Gicele C Minten

Prevalência e fatores associados à ocorrência de anemia entre menores de seis anos de idade em Pelotas, RS

OBJETIVOS: Determinar a prevalencia e investigar fatores associados a ocorrencia de anemia entre menores de seis anos de idade atendidos pela Pastoral da Crianca em Pelotas, RS. METODOS: Na fase de rastreamento de uma intervencao nutricional, as criancas foram avaliadas atraves de estudo transversal. No domicilio, apos consentimento informado, a mae foi entrevistada, sendo coletadas informacoes sobre caracteristicas demograficas e socioeconomicas da familia, saude da crianca, caracteristicas ao nascer, amamentacao e frequencia semanal de consumo de alimentos. As criancas foram pesadas e medidas. Foi coletada uma amostra de sangue capilar da polpa digital em microcuveta e a leitura da concentracao de hemoglobina foi feita em fotometro portatil (Hemocue). Considerou-se como tendo anemia quando a concentracao de hemoglobina era inferior a 11 g/dl. Por se tratar de desfecho frequente, a associacao com as variaveis independentes foi analisada por regressao de Poisson. A analise obedeceu a modelo hierarquico previamente definido. RESULTADOS: Foram identificadas 362 criancas menores de seis anos, sendo a hemoglobina dosada em 304 (84,0%) delas. A prevalencia de anemia foi de 53,0% (IC95% 47,2% - 58,7%). Os fatores de risco foram a menor idade da crianca, cor nao branca, presenca de familia numerosa e classe social E (em comparacao a D). A disponibilidade de agua encanada dentro de casa e o maior peso ao nascer mostraram-se fatores protetores. CONCLUSOES: os achados deste estudo mostram uma alta prevalencia de anemia entre as criancas alvo da acao da Pastoral da Crianca, bem como a presenca de diversos fatores de risco e poucos fatores de protecao, o que mostra a necessidade de intervencoes preventivas.

Consumption of ultra-processed foods and their impact on the diet of young adults.

OBJECTIVE To evaluate the consumption of ultra-processed foods, its associated factors, and its influence on nutrient intake in young adults. METHODS In 2004-2005, the individuals belonging to the Pelotas birth cohort of 1982 were identified for a home interview. A total of 4,297 individuals were interviewed and 4,202 individuals were included in the study (follow-up rate of 77.4%). Diet was assessed using a questionnaire on dietary intake and the percentage of daily caloric intake attributed to ultra-processed foods as well as the intake of macro- and micronutrients were estimated. The association between cohort characteristics and the consumption of ultra-processed foods was assessed using linear regression. Analysis of variance and Pearson’s Chi-square test were used to evaluate the association between the quintiles of the consumption of ultra-processed food, nutrient intake and adequacy of nutrient intake, respectively. RESULTS The consumption of ultra-processed foods corresponded to 51.2% of the total caloric intake. The consumption of ultra-processed foods was higher among women, individuals with higher education, and individuals who were never poor and eutrophic. The increased consumption of ultra-processed foods was positively correlated with the consumption of fat, cholesterol, sodium, iron, calcium, and calories (p < 0.001) and was negatively correlated with the consumption of carbohydrates, protein, and dietary fiber (p < 0.001). CONCLUSIONS The high consumption of ultra-processed foods and its positive correlation with the intake of sodium, cholesterol, and fats underscores the need to perform interventions aimed at decreasing the intake of this food group.

