Rosângela Alves Pereira

Razão cintura/quadril como preditor de hipertensão arterial

This study aims to define cut-off points for the waist:hips girth ratio (WHR), using arterial hypertension as the outcome. The data refer to 3,282 individuals over twenty years of age examined in a survey conducted in the municipality of Rio de Janeiro in 1995-1996, using a two-stage sample. Sixty census tracts were drawn initially; subsequently, 34 households were selected systematically from each tract. Stature, weight, waist and hips girths, and blood pressure were measured in the households. The criterion for hypertension was a systolic blood pressure of ( 140 mmHg or diastolic pressure of ( 90 mmHg, or use of medication to reduce blood pressure. The sensitivity and specificity of different cut-off points for WHR were calculated in the prediction of arterial hypertension according to sex, age, and presence of overweight, classified according to World Health Organization guidelines. The best cut-off points for WHR were 0.95 for men and 0.80 for women. Compared to the waist:stature ratio and waist circumference, the WHR proved more capable of predicting arterial hypertension and less correlated with body mass index.

O consumo alimentar de gestantes adolescentes no Município do Rio de Janeiro

The increase in teenage pregnancy has been viewed with concern by public health experts. Food consumption to help maintain high nutrient demands has been identified as one of the most relevant components. This study aims to present the habitual consumption of food and energy-specific nutrients by pregnant adolescents. A total of 1,180 adolescent mothers were interviewed in maternity hospitals in the City of Rio de Janeiro, and a simplified questionnaire on semi-quantitative frequency of food consumption was applied. Lower consumption of fruit juice, vegetables, and fruits was observed among adolescent mothers over 15. Adolescent mothers classified in the lowest quartile of consumption lack the minimum recommended consumption of energy and nutrients. An inverse association was found between the number of household members and energy and nutrient consumption. Adolescent mothers who received dietary information and changed their eating habits during pregnancy showed better results concerning the consumption of energy and nutrients. Prenatal care was a key factor for improving the results of pregnancy, emphasizing the importance of providing dietary information.

The relationship between parental nutritional status and overweight children/adolescents in Rio de Janeiro, Brazil

BACKGROUND The association between overweight parents and overweight children/adolescents was investigated in Rio de Janeiro, Brazil between 1995 and 1996, controlling for the influence of socio-economic and demographic factors. METHODS Data were obtained from a two-stage, residence-based, random sample survey of children and adolescents aged 6-19 years and their parents. Body mass index (BMI) was used to classify nutritional status. Initially, a logistic regression model was built, using an indicator of parental weight (maternal BMI) as one of the independent variables and the child/adolescents BMI as the dependent variable. Following that, the association between socio-economic and demographic variables and overweight children/adolescents was analysed in a univariate analysis. These variables were pre-selected for inclusion in the logistic model, provided that their levels of statistical significance were below P=0.25, and were added to the model individually according to the order of association strength in the univariate analysis. Finally, variables were retained in this model at a significance level of P=0.05. RESULTS This study found that 20.7% of girls and 26.9% of boys were overweight, with a larger prevalence among children aged less than 9 years. In addition to maternal BMI, the predictors of overweight children and adolescents were age, gender and the number of people in a house. CONCLUSIONS These results demonstrate the relationship between maternal nutritional status and overweight children and adolescents, suggesting that obesity-prevention programmes should be focused on the family.

Uso do questionário de freqüência na avaliaçäo do consumo alimentar pregresso

This paper aims to discuss which one is the best estimator of past diet: a retrospective report or a recent diet recall. The analysis included 13 articles published between 1984-1997 and selected from a MEDLINE search and from other reviews on this subject. The selection criterion was the use of a food frequency questionnaire (FFQ) in a validation study of retrospective report of dietary intake in remote past. Literature review shows that even taking into account misclassification, retrospective report of diet usually yields to a more reliable estimate of past diet pattern than current report. Past diet recall was strongly influenced by current intake and by diet patterns change. Analyzed investigations indicate that agreement between original and retrospective report was higher either for foods eaten rarely or frequently and lower for foods moderately consumed. This review allows considering the FFQ as a valuable instrument when studying the role of diet on the etiology of chronic diseases.

Inadequate nutrient intake among the Brazilian elderly: National Dietary Survey 2008-2009

OBJETIVO: Estimar la prevalencia de ingestion inadecuada de nutrientes en la poblacion anciana brasilena. METODOS: Se analizaron datos de la Pesquisa Nacional de Alimentacion como parte de la Investigacion de Presupuestos Familiares, en 2008-2009. Datos de consumo alimentario individual de 4.322 individuos con 60 anos o mas se obtuvieron por medio de registro alimentario de dos dias no consecutivos. La ingestion habitual para cada nutriente fue estimada por el metodo del National Cancer Institute, cuyos modelos tuvieron como co-variables sexo y region. Las prevalencias de inadecuacion de ingestion de micronutrientes se estimaron segun sexo y region utilizando el metodo de la EAR como punto de corte. RESULTADOS: Elevadas prevalencias de inadecuacion (>50%) se observaron para las vitaminas E, D, A, calcio, magnesio y piridoxina en ambos sexos. En todas las regiones, se observo 100% de inadecuacion de vitamina E. Vitamina D obtuvo porcentajes de inadecuacion proximos a 100% en todas las regiones, excepto para la region Norte. Las prevalencias de inadecuacion de vitamina A fueron superiores a 70% en las regiones Norte, Noreste y Centro-oeste. Calcio y magnesio fueron los minerales con mayor prevalencia de ingestion inadecuada (>80%) en todas las regiones. CONCLUSIONES: Ancianos brasilenos presentaban elevada inadecuacion de ingestion de nutrientes, reconocidos como protectores contra enfermedades cronicas.

