Mônica Leila Portela de Santana

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.

Metabolic syndrome and associated factors in children and adolescents of a Brazilian municipality.

BACKGROUND the risk factors associated to metabolic syndrome (MS) have been extensively studied in adults, but in children and adolescents it is poorly explored. OBJECTIVE To identify the prevalence of MS and associated factors in children and adolescents. METHODS A cross-sectional study with 540 children and adolescents from 7 to 14 years of age. The socioeconomic, demographic and lifestyle data and the family history of chronic diseases were reported by the individual and/or guardian and recorded in a structured questionnaire. Biochemical tests (fasting blood glucose, triacylglycerols, reduced high-density lipoprotein, very-low-density lipoprotein, homocysteine and cysteine), an anthropometric assessment and a blood pressure measurement were performed. MS was defined according to the criteria of The National Cholesterol Education Program Adult Treatment Panel III adapted by Ferranti. A Poisson regression was used to identify the factors statistically associated with MS. RESULTS The MS prevalence was 12.8%, in which the most frequent component was a decreased high-density lipoprotein level (58.2%), followed by hypertriglyceridemia (41.8%), elevated blood pressure (29.1%), increased waist circumference (26.7%) and hyperglycemia (7.2%). Associations between metabolic syndrome and overweight [prevalence ratio (PR): 2.2 (1.22-3.95)], father education [PR: 2.19 (1.10-4.37)], serum very low-density lipoprotein concentration [PR: 1.08 (1.04-1.11)] and concomitantly increased serum homocysteine and cysteine concentrations [PR: 2.58 (1.32-5.04)] were observed. CONCLUSIONS The MS prevalence is high in children and adolescents and it is increased in patients with overweight, higher father education, increased serum very-low-density lipoprotein concentrations and a concomitant serum homocysteine and cysteine high levels.

Mudança nos parâmetros antropométricos: a influência de um programa de intervenção nutricional e exercício físico em mulheres adultas

Obesity prevalence is increasing worldwide, with inadequate nutrition and physical inactivity as the main risk factors. The objective was to evaluate the impact of a nutritional intervention and physical activity program on body mass index (BMI) and waist circumference (WC) in adult women. This quasi-experimental study, lasting 12 months, enrolled 69 adult women that reported physical activity three times a week, besides receiving nutritional counseling and lectures on healthy living, evaluated at baseline and at 6 and 12 months of follow-up. Lower levels of physical activity and higher intake of high-risk foods were associated with a 2.28cm increase in mean WC, has compared to higher physical activity and lower intake of high-risk foods (p < 0.01). Lower levels of physical activity associated with high intake of protective foods increased the mean BMI by 0.68kg/m2, as compared to higher physical activity and high intake of protective foods. The intervention was positively associated with the target parameters.

Factors associated with body image dissatisfaction among adolescents in public schools students in Salvador, Brazil.

OBJECTIVE To identify the prevalence of body image dissatisfaction and associated factors among students in Salvador, Brazil. METHODS A cross-sectional study involving a random sample of 1,494 (852 girls and 642 boys) adolescents between 11 and 17 years of age who were students in the public schools in Salvador, Brazil. Participants completed the Body Shape Questionnaire and the Eating Attitudes Test-26. Body image was characterized as satisfactory or unsatisfactory. We obtained demographic, anthropometric and economic information and information regarding the stage of maturation, self-perception of body weight, and consumption of sweetened beverages and diet soft drinks. To identify associated factors we used Poisson regression analysis. RESULTS Body image dissatisfaction was present in 19.5% of the adolescents, with a prevalence of 26.6% among the girls and 10% among the boys. Independent of sex, the prevalence of body image dissatisfaction was higher among adolescents who were overweight or obese (girls, PR: 1.38, CI: 1.09-1.73 and boys, PR: 2.26, CI: 1.08-4.75), higher among those who perceived themselves as fat (girls, PR: 2.85, CI: 2.07-3.93 and boys, PR: 3.17, CI: 1.39-7.23), and higher among those who had negative attitudes toward eating (girls, PR: 2.42, CI: 1.91-3.08 and boys, PR: 4.67, CI: 2.85-7.63).. A reduction in body image dissatisfaction was only identified among underweight girls (PR: 0.12, CI: 0.03-0.49). CONCLUSIONS A high occurrence of body image dissatisfaction was observed among the adolescents, and biological and behavioral factors were associated with this dissatisfaction.

