Rogério da Silva Linhares

Distribuição de obesidade geral e abdominal em adultos de uma cidade no Sul do Brasil

O objetivo foi determinar a prevalencia e a evolucao da obesidade geral e abdominal em adultos com 20 anos ou mais em Pelotas, Rio Grande do Sul, Brasil. Estudo transversal de base populacional realizado em 2010. A obesidade geral foi definida pelo indice de massa corporal (IMC) > 30kg/m² e a obesidade abdominal definida como > 88cm para mulheres e > 102cm para homens. Foram entrevistados 2.448 individuos. A prevalencia de obesidade foi de 21,7% nos homens e 29,2% nas mulheres, ja a obesidade abdominal foi de 19,5% e 37,5%, respectivamente. Na analise multivariada, menor escolaridade esteve associada ao aumento da obesidade geral e abdominal em mulheres. Renda familiar apresentou relacao inversa com obesidade abdominal em homens. Comparativamente, mostraram aumento das prevalencias de obesidade de 1,2 vez para as mulheres e 1,5 vez para os homens, com estudos em 1994 e 2000. Porem, para obesidade abdominal houve pequena reducao entre as mulheres e se manteve semelhante para os homens. A prevalencia de obesidade geral aumentou nos ultimos 10 anos, enquanto que a obesidade abdominal mostrou estabilidade.

Insatisfação corporal em adolescentes: um estudo de base populacional

The scope of this study was to evaluate body dissatisfaction among adolescents, and to explore differences according to sex, socioeconomic status and body mass index. 4325 individuals aged 14-15 years old from Pelotas, Brazil, were studied. Body dissatisfaction was evaluated comparing the desired image with the perceived image, according to the Tiggemann & Wilson-Barret silhouette scale. The nutritional status was categorized in accordance with World Health Organization criteria, whereas socioeconomic status was evaluated using classifications of the Brazilian Association of Research Institutes. It was found that 27.6% of teens were overweight. Body dissatisfaction, appraised by the silhouette scale, affected 51% of boys and 65.6% of girls. The economic and nutritional status was associated with the outcome. Most overweight adolescents wished to have a slimmer silhouette than the perceived one. The economic level modified the effect of nutritional status on body dissatisfaction. Adolescents from the wealthier economic classes who were not in the ideal weight range manifested greater body dissatisfaction than the less affluent individuals and, irrespective of economic status, girls are more dissatisfied with excess body weight and boys with slimness.

Prevalência de internação hospitalar e fatores associados em Pelotas, RS

OBJECTIVE To estimate the prevalence of hospitalizations and to identify characteristics associated with hospital admission. METHODS We carried out a population-based cross-sectional study of subjects of both sexes, aged 20-69 years, and who lived in the urban area of Pelotas, Southern Brazil, between 1999 and 2000. Subjects were interviewed using a standardized, pre-coded questionnaire. Analysis was stratified by sex and confounder control was carried out using Poisson regression. Variables analyzed included socioeconomic and demographic characteristics, lifestyle, morbidities, and medical appointments in the last year. RESULTS Of the 1,916 subjects interviewed, 146 (7.6%; 95%CI: 6.4;8.8) had been hospitalized in the year preceding the interview. Among men, characteristics associated with hospitalization included age above 50 years, schooling between five and seven years, history of smoking, minor psychiatric disorders, and medical appointments in the last year. For women, hospitalization was more frequent among subjects aged 60-69 years, with five to seven years of schooling, and who had had medical appointments within the last year. Women who consumed under 30 g/day of alcohol were less likely to have been hospitalized. Prevalence of hospitalization for primary care-sensitive causes was 13.0% (95%CI: 7.6;18.5). CONCLUSIONS Prevalence of hospitalization is similar in men and women. Schooling, but not income, was found to be associated with hospitalization.OBJETIVO: Estimar a prevalencia de hospitalizacoes e identificar caracteristicas associadas a internacao hospitalar. METODOS: Estudo transversal de base populacional realizado com individuos de ambos os sexos, de 20 a 69 anos, residentes na zona urbana de Pelotas, RS, entre 1999 e 2000. Foi utilizado questionario padronizado e pre-codificado. Foi realizada analise estratificada entre os sexos e controle de fatores de confusao por meio de Regressao de Poisson. Foram incluidas na analise variaveis socioeconomicas, demograficas, habitos de vida, morbidades e consulta com medico no ultimo ano. RESULTADOS: Dos 1.916 individuos, 146 (7,6%, IC95%:6,4;8,8) haviam sido hospitalizados no ultimo ano desde a entrevista. Entre os homens, as caracteristicas que se mostraram associadas a internacao foram: idade de 50 anos ou mais, entre cinco e sete anos de escolaridade, ex-fumantes, disturbios psiquiatricos menores e consulta com medico no ultimo ano. Entre as mulheres com idade entre 60 e 69 anos, entre cinco e sete anos de escolaridade e consulta medica no periodo de um ano antes da entrevista, ocorreram maiores prevalencias de hospitalizacao. As mulheres que consumiam menos de 30 g/dia de alcool mostraram menor frequencia de hospitalizacao. A prevalencia de internacao por causas sensiveis a atencao primaria foi de 13,0% (IC 95%: 7,6;18,5). CONCLUSOES: Homens e mulheres apresentaram prevalencias semelhantes de internacao hospitalar. Foi encontrada associacao entre escolaridade e internacao, mas nao entre renda e internacao.

