Leopoldina Augusta de Souza Sequeira

Excesso de peso em crianças e adolescentes no Estado de Pernambuco, Brasil: prevalência e determinantes

This study aimed to determine the prevalence of overweight and associated risk factors in children and adolescents in Pernambuco State, Brazil, in 2006. The cross-sectional, population-based study included 1,435 individuals from 5 to 19 years of age. Poisson regression was used to evaluate the association between selected variables and overweight. Prevalence was 13.3% for overweight (95%CI: 11.6-15.1) and 3.8% for obesity. Adjusted prevalence ratios showed that higher family income, maternal schooling, possession of household consumer goods, living in urban areas, and maternal overweight were associated with overweight in children and adolescents. The high prevalence of overweight in Pernambuco emphasizes the need for public health measures targeting all families regardless of socioeconomic status.

Insegurança alimentar e estado nutricional de crianças de Gameleira, zona da mata do Nordeste brasileiro

OBJECTIVES: to analyze the association between the food insecurity of families and the nutritional status of children aged under five years. METHODS: a cross-sectional study covering 501 families and 697 children aged under five years in the municipality of Gameleira, in the Brazilian State of Pernambuco. Food insecurity was assessed using the Brazilian Food Insecurity Scale (EBIA). Nutritional status was classified according to height/age, weight/age and body mass index (BMI), using the infant growth standards of the WHO. The study investigated the association between socio-economic indicators, food (in)security and biological variables relating to the child such as height/age, using linear multivariate regression analysis. RESULTS: food insecurity was found in almost 90% of families, with the most severe form being the most prevalent. There was a low prevalence of underweight in terms of BMI but high levels of underweight in terms of height for age. The final model of this analysis showed that the variables household per capita income, level of schooling of mother, and age of child had a significant influence on the nutritional status of the child, although the EBIA was not significantly associated with this. CONCLUSIONS: there is a clear discrepancy between the prevalence of food insecurity in families and the low frequency of malnutrition in children, suggesting that the two indicators evaluate quite distinct features and situations.

Determinantes do déficit estatural em menores de cinco anos no Estado de Pernambuco

OBJECTIVE To describe the prevalence of stunting in children under five and identify factors associated. METHODS Population-based cross-sectional study conducted in 1991, 1997 and 2006 in the state of Pernambuco, northeastern Brazil. The following variables associated with the prevalence of stunting (height-for-age < -2 z-score) were studied: socioeconomic condition, maternal and child characteristics, and health care provided. A hierarchical model was used in the multiple logistic regression to assess the impact of explanatory variables on childrens stunting. RESULTS The prevalence of child malnutrition (height-for-age) was reduced by 65% from 1991 to 2006. Socioeconomic variables (per capita family income, maternal education, number of people living in the household and access to consumer goods), maternal height and birth weight were associated with stunting in children under five. CONCLUSIONS All the determinants studied improved over the study period though not consistently. Despite significant reduction of child malnutrition in Pernambuco there remain differences regarding stunting, and children with better socioeconomic conditions have more favorable outcomes.OBJETIVO: Descrever o deficit estatural de menores de cinco anos e identificar fatores associados. METODOS: Estudo transversal de base populacional realizado em 1991, 1997 e 2006 no Estado de Pernambuco. A analise da prevalencia e fatores associados ao deficit estatural (altura para idade < -2 escore Z) incluiu: condicoes socioeconomicas, caracteristicas maternas e da crianca e de assistencia a saude. A regressao logistica multipla utilizou o modelo hierarquizado, para avaliar o impacto das variaveis explanatorias sobre o deficit de estatura das criancas. RESULTADOS: A prevalencia da desnutricao em criancas pelo indice altura para idade diminuiu 65% entre 1991 e 2006. As variaveis socioeconomicas (renda familiar per capita, escolaridade materna, numero de pessoas na residencia e acesso a bens de consumo), a altura materna e o peso ao nascer permaneceram entre os fatores associados ao deficit estatural das criancas. CONCLUSOES: Todos os determinantes analisados melhoraram no periodo analisado, nem sempre de forma igualitaria. Apesar da reducao expressiva da desnutricao nas criancas pernambucanas, ainda existem diferenciais em relacao ao deficit de estatura, sendo mais favoraveis para as criancas em melhores condicoes socioeconomicas.

