Elizabete de Jesus Pinto

Fatores associados à anemia em crianças e adolescentes de escolas públicas de Salvador, Bahia, Brasil

This study aimed to assess factors associated with anemia in schoolchildren. All subjects (N = 1,013; age 7-14 yrs.) were students enrolled in the public school system in Salvador, Bahia State, Brazil. Blood tests were done to determine hemoglobin levels, anthropometric data were collected, and a 24-hour food recall was performed. The study also gathered socioeconomic, environmental, and household data, as well as information on care by the mother. Anemia was detected in 24.5% of subjects, with mean hemoglobin of 12.68g/dL (range 7.7g-16.8g/dL). Anemia was significantly associated with inadequate intake of bioavailable iron (OR50-99.9% adequacy = 1.57; 95%CI: 1.07-2.29; p = 0.020 and OR< 50% adequacy = 1.68; 95%CI: 1.10-2.56; p = 0.016) and family income below 1 minimum wage (OR = 1, 42; 95%CI: 1.03-1.96; p = 0.035). Anemia prevalence in children and adolescents was high, especially among the poorest subjects and those with low intake of bioavailable iron.

Prevalência de pré-hipertensão e de hipertensão arterial e avaliação de fatores associados em crianças e adolescentes de escolas públicas de Salvador, Bahia, Brasil

This study aimed to assess pre-hypertension and hypertension-related factors in 1,125 seven- to-14-year-old subjects enrolled in the public school system in Salvador, Bahia State, Brazil. Exposure variables, namely body mass index, waist circumference, gender, age, physical activity, environmental and housing status, family income, diet, schooling, and maternal age were analyzed by polytomous logistic regression, and the outcome variable was categorized as normal, pre-hypertensive, and hypertensive. Prevalence of high blood pressure was 14.1%, including the prevalence of both hypertension (4.8%) and pre-hypertension (9.3%). An association was shown between pre-hypertension and overweight (OR: 3.13; 95%CI: 1.75-5.57). Hypertension was associated with overweight (OR: 3.02; 95%CI: 1.45-6.28), female gender (OR: 2.49; 95%CI: 1.24-4.98), and high-risk eating patterns (OR: 1.93; 95%CI: 1.04-3.56). In short, prevalence of pre-hypertension and hypertension in children and adolescents was higher among girls and individuals with overweight and inadequate diet.

Fatores associados à interrupção precoce do aleitamento materno: um estudo de coorte de nascimento em dois municípios do Recôncavo da Bahia, Brasil

Este estudo objetivou identificar a duracao mediana e os fatores associados a interrupcao precoce do aleitamento materno. Envolveu uma coorte de nascimento de 531 criancas acompanhadas ate os dois anos de idade em dois municipios do Reconcavo da Bahia, Brasil. Utilizaram-se a analise de sobrevivencia e o modelo multivariado de Cox. A duracao mediana foi de 74,73, 211,25 e 432,63 dias, respectivamente, para o aleitamento materno exclusivo, misto complementado e total. A ausencia materna ao pre-natal elevou em 173% (HR = 2,73; IC95%: 1,89-3,93) o risco de diminuir a duracao do aleitamento materno exclusivo, em 83% (HR = 1,83; IC95%: 1,06-3,16) o risco da adocao do aleitamento misto complementado e em 38% (HR = 1,38; IC95%: 1,06-1,81) o risco da descontinuidade do aleitamento materno. O trabalho materno fora do domicilio e a area de residencia urbana aumentaram o risco para interrupcao precoce do aleitamento materno. A ampliacao do acesso ao pre-natal e da rede de protecao as maes que trabalham fora do domicilio e aquelas que residem na area urbana poderia aumentar a duracao da amamentacao no Reconcavo da Bahia.

Factors associated with body image dissatisfaction among adolescents in public schools students in Salvador, Brazil.

