Catarina Machado Azeredo

Sociodemographic and behavioral factors associated with physical activity in Brazilian adolescents

BackgroundPhysical activity in adolescents is associated with short- and long-term health benefits. Physical activity can occur in various domains and is influenced by a complex network of factors. The aims of this study are 1) to describe the physical activity of Brazilian adolescents in physical education classes, during leisure time, and during active commuting and 2) to investigate the socio-demographic and behavioral factors associated with physical activity.MethodsThe representative sample included 109,104 Brazilian students in the final year of elementary school from 2,842 schools. The weekly frequency and duration of physical activity were assessed. A variety of socio-demographic and behavioral factors were studied. A multiple Poisson regression analysis was used to test for associations between physical activity and the socio-demographic and behavioral variables.ResultsMost of the students (97.0%) engaged in physical activity in at least one of the domains studied, especially physical education at school (81.7%) and leisure time physical activity (67.5%). However, only 29% of the adolescents reached the recommended level of physical activity. Among the adolescents who reached the minimum recommended time for physical activity, the various domains contributed the following proportions to total physical activity: leisure time physical activity (PR 12.5; 95% CI 11.17-13.97), active commuting (PR 1.63; 95% CI 1.59-1.67), and physical education at school (PR 1.36; 95% CI 1.29-1.44). The weekly frequency of all activities was greater among boys than among girls. Moreover, nearly two-thirds (61.8%) of students spent more than two hours per day engaging in sedentary behaviors; the prevalence of sedentary behaviors was similar between boys and girls (59.0 and 64.5%, respectively).Total level of physical activity, leisure time physical activity, and active commuting were associated with higher nutritional scores.ConclusionsPhysical activity is important in any health promotion program. Therefore, it is necessary to invest in policies and interagency initiatives that promote all domains and to ensure that the general population helps determine the scope and design of such policies.

Dietary intake of Brazilian adolescents

OBJECTIVE To analyse the dietary intake of Brazilian adolescents and investigate its association with sociodemographic factors as well as health-risk and health-protective behaviours. DESIGN Cross-sectional study. SETTING The study was based on data supplied by the National Survey of Schoolchildrens Health (2012) on sociodemographic factors, dietary intake and health-risk and health-protective behaviours of schoolchildren in Brazil. A nutritional scale was elaborated combining markers of healthy and unhealthy diets. Poisson regression analysis was applied to investigate the association between the sociodemographic factors and regular intake (≥5 times/week) of selected foods; linear regression analysis was applied to investigate the association of sociodemographic and behavioural factors with nutritional scale score. SUBJECTS A total of 109 104 adolescents attending the ninth year of education at 2842 schools in Brazil. RESULTS Fewer than 30 % of the adolescents consumed raw or cooked vegetables on a regular basis, whereas more than one-third reported regular intake of sweets, soft drinks and sweet biscuits. Adolescents from the southern area and the oldest ones were those most exposed to inadequate dietary intake. The nutritional scale average score was higher in the students attending public school and exhibited a positive correlation with protective behaviours, such as being physically active, having meals with parents and eating breakfast, and a negative correlation with risk behaviours such as eating while studying or watching television and having smoked, drunk alcohol or used other drugs in the previous 30 d. CONCLUSIONS The results indicate an association between undesirable nutritional habits and other risk behaviours among Brazilian adolescents.

A problemática da adesão na prevenção da anemia ferropriva e suplementação com sais de ferro no município de Viçosa (MG)

The scope of this article is to analyze the understanding of mothers and persons responsible for infants taking ferrous sulfate supplement about anemia and its consequences, assessed by the level of adherence to supplementation. A prospective, qualitative and quantitative population study was conducted with non-anemic children not taking supplements to receive prophylactic supplementation with ferrous sulfate for six months. After six months, there was adherence to supplementation. Among the 133 children initially eligible for the study, 97 returned for the second evaluation. Of these, 4 had anemia during the follow-up and began treatment and 3 others were brought in by individuals who were unable to provide information on use of the supplement. High adherence was showed by 56.7% of children and low adherence by 43.3%, while 23.3% had interrupted supplementation due to the lack of guidance and support of the health service. Mothers and persons responsible of the two groups (high and low adherence) manifested little knowledge about anemia, its prevention and health consequences for the child. More information regarding iron deficiency anemia, routine follow-up by professionals and evaluation of the perception of individuals involved with iron supplementation is necessary.