Fatores associados ao declínio do déficit estatural em crianças e adolescentes em Pernambuco

OBJETIVO: Analisar a evolucao do deficit estatural em criancas e adolescentes e identificar seus fatores associados. METODOS: Estudo transversal, com dados das Pesquisas Estaduais de Saude e Nutricao realizadas em Pernambuco nos anos de 1997 e 2006. A amostra do tipo probabilistica (aleatoria estratificada), com representatividade para os estratos urbanos e rurais do estado. Para a coleta de dados foram utilizados questionarios com perguntas pre-codificadas referentes a informacoes sobre as variaveis socioeconomicas, demograficas e antropometricas (das maes, criancas e adolescentes). A populacao estudada foi de, respectivamente, 1.853 e 1.484 criancas e adolescentes de cinco a 19 anos. A analise de regressao multipla com selecao hierarquizada foi utilizada para avaliar a associacao das variaveis explanatorias sobre o deficit estatural. RESULTADOS: A prevalencia do deficit de estatura apresentou reducao significante de 43% (de 16,9% em 1997 para 9,6% em 2006). As variaveis socioeconomicas e a estatura materna estiveram associadas a este declinio, com reducoes variando de 39% a 60% entre os estratos analisados. Na analise dos determinantes do deficit estatural, no ano de 2006, permaneceram como significantes: a renda familiar per capita (<0,25 salario minimo), a posse de bens domesticos (< tres), o maior numero de pessoas por domicilio, a menor escolaridade e menor estatura materna. CONCLUSOES: A reducao do deficit de estatura refletiu a melhoria nas condicoes sociais e economicas. Entretanto, permanecem necessarios a manutencao e incremento de politicas publicas, de modo a aumentar o poder aquisitivo dos mais pobres e universalizar o acesso da populacao a servicos de saude e educacao.OBJETIVO: Analizar la evolucion de la disminucion del deficit de estatura en ninos y adolescentes e identificar sus factores asociados. METODOS: Estudio transversal, con datos de las Investigaciones Estatales de Salud y Nutricion realizadas en Pernambuco (Noreste de Brasil) en los anos de 1997 y 2006. La muestra de tipo probabilistica (aleatoria estratificada), con representacion de los estratos urbanos y rurales del estado. Para la colecta de datos fueron utilizados cuestionarios con preguntas pre-codificadas referentes a informaciones sobre las variables socioeconomicas, demograficas y antropometricas (de las madres, ninos y adolescentes). La poblacion estudiada fue de, respectivamente, 1.853 y 1.484 ninos y adolescentes de cinco a 19 anos. El analisis de regresion multiple con seleccion jerarquizada fue utilizado para evaluar la asociacion de las variables explicativas sobre el deficit de estatura. RESULTADOS: La prevalencia del deficit de estatura presento reduccion significativa de 43% (de 16,9% en 1997 a 9,6% en 2006). Las variables socioeconomicas y la estatura materna estuvieron asociadas a esta disminucion, con reducciones variando de 39% a 60% entre los estratos analizados. En el analisis de los determinantes del deficit de estatura, en el ano 2006, permanecieron como significativos: la renta familiar per capita (<0,25 salario minimo), la posesion de bienes domesticos (< tres), el mayor numero de personas por domicilio, la menor escolaridad y menor estatura materna. CONCLUSIONES: La reduccion del deficit de estatura reflejo la mejoria en las condiciones sociales y economicas. Sin embargo, permanecen necesarios el mantenimiento e incremento de politicas publicas, de modo a aumentar el poder adquisitivo de los mas pobres y universalizar el acceso de la poblacion a servicios de salud y educacion.OBJECTIVE To analyze the evolution of stunting among children and adolescents and identify their associated factors. METHODS This was a cross-sectional study using data from the state health and nutrition surveys that were conducted in Pernambuco (Northeastern Brazil) in 1997 and 2006. The sample was probabilistic (random and stratified) and was representative of urban and rural strata of the state. Questionnaires containing precoded questions relating to information on socioeconomic, demographic and anthropometric variables (of the mothers, children and adolescents) were used for data gathering. The population studied comprised 1853 children and 1484 adolescents between the ages of five and 19 years. Multiple regression analysis with hierarchical selection was used to evaluate associations between explanatory variables relating to stunting. RESULTS The prevalence of stunting presented a significant reduction of 43% (from 16.9% in 1997 to 9.6% in 2006). Socioeconomic variables and maternal height were associated with this decline. The reductions ranged from 39% to 60% among the strata analyzed. Analysis on determinants of stunting showed that in 2006, the following remained significant: per capita family income (< 0.25 minimum salary), possession of domestic goods (< three), greater number of people per household, lower schooling level and lower maternal height. CONCLUSIONS The reduction in stunting reflected improvements in social and economic conditions. However, it remains necessary to maintain and improve public policies, in order to increase the purchasing power of the poorest people and to achieve universal access to health and education services for the population.

