Alexandra Dias Moreira

Sugar-Sweetened Soft Drinks and Fructose Consumption Are Associated with Hyperuricemia: Cross-Sectional Analysis from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

The secular trend of hyperuricemia coincides with the substantial increase in the consumption of sugar-sweetened beverages. Our aim was to evaluate the association between the consumption of soft drinks, dietary fructose and unsweetened, non-processed fruit juices with hyperuricemia in a cross-sectional analysis of baseline data (2008–2010; n = 7173) of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). The explanatory variables were the consumption of soft drinks, fruit juice, and fructose using a validated semi-quantitative food frequency questionnaire. The outcomes were hyperuricemia and the uric acid concentration in serum. Regression models were tested, and a significance level of 5% was adopted. In men, the daily consumption of a portion of soft drink/day (250 mL) almost doubled the chance of hyperuricemia with a linear trend. In women, the consumption of ≥0.1 to <1.0 soft drink/day was associated with a higher chance of hyperuricemia, but there was no linear trend. High fructose consumption in men and moderate and high consumption in women were associated with hyperuricemia. All categories of soft drinks consumption were linearly associated with increased serum uric acid levels. Our findings suggest that the consumption of soft drinks and dietary fructose is positively associated with a higher chance of hyperuricemia and higher uric acid levels in Brazilian adults.

Validade e reprodutibilidade de inquérito telefônico de atividade física no Brasil

RESUMO: Introducao: A atividade fisica no Brasil e avaliada pelo Sistema de Vigilância de Fatores de Risco e Protecao para Doencas Cronicas por Inquerito Telefonico (VIGITEL). Objetivo: Avaliar a reprodutibilidade e a validade dos indicadores de atividade fisica do VIGITEL. Metodos: Para o estudo de reprodutibilidade, 305 individuos em Belo Horizonte responderam a entrevistas do VIGITEL repetidas com intervalos de 7 a 15 dias, em 2013. Os indicadores avaliados foram “suficientemente ativos no lazer”, “ativos no deslocamento”, “inativos em quatro dominios da atividade fisica” (lazer, trabalho, transporte e atividades domesticas) e “assistir TV por longos periodos”. O Coeficiente Kappa (k) foi utilizado para medir concordância entre as entrevistas. Para a validade, os participantes responderam tambem o Questionario Global de Atividade Fisica (GPAQ), metodo de referencia para a comparacao dos indicadores VIGITEL. A comparacao foi avaliada por sensibilidade, especificidade, valores preditivos positivos (VPP) e negativos (VPN). Resultados: A reprodutibilidade mostrou concordância substancial para os individuos ativos no lazer (k = 0,70) e inativos (k = 0,64). A concordância do habito de assistir TV foi moderada (k = 0,56) e o deslocamento mostrou concordância regular (k = 0,35). No estudo de validade, a sensibilidade variou de 54,8 a 67,7 na frequencia de inativos e ativos no lazer, respectivamente. O deslocamento foi representado por 11,9 de sensibilidade. A especificidade variou de 72,0 a 91,2 nos quatro dominios da atividade fisica e inativos. Conclusao: O questionario de atividade fisica utilizado pelo Sistema de Vigilância parece ser confiavel em todos os dominios, exceto nas questoes de deslocamento. O VIGITEL foi comparavel ao GPAQ na maioria dos aspectos da atividade fisica.

Consumption of alcohol and blood pressure: Results of the ELSA-Brasil study

Background Prevention and reduction of excessive use of alcohol represents damages to society in general. In turn, arterial hypertension is the main attributable risk factor premature life lost years and disability. Objective To investigate the relationship between alcohol consumption and high blood pressure in participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Methodology A baseline data of total of 7,655 participants volunteers between 35 and 74 years of age, of both genders, in six educational and research institutions of three different regions of the country were interviewed between 2008–2010. Socioeconomic, haemodynamic, anthropometric and health data were collected in the research centers of ELSA-Brasil. The presence of high blood pressure was identified when the systolic blood pressure was ≥140 mm Hg and/or the diastolic was ≥90 mm Hg. Alcohol consumption was estimated and categorized regarding consumption and pattern of ingestion. The Student’s t-test, chi-squared and logistic regression tests were used for analysis, including potential co-variables of the model, and a 5% significance level was adopted. Results A dose-response relation was observed for the consumption of alcohol (g/week) in systolic blood pressure and diastolic blood pressure. Alcohol consumption was associated with high blood pressure in men who reported moderate (OR = 1.69; 95%CI 1.35–2.11) and excessive (OR = 2.70; 95%CI 2.04–3.59) consumption. Women have nearly three times more chance of presenting elevated blood pressure when presenting excessive consumption (OR = 2.86, 95%CI 1.77–4.63), and binge drinkers who drink more than 2 to 3 times a month have approximately 70% more chance of presenting with elevated blood pressure, after adjusting for consumption of drinks with meals. Conclusion The consumption of alcohol beverages increases the odds of elevated blood pressure, especially among excessive drinkers. Therefore alcohol consumption needs a more robust regulation in view of its impact on population health.

