Emilia Chagas Costa

Desnutrição e excesso de peso em crianças e adolescentes: uma revisão de estudos brasileiros

OBJETIVO: Revisar la literatura brasilena de 2001 a 2010 sobre las prevalencias y los factores asociados al deficit de estatura y al exceso de peso en ninos y adolescentes de cinco a 19 anos. FUENTES DE DATOS: La investigacion fue realizada en las bases de datos Pubmed y Bireme, utilizandose los descriptores a continuacion: «desnutricion», «deficit estatural», «obesidad», «sobrepeso», «IMC», «nino», «escolar», «adolescente», «Brasil» y «determinantes». Se consideraron los siguientes criterios de seleccion: articulo original de base poblacional, evaluacion de los factores asociados, por medio de analisis estadistico de regresion, y articulos publicados entre 2000 y 2009. SINTESIS DE LOS DATOS: En lo que se refiere al deficit estatural, solamente dos estudios atendieron a los criterios establecidos, presentando variaciones de 3,5 a 16,7%, e indicacion de la condicion social y de la escolaridad de los jovenes como factores asociados. De los 12 estudios que investigaron el exceso de peso, 66,6% fueron realizados en la region Sur de Brasil y ninguno incluyo al Norte del pais. La mayoria presento delineacion transversal. Las prevalencias variaron de 13,9 a 38,9%, siendo los principales factores asociados: estandares socioeconomicos, influencia familiar y estilo de vida sedentario. CONCLUSIONES: Las asociaciones de las variables ingresos y nivel de escolaridad con el deficit de estatura y el sobrepeso, aunque con tendencias opuestas, llaman la atencion. Se sugiere la realizacion de mas estudios, en especial en las regiones Norte y Nordeste de Brasil.

Estado nutricional de crianças e adolescentes de um município do semiárido do Nordeste brasileiro

Objective: To evaluate the nutritional status of schoolchildren, resident in a semiarid region in the Northeastern Brazil. Methods: This is a cross-sectional study, involving 860 children and adolescents aged from 5-19 years-old, enrolled in three public schools in the county. The selection of schools was non-probabilistic type and unintentional. The initial population, which integrated the database, was composed by 1,035 children and teenagers, and 175 students (16.9%) were excluded because of inconsistency in the anthropometric data, resulting in a sample of 860 students. The following outcomes were considered: stunting (malnutrition), overweight and obesity (overweight), being the height/age and body mass index/age (BMI/Age), indices respectively used. Children and adolescents with height <-2 standard deviations and overweight and obese weight z score ≥1 were considered stunted. The statistical analysis was descriptive. Results: The prevalence of stunting and overweight/obesity was 9.1% and 24.0%, respectively. Overweight and stunting were higher in adolescents aged 15 and over, compared to other age groups analyzed. In relation to gender, malnutrition presented itself in a similar way, but overweight was more frequent among females. Conclusions: The results revealed that excess weight, here represented by the sum of overweight and obesity, was more prevalent than stunting (malnutrition), highlighting the urgent need for attention to this problem in order to design interventions capable of contributing to the improvement of schoolchildren nutritional status.Objective:To evaluate the nutritional status of schoolchildren, resident in a semiarid region in the Northeastern Brazil.Methods:This is a cross-sectional study, involving 860 children and adolescents aged from 5-19 years-old, enrolled in three public schools in the county. The selection of schools was non-probabilistic type and unintentional. The initial population, which integrated the database, was composed by 1,035 children and teenagers, and 175 students (16.9%) were excluded because of inconsistency in the anthropometric data, resulting in a sample of 860 students. The following outcomes were considered: stunting (malnutrition), overweight and obesity (overweight), being the height/age and body mass index/age (BMI/Age), indices respectively used. Children and adolescents with height <-2 standard deviations and overweight and obese weight z score ≥1 were considered stunted. The statistical analysis was descriptive.Results:The prevalence of stunting and overweight/obesity was 9.1% and 24.0%, respectively. Overweight and stunting were higher in adolescents aged 15 and over, compared to other age groups analyzed. In relation to gender, malnutrition presented itself in a similar way, but overweight was more frequent among females.Conclusions:The results revealed that excess weight, here represented by the sum of overweight and obesity, was more prevalent than stunting (malnutrition), highlighting the urgent need for attention to this problem in order to design interventions capable of contributing to the improvement of schoolchildren nutritional status.