Avaliação nutricional de adultos da coorte de nascimentos de 1982, Pelotas, RS

OBJETIVO: Estimar a prevalencia de desnutricao por deficit ou excesso de peso e sua associacao com fatores demograficos e socioeconomicos. METODOS: Estudo longitudinal de coorte de jovens nascidos em 1982 em Pelotas, RS. Em 2004-5 foram entrevistados 4.198 dos 5.914 individuos dessa coorte, que tiveram suas medidas de peso e estatura coletadas para calculo do indice de massa corporal (IMC). Definiu-se baixo peso pelo valor de IMC inferior a 18,5 kg/m2; excesso de peso, pelo IMC entre 25 e 30kg/m2; e obesidade pelo IMC>30kg/m2. Os efeitos de variaveis socioeconomicas (renda familiar e escolaridade), demografica (cor da pele), peso ao nascer e amamentacao sobre baixo peso, excesso de peso e obesidade foram analisados utilizando regressao de Poisson separadamente para homens e mulheres. RESULTADOS: As prevalencias de baixo peso, obesidade e excesso de peso foram 6,0%, 8,2% e 28,9%, respectivamente. Na analise ajustada somente o peso ao nascer manteve-se associado com baixo peso em homens e mulheres. Homens pobres tiveram maior risco de baixo peso, mas ficaram protegidos da obesidade e do excesso de peso. Por outro lado, o risco de obesidade e excesso de peso foi maior entre as mulheres pobres. CONCLUSOES: Os resultados reforcam a importância da determinacao socioeconomica sobre o estado nutricional, chamando atencao como esses fatores agem de forma distinta em homens e mulheres de diferentes situacoes nutricionais, indicando atencao no que se refere a medidas especificas na prevencao, melhorando o acesso a informacao sobre educacao alimentar e nutricional para toda populacao.OBJECTIVE To estimate the prevalence of over/underweight and its association with demographic and socioeconomic factors. METHODS Longitudinal cohort study of youths born in 1982 in Pelotas, Southern Brazil. In 2004-5 we interviewed 4,198 of the 5,914 cohort subjects, obtaining weight and stature measurements that were used to calculate body mass index (BMI). Underweight was defined as BMI lower than 18,5 kg/m(2); overweight as BMI between 25 and 30kg/m(2); and obesity as BMI IMC > 30kg/m(2). The effects of socioeconomic (family income and schooling) and demographic (skin color) variables, birthweight, and breastfeeding on underweight, overweight, and obesity were analyzed separately for men and women using Poisson regression. RESULTS Prevalence of underweight, obesity, and overweight were 6.0%, 8.2%, and 28.9%, respectively. In adjusted analysis, only birthweight remained associated with underweight among men and women. Poor men showed higher risk of underweight, but were protected from obesity and overweight. By contrast, risk of obesity and overweight was higher among poor women. CONCLUSIONS The present results underscore the importance of socioeconomic determinants on nutritional status, with special emphasis on the distinct effects these factors have among men and women in different nutritional conditions.

Prevalence and early determinants of common mental disorders in the 1982 birth cohort, Pelotas, Southern Brazil