Sweetened Soft Drinks Consumption Is Associated with Metabolic Syndrome: Cross-sectional Analysis from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Objective: To estimate the association between regular consumption of sweetened soft drinks, natural fruit juice, and coconut water with metabolic syndrome (MetS). Methods: This was a cross-sectional study including men and women aged 35–74 years from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) Study, excluding patients with type 2 diabetes. The main explanatory variables were beverage consumption and the outcome variable was metabolic syndrome (Adult Treatment Panel III). Results: After adjustments, a daily intake of 250 ml of soft drink increased the chance of metabolic syndrome (odds ratio [OR] = 1.95; 95% confidence interval [CI], 1.60–2.38). There was no association between coconut water and MetS. Moderate consumption of fruit juices has low odds of MetS compared to no consumption. Conclusion: Our results add evidence to potential negative effects of sweetened soft drinks on cluster metabolic abnormalities in middle-income countries.

Association between maternal nutritional extremes and offspring mortality: A population-based cross-sectional study, Brazil, Demographic Health Survey 2006

OBJECTIVE to estimate the association between maternal nutritional extremes and offspring mortality in the Brazilian population. METHODS this cross-sectional study used secondary data from Brazilian women of reproductive age obtained from the National Demographic and Health Survey 2006. Maternal anthropometric indices were used: height, body mass index (BMI), and waist circumference. Logistic regression modelling was used to evaluate the relationship between obesity and offspring mortality. The data analysis was appropriate for the complex sample design. RESULTS children of mothers of short stature were at greater risk of death in the postnatal period than children of mothers of normal height, even after adjusting for sociodemographic characteristics [odds ratio (OR) 4.54, 95% confidence interval (CI) 1.31-15.77]. Maternal obesity was associated with mortality, and children whose mothers were abdominally obese were at greater risk of dying in the neonatal period (OR 3.19, 95% CI 1.23-8.27). Children of mothers who were overweight or obese (BMI≥25kg/m(2)) were at greater risk of dying in the neonatal period (OR 2.41, 95% CI 1.12-5.16), and children of malnourished mothers (BMI<18.5kg/m(2)) were at greater risk of dying during the postneonatal period (OR 9.47, 95% CI 2.07-43.41). CONCLUSION maternal obesity is a risk factor for neonatal death, maternal malnutrition is a risk factor for postneonatal death, and maternal short stature is a risk factor for mortality among Brazilian children.

Prevalência e aglomeração de fatores de risco cardiometabólicos em população idosa residente em área rural

