Lina Enriqueta Frandsen Paez de Lima Rosado

Índice de massa corporal e circunferência abdominal: associação com fatores de risco cardiovascular

OBJECTIVE To evaluate the association between cardiovascular risk factors and the anthropometric values--body mass index (BMI) and waist circumference (WC). METHODS It was studied 231 employees of Federal University of Viçosa, Brazil, 54.1% of them were men (21-76 years old). Glycemia, total cholesterol, LDL, HDL, triglycerides, blood pressure, BMI, WC, waist-to-hip ratio and body fatness were measured. It was also investigated smoking, alcohol consumption and physical activity. RESULTS The prevalence of overweight/obesity in this population was high mainly in women. The abdominal obesity was observed in 74% of the women and 46.1% of the men. The average of BMI, body fatness, total cholesterol, HDL and triglycerides were significantly higher in men than in women. (p < 0,05). The sedentary lifestyle was a risk factor for obesity. Smoking and alcohol consumption were more common among men and normal weight volunteers. Most of the correlations between anthropometric indices and risk factors for cardiovascular diseases were significant, but weak and the WC was the index that had the strongest correlation and that associated with the largest number of variables. It was observed that with an increase of the BMI and the abdominal fat, there was also an increase of the glycemia, triglycerides and blood pressure and a decrease of HDL. The metabolic syndrome was more common among men and overweight and obese volunteers. CONCLUSION In this study, the frequency of cardiovascular risk factors increased along with BMI and WC.

HOMA1-IR and HOMA2-IR indexes in identifying insulin resistance and metabolic syndrome: Brazilian Metabolic Syndrome Study (BRAMS)

OBJECTIVE To investigate cut-off values for HOMA1-IR and HOMA2-IR to identify insulin resistance (IR) and metabolic syndrome (MS), and to assess the association of the indexes with components of the MS. METHODS Nondiabetic subjects from the Brazilian Metabolic Syndrome Study were studied (n = 1,203, 18 to 78 years). The cut-off values for IR were determined from the 90th percentile in the healthy group (n = 297) and, for MS, a ROC curve was generated for the total sample. RESULTS In the healthy group, HOMA-IR indexes were associated with central obesity, triglycerides and total cholesterol (p < 0.001). The cut-off values for IR were: HOMA1-IR > 2.7 and HOMA2-IR > 1.8; and, for MS were: HOMA1-IR > 2.3 (sensitivity: 76.8%; specificity: 66.7%) and HOMA2-IR > 1.4 (sensitivity: 79.2%; specificity: 61.2%). CONCLUSION The cut-off values identified for HOMA1-IR and HOMA2-IR indexes have a clinical and epidemiological application for identifying IR and MS in Westernized admixtured multi-ethnic populations.

Fatores determinantes da capacidade funcional em idosos longevos

CONTEXTUALIZACAO: A faixa etaria que mais cresce no Brasil e no mundo e a de idosos com 80 anos e mais. Entre esses individuos, a prevalencia de incapacidades e morbidades e maior que em outros grupos. OBJETIVOS: Investigar a influencia de fatores socioeconomicos, demograficos, biologicos e de saude, nutricionais, de relacoes sociais, alem da autoavaliacao da saude sobre a capacidade funcional de idosos longevos (80 anos e mais). METODOS: Trata-se de um estudo transversal, de base populacional, em que os dados foram obtidos por meio de questionarios e medidas antropometricas. A capacidade funcional foi avaliada utilizando-se o modelo desenvolvido por Andreotti e Okuma (1999). Foram realizadas analises univariada e multivariada. RESULTADOS: Os fatores independentes associados a pior capacidade funcional foram: ter 85 anos e mais (OR=2,91), ser do genero feminino (OR=6,09), fazer uso continuo de cinco ou mais medicamentos (OR=2,67), nao visitar parentes e/ou amigos pelo menos uma vez por semana (OR=11,91) e considerar a propria saude pior que a de seus pares (OR=4,40). CONCLUSOES: Os resultados sugerem que a capacidade funcional esta associada a uma complexa rede de fatores multidimensionais, sendo importante o desenvolvimento de acoes relacionadas aqueles fatores que sao passiveis de intervencao, visando propiciar melhores condicoes de saude e qualidade de vida a esses individuos.

Influência das características sociodemográficas e epidemiológicas na capacidade funcional de idosos residentes em Ubá, Minas Gerais

OBJECTIVE: The aim of this study was to identify the functional capacity of elderly individuals and its determinants. METHODS: A cross-sectional, population-based study was conducted with a sample of 397 elderly residents in the urban area of the city of Uba, Minas Gerais. A semi-structured, pre-tested questionnaire was applied as an interview in order to assess the sociodemographic, economic and health characteristics of elderly individuals. The functional capacity was assessed by means of the scale of basic and instrumental activities of daily living. The associations between functional capacity and socioeconomic, demographic and epidemiological characteristics were investigated. Data were analyzed with the softwares Epi Info version 6.0 and SigmaStat. A significance level of 0.05 was considered. For statistical analysis, frequency distribution and measures of association (odds ratio) were performed between the functional capacity and the socioeconomic, demographic and epidemiological variables. Multiple logistic regression analysis was conducted. RESULTS: The impaired functional capacity was related to self-referred deteriorated health conditions, falls, female gender, widowhood, more advanced age, low educational level and income, and retirement from the job market. CONCLUSION: The lack of integral health care for the elderly, especially those without financial resources, can contribute negatively to worsened health conditions, especially functional capacity.

