Bruna Celestino Schneider

Fatores de risco comportamentais acumulados para doenças cardiovasculares no sul do Brasil

OBJETIVO: Estimar la prevalencia e identificar factores asociados con la acumulacion de conductas de riesgo en enfermedades cardiovasculares entre adultos. METODOS: Estudio transversal de base poblacional con muestra representativa de 2.732 adultos de ambos sexos de Pelotas, Sur de Brasil, en 2010. Los factores de riesgo conductuales investigados fueron: tabaquismo; inactividad fisica en las horas de ocio; consumo habitual de grasa aparente de la carne, e consumo diario de embutidos, carne roja y leche integral. El desenlace del estudio fue el escore de aglomeracion de factores de riesgo conductuales, variando de cero a tres: ningun factor de riesgo conductual para enfermedades cardiovasculares o exposicion a 1, 2 o > 3 factores de riesgo conductuales. Se realizo regresion logistica multinomial para evaluar el efecto ajustado de las caracteristicas individuales sobre la acumulacion de factores de riesgo conductuales, teniendo como categoria de referencia individuos sin alguno de los factores. RESULTADOS: La inactividad fisica fue el factor de riesgo mas prevaleciente (75,6%), seguido del consumo habitual de grasa aparente de la carne (52,3%). Dos tercios de la poblacion presentaron dos o mas factores de riesgo conductuales. La combinacion de inactividad fisica y consumo habitual de grasa aparente de la carne ocurrio en 17,5% de la muestra; e inactividad fisica, consumo habitual de grasa aparente de la carne y tabaquismo, en 6,7%. Los odds ratios de acumulacion de dos o mas factores fueron mayores entre hombres y se asociaron inversamente con el indicador economico nacional. CONCLUSIONES: La acumulacion de factores de riesgo conductuales en enfermedades cardiovasculares es elevada en la poblacion estudiada. Son necesarias intervenciones publicas capaces de prevenir la ocurrencia simultanea de tales factores.OBJECTIVE To estimate the prevalence of, and identify factors associated with, accumulated risky behavior relating to cardiovascular diseases among adults. METHODS This was a population-based cross-sectional study on a representative sample of 2732 adults of both sexes in Pelotas, Southern Brazil, in 2010. The behavioral risk factors investigated were: smoking; leisure-time physical inactivity; habitual consumption of visible fat in meat; and daily consumption of processed meats, red meat and whole milk. The study outcome was the accumulated behavioral risk factors score, ranging from zero to three: no behavioral risk factor for cardiovascular diseases or exposure to 1, 2 or > 3 behavioral risk factors. Multinomial logistic regression was performed to evaluate the adjusted effect of individual characteristics on behavioral risk factors accumulation, taking individuals without any of these factors as the reference category. RESULTS Physical inactivity was the most prevalent risk factor (75.6%), followed by habitual consumption of visible fat in meat (52.3%). Two thirds of the population presented two or more behavioral risk factors. Combined physical inactivity and habitual consumption of visible fat in meat was observed in 17.5% of the sample; and combined physical inactivity, habitual consumption of visible fat in meat and smoking in 6.7%. The odds ratios for accumulation of two or more risk factors were higher among men and were inversely associated with a national economic indicator. CONCLUSIONS There was a high accumulation of behavioral risk factors for cardiovascular diseases among the study population. Public interventions with the capacity to prevent simultaneous occurrence of these factors are needed.OBJETIVO: Estimar a prevalencia e identificar fatores associados ao acumulo de comportamentos de risco para doencas cardiovasculares entre adultos. METODOS: Estudo transversal de base populacional com amostra representativa de 2.732 adultos de ambos os sexos de Pelotas, RS, em 2010. Os fatores de risco comportamentais investigados foram: tabagismo; inatividade fisica no lazer; consumo habitual de gordura aparente da carne; e consumo diario de embutidos, carne vermelha e leite integral. O desfecho do estudo foi o escore de aglomeracao de fatores de risco comportamentais, variando de zero a tres: nenhum fator de risco comportamental para doencas cardiovasculares ou exposicao a 1, 2 ou > 3 fatores de risco comportamentais. Realizou-se regressao logistica multinomial para avaliar o efeito ajustado das caracteristicas individuais sobre o acumulo de fatores de risco comportamentais, tendo como categoria de referencia individuos sem qualquer dos fatores. RESULTADOS: A inatividade fisica foi o fator de risco mais prevalente (75,6%), seguido do consumo habitual de gordura aparente da carne (52,3%). Dois tercos da populacao apresentaram dois ou mais fatores de risco comportamentais. A combinacao de inatividade fisica e consumo habitual de gordura aparente da carne ocorreu em 17,5% da amostra; e inatividade fisica, consumo habitual de gordura aparente da carne e tabagismo, em 6,7%. Os odds ratios de acumulo de dois ou mais fatores foram maiores entre homens e associaram-se inversamente com o indicador economico nacional. CONCLUSOES: O acumulo de fatores de risco comportamentais para doencas cardiovasculares e elevado na populacao estudada. Sao necessarias intervencoes publicas capazes de prevenir a ocorrencia simultânea desses fatores.

