Adelson Luiz Araújo Tinôco

Body fat assessment by bioelectrical impedance and its correlation with different anatomical sites used in the measurement of waist circumference in children

OBJECTIVE: To compare the different anatomical sites used in the measurement of waist circumference, as well as the effectiveness of these landmarks to predict the percentage of body fat by tetrapolar bioelectrical impedance analysis. METHODS: We evaluated 205 children from 6 to 9 years of age of both sexes. Data on weight, height and waist circumference were collected at three different sites: at the lower abdominal curvature, above the navel and at the midpoint between the last rib and the iliac crest. Nutritional status was assessed through the body mass index (BMI)/age as recommended by the World Health Organization. RESULTS: The sample was considered homogeneous in terms of sex, and the mean age was 7.2±1.2 years. Regarding nutritional status, 6.3% of the children had low weight, 75.1% were eutrophic, 7.3% were overweight, and 11.2% were obese. Among males, there was no statistical difference between the different sites of measurement; in females, the measurement above the navel was statistically higher. In the correlation analysis, the midpoint measurement showed the best correlation with percentage of body fat, with values of 0.50 in boys and 0.62 in girls. CONCLUSION: Waist circumference measured at the midpoint between the last rib and the iliac crest presented the best correlation with percentage of body fat.

Avaliação dos resultados da atenção multiprofissional sobre o controle glicêmico, perfil lipídico e estado nutricional de diabéticos atendidos em nível primário

OBJECTIVE: This work evaluates the multiprofessional intervention results on glucemic control, lipid profile, and nutritional status of diabetic patients, who received primary level health care in Belo Horizonte, state of Minas Gerais, Brazil. METHODS: An examination was carried out, to evaluate the levels of glucemia, body mass index, and lipid profile of 190 type-2 diabetic patients (31 to 83 years old), assisted during the period of 1993 to the year 2000. The data were collected at the 1st. consultation on nutrition, and after three months, whereas some data were also collected at a 3rd. moment (6 months after the initial consultation). RESULTS: Initially, the registered data were the high average and medium values for body mass index, fasting glucemia, total cholesterol, LDL-c and triglycerides. Over the first three months after intervention, a significant reduction occurred in the body mass index (from 28.3 to 27.8kg/m2), fasting glucemia levels (from 178.5 to 135.0mg/dL), total cholesterol (from 251.0 to 230.0mg/dL), LDL-c (from 185.5 to 159mg/dL) and triglycerides (from 243.0 to 190.0mg/dL); however, no alteration occurred in the HDL-c levels. The patients with body mass index <30kg/m2, as well as those with a more recent history of diabetes obtained better outcomes. CONCLUSION: This studys results allow us to conclude that multiprofessional health care is fundamental in controlling diabetes, and such care should begin as soon as possible.

Comparison of functional autonomy with associated sociodemographic factors, lifestyle, chronic diseases (CD) and neuropsychiatric factors in elderly patients with or without the metabolic syndrome (MS)

The objective of this study was to compare autonomy and its associated factors in the elderly with and without MS. This study was a cross-sectional evaluation comprised of 402 subjects aged 60 years or older, of both sexes, consulting at the Family Health program, in Viçosa/MG. Autonomy was classified according to the Group of Latin American Development to Maturity (GDLAM) protocol and MS according to classification of the International Diabetes Federation. The independent variables were sociodemographic gender, age, marital status, education, those related to lifestyle including levels of physical activity and sedentary behavior, neuropsychological aspects included depressive symptoms, level of cognition and the presence of CD. A multiple linear regression model was used to estimate associations of variables with autonomy in the elderly with or without the MS. In the elderly group without MS, autonomy was associated with increasing age, sedentary behavior and depressive symptoms. In the group of elderly patients with MS, in addition to these factors, autonomy was also associated with being illiterate, not being physically active and presenting chronic illness. It was concluded that the presence of MS worsened the functional autonomy of elderly persons.

Anthropometry and physical activity level in the prediction of metabolic syndrome in children

OBJECTIVE To evaluate the effectiveness of anthropometric measures and physical activity level in the prediction of metabolic syndrome (MetS) in children. DESIGN Cross-sectional study with children from public and private schools. Children underwent an anthropometric assessment, blood pressure measurement and biochemical evaluation of serum for determination of TAG, HDL-cholesterol and glucose. Physical activity level was calculated and number of steps per day obtained using a pedometer for seven consecutive days. SETTING Viçosa, south-eastern Brazil. SUBJECTS Boys and girls (n 187), mean age 9·90 (SD 0·7) years. RESULTS Conicity index, sum of four skinfolds, physical activity level and number of steps per day were accurate in predicting MetS in boys. Anthropometric indicators were accurate in predicting MetS for girls, specifically BMI, waist circumference measured at the narrowest point and at the level of the umbilicus, four skinfold thickness measures evaluated separately, the sum of subscapular and triceps skinfold thickness, the sum of four skinfolds and body fat percentage. CONCLUSIONS The sum of four skinfolds was the most accurate method in predicting MetS in both genders.

