yogurt, milk, pulses, and whole grains seem to be associated with the emergence and high prevalence of obesity in Cordoba, Argentina.

Introduction: the identification of risk group of oral cancer allows reducing the typical morbidity and mortality rates of this pathology., Objetive: it was analyzed the role of red meat, macronutrients and micronutrients on Oral Squamous Cell carcinoma (OSCC) in a case-control study carried out in Cordoba, Argentina., Methods: case-control study 3:1, both genders, aged 24-80 years. Dietary information was collected using a quali-quantitative food frequency questionnaire. The logistic regression was applied for assessing the association among case/control status and daily red meat/macronutrient/ micronutrients/energy intake., Results: micronutrients and minerals in the diet that showed high significant median values of common consumption in cases relative to controls were iron, phosphorus, vitamins B1, B5, B6, E and K and selenium. The association measurement estimated by logistic regression was showed that a significant association between red meat, fat, daily energy, phosphorous, vitamin B5, vitamin E, and selenium intake and OSCC presence., Conclusions: a high intake of fats, phosphorus, vitamin B5, vitamin E, and selenium intake and red meat appears to be related to the presence OSCC in Cordoba, Argentina. In relation to red meat consumption and risk of OSCC, the future research should center of attention on reducing the complexity of diet and disease relationships and reducing variability in intake data by standardizing of criteria in order to implement simple strategies in public health for recognizing risk groups of OSCC., (Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.)

Introduction: There is increasing scientific evidence that nutrition influence positive and negative on health along life. Many studies have reported that the student population is a particularly vulnerable group from the nutritional point of view, due to it is characterized by meal skipping frequently and nibble between eating occasions., Objective: to establish the relationship between the number of daily dietary intakes and nutritional status in male students aged 23 to 33 years of the National Technological University, in the city of Córdoba, in 2013., Methods: in order to achieve this aim, a prospective, cross-sectional and descriptive correlational design was used. Descriptive and inferential analysis were applied by using multiple logistic regression models., Results: Almost 50% of the sample analyzed presented overweight (OW) and 40% high body fat (BF). In relation to the intakes numbers, the students that take less than 4 and more than 6 had 2 times more chance of presenting overweight and high body fat. It was found that as age increases it also does the Body Fat Storage, whereas diminished physical activity increases the chance of having high Body Mass Index and Body Fat. Moreover, high ingestion of carbohydrates increases the chance of high Body Fat and Overweight, and a high intake of protein and lipids increases the risk of high Body Fat., Conclusion: it is recognized that high or low number of daily intakes than recommended, low level of physical activity, high consumption of carbohydrates and having more than 29 years is related to high overweight and body fat., (Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.)

Introduction: Feeding habits play a prominent role in carcinogenesis. The dietary patterns approach applied to the study of chronic diseases is of increasing interest in nutritional epidemiology. Nevertheless, it has been seldom used in Latin America., Objective: To identify dietary patterns in adult population in Córdoba (Argentina) and to estimate their effects on the risk of colon-rectal (CRC), urothelial (UC), breast (BC) and prostate (PC) cancers., Methods: Four case control studies were conducted, 2006-2012 for CRC, PC, BC and UC. To identify the dietary patterns, a Principal Components Factor Analysis was conducted. A multilevel logistic regression was adjusted for the risk analyses., Results: Characteristic dietary patterns in the whole population, and in women and men independently, were identified. In the whole population South Cone and Sweet Beverages patterns behaved as promoters for CRC and UC while the Prudent Pattern had a protective effect. Female South Cone, Rural and Starchy patterns were associated to a higher BC risk. Prudent Pattern lowered BC risk. In men, South Cone, Sweet Beverages and Typical Measured patterns promoted PC., Conclusion: It is necessary to promote a regular intake of vegetables, fruits and diary products (although a moderate intake for men), and to reduce red meat (especially fat meat), processed meat, starchy vegetables, wine and sweet beverages intakes, to prevent the occurrence of cancer. In men, it is recommended a moderate intake of egg. In women, it is advised a moderate intake of refined grains, bakery products, oils and mayonnaise intake., (Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.)

Introduction: Several studies have shown the effect of dietary patterns on breast cancer risk, but none has been conducted in Argentina. The aim of this study was to extract dietary patterns from Food Frequency Questioner, to estimate their effect on breast cancer occurrence while taking into account aggregation factors (family history of breast cancer) and to explore the sensitivity of the estimates to changes in the assumptions., Methods: A principal component exploratory factor analysis was applied to identify dietary patterns, which were then included as covariates in a multilevel logistic regression. Family history of BC was considered as a clustering variable. A multiple probabilistic sensitivity analysis was also performed., Results: The study included 100 cases and 294 controls. Four dietary patterns were identified. Traditional (fat meats, bakery products, and vegetable oil and mayonnaise) (OR III tertile vs I 3.13, 95% CI 2.58-3.78), Rural (processed meat) (OR III tertile vs I 2.02, 95% CI 1.21-3.37) and Starchy (refined grains) (OR III tertile vs I 1.82, 95 % CI 1.18-2.79) dietary patterns were positively associated with BC risk, whereas the Prudent pattern (fruit and non-starchy vegetables) (OR III tertile vs I 0.56, 95% CI 0.41-0.77) showed a protective effect. For Traditional pattern, the median bias-adjusted ORs (3.52) were higher than the conventional (2.76)., Conclusions: While the Prudent pattern was associated with a reduced risk of BC, Traditional, Rural and Starchy patterns showed a promoting effect. Despite the threats to validity, the nature of associations was not strongly affected.

