Sara Araújo da Silva

Prevalence of smoking among adults residing in the Federal District of Brasília and in the state capitals of Brazil, 2008

OBJECTIVE To determine the prevalence of smoking in the adult population of Brazil, in order to propose recommendations for the reduction of tobacco use. METHODS This was a population-based, cross-sectional study including a sample composed of residents (> 18 years of age) of the capital cities of 26 Brazilian states and in the Federal District of Brasília, Brazil. For the determination of sample size, a 95% confidence interval and a 2% sample error were defined. The participants were selected and interviewed by means of the Sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (VIGITEL, Telephone-based System for the Surveillance of Risk and Protective Factors for Chronic Diseases).The proportion of smokers and the number of cigarettes smoked per day were estimated and stratified according to sociodemographic variables. In addition, the male/female ratio was estimated for the prevalence of smoking. RESULTS The prevalence of smoking was 16.1% (20.5% among males and 12.4% among females). The proportion of adults that reported smoking > 20 cigarettes a day was 4.9%, being greater in males (6.5% vs. 3.6%). The prevalence of smoking was greater among individuals with a lower level of education (< 8 years of schooling). The number of cigarettes smoked per day by males was approximately the double that smoked by females. CONCLUSIONS The VIGITEL estimates indicate a reduction in the prevalence of smoking, which was, however, still greater among males than among females. The VIGITEL has been fundamental to monitoring smoking, as well as to informing decisions regarding public policies for health promotion and the prevention of chronic nontransmissible diseases.

Fatores de risco e proteção para doenças crônicas não transmissíveis entre beneficiários da saúde suplementar: resultados do inquérito telefônico Vigitel, Brasil, 2008

This article aims at estimating the prevalence of adults engaging in protective and risk health behaviors among members of private health insurance plans. It was used a random sample of individuals over the age of 18 living in the Brazilian state capitals collected on 28,640 telephone interviews in 2008. The results showed that among males there was a high prevalence of the following risk factors: tobacco, overweight, low fruit and vegetable consumption, high meat with fat consumption and alcohol drinking. Among females we found a high prevalence of high blood pressure, diabetes, dyslipidemia and osteoporosis. Men were generally more physically active and women consumed more fruit and vegetables. As more educated males were lower was the prevalence of tobacco, high blood pressure, but also a higher prevalence of overweight, consumption of meat with fat, dyslipidemia and lower number of yearly check-ups done. For females, tobacco smoking, overweight, obesity, decreasing with schooling, and consumption of fruit and vegetables, physical activity, mammography and PAP test, increased with schooling. The health insurance user population constitutes about 26% of Brazilian people and the current study aims to accumulate evidence for health promotion actions by this public.

Fatores de risco e proteção para doenças crônicas: vigilância por meio de inquérito telefônico, VIGITEL, Brasil, 2007

This article describes the prevalence of risk and protective factors for chronic non-communicable diseases in Brazil, using data collected in 2007 through the telephone disease surveillance system (VIGITEL). We evaluated 54,252 adults residing in Brazils State capitals and Federal District. Men showed higher rates of smoking, overweight, consumption of soft drinks and fatty meat, sufficient leisure-time physical activity, sedentary lifestyle, and binge drinking; women showed higher consumption of fruits and vegetables. For men with more schooling, the probability of smoking decreased by 42% and consumption of fatty meat decreased by 31%; overweight increased 86%, sedentary lifestyle 42%, regular consumption of fruits and vegetables 89%, and leisure-time physical activity 78%. For women with more schooling, the probability of smoking decreased 31%, overweight 26%, and consumption of fatty meat 35%; sedentary lifestyle increased 76%, leisure-time physical activity 77%, regular consumption of fruits and vegetables 48%, and recommended consumption of fruits and vegetables 75%.

Associação entre excesso de peso e consumo de feijão em adultos

OBJETIVO: Avaliar associacao entre excesso de peso e consumo de feijao em adultos. METODOS: O estudo constou de individuos adultos (>18 anos), moradores em Belem (PA), em 2005. A amostragem foi realizada por sorteio de residencias com telefone fixo e de um morador adulto de cada casa sorteada. A variavel desfecho foi excesso de peso, a variavel explanatoria consumo de feijao e as variaveis de controle foram idade, escolaridade e situacao conjugal, alem de atividade fisica no lazer e habitos alimentares de risco. A analise dos dados foi feita pelo teste do qui-quadrado e por regressao logistica. RESULTADOS: Foram avaliados 2 352 individuos (39,8% do sexo masculino). O excesso de peso atingiu mais os homens, 49,3%, do que as mulheres, 34,0% (p<0,001). A prevalencia de excesso de peso apresentou associacao direta com idade em ambos os sexos e com escolaridade para homens, para as mulheres a associacao com a escolaridade foi inversa. A variavel referente ao consumo alimentar que melhor se associou com excesso de peso foi o consumo de feijao. Apos ajuste para as demais variaveis, o risco de excesso de peso foi cerca de 1,4 vez maior para os homens que consomem feijao menos do que cinco vezes na semana, porem o inverso para as mulheres. CONCLUSAO: Os resultados indicam a necessidade de estudos mais controlados para melhor entendimento da associacao entre consumo de feijao e excesso de peso.

Monitoring of risk and protective factors for chronic non communicable diseases by telephone survey in Brazilian State Capitals, 2008.