Com este artigo objetivou-se avaliar a prevalencia e aglomeracao dos fatores de risco para doencas cardiovasculares em populacao idosa da arearural. Foi realizado estudo transversal com 236 individuos, com idade entre 60 e 99 anos, residentes em area rural. Os fatores analisados foram:excesso de peso (IMC ≥ 27 kg/m²), obesidade abdominal (circunferencia da cintura ≥ 88 cm para as mulheres e ≥ 102 para os homens), colesteroltotal ≥ 200 mg/dL, triglicerideos ≥ 150 mg/dL, colesterol LDL ≥ 160 mg/dL, colesterol HDL ≤ 40 mg/dL para homens e ≤ 50 mg/dL para mulheres,glicemia ≥ 100 mg/dL, pressao arterial sistolica/diastolica > 140/90 mmHg, tabagismo, sindrome metabolica definida de acordo com criteriosdo National Cholesterol Education Program e escore de dieta ruim. Razoes de prevalencia (RP) e intervalos de confianca de 95% (IC95%) foramcalculados segundo sexo. Foi encontrada aglomeracao de quatro ou mais fatores de risco em 47,4% da populacao. As mulheres apresentaramalta prevalencia de excesso de peso (RP = 1,9; IC95% = 1,05-3,61), obesidade abdominal (RP = 3,1; IC95% = 1,80-5,50), colesterol LDL aumentado(RP = 2,4; IC95% = 1,31-4,21), sindrome metabolica (RP = 2,2; IC95% = 1,25-3,84), hipercolesterolemia (RP = 1,3; IC95% = 1,06-1,68) e dislipidemia(RP = 1,1; IC95% = 1,01-1,29) quando comparadas aos homens. Este estudo confirma a alta prevalencia de fatores de risco cardiovasculares napopulacao idosa e a necessidade de politicas publicas efetivas de prevencao de doencas, objetivando envelhecimento saudavel.(AU) This study assessed the prevalence and clustering of risk factors for cardiovascular diseases in the elderly population of rural areas. This crosssectionalstudy was performed with 236 individuals, aged between 60 and 99 years, residents in a rural area. The factors analyzed were:overweight (BMI ≥ 27 kg/m²), abdominal obesity (waist circumference ≥ 88 cm for women and ≥ 102 for men), total cholesterol ≥ 200 mg/dL, triglycerides ≥ 150 mg/dL, LDL cholesterol ≥ 160 mg/dL, HDL cholesterol ≤ 40 mg/dL for men and ≤ 50 mg/dL for women, blood glucose ≥100 mg/dL, systolic/diastolic blood pressure ≥ 140/90 mmHg, smoking, metabolic syndrome defined according to criteria from the NationalCholesterol Education Program, and bad diet score. Ratios of prevalence (PR) and 95% confidence intervals (IC95%) were calculated according tosex. Agglomeration of four or more risk factors was observed in 47.4% of the population. Women showed high prevalence of overweight (PR = 1.9;IC95% = 1.05-3.61), abdominal obesity (PR = 3.1; IC95% = 1.80-5.50), increased LDL cholesterol (PR = 2.4; IC95% = 1.31-4.21), metabolic syndrome(PR = 2.2; IC95% = 1.25 -3.84), hypercholesterolemia (PR = 1.3; IC95% = 1.06-1.68), and dyslipidemia (PR = 1.1; IC95% = 1.01-1.29) when comparedto men. This study confirms the high prevalence of cardiovascular risk factors in the elderly population and the need for effective public policiesfor prevention, aiming at healthy aging.(AU) Este articulo estima la prevalencia y aglomeracion de factores de riesgo cardiovascular entre la poblacion anciana de una zona rural. Estudiotransversal realizado con 236 individuos entre 60 y 99 anos. Los factores estudiados fueron (IMC≥27kg/m²), obesidad abdominal (circunferencia de...(AU)

Associação entre fatores sociodemográficos e relacionados à saúde com a prática de caminhada em área rural

The regular practice of walking can contribute to a better quality of life, reducing the risk of cardiovascular disease. OBJECTIVE To assess the association between sociodemographic and health factors related to adult practice of walking in the Brazilian rural context. METHODS Cross-sectional study of 567 adults. The outcome variable was the regular practice of walking (≥150 minutes per week) and the explanatory variables were sociodemographic factors, anthropometric measures, laboratory tests and self-perceived health. The chi-square test and Poisson regression were used in analysis, considering p ≤ 0.05. RESULTS Only 34.7% of the population practices walking regularly. Women (PR 0.84, 95% CI 0.78-0.89), age of 31-45 years (OR 1.11, 95% CI 1.02-1.22, comparing to 18-30 years), and self-perception of poor/fair health (OR 0.90, 95% CI 0.84-0.97 comparing to people with great/good health) remained independently associated with regular practice of walking. Conclusion Age between 31 and 45 years and males were positively associated with walking and the perception of poor/fair health had negative association. These findings may suggest that public policies to encourage physical activity in urban areas should also be applied to rural areas.Resumo A pratica regular da caminhada contribui para melhor qualidade de vida, reduzindo riscos para doencas cardiovasculares. O objetivo deste artigo e verificar a associacao entre fatores sociodemograficos e de saude relacionados a pratica de caminhada de adultos no contexto rural brasileiro. Estudo transversal com 567 adultos. A variavel desfecho foi a pratica regular de caminhada (≥ 150 minutos/semana) e as de exposicao foram as sociodemograficas, antropometricas, clinico laboratoriais e autopercepcao de saude. As analises foram realizadas pelo teste do qui-quadrado e regressao de Poisson, considerando p ≤ 0,05. Apenas 34,7% da populacao pratica a caminhada de forma regular. O sexo feminino (RP 0,84; IC95% 0,78–0,89), a idade entre 31-45 anos (RP 1,11; IC95% 1,02–1,22 para comparacao entre pessoas de 18-30 anos) e a autopercepcao de saude ruim/regular (RP 0,90; IC95% 0,84–0,97 para a comparacao entre pessoas com autopercepcao excelente/boa) permaneceram independentemente associadas a pratica regular de caminhada. A idade entre 31-45 anos e o sexo masculino foram positivamente associados a caminhada e a percepcao de saude regular/ruim apresentou associacao negativa. Esses achados podem sugerir que as politicas publicas de incentivo a atividade fisica nas areas urbanas podem ser aplicadas tambem nas rurais.