Diego Augusto Santos Silva

Prevalence and associated factors with body image dissatisfaction among adults in southern Brazil: a population-based study.

We investigated the prevalence of body image dissatisfaction (BID) and associated factors in Florianopolis, Brazil. BID was analyzed in a sample (N=1720) of adults through the Figure Rating Scale. The independent variables were sociodemographic factors, health behaviors, and morbidities. A multinomial logistic regression analysis was used. More men (14.2%) than women (6.1%) presented BID by being lighter than ideal (LI). Conversely, more women (66.6%) than men (46.3%) showed BID by being heavier than ideal (HI). BID by being HI was higher among older women, those with high BMI and those with a partner. In men, lower BMI and the presence of common mental disorders were associated with BID due to being LI. Advanced ages, alcohol abuse, physical inactivity, and obesity were associated with BID due to being HI. We must consider different public health interventions for men and women to reduce BID in Brazilian adults.

Aptidão física relacionada à saúde de escolares brasileiros: dados do projeto esporte Brasil

OBJETIVE: To analyze the physical fitness of Brazilian schoolchildren, according to a health-referenced criteria assessment. METHODS: This was a cross-sectional, school-based, epidemiological study of 7,507 schoolchildren (4,114 boys and 3,393 girls) aged 7 to 10 years. The following variables were measured: body weight, height, flexibility (sit-and-reach), muscle strength/resistance (1 minute modified abdominal) and cardiorespiratory fitness (9- minute walk/run). The criteria and classifications used for the motor tests were recommended by the Physical Best. RESULTS: The motor tests demonstrated low physical fitness, representing health risk in terms of flexibility (boys: 58.3%; girls: 51.2%, p<0.001), muscle strength/resistance (boys: 75.3%; girls: 73.8%, p<0.001) and cardiorespiratory fitness (boys: 80.8%; girls: 77.6%, p<0.001). The overall classification derived from all the three motor tests showed that very high proportion of the schoolchildren (~96%) did not meet the preestablished cut-offs for a satisfactory level of physical fitness. CONCLUSIONS: Effective intervention programs promoting changes in physical fitness standards are needed in order to contribute to the development of healthier levels of motor performance, especially based on public policy initiatives that provide opportunities for physical activity and sports in neighborhoods, parks and condominiums.

Comparison between the growth of Brazilian children and adolescents and the reference growth charts: data from a Brazilian project

OBJECTIVE To compare the growth of Brazilian children and adolescents with reference growth charts. METHODS School-based cross-sectional study involving 41,654 students (23,328 boys and 18,326 girls) aged 7 to 17 years. Physical growth variables (body weight, height) and body mass index (BMI) were measured. Height, 50th percentile, and BMI, 85th percentile, were compared with the World Health Organization (WHO) reference values, and weight, 50th percentile, was compared with the Centers for Disease Control and Prevention (CDC) growth charts. RESULTS Mean height and body weight of Brazilian schoolchildren were generally higher than the WHO and CDC reference values for both genders at most ages. BMI values of Brazilian schoolchildren were significantly lower than the WHO obesity values at all ages. CONCLUSION The growth in body weight, height, and BMI of children and adolescents in the urban area of Brazil is increasingly similar to those reported in developed countries. Further prospective studies should be conducted in Brazil comparing their results with the international growth charts to enable more accurate inferences.

Clustering of risk behaviors for chronic noncommunicable diseases: a population-based study in southern Brazil.

OBJECTIVE The purpose of this study was to investigate the prevalence and identify factors associated with simultaneous risk behaviors for chronic noncommunicable diseases in adults in a southern capital in Brazil. METHOD A cross-sectional, population-based study was carried out with 1720 adults in Florianópolis, Brazil. The simultaneous occurrence of tobacco smoking, abusive drinking, inadequate or unhealthy diet, and physical inactivity during leisure was assessed. The independent variables were demographic and socioeconomic characteristics. RESULTS Only 8.3% of the respondents did not have any of these factors, whereas the simultaneous occurrence of two or more risk behaviors was 59.4%. The simultaneous presence of four risk behaviors (3.4%) was 220% higher of what would be expected by combining the individual prevalence of these factors (1.5%). The likelihood of individuals having two or more risk behaviors simultaneously was greater in young men, with black skin color, living without a partner, with lower household per capita income, and lower education. CONCLUSION It is necessary to implement programs that reduce the risk behaviors for chronic noncommunicable diseases among adults in Brazil, especially between young men with low education and income.