OBJECTIVE To estimate the prevalence of protective and risk factors for the most important chronic non communicable diseases in all Brazilian capitals, including the Federal District. METHODS Data used were collected in 2008 through VIGITEL, an ongoing population-based telephone survey surveillance system implemented in all Brazilian State capitals since 2006. In 2008, over 54,000 interviews were completed over the phone with a random sample of individuals living in all 27 capitals. RESULTS The analyses showed differences in the prevalence of determinants of chronic diseases by demographic characteristics such as gender, age and schooling. Men were more likely to be current smokers, overweight, and consumers of soft drinks, fatty meat and alcohol. They were also more likely to be more active in leisure. Women reported being more likely to eat healthy, but also were more likely to have a physician diagnosis of high blood pressure, dyslipidemia, osteoporosis and overall poor health status. In general, the prevalence of risk factors studied increased with decreasing levels of schooling. DISCUSSION The VIGITEL system was implemented to monitor changes in the prevalence of determinants of chronic diseases over time to inform public health workers and decision makers to adjust existing programs and policies according to the changing profile of consumers. The ultimate goal is to improve the health of the Brazilian population.

Health status determinants among river-dwelling children under two years of age in Pará State, Brazil: a cross-sectional study

The aim of this study was to identify predictors of poor health in children less than two years of age from river-dwelling families in Pará State, Brazil. A total of 202 children were evaluated, considering poor health as the outcome variable, consisting of the combination of nutritional status, psychomotor development, and intercurrent illnesses in the previous month. The data were analyzed with a multilevel hierarchical model, and predictors of poor health were defined as variables with p < 0.05 after adjustment. According to the crude odds ratio, poor health is associated with families that own their own homes, are older, and present exclusive breastfeeding at two, three, four, and five months. After adjustment, children with families that own their homes showed 2.76 greater odds of having poor health; poor health also increased with age, and was 5.04 higher among children from 18 to 23 months, as compared to infants less than 7 months of age. In these communities, home owning and higher age represent longer exposure to the risk of poor health.

Vitamin A status and associated factors in infants attending at Primary Health Care in Goiânia, Goiás, Brazil

OBJECTIVE This study aimed to assess the nutritional status of vitamin A and associated factors in children assisted in Primary Care Health in Goiânia, Goiás, Brazil. METHODS This is a cross-sectional study with a sample of 228 children 12 to 16 months of age. The nutritional status of vitamin A was assessed by serum retinol concentration, determined by high performance liquid chromatography. Multiple linear regression models with hierarchical selection of independent variables were used to evaluate the correlation with serum retinol as the dependent variable. RESULTS The vitamin A deficiency (retinol < 0,7 μmol/L) was observed in 14,0% of the children. Maternal schooling and hemoglobin concentration were positively correlated with serum retinol concentration, while C-reactive protein showed a negative correlation (R2 = 0,1648). CONCLUSION The vitamin A deficiency in one-year-old children attended in Basic Health Units in Goiânia configures itself as a moderate public health problem. Actions to promote maternal education, morbidity control and prevention of other micronutrient deficiencies are important for prevention and control of the vitamin A deficiency in this population.

Anemia and micronutrient deficiencies in infants attending at Primary Health Care in Rio Branco, Acre, Brazil.

The present study investigated the factors associated with anemia and micronutrient deficiencies in a cross-sectional analysis conducted with 150 children aged 11 to 14 months attending at basic health centers in Rio Branco, Acre. Venous blood samples were obtained to assess the occurrence of anemia and deficiencies of iron (ID), vitamin A (VAD), and B12 (VB12D). Multiple Poisson regression models were used to identify factors associated with anemia. Anemia, ID, VAD and B12D were observed in 23%, 76%, 18% and 20% of children, respectively. The factors associated with anemia were: do not be only child, living in households without access to cable TV or internet, stunting, late introduction of the complementary feeding (more than 240 days), VAD, VB12D, and current evidence of infection (plasma CRP > 5 mg/L). There was a lower prevalence of anemia among children with birth weight > 3,500 g. Overall, 82% of the study children had at least one of the micronutrient deficiencies (ID, VAD and VB12D). Actions with emphasis on timely and healthy feeding practices, better management of morbidities and supplementation with other micronutrients should be focused on the improvement of child care services at primary health care in this county.

Sodium Reduction in Processed Foods in Brazil: Analysis of Food Categories and Voluntary Targets from 2011 to 2017

Non-communicable diseases, including cardiovascular diseases, are responsible for over 70% of deaths in Brazil. Currently, over 25% of Brazilian adults are diagnosed as hypertensive; overall, current dietary sodium intake in Brazil (4700 mg/person) is over twice the international recommendations, and 70–90% of adolescents and adults consume excessive sodium. National sodium reduction strategies consider the main dietary sources of sodium to be added salt to foods, foods consumed outside of the household, and sodium in processed foods. The national voluntary strategy for sodium reduction in priority food categories has been continuously monitored over a 6-year period (2011–2017) and there was a significant 8–34% reduction in the average sodium content of over half food categories. Different food categories have undergone differing reductions in sodium over time, aiding gradual biannual targets to allow industries to develop new technologies and consumers to adapt to foods with less salt. By 2017, most products of all food categories had met the regional targets proposed by the Pan American Health Organization, showing that voluntary sodium reduction strategies can potentially contribute to food reformulation. Nevertheless, regulatory approaches may still be necessary in the future in order to reach all food producers and to allow stronger enforcement to meet more stringent regional targets.