Accumulated behavioral risk factors for cardiovascular diseases in Southern Brazil

OBJETIVO: Estimar la prevalencia e identificar factores asociados con la acumulacion de conductas de riesgo en enfermedades cardiovasculares entre adultos. METODOS: Estudio transversal de base poblacional con muestra representativa de 2.732 adultos de ambos sexos de Pelotas, Sur de Brasil, en 2010. Los factores de riesgo conductuales investigados fueron: tabaquismo; inactividad fisica en las horas de ocio; consumo habitual de grasa aparente de la carne, e consumo diario de embutidos, carne roja y leche integral. El desenlace del estudio fue el escore de aglomeracion de factores de riesgo conductuales, variando de cero a tres: ningun factor de riesgo conductual para enfermedades cardiovasculares o exposicion a 1, 2 o > 3 factores de riesgo conductuales. Se realizo regresion logistica multinomial para evaluar el efecto ajustado de las caracteristicas individuales sobre la acumulacion de factores de riesgo conductuales, teniendo como categoria de referencia individuos sin alguno de los factores. RESULTADOS: La inactividad fisica fue el factor de riesgo mas prevaleciente (75,6%), seguido del consumo habitual de grasa aparente de la carne (52,3%). Dos tercios de la poblacion presentaron dos o mas factores de riesgo conductuales. La combinacion de inactividad fisica y consumo habitual de grasa aparente de la carne ocurrio en 17,5% de la muestra; e inactividad fisica, consumo habitual de grasa aparente de la carne y tabaquismo, en 6,7%. Los odds ratios de acumulacion de dos o mas factores fueron mayores entre hombres y se asociaron inversamente con el indicador economico nacional. CONCLUSIONES: La acumulacion de factores de riesgo conductuales en enfermedades cardiovasculares es elevada en la poblacion estudiada. Son necesarias intervenciones publicas capaces de prevenir la ocurrencia simultanea de tales factores.OBJECTIVE To estimate the prevalence of, and identify factors associated with, accumulated risky behavior relating to cardiovascular diseases among adults. METHODS This was a population-based cross-sectional study on a representative sample of 2732 adults of both sexes in Pelotas, Southern Brazil, in 2010. The behavioral risk factors investigated were: smoking; leisure-time physical inactivity; habitual consumption of visible fat in meat; and daily consumption of processed meats, red meat and whole milk. The study outcome was the accumulated behavioral risk factors score, ranging from zero to three: no behavioral risk factor for cardiovascular diseases or exposure to 1, 2 or > 3 behavioral risk factors. Multinomial logistic regression was performed to evaluate the adjusted effect of individual characteristics on behavioral risk factors accumulation, taking individuals without any of these factors as the reference category. RESULTS Physical inactivity was the most prevalent risk factor (75.6%), followed by habitual consumption of visible fat in meat (52.3%). Two thirds of the population presented two or more behavioral risk factors. Combined physical inactivity and habitual consumption of visible fat in meat was observed in 17.5% of the sample; and combined physical inactivity, habitual consumption of visible fat in meat and smoking in 6.7%. The odds ratios for accumulation of two or more risk factors were higher among men and were inversely associated with a national economic indicator. CONCLUSIONS There was a high accumulation of behavioral risk factors for cardiovascular diseases among the study population. Public interventions with the capacity to prevent simultaneous occurrence of these factors are needed.OBJETIVO: Estimar a prevalencia e identificar fatores associados ao acumulo de comportamentos de risco para doencas cardiovasculares entre adultos. METODOS: Estudo transversal de base populacional com amostra representativa de 2.732 adultos de ambos os sexos de Pelotas, RS, em 2010. Os fatores de risco comportamentais investigados foram: tabagismo; inatividade fisica no lazer; consumo habitual de gordura aparente da carne; e consumo diario de embutidos, carne vermelha e leite integral. O desfecho do estudo foi o escore de aglomeracao de fatores de risco comportamentais, variando de zero a tres: nenhum fator de risco comportamental para doencas cardiovasculares ou exposicao a 1, 2 ou > 3 fatores de risco comportamentais. Realizou-se regressao logistica multinomial para avaliar o efeito ajustado das caracteristicas individuais sobre o acumulo de fatores de risco comportamentais, tendo como categoria de referencia individuos sem qualquer dos fatores. RESULTADOS: A inatividade fisica foi o fator de risco mais prevalente (75,6%), seguido do consumo habitual de gordura aparente da carne (52,3%). Dois tercos da populacao apresentaram dois ou mais fatores de risco comportamentais. A combinacao de inatividade fisica e consumo habitual de gordura aparente da carne ocorreu em 17,5% da amostra; e inatividade fisica, consumo habitual de gordura aparente da carne e tabagismo, em 6,7%. Os odds ratios de acumulo de dois ou mais fatores foram maiores entre homens e associaram-se inversamente com o indicador economico nacional. CONCLUSOES: O acumulo de fatores de risco comportamentais para doencas cardiovasculares e elevado na populacao estudada. Sao necessarias intervencoes publicas capazes de prevenir a ocorrencia simultânea desses fatores.