Determinants of stunting in children under five in Pernambuco, Northeastern Brazil

OBJECTIVE To describe the prevalence of stunting in children under five and identify factors associated. METHODS Population-based cross-sectional study conducted in 1991, 1997 and 2006 in the state of Pernambuco, northeastern Brazil. The following variables associated with the prevalence of stunting (height-for-age < -2 z-score) were studied: socioeconomic condition, maternal and child characteristics, and health care provided. A hierarchical model was used in the multiple logistic regression to assess the impact of explanatory variables on childrens stunting. RESULTS The prevalence of child malnutrition (height-for-age) was reduced by 65% from 1991 to 2006. Socioeconomic variables (per capita family income, maternal education, number of people living in the household and access to consumer goods), maternal height and birth weight were associated with stunting in children under five. CONCLUSIONS All the determinants studied improved over the study period though not consistently. Despite significant reduction of child malnutrition in Pernambuco there remain differences regarding stunting, and children with better socioeconomic conditions have more favorable outcomes.OBJETIVO: Descrever o deficit estatural de menores de cinco anos e identificar fatores associados. METODOS: Estudo transversal de base populacional realizado em 1991, 1997 e 2006 no Estado de Pernambuco. A analise da prevalencia e fatores associados ao deficit estatural (altura para idade < -2 escore Z) incluiu: condicoes socioeconomicas, caracteristicas maternas e da crianca e de assistencia a saude. A regressao logistica multipla utilizou o modelo hierarquizado, para avaliar o impacto das variaveis explanatorias sobre o deficit de estatura das criancas. RESULTADOS: A prevalencia da desnutricao em criancas pelo indice altura para idade diminuiu 65% entre 1991 e 2006. As variaveis socioeconomicas (renda familiar per capita, escolaridade materna, numero de pessoas na residencia e acesso a bens de consumo), a altura materna e o peso ao nascer permaneceram entre os fatores associados ao deficit estatural das criancas. CONCLUSOES: Todos os determinantes analisados melhoraram no periodo analisado, nem sempre de forma igualitaria. Apesar da reducao expressiva da desnutricao nas criancas pernambucanas, ainda existem diferenciais em relacao ao deficit de estatura, sendo mais favoraveis para as criancas em melhores condicoes socioeconomicas.

Excesso de peso em adultos do Estado de Pernambuco, Brasil: magnitude e fatores associados

In order to evaluate the prevalence of overweight and associated factors in Pernambuco State, Brazil, a cross-sectional population-based study was conducted in 2006, including 1,580 adults 25 to 59 years of age. Overweight was defined as body mass index > 25kg/m2. The conceptual model included demographic, socioeconomic, reproductive, and behavioral variables. Prevalence of overweight was 51.1% (95%CI: 48.6-53.6) and was statistically associated with age over 40 years (PR = 1.27; 95%CI: 1.10-1.46), female gender (PR = 1.29; 95%CI: 1.16-1.43), former smoking (PR = 1.42; 95%CI: 1.20-1.69), higher income (PR = 1.49; 95%CI: 1.30-1.71), and history of early pregnancy (< 18 years) (PR = 1.25; 95%CI: 1.11-1.66). There was no association with alcohol consumption, level of physical activity, or specific foods. The high prevalence of overweight is consistent with epidemic levels of this problem elsewhere in world, and the association with several factors supports its multifactor etiology.

