Carolina Perim de Faria

Reprodutibilidade e validade relativa do Questionário de Frequência Alimentar do ELSA-Brasil

Avaliou-se a reprodutibilidade e a validade do Questionario de Frequencia Alimentar (QFA) utilizado no Estudo Longitudinal de Saude do Adulto (ELSA-Brasil). Foram aplicados tres registros alimentares e um QFA em dois momentos no periodo de um ano (n = 281). Valores de energia e nutrientes dos registros alimentares foram deatenuados e Log transformados. Para avaliacao da reprodutibilidade e validade foi aplicado o teste de correlacao intraclasse (CCI) e calculados percentuais de concordância do consumo de nutrientes apos categorizacao por tercis. Na avaliacao da reprodutibilidade, coeficientes de CCI variaram de 0,55-0,83 para proteina e vitamina E, respectivamente; na avaliacao da validade, variaram de 0,20-0,72 para selenio e calcio, respectivamente. Concordâncias exata e adjacente entre metodos variaram de 82,9% para vitamina E a 89% para lipidio e calcio (media = 86%). Foi encontrada uma discordância media de 13,6%. Conclui-se que o QFA ELSA-Brasil apresenta confiabilidade satisfatoria para todos nutrientes e validade relativa razoavel para energia, macronutrientes, calcio, potassio e vitaminas E e C.

Fatores de risco cardiovascular em crianças de 7 a 10 anos de área urbana, Vitória, Espírito Santo, Brasil

The study aimed to identify the simultaneous occurrence of cardiovascular risk factors in children 7 to 10 years of age in Vitória, Espírito Santo State, Brazil, and investigate associated socioeconomic variables. In a sample of 1,282 children, anthropometric data were obtained and blood pressure was measured with an automatic device. Socioeconomic, nutritional, and physical activity data were obtained with a questionnaire. To evaluate the simultaneous occurrence of cardiovascular risk factors, an index was developed including overweight, high blood pressure, poor eating, and sedentary leisure > 4 hours/day. The simultaneous presence of four cardiovascular risk factors was defined as high risk. Socioeconomic status and maternal schooling were included in the logistic regression model. Some 34% of the children presented two cardiovascular risk factors, 20% three factors, and 6.4% four cardiovascular risk factors. Maternal schooling remained associated with high cardiovascular risk (OR: 7.36, 95%CI: 2.09-25.97) and medium risk (OR: 2.57, 95%CI: 1.58-4.20). Low maternal schooling was the most important factor associated with cardiovascular risk.

Reproducibility and relative validity of the Food Frequency Questionnaire used in the ELSA-Brasil

This study evaluated the reproducibility and relative validity of the Food Frequency Questionnaire (FFQ) used in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Participants (n = 281) completed the FFQ and three food records on two occasions during a 12-month period. Energy and nutrient values from food records were disattenuated and log-transformed. Reproducibility and validity were assessed by the intra-class correlation coefficient (ICC). Agreement between the two methods was evaluated by classification in tertiles. In the evaluation of reproducibility, ICC estimated ranged from 0.55 to 0.83 for protein and vitamin E, respectively. On relative validity, ICC ranged from 0.20 to 0.72 for selenium and calcium, respectively. Exact and adjacent agreement between methods varied from 82.9% for vitamin E to 89% for lipids and calcium (mean 86%). Average disagreement was 13.6%. In conclusion, this FFQ showed satisfactory reliability for all nutrients and reasonable validity, especially for energy, macronutrients, calcium, potassium, and vitamins E and C.

Diet assessment in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil): Development of a food frequency questionnaire

OBJECTIVE: The objective of this article is to present the development of the Food Frequency Questionaire used in the Longitudinal Study of Adult Health-Brazil and analyze how diet exposes individuals to cardiovascular diseases and type 2 diabetes Mellitus. METHODS: The Longitudinal Study of Adult Health-Brazil dietary assessment instrument is based on a previously validated Food Frequency Questionaire and the final list of items took into consideration a study done in the six Longitudinal Study of Adult Health-Brazil investigation centers. RESULTS: New foods/preparations were included in the Food Frequency Questionaire with their respective portions, totaling 114 items. The perspectives of dietary analysis and cardiovascular diseases and diabetes are presented in Longitudinal Study of Adult Health-Brazil. CONCLUSION: A new instrument was developed to cover the regional particularities of the study population.