Prevalência e fatores associados ao consumo de frutas, legumes e verduras entre adolescentes de escolas públicas de Caruaru, PE

This is a cross-sectional school-based study that evaluated the prevalence and associated factors of the daily intake of fruit and vegetables by adolescents at public schools in Caruaru, Pernambuco. Poisson regression with a hierarchical model, including sociodemographic variables in the first hierarchical level, behavioral variables in the second and diet-related variables in the third was used to assess the factors associated with fruit and vegetable intake. The results showed that of the 600 adolescents interviewed, 10% reported never eating fruit and 30.7% mentioned not eating vegetables. Prevalence of fruit intake was 32.9% and vegetables 29.0%. Only 6.5% reported eating both kinds of food daily. Merely the daily vegetable intake showed a significant difference according to sex (higher among girls). Daily fruit intake was 63% higher among adolescents living in urban areas. Not consuming alcohol was associated with higher fruit intake, though not to vegetable intake. Daily intake of fruits and vegetables was 2.4 times higher among adolescents who consumed rice and beans daily. Daily fruit and vegetable intake among adolescents in Caruaru is below the recommendations, and was associated with gender, residence area, consumption of alcoholic beverages and consumption of rice and beans.

Consumo de carnes por adolescentes do Sul do Brasil

OBJETIVO: Descrever a frequencia de consumo de diferentes tipos de carnes conforme variaveis sociodemograficas e nutricionais, e analisar o consumo, em adolescentes do Sul do Brasil, de dieta rica em gordura conforme os tipos de carne consumidos. METODOS: Estudo transversal realizado com adolescentes pertencentes a coorte de nascimentos de 1993, em Pelotas (RS). A frequencia de consumo de carnes vermelhas, brancas, visceras e embutidos foi avaliada por um Questionario de Frequencia de Consumo Alimentar, adaptado para este estudo. A ingestao de dieta rica em gordura foi avaliada a partir do instrumento proposto por Block. As variaveis independentes foram sexo, cor da pele, nivel socioeconomico, escolaridade materna e estado nutricional. Nas analises estatisticas, foram utilizados testes Qui-quadrado de heterogeneidade e de tendencia linear. RESULTADOS: Foram avaliados 4.325 adolescentes com idade media de 14,7, DP=0,3 anos, dos quais 51,2% eram do sexo feminino. A frequencia de consumo diario de carnes vermelhas foi maior do que a de carnes brancas (43,0% e 9,7%, respectivamente). O consumo de embutidos por mais do que quatro vezes por semana foi referido por 48,5% dos individuos, e 81,4% relataram consumir visceras raramente ou nunca. Adolescentes de maior nivel socioeconomico e filhos de maes com maior escolaridade apresentaram maior consumo de carnes vermelhas e embutidos, enquanto aqueles em situacao oposta apresentaram maior consumo de carnes brancas. Adolescentes que consomem carnes com maior frequencia tambem consomem dieta rica em gordura. CONCLUSAO: As carnes consumidas com maior frequencia pelos adolescentes foram as vermelhas e os embutidos. No entanto, adolescentes de maior nivel socioeconomico consomem carnes vermelhas com maior frequencia, enquanto adolescentes menos favorecidos economicamente consomem mais carnes brancas.