Prevalência e fatores associados à obesidade abdominal em indivíduos na faixa etária de 25 a 59 anos do Estado de Pernambuco, Brasil

In order to estimate the prevalence of abdominal obesity and associated factors in Pernambuco State, Brazil, a cross-sectional population-based study was conducted in 2006, including 1,580 adults 25 to 59 years of age. Abdominal obesity was defined as waist circumference (WC) ≥ 80 cm in women and ≥ 94 cm in men. The conceptual model included demographic, socioeconomic, reproductive, and behavioral variables. Prevalence of abdominal obesity was 27.1% (95%CI: 23.8-30.7) in males and 69.9% (95%CI: 66.8-72.8) in females (p < 0.001). Multivariate analysis showed higher prevalence in men 50 years or older in the metropolitan area and those with higher income, former smokers, and drinkers. Among women, obesity was more prevalent above 30 years of age, in former smokers, and in women with first pregnancy before age 18. Central adiposity is clearly a multifactor condition in the State of Pernambuco, and the determinants of obesity differ between the sexes.Com o objetivo de estimar a prevalencia de obesidade abdominal e avaliar os fatores associados em adultos do Estado de Pernambuco, Brasil, foi realizado, em 2006, um estudo transversal, de base populacional, envolvendo 1.580 individuos na faixa etaria de 25-59 anos. A obesidade abdominal foi determinada pela circunferencia da cintura ≥ 80cm para mulheres e ≥ 94cm para homens. O modelo conceitual considerou variaveis socioeconomicas, demograficas, reprodutivas e comportamentais. A prevalencia de obesidade abdominal foi de 27,1% (IC95%: 23,8-30,7) no sexo masculino e 69,9% (IC95%: 66,8-72,8) no feminino (p < 0,001). A analise ajustada revelou maior prevalencia em homens a partir de 50 anos, da regiao metropolitana, de maior renda, ex-fumantes e consumidores de bebidas alcoolicas. Entre as mulheres, foi mais prevalente a partir de 30 anos, em ex-fumantes e naquelas com a primeira gestacao antes de 18 anos. Fica evidente a gravidade e a multifatorialidade do problema da adiposidade central no Estado de Pernambuco, alem de ser possivel destacar que os determinantes da obesidade sao diferentes entre os sexos.

Factors associated with the decline in stunting among children and adolescents in Pernambuco, Northeastern Brazil.

