Ana Paula Muraro

Prevalência e fatores associados aos comportamentos sedentários em adolescentes

OBJECTIVE To analyze the prevalence of sedentary behavior and associated factors in adolescents. METHODS A cross-sectional study with adolescents aged 10 to 17 years, of both sexes, belonging to a 1994-1999 birth cohort in the city of Cuiabá, MT, Central Western Brazil. Data were collected using a questionnaire containing sociodemographic, economic, lifestyle and anthropometric variables. Sedentary behavior was determined as using television and/or computer/video games for a time greater than or equal to 4 hours/day. Associations with sedentary behavior were evaluated using body mass index in childhood and adolescence and sociodemographic and behavioral variables using hierarchical logistic regression. RESULTS The overall prevalence of sedentary behavior was 58.1%. Of the 1,716 adolescents evaluated, 50.7% (n = 870) were male. In multivariate analysis, after adjustment for confounding factors, the variables that remained associated with sedentary behavior were: age (14 and over) (OR = 3.51, 95%CI 2.19;5.60); higher socioeconomic class (OR = 3.83, 95%CI 2.10;7.01), higher level of maternal education (OR = 1.81, 95%CI 1.09;3.01); living in the country (OR = 0.49, 95%CI 0.30;0.81); insufficient physical activity (OR = 1.25, 95%CI 1.02;1.53); experimentation with alcoholic beverages (OR = 1.34, 95%CI 1.08;1.66) and being overweight in adolescence (OR = 1.33, 95%CI 1.06;1.68). CONCLUSIONS The high proportion of adolescents in sedentary activities and the lack of association with being overweight in childhood, indicates the need for educational initiatives to reduce multiple risk behaviors. Encouraging physical activity in young people as a way of reducing sedentary behavior and, consequently, being overweight is fundamental.OBJECTIVE To analyze the prevalence of sedentary behavior and associated factors in adolescents. METHODS A cross-sectional study with adolescents aged 10 to 17 years, of both sexes, belonging to a 1994-1999 birth cohort in the city of Cuiaba, MT, Central Western Brazil. Data were collected using a questionnaire containing sociodemographic, economic, lifestyle and anthropometric variables. Sedentary behavior was determined as using television and/or computer/video games for a time greater than or equal to 4 hours/day. Associations with sedentary behavior were evaluated using body mass index in childhood and adolescence and sociodemographic and behavioral variables using hierarchical logistic regression. RESULTS The overall prevalence of sedentary behavior was 58.1%. Of the 1,716 adolescents evaluated, 50.7% (n = 870) were male. In multivariate analysis, after adjustment for confounding factors, the variables that remained associated with sedentary behavior were: age (14 and over) (OR = 3.51, 95%CI 2.19;5.60); higher socioeconomic class (OR = 3.83, 95%CI 2.10;7.01), higher level of maternal education (OR = 1.81, 95%CI 1.09;3.01); living in the country (OR = 0.49, 95%CI 0.30;0.81); insufficient physical activity (OR = 1.25, 95%CI 1.02;1.53); experimentation with alcoholic beverages (OR = 1.34, 95%CI 1.08;1.66) and being overweight in adolescence (OR = 1.33, 95%CI 1.06;1.68). CONCLUSIONS The high proportion of adolescents in sedentary activities and the lack of association with being overweight in childhood, indicates the need for educational initiatives to reduce multiple risk behaviors. Encouraging physical activity in young people as a way of reducing sedentary behavior and, consequently, being overweight is fundamental.

