Rosario Suárez

Background/Objectives: Cardiovascular disease (CV) is the leading cause of death in Ecuador, and educational workers have been described as exposed to occupational stress and sedentary behavior, factors that may increase cardiometabolic risk. This study evaluated the concordance among three central adiposity indicators, waist circumference (WC), waist-to-hip ratio (WHR), and bioelectrical impedance analysis (BIA)-estimated visceral fat level (VFL), and their associations with cardiometabolic markers and dietary quality (DQ) in educational workers in Loja, Ecuador. Methods: Cross-sectional study of 101 workers (73 women, 28 men; mean age 37.7 years). Adiposity was classified using sex-specific cut-offs for WC (≥90/≥80 cm), WHR (≥0.90/≥0.85) (men/women) and a BIA-estimated VFL (>9). Fasting lipid profiles, fasting glucose, and DQ were assessed once, with DQ evaluated using the Diet Quality Questionnaire (DQQ). Statistical analyses included Cohen’s kappa; Spearman correlation, and binary logistic regression. Results: Overweight or obesity was present in 65.3% of participants, and 57.4% had all three central adiposity indicators simultaneously elevated. Indicator concordance was substantial (κ = 0.625–0.747). Altered cardiometabolic markers were common, notably low HDL-c (49.0%) and impaired fasting glucose (IFG, 32.3%). In exploratory sex-stratified analyses, WHR showed the strongest correlations with triglycerides (r_s = +0.607) and cumulative altered markers (r_s = +0.450). Age ≥ 40 years independently raised odds of IFG (aOR = 5.5; 95% CI: 2.0–15.3) and hypertriglyceridemia (aOR = 3.8; 95% CI: 1.2–11.8). Teaching staff exhibited lower DQ scores than support staff (p = 0.041). DQ scores showed no significant association with metabolic markers. Conclusions: Educational workers in this sample present a heavy burden of central adiposity and metabolic alterations. All three indicators showed substantial concordance; WHR displayed the broadest associations, although the small male subgroup requires larger validation. These associations reflect statistical relationships and agreement in classification, not diagnostic accuracy; no single indicator can be recommended as a standalone screening tool on the basis of these data. Older workers showed a higher burden of cardiometabolic alterations, which may warrant closer attention in future preventive research.

Ultra-processed foods (UPFs) intake has rapidly increased in global diets, posing a mounting threat to nutritional adequacy and functional health in adults. This narrative review summarizes recent evidence on the relationship between UPF consumption and functional decline, including sarcopenia and reduced handgrip strength, and potential biological mechanisms underlying the detrimental effects of high UPF consumption and aging processes. We examined epidemiological studies, clinical trials, and mechanistic research and evaluated the effectiveness and limitations of mitigation strategies, such as product reformulation, front-of-pack labeling, pricing policies, and community-based nutrition programs. Consistent evidence indicates that higher UPF intake is associated with a greater risk of micronutrient inadequacy, low-grade systemic inflammation and oxidative damage, measurable advances in biological age relative to chronological age, and higher risk of functional impairment. Although evidence linking UPF consumption with health and aging outcomes is steadily increasing, several gaps remain, including the underrepresentation of low- and middle-income settings, the lack of long-term intervention trials with aging and functional endpoints, the heterogeneous assessment of UPFs, and the limited use of mechanistic biomarkers and “omics” approaches in population studies. We suggest an interdisciplinary research approach that combines nutritional epidemiology with validated aging outcomes. In parallel, practical policy measures should prioritize minimally processed foods, fortify regulatory frameworks, and customize community and clinical interventions to meet the needs of older adults, thereby safeguarding healthy aging.