Consumo alimentar de crianças em municípios de baixo índice de desenvolvimento humano no nordeste do Brasil

OBJECTIVE: This study analyzes the food consumption of children from Gameleira, located in the Southern Forest Area of Pernambuco, and from Sao Joao do Tigre, located in the semiarid region of Paraiba, in the Brazilian Northeast. METHODS: This cross-sectional study included 238 children from Gameleira and 207 from Sao Joao do Tigre aged <2 years. Food consumption was investigated using a 24-hour dietary recall. Nutrient intake adequacy was classified according to the Dietary Reference Intakes. RESULTS: Mean intakes of energy and most nutrients were above the reference values for all ages in both cities. The prevalences of risk of inadequate nutrient intake were high for most nutrients, especially iron and zinc, in children aged 7 to 11 months. Sao Joao do Tigre presented higher said prevalences for most studied age groups and nutrients, except for protein and iron in children aged 12 to 23 months, although the difference was not statistically significant. CONCLUSION: The nutrition situation of this population is still of concern because of the high prevalence of risk of inadequate nutrient intake. Therefore, strategies that promote and ensure food and nutrition security are needed for these populations to prevent risk of nutrition disorders.

Malnutrition and excess weight in children and adolescents: a review of Brazilian studies

OBJETIVO: Revisar la literatura brasilena de 2001 a 2010 sobre las prevalencias y los factores asociados al deficit de estatura y al exceso de peso en ninos y adolescentes de cinco a 19 anos. FUENTES DE DATOS: La investigacion fue realizada en las bases de datos Pubmed y Bireme, utilizandose los descriptores a continuacion: «desnutricion», «deficit estatural», «obesidad», «sobrepeso», «IMC», «nino», «escolar», «adolescente», «Brasil» y «determinantes». Se consideraron los siguientes criterios de seleccion: articulo original de base poblacional, evaluacion de los factores asociados, por medio de analisis estadistico de regresion, y articulos publicados entre 2000 y 2009. SINTESIS DE LOS DATOS: En lo que se refiere al deficit estatural, solamente dos estudios atendieron a los criterios establecidos, presentando variaciones de 3,5 a 16,7%, e indicacion de la condicion social y de la escolaridad de los jovenes como factores asociados. De los 12 estudios que investigaron el exceso de peso, 66,6% fueron realizados en la region Sur de Brasil y ninguno incluyo al Norte del pais. La mayoria presento delineacion transversal. Las prevalencias variaron de 13,9 a 38,9%, siendo los principales factores asociados: estandares socioeconomicos, influencia familiar y estilo de vida sedentario. CONCLUSIONES: Las asociaciones de las variables ingresos y nivel de escolaridad con el deficit de estatura y el sobrepeso, aunque con tendencias opuestas, llaman la atencion. Se sugiere la realizacion de mas estudios, en especial en las regiones Norte y Nordeste de Brasil.

Disponibilidade familiar de alimentos na Zona da Mata e Semi-Árido do Nordeste do Brasil

OBJECTIVE: The purpose of this study was to determine household food availability in Gameleira (PE) and Sao Joao do Tigre (PB), municipalities in the abovementioned regions, taking into account the frequency of food consumption, number of people per household, and education level of the head of the household. METHODS: The sample consisted of 502 and 458 families in Gameleira (PE) and Sao Joao do Tigre (PB), respectively, living in both urban and rural areas. Information on food consumption during the seven days prior to the interview was provided by the person in charge of preparing the meals. RESULTS: The number of available food types was 34 in Gameleira and 30 in Sao Joao de Tigre for more than 20% of the families in Gameleira (PE) and had 33 and 30 different food items per household, respectively; yet 50% of the households in both municipalities had as few as 16 and 15 different food items per household, respectively. The food items available in most households were high-energy foods belonging to the grain and legume groups, instead of other vegetables, fruits and animal source foods. Basically, the number of people per household and the education level of the head of the household did not affect food availability. CONCLUSION: Government efforts to fight hunger should focus on promoting an increase in the quality and quantity of food items per household.

