Lucivalda Pereira Magalhães de Oliveira

Alimentação complementar nos primeiros dois anos de vida

Este e um estudo transversal, com amostra constituida de 724 criancas residentes na cidade de Salvador, BA,Brasil, elegiveis por meio de amostragem por conglomerados em tres estagios. As informacoes referentes aoconsumo alimentar foram coletadas por meio do inquerito recordatorio de 24 horas e processadas peloprograma

Fatores associados a excesso de peso e concentração de gordura abdominal em adultos na cidade de Salvador, Bahia, Brasil

O objetivo foi identificar os fatores associados ao excesso de peso e concentracao de gordura abdominal em adultos de ambos os sexos. Um estudo transversal envolvendo amostra representativa de 570 adultos de Salvador, Bahia, Brasil. A regressao de Poisson foi utilizada na analise, adotando-se o indice de massa corporal (IMC) e a circunferencia da cintura como variaveis dependentes. Para as mulheres, a inadequacao do IMC e da circunferencia da cintura ocorreu com o aumento da idade e entre as que faziam dieta no momento do estudo, a historia familiar de obesidade associou-se apenas com o IMC elevado. Para os homens, o IMC elevou-se na faixa etaria de 30 a 39 e 50 a 59 anos. A circunferencia da cintura elevou-se com a realizacao de tres ou menos refeicoes-dia, com a hipertensao arterial, uso de bebida alcoolica e diminuiu entre mulatos e negros. Tanto IMC quanto circunferencia da cintura elevaram-se com a historia familiar de infarto. Portanto sao distintos os fatores que se associam ao excesso de peso e da gordura abdominal em homens e mulheres. Mas muitos deles podem ser modificados com a adocao do estilo de vida saudavel.

Childhood anemia prevalence and associated factors in Salvador, Bahia, Brazil

A cross-sectional study was conducted in 1996 to estimate the prevalence of anemia in a stratified sample of 603 preschool children and identify factors associated with the disease. Hemoglobin assays were conducted in finger-prick blood samples using a Hemocue hemoglobinometer. Anemia was defined as hemoglobin below 11.0 g/dl. Logistic regression analysis was used to evaluate the potential associations. Observed anemia prevalence was 46.3%. Associated factors were: the 6-12-month and 12-24-month age brackets, the lowest tertiles for iron density and protein content dietary intake, and any degree of deficit in the height-for-age anthropometric parameter. Inadequate physical, sanitary, and environmental conditions in the home were associated with a significantly increased risk of anemia. Anemia constitutes an important health problem in this studys child population. Improvements in living conditions and dietary quality could contribute to a reduction in anemia prevalence.

Duração do aleitamento materno, regime alimentar e fatores associados segundo condições de vida em Salvador, Bahia, Brasil

This cross-sectional study aimed to identify breastfeeding duration, infant feeding regimes, and factors related to living conditions among 811 children under 24 months of age in Salvador, Bahia, Brazil. Data were statistically analyzed by survival analysis, Pearsons chi-square test, and multivariate logistic regression. Median duration of exclusive, predominant, and total breastfeeding was 30.6, 73.0, and 131.5 days, respectively. Exclusive or predominant breastfeeding was discontinued in 83.6% of the subjects. Children with poor living conditions were 2.3 times more likely (95%CI: 1.09-5.01) to receive early supplementary food, whereas the figure for the very poor increased to 2.5 (95%CI: 1.20-5.34). Early exclusive or predominant breastfeeding discontinuation was associated with early pregnancy and poor living conditions of the children and their families. Programs directed towards proper breastfeeding and healthy feeding practices in childhood should consider the social factors associated with early introduction of supplementary foods in this population.

Preditores do retardo de crescimento linear em pré-escolares: uma abordagem multinível

This study focuses on the determinants of linear growth deficit in under-five children using multilevel modeling. The sample included 3,746 preschoolers from 15 Brazilian municipalities (ten from the State of Bahia and five from Sao Paulo), with a three-tier analysis (municipalities, households, and children). Municipal data were obtained from the 1991 National Census. Individual and household data were collected from 1999 to 2001 using structured questionnaires and measuring childrens weight and height. Analysis used the MLwiN software. In the final multilevel model, low HDI and prenatal care at the municipal level, poor environmental and economic conditions and maternal schooling at the household level, and low birth weight, incomplete immunization, prior history of malnutrition, and no report of breastfeeding at the individual level were strongly associated with linear growth deficit. Total variability of deficit explained by the model was 27.4%, of which 51.3%, 33%, and 15.7% were explained, respectively, by individual, household, and municipal variables.

Desigualdade, pobreza e condições de saúde e nutrição na infância no Nordeste brasileiro

Estudo transversal, envolvendo 2.001 criancas das areas rural e urbana de dez municipios da Bahia, Brasil. Avalia-se a relacao entre os gradientes da desigualdade e os fatores do ambiente familiar, de saude e nutricao, utilizando-se a regressao logistica multinomial multivariada. As criancas do tercil intermediario das condicoes de vida e aquelas do tercil mais pobre tem chances significantes e crescentes de viverem na area rural, em domicilio chefiado pela mulher, ter o pai desempregado, mae com baixa escolaridade, de dormir com mais de uma pessoa na mesma cama, deficit linear grave e consumir retinol abaixo da mediana. A existencia de mais de uma crianca no domicilio, ser portadora de deficit ponderal e ter o consumo de lipideo abaixo da mediana foram eventos tambem significantes para as criancas mais pobres. A anemia foi identificada entre as criancas do tercil intermediario. A desigualdade expoe as criancas a chances crescentes de inadequado estado de saude e nutricao. Politicas de saude podem implementar medidas emergenciais no sentido de minimizar os males impostos pela desigualdade a saude e nutricao na infância.