Identificação da área de influência do serviço de atenção básica do sistema público de saúde à população idosa, município de Viçosa-MG

This study aimed to describe the demographic and epidemiological characteristics of the elderly population, identify the area of influence of basic care in relation to the area of residence of the elderly and the rate of service use, as well as to map the demand according to the geographic location of the Basic Care Unit. The sample comprised 6,964 male and female subjects aged 60 years or more, who sought any of the outpatient public health services between May 2003 and April 2004. From this total, 64.1% were women and 35.9% men. The results show that cardiovascular diseases account for the greater part of medical consultations in the health system, with a mean of 3,576 consultations per year per elderly. Geographic mapping showed the demand for medical consultations in determinate basic care units to be related with the medical specialty available at these units. These results allow identifying the neighborhoods with the highest concentrations of specific diseases, indicating the need for insertion/redistribution of professionals between the basic care units in order to improve the quality of life of the elderly.

Different waist circumference measurements and prediction of cardiovascular risk factors and metabolic syndrome in children

SUMMARY OBJECTIVE To compare the effectiveness of three waist circumference (WC) measurement sites to predict cardiovascular risk factors and metabolic syndrome (MS) in Brazilian children. METHODS 187 children (mean age = 9.9 ± 0.7 years) were evaluated for weight, height, WC at three different sites: midpoint between the lower rib and iliac crest (WC1), umbilicus (WC2), and narrowest waist (WC3). Skinfolds (triceps and subscapular) and blood pressure were also measured. Analyses for triglycerides, HDL-C and glucose were carried out in 141 children. RESULTS For boys, the most accurate predictor of overweight and obesity (from body mass index, BMI) and low HDL-C levels was WC3, and for high percentage of body fat (from skinfolds) was WC1. For girls, WC2 was the most accurate predictor of MS, and hypertriglyceridemia, and for overweight and obesity, high body fat percentage, and low HDL-C levels, WC3 was the best predictor. WC1 was the most accurate in the prediction of high blood pressure. CONCLUSIONS Each WC measurement site was accurate in predicting cardiovascular risk factors and MS. However, our results indicate that WC3 was the best predictor of cardiovascular risk factors and MS in boys and girls.

LIPID PROFILE AND ASSOCIATED FACTORS AMONG ELDERLY PEOPLE, ATTENDED AT THE FAMILY HEALTH STRATEGY, VIÇOSA/MG.

BACKGROUND the aging population has been accompanied by epidemiological changes of the Brazilian population, with the highlight being the continued growth of the prevalence of non-communicable chronic diseases especially cardiovascular or artery-coronary, resulting from changes in the lipid profile of the elderly. OBJECTIVE this study had the aim to describe the behavioral, anthropometric, lifestyle and body composition factors and their association with changes in the lipid profile of elderly people. METHODOLOGY the sample included 402 participants attended at the Family Health Strategy, Viçosa (MG), to which a questionnaire with socio-demographic, behavioral and lifestyle information was applied. Blood sample was collected to obtain the lipid fractions, and the weight, height, waist circumference and body fat percentage were measured. Multiple linear regression was performed to identify independently associated factors with changes in each of the selected lipid fractions. RESULTS the factors independently associated with increased levels of total cholesterol were the presence of sedentary behavior, high body fat percentage, greater waist height and greater waist circumference. The consumption of alcoholic beverages and a higher waist-hip ratio remained independently associated with decreased high-density lipoprotein levels. The increased waist circumference was independently associated with low values of the low-density lipoprotein levels. The value of increased triglyceride was independently associated with higher waist-hip ratio, higher body mass index and smoking. CONCLUSIONS modifiable risk factors associated with a changed lipid profile should be prioritized among the actions to be considered in structuring health programs for the elderly.

Skinfold reference curves and their use in predicting metabolic syndrome risk in children

OBJECTIVES To draw skinfold (SF) reference curves (subscapular, suprailiac, biceps, triceps) and to determine SF cutoff points for predicting the risk of metabolic syndrome (MetS) in children aged 6-10 years old. METHODS This was a cross-sectional study with a random sample of 1480 children aged 6-10 years old, 52.2% females, from public and private schools located in the urban and rural areas of the municipality of Uberaba (MG). Anthropometry, blood pressure, and fasting blood samples were taken at school, following specific protocols. The LMS method was used to draw the reference curves and ROC curve analysis to determine the accuracy and cutoff points for the evaluated skinfolds. RESULTS The four SF evaluated (subscapular, suprailiac, biceps, and triceps) and their sum (∑4SF) were accurate in predicting MetS for both girls and boys. Additionally, cutoffs have been proposed and percentile curves (p5, p10, p25, p50, p75, p90, and p95) were outlined for the four SF and ∑4SF, for both genders. CONCLUSION SF measurements were accurate in predicting metabolic syndrome in children aged 6-10 years old. Age- and gender-specific smoothed percentiles curves of SF provide a reference for the detection of risk for MetS in children.