Association between food consumption in the first months of life and socioeconomic status: a longitudinal study

OBJETIVO: Objetivou-se descrever a qualidade do consumo alimentar de criancas a partir da inclusao da alimentacao complementar liquida e semi-solida, nos primeiros meses de vida, alem de determinar as associacoes entre as praticas alimentares e as condicoes socioeconomicas. METODOS: O grupo inicial constituiu-se por 86 bebes com idades de 0 a 3 meses, selecionados em areas de abrangencia de tres Unidades Basicas de Saude do Municipio de Vitoria (ES). Realizaram-se sete visitas domiciliares, coletando-se dados sobre as caracteristicas maternas, o padrao de dieta adotado pelas maes e os habitos de succao da crianca. Os testes de Qui-quadrado foram aplicados e analises de regressao logistica foram realizadas para mensurar as associacoes. RESULTADOS: Aproximadamente 50% iniciaram alimentacao complementar por mamadeira ate os tres meses de vida, enquanto a alimentacao complementar semi-solida ate os seis meses de vida ocorreu em 75% das criancas. Os modelos de regressao logistica mostraram que a ausencia de participacao paterna na renda familiar configura-se como risco para o consumo de feijao (OR=3,9: IC 95%= 1,2-12,6). A renda maior ou igual a dois salarios minimos torna-se potencialmente fator de protecao para o consumo de frutas (OR=0,4: IC 95% 0,14-1,15). CONCLUSAO: Os percentuais de consumo alimentar revelaram a predominância de um padrao inadequado a faixa etaria de menores de dois anos. O grau de instrucao da mae e a participacao direta do pai na renda da familia parecem influenciar nas escolhas de alguns alimentos, como frutas e feijao. Entretanto, nao explicam completamente as praticas alimentares infantis nos primeiros meses de vida, sinalizando que outras questoes mais complexas podem estar envolvidas.OBJECTIVE: This paper aims to describe the quality of the feeding practices of infants from the moment liquids and semi-solid foods are introduced into their diets and to determine associations between feeding practices and socioeconomic status. METHODS: The initial population consisted of 86 infants aged 0 to 3 months; they were selected from 3 Public Primary Healthcare Units of the city of Vitoria. Seven visits were made to the childrens homes to collect descriptive data on the mother, house, eating habits and sucking habits. Chi-square tests were applied and logistic regression analysis was performed to measure the associations. RESULTS: Approximately 50% of the children were given bottles before age 3 months, while semi-solid foods were given to 75% of the infants aged 6 months or less. Logistic regression models showed that the lack of paternal contribution to the familys income is a risk factor for the consumption of beans (OR =3.9; CI - 95% =1.2-12.6). Family income equal to or above two minimum wages was likely to promote fruit consumption (OR =0.4: CI - 95%=0.14-1.15). CONCLUSION: Food variety percentages revealed that most children under two years of age were not being fed properly. The mothers education level and contribution of the father to family income seem to influence the consumption of certain foods, such as fruits and beans. However, they do not fully explain the feeding practices found in the first months of life, showing that other more complex issues may be involved.

Reprodutibilidade da pressao arterial medida no ELSA-Brasil com a monitorizacao pressorica de 24h