Anthropometric indicators of insulin resistance

Some studies have analyzed the efficacy of anthropometric indicators in predicting insulin resistance (IR), for they are more economic and accessible. In this study, the objective was to discuss the measures and anthropometric indices that have been associated with IR. A bibliographic review was done, based on Scielo, Science Direct and Pubmed. Among these studies, waist and sagittal abdominal diameter presented better predictive capacity for IR, with more consistent results. The waist-to-thigh, waist-to-size, neck-to-thigh ratios, the conicity and the sagittal index have showed positive results; nevertheless, more studies are necessary to consolidate them as predictors to IR. The obtained results, with the use of body mass index and of the waist-to-hip ratio, were inconsistent. In the Brazilian population, the realization of studies evaluating the performance of these indicators in predicting IR is suggested, since the results of the studies conducted in other populations are not always applicable to ours, due to ethnic differences resulting from the great miscegenation in the country.Alguns estudos tem analisado a eficiencia de indicadores antropometricos em predizer resistencia a insulina (RI), por serem mais economicos e acessiveis. Neste estudo, objetivou-se discutir sobre as medidas e indices antropometricos que tem sido associados a RI. Realizou-se um levantamento bibliografico nas bases Scielo, Science Direct e Pubmed. Dentre os estudos analisados, perimetro da cintura e diâmetro abdominal sagital apresentaram melhor capacidade preditiva para RI, com resultados mais consistentes. As relacoes cintura/coxa, cintura/estatura, pescoco/coxa, o indice de conicidade e o indice sagital demonstraram resultados positivos, contudo mais estudos sao necessarios para consolida-los como preditores de RI. Os resultados obtidos com o uso do indice de massa corporal e da relacao cintura/quadril foram mais inconsistentes. Sugere-se a realizacao de estudos avaliando o desempenho desses indicadores em predizer RI na populacao brasileira, pois resultados de estudos feitos com outras populacoes muitas vezes nao sao aplicaveis a nossa, devido as diferencas etnicas resultantes da grande miscigenacao no Pais.

Associação entre estado nutricional e atividade física em escolares da Rede Municipal de Ensino em Corumbá - MS

A sedentary life style is a factor of risk for the development of overweight and childhood obesity, conditions associated with dyslipidemia, arterial hypertension and insulin resistance, among other disorders. The objective of this study was to evaluate the nutritional status and the association with the profile of physical activity in Municipal Schools in Corumbá – MS. A cross-sectional study was carried out in a sample of 403 pupils, aged 7-10 years, in which children with Body Mass Index (BMI) values > 85th and < 95th and > 95th percentile were classified in risk of overweight and overweight, respectively. The index of physical activity was determined by a specific questionnaire for the study, to obtain data about duration (minutes), intensity (metabolic equivalent) and energy expenditure (kcalories) of both active and sedentary physical activities. A prevalence of 6.2% e 6.5% to risk of overweight and overweight, respectively, was verified, with higher prevalence in girls than in boys. Most physical activities performed by children were light (< 3 METs) and moderated (3 a 6 METs); no vigorous (> 6 METs) physical activity was recorded. The older the children, the lesser the time spent in active physical activities. Normal-weight children are more active, practice more intense physical activities and spend less time watching television and playing video-games than overweight children. The data emphasize the importance of promoting changes in the life-style through the introduction of healthy habits, since infancy, and their maintenance for the whole life. Active children favor an active healthy adult population too, which can contribute, consequently, for a reduction in the incidence of morbidity and mortality at adulthood.O sedentarismo e fator de risco para o desenvolvimento de sobrepeso e obesidade infantil, condicoes que se associam a dislipidemia, hipertensao arterial e resistencia insulinica, entre outras alteracoes. O objetivo deste estudo foi avaliar o estado nutricional e a associacao com o padrao de atividade fisica em escolares da Rede Municipal de Ensino de Corumba (MS). Foi realizado estudo analitico transversal em uma amostra de 403 escolares, com idade entre sete e 10 anos, no qual se consideraram com risco de sobrepeso e sobrepeso as criancas com percentis de IMC 6 METs) foi registrada. Quanto maior a idade, menor o tempo despendido nas atividades fisicas ativas. Constatou-se que criancas eutroficas sao mais ativas, praticam atividades fisicas mais intensas e gastam menos tempo assistindo a televisao e jogando videogames do que as criancas com sobrepeso. Os dados evidenciam a importância em promover mudancas no estilo de vida com a adocao de habitos saudaveis, desde a infância, e a sua manutencao por toda a vida. Criancas ativas favorecem uma populacao adulta tambem ativa e saudavel contribuindo, consequentemente, para a reducao da incidencia de morbidade e mortalidade na idade adulta.