OBJECTIVE To identify the prevalence of body image dissatisfaction and associated factors among students in Salvador, Brazil. METHODS A cross-sectional study involving a random sample of 1,494 (852 girls and 642 boys) adolescents between 11 and 17 years of age who were students in the public schools in Salvador, Brazil. Participants completed the Body Shape Questionnaire and the Eating Attitudes Test-26. Body image was characterized as satisfactory or unsatisfactory. We obtained demographic, anthropometric and economic information and information regarding the stage of maturation, self-perception of body weight, and consumption of sweetened beverages and diet soft drinks. To identify associated factors we used Poisson regression analysis. RESULTS Body image dissatisfaction was present in 19.5% of the adolescents, with a prevalence of 26.6% among the girls and 10% among the boys. Independent of sex, the prevalence of body image dissatisfaction was higher among adolescents who were overweight or obese (girls, PR: 1.38, CI: 1.09-1.73 and boys, PR: 2.26, CI: 1.08-4.75), higher among those who perceived themselves as fat (girls, PR: 2.85, CI: 2.07-3.93 and boys, PR: 3.17, CI: 1.39-7.23), and higher among those who had negative attitudes toward eating (girls, PR: 2.42, CI: 1.91-3.08 and boys, PR: 4.67, CI: 2.85-7.63).. A reduction in body image dissatisfaction was only identified among underweight girls (PR: 0.12, CI: 0.03-0.49). CONCLUSIONS A high occurrence of body image dissatisfaction was observed among the adolescents, and biological and behavioral factors were associated with this dissatisfaction.

The prevalence of overweight and obesity in adolescents in Bahia, Brazil

AIM A cross-sectional study was conducted with 1,477 middle school students enrolled in the public school network in Salvador, Bahia, Brazil to assess the prevalence of overweight and obesity. METHODS The sample was determined using a two-stage cluster sampling technique for selecting schools and classes. A posteriori error was estimated. The students were classified as overweight or obese according to the World Health Organizations 2007 classifications. They were also classified according to age, stage of sexual maturity, socioeconomic class and the presence of abdominal obesity. RESULTS Overall, 9.3% of the students were overweight and 6.4% were obese; therefore, 15.7% of the students were considered to have excess weight (obesity + overweight), at a 95% confidence interval. Abdominal obesity was found in 12.9% of all students and in 13% of those of normal weight. An association was found between excess weight and age < 14 years (p = 0.030) and abdominal obesity (p = 0.001). CONCLUSIONS Intervention programs should be implemented to prevent and treat obesity in childhood and adolescence. In addition, professionals working with individuals in this age group should be sensitized to this problem. The need to standardize the anthropometric indicators used in the different studies is also emphasized.

The prevalence of wheezing and its association with body mass index and abdominal obesity in children.

Objective. To evaluate the relative importance of body mass index (BMI) and abdominal obesity in the prevalence of wheezing in Brazilian children. Materials and methods. This is a cross-sectional study of male and female students, 6–12 years old, from the public elementary schools of São Francisco do Conde, Bahia, Northeast Brazil. Reports of wheezing in the past 12 months were collected using a questionnaire from the International Study of Asthma and Allergies in Childhood Program (ISAAC) phase III, adapted to Portuguese. Anthropometric, demographic, and socioeconomic information was collected. Multivariate logistic regression analyses were used to assess the associations of interest. Results. Of the children surveyed, 10.6% reported wheezing. Excess weight was observed in 16.2%, 10.5%, and 7.9% of the sample, measured by BMI, waist circumference (WC), and the waist-to-height ratio (WHtR), respectively. The percentage of patients with wheezing attributable to BMI ≥ 85th percentile (8.2%) slightly exceeded those identified with abdominal obesity, WC ≥ 80th percentile (7.3%) and WHtR > 0.5 (7.1%). Conclusion. The results suggest that an excess of fat deposits, either in the abdominal region or elsewhere in the body, increased the risk of wheezing. Since obesity is an important public health problem worldwide, control of this problem may partially reduce the occurrence of wheezing in youth.

Iniquidades socioeconômicas na conformação dos padrões alimentares de crianças e adolescentes

OBJECTIVE: The present study identified and quantified the influence of socioeconomic factors on dietary patterns. METHODS: This cross-sectional, population-based study investigated the food habits of 1136 children and adolescents of both genders, aged 7 to 14 years, enrolled in public schools of Salvador (BA), Brazil, using the qualitative food frequency questionnaire. Intake patterns were identified by principal component analysis. Quantile regression models were used to study the influence of socioeconomic indicators on dietary patterns. RESULTS: The sample’s eating patterns were classified into obesogenic or traditional. Quantile regression models adjusted for age and gender showed that, for most percentiles, low maternal education level was significantly negatively associated with consumption of foods included in the obesogenic pattern. Low income was negatively associated with the highest percentiles (p>95). The data showed that socioeconomic indicators do not influence the consumption of foods included in the traditional pattern. CONCLUSION: Socioeconomic factors promote adherence to obesogenic eating patterns. These results indicate that public authorities need to identify the Western consumption pattern, commonly observed in studies that assess the current consumption patterns of the Brazilian population, especially of children and adolescents, characterized by foods that promote non-communicable chronic diseases.