Obesidade: principal fator de risco para hipertensão arterial sistêmica em adolescentes brasileiros participantes de um estudo de coorte

OBJECTIVE: To identify the prevalence and factors associated with hypertension in adolescents. SUBJECTS AND METHODS: Cross-sectional study of 1,716 adolescents of a cohort study, aged from 10 to 16 years old sociodemographic, economic, and lifestyle characteristics were obtained from an interview, and birth weight from hospital records. Hypertension was defined as systolic or diastolic blood pressure above the 95th percentile according to the classification recommended by the Second Task Force High Blood Pressure in Children and Adolescents. Nutritional status was diagnosed by body mass index (BMI), according to the z score from curves published by the World Health Organization. Waist circumference was measured at the natural waist. The association between hypertension and the explanatory variables was measured using logistic regression. RESULTS: The adolescents interviewed represent 71.4% of the baseline, and 50.7% of them were males. The prevalence of hypertension was 11.7%. In the multivariate analysis, after adjustment for age sex and skin color, hypertension was associated with obesity [OR = 2.27, (95%) CI = 1.64 to 3.14] but not associated with waist circumference after adjusting for BMI. Early life factors were not associated with hypertension in adolescence. CONCLUSION: The results show an association between obesity and hypertension among adolescents.

O censo escolar como estratégia de busca de crianças e adolescentes em estudos epidemiológicos

Low-cost alternatives that allow for the monitoring of population groups are important strategies in conducting cohort studies. This paper presents the procedures for the use of the National School Census as a search tool for children and adolescents in follow-up studies. The study was conducted among adolescent students who took vaccinations in clinics in Cuiaba, Mato Grosso State, Brazil in 1999. A total of 86.8% were identified in the census and 0.2% in the Mortality Information System. Of those identified, 1,716 were interviewed, representing a follow-up rate of 71.4%. In this study, the school census proved to be an effective method for finding students.

Effect of tobacco smoke exposure during pregnancy and preschool age on growth from birth to adolescence: a cohort study

BackgroundThere is strong evidence of an association between maternal smoking during pregnancy and restriction of intrauterine growth, but the effects of this exposure on postnatal linear growth are not well defined. Furthermore, few studies have investigated the role of tobacco smoke exposure also after pregnancy on linear growth until adolescence. In this study we investigated the effect of maternal smoking exposure during pregnancy and preschool age on linear growth from birth to adolescence.MethodsWe evaluated a cohort of children born between 1994 and 1999 in Cuiabá, Brazil, who attended primary health clinics for vaccination between the years 1999 and 2000 (at preschool age) and followed-up after approximately ten years. Individuals were located in public and private schools throughout the country using the national school census. Height/length was measured, and length at birth was collected at maternity departments. Stature in childhood and adolescence was assessed using the height-for-age index sex-specific expressed as z-score from curves published by the World Health Organization. Linear mixed effects models were used to estimate the association between exposure to maternal smoking, during pregnancy and preschool age, and height of children assessed at birth, preschool and school age, adjusted for age of the children.ResultsWe evaluated 2405 children in 1999–2000, length at birth was obtained from 2394 (99.5%), and 1716 at follow-up (71.4% of baseline), 50.7% of the adolescents were male. The z-score of height-for-age was lower among adolescents exposed to maternal smoking both during pregnancy and childhood (p < 0.01). Adjusting for age, sex, maternal height, maternal schooling, socioeconomic position at preschool age, and breastfeeding, children exposed to maternal smoking both during pregnancy and preschool age showed persistent lower height-for-age since birth to adolescence (coefficient: −0.32, p < 0.001) compared to non-exposed. Paternal smoking at preschool age was not associated with growth after adjustment for confounders.ConclusionExposure to maternal smoking not only during pregnancy, but also at early childhood, showed long-term negative effect on height of children until adolescence.

Effects of social mobility from childhood to adolescence on BMI.

