Mariana Santos Felisbino-Mendes

Distúrbios metabólicos e adiposidade em uma população rural

The aim of this cross-sectional study was to verify the prevalence of overweight and central adiposity (CA) in a sample of 287 adult subjects that lived in a rural community of Minas Gerais State. Means lipids, lipoproteins, glucose and blood pressure levels were compared according adiposity categories using One-way ANOVA and Tukey tests. Prevalence of overweight was 24.8% (37.4% for female; 11.5% for male). CA was verified in 28.1% of the individuals (50.3% for female; 4.3% for male). The associations between CA and overweight with the metabolic disorders: arterial hypertension (AH), dyslipidemia and hyperglycemia were estimated. Subjects with CA presented higher mean values of blood pressure, total cholesterol, LDL, triglycerides, fasting glucose, and lower mean values of HDL. CA was associated with AH, dyslipidemia and hyperglycemia. Associations between overweight and AH, dyslipidemia and hyperglycemia were also verified. These results confirm the potential effect of body composition shifting, especially at the abdominal level, on lipids, glucose metabolism and on blood pressure levels in rural populations.

Factors associated with the contraindicated use of oral contraceptives in Brazil.

OBJECTIVE To estimate the prevalence of the contraindicated use of oral contraceptives and the associated factors in Brazilian women. METHODS 20,454 women who answered the VIGITEL survey in 2008 also participated in this study, of which 3,985 reported using oral contraceptives. We defined the following conditions for the contraindicated use of contraceptives: hypertension; cardiovascular diseases such as heart attack, stroke/cerebrovascular accident; diabetes mellitus; being smoker and 35 years old or older. We estimated the prevalence and 95% confidence intervals of contraindicated use in users of oral contraceptives and the factors associated with contraindication by prevalence ratio and 95% confidence intervals. RESULTS In the total population, 21% (95%CI 19.7–21.9) of women showed some contraindication to the use of oral contraceptives, of which 11.7% (95%CI 10.6–13.7) belonged to the group of users of oral contraceptives. The most frequent contraindication in users of oral contraceptives was hypertension (9.1%). The largest proportion of women with at least one contraindication was aged between 45 and 49 years (45.8%) and with education level between zero and eight years (23.8%). The prevalence of contraindication to oral contraceptives was higher in women less educated (zero to eight years of study) (PR = 2.46; 95%CI 1.57–3.86; p < 0.05) and with age between 35-44 years (PR = 4.00; 95%CI 2.34–6.83) and 45-49 years (PR = 5.59; 95%CI 2.90–10.75). CONCLUSIONS Age greater than or equal to 35 and low education level were demographic and iniquity factors, respectively, in the contraindicated use of oral contraceptives.

Avaliação do estado nutricional de crianças menores de 10 anos no município de Ferros, Minas Gerais

Brazil is going through problems with obesity as well as malnutrition and starvation - the nutritional transition. This is a cross sectional study with a sample of 1322 children under 10 years of age, residents in Ferros, Minas Gerais, Brazil, enrolled in SISVAN. Results showed that: 20.7% of children had nutritional disorder (10.1% nutritional risk, 3.8% malnourished and 6.7% overweight risk). Malnutrition risk factors were also identified: low birth-weight, RP=3.57, IC 95% (1.96-6.52); stunting, RP=19.36, IC 95% (11.53-32.52); no breastfeeding, RP=2.23, IC 95% (1.19-4.18); family income below R

Factors associated with alcohol intake and alcohol abuse among women in Belo Horizonte, Minas Gerais State, Brazil

95, RP=2.39, IC 95% (1.10-5.16). Prevalence for overweight was higher than for malnutrition. While the rural population presented higher prevalence for nutritional risk and malnutrition, in the urban area there was higher prevalence of risk for overweight. These results show the need for specific nutritional interventions according to the specific issues identified.Brazil is going through problems with obesity as well as malnutrition and starvation--the nutritional transition. This is a cross sectional study with a sample of 1322 children under 10 years of age, residents in Ferros, Minas Gerais, Brazil, enrolled in SISVAN. Results showed that: 20.7% of children had nutritional disorder (10.1% nutritional risk, 3.8% malnourished and 6.7% overweight risk). Malnutrition risk factors were also identified: low birth-weight, RP = 3.57, IC 95% (1.96-6.52); stunting, RP = 19.36, IC 95% (11.53-32.52); no breastfeeding, RP = 2.23, IC 95% (1.19-4.18); family income below RS 95, RP = 2.39, IC 95% (1.10-5.16). Prevalence for overweight was higher than for malnutrition. While the rural population presented higher prevalence for nutritional risk and malnutrition, in the urban area there was higher prevalence of risk for overweight. These results show the need for specific nutritional interventions according to the specific issues identified.