Exercise-induced bronchospasm in a hot and dry region: study of asthmatic, rhinitistic and asymptomatic adolescents

ABSTRACT Background: Exercise-induced bronchospasm (EIB) is the bronchial narrowing that occurs after intense exercise in a significant number of asthmatics and in some non-asthmatics. This study aims to evaluate the occurrence of EIB in adolescents with asthma, rhinitis and respiratory asymptomatics in a hot and dry climate. Research design and methods: This is a cross-sectional study based on an epidemiological study that evaluated the prevalence of asthma in schoolchildren in a semi-arid zone of Brazil. The EIB was defined as a reduction in forced expiratory volume in first second (FEV1) greater than 10%. Results: A total of 114 individuals participated in the study (36.8% male), of whom 54 were asymptomatic, 30 asthmatic and 30 with rhinitis. Asthmatics presented a higher proportion of EIB in comparison to rhinitis and asymptomatics (46.7% vs. 13.3% and 7.4%, p = 0.001) and none of the individuals had severe EIB (ΔFEV1 ≥ 50%). Conclusions: A large proportion of the asthmatics selected from the community for the clinical study had EIB. Among participants with rhinitis, EIB was found in slightly more than 10%, while in the asymptomatics the frequency was slightly more than 5%. This study presents an important aspect in individuals living in hot and dry climates.

Intake of protein, calcium and sodium in public child day care centers

OBJETIVO:Avaliar a ingestao de calcio, proteina e sodio e compara-la com a recomendada, em criancas que frequentam creches publicas.METODOS:Estudo transversal descritivo realizado em bercarios de sete creches publicas do municipio de Sao Paulo, que atendiam 366 criancas entre 12 e 36 meses, com coleta entre setembro a dezembro de 2010. Avaliou-se cada creche durante tres dias nao consecutivos, totalizando 42 dias e 210 refeicoes. O consumo alimentar foi avaliado por metodo de pesagem direta de alimentos. Para o calculo nutricional, utilizou-se o software DietWin Profissional 2.0(r) e a adequacao foi calculada segundo as recomendacoes do Programa Nacional de Alimentacao Escolar (PNAE) para energia, proteina, calcio e sodio. A relacao calcio/proteina e a densidade de calcio (mg/1.000kcal) tambem foram computadas.RESULTADOS:Constatou-se que o consumo de energia (406,4kcal), de proteina (18,2g) e de calcio (207,6mg) nao atingiu os valores recomendados em todas as creches estudadas, sendo que a ingestao de sodio ultrapassou em ate tres vezes a recomendacao. A relacao calcio/proteina de 11,7mg/g foi inferior a adequacao (20mg/g).CONCLUSOES:Ha inadequacao do consumo alimentar de calcio, proteina e sodio, em criancas inseridas no contexto de creches publicas.OBJECTIVE: To assess calcium, protein and sodium intake, of children that attend public day-care centers and to compare it with the recommended one. METHODS: Cross-sectional descriptive study in seven public day care centers of São Paulo city, Southeast Brazil, which enrolled 366 children between 12 and 36 months of age. The data collection occurred between September and December 2010. Each day care center was evaluated for three non-consecutive days, totaling 42 days and 210 meals. Dietary intake was assessed by a direct food weighing method. For the nutritional calculation, DietWin(r) Profissional 2.0 was used, and the adequacy was calculated according to the recommendations of the National School Feeding Program for energy, protein, calcium and sodium. The calcium/protein relation was also calculated, as well as calcium density (mg/1,000kcal). RESULTS: The energy (406.4kcal), protein (18.2g) and calcium (207.6mg) consumption did not reach the recommended values in all the evaluated day care centers. Sodium intake exceeded up to three times the recommendation. The calcium/protein ratio of 11.7mg/g was less than the adequate one (20mg/g). CONCLUSIONS: There was inadequacy of calcium, protein and sodium dietary intake, in children attending public day-care centers.