Accuracy and adequacy of waist circumference cut-off points currently recommended in Brazilian adults

OBJECTIVE To evaluate the adequacy and accuracy of cut-off values currently recommended by the WHO for assessment of cardiovascular risk in southern Brazil. DESIGN Population-based study aimed at determining the predictive ability of waist circumference for cardiovascular risk based on the use of previous medical diagnosis for hypertension, diabetes mellitus and/or dyslipidaemia. Descriptive analysis was used for the adequacy of current cut-off values of waist circumference, receiver operating characteristic curves were constructed and the most accurate criteria according to the Youden index and points of optimal sensitivity and specificity were identified. SETTING Pelotas, southern Brazil. SUBJECTS Individuals (n 2112) aged ≥20 years living in the city were selected by multistage sampling, since these individuals did not report the presence of previous myocardial infarction, angina pectoris or stroke. RESULTS The cut-off values currently recommended by WHO were more appropriate in men than women, with overestimation of cardiovascular risk in women. The area under the receiver operating characteristic curve showed moderate predictive ability of waist circumference in men (0.74, 95% CI 0.71, 0.76) and women (0.75, 95% CI 0.73, 0.77). The method of optimal sensitivity and specificity showed better performance in assessing the accuracy, identifying the values of 95 cm in men and 87 cm in women as the best cut-off values of waist circumference to assess cardiovascular risk. CONCLUSIONS The cut-off values currently recommended for waist circumference are not suitable for women. Longitudinal studies should be conducted to evaluate the consistency of the findings.

Carotid Intima-Media Thickness at Age 30, Birth Weight, Accelerated Growth during Infancy and Breastfeeding: A Birth Cohort Study in Southern Brazil

Objective To examine the relationship between carotid intima-media thickness (IMT) at age 30 and birth characteristics, growth during infancy, and breastfeeding duration, among subjects who have been prospectively followed since birth. Methods and Results In 1982, all births in the city of Pelotas, southern Brazil, were identified and those children (n = 5,914) whose families lived in the urban area of the city have been followed and evaluated at several time points. The cohort participants were evaluated in 2012–13, and IMT was measured at the posterior wall of the right and left common carotid arteries in longitudinal planes using ultrasound imaging. We obtained valid IMT measurements for 3,188 individuals. Weight-for-age z-score (WAZ) at age 2 years, weight-for-height z-score (WHZ) at age 4, height-for-age z-score (HAZ) at 4 years, WAZ at age 4 and relative conditional weight at 4 years were positively associated with IMT, even after controlling for confounding variables. The beta-coefficient associated with ≥1 s.d. WAZ at age 2 (compared to those with a <–1 s.d.) was 3.62 μm (95% CI 0.86 to 6.38). The beta-coefficient associated with ≥1 s.d. WHZ at 4 (in relation to <–1 s.d) was 3.83 μm (95% CI 0.24 to 7.42). For HAZ at 4, the beta-coefficient for ≥1 s.d. in relation to <–1 s.d. was 4.19 μm (95% CI 1.14 to 7.25). For WAZ at 4, the beta-coefficient associated with ≥1 s.d. in relation to <–1 s.d. was 4.28 μm (95% CI 1.59 to 6.97). The beta-coefficient associated with conditional weight gain at age 2–4 was 1.26 μm (95% CI 0.49 to 2.02). Conclusion IMT at age 30 was positively associated with WAZ at age 2 years, WHZ at age 4, HAZ at age 4, WAZ at age 4 and conditional weight gain at age 4 years.