Prevalência de saúde cardiovascular ideal na população brasileira - Pesquisa Nacional de Saúde (2013)

O objetivo do presente estudo foi analisar os fatores associados ao consumo de alcool entre mulheres adultas no Municipio de Belo Horizonte, Minas Gerais, Brasil, baseado em dados do Sistema de Vigilância de Fatores de Risco e Protecao para Doencas Cronicas por Inquerito Telefonico no ano de 2011. Considerou-se uso habitual a referencia de ingestao de pelo menos uma dose de bebida alcoolica nos ultimos 30 dias, e abuso a ingestao de quatro ou mais doses em pelo menos uma ocasiao. A regressao logistica polinomial foi utilizada para avaliar os possiveis fatores associados ao uso e abuso de alcool. O uso habitual de alcool foi mais prevalente entre as mulheres na faixa etaria de 24 a 34 anos (p < 0,05), enquanto o abuso esteve associado a age mais jovem, alta escolaridade, classificacao do estado de saude como ruim e tabagismo (p < 0,05). Os resultados apontam a necessidade de politicas intersetoriais de prevencao do consumo abusivo de alcool entre as mulheres, principalmente as jovens, fumantes, escolarizadas e que nao vivem em uniao estavel.The main objective of this cross-sectional study was to analyze factors associated with alcohol consumption among adult women living in Belo Horizonte, Minas Gerais State, Brazil, in 2011. Data for Belo Horizonte were obtained from the VIGITEL system (Telephone-Based Surveillance of Risk and Protective Factors for Chronic Diseases). Alcohol use was defined as self-reported intake of at least one dose in the previous 30 days; alcohol abuse was defined as four or more doses on at least one occasion during the same period. Polytomous logistic regression was used to evaluate factors associated with alcohol use and abuse. Alcohol use was more prevalent among women 25 to 34 years of age. Alcohol abuse was associated with age, schooling, health status, and smoking. The results suggest the need for policies to prevent alcohol abuse among women, especially targeting those who are younger, single, smokers, and with more education.

Fatores de risco relacionados à carga global de doença do Brasil e Unidades Federadas, 2015

Primordial prevention is defined as the initial prevention of risk factors, through the adoption of healthier behaviors. Within this concept, the American Heart Association (AHA) has defined seven metrics, based on evidence, to achieve ideal cardiovascular health. The aim of this study was to evaluate the prevalence of cardiovascular health in the Brazilian population, according to sex, age, and region of residence, using data from the latest National Health Survey (2013). We assessed the risk factors, as recommended by the AHA, combined (number of factors) and individually: four behavioral (smoking, physical activity, body mass index and diet) and three biological factors (blood pressure, blood glucose and cholesterol levels). The Brazilian population has reached very low prevalence (1%), for the sum of 7 factors in ideal level. Individually, 3.2% of the population consumed ideal diet, followed by physical activity (23.6%) and body mass index (43.7%). The subjects aged between 18 and 35 years showed higher prevalence of metrics combined at the optimal levels (0.5%), which was also reached by the population of the Northern region. These results indicate that greater efforts are urgent by public policies at the level of primordial prevention in order to achieve appropriate targets of cardiovascular health in the Brazilian population.

Avaliação dos fatores de risco cardiovasculares em uma população rural brasileira

Objective: To analyze the global burden of disease related to disability adjusted life years (DALYs) attributed to selected risk factors in Brazil and its 27 Federated Units. Methods: Databases from the Global Burden of Disease study in Brazil and its Federated Units were used, estimating the summary exposure value (SEV) for selected environmental, behavioral, and metabolic risk factors (RFs), and their combinations. The DALYs were used as the main metric. The ranking of major RFs between 1990 and 2015 was compiled, comparing data by sex and states. Results: The analyzed RFs account for 38.8% of the loss of DALYs in the country. Dietary risks was the main cause of DALYs in 2015. In men, dietary risks contributed to 12.2% of DALYs and in women, to 11.1%. Other RFs were high systolic blood pressure, high body mass index, smoking, high fasting plasma glucose and, among men, alcohol and drug use. The main RFs were metabolic and behavioral. In most states, dietary risks was the main RF, followed by high blood pressure. Conclusion: Dietary risks leads the RF ranking for Brazil and its Federated Units. Men are more exposed to behavioral risk factors, and women are more exposed to metabolic ones.RESUMO: Objetivo: Analisar a carga global de doenca, quanto aos anos de vida ajustados por incapacidade (disability adjusted life years - DALYs) atribuidos a fatores de risco (FRs) selecionados, para Brasil e 27 Unidades Federadas (UFs). Metodos: Foram utilizadas bases de dados do estudo Carga Global de Doenca (Global Burden of Disease - GBD) para Brasil e UFs estimando a sintese de exposicao de risco (summary exposure value - SEV) para FRs selecionados, incluindo os ambientais, comportamentais, metabolicos e suas combinacoes. Os DALYs foram usados como metrica principal do estudo. Construiu-se o ranking dos principais FRs entre 1990 e 2015, com comparacoes por sexo e UF. Resultados: Os FRs analisados explicariam 38,8% da perda de DALYs no pais. A dieta inadequada foi a principal causa de DALYs em 2015. Em homens, a dieta inadequada contribuiu com 12,2% dos DALYs, e, em mulheres, com 11,1% deles. Outros FRs importantes foram: pressao arterial sistolica elevada, indice de massa corporal (IMC) elevado, tabagismo, glicose serica elevada; entre homens, destaca-se o uso de alcool e drogas. Os principais FRs foram metabolicos e comportamentais. Na maioria das UFs, predominou a dieta inadequada, seguida da pressao arterial elevada. Conclusao: A dieta inadequada lidera o ranking de FRs para Brasil e UF. Os homens estao mais expostos aos FRs comportamentais, e as mulheres, aos metabolicos.