Food and nutrition insecurity: a marker of vulnerability to asthma symptoms.

OBJECTIVE To evaluate the association between food and nutrition insecurity and asthma in children from Latin America. DESIGN Cross-sectional study. SETTING São Francisco do Conde, Bahia, north-eastern Brazil. SUBJECTS The study included 1307 children aged 6-12 years from public elementary schools. Asthma symptoms were collected using a questionnaire that was translated and adapted from the International Study of Asthma and Allergies in Childhood, phase III. The diagnosis of asthma was determined based on reports of wheezing in the previous 12 months. The Brazilian Food Insecurity Scale was used to identify food insecurity. We also obtained demographic, socio-economic and anthropometric information for each participant. We used multivariate logistic regression analyses to assess the associations of interest. RESULTS Of the children surveyed, 10·4% had a history of wheezing and 64·5% had some degree of food and nutrition insecurity. We found a positive dose-response relationship and statistically significant associations of asthma with moderate (OR = 1·71, 95% CI 1·01, 2·89) and severe (OR = 2·51, 95% CI 1·28, 4·93) food and nutrition insecurity. CONCLUSIONS The results show that moderate and severe food and nutrition insecurity are markers of vulnerability to wheezing. It is important to note that the results of studies in this field have potential implications for social policies that promote food security. Further studies to identify the mechanisms involved in the relationship between food and nutrition insecurity and asthma are needed.

Fatores associados a sintomas de transtornos alimentares entre escolares da rede pública da cidade do Salvador, Bahia

OBJECTIVE: To identify the prevalence and factors associated with symptoms of eating disor-ders among students. METHODS: Cross sectional study involving 365 students from 7 to 14 years old from elementary school in Salvador, Bahia. It was applied for the students of 13 years old it was adopted the Eating Attitudes Test-26, Bulimic Investigatory Test of Edinburgh and Body Shape Questionnaire. The Child Behavior Checklist was administered to all students. Data was collected anthropometric and dietary, lifestyle, demographic, socioeconomic, and pubertal. Poisson regression was used for statistical analysis. RESULTS: Symptoms of ea-ting disor-ders were present in 23% of the students. Age (PR: 1.25, 95% CI: 1.11 to 1.40), body image dissatisfaction (PR: 4.23, 95% CI: 2.53 to 7.08), internalizing behavior problems (PR: 1.78, 95% CI: 1.11 to 2.85), replacing the consumption of meals by candies (PR: 2.14, 95% CI: 1.24 to 3.69), higher consumption of fruits and other vegetables (PR: 2.49, 95% CI: 1.55 to 3.99) and maternal education from 5th to 8th grade (PR: 1.95, 95% CI: 1.06 to 3.58), increase the occurrence of symptoms of eating disorders. CONCLUSION: A high prevalence of symptoms of eating disorders among students; sociodemographic and behavioral factors were associated with the event.

Fatores associados à inatividade física em adolescentes de 10-14 anos de idade, matriculados na rede pública de ensino do município de Salvador, BA

OBJECTIVE To investigate the factors associated to the physical inactivity among teenagers in Salvador, BA. METHODOLOGY A cross-sectional study was made with 803 teenagers from 10 to 14 years old, enrolled in public high schools in Salvador, BA. Information concerning physical activity levels (dependent variable), sedentary behavior, demographic, anthropometric, socioeconomic and maternal characteristics (independent variables) were collected. The Poisson multivariate analysis was chosen to analyze the statistical data. RESULTS The prevalence of physical inactivity was 49,6% (CI 95% 46,14 - 53,06); with higher standards between females (girls: 59,9%; boys: 39%, p < 0,001). With the multivariate analyses, it was verified a inverse association between physical inactivity and family economical condition that was classified in D/E worse economical levels either among males (PR = 0,73, CI 95%, 0,54 - 0,046), as among females (PR = 0,79; CI 95%; 0,66 - 0,96). In complementary analysis according to domains of physical activity, It was observed a significant decrease of physical inactivity in displacement domain between teenagers of lower economical levels (Boys - Classes B1/B2/C1 = 20,6%, C2 = 11%, D/E = 6%, p = 0,001; Girls - Classes B1/B2/C1 = 26,7%, C2 = 12,5%, D/E = 10,8%, p = 0,003). CONCLUSIONS The prevalence of physical inactivity is high among the studied teenagers. Youths with lower economical levels are more active comparing with those with higher economical standards. Moreover, the association between physical activity and economical condition is influenced by physical activity domain that was investigated.