OBJETIVO: Estimar a prevalencia de transtornos mentais comuns e sua associacao com fatores de risco numa coorte de adultos jovens. METODOS: Estudo transversal aninhado a coorte de nascimentos de 1982 de Pelotas, RS. Em 2004-5, 4.297 individuos foram entrevistados em visita domiciliar. A probabilidade de transtornos mentais comuns foi estimada pelo Self-Report Questionnaire. Os fatores de risco incluiram variaveis socioeconomicas, demograficas, perinatais e ambientais. A analise foi estratificada por sexo e as razoes de prevalencia simples e ajustadas foram estimadas utilizando-se regressao de Poisson. RESULTADOS: A prevalencia de transtornos mentais comuns na populacao geral foi 28,0%; 32,8% e 23,5%, respectivamente, entre mulheres e homens. Independentemente da pobreza em 1982, homens e mulheres pobres em 2004-5 apresentaram risco aproximado de 1,5 para esses transtornos (p<0,001), quando comparados aos que nunca foram pobres. Entre as mulheres, ter sido pobre na infância (p<0,001) e ter cor da pele preta ou parda (p=0,002) tambem aumentou o risco para transtornos mentais comuns. O baixo peso ao nascer e a duracao da amamentacao nao estiveram associadas com o risco desses transtornos. CONCLUSOES: A maior prevalencia de transtornos mentais comuns nos individuos com baixa renda familiar e de minorias etnico-raciais mostra haver impacto das desigualdades sociais, presentes no nascimento, sobre esses transtornos.OBJECTIVE To estimate the prevalence of common mental disorders and assess its association with risk factors in a cohort of young adults. METHODS Cross-sectional study nested in a 1982 birth cohort study conducted in Pelotas, Southern Brazil. In 2004-5, 4,297 subjects were interviewed during home visits. Common mental disorders were assessed using the Self-Report Questionnaire. Risk factors included socioeconomic, demographic, perinatal, and environmental variables. The analysis was stratified by gender and crude and adjusted prevalence ratios were estimated by Poisson regression. RESULTS The overall prevalence of common mental disorders was 28.0%; 32.8% and 23.5% in women and men, respectively. Men and women who were poor in 2004-5, regardless of their poor status in 1982, had nearly 1.5-fold increased risk for common mental disorders (p<0.001) when compared to those who have never been poor. Among women, being poor during childhood (p<0.001) and black/mixed skin color (p=0.002) increased the risk for mental disorders. Low birth weight and duration of breastfeeding were not associated to the risk of these disorders. CONCLUSIONS Higher prevalence of common mental disorders among low-income groups and race-ethnic minorities suggests that social inequalities present at birth have a major impact on mental health, especially common mental disorders.

Prevalência e determinantes precoces dos transtornos mentais comuns na coorte de nascimentos de 1982, Pelotas, RS

OBJETIVO: Estimar a prevalencia de transtornos mentais comuns e sua associacao com fatores de risco numa coorte de adultos jovens. METODOS: Estudo transversal aninhado a coorte de nascimentos de 1982 de Pelotas, RS. Em 2004-5, 4.297 individuos foram entrevistados em visita domiciliar. A probabilidade de transtornos mentais comuns foi estimada pelo Self-Report Questionnaire. Os fatores de risco incluiram variaveis socioeconomicas, demograficas, perinatais e ambientais. A analise foi estratificada por sexo e as razoes de prevalencia simples e ajustadas foram estimadas utilizando-se regressao de Poisson. RESULTADOS: A prevalencia de transtornos mentais comuns na populacao geral foi 28,0%; 32,8% e 23,5%, respectivamente, entre mulheres e homens. Independentemente da pobreza em 1982, homens e mulheres pobres em 2004-5 apresentaram risco aproximado de 1,5 para esses transtornos (p<0,001), quando comparados aos que nunca foram pobres. Entre as mulheres, ter sido pobre na infância (p<0,001) e ter cor da pele preta ou parda (p=0,002) tambem aumentou o risco para transtornos mentais comuns. O baixo peso ao nascer e a duracao da amamentacao nao estiveram associadas com o risco desses transtornos. CONCLUSOES: A maior prevalencia de transtornos mentais comuns nos individuos com baixa renda familiar e de minorias etnico-raciais mostra haver impacto das desigualdades sociais, presentes no nascimento, sobre esses transtornos.OBJECTIVE To estimate the prevalence of common mental disorders and assess its association with risk factors in a cohort of young adults. METHODS Cross-sectional study nested in a 1982 birth cohort study conducted in Pelotas, Southern Brazil. In 2004-5, 4,297 subjects were interviewed during home visits. Common mental disorders were assessed using the Self-Report Questionnaire. Risk factors included socioeconomic, demographic, perinatal, and environmental variables. The analysis was stratified by gender and crude and adjusted prevalence ratios were estimated by Poisson regression. RESULTS The overall prevalence of common mental disorders was 28.0%; 32.8% and 23.5% in women and men, respectively. Men and women who were poor in 2004-5, regardless of their poor status in 1982, had nearly 1.5-fold increased risk for common mental disorders (p<0.001) when compared to those who have never been poor. Among women, being poor during childhood (p<0.001) and black/mixed skin color (p=0.002) increased the risk for mental disorders. Low birth weight and duration of breastfeeding were not associated to the risk of these disorders. CONCLUSIONS Higher prevalence of common mental disorders among low-income groups and race-ethnic minorities suggests that social inequalities present at birth have a major impact on mental health, especially common mental disorders.