OBJECTIVE To determine the reproducibility of casual arterial pressure measurement and to confirm pressure diagnosis by monitoring of participants in the ELSA-Brasil (Estudo Longitudinal de Saúde do Adulto - Brazilian Longitudinal Study for Adult Health). METHODS Casual blood pressure was measured with an oscilometric device. A sub-sample of participants (N = 255) from Espírito Santo state (Southeastern Brazil) was reevaluated using the same methodology following one to ten weeks and, in addition, underwent arterial blood pressure monitoring. Diagnosis of hypertension used cut off points of 140/90 mmHg for casual pressure and 130/80 mmHg for arterial blood pressure monitoring. White coat hypertension was defined as the presence of hypertension in casual blood pressure and normal arterial blood pressure monitoring, and converse findings characterized masked hypertension. RESULTS Data are from 230 participants that on the two occasions were free from antihypertensive medication (N1 = 153) or under the same antihypertensive regimen (N2 = 77). Normotension was confirmed by arterial blood pressure monitoring in 120 out of 134 participants of the N1 group. In N2, blood pressure control was confirmed by arterial blood pressure monitoring in 43 of 54 participants with controlled hypertension per casual blood pressure. Overall diagnostic concordance between casual blood pressure and arterial blood pressure monitoring was 78% (kappa = 0.44). In the N1 group, six subjects (4%) presented white coat hypertension, and 23 subjects (25%) presented with masked hypertension. CONCLUSIONS Diagnostic concordance between casual blood pressure and arterial blood pressure monitoring was moderate. The rigorous standardization of casual blood pressure measurement adopted in the ELSA-Brasil study was able to reduce white coat hypertension. The high frequency of masked hypertension may suggest that pressure values obtained by arterial blood pressure monitoring indicate an elevated degree of stress at work.OBJECTIVE: To determine the reproducibility of casual arterial pressure measurement and to confirm pressure diagnosis by monitoring of participants in the ELSA-Brasil (Estudo Longitudinal de Saude do Adulto - Brazilian Longitudinal Study for Adult Health). METHODS: Casual blood pressure was measured with an oscilometric device. A sub-sample of participants (N = 255) from Espirito Santo state (Southeastern Brazil) was reevaluated using the same methodology following one to ten weeks and, in addition, underwent arterial blood pressure monitoring. Diagnosis of hypertension used cut off points of 140/90 mmHg for casual pressure and 130/80 mmHg for arterial blood pressure monitoring. White coat hypertension was defined as the presence of hypertension in casual blood pressure and normal arterial blood pressure monitoring, and converse findings characterized masked hypertension. RESULTS: Data are from 230 participants that on the two occasions were free from antihypertensive medication (N1 = 153) or under the same antihypertensive regimen (N2 = 77). Normotension was confirmed by arterial blood pressure monitoring in120 out of 134 participants of the N1 group. In N2, blood pressure control was confirmed by arterial blood pressure monitoring in 43 of 54 participants with controlled hypertension per casual blood pressure. Overall diagnostic concordance between casual blood pressure and arterial blood pressure monitoring was 78% (kappa = 0.44). In the N1 group, six subjects (4%) presented white coat hypertension, and 23 subjects (25%) presented with masked hypertension. CONCLUSIONS: Diagnostic concordance between casual blood pressure and arterial blood pressure monitoring was moderate. The rigorous standardization of casual blood pressure measurement adopted in the ELSA-Brasil study was able to reduce white coat hypertension. The high frequency of masked hypertension may suggest that pressure values obtained by arterial blood pressure monitoring indicate an elevated degree of stress at work.

Sodium and potassium intake estimated using two methods in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

CONTEXT AND OBJECTIVE Sodium and potassium intake from different food sources is an important issue regarding cardiovascular physiology. Epidemiological assessment of the intake of these electrolytes intake is done through food frequency questionnaires or urinary excretion measurements. Our aim was to compare these methods using a sample of Brazilian civil servants. DESIGN AND SETTING Cross-sectional baseline evaluation from the Brazilian Longitudinal Study of Adult Health. METHODS Sodium and potassium intake was obtained using two methods: a semi-quantitative questionnaire including 114 food items; and overnight 12-hour urinary excretion measurement. Sodium and potassium estimates obtained through the questionnaire were adjusted for energy intake using the residual method. Urinary excretion measurements were considered valid if they met three adequacy criteria: collection time, volume and total creatinine excretion. Mean nutrients were estimated, and Spearman correlations were calculated. Sodium and potassium intake was categorized into quintiles, and weighted kappa coefficients and percentage agreement were calculated. The significance level for all tests was 0.05. RESULTS Data from 15,105 participants were analyzed, and significant differences between mean intakes of sodium (questionnaire: 4.5 ± 1.7 g; urine: 4.2 ± 2.1 g) and potassium (questionnaire: 4.7 ± 1.8 g; urine: 2.4 ± 1 g) were found. Weak agreement was found for sodium (K = 0.18) and potassium (K = 0.16). The percentage disagreement between methods ranged from 41.8 to 44.5%, while exact concordance ranged from 22.1% to 23.9%. CONCLUSIONS The agreement between the food frequency questionnaire and urinary excretion measurements for assessment of sodium and potassium intakes was modest.

