Regina Maria Veras Gonçalves-Silva

Acurácia da circunferência da cintura e da relação cintura/quadril como preditores de dislipidemias em estudo transversal de doadores de sangue de Cuiabá, Mato Grosso, Brasil

This study evaluated the accuracy of anthropometric fat location indices (waist circumference and waist-to-hip ratio) as predictors of dyslipidemia, in addition to defining their respective cut-offs. The sample consisted of 416 healthy male blood donors from 20 to 58 years of age at the Blood Center in Cuiabá, capital of Mato Grosso State, Brazil. Serum lipids were determined through the enzymatic method. Data analysis through the ROC curve identified the best indicator and the cut-off with the largest statistically significant area under the ROC curve. The best cut-off points for waist-to-hip ratio and waist circumference were 0.90 and 85cm, respectively. The area under the ROC curve between waist circumference and high cholesterol/HDL relation included the 0.50 value, so waist circumference could not be considered a predictor of dyslipidemia. The best sensitivity and specificity were in the youngest group. Waist-to-hip ratio was a better predictor of dyslipidemia than waist circumference, although the latter showed better discriminating power to detect hypertriglyceridemia. The most accurate cut-off points were lower than those set by the World Health Organization.

Consumo de bebida alcoólica e adiposidade abdominal em doadores de sangue

OBJECTIVE To evaluate the association between alcohol consumption and abdominal fat. METHODS Cross-sectional study carried out in a sample of male blood donors (n=1,235), aged 20-59 years, in the city of Cuiabá, Central-West Brazil, between August 1999 and January 2000. Waist circumference and waist-to-hip ratio were indicators of abdominal fat, adjusted for total adiposity. Weight, height, waist and hip circumferences were measured. Alcohol consumption was evaluated using a questionnaire collecting information on type, frequency, and amount of consumption. The association between alcohol consumption and abdominal fat was assessed through multiple linear regression models adjusted for age, physical activity, smoking, and percent of body fat. RESULTS After adjustment, waist circumference and waist-to-hip ratio were positively associated with beer (p=0.02) and total alcohol consumption (p=0.01; p=0.03, respectively). Waist circumference was positively associated with spirit consumption (p=0.04). CONCLUSIONS Alcohol intake, particularly beer, was positively associated to abdominal fat.OBJETIVO: Analisar a associacao entre o consumo de bebidas alcoolicas e adiposidade abdominal. METODOS: Estudo transversal com uma amostra de homens doadores de sangue (N=1.235), de 20 a 59 anos, em Cuiaba (MT), realizado de agosto/1999 a janeiro/2000. Os indicadores de adiposidade abdominal foram circunferencia da cintura e relacao cintura/quadril, ajustados pela adiposidade total. As medidas aferidas foram: peso, estatura, circunferencias da cintura e do quadril. O consumo de alcool foi avaliado utilizando-se um questionario sobre tipo, frequencia e quantidade da bebida consumida. A associacao entre o consumo de alcool e adiposidade abdominal foi analisada por regressao linear multipla, com os modelos ajustados para idade, atividade fisica, tabagismo e adiposidade total. RESULTADOS: Apos ajuste, a circunferencia da cintura e a relacao cintura quadril mantiveram-se associadas positivamente ao consumo de cerveja (p=0,02) e ao total de alcool consumido (p=0,01 e 0,03, respectivamente). O consumo de aguardente mostrou associacao somente com a circunferencia da cintura (p=0,04). CONCLUSOES: O consumo de alcool, particularmente de cerveja, associou-se com a localizacao abdominal de gordura.

