Silvania Suely Caribé de Araújo Andrade

Trends in prevalence of overweight and obesity in adults in 26 Brazilian state capitals and the Federal District from 2006 to 2012

OBJECTIVE To describe the annual evolution of the prevalence of overweight and obesity in the adult population of the 26 Brazilian state capitals and the Federal District from 2006 to 2012. METHODS Annual interviews (around 54,000 per year) from VIGITEL (Surveillance System of Risk and Protective Factors for Chronic Non-Communicable Diseases through Telephone Interviews) were used. Self-reported weight and height were used to estimate body mass index and nutritional status. Prevalence estimates of overweight and obesity are presented according to gender, age and schooling and to each city. Linear regression model was used to evaluate the time trend of prevalence. RESULTS Prevalence of overweight in adults in the 27 cities monitored by VIGITEL increased from 43.2% (2006) to 51.0% (2012), with an annual increase rate of 1.37%. Prevalence of obesity increased from 11.6% to 17.4%, with an annual increase rate of 0.89%. The study showed a statistically significant increase in the prevalence of overweight in all cities, and for both genders, all age groups and all levels of schooling. Similar trends were also verified for obesity. CONCLUSIONS If the trends verified from 2006 to 2012 are maintained, in ten years, around two-thirds of the adults in Brazilian state capitals will be overweight, and a quarter will be obese. This perspective requests urgent response from government and intersectoral actions to combat the obesogenic environment.

Relação entre violência física, consumo de álcool e outras drogas e bullying entre adolescentes escolares brasileiros

O objetivo deste estudo foi identificar a associacao entre o consumo de alcool e outras drogas e o bullying com o envolvimento em situacoes de violencia fisica entre adolescentes de 13 a 15 anos, em escolas publicas e privadas das capitais brasileiras e do Distrito Federal. Foram analisados os dados da Pesquisa Nacional de Saude do Escolar (PeNSE) de 2009. Para analise dos dados foi utilizada a regressao logistica. A prevalencia de envolvimento em situacoes de violencia fisica foi 12,9% maior no sexo masculino. Em ambos os sexos, foram observadas associacoes entre violencia fisica e ser vitima de bullying com o uso de drogas ilicitas e efeito potencializado do consumo de alcool e drogas. Para o sexo masculino, o uso de alcool mostrou associacao significante com violencia fisica. Morar o pai ou ambos os genitores na residencia apresentou associacao inversa para violencia fisica no sexo feminino. O conhecimento de fatores associados a violencia fisica entre adolescentes e importante para auxiliar estrategias de promocao da saude e da cultura de paz, rompendo com a ideia de que a violencia entre adolescentes e algo banal e esperado.This study aimed to identify the association between alcohol and drug consumption and bullying on the one hand and involvement in situations of physical violence among adolescents 13 to 15 years in public and private schools in State capitals and the Federal District of Brazil. The study analyzed data from the National School Health Survey (PeNSE) for the year 2009. Data analysis used logistic regression. Prevalence of involvement in physical violence was 12.9% more common in boys than girls. Both genders showed associations between physical violence or being a victim of bullying and use of illegal drugs, plus the heightened effect of the combined consumption of alcohol and other drugs. In boys, alcohol consumption showed a significant association with physical violence. Having the father or both parents living at home was inversely associated with physical violence in girls. Knowledge of factors associated with physical violence among adolescents is important for supporting health promotion strategies and a culture of peace, thereby counteracting the idea of taking teenage violence for granted.

Trend of the risk and protective factors of chronic diseases in adolescents, National Adolescent School-based Health Survey (PeNSE 2009 e 2012)

OBJECTIVE To compare the prevalence of major risk and protection factors for chronic non-communicable diseases in school-aged children in Brazilian capitals surveyed in the National Adolescent School-based Health Survey in its two editions, 2009 and 2012. METHODS The frequencies, with Confidence Interval of 95%, of the following demographic variables were compared: food intake, body image, physical activity, smoking, alcohol and other drugs. Prevalence was compared in the two editions of the survey. RESULTS The proportion of students who attend two physical education classes a week was maintained at 49% between 2009 and 2012, increasing in public schools from 50.6% (95%CI 49.8 - 51.4) to 52.5% (95%CI 49.2 - 55.7), and decreasing in private schools. There was no change in the proportion of students who watch two hours or more of television daily, about 80%. As for body image, there was no change between the two editions, and about 60% considered themselves being of normal weight. There was a reduction in the percentage of adolescents who experienced cigarettes, from 24.2% (95%CI 23.6 - 24.8) to 22.3% (95%CI 21.4 - 23.2), and the prevalence of smoking was maintained at about 6% (there was no statistical difference between 2009 and 2012). The consumption of beans, fruits, sweets and soft drinks also decreased. Frequency of drug experimentation was of 8.7% (95%CI 8.3 - 9.1) in 2009, and 9.6% (95%CI 9.0 - 10.3) in 2012, with no difference between confidence intervals, and the frequency of alcohol experimentation was maintained at about 70%; the percentage of use in the past 30 days was also maintained at around 27%. CONCLUSION In the Brazilian capitals, the vast majority of prevalence of risk factors were kept stable in the two editions of the National Survey of School. These data generate evidence to guide the implementation of public policies to minimize the exposure of adolescents to risk factors.