Prevalence and factors associated with vitamin B 12 deficiency in elderly from Viçosa/MG, Brasil

The prevalence of vitamin B12 nutritional deficiency increases with age and it is particularly common in elderly people. The objective this study was determining its prevalence and the factors associated with this condition in non-institutionalized elderly from Vicosa, Minas Gerais State, Brazil.a cross-sectional, population-based study was conducted in order to identify the prevalence and the factors associated with vitamin B12 deficiency among the elderly population in Vicosa (MG). Data were collected from August 2011 to June 2012, by means of a household survey and hematological and biochemical tests performed in 340 elderly.the prevalence of vitamin B12 deficiency in this group was 17.4% (95% CI, 13.4% - 21.4%). Cognitive impairment appears to be an important factor related to vitamin B12 deficiency.the current paper contributes to studies that emphasize some factors that may affect elderly performance in their natural aging process, especially when these factors are associated with cognitive impairment and lead to significant disability and loss of quality of life. Thus, the herein presented results were able to provide more comprehensive knowledge on the relation between B12 deficiency and its impact on this population. They also proved to be relevant for planning public health programs and initiatives that target on this age group.UNLABELLED The prevalence of vitamin B12 nutritional deficiency increases with age and it is particularly common in elderly people. The objective this study was determining its prevalence and the factors associated with this condition in non-institutionalized elderly from Viçosa, Minas Gerais State, Brazil. METHODS a cross-sectional, population-based study was conducted in order to identify the prevalence and the factors associated with vitamin B12 deficiency among the elderly population in Viçosa (MG). Data were collected from August 2011 to June 2012, by means of a household survey and hematological and biochemical tests performed in 340 elderly. RESULTS the prevalence of vitamin B12 deficiency in this group was 17.4% (95% CI, 13.4% - 21.4%). Cognitive impairment appears to be an important factor related to vitamin B12 deficiency. CONCLUSIONS the current paper contributes to studies that emphasize some factors that may affect elderly performance in their natural aging process, especially when these factors are associated with cognitive impairment and lead to significant disability and loss of quality of life. Thus, the herein presented results were able to provide more comprehensive knowledge on the relation between B12 deficiency and its impact on this population. They also proved to be relevant for planning public health programs and initiatives that target on this age group.

Nível de atividade física como preditor de fatores de risco cardiovasculares em crianças

This study evaluated the effectiveness of the physical activity level (PAL), engagement in physical activity of moderate to vigorous intensity (MVPA) and number of steps/day as prediction of cardiovascular risk factors (CVRF) in children. We measured anthropometric parameters, body composition, blood pressure, blood glucose, HDL-c and triglycerides. The PAL and engagement in MVPA were obtained using a questionnaire and computing number steps/days with a pedometer. Participants were 187 children, with a mean age of 9.90 (± 0.7) years. The PAL showed a significant area under the ROC curve as a predictir of obesity, high body fat %, and high blood pressure (HBP) in girls. The PAL accurately predicted obesity and metabolic syndrome (MS), and MVPA accurately predicted MS and HBP in boys. Boys who achieved the recommended 13.000 steps/day were protected from MS and low HDL-c. Achieving the recommendations of engagement in MVPA and number of steps were protection against CVRFfactors in children.En este estudio se evaluo la efectividad del nivel de actividad fisica (NAF), la participacion en la actividad fisica de intensidad moderada a vigorosa (ATMV) y el numero de pasos / dia para la prediccion de los factores de riesgo cardiovascular (FRCV) en ninos. Medimos las medidas antropometricas, composicion corporal, presion arterial, glucemia, colesterol HDL y trigliceridos. NAF y la participacion en ATMV se obtuvieron los registros de la actividad fisica y los pasos podometro por numero. 187 ninos participan 9,90 ± 0,7 anos. NAF tuvo un area bajo la curva ROC significativa para la prediccion de la obesidad, alto% de grasa corporal y la presion arterial enmendada (PAE) en las ninas. NAF fue precisa en la prediccion de la obesidad y el sindrome metabolico (SM) y moderada a vigorosa fue precisa en la prediccion de SM y PAE en los ninos. Los ninos que alcanzaron la cantidad recomendada de 13000 pasos /dia fueron protegidos de la SM y bajo HDL-c. Alcanzar las recomendaciones de la participacion en ATMV y el numero de pasos proteger a los ninos de los FRCV.