OBJECTIVE Little is known about the contribution of childhood socio-economic position (SEP) and social mobility to weight change. The present study evaluated the effect of family SEP during the pre-school years and social mobility on BMI between birth and adolescence. DESIGN Longitudinal. The SEP of each childs family was classified according to an asset-based wealth index as low, medium or high. Four different categories of childhood-adolescence SEP groups were created in order to examine social mobility: low-medium/high, medium-medium, medium-high and high-high/medium. For each of these categories, BMI was tracked from birth to adolescence. Linear mixed-effects models were used to analyse the data. SETTING Cuiabá-MT, Brazil. SUBJECTS A population-based cohort of children born between 1994 and 1999 was assessed between 1999 and 2000, and again between 2009 and 2011. RESULTS A total of 1716 adolescents were followed from childhood to adolescence (71·4 % of baseline). The prevalence of overweight/obesity was 20·4 % in childhood and 27·7 % in adolescence. A higher SEP in childhood was associated with a greater prevalence of overweight in adolescence. Expressive upward social mobility occurred, mainly in the lowest SEP group. There was a greater rate of change in BMI between birth and adolescence among children with a higher SEP in childhood and children who remained in the higher SEP from childhood to adolescence. CONCLUSION Individuals from a higher SEP in childhood and those who remained in the higher social classes showed greater rate of change in BMI. Thus, initial SEP was the major determinant of changes in BMI.

Mobilidade social, estilo de vida e índice de massa corporal de adolescentes

OBJECTIVE To analyze the association between social mobility, lifestyle and body mass index in adolescents. METHODS A cohort study of 1,716 adolescents aged 10 to 17 years of both sexes. The adolescents were participants in a cohort study and were born between 1994 and 1999. The adolescents, from public and private schools, were assessed between 2009 and 2011. Lifestyle was assessed by interview and anthropometry was used to calculatebody mass index. For the economic classification, both at pre-school age and in adolescence, the criteria recommended by the Brazilian Association of Research Companies were used. Upward social mobility was categorized as an increase by at least one class in economic status within a 10-year-period. Poisson regression was used to estimate the association between upward social mobility and the outcomes assessed. RESULTS Among all respondents (71.4% follow-up of the cohort), 60.6% had upward social mobility. Among these, 93.6% belonged to socioeconomic class D and 99.9% to economy class E. Higher prevalence of social mobility was observed for students with black skin (71.4%) and mulatto students (61.9%) enrolled in public schools (64.3%) whose mothers had less schooling in the first evaluation (67.2%) and revaluation (68.7%). After adjustment for confounding variables, upward social mobility was associated only with sedentary behavior (p = 0.02). The socioeconomic class in childhood was more associated with the outcomes assessed than was upward mobility. CONCLUSIONS Upward social mobility was not associated with most of the outcomes evaluated, possibly as it is discreet and because the period considered in the study may not have been sufficient to reflect substantial changes in lifestyle and body mass index in adolescents.

Agregação familiar e padrões alimentares na população brasileira

The aim of the study was to identify dietary patterns in Brazil and verify aggregation among members of the same family based on the Brazilian National Dietary Survey, a nationwide dietary survey conducted in 2008-2009 in individuals over 10 years of age. Dietary intake was estimated with a food record. Dietary patterns were identified by factor analysis, and familial aggregation was verified by linear regression. Three major dietary patterns were identified: (1) a traditional snack featuring coffee, rolls, oils and fats, and cheese; (2) traditional main meal, based on rice, beans and other legumes, and meat; and (3) fast food type snacks, namely sandwiches, processed meats, soft drinks, snacks, and pizza. Pattern 2 showed the strongest association (β = 0.37-0.64). Patterns 1 and 3 showed positive associations for all pairs of family members, with β ranging from 0.27 to 0.44 and 0.32 to 0.42, respectively. The study showed familial aggregation of dietary patterns in the Brazilian population.The aim of the study was to identify dietary patterns in Brazil and verify aggregation among members of the same family based on the Brazilian National Dietary Survey, a nationwide dietary survey conducted in 2008-2009 in individuals over 10 years of age. Dietary intake was estimated with a food record. Dietary patterns were identified by factor analysis, and familial aggregation was verified by linear regression. Three major dietary patterns were identified: (1) a traditional snack featuring coffee, rolls, oils and fats, and cheese; (2) traditional main meal, based on rice, beans and other legumes, and meat; and (3) fast food type snacks, namely sandwiches, processed meats, soft drinks, snacks, and pizza. Pattern 2 showed the strongest association (β = 0.37-0.64). Patterns 1 and 3 showed positive associations for all pairs of family members, with β ranging from 0.27 to 0.44 and 0.32 to 0.42, respectively. The study showed familial aggregation of dietary patterns in the Brazilian population.