Desenho de um questionário de frequência alimentar digital autoaplicado para avaliar o consumo alimentar de adolescentes e adultos jovens: coortes de nascimentos de Pelotas, Rio Grande do Sul

PURPOSE Methodological paper aiming to describe the development of a digital and self-reported food frequency questionnaire (FFQ), created to the 1982 and 1993 Pelotas Birth Cohorts. METHODS The instrument was created based on FFQs previously applied to subjects belonging to both cohorts in the 2004 and 2008 follow-ups. The FFQ was developed including 88 foods and/or meals where frequencies were clustered from a minimum of never or once/month to a maximum of greater than or equal to 5 times/day. The closed options related to portions were based on a 24-hour recall previously asked to a subsample from the 1993 cohort. Three options for portions were created: equal to, less than or greater than. Equal to portion was described based on the 50 percentile of each food consumed reported in a 24-hour recall. Photographs of portions related to the 50 percentile for each food were also included in the software. RESULTS This digital FFQ included food and meals based on the needs of current researches. The layout of the software was attractive to the staff members as well as to the cohort members. The responding time was 12 minutes and the software allowed several individuals to use it at the same time. Moreover, this instrument dismissed interviewers and double data entry. CONCLUSION It is recommended the use of the same strategy in other studies, adapted to different contexts and situations.Purpose: Methodological paper aiming to describe the development of a digital and self-reported food frequency questionnaire (FFQ), created to the 1982 and 1993 Pelotas Birth Cohorts. Methods: The instrument was created based on FFQs previously applied to subjects belonging to both cohorts in the 2004 and 2008 follow-ups. The FFQ was developed including 88 foods and/or meals where frequencies were clustered from a minimum of never or once/month to a maximum of greater than or equal to 5 times/day. The closed options related to portions were based on a 24-hour recall previously asked to a subsample from the 1993 cohort. Three options for portions were created: equal to, less than or greater than. Equal to portion was described based on the 50 percentile of each food consumed reported in a 24-hour recall. Photographs of portions related to the 50 percentile for each food were also included in the software. Results: This digital FFQ included food and meals based on the needs of current researches. The layout of the software was attractive to the staff members as well as to the cohort members. The responding time was 12 minutes and the software allowed several individuals to use it at the same time. Moreover, this instrument dismissed interviewers and double data entry. Conclusion: It is recommended the use of the same strategy in other studies, adapted to different contexts and situations.

How Do Tracking and Changes in Dietary Pattern during Adolescence Relate to the Amount of Body Fat in Early Adulthood

Background Few studies have addressed the influence of dietary patterns (DP) during adolescence on the amount of body fat in early adulthood. Objective To analyze the associations between DP tracking and changes in the period between 15 and 18 years of age and the percentage of body fat (%BF) at age 18 years. Methods We used data from 3,823 members of the 1993 Pelotas (Brazil) birth cohort. Body density was measured at age 18 years by air displacement plethysmograph (BOD POD) and the %BF was calculated applying the Siri equation. Based on the estimates from the FFQ, we identified DP at ages 15 (“Varied”, “Traditional”, “Dieting” and “Processed meats”) and 18 years (“Varied”, “Traditional”, “Dieting” and “Fish, fast food and alcohol”). The DP tracking was defined as the individual’s adherence to the same DP at both ages. Associations were tested using multiple linear regression models stratified by sex. Results The mean %BF was 25.0% (95% CI: 24.7 to 25.4), significantly greater for girls than boys (p<0.001). The adherence to any DP at age 15 years was not associated with the %BF at age 18 years. However, individuals who adhered to a “Dieting” DP at age 18 years showed greater %BF (1.30 and 1.91 percentage points in boys and girls, respectively) in comparison with those who adhered to a “Varied” DP. Boys who presented tracking of a “Dieting” DP presented greater average %BF in comparison with others DP, as well as girls who changed from the “Traditional” or “Processed meats” DP to a “Dieting” DP. Conclusion These results may support public health policies and strategies focused on improving dietary habits of adolescents and young adults and preventing accumulation of body fat, especially among the adolescents with restrictive dietary habits.