Prevalência e fatores associados aos comportamentos sedentários em adolescentes

OBJECTIVE To analyze the prevalence of sedentary behavior and associated factors in adolescents. METHODS A cross-sectional study with adolescents aged 10 to 17 years, of both sexes, belonging to a 1994-1999 birth cohort in the city of Cuiabá, MT, Central Western Brazil. Data were collected using a questionnaire containing sociodemographic, economic, lifestyle and anthropometric variables. Sedentary behavior was determined as using television and/or computer/video games for a time greater than or equal to 4 hours/day. Associations with sedentary behavior were evaluated using body mass index in childhood and adolescence and sociodemographic and behavioral variables using hierarchical logistic regression. RESULTS The overall prevalence of sedentary behavior was 58.1%. Of the 1,716 adolescents evaluated, 50.7% (n = 870) were male. In multivariate analysis, after adjustment for confounding factors, the variables that remained associated with sedentary behavior were: age (14 and over) (OR = 3.51, 95%CI 2.19;5.60); higher socioeconomic class (OR = 3.83, 95%CI 2.10;7.01), higher level of maternal education (OR = 1.81, 95%CI 1.09;3.01); living in the country (OR = 0.49, 95%CI 0.30;0.81); insufficient physical activity (OR = 1.25, 95%CI 1.02;1.53); experimentation with alcoholic beverages (OR = 1.34, 95%CI 1.08;1.66) and being overweight in adolescence (OR = 1.33, 95%CI 1.06;1.68). CONCLUSIONS The high proportion of adolescents in sedentary activities and the lack of association with being overweight in childhood, indicates the need for educational initiatives to reduce multiple risk behaviors. Encouraging physical activity in young people as a way of reducing sedentary behavior and, consequently, being overweight is fundamental.OBJECTIVE To analyze the prevalence of sedentary behavior and associated factors in adolescents. METHODS A cross-sectional study with adolescents aged 10 to 17 years, of both sexes, belonging to a 1994-1999 birth cohort in the city of Cuiaba, MT, Central Western Brazil. Data were collected using a questionnaire containing sociodemographic, economic, lifestyle and anthropometric variables. Sedentary behavior was determined as using television and/or computer/video games for a time greater than or equal to 4 hours/day. Associations with sedentary behavior were evaluated using body mass index in childhood and adolescence and sociodemographic and behavioral variables using hierarchical logistic regression. RESULTS The overall prevalence of sedentary behavior was 58.1%. Of the 1,716 adolescents evaluated, 50.7% (n = 870) were male. In multivariate analysis, after adjustment for confounding factors, the variables that remained associated with sedentary behavior were: age (14 and over) (OR = 3.51, 95%CI 2.19;5.60); higher socioeconomic class (OR = 3.83, 95%CI 2.10;7.01), higher level of maternal education (OR = 1.81, 95%CI 1.09;3.01); living in the country (OR = 0.49, 95%CI 0.30;0.81); insufficient physical activity (OR = 1.25, 95%CI 1.02;1.53); experimentation with alcoholic beverages (OR = 1.34, 95%CI 1.08;1.66) and being overweight in adolescence (OR = 1.33, 95%CI 1.06;1.68). CONCLUSIONS The high proportion of adolescents in sedentary activities and the lack of association with being overweight in childhood, indicates the need for educational initiatives to reduce multiple risk behaviors. Encouraging physical activity in young people as a way of reducing sedentary behavior and, consequently, being overweight is fundamental.

Obesidade: principal fator de risco para hipertensão arterial sistêmica em adolescentes brasileiros participantes de um estudo de coorte

OBJECTIVE: To identify the prevalence and factors associated with hypertension in adolescents. SUBJECTS AND METHODS: Cross-sectional study of 1,716 adolescents of a cohort study, aged from 10 to 16 years old sociodemographic, economic, and lifestyle characteristics were obtained from an interview, and birth weight from hospital records. Hypertension was defined as systolic or diastolic blood pressure above the 95th percentile according to the classification recommended by the Second Task Force High Blood Pressure in Children and Adolescents. Nutritional status was diagnosed by body mass index (BMI), according to the z score from curves published by the World Health Organization. Waist circumference was measured at the natural waist. The association between hypertension and the explanatory variables was measured using logistic regression. RESULTS: The adolescents interviewed represent 71.4% of the baseline, and 50.7% of them were males. The prevalence of hypertension was 11.7%. In the multivariate analysis, after adjustment for age sex and skin color, hypertension was associated with obesity [OR = 2.27, (95%) CI = 1.64 to 3.14] but not associated with waist circumference after adjusting for BMI. Early life factors were not associated with hypertension in adolescence. CONCLUSION: The results show an association between obesity and hypertension among adolescents.

Compulsão alimentar e fatores associados em adolescentes de Cuiabá, Mato Grosso, Brasil