Prenatal follow-up of Haitian and Brazilian women in Mato Grosso

Objectives: to analyze the prenatal follow-up performed by pregnant women in Haiti and Brazil in the state of Mato Grosso. Methods: a cross-sectional study of secondary database, with analysis of SINASC birth records in Mato Grosso between 2013 and 2015, of Brazilian children, born from both Brazilian and Haitian mothers. Variables related to the identification of the newborn and the woman, maternal data on gestational history, including information on prenatal follow-up of the last gestation were evaluated, besides the birth characteristics. Results: 167,820 live births were registered in the state in the period, of which 139 (0.08%) were children of Haitian women. Haitian mothers were older, however with lower schooling when compared to Brazilian mothers. The proportion of mothers of Haitian nationality who had at least 6 prenatal consultations was lower, and the proportion of vaginal births was higher, when compared to Brazilian women. The prevalence of low birth weight among live births of Haitian mothers was also higher. Conclusions: the results of this study point to the need to understand these differences, since some indicators have distanced from those advocated by WHO. These findings may contribute to the public policies development aimed at this population.

Skipping breakfast and associated factors among Brazilian adolescents

Objective To analyze the prevalence and factors associated with breakfast skipping among adolescents. Methods Cross-sectional study, with adolescents aged 10–17 years, evaluated between 2009 and 2011, belonging to a cohort study in the Central-West region of Brazil. Breakfast skipping was considered as not having breakfast every day. Demographic, socioeconomic, and lifestyle factors were evaluated through a questionnaire. Anthropometric assessment included measurement of weight and height, which were used to classify weight status using body mass index. Poisson regression was used to assess the association of breakfast skipping with demographic and socioeconomic variables, lifestyle factors, and weight status. Results Among 1,716 Brazilian adolescents evaluated, 36.2% reported not consuming breakfast every day, with the highest prevalence among girls (p=0.03). After adjusting for age and economic class, breakfast skipping was associated with not consuming breakfast with parents and morning shift at school, in both genders, and with obesity only in boys. Lifestyle factors such as alcohol consumption, physical activity, diet quality, and smoking were not associated with skipping breakfast.

Effects of socioeconomic position and social mobility on linear growth from early childhood until adolescence

OBJECTIVE To assess the effect of socioeconomic position (SEP) in childhood and social mobility on linear growth through adolescence in a population-based cohort. METHODS Children born in Cuiabá-MT, central-western Brazil, were evaluated during 1994 - 1999. They were first assessed during 1999 - 2000 (0 - 5 years) and again during 2009 - 2011 (10 - 17 years), and their height-for-age was evaluated during these two periods.Awealth index was used to classify the SEP of each childs family as low, medium, or high. Social mobility was categorized as upward mobility or no upward mobility. Linear mixed models were used. RESULTS We evaluated 1,716 children (71.4% of baseline) after 10 years, and 60.6% of the families showed upward mobility, with a higher percentage among the lowest economic classes. A higher height-for-age was also observed among those from families with a high SEP both in childhood (low SEP= -0.35 z-score; high SEP= 0.15 z-score, p < 0.01) and adolescence (low SEP= -0.01 z-score; high SEP= 0.45 z-score, p < 0.01), whereas upward mobility did not affect their linear growth. CONCLUSION Expressive social mobility was observed, but SEP in childhood and social mobility did not greatly influence linear growth through childhood in this central-western Brazilian cohort.