Prevalence of hospitalization and associated factors in Pelotas, Southern Brazil.

OBJECTIVE To estimate the prevalence of hospitalizations and to identify characteristics associated with hospital admission. METHODS We carried out a population-based cross-sectional study of subjects of both sexes, aged 20-69 years, and who lived in the urban area of Pelotas, Southern Brazil, between 1999 and 2000. Subjects were interviewed using a standardized, pre-coded questionnaire. Analysis was stratified by sex and confounder control was carried out using Poisson regression. Variables analyzed included socioeconomic and demographic characteristics, lifestyle, morbidities, and medical appointments in the last year. RESULTS Of the 1,916 subjects interviewed, 146 (7.6%; 95%CI: 6.4;8.8) had been hospitalized in the year preceding the interview. Among men, characteristics associated with hospitalization included age above 50 years, schooling between five and seven years, history of smoking, minor psychiatric disorders, and medical appointments in the last year. For women, hospitalization was more frequent among subjects aged 60-69 years, with five to seven years of schooling, and who had had medical appointments within the last year. Women who consumed under 30 g/day of alcohol were less likely to have been hospitalized. Prevalence of hospitalization for primary care-sensitive causes was 13.0% (95%CI: 7.6;18.5). CONCLUSIONS Prevalence of hospitalization is similar in men and women. Schooling, but not income, was found to be associated with hospitalization.OBJETIVO: Estimar a prevalencia de hospitalizacoes e identificar caracteristicas associadas a internacao hospitalar. METODOS: Estudo transversal de base populacional realizado com individuos de ambos os sexos, de 20 a 69 anos, residentes na zona urbana de Pelotas, RS, entre 1999 e 2000. Foi utilizado questionario padronizado e pre-codificado. Foi realizada analise estratificada entre os sexos e controle de fatores de confusao por meio de Regressao de Poisson. Foram incluidas na analise variaveis socioeconomicas, demograficas, habitos de vida, morbidades e consulta com medico no ultimo ano. RESULTADOS: Dos 1.916 individuos, 146 (7,6%, IC95%:6,4;8,8) haviam sido hospitalizados no ultimo ano desde a entrevista. Entre os homens, as caracteristicas que se mostraram associadas a internacao foram: idade de 50 anos ou mais, entre cinco e sete anos de escolaridade, ex-fumantes, disturbios psiquiatricos menores e consulta com medico no ultimo ano. Entre as mulheres com idade entre 60 e 69 anos, entre cinco e sete anos de escolaridade e consulta medica no periodo de um ano antes da entrevista, ocorreram maiores prevalencias de hospitalizacao. As mulheres que consumiam menos de 30 g/dia de alcool mostraram menor frequencia de hospitalizacao. A prevalencia de internacao por causas sensiveis a atencao primaria foi de 13,0% (IC 95%: 7,6;18,5). CONCLUSOES: Homens e mulheres apresentaram prevalencias semelhantes de internacao hospitalar. Foi encontrada associacao entre escolaridade e internacao, mas nao entre renda e internacao.

Iniquidade na suplementação de sulfato ferroso entre gestantes no sul do Brasil

INTRODUCTION The use of ferrous sulfate is recommended for all pregnant women from the 20th week of gestation to the 3rd month after delivery. OBJECTIVE To evaluate the coverage of ferrous sulfate among pregnant women and differentials according to demographic and socioeconomic variables. METHOD A cross-sectional population-based study with women who had children in Rio Grande, Rio Grande do Sul, Brazil, from January 1st to December 31st, 2013. Ferrous sulfate coverage was assessed according to maternal age, schooling, family income, and type of prenatal care. Statistical analysis included Pearsons χ2 test and Poisson regression. RESULTS 2,685 postpartum women (97% of the total) were interviewed and the ferrous sulfate coverage was 63%. The largest relative differences were between the extreme maternal schooling groups (50%) and the type of medical care in prenatal care (72%). Women aged between 13 and 19 years were significantly associated with the use of supplement (RP = 1.16; 95%CI 1.08 - 1.25) when compared to women aged ≥ 30 years. Those who used the public service in prenatal care were more strongly associated with the outcome when compared to those who used the private system (PR = 1.61; 95%CI 1.49 - 1.74). CONCLUSION Considering that there are unusual situations in the health sector in which disadvantaged groups are privileged, these findings are rare and indicate the presence of inequality in a way that is opposite to what was expected. The supplement should consider all women, especially older women, with higher education and better socioeconomic status.