Socioeconomic and demographic transformations are occurring very rapidly in some areas of the world, especially in South America, and are accompanied by changes in lifestyle, dietary patterns, and the epidemiological profile of prevalent diseases. This review examines whether obesity and overweight are related to metabolic syndrome, cardiovascular disease, and cancer in South America. Research carried out in more than 6,000 cases and controls was evaluated, along with most of the available publications related to South America. In South America, obesity and risk factors for cardiovascular disease are related mainly to aging, ethnicity effects, and preventable risky lifestyle conditions. Most of the studies that found an association between cancer and obesity are from the Southern Cone, the geographic area most affected by this pathology. Overall, the prevalence of metabolic syndrome was highest in Chile, followed in decreasing order by Colombia, Peru, Argentina, and Ecuador, with differences noted between urban and rural areas or between urban and periurban areas. Obesity and cancer may be preventable, at least in part, by healthy behavior; hence, exercise, weight control, and healthy dietary habits are important to reduce the risk of these major chronic diseases., (© 2013 International Life Sciences Institute.)

Cancer occurrence is associated with Arsenic (As) in drinking water. In Argentina, there are high As concentrations in groundwater but there is no published evidence yet of an association between geographic patterns of cancer incidence and the distribution of As in groundwater supplies. The purpose of this study is to assess the association between cancer incidence patterns and As in Córdoba province's aquifers. Age standardized incidence rates (ASIRs) were obtained from Córdoba Cancer Registry (CCR), and As data from official reports of monitoring wells. A multilevel model was applied. Total ASIRs by aquifers for males/females were 191.01/249.22 (Rioja plain); 215.03/225.37 (Pampa hills); and 239.42/188.93 (Chaco-Pampa plain). As was associated with increased risk of colon cancer in women, and lung and bladder cancers in both sexes. It had no association with breast cancer. ASIRs were related to As, controlling for unobserved heterogeneity. An overlapping pattern of higher As and higher risks was evident for lung, bladder and female colon cancers.

Cancer is the second cause of death in Argentina; nevertheless the distribution of the cancer incidence rates throughout the country is unknown. This study was conducted to describe cancer incidence patterns in Córdoba Province. Incidence data were supplied by the Government Córdoba Cancer Registry. Demographic information (age, sex, and place of residence) and diagnosis, certified by a pathologist, about all incident cases from June 2003 to May 2005 by type and 5-year age groups were obtained. Comparison of the incidence rate of cancer in various counties was performed by using standardized incidence rates (SIR) per 100,000 inhabitants using the world standard population. Estimated SIRs were used to build up incidence maps. Two indicators were created: sex ratio and site-specific ratio. Mixed Poisson models were fitted. Taken as a whole for all counties, SIR was 121.42 and 141.57 for men and women, respectively. The most common sites in men were prostate (13.62), lung (10.12), colon (7.53), and bladder (7.03); in women were breast (22.51) and colon (3.31). The highest and lowest rates were in urban and rural areas, respectively. Cancer registry has a pivotal role in cancer control. Such information is the primary resource of information not only for epidemiological research on cancer determinants but also for planning and evaluating health services for the policies of prevention, diagnosis and treatment of the disease.

Background: Obesity has become a threat to public health, as the epidemic is not confined to developed countries but is affecting many developing countries. Because obesity is known to vary according to socio-cultural factors, including socio-economic position and social roles, a multi-stage random sample population-based study was conducted in Córdoba, Argentina, from January 2005 to December 2006, to explore the effect of selected social factors on the prevalence of obesity., Methods: Information was obtained about demographic, anthropometric, lifestyle, dietary and physical activity characteristics. Logistic regression (LR) and proportional odds models (POM) were used in data analysis., Results: The prevalence of overweight and obesity was 52 and 17%, respectively. LR models revealed that overweight was positively associated with gender (men), decreasing socio-economic status (SES), married and divorced status and negatively with increasing levels of physical activity whereas obesity was positively associated with decreasing SES levels, married status and negatively associated with physical activity levels. POM revealed strong associations between variables and the outcomes and an effect modification among women aged 30 years or older with a low SES., Conclusions: Our data indicate a high prevalence of overweight and obesity in this population; several social factors and lifestyle characteristics are associated with both overweight and obesity. However, a prospective cohort study would be needed to investigate causality., (© Published by Elsevier Ltd on behalf of Asia Oceania Assoc. for the Study of Obesity.)