Objective: To evaluate the association between adherence to the Mediterranean Diet (MedDiet) and the risk of type 2 diabetes mellitus (T2D) in an urban Ecuadorian population, with emphasis on the protective role of specific dietary components and body composition. Methods: A cross-sectional analytical study was conducted with 1373 adults aged 18–75 years. Adherence to the MedDiet was assessed using the 14-item Mediterranean Diet Adherence Screener (MEDAS-14), while T2D risk was estimated using the Finnish Diabetes Risk Scale (FINDRISC). Anthropometric and body composition parameters were measured using standardized procedures. Adjusted associations between exposure variables and T2D risk were estimated using Poisson regression with robust variance, and prevalence ratios were calculated after controlling for sociodemographic and lifestyle factors. Results: Most participants showed low adherence to the MedDiet (85.2%), which was significantly associated with higher T2D risk. Multivariate analysis of individual dietary components showed relevant associations. Regular consumption of sofrito was associated with lower T2D risk (PR = 0.817; 95% CI: 0.682–0.979; p = 0.028). Similarly, low fruit consumption was associated with a substantially higher T2D risk (PR = 1.350; 95% CI: 1.146–1.589; p = 0.001). In addition, higher body mass index (BMI) and waist circumference (WC) were consistently related to greater T2D risk. Conclusions: Greater adherence to the MedDiet, particularly consumption of key components such as sofrito and fruits, was associated with lower T2D risk. These findings highlight the importance of preventive lifestyle interventions adapted to the Latin American context.

Objective. To evaluate the association between adherence to the Mediterranean Diet (MedDiet) and the risk of developing type 2 diabetes mellitus (T2D) in an urban Ecuadorian population, with emphasis on the protective effect of specific dietary components and body composition. Methods. A cross-sectional analytical study was conducted with 1,373 adults aged 18–75 years. Adherence to the MedDiet was assessed using the MEDAS-14 questionnaire, while the risk of developing T2D was estimated using the Finnish Diabetes Risk Scale (FINDRISC). Anthropometric and body composition parameters were measured using standardized procedures. Adjusted associations between exposure variables and T2D risk were estimated using Poisson regression with robust variance, calculating prevalence ratios and controlling for sociodemographic and lifestyle factors. Results. The majority of participants showed low adherence to the MedDiet (85.2%), which was significantly associated with the risk of T2D. Multivariate analysis of individual dietary components showed relevant associations. Regular consumption of sofrito was associated with a lower risk (PR=0.817; 95% CI: 0.682–0.979; p = 0.028). Similarly, low fruit consumption was associated with a substantially higher risk of T2D (PR = 1.350; 95% CI: 1.146–1.589; p = 0.001). In addition, higher body mass index (BMI) and waist circumference (WC) were consistently related to greater T2D risk. Conclusions. Adherence to the Med Diet and the consumption of key components such as sofrito and fruits are associated with a lower risk of developing T2D, highlighting the importance of preventive lifestyle interventions adapted to the Latin American context.

Background: Cardiovascular diseases (CVD) are the leading global cause of death, disproportionately affecting Latin America. This study evaluated the impact of a contextualized workplace intervention, adapted from the Diabetes Prevention Program (DPP), on reducing cardiovascular risk (CVR) in a Latin American population. Methods: A quasi-experimental, pre-post study was conducted with 100 adults (34 males, 66 females) affiliated with the social security system. The 16-week “Transforma tu vida con cambios diarios” program, included ten sessions focused on motivation, healthy eating and physical activity. Sociodemographic, anthropometric, clinical, and biochemical parameters were measured before and after the intervention. CVR was estimated as a 10-year risk percentage using the non-laboratory Globorisk model. Analysis included paired t-test and Cohen’s d effect sizes. Results: Significant improvements (p < 0.05) were associated with the intervention. The predicted mean CVR score decreased from 8.03% to 6.71% (p = 0.03, d = 0.658). Reductions were observed in weight (73.1 to 71.7 kg, p < 0.001, d = 0.424), BMI (29.0 to 28.5 kg/m², p < 0.001, d = 0.363), and physical inactivity (60% to 39%, p = 0.001). A moderate-low clinical impact was found for systolic blood pressure (124.9 to 121.2 mmHg; p = 0.003, d = 0.301) and glucose (103.3 to 101.1 mg/dL; p = 0.04, d = 0.218) and HDL cholesterol (51.5 to 54.9 mg/dL; p = 0.02, d = −0.286) showed significant but small effects. Conclusions: The intervention was associated with favorable changes in clinical and anthropometric indicators. The results provide preliminary evidence that logistical adaptation to the workplace can effectively reach at-risk Latino populations, with weight and BMI improvements reflecting the program’s strong physical activity component.