Sobrepeso e obesidade em escolares brasileiros de sete a nove anos: dados do projeto Esporte Brasil

OBJECTIVES: To describe the prevalence of overweight and obesity in Brazilian schoolchildren aged 7 to 9 years and determine its association with gender, age and geographic region. METHODS: This cross-sectional epidemiological study enrolled 2,913 students (1,478 boys and 1,435 girls) aged 7 to 9 years and was conducted between 2004 and 2005. The body mass index cutoff values proposed by the International Obesity Task Force were used as a diagnostic criterion for overweight and obesity. The chi-square test was used for comparison of proportions, and differences in prevalence rates were determined by testing for comparison between two proportions. RESULTS: The prevalence of overweight and obesity was 15.4% and 7.8% in boys and girls, respectively, with similar proportions in both genders and across all ages. In boys, overweight and obesity were only associated with geographic region (p<0.001), with a higher prevalence found in children from the South region. In girls, the prevalence of overweight was highest among those aged 7 years and those from the North region. In addition, an overall higher prevalence of obesity was observed among children from the South region. CONCLUSIONS: Schoolchildren from the South region of Brazil have a higher prevalence of overweight and obesity than those from other areas of the country. We conclude that overweight and obesity in childhood are on an upward trend, and our findings corroborate the results reported in other Brazilian studies.

Global Cardiovascular and Renal Outcomes of Reduced GFR

The burden of premature death and health loss from ESRD is well described. Less is known regarding the burden of cardiovascular disease attributable to reduced GFR. We estimated the prevalence of reduced GFR categories 3, 4, and 5 (not on RRT) for 188 countries at six time points from 1990 to 2013. Relative risks of cardiovascular outcomes by three categories of reduced GFR were calculated by pooled random effects meta-analysis. Results are presented as deaths for outcomes of cardiovascular disease and ESRD and as disability-adjusted life years for outcomes of cardiovascular disease, GFR categories 3, 4, and 5, and ESRD. In 2013, reduced GFR was associated with 4% of deaths worldwide, or 2.2 million deaths (95% uncertainty interval [95% UI], 2.0 to 2.4 million). More than half of these attributable deaths were cardiovascular deaths (1.2 million; 95% UI, 1.1 to 1.4 million), whereas 0.96 million (95% UI, 0.81 to 1.0 million) were ESRD-related deaths. Compared with metabolic risk factors, reduced GFR ranked below high systolic BP, high body mass index, and high fasting plasma glucose, and similarly with high total cholesterol as a risk factor for disability-adjusted life years in both developed and developing world regions. In conclusion, by 2013, cardiovascular deaths attributed to reduced GFR outnumbered ESRD deaths throughout the world. Studies are needed to evaluate the benefit of early detection of CKD and treatment to decrease these deaths.

Fatores associados à obesidade central em adultos de Florianópolis, Santa Catarina: estudo de base populacional

OBJETIVO: Estimar a prevalencia e os fatores sociodemograficos e comportamentais associados a obesidade central em adultos de Florianopolis, Santa Catarina. METODOS: Pesquisa de delineamento transversal de base populacional com amostra de 1.720 adultos de 20 a 59 anos. A obesidade central foi avaliada pela razao entre as medidas da cintura e estatura, sendo considerada como acima do recomendavel > 0,50. A Regressao de Poisson foi utilizada para estimar Razoes de Prevalencia (RP) nas analises brutas e multivariavel entre a obesidade central e os indicadores sociodemograficos e comportamentos relacionados a saude. Todas as analises foram estratificadas por sexo. RESULTADOS: A prevalencia de obesidade central foi de 50,5% (IC 95%: 46,6-54,4) para os homens e 38,9% (IC 95%: 34,4-43,5) para as mulheres. Apos a analise multivariavel, maiores prevalencias de obesidade central foram observadas para as mulheres com faixa de idade de 50 a 59 anos e aquelas que vivem com companheiro(a) e, com menores prevalencias, para as mulheres com escolaridade maior e igual a 12 anos (RP: 0,63; IC 95%: 0,47-0,85) e maior renda (RP: 0,64; IC 95%: 0,47-0,86). Para os homens, maiores prevalencias foram evidenciadas com a faixa de idade de 50 a 59 anos, que vivem com companheiro(a) e com menor renda. CONCLUSAO: A prevalencia de obesidade central foi elevada nesta populacao e as variaveis demograficas e socioeconomicas foram fortemente discriminantes da prevalencia de obesidade central em ambos os sexos. O conhecimento dos fatores associados a obesidade central pode orientar as intervencoes dirigidas a prevencao deste importante problema de saude publica.

Pré-hipertensão e hipertensão em adultos de Florianópolis: estudo de base populacional