Determinants of mild-to-moderate malnutrition in preschoolers in an urban area of Northeastern Brazil: a hierarchical approach

OBJECTIVE To investigate the determinants of mild-to-moderate malnutrition in preschoolers. DESIGN Cross-sectional study conducted in October and November 1996, with a representative sample of 1740 children less than 5 years old from the city of Salvador, situated in the Brazilian Northeastern region. Socio-economic and dietary data were collected through a structured questionnaire. Anthropometric measures were performed in duplicate and data analysis was based upon the hierarchical model approach. Logistic regression analysis was used to estimate the prevalence ratio and to identify the determinants of mild-to-moderate deficits in weight-for-age and height-for-age Z-scores. RESULTS Family monthly income under US

Metabolic syndrome in patients with chronic hepatitis C virus genotype 1 infection who do not have obesity or type 2 diabetes

67.00 per capita and family headed by a woman were the main basic determinants of mild-to-moderate weight-for-age and height-for-age deficits in the studied children. Household agglomeration, an underlying determinant, was associated with weight-for-age and height-for-age deficits. Among the immediate determinants, age above 6 months and dietary caloric availability in the lowest tertile (<930 kcal day-1) were also associated with weight-for-age deficits. In addition to these, hospitalisation in the 12 months preceding the interview was shown to be a predictor of mild-to-moderate weight-for-age and height-for-age deficits. CONCLUSION Adverse social and economic factors interact with family environmental factors to define food consumption and morbidity patterns that culminate in a high prevalence of mild-to-moderate malnutrition. The strengthening and restructuring of nutrition and healthcare actions, the definition of public policies that improve family income, and the adequate insertion of women in the labour market are possible strategies to reduce mild-to-moderate malnutrition and to sustain the decline already observed in severe malnutrition.

Breastfeeding and maternal weight changes during 24 months post-partum: a cohort study

OBJECTIVE: The individual components of metabolic syndrome may be independent predictors of mortality in patients with liver disease. We aimed to evaluate the prevalence of metabolic syndrome and its related components in hepatitis C virus–infected patients who are not obese and do not have type 2 diabetes. METHODS: This cross-sectional study included 125 patients infected with hepatitis C virus genotype 1. Metabolic syndrome was defined according to the International Diabetes Federation. Anthropometric data were measured according to standardized procedures. Bioimpedance analysis was performed on all patients. RESULTS: Metabolic syndrome was diagnosed in 21.6% of patients. Of the subjects with metabolic syndrome, 59.3% had hypertension, 77.8% had insulin resistance, 85.2% were overweight, 48.1% had a high waist circumference, 85.2% had an increased body fat percentage, and 92.3% had an elevated waist:hip ratio. In the bivariate analysis, female sex (OR 2.58; 95% CI: 1.09–6.25), elevated gamma-glutamyl transferase (γGT) (OR 2.63; 95% CI: 1.04–7.29), elevated fasting glucose (OR 8.05; 95% CI: 3.17-21.32), low HDL cholesterol (OR 2.80; 95% CI: 1.07–7.16), hypertriglyceridemia (OR 7.91; 95% CI: 2.88–22.71), elevated waist circumference (OR 10.33; 95% CI: 3.72–30.67), overweight (OR 11.33; 95% CI: 3.97–41.07), and increased body fat percentage (OR 8.34; 95% CI: 2.94–30.08) were independent determinants of metabolic syndrome. Using the final multivariate regression model, similar results were observed for abdominal fat (OR 9.98; 95% CI: 2.63–44.41) and total body fat percentage (OR 8.73; 95% CI: 2.33–42.34). However, metabolic syndrome risk was also high for those with blood glucose ≥5.55 mmol/L or HDL cholesterol <0.9 mmol/L (OR 16.69; 95% CI: 4.64–76.35; OR 7.23; 95% CI: 1.86–32.63, respectively). CONCLUSION: Metabolic syndrome is highly prevalent among hepatitis C virus–infected patients without type 2 diabetes or obesity. Metabolic syndrome was significantly associated with hypertension, insulin resistance, increased abdominal fat, and overweight.

Prevalência e fatores associados ao excesso de peso em adolescentes de Salvador, Bahia, Brasil

The relationship between breastfeeding and the loss of weight gained during pregnancy remains unclear. This study aimed to investigate the association between breastfeeding and maternal weight changes during 24 months post-partum. We studied a dynamic cohort comprising 315 women living in two cities in the state of Bahia, Brazil. The outcome variable was change in the post-partum weight; the exposure variable was the duration and intensity of breastfeeding. Demographic, socio-economic, environmental, reproductive and lifestyle factors were integrated in the analysis as covariates. The data were analysed using multiple linear regression and linear mixed-effects models. The average cumulative weight loss at 6 months post-partum was 2.561 kg (SD 4.585), increasing at 12 months (3.066 kg; SD 5.098) and decreasing at 18 months (1.993 kg; SD 5.340), being 1.353 kg (SD, 5.574) at 24 months post-partum. After adjustment, the data indicated that for every 1-point increase in breastfeeding score, the estimated average post-partum weight loss observed was 0.191 kg at 6 months (P = 0.03), 0.090 kg at 12 months (P = 0.043), 0.123 kg at 18 months (P < 0.001) and 0.077 kg at 24 months (P = 0.001). Based on these results, we concluded that despite the low expressiveness, the intensity and duration of breastfeeding was associated with post-partum weight loss at all stages of the study during the 24-month follow-up.