Reproducibility of arterial pressure measured in the ELSA-Brasil with 24-hour pressure monitoring

OBJECTIVE To determine the reproducibility of casual arterial pressure measurement and to confirm pressure diagnosis by monitoring of participants in the ELSA-Brasil (Estudo Longitudinal de Saúde do Adulto - Brazilian Longitudinal Study for Adult Health). METHODS Casual blood pressure was measured with an oscilometric device. A sub-sample of participants (N = 255) from Espírito Santo state (Southeastern Brazil) was reevaluated using the same methodology following one to ten weeks and, in addition, underwent arterial blood pressure monitoring. Diagnosis of hypertension used cut off points of 140/90 mmHg for casual pressure and 130/80 mmHg for arterial blood pressure monitoring. White coat hypertension was defined as the presence of hypertension in casual blood pressure and normal arterial blood pressure monitoring, and converse findings characterized masked hypertension. RESULTS Data are from 230 participants that on the two occasions were free from antihypertensive medication (N1 = 153) or under the same antihypertensive regimen (N2 = 77). Normotension was confirmed by arterial blood pressure monitoring in 120 out of 134 participants of the N1 group. In N2, blood pressure control was confirmed by arterial blood pressure monitoring in 43 of 54 participants with controlled hypertension per casual blood pressure. Overall diagnostic concordance between casual blood pressure and arterial blood pressure monitoring was 78% (kappa = 0.44). In the N1 group, six subjects (4%) presented white coat hypertension, and 23 subjects (25%) presented with masked hypertension. CONCLUSIONS Diagnostic concordance between casual blood pressure and arterial blood pressure monitoring was moderate. The rigorous standardization of casual blood pressure measurement adopted in the ELSA-Brasil study was able to reduce white coat hypertension. The high frequency of masked hypertension may suggest that pressure values obtained by arterial blood pressure monitoring indicate an elevated degree of stress at work.OBJECTIVE: To determine the reproducibility of casual arterial pressure measurement and to confirm pressure diagnosis by monitoring of participants in the ELSA-Brasil (Estudo Longitudinal de Saude do Adulto - Brazilian Longitudinal Study for Adult Health). METHODS: Casual blood pressure was measured with an oscilometric device. A sub-sample of participants (N = 255) from Espirito Santo state (Southeastern Brazil) was reevaluated using the same methodology following one to ten weeks and, in addition, underwent arterial blood pressure monitoring. Diagnosis of hypertension used cut off points of 140/90 mmHg for casual pressure and 130/80 mmHg for arterial blood pressure monitoring. White coat hypertension was defined as the presence of hypertension in casual blood pressure and normal arterial blood pressure monitoring, and converse findings characterized masked hypertension. RESULTS: Data are from 230 participants that on the two occasions were free from antihypertensive medication (N1 = 153) or under the same antihypertensive regimen (N2 = 77). Normotension was confirmed by arterial blood pressure monitoring in120 out of 134 participants of the N1 group. In N2, blood pressure control was confirmed by arterial blood pressure monitoring in 43 of 54 participants with controlled hypertension per casual blood pressure. Overall diagnostic concordance between casual blood pressure and arterial blood pressure monitoring was 78% (kappa = 0.44). In the N1 group, six subjects (4%) presented white coat hypertension, and 23 subjects (25%) presented with masked hypertension. CONCLUSIONS: Diagnostic concordance between casual blood pressure and arterial blood pressure monitoring was moderate. The rigorous standardization of casual blood pressure measurement adopted in the ELSA-Brasil study was able to reduce white coat hypertension. The high frequency of masked hypertension may suggest that pressure values obtained by arterial blood pressure monitoring indicate an elevated degree of stress at work.