Ingestão inadequada de nutrientes na população de idosos do Brasil: Inquérito Nacional de Alimentação 2008-2009

OBJETIVO: Estimar a prevalencia de ingestao inadequada de nutrientes na populacao idosa brasileira. METODOS: Foram analisados dados do Inquerito Nacional de Alimentacao como parte da Pesquisa de Orcamentos Familiares, em 2008-2009. Dados de consumo alimentar individual de 4.322 individuos com 60 anos ou mais foram obtidos por meio do registro alimentar de dois dias nao consecutivos. A ingestao habitual para cada nutriente foi estimada pelo metodo do National Cancer Institute, cujos modelos tiveram como covariaveis sexo e regiao. As prevalencias de inadequacao de ingestao de micronutrientes foram estimadas segundo sexo e regiao utilizando o metodo da EAR como ponte de corte. RESULTADOS: Elevadas prevalencias de inadequacao (> 50%) foram observadas para as vitaminas E, D, A, calcio, magnesio e piridoxina em ambos os sexos. Em todas as regioes, observou-se 100% de inadequacao de vitamina E. Vitamina D obteve percentuais de inadequacao proximos de 100% em todas as regioes, exceto para a regiao Norte. As prevalencias de inadequacao de vitamina A foram superiores a 70% nas regioes Norte, Nordeste e Centro-Oeste. Calcio e magnesio foram os minerais com maior prevalencia de ingestao inadequada (> 80%) em todas as regioes. CONCLUSOES: Idosos brasileiros apresentam elevada inadequacao da ingestao de nutrientes, reconhecidos como protetores contra doencas cronicas.

Associação entre fatores da dieta e tumores de cérebro em adultos: uma revisão da literatura

This paper reviews the scientific literature published from 1986 to 1999 assessing the relationship between dietary factors and brain tumors in adults. The work aimed to describe the estimated associations and to discuss methodological aspects that might influence the results. The studies generally appear to show a moderate association between dietary factors and brain tumors. There is evidence that N-nitroso compounds enhance the risk of developing such tumors and that consumption of fruits and vegetables can inhibit them. Use of proxies in most of the studies may have introduced bias, thereby contributing to some inconsistent observations. Epidemiological research on diet and brain tumors should consider other components of food besides N-nitroso compounds. It is important to carefully assess exposure periods and to prevent bias related to control selection and recall.Analisou-se, a partir dos dados da Pesquisa sobre Padroes de Vida (PPV) inquerito de base domiciliar realizado em 1996/97, nas regioes Sudeste e Nordeste do Brasil, a distribuicao do recebimento de vale-refeicao/cesta basica e sua relacao com o estado nutricional (indice de massa corporal - IMC) de adultos com idade ³ 20 anos. Do total da populacao ocupada, somente 19,9% recebia o beneficio (24,9% no Sudeste e 11,7% no Nordeste) concentrando-se na area urbana (15,8% no Nordeste e 25,9% no Sudeste) e com aumento conforme a elevacao da renda domiciliar per capita. Observou-se um quadro de sobrepeso (IMC ³ 25) importante (38,5%) particularmente no Sudeste e na area urbana (@ 41%). O baixo peso (IMC < 18,5) foi maior nas mulheres (6,1%) do que entre os homens (3,4%) e mais individuos com sobrepeso recebiam o beneficio do que os com baixo peso (31,7 e 23,5%, respectivamente). Aparentemente, ha uma inadequacao entre as caracteristicas do grupo alvo e o acesso a vale refeicao (ou cesta basica) no Nordeste e Sudeste.

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.

Dietary recommendations: comparing dietary guidelines from Brazil and the United States

O guia alimentar brasileiro e baseado parcialmente nas recomendacoes americanas a despeito das criticas e problemas identificados no documento dos Estados Unidos. Neste artigo, as recomendacoes alimentares para o Brasil sao resumidas e discutidas em comparacao com as recomendacoes estadunidenses. Os guias alimentares brasileiro e americano sao bastante similares em diversos aspectos, particularmente aqueles relacionados com a variacao da dieta, a importância da atividade fisica e o gerenciamento do peso. Diferentemente dos Estados Unidos, o guia brasileiro estimula o consumo de alimentos frescos, aconselha o uso de fontes saudaveis de gorduras, a limitacao do consumo de gordura trans, o consumo de boas fontes de proteinas, mas nao indica o consumo de graos integrais. Alem dos desafios relacionados com a sua implantacao, os indicadores para a avaliacao da eficacia dos guias alimentares devem ser estabelecidos desde sua implantacao, particularmente, os relacionados a mudancas nos habitos alimentares e a prevalencia da obesidade.

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.