Individual and contextual factors associated with verbal bullying among Brazilian adolescents.

BackgroundFew studies have been carried out in low- middle-income countries assessing contextual characteristics associated with bullying. This study aimed to assess the relative importance of contextual (school and city) and individual-level factors to explain the variance in verbal bullying among a nationally representative sample of Brazilian adolescents.Methods59,348 students from 1,453 schools and 26 state capitals and the Federal District participated in the National Survey of School Health among 9th Grade Students (PeNSE, 2009). We performed multilevel logistic regression in a three level model (individual, school and city).ResultsThe 30-day prevalence of verbal bullying among these students was 14.2%. We found that 1.8% and 0.3% of the total variance in bullying occurred at school-level and city-level, respectively, and 97.9% at individual-level. At city-level, all factors included failed to demonstrate a significant association with bullying (p <0.05) whereas at school-level, private schools presented more bullying than public schools (OR = 1.17, CI 1.04-1.31). At individual-level, male gender, younger age, not living with both parents, exposed to domestic violence, under or overweight were all associated with bullying.ConclusionsAll socioeconomic indicators assessed contributed little to explain the variance in bullying at individual, school or city-level. Population subgroups at risk identified according to their individual profile could be targeted in future interventions in Brazil.

Patterns of health-related behaviours among adolescents: a cross-sectional study based on the National Survey of School Health Brazil 2012

Objectives The aim of this study was to analyse the clustering of multiple health-related behaviours among adolescents and describe which socio-demographic characteristics are associated with these patterns. Design Cross-sectional study. Setting Brazilian schools assessed by the National Survey of School Health (PeNSE, 2012). Participants 104 109 Brazilian ninth-grade students from public and private schools (response rate=82.7%). Methods Exploratory and confirmatory factor analyses were performed to identify behaviour clustering and linear regression models were used to identify socio-demographic characteristics associated with each one of these behaviour patterns. Results We identified a good fit model with three behaviour patterns. The first was labelled ‘problem-behaviour’ and included aggressive behaviour, alcohol consumption, smoking, drug use and unsafe sex; the second was labelled ‘health-compromising diet and sedentary behaviours’ and included unhealthy food indicators and sedentary behaviour; and the third was labelled ‘health-promoting diet and physical activity’ and included healthy food indicators and physical activity. No differences in behaviour patterns were found between genders. The problem-behaviour pattern was associated with male gender, older age, more developed region (socially and economically) and public schools (compared with private). The ‘health-compromising diet and sedentary behaviours’ pattern was associated with female gender, older age, mothers with higher education level and more developed region. The ‘health-promoting diet and physical activity’ pattern was associated with male gender and mothers with higher education level. Conclusions Three health-related behaviour patterns were found among Brazilian adolescents. Interventions to decrease those negative patterns should take into account how these behaviours cluster together and the individuals most at risk.

The Role of School Environment in Physical Activity among Brazilian Adolescents

Objective To analyze the association of physical activity facilities and extracurricular sports activities in schools with physical activity among adolescents. Methodology/Principal Findings We used data collected for the National Survey of School Health in 2012. The national representative sample comprised 109,104 Brazilian students from 2,842 schools. We calculated the prevalence of participation in physical education classes, leisure-time physical activity, and total physical activity level. We also evaluated the following physical activity facilities: sports courts, running/athletics tracks, schoolyard with teacher-directed physical activities, swimming pools, locker rooms; and the offer of extracurricular sports activities. Schools with at least one physical activity facility had increased odds of participation in physical education (OR 1.59; 95% CI 1.20 to 2.10). However, in order to increase leisure-time physical activity (OR1.14; 95% CI 1.03 to 1.26) and total physical activity level (OR 1.15; 95% CI 1.06 to 1.24) at least four and two facilities, respectively, were necessary. Extracurricular sports activities in schools were positively associated with leisure-time physical activity and physical activity level. The number of sports courts and swimming pool in a school were associated with participation in physical education classes. Availability of sports courts, running/athletics tracks, and swimming pool in schools were associated with leisure-time physical activity. Total physical activity was associated with schools with sports courts, schoolyard with teacher-directed physical activities, and swimming pool. Conclusions School-level characteristics have important potential to increase the possibility of engagement in physical activity in and out of school, and therefore have a fundamental role in promoting these practices.