Clustering and combining pattern of metabolic syndrome components in a rural Brazilian adult population

This cross-sectional study assessed cardiovascular health in 863 adults in rural communities in the Jequitinhonha Valley, Minas Gerais State, Brazil, focusing on seven factors, four of which behavioral (diet, physical activity, smoking, and body weight) and three biological (total cholesterol, fasting blood glucose, and arterial pressure), classified as ideal, intermediate, or poor. Men showed better results in behavioral factors (p = 0.01), with more men displaying 2 or 3 factors at ideal levels (48.5 and 25.8%, respectively), when compared to women (44.2 and 19.8%, respectively) (p = 0.01). Women presented more biological factors at ideal levels (19.1%) when compared to men (7.9%) (p < 0.001). Only three participants (0.4%) showed all seven factors at ideal levels. Prevalence of ideal indices was very low, showing the need for strategies to improve cardiovascular health in this population.Trata-se de um estudo transversal que avaliou indicadores de saude cardiovascular em 863 individuos adultos residentes em comunidades rurais do Vale do Jequitinhonha, Minas Gerais, Brasil. Foram avaliados sete fatores, quatro comportamentais (dieta, atividade fisica, tabagismo e peso corporal) e tres biologicos (colesterol total, glicemia em jejum e pressao arterial), classificados em niveis ideal, intermediario e ruim. Considerando os fatores comportamentais os homens tiveram melhor desempenho (p = 0,01), sendo observado um maior numero de homens com 2 e 3 fatores em niveis ideais (48,5 e 25,8%, respectivamente), em detrimento das mulheres (44,2 e 19,8%, respectivamente) (p = 0,01). Por outro lado, as mulheres apresentaram maior numero de fatores biologicos em niveis ideais (19,1%) quando comparadas com os homens (7,9%) (p < 0,001). Somente tres (0,4%) participantes apresentaram os sete fatores na categoria ideal. A prevalencia dos indicadores em nivel ideal foi muito baixa, demonstrando a urgencia de estrategias visando melhorar a saude cardiovascular desta populacao.

Nutritional assessment in children under 10 in ferros, Minas Gerais

CONTEXT AND OBJECTIVE Metabolic syndrome is characterized by clustering of cardiovascular risk factors such as obesity, dyslipidemia, insulin resistance, hyperinsulinemia, glucose intolerance and arterial hypertension. The aim of this study was to estimate the probability of clustering and the combination pattern of three or more metabolic syndrome components in a rural Brazilian adult population. DESIGN AND SETTING This was a cross-sectional study conducted in two rural communities located in the Jequitinhonha Valley, Minas Gerais, Brazil. METHODS The sample was composed of 534 adults (both sexes). Waist circumference, blood pressure and demographic, lifestyle and biochemical characteristics were assessed. The prevalences of metabolic syndrome and its components were estimated using the definitions of the National Cholesterol Education Program - Adult Treatment Panel III. A binomial distribution equation was used to evaluate the probability of clustering of metabolic syndrome components. The statistical significance level was set at 5% (P < 0.05). RESULTS Metabolic syndrome was more frequent among women (23.3%) than among men (6.5%). Clustering of three or more metabolic syndrome components was greater than expected by chance. The commonest combinations of three metabolic syndrome components were: hypertriglyceridemia + low levels of HDL-c + arterial hypertension and abdominal obesity + low levels of HDL-c + arterial hypertension; and of four metabolic syndrome components: abdominal obesity + hypertriglyceridemia + low levels of HDL-c + arterial hypertension. CONCLUSION The population studied presented high prevalence of metabolic syndrome among women and clustering of its components greater than expected by chance, suggesting that the combination pattern was non-random.

Validade e reprodutibilidade de inquérito telefônico de atividade física no Brasil

Brazil is going through problems with obesity as well as malnutrition and starvation - the nutritional transition. This is a cross sectional study with a sample of 1322 children under 10 years of age, residents in Ferros, Minas Gerais, Brazil, enrolled in SISVAN. Results showed that: 20.7% of children had nutritional disorder (10.1% nutritional risk, 3.8% malnourished and 6.7% overweight risk). Malnutrition risk factors were also identified: low birth-weight, RP=3.57, IC 95% (1.96-6.52); stunting, RP=19.36, IC 95% (11.53-32.52); no breastfeeding, RP=2.23, IC 95% (1.19-4.18); family income below R