Reproducibilidad de la presion arterial medida en el ELSA con el monitoreo de las medidas presoricas de 24h

OBJECTIVE To determine the reproducibility of casual arterial pressure measurement and to confirm pressure diagnosis by monitoring of participants in the ELSA-Brasil (Estudo Longitudinal de Saúde do Adulto - Brazilian Longitudinal Study for Adult Health). METHODS Casual blood pressure was measured with an oscilometric device. A sub-sample of participants (N = 255) from Espírito Santo state (Southeastern Brazil) was reevaluated using the same methodology following one to ten weeks and, in addition, underwent arterial blood pressure monitoring. Diagnosis of hypertension used cut off points of 140/90 mmHg for casual pressure and 130/80 mmHg for arterial blood pressure monitoring. White coat hypertension was defined as the presence of hypertension in casual blood pressure and normal arterial blood pressure monitoring, and converse findings characterized masked hypertension. RESULTS Data are from 230 participants that on the two occasions were free from antihypertensive medication (N1 = 153) or under the same antihypertensive regimen (N2 = 77). Normotension was confirmed by arterial blood pressure monitoring in 120 out of 134 participants of the N1 group. In N2, blood pressure control was confirmed by arterial blood pressure monitoring in 43 of 54 participants with controlled hypertension per casual blood pressure. Overall diagnostic concordance between casual blood pressure and arterial blood pressure monitoring was 78% (kappa = 0.44). In the N1 group, six subjects (4%) presented white coat hypertension, and 23 subjects (25%) presented with masked hypertension. CONCLUSIONS Diagnostic concordance between casual blood pressure and arterial blood pressure monitoring was moderate. The rigorous standardization of casual blood pressure measurement adopted in the ELSA-Brasil study was able to reduce white coat hypertension. The high frequency of masked hypertension may suggest that pressure values obtained by arterial blood pressure monitoring indicate an elevated degree of stress at work.OBJECTIVE: To determine the reproducibility of casual arterial pressure measurement and to confirm pressure diagnosis by monitoring of participants in the ELSA-Brasil (Estudo Longitudinal de Saude do Adulto - Brazilian Longitudinal Study for Adult Health). METHODS: Casual blood pressure was measured with an oscilometric device. A sub-sample of participants (N = 255) from Espirito Santo state (Southeastern Brazil) was reevaluated using the same methodology following one to ten weeks and, in addition, underwent arterial blood pressure monitoring. Diagnosis of hypertension used cut off points of 140/90 mmHg for casual pressure and 130/80 mmHg for arterial blood pressure monitoring. White coat hypertension was defined as the presence of hypertension in casual blood pressure and normal arterial blood pressure monitoring, and converse findings characterized masked hypertension. RESULTS: Data are from 230 participants that on the two occasions were free from antihypertensive medication (N1 = 153) or under the same antihypertensive regimen (N2 = 77). Normotension was confirmed by arterial blood pressure monitoring in120 out of 134 participants of the N1 group. In N2, blood pressure control was confirmed by arterial blood pressure monitoring in 43 of 54 participants with controlled hypertension per casual blood pressure. Overall diagnostic concordance between casual blood pressure and arterial blood pressure monitoring was 78% (kappa = 0.44). In the N1 group, six subjects (4%) presented white coat hypertension, and 23 subjects (25%) presented with masked hypertension. CONCLUSIONS: Diagnostic concordance between casual blood pressure and arterial blood pressure monitoring was moderate. The rigorous standardization of casual blood pressure measurement adopted in the ELSA-Brasil study was able to reduce white coat hypertension. The high frequency of masked hypertension may suggest that pressure values obtained by arterial blood pressure monitoring indicate an elevated degree of stress at work.