Tabagismo na coorte de nascimentos de 1982: da adolescência à vida adulta, Pelotas, RS

OBJECTIVE To assess smoking prevalence in adolescents and young adults of a population-based birth cohort. METHODS Prospective birth cohort study of infants born in 1982, in the city of Pelotas, Southern Brazil, and interviewed in 1997, 2000-2001 and 2005. In the 1997 and 2000-2001 follow-up visits, the outcome studied was smoking, defined as the consumption of at least one cigarette in the previous week. In the 2005 follow-up visit, the dependent variable was current smoking. Adjusted analysis was performed using Poisson regression. RESULTS Smoking prevalences among males were 5.9%, 20.2% and 27.6% in the 1997, 2000-2001 and 2005 follow-up visits, respectively. Among females, respective values were 9.3%, 27.5% and 23.6%. Mean age of smoking onset was 15.1 years (SD=2.5). In the multivariate analysis, lower maternal level of education, low income level in 1982, poverty during the follow-up period and maternal smoking were significantly associated with higher smoking prevalences in both sexes. Being non-white was associated with higher risk of smoking among females exclusively. Breastfeeding was not associated with smoking. Among females, smoking was inversely associated with birth weight in the crude analysis, but lost its significance in the adjusted analysis. CONCLUSIONS Higher incidence of smoking in poorer groups suggests that behavior such as avoiding smoking during pregnancy and increasing cigarette prices can have an important population impact.OBJETIVO: Avaliar a prevalencia de tabagismo em adolescentes e adultos jovens pertencentes a uma coorte de nascimentos de base populacional. METODOS: Estudo prospectivo de coorte dos nascidos em 1982 na cidade de Pelotas, RS, entrevistados em 1997, 2000-1 e 2005. O desfecho estudado foi o tabagismo, definido como consumo de pelo menos um cigarro na ultima semana nos acompanhamentos de 1997 e 2000-1. No acompanhamento de 2005, a variavel dependente foi tabagismo atual. A analise ajustada foi realizada por meio de regressao de Poisson. RESULTADOS: As prevalencias de tabagismo entre homens foram de 5,9%, 20,2% e 27,6% nos acompanhamentos de 1997, 2000-1 e 2005, respectivamente. Os respectivos valores para as mulheres foram 9,3%, 27,5% e 23,6%. A idade media de inicio do fumo foi de 15,1 anos (dp=2,5). Na analise multivariavel, menor escolaridade materna, baixa renda familiar em 1982, ter sido pobre durante todo o periodo acompanhado e fumo materno na gravidez estiveram significativamente associados com maiores prevalencias de fumo em ambos os sexos. A cor da pele nao branca associou-se com maior risco de fumo apenas entre as mulheres. A amamentacao nao mostrou associacao com tabagismo. Nas mulheres, o fumo esteve inversamente associado com o peso ao nascer na analise bruta, mas perdeu a significância na ajustada. CONCLUSOES: A maior concentracao de tabagismo nos grupos mais pobres sugere que condutas como o combate ao fumo na gestacao e o aumento do preco do cigarro poderiam ter importante impacto populacional.