Baixo peso e dependência funcional em idosos institucionalizados de Uberlândia (MG), Brasil

This article seeks to identify the association between nutritional status and functional dependence in institutionalized elderly interns in Uberlândia, Minas Gerais. It involved a cross-sectional study with 233 elderly interns in which sociodemographic variables, nutritional status and degree of dependency were assessed. Multivariate analysis was performed using Poisson regression with robust variance to assess the association between nutritional status and functional dependence of these senior citizens. Low weight by the Body Mass Index was associated with functional dependence after controlling for socioeconomic and demographic variables. The elderly with low weight had a prevalence ratio of dependence of 1.2 times the prevalence rate of dependence of well nourished elderly interns. As reported in the literature, age was also associated with dependence with a prevalence ratio of 1.19 for the longest living. Low weight is an important factor associated with functional disability. Thus, the need for evaluation, monitoring and recovery of nutritional status in the institutionalized elderly is stressed, as in addition to reducing morbidity and mortality from several diseases and improve quality of life, it can also prevent and delay functional dependency.

Coronary heart disease mortality, cardiovascular disease mortality and all-cause mortality attributable to dietary intake over 20 years in Brazil

BACKGROUND/OBJECTIVES In the last two decades, in Brazil, there has been a decreasing trend of consumption of in natura or minimally processed food, while intake of ultra-processed food has markedly increased. We estimated the contribution of dietary intake in trends from coronary heart disease mortality (CHDM), cardiovascular disease mortality (CVDM), and all-cause mortality (ACM) over 20years in Brazil. METHODS We used a representative sample of Brazilian households located in metropolitan areas to estimate dietary intake in 1987/88 and 2008/09. For both periods, we estimated fractions of CHDM, CVDM, and ACM attributable to healthy (fruits and vegetables) and unhealthy food items (sugar-sweetened beverages, processed and red meat). We also estimated the number of prevented or postponed deaths attributable to these food items. RESULTS The fraction of CHDM attributable to all food items increased from 28.6% in 1987/88 to 38.7% in 2008/09. CVDM attributable to food items increased from 13.7% in 1974 to 19.3% in 2008/09. ACM attributable to all food items increased from 20.1% in 1987/88 to 27.3% in 2008/09. Without the decrease in healthy food item consumption, and the increase in unhealthy food items, 3195 deaths from coronary heart disease, 5340 from cardiovascular disease, and 16,970 from all causes could have been prevented or postponed. CONCLUSIONS The burden of cardiovascular diseases and mortality attributable to dietary intake has increased over the last 20years in Brazil. These findings suggest a need for a population prevention approach, focused on dietary intake to reduce the burden of disease.

Maternal depression and bullying victimization among adolescents: Results from the 2004 Pelotas cohort study

Maternal depression impacts on several detrimental outcomes during a childs life course, and could increase their risk of victimization. This longitudinal study examined the association between antenatal maternal depression, postnatal trajectories, and current maternal depression and offspring bullying victimization at 11 years.

Out-of-Home Food Consumers in Brazil: What do They Eat?

Considering the increased contribution of foods consumed outside home and their potential impact on diet, this study aims to identify eating out patterns and their association with nutritional dietary quality in Brazil. We used the Individual Food Intake Survey 2008–2009, conducted with 34,003 individuals aged 10 and up. We used factor analysis by principal component to identify out-of-home eating patterns and linear regression to explore the association between patterns scores and dietary quality. We identified three food patterns. The “Traditional meal” pattern carried more rice, beans, meat, roots and tubers, pasta, vegetables and eggs. The “typical Brazilian breakfast/tea” pattern carried more fresh bread, margarine, milk, cheese and butter. The “Ultra-processed food” pattern carried more ready-to-eat meals and soft drinks. The “traditional meal” pattern was positively associated with calories from proteins, fiber, iron, potassium and sodium densities, whereas “typical Brazilian breakfast/tea” and “ultra-processed food” patterns were positively associated with energy density, the percentage of calories from lipids or carbohydrates, trans fat and free sugar. Out-of-home eating may have a negative impact on nutritional dietary quality when based on ultra-processed food. However, it is possible to maintain a healthy out-of-home diet with adherence to traditional Brazilian cuisine.