Prevalence of weight-loss strategies of young adults from the 1982 birth cohort in Pelotas, RS

The objective of this article was to identify, among the members of the 1982 birth cohort in Pelotas, those who were trying to lose weight at the age of 23, and which strategies they used. From 2004 to 2005, 4,297 individuals from the 1982 cohort were interviewed. The effects of demographic, socioeconomic and behavioral factors on the prevalence of any strategy to lose weight in the past year were assessed in a cross-sectional analysis with the Poisson regression. Out of all the youngsters interviewed, 28.5% reported having used some strategy to lose weight. In the adjusted analysis, gender, schooling, family income, body mass index and smoking were associated with the use of some strategy. The strategy used by most of the young people was diet followed by physical activity. The results showed that appropriate preventive measures and body weight control are necessary, along with public policies aimed at encouraging healthy habits among young people, including physical and dietary education.

Prevalencia de internación hospitalaria y factores asociados en Pelotas, Sur de Brasil

OBJECTIVE To estimate the prevalence of hospitalizations and to identify characteristics associated with hospital admission. METHODS We carried out a population-based cross-sectional study of subjects of both sexes, aged 20-69 years, and who lived in the urban area of Pelotas, Southern Brazil, between 1999 and 2000. Subjects were interviewed using a standardized, pre-coded questionnaire. Analysis was stratified by sex and confounder control was carried out using Poisson regression. Variables analyzed included socioeconomic and demographic characteristics, lifestyle, morbidities, and medical appointments in the last year. RESULTS Of the 1,916 subjects interviewed, 146 (7.6%; 95%CI: 6.4;8.8) had been hospitalized in the year preceding the interview. Among men, characteristics associated with hospitalization included age above 50 years, schooling between five and seven years, history of smoking, minor psychiatric disorders, and medical appointments in the last year. For women, hospitalization was more frequent among subjects aged 60-69 years, with five to seven years of schooling, and who had had medical appointments within the last year. Women who consumed under 30 g/day of alcohol were less likely to have been hospitalized. Prevalence of hospitalization for primary care-sensitive causes was 13.0% (95%CI: 7.6;18.5). CONCLUSIONS Prevalence of hospitalization is similar in men and women. Schooling, but not income, was found to be associated with hospitalization.OBJETIVO: Estimar a prevalencia de hospitalizacoes e identificar caracteristicas associadas a internacao hospitalar. METODOS: Estudo transversal de base populacional realizado com individuos de ambos os sexos, de 20 a 69 anos, residentes na zona urbana de Pelotas, RS, entre 1999 e 2000. Foi utilizado questionario padronizado e pre-codificado. Foi realizada analise estratificada entre os sexos e controle de fatores de confusao por meio de Regressao de Poisson. Foram incluidas na analise variaveis socioeconomicas, demograficas, habitos de vida, morbidades e consulta com medico no ultimo ano. RESULTADOS: Dos 1.916 individuos, 146 (7,6%, IC95%:6,4;8,8) haviam sido hospitalizados no ultimo ano desde a entrevista. Entre os homens, as caracteristicas que se mostraram associadas a internacao foram: idade de 50 anos ou mais, entre cinco e sete anos de escolaridade, ex-fumantes, disturbios psiquiatricos menores e consulta com medico no ultimo ano. Entre as mulheres com idade entre 60 e 69 anos, entre cinco e sete anos de escolaridade e consulta medica no periodo de um ano antes da entrevista, ocorreram maiores prevalencias de hospitalizacao. As mulheres que consumiam menos de 30 g/dia de alcool mostraram menor frequencia de hospitalizacao. A prevalencia de internacao por causas sensiveis a atencao primaria foi de 13,0% (IC 95%: 7,6;18,5). CONCLUSOES: Homens e mulheres apresentaram prevalencias semelhantes de internacao hospitalar. Foi encontrada associacao entre escolaridade e internacao, mas nao entre renda e internacao.