Premenstrual symptoms and syndrome according to age at menarche in a 1982 birth cohort in southern Brazil

Premenstrual symptoms and syndrome were studied in young women who have been followed since birth. Data were collected on the intensity of four symptoms: irritability, anxiety or stress, depressed mood, and affective lability. Premenstrual syndrome was defined according to intensity of symptoms. Association between age at menarche and premenstrual symptoms and syndrome were investigated through Poisson regression. Adjusted analysis was conducted, controlling for possible confounding factors. The symptoms most frequently reported by the women from the 1982 Pelotas, Rio Grande do Sul, Brazil, birth cohort who were interviewed in 2004-2005 were: irritability (52.3%) and anxiety (40.2%). The prevalence rates for moderate and severe premenstrual syndrome were 13.4% and 5.8%, respectively. Mean age at menarche was 12.4 (+/-1.5) years. Prevalence rates for symptoms and premenstrual syndrome were higher in women whose age at menarche was less than 11 years, but this difference was not statistically significant. Information on symptoms and premenstrual syndrome is scarce in other studies.

Smoking prevalence in the 1982 birth cohort: from adolescence to adult life, Pelotas, Southern Brazil

OBJECTIVE To assess smoking prevalence in adolescents and young adults of a population-based birth cohort. METHODS Prospective birth cohort study of infants born in 1982, in the city of Pelotas, Southern Brazil, and interviewed in 1997, 2000-2001 and 2005. In the 1997 and 2000-2001 follow-up visits, the outcome studied was smoking, defined as the consumption of at least one cigarette in the previous week. In the 2005 follow-up visit, the dependent variable was current smoking. Adjusted analysis was performed using Poisson regression. RESULTS Smoking prevalences among males were 5.9%, 20.2% and 27.6% in the 1997, 2000-2001 and 2005 follow-up visits, respectively. Among females, respective values were 9.3%, 27.5% and 23.6%. Mean age of smoking onset was 15.1 years (SD=2.5). In the multivariate analysis, lower maternal level of education, low income level in 1982, poverty during the follow-up period and maternal smoking were significantly associated with higher smoking prevalences in both sexes. Being non-white was associated with higher risk of smoking among females exclusively. Breastfeeding was not associated with smoking. Among females, smoking was inversely associated with birth weight in the crude analysis, but lost its significance in the adjusted analysis. CONCLUSIONS Higher incidence of smoking in poorer groups suggests that behavior such as avoiding smoking during pregnancy and increasing cigarette prices can have an important population impact.OBJETIVO: Avaliar a prevalencia de tabagismo em adolescentes e adultos jovens pertencentes a uma coorte de nascimentos de base populacional. METODOS: Estudo prospectivo de coorte dos nascidos em 1982 na cidade de Pelotas, RS, entrevistados em 1997, 2000-1 e 2005. O desfecho estudado foi o tabagismo, definido como consumo de pelo menos um cigarro na ultima semana nos acompanhamentos de 1997 e 2000-1. No acompanhamento de 2005, a variavel dependente foi tabagismo atual. A analise ajustada foi realizada por meio de regressao de Poisson. RESULTADOS: As prevalencias de tabagismo entre homens foram de 5,9%, 20,2% e 27,6% nos acompanhamentos de 1997, 2000-1 e 2005, respectivamente. Os respectivos valores para as mulheres foram 9,3%, 27,5% e 23,6%. A idade media de inicio do fumo foi de 15,1 anos (dp=2,5). Na analise multivariavel, menor escolaridade materna, baixa renda familiar em 1982, ter sido pobre durante todo o periodo acompanhado e fumo materno na gravidez estiveram significativamente associados com maiores prevalencias de fumo em ambos os sexos. A cor da pele nao branca associou-se com maior risco de fumo apenas entre as mulheres. A amamentacao nao mostrou associacao com tabagismo. Nas mulheres, o fumo esteve inversamente associado com o peso ao nascer na analise bruta, mas perdeu a significância na ajustada. CONCLUSOES: A maior concentracao de tabagismo nos grupos mais pobres sugere que condutas como o combate ao fumo na gestacao e o aumento do preco do cigarro poderiam ter importante impacto populacional.