Binge eating means ingesting a large amount of food during a certain period of time, followed by a sensation of lack of control over what and how much has been eaten. The study aimed to estimate the prevalence of binge eating episodes and associated factors in teenagers. The cross-sectional study included 1,209 teenagers (14 to 19 years old). Diagnosis of binge eating was based on the revised Questionnaire on Eating and Weight Patterns. The analysis used Poisson regression with a hierarchical approach. Prevalence of binge eating episodes was 24.6% (95%CI: 22.3-27.2), and factors that remained associated were: female gender (HR = 1.93; 95%CI: 1.47-2.53); age 15 to 18 (HR = 1.54; 95%CI: 1.01-2.37) and age 19 (HR = 2.60; 95%CI: 1.15-5.86); alcohol consumption more than 3 times a month (HR = 1.54; 95%CI: 1.03-2.33); and current weight oscillation (HR = 1.76; 95%CI: 1.33-2.31). In conclusion, prevalence of binge eating episodes was high and associated with female gender, age, alcohol consumption, and weight oscillation.O episodio de compulsao alimentar e caracterizado pela ingestao de grande quantidade de alimentos em tempo delimitado acompanhada de perda de controle sobre o que/quanto se come. O estudo objetivou estimar a prevalencia e os fatores associados aos episodios de compulsao alimentar. Estudo transversal com 1.209 adolescentes de 14 a 19 anos. Para o diagnostico dos episodios de compulsao alimentar utilizou-se o Questionario sobre Padroes de Alimentacao e Peso - Revisado (QEWP-R). Foi realizada analise atraves da regressao de Poisson com abordagem hierarquica. A prevalencia de episodios de compulsao alimentar foi 24,6% (IC95%: 22,3-27,2) e os fatores que permaneceram associados foram: sexo feminino (RP = 1,93; IC95%: 1,47-2,53), idade de 15 a 18 anos (RP = 1,54; IC95%: 1,01-2,37) e 19 anos (RP = 2,60; IC95%: 1,15-5,86), uso de bebidas alcoolicas mais de tres vezes por mes (RP = 1,54; IC95%: 1,03-2,33) e flutuacoes de peso (RP = 1,76; IC95%: 1,33-2,31). Conclui-se que a prevalencia de episodios de compulsao alimentar foi alta e associada ao sexo feminino, idade, uso de bebidas alcoolicas e flutuacao de peso.

Dietary patterns associated with anthropometric indicators of abdominal fat in adults

This study aimed to identify dietary patterns and assess their association with abdominal fat. A cross-sectional study was conducted in the Central West Region of Brazil with a probabilistic sample of 208 adults of both sexes. Data on food intake was obtained using a food frequency questionnaire and factor analysis (principal components) was conducted to identify dietary patterns. Waist circumference (WC) and waist-to-hip ratio (WHR) were used to assess abdominal fat. The association between dietary patterns and body fat distribution was examined using multiple linear regression analysis adjusted for confounders. Three dietary patterns were identified: Western, regional traditional, and prudent. A positive association was found between the Western pattern and WC (p = 0.04) and WHR (p = 0.001) and between the regional traditional pattern and WHR (p = 0.05) among women. A slight association was also found between the latter pattern and WC (p = 0.07) also among women. An association was found between the Western and regional traditional dietary patterns and a larger concentration of abdominal fat among women.Este estudo teve o objetivo identificar padroes alimentares e analisar a associacao com a adiposidade abdominal. Estudo transversal, realizado na Regiao Centro-Oeste do Brasil, com amostra probabilistica de 208 adultos, de ambos os sexos. O consumo alimentar foi obtido por questionario de frequencia alimentar e aplicada analise fatorial (componentes principais) para identificar padroes alimentares. A circunferencia da cintura (CC) e a relacao cintura quadril (RCQ) foram indicadores de adiposidade abdominal. A associacao dos padroes alimentares com adiposidade abdominal foi analisada em modelos de regressao linear multipla ajustados por fatores de confusao. Identificaram-se tres padroes alimentares: ocidental, tradicional regional e prudente. O padrao ocidental associou-se positivamente com CC (p = 0,04) e RCQ (p = 0,001) e o padrao tradicional regional associou-se tambem com RCQ (p = 0,05), e marginal a associacao com a CC (p = 0,07) somente em mulheres. Os padroes ocidental e tradicional regional associaram a maior adiposidade abdominal em mulheres.

Tabagismo domiciliar em famílias com crianças menores de 5 anos no Brasil

OBJECTIVES To estimate the prevalence of exposure to smoking in households with children younger than 5 years of age in the city of Cuiabá, Mato Grosso, Brazil, and to identify the main determinants of that exposure. METHODS This cross-sectional, population-based study included 2 037 families from the city of Cuiabá. The parents of the children or other caregivers answered a questionnaire concerning the smoking habits of people living in the household, sociodemographic characteristics of the household, and the households living conditions. RESULTS The overall prevalence of smoking in the households was 37.7%. In terms of income, in the households with a monthly per capita income of 2 minimum wages or more, the prevalence of smoking was 24.1%; it was 31.3% in the households with a monthly per capita income between 1 and 1.9 minimum wages; and it was 46.0% in households with a monthly per capita income below 1 minimum wage. With respect to socioeconomic level (the familys material goods and purchasing power and the educational level of the head of the household, divided into five classes, from A (highest) to E (lowest)), the higher the socioeconomic level, the lower was the prevalence of smoking in the household: 26.9% for class A, 26.4% for class B, 34.9% for class C, 45.1% for class D, and 47.2% for class E. There was a higher prevalence of smoking when the father did not live in the home (47.5% versus 35.5%), when the head of the family was someone other than the father or the mother (53.8% versus 33.9% and 38.8%, respectively), when the father was younger than 20 years (52.3% versus 31.2% for fathers 40 or older), and when the mother was younger than 20 years (46.1% versus 22.5% for mothers 40 or older). In terms of occupation, the lowest prevalence of household smoking was found with health professionals and teachers, for both women (18.3%) and men (14.7%). After multivariate logistic regression analysis, the following variables remained associated with household smoking: absence of the father from the household, maternal and paternal schooling, maternal and paternal occupation, childs age, and household monthly per capita income. CONCLUSION The risk of exposure to household smoking (and thus to passive smoking) in this sample of children younger than 5 years of age was higher in households living in poorer socioeconomic conditions.