Causas externas em adolescentes: atendimentos em serviços sentinelas de urgência e emergência nas Capitais Brasileiras - 2009

Adolescents are seeking new references and experiences, which may involve attitudes of risk and exposure to accidents and violence from external causes. These events constitute a serious Public Health problem. The scope of this study was to analyze the occurrence of accidents by external causes in adolescents from 10 to 19 years of age attended at sentinel urgency and emergency services in Brazil. Data from the 2009 Surveillance System for Violence and Accidents (VIVA 2009) was analyzed in 74 emergency units in 23 state capitals and the Federal District. The findings revealed that 6,434 adolescents (89.8%) were victims of accidents and 730 (10.2 %) were victims of violence. The main causes of the accidents were falls and traffic accidents, and assaults were predominant in violence. For both accidents and violence, non-white male adolescents were predominant and the events occurred most frequently on the public highways. A marked increase was detected, with hospitalization of victims of violence between 15 and 19 years of age. Understanding the epidemiological reality of external causes among adolescents represents an important tool for health prevention and promotion policies and the culture of peace seeking to reduce morbidity and mortality.

Bullying in Brazilian school children: analysis of the National Adolescent School-based Health Survey (PeNSE 2012)

OBJECTIVE To describe the victimization and bullying practice in Brazilian school children, according to data from the National Adolescent School-based Health Survey and to compare the surveys from 2009 and 2012. METHODS This is a cross-sectional study with univariate and multivariate analyzes of the following variables: to have been treated badly by colleagues, to have been bullied and to have bullied other children. The following independent variables were analyzed: age, sex, race/color, type of school, maternal education. Prevalence rates were compared between the editions of 2009 and 2012 of the survey. RESULTS Of all the adolescents analyzed, 27.5% have not been treated well by peers at school, with greater frequency among boys (OR = 1.50), at the age of 15 years (OR = 1.29) and 16 (OR = 1.41), public school students (OR = 2.08), black (OR = 1.18) and whose mothers had less education; 7.2% reported having been bullied, with a greater chance in younger students (13 years old), male (OR = 1.26), black (OR = 1.15) and indigenous (OR = 1.16) and whose mothers had less education; 20.8% reported to have bullied other children, with a greater chance for older students, at the age of 14 (OR = 1.08) and 15 years (OR = 1.18), male (OR = 1.87), black (OR = 1.14) and yellow (OR = 1.15), children of mothers with higher education, private school students. There was an increase of bullying in the Brazilian capitals, from 5.4 to 6.8%, between 2009 and 2012. DISCUSSION The occurrence of bullying reveals that the Brazilian school context is also becoming a space of reproduction of violence, in which it is crucial to act intersectorally and to articulate social protection networks, aiming to face this issue.

Psychoactive substance use, family context and mental health among Brazilian adolescents, National Adolescent School-based Health Survey (PeNSE 2012)

OBJECTIVE To evaluate the association between the consumption of psychoactive substances (tobacco, alcohol and illicit drugs) and demographic variables, mental health and family context among school-aged children. METHODS The National Adolescent School-based Health Survey was held with a national sample of 109,104 students. Data regarding demographic variables, family background and mental health were collected. Logistic regression was used to evaluate the associations of interest. RESULTS Multivariate analyses showed that alcohol consumption was higher among girls, drug experimentation was more frequent among boys and that there was no difference between sexes for smoking. Being younger and mulatto were negatively associated with the use of tobacco, alcohol and illicit drugs. Also negatively associated with such risk behaviors were characteristics of the family context represented by: living with parents, having meals together and parental supervision (when parents know what the child does in their free time). Moreover, characteristics of mental health such as loneliness and insomnia were positively associated with use of tobacco, alcohol and illicit drugs. Not having friends was positively associated with use of tobacco and illicit drugs and negatively associated with alcohol use. CONCLUSIONS The study shows the protective effect of family supervision in the use of tobacco, alcohol and drugs and, on the contrary, the increasing use of substances according to aspects of mental health, such as loneliness, insomnia and the fact of not having friends. The studys findings may support actions from health and education professionals, as well as from the government and families in order to prevent the use of these substances by adolescents.