OBJETIVO: Analisar a evolucao do deficit estatural em criancas e adolescentes e identificar seus fatores associados. METODOS: Estudo transversal, com dados das Pesquisas Estaduais de Saude e Nutricao realizadas em Pernambuco nos anos de 1997 e 2006. A amostra do tipo probabilistica (aleatoria estratificada), com representatividade para os estratos urbanos e rurais do estado. Para a coleta de dados foram utilizados questionarios com perguntas pre-codificadas referentes a informacoes sobre as variaveis socioeconomicas, demograficas e antropometricas (das maes, criancas e adolescentes). A populacao estudada foi de, respectivamente, 1.853 e 1.484 criancas e adolescentes de cinco a 19 anos. A analise de regressao multipla com selecao hierarquizada foi utilizada para avaliar a associacao das variaveis explanatorias sobre o deficit estatural. RESULTADOS: A prevalencia do deficit de estatura apresentou reducao significante de 43% (de 16,9% em 1997 para 9,6% em 2006). As variaveis socioeconomicas e a estatura materna estiveram associadas a este declinio, com reducoes variando de 39% a 60% entre os estratos analisados. Na analise dos determinantes do deficit estatural, no ano de 2006, permaneceram como significantes: a renda familiar per capita (<0,25 salario minimo), a posse de bens domesticos (< tres), o maior numero de pessoas por domicilio, a menor escolaridade e menor estatura materna. CONCLUSOES: A reducao do deficit de estatura refletiu a melhoria nas condicoes sociais e economicas. Entretanto, permanecem necessarios a manutencao e incremento de politicas publicas, de modo a aumentar o poder aquisitivo dos mais pobres e universalizar o acesso da populacao a servicos de saude e educacao.OBJETIVO: Analizar la evolucion de la disminucion del deficit de estatura en ninos y adolescentes e identificar sus factores asociados. METODOS: Estudio transversal, con datos de las Investigaciones Estatales de Salud y Nutricion realizadas en Pernambuco (Noreste de Brasil) en los anos de 1997 y 2006. La muestra de tipo probabilistica (aleatoria estratificada), con representacion de los estratos urbanos y rurales del estado. Para la colecta de datos fueron utilizados cuestionarios con preguntas pre-codificadas referentes a informaciones sobre las variables socioeconomicas, demograficas y antropometricas (de las madres, ninos y adolescentes). La poblacion estudiada fue de, respectivamente, 1.853 y 1.484 ninos y adolescentes de cinco a 19 anos. El analisis de regresion multiple con seleccion jerarquizada fue utilizado para evaluar la asociacion de las variables explicativas sobre el deficit de estatura. RESULTADOS: La prevalencia del deficit de estatura presento reduccion significativa de 43% (de 16,9% en 1997 a 9,6% en 2006). Las variables socioeconomicas y la estatura materna estuvieron asociadas a esta disminucion, con reducciones variando de 39% a 60% entre los estratos analizados. En el analisis de los determinantes del deficit de estatura, en el ano 2006, permanecieron como significativos: la renta familiar per capita (<0,25 salario minimo), la posesion de bienes domesticos (< tres), el mayor numero de personas por domicilio, la menor escolaridad y menor estatura materna. CONCLUSIONES: La reduccion del deficit de estatura reflejo la mejoria en las condiciones sociales y economicas. Sin embargo, permanecen necesarios el mantenimiento e incremento de politicas publicas, de modo a aumentar el poder adquisitivo de los mas pobres y universalizar el acceso de la poblacion a servicios de salud y educacion.OBJECTIVE To analyze the evolution of stunting among children and adolescents and identify their associated factors. METHODS This was a cross-sectional study using data from the state health and nutrition surveys that were conducted in Pernambuco (Northeastern Brazil) in 1997 and 2006. The sample was probabilistic (random and stratified) and was representative of urban and rural strata of the state. Questionnaires containing precoded questions relating to information on socioeconomic, demographic and anthropometric variables (of the mothers, children and adolescents) were used for data gathering. The population studied comprised 1853 children and 1484 adolescents between the ages of five and 19 years. Multiple regression analysis with hierarchical selection was used to evaluate associations between explanatory variables relating to stunting. RESULTS The prevalence of stunting presented a significant reduction of 43% (from 16.9% in 1997 to 9.6% in 2006). Socioeconomic variables and maternal height were associated with this decline. The reductions ranged from 39% to 60% among the strata analyzed. Analysis on determinants of stunting showed that in 2006, the following remained significant: per capita family income (< 0.25 minimum salary), possession of domestic goods (< three), greater number of people per household, lower schooling level and lower maternal height. CONCLUSIONS The reduction in stunting reflected improvements in social and economic conditions. However, it remains necessary to maintain and improve public policies, in order to increase the purchasing power of the poorest people and to achieve universal access to health and education services for the population.