O censo escolar como estratégia de busca de crianças e adolescentes em estudos epidemiológicos

Low-cost alternatives that allow for the monitoring of population groups are important strategies in conducting cohort studies. This paper presents the procedures for the use of the National School Census as a search tool for children and adolescents in follow-up studies. The study was conducted among adolescent students who took vaccinations in clinics in Cuiaba, Mato Grosso State, Brazil in 1999. A total of 86.8% were identified in the census and 0.2% in the Mortality Information System. Of those identified, 1,716 were interviewed, representing a follow-up rate of 71.4%. In this study, the school census proved to be an effective method for finding students.

Effect of tobacco smoke exposure during pregnancy and preschool age on growth from birth to adolescence: a cohort study

BackgroundThere is strong evidence of an association between maternal smoking during pregnancy and restriction of intrauterine growth, but the effects of this exposure on postnatal linear growth are not well defined. Furthermore, few studies have investigated the role of tobacco smoke exposure also after pregnancy on linear growth until adolescence. In this study we investigated the effect of maternal smoking exposure during pregnancy and preschool age on linear growth from birth to adolescence.MethodsWe evaluated a cohort of children born between 1994 and 1999 in Cuiabá, Brazil, who attended primary health clinics for vaccination between the years 1999 and 2000 (at preschool age) and followed-up after approximately ten years. Individuals were located in public and private schools throughout the country using the national school census. Height/length was measured, and length at birth was collected at maternity departments. Stature in childhood and adolescence was assessed using the height-for-age index sex-specific expressed as z-score from curves published by the World Health Organization. Linear mixed effects models were used to estimate the association between exposure to maternal smoking, during pregnancy and preschool age, and height of children assessed at birth, preschool and school age, adjusted for age of the children.ResultsWe evaluated 2405 children in 1999–2000, length at birth was obtained from 2394 (99.5%), and 1716 at follow-up (71.4% of baseline), 50.7% of the adolescents were male. The z-score of height-for-age was lower among adolescents exposed to maternal smoking both during pregnancy and childhood (p < 0.01). Adjusting for age, sex, maternal height, maternal schooling, socioeconomic position at preschool age, and breastfeeding, children exposed to maternal smoking both during pregnancy and preschool age showed persistent lower height-for-age since birth to adolescence (coefficient: −0.32, p < 0.001) compared to non-exposed. Paternal smoking at preschool age was not associated with growth after adjustment for confounders.ConclusionExposure to maternal smoking not only during pregnancy, but also at early childhood, showed long-term negative effect on height of children until adolescence.

Qualidade da dieta de adolescentes e fatores associados

Analisar a qualidade da dieta de adolescentes pelo Indice de Qualidade da Dieta Revisado (IQD-R) e os fatores associados. Foi realizado estudo transversal com 1.326 adolescentes de escolas publicas e privadas. O consumo alimentar foi obtido utilizando-se questionario de frequencia alimentar. Utilizou-se razao de prevalencia para avaliar a associacao entre o IQD-R elevado (≥ percentil 75) e as variaveis independentes. Variaveis com valor de p <0,20 foram incluidas na regressao de Poisson. A media do IQD-R foi de 75,1 pontos (IC95%: 74,8-75,5). Tempo ≤ 2 horas diarias gasto em atividades sedentarias como assistir televisao, usar computador ou games; tempo ≥ 300 minutos por semana de atividade fisica e excesso de peso dos adolescentes foram associados a maiores pontuacoes do IQD-R. Estilo de vida saudavel foi associado a dieta de melhor qualidade. Destaca-se a importância do incentivo a pratica de atividade fisica, reducao do numero de horas diarias em atividades sedentarias e intervencao na pratica alimentar dos adolescentes.