Prevalence of self-reported arterial hypertension in Brazilian capitals in 2011 and analysis of its trends in the period between 2006 and 2011

OBJECTIVE: To describe the prevalence of self-reported arterial hypertension in the adult population in the Brazilian state capitals and Federal District in 2011, and analyze the trend from 2006 to 2011. METHODS: A time series study was conducted with data from the monitoring system by telephone survey (Vigitel) in the period between 2006 and 2011. Approximately 54,000 individuals were assessed per year in the locations studied. A polynomial regression model was used for trend analysis according to gender, age, education and region of the country. RESULTS: The prevalence of hypertension was 22.7% in 2011, higher in women (25.4%; 95%CI 24.2 - 26.5) than in men (19.5%; 95%CI 18.4 - 20.7). In the period between 2006 and 2011, the lower frequency of hypertension was observed in 2006 (21.5%), and the higher in 2009 (24.4%), with no statistically significant difference in the period. CONCLUSION: There was no significant sex-specific trend, maintaining the higher frequency among women. The prevalence of hypertension increased progressively with age and was higher among adults with lower education (0 - 8 years of study). The South was the only region that showed a statistically significant increasing trend for the years between 2006 and 2011 (15% per year).OBJECTIVE: To describe the prevalence of self-reported arterial hypertension in the adult population in the Brazilian state capitals and Federal District in 2011, and analyze the trend from 2006 to 2011. METHODS: A time series study was conducted with data from the monitoring system by telephone survey (Vigitel) in the period between 2006 and 2011. Approximately 54,000 individuals were assessed per year in the locations studied. A polynomial regression model was used for trend analysis according to gender, age, education and region of the country. RESULTS: The prevalence of hypertension was 22.7% in 2011, higher in women (25.4%; 95%CI 24.2 - 26.5) than in men (19.5%; 95%CI 18.4 - 20.7). In the period between 2006 and 2011, the lower frequency of hypertension was observed in 2006 (21.5%), and the higher in 2009 (24.4%), with no statistically significant difference in the period. CONCLUSION: There was no significant sex-specific trend, maintaining the higher frequency among women. The prevalence of hypertension increased progressively with age and was higher among adults with lower education (0 - 8 years of study). The South was the only region that showed a statistically significant increasing trend for the years between 2006 and 2011 (15% per year).OBJECTIVE To describe the prevalence of self-reported arterial hypertension in the adult population in the Brazilian state capitals and Federal District in 2011, and analyze the trend from 2006 to 2011. METHODS A time series study was conducted with data from the monitoring system by telephone survey (Vigitel) in the period between 2006 and 2011. Approximately 54,000 individuals were assessed per year in the locations studied. A polynomial regression model was used for trend analysis according to gender, age, education and region of the country. RESULTS The prevalence of hypertension was 22.7% in 2011, higher in women (25.4%; 95%CI 24.2 - 26.5) than in men (19.5%; 95%CI 18.4 - 20.7). In the period between 2006 and 2011, the lower frequency of hypertension was observed in 2006 (21.5%), and the higher in 2009 (24.4%), with no statistically significant difference in the period. CONCLUSION There was no significant sex-specific trend, maintaining the higher frequency among women. The prevalence of hypertension increased progressively with age and was higher among adults with lower education (0 - 8 years of study). The South was the only region that showed a statistically significant increasing trend for the years between 2006 and 2011 (15% per year).

Tendência temporal dos indicadores de excesso de peso em adultos nas capitais brasileiras, 2006-2013

The scope of this article is to analyze time trends in excess weight (overweight, obesity and class III obesity) among adults (≥ 18 years of age) in Brazilian capitals between 2006 and 2013. It is a study of temporal trends in excess weight indicators using data from the telephone-based Surveillance System of Risk and Protective Factors for Chronic Non-Communicable Diseases (Vigitel). The Prais regression model was performed. In 2013, the following statistics were observed in the adult population: overweight in 32.2%; obesity in 17.5%, and class III obesity in 1.5%. From 2006 to 2013, there was a significant increase in major indicators, for sex, age group, level of schooling (years) and regions. Overweight and obesity indicators demand attention since they result in a burden on the individual, society and health services.