Consumo diário de refrigerantes, doces e frituras em adolescentes do Nordeste brasileiro

A school-based cross-sectional study in 2007 evaluated the prevalence and associated factors of daily consumption of soft drinks, sweets and fried foods among adolescents (15 to 20 years of age) in public schools in Caruaru in the state of Pernambuco. To evaluate the factors associated with the daily consumption of the above foods, a multivariate and hierarchical analysis was conducted using Poisson regression, with social and demographic variables at the first hierarchical level, behavioral variables at the second level and dietary standards at the third level. Consumption of soft drinks, sweets and fried foods at least once a week was declared by 90.9%, 95.4% and 89.6% of the adolescents, respectively. The corresponding prevalence of the daily consumption of these items was 30.2%, 42% and 28.3%. The daily consumption of sweets was 21% higher among girls and 25% higher among adolescents who ate rice and beans daily. With respect to fried foods, girls mentioned 37% greater consumption than boys. Adolescents who consumed meat every day admitted a 43% higher daily consumption of fried foods. The consumption of soft drinks, sweets and fried foods among the adolescents from Caruaru was high and showed a homogeneous consumption standard for most variables analyzed.

Consumo de carnes por adultos do sul do Brasil: um estudo de base populacional

This paper is the result of a cross-sectional population-based study that evaluated individuals aged 20 or more living in the urban area of Pelotas in the state of Rio Grande do Sul and sought to describe the frequency of meat consumption and the habit of eating meat with an excess of fat. It evaluated the consumption over the past year of red meat (including bone, steak and ground beef), white meats (chicken and fish) and viscera and processed meats. Of the 2,730 people interviewed, 99.1% (CI95% 98.7 - 99.5) consumed some type of meat over the past year, while around 32% reported daily consumption. The prevalence of consumption of red meat (99.3% CI95% 98.9 - 99.6) and white meat (99.4% CI95% 99.1 - 99.7) was similar. Chicken was the meat most consumed by interviewees (98.0% CI95% 97.4 - 98.5), while viscera were the least consumed (59.1% CI95% 56.4 - 61.7). The processed meats consumed by 85.5% (CI95% 83.7 - 87.2) of the respondents, presented the highest prevalence of daily consumption (16.6%). Meats with excess of fat were consumed by 52.3% (CI95% 49.8 - 54.8) of adults, especially men and people of lower education and economic status.

Determinantes nutricionais precoces da massa livre de gordura no início da vida adulta: revisão sistemática da literatura

Aspectos nutricionais relativos aos primeiros anos de vida podem desempenhar um papel fundamental sobre o desenvolvimento da composicao corporal em outras fases da vida. Foi realizada uma revisao sistematica da literatura, identificando estudos que avaliaram a associacao entre determinantes nutricionais precoces e a massa livre de gordura no inicio da vida adulta. Foram utilizadas as bases de dados eletronicas PubMed e Biblioteca Virtual em Saude. Nove estudos foram incluidos, apos revisao por pares das 576 referencias encontradas, publicados entre os anos de 2003 e 2009, conduzidos com individuos saudaveis e com analise longitudinal. As variaveis peso e altura ao nascer, assim como suas variacoes ao longo da infância, sao fortes preditores da massa livre de gordura em idades posteriores. Os estudos mostram que quanto maior o peso ao nascer e o ganho de peso nos primeiros anos de vida, maior sera a massa livre de gordura na vida adulta. Porem, os dados disponiveis sao poucos e inconclusivos com relacao a alimentacao nos primeiros anos de vida como preditor da massa livre de gordura em idades posteriores.

Diet and body fat in adolescence and early adulthood: a systematic review of longitudinal studies

Adipose tissue is a vital component of the human body, but in excess, it represents a risk to health. According to the World Health Organization, one of the main factors determining excessive body adiposity is the dietary habit. This systematic review investigated longitudinal studies that assessed the association between diet and body fat in adolescents and young adults. Twenty-one relevant papers published between 2001 and 2015 were selected. The most used method for estimating body fat was the body mass index (15 studies). Diet was most commonly assessed by estimating the consumption of food groups (cereals, milk and dairy products) and specific foods (sugar-sweetened beverages, soft drinks, fast foods, milk, etc.). Ten studies found a direct association between diet and quantity of body fat. During adolescence, adhering to a dietary pattern characterized by high consumption of energy-dense food, fast foods, sugar-sweetened beverages and soft drinks, as well as low fiber intake, appears to contribute to an increase in body fat in early adulthood. The findings of the present study suggest that the frequent consumption of unhealthy foods and food groups (higher energy density and lower nutrient content) in adolescence is associated with higher quantity of body fat in early adulthood.