Evolução do excesso de peso e fatores associados em mulheres de 10 a 49 anos em Pernambuco, Nordeste, Brasil

OBJETIVO: Este estudo tem como objetivo verificar a evolucao do excesso do peso e fatores a ele associados, em mulheres de 10 a 49 anos, no Estado de Pernambuco, em pesquisas realizadas em 1997 e em 2006. METODOS: Trata-se de estudo transversal, de base populacional, com amostra probabilistica representativa dos meios urbano e rural de Pernambuco, abrangendo 1 . 105 mulheres em 1997, e 1 . 464 em 2006. Para mulheres entre 10 e 19 anos, foi utilizada a relacao indice de massa corporal/idade, observados os seguintes parâmetros: deficit de peso: valores abaixo de -2 escores-Z; peso adequado: entre -2 e 1 e 2 escore-Z. Para mulheres com idade superior a 19 anos, consideraram-se os seguintes valores: deficit de peso: indice de massa corporal 18,5 e 25,0 e 30 kg/m2. A analise de regressao de Poisson foi utilizada para avaliar a associacao entre o excesso de peso e as variaveis explanatorias. RESULTADOS: Em relacao ao estado nutricional no periodo compreendido entre 1997 e 2006, houve um aumento significativo no sobrepeso e obesidade, com estabilizacao na prevalencia de deficit de peso. O excesso de peso aumentou de 32,8% em 1997 para 41,7% em 2006, representando um incremento de 27,1%. As mulheres da Regiao Metropolitana do Recife, do Interior Urbano e Rural apresentaram um aumento de excesso de peso de 40,2%, 6,8% e 45,2%, respectivamente. Na avaliacao dos fatores associados a esse agravo, em 2006, permaneceram significantes, apos ajuste, baixa escolaridade (quatro ou menos anos de estudo), a posse de tres ou mais bens de uso domestico, idade e maior numero de gestacoes, em contraste com o estudo de 1997, que apontava sobrepeso associado a idade e ao maior numero de gestacoes. CONCLUSAO: O excesso de peso em mulheres em idade fertil, no Estado de Pernambuco, aumentou significativamente, observando-se menor ritmo no Interior Urbano. Evidencia-se nas categorias de condicoes socioeconomicas e microambientais mais favoraveis uma clara desaceleracao no incremento temporal do excesso ponderal.

Proposta de utilização da técnica de contagem como preditor da capacidade vital lenta em indivíduos hospitalizados

PURPOSE:to evaluate if there is a correlation between the slow vital capacity and the maximum phonation time by technique of counting numbers and if it is possible from the maximum phonation time estimate the slow vital capacity in hospitalized individuals.METHODS:it is a cross-sectional study, crossover and choice of techniques (technique of numerical count and spirometry) were performed randomly (simple draw). The slow vital capacity was measured by spirometry and maximum phonation time was assessed using the technique of counting numbers.RESULTS:participated in the research 221 hospitalized patients. A positive correlation was observed between the Slow vital capacity and maximum phonation time evaluated on an absolute (r = 0.75; p <0.001) and relative (r = 0.76; p <0.001). From the simple linear regression of the data, were verified equations of the lines analyzed absolutely, Slow vital capacity = 55 Technique of numerical count + 735 (r2= 0,56; p < 0,0001) and relative Slow vital capacity = 0,84 Technique of numerical count + 14 (r2= 0,57; p < 0,0001).CONCLUSIONS:the results obtained in this study showed a good correlation between the techniques evaluated, possible to estimate the Slow vital capacity from the technique of counting numbers in hospitalized individuals.

Quality of life and physical activity in intensive care professionals from middle São Francisco

OBJECTIVE The objective was to assess the level of physical activity (LPA) and the quality of life QL of the professionals who work in ICU. METHOD This was a cross-sectional study carried out in Adult ICUs. LPA was assessed by the International Questionnarie of Physical Activity--short form (IQPA-SF) and the QL by the Medical Outcomes Study 36 (SF-36) questionnaire. RESULTS It was classified active 50.89% out of a total of 59 professionals. Nursing technicians were considered the most active with 60.6%. The QL of the professionals who were considered active were better when compared to inactives, with statistical differences to the category of physical aspects limitation, social aspects and mental health. The working hours were higher than recommend, the physicians were higher than the physical therapist, nurses and technicians nurses (p = 0.046). CONCLUSION Physically active professionals who work in ICU had higher quality of life probably why have lower hours of work and consequently more free time to engage in physical activity.