Prevalência da hipertensão arterial autorreferida nas capitais brasileiras em 2011 e análise de sua tendência no período de 2006 a 2011

OBJECTIVE: To describe the prevalence of self-reported arterial hypertension in the adult population in the Brazilian state capitals and Federal District in 2011, and analyze the trend from 2006 to 2011. METHODS: A time series study was conducted with data from the monitoring system by telephone survey (Vigitel) in the period between 2006 and 2011. Approximately 54,000 individuals were assessed per year in the locations studied. A polynomial regression model was used for trend analysis according to gender, age, education and region of the country. RESULTS: The prevalence of hypertension was 22.7% in 2011, higher in women (25.4%; 95%CI 24.2 - 26.5) than in men (19.5%; 95%CI 18.4 - 20.7). In the period between 2006 and 2011, the lower frequency of hypertension was observed in 2006 (21.5%), and the higher in 2009 (24.4%), with no statistically significant difference in the period. CONCLUSION: There was no significant sex-specific trend, maintaining the higher frequency among women. The prevalence of hypertension increased progressively with age and was higher among adults with lower education (0 - 8 years of study). The South was the only region that showed a statistically significant increasing trend for the years between 2006 and 2011 (15% per year).OBJECTIVE: To describe the prevalence of self-reported arterial hypertension in the adult population in the Brazilian state capitals and Federal District in 2011, and analyze the trend from 2006 to 2011. METHODS: A time series study was conducted with data from the monitoring system by telephone survey (Vigitel) in the period between 2006 and 2011. Approximately 54,000 individuals were assessed per year in the locations studied. A polynomial regression model was used for trend analysis according to gender, age, education and region of the country. RESULTS: The prevalence of hypertension was 22.7% in 2011, higher in women (25.4%; 95%CI 24.2 - 26.5) than in men (19.5%; 95%CI 18.4 - 20.7). In the period between 2006 and 2011, the lower frequency of hypertension was observed in 2006 (21.5%), and the higher in 2009 (24.4%), with no statistically significant difference in the period. CONCLUSION: There was no significant sex-specific trend, maintaining the higher frequency among women. The prevalence of hypertension increased progressively with age and was higher among adults with lower education (0 - 8 years of study). The South was the only region that showed a statistically significant increasing trend for the years between 2006 and 2011 (15% per year).OBJECTIVE To describe the prevalence of self-reported arterial hypertension in the adult population in the Brazilian state capitals and Federal District in 2011, and analyze the trend from 2006 to 2011. METHODS A time series study was conducted with data from the monitoring system by telephone survey (Vigitel) in the period between 2006 and 2011. Approximately 54,000 individuals were assessed per year in the locations studied. A polynomial regression model was used for trend analysis according to gender, age, education and region of the country. RESULTS The prevalence of hypertension was 22.7% in 2011, higher in women (25.4%; 95%CI 24.2 - 26.5) than in men (19.5%; 95%CI 18.4 - 20.7). In the period between 2006 and 2011, the lower frequency of hypertension was observed in 2006 (21.5%), and the higher in 2009 (24.4%), with no statistically significant difference in the period. CONCLUSION There was no significant sex-specific trend, maintaining the higher frequency among women. The prevalence of hypertension increased progressively with age and was higher among adults with lower education (0 - 8 years of study). The South was the only region that showed a statistically significant increasing trend for the years between 2006 and 2011 (15% per year).

Tendência da prevalência do diabetes melito autorreferido em adultos nas capitais brasileiras, 2006 a 2012

OBJETIVO:avaliar a tendencia da prevalencia de diabetes melito autorreferido nas capitais brasileiras, entre 2006 e 2012.METODOS:estudo ecologico com dados da Vigilância de Fatores de Risco e Protecao para Doencas Cronicas por Inquerito Telefonico (Vigitel) referentes a adultos (≥18 anos), analisados por meio de regressao linear simples.RESULTADOS:no periodo estudado, houve tendencia de aumento de 5,7% para 7,4% no conjunto da populacao adulta das capitais (p=0,008), de 4,8% para 6,5% entre homens (p=0,002) e de 6,4% para 8,1% entre mulheres (p=0,039); a elevacao entre mulheres ocorreu em 9 capitais - Belem-PA, Belo Horizonte-MG, Curitiba-PR, Macapa-AP, Maceio-AL, Palmas-TO, Recife-PE, Rio Branco-AC e Vitoria-ES -; e entre homens, em 6 capitais - Boa Vista-RR, Florianopolis-SC, Fortaleza-CE, Rio Branco-AC, Rio de Janeiro-RJ e Sao Paulo-SP.CONCLUSAO:houve aumento da prevalencia do diabetes em diversas capitais brasileiras; o monitoramento das tendencias e fatores de risco e util ao planejamento em saude.