The prevalence of overweight and obesity in adolescents in Bahia, Brazil

AIM A cross-sectional study was conducted with 1,477 middle school students enrolled in the public school network in Salvador, Bahia, Brazil to assess the prevalence of overweight and obesity. METHODS The sample was determined using a two-stage cluster sampling technique for selecting schools and classes. A posteriori error was estimated. The students were classified as overweight or obese according to the World Health Organizations 2007 classifications. They were also classified according to age, stage of sexual maturity, socioeconomic class and the presence of abdominal obesity. RESULTS Overall, 9.3% of the students were overweight and 6.4% were obese; therefore, 15.7% of the students were considered to have excess weight (obesity + overweight), at a 95% confidence interval. Abdominal obesity was found in 12.9% of all students and in 13% of those of normal weight. An association was found between excess weight and age < 14 years (p = 0.030) and abdominal obesity (p = 0.001). CONCLUSIONS Intervention programs should be implemented to prevent and treat obesity in childhood and adolescence. In addition, professionals working with individuals in this age group should be sensitized to this problem. The need to standardize the anthropometric indicators used in the different studies is also emphasized.

Overweight and Obesity Associated with Higher Depression Prevalence in Adults: A Systematic Review and Meta-Analysis

ABSTRACT Objective: This study aims to review and synthesize scientific evidence to assess the association between excess body weight and depression among adults. Methods: The systematic research of observational studies was held from January to March 2015 on Pubmed, Web of Science, Scopus, Embase, PsycInfo, Psicodoc, Psycarticles, and Isi Web. A prevalence ratio (PR) was adopted as a summary measurement. All articles were evaluated for methodological quality and risk of bias. Metaregression was used to investigate heterogeneity and to identify the variation between the studies in relation to the estimates of the effects. Results: In this review, 9 studies (N = 171,701) met the inclusion criteria. All articles obtained adequate methodological quality. Most studies had high or unclear risk of bias. Overweight and obesity were assessed by body mass index. People with obesity were 32% more likely to have depression compared to those who were eutrophic (PR = 1.32; 95% confidence interval [CI], 1.26–1.38). After a gender analysis, the results showed statistically significant differences in obese versus eutrophic women (PR = 1.36; 95% CI, 1.28–1.34). Conclusions: There is consistent evidence that overweight or obesity was associated with depression.

Relação entre os níveis de vitamina A e os marcadores bioquímicos do estado nutricional de ferro em crianças e adolescentes

OBJETIVO: Verificar a relacao entre vitamina A e os marcadores bioquimicos da situacao nutricional do ferro. METODOS: Participaram deste estudo 178 individuos com idade entre 7 e 17 anos, residentes na cidade de Jequie (BA). Os individuos foram submetidos a exame de sangue para dosagem de retinol e de marcadores bioquimicos do estado nutricional relativo ao ferro. Alem disso, foram realizados exames antropometricos, parasitologico de fezes e coletadas informacoes de consumo dietetico de ferro e das condicoes socio-ambiental e domiciliar da familia. Utilizou-se a analise de regressao linear multipla como tecnica estatistica para avaliar a associacao de interesse. RESULTADOS: Constatou-se associacao positiva e estatisticamente significante entre os niveis de retinol serico e a concentracao de hemoglobina (p=0,007), ferro serico (p=0,010) e transferrina saturada (p=0,027). Esses efeitos se mantiveram apos ajuste dos modelos pelas variaveis demograficas, infeccoes parasitarias (Schistosoma mansoni, Trichiura trichuris, Ascaris lumbricoides e ancilostomideos), consumo de ferro alimentar biodisponivel e condicoes ambientais e domiciliares. CONCLUSAO: A vitamina A parece contribuir para elevar o ferro orgânico da populacao, em especial, em areas onde a deficiencia de vitamina A e a anemia coexistem.