Background: Type 2 diabetes (T2D) is a global public health challenge globally. Effective prevention programs must be tailored to cultural and logistical contexts. Purpose: This study evaluated the comparative efficacy of a culturally adapted diabetes prevention program (DPP) intervention versus usual care in reducing T2D risk factors in Ecuadorian institutional settings. Methods: This quasi-experimental study included adults with high T2D risk (FINDRISC score ≥12). Participants voluntarily enrolled to an experimental group (EG, N = 192) receiving a 16-week, 10 session culturally adapted DPP, or a control group (CG, N = 91), receiving usual care. Primary comparative efficacy was assessed using analysis of covariance (ANCOVA), adjusting for key baseline imbalances. Results: Intragroup analysis showed that EG achieved significant reductions in weight (average loss of 1.06%), BMI, and body fat mass (P < .05). However, the primary outcome reduction in FINDRISC score (P = .013) did not retain significance after Holm–Bonferroni correction. The comparative ANCOVA analysis revealed no significant difference between EG and CG for the primary outcomes of weight (P = .330) or FINDRISC score (P = .291). The intervention showed a reduction in systolic blood pressure (SBP) that was statistically significant in the per-protocol analysis (adjusted Δ = −3.338 mmHg; F = 5.160, P = .024), although this effect was attenuated to a trend (P = .079) in a multiply imputed intention-to-treat sensitivity analysis. Conclusion: The short-term, culturally adapted DPP intervention failed to demonstrate superior comparative efficacy in achieving the primary goals of T2D risk reduction or weight loss compared to usual care. Nevertheless, the per-protocol analysis identified a promising reduction in SBP, whose robustness was supported by inverse probability of treatment weighting but attenuated under intention-to-treat multiple imputation. These findings suggest partial efficacy of the short-term adaptation on cardiovascular health and underscore the critical need for longer program duration and strategies to reduce attrition in similar institutional settings.

Cardiovascular diseases are a leading cause of global mortality, with hypertension, obesity, and other factors contributing significantly to risk. Artificial Intelligence has emerged as a valuable tool for early detection, offering predictive models that outperform traditional methods. This study analyzed a dataset of 709 individuals from Ecuador, including demographic and clinical variables, to estimate cardiovascular risk. During preprocessing, records with missing values and duplicates were removed, and highly correlated variables were excluded to reduce multicollinearity and prevent overfitting. The performance of several machine learning algorithms–including Decision Trees, Random Forest, Gradient Boosting, Extreme Gradient Boosting, LightGBM, Extra Trees, AdaBoost, and Bagging–was compared, while addressing class imbalance using SMOTE and a hybrid ROS–SMOTE approach. Gradient Boosting with the hybrid technique achieved the best performance, obtaining an accuracy of 0.87, a precision of 0.81, a recall of 0.74, and an F1-score of 0.75. Its superior performance is attributed to its sequential error correction mechanism and integrated regularization strategies, which effectively reduce overfitting and improve generalization in noisy or imbalanced datasets. These findings demonstrate the potential of AI-based models to improve early detection and management of cardiovascular disease, highlighting the importance of anthropometric, clinical, and blood pressure variables in predicting cardiovascular risk.

Article: Short-medium term complications of bariatric surgery: a pilot study - Minerva Endocrinology 2024 Dec 06 - Minerva Medica - Journals

Background: Type 2 diabetes mellitus (T2D) is an increasingly pressing public health concern in Latin America. Lifestyle modification strategies, such as the Diabetes Prevention Program (DPP) have demonstrated significant benefits in reducing diabetes risk. However, limited evidence exists regarding their effectiveness in Latino communities, particularly when implemented in culturally tailored formats. Methods: This quasi-experimental study was conducted in Loja, Ecuador, from November 2023 to February 2024. A total of 126 adults aged 18 to 75 years with a FINDRISC score of 12 or higher participated in a 10-session, culturally adapted lifestyle intervention based on the DPP model. The intervention addressed motivation, physical activity, and nutrition. Anthropometric measures, body composition, lipid profiles (total cholesterol, HDL-c, LDL-c, and triglycerides), and fasting glucose levels were assessed before and after the intervention. Results: Post-intervention results revealed a statistically significant reduction in fasting glucose (from 107.33 ± 20.09 to 104.80 ± 15.65 mg/dL; p = 0.030), while lipid parameters remained unchanged. Both sexes experienced reductions in weight, with women showing greater improvements in systolic blood pressure, body mass index, waist-to-hip ratio, and body fat mass (p < 0.05). Conclusions: These findings suggest that short-term, culturally adapted lifestyle interventions may offer a feasible and effective strategy to improve glycemic outcomes among Latino adults at risk for T2D in community settings.