title: Study protocol for the Maule Cohort (MAUCO) of chronic diseases, Chile 2014-2024.
abstract: BACKGROUND
  Maule Cohort (MAUCO), a Chilean cohort study, seeks to analyze the natural history of chronic diseases in the agricultural county of Molina (40,000 inhabitants) in the Maule Region, Chile. Molina´s population is of particular interest because in the last few decades it changed from being undernourished to suffering excess caloric intake, and it currently has the highest national rates of cardiovascular diseases, stomach cancer and gallbladder cancer. Between 2009 and 2011 Molina´s poverty rate dropped from 24.1 % to 13.5 % (national average 20.4 %); in this period the county went from insufficient to almost complete basic sanitation. Despite these advances, chemical pollutants in the food and air are increasing. Thus, in Molina risk factors typical of both under-developed and developed countries coexist, generating a unique profile associated with inflammation, oxidative stress and chronic diseases.
  
  
  METHODS
  MAUCO is the core project of the recently established Advanced Center for Chronic Diseases (ACCDiS), Universidad de Chile & Pontificia Universidad Católica de Chile. In this study, we are enrolling and following 10,000 adults aged 38 to 74 years over 10 years. All eligible Molina residents will be enrolled. Participants were identified through a household census. Consenting individuals answer an epidemiological survey exploring risk factors (psycho-social, pesticides, diet, alcohol, and physical activity), medical history and physical and cognitive conditions; provide fasting blood, urine, and saliva samples; receive an electrocardiogram, abdominal ultrasound and bio-impedance test; and take a hand-grip strength test. These subjects will be re-interviewed after 2, 5 and 7 years. Active surveillance of health events is in place throughout the regional healthcare system. The MAUCO Bio-Bank will store 30 to 50 aliquots per subject using an NIH/NCI biorepository system for secure and anonymous linkage of samples with data.
  
  
  CONCLUSIONS
  MAUCO´s results will help design public health interventions tailored to agricultural populations in Latin America.
authors: Advanced Center for Chronic Diseases (ACCDiS), Facultad Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. cferrec@med.puc.cl.
authors: Catterina
authors: C
authors: Ferreccio
authors: Advanced Center for Chronic Diseases (ACCDiS), Facultad Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors: Juan Carlos
authors: JC
authors: Roa
authors: Advanced Center for Chronic Diseases (ACCDiS), Facultad Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors: Claudia
authors: C
authors: Bambs
authors: Advanced Center for Chronic Diseases (ACCDiS), Facultad Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors: Alejandra
authors: A
authors: Vives
authors: Advanced Center for Chronic Diseases (ACCDiS), Facultad Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors: Alejandro H
authors: AH
authors: Corvalán
authors: Advanced Center for Chronic Diseases (ACCDiS), Facultad Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors: Sandra
authors: S
authors: Cortés
authors: Advanced Center for Chronic Diseases (ACCDiS), Facultad Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors: Claudia
authors: C
authors: Foerster
authors: Advanced Center for Chronic Diseases (ACCDiS), Facultad Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors: Johanna
authors: J
authors: Acevedo
authors: Advanced Center for Chronic Diseases (ACCDiS), Facultad Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.|Facultad Medicina, Universidad Católica del Maule, Talca, Chile.
authors: Andrea
authors: A
authors: Huidobro
authors: Advanced Center for Chronic Diseases (ACCDiS), Facultad Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors: Alvaro
authors: A
authors: Passi
authors: Advanced Center for Chronic Diseases (ACCDiS), Facultad Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors: Pablo
authors: P
authors: Toro
authors: Advanced Center for Chronic Diseases (ACCDiS), Facultad Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors: Yerko
authors: Y
authors: Covacevich
authors: Advanced Center for Chronic Diseases (ACCDiS), Facultad Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors: Rolando
authors: R
authors: de la Cruz
authors: Division of Cancer Epidemiology and Genetics, Infections and Immunoepidemiology Branch, National Cancer Institute, Bethesda, MD, USA.
authors: Jill
authors: J
authors: Koshiol
authors: Hospital Santa Rosa de Molina, Curicó, Chile.
authors: Mauricio
authors: M
authors: Olivares
authors: Advanced Center for Chronic Diseases (ACCDiS), Facultad Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors: Juan Francisco
authors: JF
authors: Miquel
authors: Advanced Center for Chronic Diseases (ACCDiS), Facultad Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors: Francisco
authors: F
authors: Cruz
authors: Facultad Medicina, Universidad Católica del Maule, Talca, Chile.
authors: Raúl
authors: R
authors: Silva
authors: Advanced Center for Chronic Diseases (ACCDiS), Facultad Medicina, Universidad de Chile, Santiago, Chile.
authors: Andrew F
authors: AF
authors: Quest
authors: Advanced Center for Chronic Diseases (ACCDiS), Facultad Ciencias Químicas y Farmacéuticas, Universidad de Chile, Santiago, Chile.
authors: Marcelo J
authors: MJ
authors: Kogan
authors: Advanced Center for Chronic Diseases (ACCDiS), Facultad Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors: Pablo F
authors: PF
authors: Castro
authors: Advanced Center for Chronic Diseases (ACCDiS), Facultad Medicina, Universidad de Chile, Santiago, Chile.|Advanced Center for Chronic Diseases (ACCDiS), Facultad Ciencias Químicas y Farmacéuticas, Universidad de Chile, Santiago, Chile.|Cardiology Division, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors: Sergio
authors: S
authors: Lavandero
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002677:Chile / Q000453:epidemiology; D002908:Chronic Disease / Q000453:epidemiology*; D004032:Diet; D002149:Energy Intake; D015444:Exercise; D005260:Female; D005706:Gallbladder Neoplasms / Q000453:epidemiology; D006801:Humans; D007843:Latin America; D008297:Male; D008875:Middle Aged; D010575:Pesticides / Q000032:analysis; D011203:Poverty / Q000706:statistics & numerical data; D011446:Prospective Studies; D011634:Public Health; D012107:Research Design; D012307:Risk Factors; D012424:Rural Population; D012959:Socioeconomic Factors; D013274:Stomach Neoplasms / Q000453:epidemiology
chemical_list: D010575:Pesticides