Fatores associados a sintomas de transtornos alimentares entre escolares da rede pública da cidade do Salvador, Bahia

OBJECTIVE: To identify the prevalence and factors associated with symptoms of eating disor-ders among students. METHODS: Cross sectional study involving 365 students from 7 to 14 years old from elementary school in Salvador, Bahia. It was applied for the students of 13 years old it was adopted the Eating Attitudes Test-26, Bulimic Investigatory Test of Edinburgh and Body Shape Questionnaire. The Child Behavior Checklist was administered to all students. Data was collected anthropometric and dietary, lifestyle, demographic, socioeconomic, and pubertal. Poisson regression was used for statistical analysis. RESULTS: Symptoms of ea-ting disor-ders were present in 23% of the students. Age (PR: 1.25, 95% CI: 1.11 to 1.40), body image dissatisfaction (PR: 4.23, 95% CI: 2.53 to 7.08), internalizing behavior problems (PR: 1.78, 95% CI: 1.11 to 2.85), replacing the consumption of meals by candies (PR: 2.14, 95% CI: 1.24 to 3.69), higher consumption of fruits and other vegetables (PR: 2.49, 95% CI: 1.55 to 3.99) and maternal education from 5th to 8th grade (PR: 1.95, 95% CI: 1.06 to 3.58), increase the occurrence of symptoms of eating disorders. CONCLUSION: A high prevalence of symptoms of eating disorders among students; sociodemographic and behavioral factors were associated with the event.

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

OBJETIVO: Estimar a prevalencia e identificar fatores associados ao excesso de peso em adolescentes. METODOS: Trata-se de um estudo transversal. Foram selecionados 426 adolescentes de 10 a 18 anos, da cidade de Salvador, regiao Nordeste do Brasil, por um processo de amostragem por conglomerados, aleatoria em tres estagios. Os dados sobre a frequencia de consumo alimentar e atividade fisica, maturacao sexual, medidas antropometricas e covariaveis foram coletados. O estado nutricional foi classificado por meio dos pontos de corte baseados no indice de massa corporal de criancas e adolescentes brasileiros. As caracteristicas sexuais secundarias foram autorreferidas pelos avaliados. Os adolescentes que realizaram mais de 300 minutos de atividade fisica moderada por semana, foram considerados fisicamente ativos. A etnia foi classificada pela cor da pele e atributos fisicos. RESULTADOS: A prevalencia de excesso de peso para ambos os sexos foi de 14,3%. Estimou-se que a maturacao sexual precoce (Razao de Prevalencia ajustada = 2,12, IC95% = 1,10-4,05) e insuficientes niveis de atividade fisica (RP ajustada = 1,85, IC95% = 1,01-3,41), ajustados pela idade (RP ajustada = 1,77, IC95% = 0,97-3,24), sao associados, de forma independente, ao excesso de peso em adolescentes de Salvador. CONCLUSOES: O excesso de peso pode ser considerado elevado entre os adolescentes da cidade de Salvador. Consideram-se necessarias a adocao de politicas publicas de prevencao e combate precoce ao excesso de peso corporal que melhorem o estimulo, disponibilidade e acesso a pratica continuada e sistematica da atividade fisica em nivel populacional.

Effectiveness of the Brazilian Conditional Cash Transfer Program - Bolsa Alimentação - on the variation of linear and ponderal increment in children from northeast of Brazil

BACKGROUND Social programs can improve the conditions required for families provide sufficient care and attention for an adequate health and nutrition. OBJECTIVE This study evaluates the effectiveness of the Brazilians conditional cash transfer program - Bolsa Alimentacao (PBA) on children anthropometric status. METHODS A cohort of 1847 children, followed for 12 months: 1615 PBA children; 232 non-PBA. There were 316 (14.6%) missing children during the study. A quasi- experimental study adopting the before-after strategy was applied and the effectiveness approach was used to assess the impact of the program on children nutritional status. Multilevel analysis with three levels was used in the statistical analysis. The mean increment variations of height-for-age and weight-for-age were the outcome variables and the participation in the PBA was the exposition. Four participation groups were established: children not exposed to the program (internal control group); exposed to the program throughout the 12 months, exposed to the program only in the last 6 months; and exposed to the program only in the first 6 months. Repeated measures were obtained at baseline and at 12 months. RESULTS It was found that the exposure to the program was associated to a mean variation in weight-for-age of 0.34 Z-score (IC=-0.44; 0.63) and height-for-age of 0.38 (IC=0.05; 0.70) for children who were regular program beneficiaries during the follow-up. The exposure to the program in other periods was not statistically associated with a mean variation in the indicators. CONCLUSIONS Cash transfers direct to the family were associated to anthropometric deficits reduction in childhood.