Low-value clinical practices - defined as diagnostic or therapeutic interventions that provide limited clinical benefit and may be associated with unnecessary risks or costs - remain common in endocrinology and nutrition. The Spanish Society of Endocrinology and Nutrition (SEEN) presents this second edition as an updated set of recommendations on "what not to do" in clinical practice, developed by its sections and working groups. The methodological process included the selection of relevant topics, systematic literature review, and multidisciplinary consensus. Key areas addressed include diabetes, obesity, nutrition, gonads, lipids, laboratory, mineral metabolism, and imaging, identifying low-value interventions and offering alternatives based on the best available evidence. The implementation of these recommendations aims to optimize care quality, reduce risks, and contribute to the sustainability of the healthcare system.
Introduction: Dyslipidemias are a significant risk factor for cardiovascular diseases. In Peru, nutritional transition and lifestyle changes may be contributing to an increase in the incidence of these metabolic disorders, particularly among the working population.
Objective: To determine the incidence of dyslipidemias and evaluate associated occupational factors in Peruvian workers.
Methods: A retrospective cohort study was conducted using electronic medical records from 4,200 workers attending an occupational health clinic between 2013 and 2022. Incidence rates of hypertriglyceridemia, hypercholesterolemia, and combined dyslipidemia were calculated. Specific occupational factors (type of work, sitting time, and night shift work) were analyzed using Cox regression models adjusted for age (with splines) and sex.
Results: The incidence of hypercholesterolemia (87.22 cases per 1,000 person-years; 95% CI: 79.99-94.45) was significantly higher than that of hypertriglyceridemia (65.71 cases per 1,000 person-years; 95% CI: 59.71-71.72). Combined dyslipidemia showed an incidence of 48.28 cases per 1,000 person-years (95% CI: 43.60-52.97). Workers in social services had a higher risk of developing dyslipidemias (aHR: 1.78; 95% CI: 1.27-2.49) compared to office workers. Prolonged sitting time (>4 h) was significantly associated with an increased risk of hypertriglyceridemia (aHR: 1.28; 95% CI: 1.05-1.56) and combined dyslipidemia (aHR: 1.42; 95% CI: 1.15-1.76).
Conclusions: The high incidence of dyslipidemias-particularly hypercholesterolemia-may reflect the increasing consumption of ultra-processed foods and the ongoing nutritional transition in the Peruvian population. Occupational factors play a crucial role in the development of these metabolic disorders, highlighting the need for specific preventive strategies in the workplace.