Helicobacter pylori and anemia: a community-based cross-sectional study among adults in Southern Brazil

To investigate the association between Helicobacter pylori and anemia, a community-based cross-sectional study was conducted among 18-45 year old users of the 31 primary health care units in Pelotas, Southern Brazil. Interviews using a structured questionnaire were carried out in waiting rooms during two work shifts. Anemia (hemoglobin < 11g/dL among pregnant women, < 12g/dL among women and < 13g/dL among men) was diagnosed from capillary blood (HemoCue) and H. pylori by means of a 13C-UBT. Information on socio-demographic, behavioral and biological characteristics was collected. Logistic and linear regression analyses were carried out, taking into account aggregated primary health care units. A total of 1,117 respondents fulfilled the inclusion criteria (losses/refusals: 8.1%). Prevalence of anemia was 20.6% (18.2-23.2%) and of H. pylori, 70.7% (68.0-73.6%). After allowing for age, sex and skin color the odds ratio for anemia among those who were diagnosed H. pylori positive was 0.94 (0.70-1.27). After allowing for sex, skin color, family monthly income, age, and smoking, the reduction in hemoglobin among H. pylori positive respondents was 0.07g/dL (-0.24-0.11; p = 0.4). There is no association between H. pylori and anemia among adults attending primary health care units in Southern Brazil.

Determinantes sociais da iniciação sexual precoce na coorte de nascimentos de 1982 a 2004-5, Pelotas, RS

OBJETIVO: Analisar determinantes sociais da iniciacao sexual precoce de jovens pertencentes a uma coorte de nascimentos. METODOS: Foram entrevistados em 2004-5 os individuos da coorte de nascimentos de Pelotas (RS), em 1982 (N=4.297). A iniciacao sexual precoce (<13 anos) foi o desfecho. Analises descritivas e estratificadas foram realizadas segundo o sexo. As variaveis analisadas foram renda familiar em 1982, cor da pele, escolaridade do jovem e mudanca de renda (1982-2004-5). Usaram-se dados etnograficos para complementar a analise dos resultados. RESULTADOS: A prevalencia de iniciacao sexual precoce foi maior para homens com cor da pele preta/parda, baixa escolaridade, renda familiar baixa em 1982 e em 2004-5. As exigencias para que os papeis sexuais masculinos mais tradicionais (virilidade, iniciativa sexual) mostraram ter maior repercussao e adesao desde cedo no grupo dos homens. Jovens mulheres de familia com maior renda e de maior escolaridade tenderam a postergar a iniciacao sexual. Os reflexos da imposicao de valores culturais tradicionais mostraram-se importantes para a iniciacao sexual precoce em homens e mulheres, ambos com menor escolaridade e renda. CONCLUSOES: Os resultados encontrados recolocam o fator economico como determinante dos comportamentos ou dos usos da sexualidade para ambos os sexos. Concentrar esforcos politicos que incentivem a populacao menos privilegiada economicamente a ter chances e perspectivas futuras igualitarias e uma estrategia importante para desfechos em saude.OBJECTIVE To analyze social determinants of early sexual initiation among young adults from a birth cohort. METHODS Individuals from the 1982 birth cohort (N=4,297) were interviewed in 2004-5, city of Pelotas, Southern Brazil. Early sexual initiation (<13 years of age) was the outcome. Descriptive and stratified analyses were performed according to sex. Variables analyzed were family income in 1982, ethnicity, young adults level of education and change in income (between 1982 and 2004-5). Ethnographic data were used to complement result analysis. RESULTS Prevalence of early sexual initiation was higher among black and mixed men, and those with low level of education and low family income in 1982 and 2004-5. More traditional male sexual role requirements, such as virility and sexual initiative, showed more repercussion and adherence from an early age among men. Young family women with higher income and level of education tended to delay their sexual initiation. Imposition of traditional values was found to influence early sexual initiation among men and women with lower level of education and income. CONCLUSIONS Results found re-established the economic factor as a determinant of behavior or uses of sexuality for both sexes. To focus on political efforts that help the economically disadvantaged to have opportunities and egalitarian future perspectives is an important strategy for health outcomes.