Predictive ability of anthropometric and body composition indicators in the identification of insulin resistance

OBJECTIVE To assess the ability of anthropometric and body composition indicators in identifying insulin resistance (IR), determining cut-off points for those showing the best efficacy. METHOD 138 men were evaluated. Waist perimeter (WP), sagittal abdominal diameter (SAD), conicity index, body mass index (BMI), body fat percent, sagittal index, and the waist-to-height, waist-to-hip and waist-to-thigh ratios were determined. IR was assessed by the HOMA-IR index. Statistical analysis consisted of Spearman correlation coefficient and ROC (receiver operating characteristic) curves, calculating the area under the curve (AUC). RESULTS SAD (r=0.482, AUC=0.746) and WP (r=0.464, AUC=0.739) showed stronger correlations with the HOMA-IR and greater ability to identify IR (p<0.001), being 89.3 cm and 20.0 cm the best cut-offs, respectively. CONCLUSION The anthropometric indicators of central obesity, WP and SAD, have shown greater ability to identify IR in men. We encourage studies in women and elderly people in search of the best cut-off points for the entire population.

Utilização de medidas antropométricas para a avaliação do acúmulo de gordura visceral

Visceral obesity has been associated with the development of cardiovascular diseases and some types of cancer. Therefore, there is an increasing interest in quantifying intra-abdominal adiposity in order to assess the risk of metabolic disorders, such as glucose intolerance, hyperinsulinemia, type 2 diabetes, dyslipidemia and hypertension. Imaging techniques such as computed tomography and magnetic resonance provide an accurate and precise measurement of visceral fat. However, both are costly and inapplicable in routine clinical practice and epidemiological studies. Anthropometric parameters are an option for visceral fat assessment in these situations, since they are innocuous, easy to use and inexpensive. In this context, this work aimed to critically analyze studies that assessed anthropometric parameters as indicators of visceral fat. A bibliographic review of domestic and international articles found in the databases Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior, Scientific Electronic Library Online, Science Direct and Pubmed, published from 1947 to 2007 was done. Emphasis was given to anthropometric parameters, such as body mass index, waist circumference, waist-to-hip ratio and sagittal abdominal diameter.

Aplicabilidade do índice de massa corporal na avaliação da gordura corporal

INTRODUCAO: O indice de massa corporal (IMC) e amplamente utilizado por profissionais de saude na avaliacao do estado nutricional e do risco de mortalidade. No entanto, esse indice nao fornece informacoes sobre a distribuicao e a proporcao da gordura corporal. OBJETIVO: Verificar a eficiencia do IMC em identificar individuos com excesso de gordura corporal e com obesidade abdominal. METODOS: A amostra constituiu-se de 98 homens com idade entre 20 e 58 anos. A avaliacao antropometrica incluiu peso, altura, circunferencia da cintura (CC) e do quadril. A composicao corporal foi avaliada por bioimpedância eletrica tetrapolar. RESULTADOS: A amostra foi predominantemente jovem, 50% dos individuos com idade entre 20 e 29 anos. O sobrepeso (IMC > 25kg/m2) e a obesidade abdominal (CC > 94cm) foram constatados em 36,7% e 18,4% dos homens avaliados, respectivamente. A circunferencia da cintura foi a medida antropometrica que mais se correlacionou com o IMC (r = 0,884; p 30 anos foi fator de risco para sobrepeso, obesidade abdominal e excesso de gordura corporal. CONCLUSOES: Ressalta-se a importância da combinacao do IMC e circunferencia da cintura na avaliacao do estado nutricional de homens adultos, ja que a obesidade abdominal foi constatada tambem naqueles individuos que nao foram diagnosticados como obesos pelo IMC.

Aplicabilidade de equações na avaliação da composição corporal da população brasileira

O excesso de gordura corporal esta, frequentemente, associado a alteracoes metabolicas importantes e as doencas cronicas, como diabetes, hipertensao arterial e dislipidemias. A disponibilidade de metodos que permitam estimar a composicao corporal e fundamental para avaliacao de atletas e do estado de saude de individuos. Entre os metodos existentes, as medidas de dobras cutâneas sao habitualmente utilizadas na populacao brasileira, devido a sua facilidade e relativa precisao em estimar a gordura corporal. Entretanto, existem limitacoes quanto a utilizacao desse metodo, que podem implicar em erros de estimativas da gordura corporal importantes. A proposta deste trabalho e descrever os estudos que validaram essas equacoes e os principais fatores que influenciam a acuracia das mesmas na populacao em geral. Tambem sao discutidos aspectos quanto a aplicabilidade dessas equacoes na populacao brasileira.