OBJECTIVE To assess the prevalence and factors associated with prehypertension and hypertension among adults. METHODS Population-based cross-sectional study carried out with a sample of 1,720 adults in the city of Florianópolis, southern Brazil, from September 2009 to January 2012. Information on demographic and socioeconomic factors, health-related behaviors, anthropometric measures, morbidities, and self-rated health was collected through household interviews. Systolic and diastolic blood pressure levels were also assessed as well as use of antihypertensive medications and medical diagnosis of hypertension. The dependent variable was categorized as normal blood pressure, prehypertension and hypertension. Polytomous multiple logistic regression analysis was performed with use of a multinomial logit model. RESULTS The overall prevalence of prehypertension and hypertension was 36.1% (95%CI 33.3;38.8) and 40.1% (95%CI 36.6, 43.5), respectively. The polytomous regression analysis showed that prehypertension was significantly associated with males, black skin, 50 - 59 years of age, leisure-time physical inactivity, and pre-obesity. Hypertension was associated with males, 40 years of age or more, intermediary tertile of per capita family income, less than 12 years of schooling, leisure-time physical inactivity, pre-obesity, obesity, abdominal obesity, and negative self-rated health. CONCLUSIONS It is pressing to introduce effective public health policies to control hypertension among adult population in Florianópolis, Southern Brazil.OBJETIVO: Estimar a prevalencia e os fatores associados de pre-hipertensao e hipertensao arterial em adultos. METODOS: Estudo transversal, de base populacional, com 1.720 adultos em Florianopolis, SC, de setembro de 2009 a janeiro de 2010. Informacoes demograficas, socioeconomicas, comportamentos relacionados a saude, medidas antropometricas, morbidades e autopercepcao de saude foram coletadas por meio de entrevistas domiciliares. Niveis de pressao arterial sistolica e diastolica foram avaliados. Adicionalmente perguntou-se sobre a ingestao de medicamentos e diagnostico medico para hipertensao. A variavel dependente foi categorizada em normal, pre-hipertensao e hipertensao arterial. A regressao logistica politomica multipla foi empregada com uso do modelo Logit multinomial. RESULTADOS: A prevalencia de pre-hipertensao e hipertensao arterial foi de 36,1% (IC95% 33,3;38, 8) e 40,1% (IC95% 36,6;43,5), respectivamente. A analise de regressao politomica multipla revelou que a pre-hipertensao esteve associada a homens, cor de pele preta, faixa etaria acima de 50 anos, inativos fisicamente no lazer e com pre-obesidade. A hipertensao arterial esteve associada a homens, cor de pele preta, faixa etaria acima de 40 anos, tercil intermediario de renda per capita, escolaridade menor que 12 anos, inativos fisicamente, pre-obesidade, obesidade, circunferencia da cintura elevada e percepcao negativa do estado de saude. CONCLUSOES: Para controlar a hipertensao arterial na populacao adulta de Florianopolis, e urgente haver politicas publicas eficazes para o combate a pre-hipertensao.

Epidemiology of Abdominal Obesity among Adolescents from a Brazilian State Capital

The objective of this study was to investigate the effects of socioeconomic, demographic and lifestyle factors on abdominal obesity in adolescents from a Brazilian state capital. In this cross-sectional study, 656 high school students (423 girls and 233 boys) from public schools, ranging in age from 14 to 19 yr, were evaluated. Abdominal obesity was identified based on waist circumference. Socioeconomic data (socioeconomic status, household heads education, and school grade), demographic data (gender and age), and information regarding lifestyle (physical activity, eating habits, aerobic fitness, and nutritional status) were collected. Logistic regression was used for multivariate analysis. The prevalence of abdominal obesity was 6.6% (95% confidence interval [CI]: 4.6-8.4). Being in the second (odds ratio [OR] = 0.41; 95% CI: 0.19-0.88) or third year (OR = 0.18; 95% CI: 0.06-0.59) of high school was a protective factor against abdominal obesity. In addition, students presenting low aerobic fitness (OR = 4.10; 95% CI: 1.62-10.4) and those with excess weight (OR = 208.6; 95% CI: 47.7-911.7) had a higher probability of abdominal obesity. In conclusion, demographic factors such as school grade, lifestyle habits, low aerobic fitness and excess weight are associated with central obesity.

Association Between Aerobic Fitness and High Blood Pressure in Adolescents in Brazil: Evidence for Criterion-Referenced Cut-Points

PURPOSE Criterion-referenced cut-points for health-related fitness measures are lacking. This study aimed to determine the associations between aerobic fitness and high blood pressure levels (HBP) to determine the cut-points that best predict HBP among adolescents. METHOD This cross-sectional school-based study with sample of 875 adolescents aged 14-19 years was conducted in southern Brazil. Aerobic fitness was assessed using the modified Canadian Aerobic Fitness Test (mCAFT). Systolic and diastolic blood pressure were measured by the oscillometric method with a digital sphygmomanometer. Analyses controlled for sociodemographic variables, physical activity, body mass and biological maturation. RESULTS Receiver Operating Characteristic (ROC) curves demonstrated that mCAFT measures could discriminate HBP in both sexes (female: AUC = 0.70; male: AUC = 0.63). The cut-points with the best discriminatory power for HBP were 32 mL·kg-1·min-1 for females and 40 mL·kg-1·min-1 for males. Females (OR = 8.4; 95% CI: 2.1, 33.7) and males (OR: 2.5; CI 95%: 1.2, 5.2) with low aerobic fitness levels were more likely to have HBP. CONCLUSION mCAFT measures are inversely associated with BP and cut-points from ROC analyses have good discriminatory power for HBP.