Prevalence of abdominal obesity and associated factors among individuals 25 to 59 years of age in Pernambuco State, Brazil

In order to estimate the prevalence of abdominal obesity and associated factors in Pernambuco State, Brazil, a cross-sectional population-based study was conducted in 2006, including 1,580 adults 25 to 59 years of age. Abdominal obesity was defined as waist circumference (WC) ≥ 80 cm in women and ≥ 94 cm in men. The conceptual model included demographic, socioeconomic, reproductive, and behavioral variables. Prevalence of abdominal obesity was 27.1% (95%CI: 23.8-30.7) in males and 69.9% (95%CI: 66.8-72.8) in females (p < 0.001). Multivariate analysis showed higher prevalence in men 50 years or older in the metropolitan area and those with higher income, former smokers, and drinkers. Among women, obesity was more prevalent above 30 years of age, in former smokers, and in women with first pregnancy before age 18. Central adiposity is clearly a multifactor condition in the State of Pernambuco, and the determinants of obesity differ between the sexes.Com o objetivo de estimar a prevalencia de obesidade abdominal e avaliar os fatores associados em adultos do Estado de Pernambuco, Brasil, foi realizado, em 2006, um estudo transversal, de base populacional, envolvendo 1.580 individuos na faixa etaria de 25-59 anos. A obesidade abdominal foi determinada pela circunferencia da cintura ≥ 80cm para mulheres e ≥ 94cm para homens. O modelo conceitual considerou variaveis socioeconomicas, demograficas, reprodutivas e comportamentais. A prevalencia de obesidade abdominal foi de 27,1% (IC95%: 23,8-30,7) no sexo masculino e 69,9% (IC95%: 66,8-72,8) no feminino (p < 0,001). A analise ajustada revelou maior prevalencia em homens a partir de 50 anos, da regiao metropolitana, de maior renda, ex-fumantes e consumidores de bebidas alcoolicas. Entre as mulheres, foi mais prevalente a partir de 30 anos, em ex-fumantes e naquelas com a primeira gestacao antes de 18 anos. Fica evidente a gravidade e a multifatorialidade do problema da adiposidade central no Estado de Pernambuco, alem de ser possivel destacar que os determinantes da obesidade sao diferentes entre os sexos.

Determinantes del déficit de estatura en menores de cinco años en el Estado de Pernambuco, Noreste de Brasil

OBJECTIVE To describe the prevalence of stunting in children under five and identify factors associated. METHODS Population-based cross-sectional study conducted in 1991, 1997 and 2006 in the state of Pernambuco, northeastern Brazil. The following variables associated with the prevalence of stunting (height-for-age < -2 z-score) were studied: socioeconomic condition, maternal and child characteristics, and health care provided. A hierarchical model was used in the multiple logistic regression to assess the impact of explanatory variables on childrens stunting. RESULTS The prevalence of child malnutrition (height-for-age) was reduced by 65% from 1991 to 2006. Socioeconomic variables (per capita family income, maternal education, number of people living in the household and access to consumer goods), maternal height and birth weight were associated with stunting in children under five. CONCLUSIONS All the determinants studied improved over the study period though not consistently. Despite significant reduction of child malnutrition in Pernambuco there remain differences regarding stunting, and children with better socioeconomic conditions have more favorable outcomes.OBJETIVO: Descrever o deficit estatural de menores de cinco anos e identificar fatores associados. METODOS: Estudo transversal de base populacional realizado em 1991, 1997 e 2006 no Estado de Pernambuco. A analise da prevalencia e fatores associados ao deficit estatural (altura para idade < -2 escore Z) incluiu: condicoes socioeconomicas, caracteristicas maternas e da crianca e de assistencia a saude. A regressao logistica multipla utilizou o modelo hierarquizado, para avaliar o impacto das variaveis explanatorias sobre o deficit de estatura das criancas. RESULTADOS: A prevalencia da desnutricao em criancas pelo indice altura para idade diminuiu 65% entre 1991 e 2006. As variaveis socioeconomicas (renda familiar per capita, escolaridade materna, numero de pessoas na residencia e acesso a bens de consumo), a altura materna e o peso ao nascer permaneceram entre os fatores associados ao deficit estatural das criancas. CONCLUSOES: Todos os determinantes analisados melhoraram no periodo analisado, nem sempre de forma igualitaria. Apesar da reducao expressiva da desnutricao nas criancas pernambucanas, ainda existem diferenciais em relacao ao deficit de estatura, sendo mais favoraveis para as criancas em melhores condicoes socioeconomicas.