Taísa Sabrina Silva Pereira

Reprodutibilidade e validade relativa do Questionário de Frequência Alimentar do ELSA-Brasil

Avaliou-se a reprodutibilidade e a validade do Questionario de Frequencia Alimentar (QFA) utilizado no Estudo Longitudinal de Saude do Adulto (ELSA-Brasil). Foram aplicados tres registros alimentares e um QFA em dois momentos no periodo de um ano (n = 281). Valores de energia e nutrientes dos registros alimentares foram deatenuados e Log transformados. Para avaliacao da reprodutibilidade e validade foi aplicado o teste de correlacao intraclasse (CCI) e calculados percentuais de concordância do consumo de nutrientes apos categorizacao por tercis. Na avaliacao da reprodutibilidade, coeficientes de CCI variaram de 0,55-0,83 para proteina e vitamina E, respectivamente; na avaliacao da validade, variaram de 0,20-0,72 para selenio e calcio, respectivamente. Concordâncias exata e adjacente entre metodos variaram de 82,9% para vitamina E a 89% para lipidio e calcio (media = 86%). Foi encontrada uma discordância media de 13,6%. Conclui-se que o QFA ELSA-Brasil apresenta confiabilidade satisfatoria para todos nutrientes e validade relativa razoavel para energia, macronutrientes, calcio, potassio e vitaminas E e C.

Reproducibility and relative validity of the Food Frequency Questionnaire used in the ELSA-Brasil

This study evaluated the reproducibility and relative validity of the Food Frequency Questionnaire (FFQ) used in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Participants (n = 281) completed the FFQ and three food records on two occasions during a 12-month period. Energy and nutrient values from food records were disattenuated and log-transformed. Reproducibility and validity were assessed by the intra-class correlation coefficient (ICC). Agreement between the two methods was evaluated by classification in tertiles. In the evaluation of reproducibility, ICC estimated ranged from 0.55 to 0.83 for protein and vitamin E, respectively. On relative validity, ICC ranged from 0.20 to 0.72 for selenium and calcium, respectively. Exact and adjacent agreement between methods varied from 82.9% for vitamin E to 89% for lipids and calcium (mean 86%). Average disagreement was 13.6%. In conclusion, this FFQ showed satisfactory reliability for all nutrients and reasonable validity, especially for energy, macronutrients, calcium, potassium, and vitamins E and C.

Active and sedentary behaviours in children aged 7 to 10 years old: the urban and rural contexts, Brazil

BackgroundAlthough the effects of physical activity (PA) on health and wellness are well-established, incorporating sedentary behaviours in the daily lives of populations from high- and medium-income countries is becoming increasingly common. Regardless of other factors, the area of residence can influence the physical activity level and sedentary behaviours. The aim of this study was to identify and analyse active and sedentary behaviours and factors associated with physical activity in two different geographical areas in south-eastern Brazil.Methods1.770 schoolchildren aged 7-10 years old were studied. Parents or caregivers completed a validated questionnaire on PA and sedentary behaviours. Screen time (ST) was calculated from the time spent watching television, playing video games and using the computer. The level of active PA (>300 minutes per week) was identified and compared between the areas of study. Parametric and non-parametric tests and Poisson regression model with robust variance were used for statistical analysis.ResultsCompared to schoolchildren from the urban area, those from the rural area showed a higher percentage of compliance with the PA recommendations (87 vs. 69.7%) and screen time <2 h (34.8 vs. 18.8%) and less participation in supervised PA. Active commuting to school was more common among schoolchildren from urban areas, although using a bicycle was more common in rural areas. The characteristics of children who do not meet the recommended weekly PA are as follows: being female, living in urban areas, being overweight, not using video games or performing supervised PA. Total ST as well as daily use of television and the computer was not associated with physical activity level in the present sample. Participation in supervised physical activities in both areas was found to increase the prevalence of being active in the areas studied.ConclusionsThe results of the present study suggest that while schoolchildren from rural areas are more active and spend less time on sedentary activities than those from the urban area, the time spent in sedentary behaviors, such as watching television, playing video games and using the computer, is high in both contexts, and it is not associated with physical activity recommendation compliance.

Sodium and potassium intake estimated using two methods in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

CONTEXT AND OBJECTIVE Sodium and potassium intake from different food sources is an important issue regarding cardiovascular physiology. Epidemiological assessment of the intake of these electrolytes intake is done through food frequency questionnaires or urinary excretion measurements. Our aim was to compare these methods using a sample of Brazilian civil servants. DESIGN AND SETTING Cross-sectional baseline evaluation from the Brazilian Longitudinal Study of Adult Health. METHODS Sodium and potassium intake was obtained using two methods: a semi-quantitative questionnaire including 114 food items; and overnight 12-hour urinary excretion measurement. Sodium and potassium estimates obtained through the questionnaire were adjusted for energy intake using the residual method. Urinary excretion measurements were considered valid if they met three adequacy criteria: collection time, volume and total creatinine excretion. Mean nutrients were estimated, and Spearman correlations were calculated. Sodium and potassium intake was categorized into quintiles, and weighted kappa coefficients and percentage agreement were calculated. The significance level for all tests was 0.05. RESULTS Data from 15,105 participants were analyzed, and significant differences between mean intakes of sodium (questionnaire: 4.5 ± 1.7 g; urine: 4.2 ± 2.1 g) and potassium (questionnaire: 4.7 ± 1.8 g; urine: 2.4 ± 1 g) were found. Weak agreement was found for sodium (K = 0.18) and potassium (K = 0.16). The percentage disagreement between methods ranged from 41.8 to 44.5%, while exact concordance ranged from 22.1% to 23.9%. CONCLUSIONS The agreement between the food frequency questionnaire and urinary excretion measurements for assessment of sodium and potassium intakes was modest.

Factors associated with arterial stiffness in children aged 9-10 years

OBJECTIVE To analyze the factors associated with stiffness of the great arteries in prepubertal children. METHODS This study with convenience sample of 231 schoolchildren aged 9-10 years enrolled in public and private schools in Vitória, ES, Southeastern Brazil, in 2010-2011. Anthropometric and hemodynamic data, blood pressure, and pulse wave velocity in the carotid-femoral segment were obtained. Data on current and previous health conditions were obtained by questionnaire and notes on the child’s health card. Multiple linear regression was applied to identify the partial and total contribution of the factors in determining the pulse wave velocity values. RESULTS Among the students, 50.2% were female and 55.4% were 10 years old. Among those classified in the last tertile of pulse wave velocity, 60.0% were overweight, with higher mean blood pressure, waist circumference, and waist-to-height ratio. Birth weight was not associated with pulse wave velocity. After multiple linear regression analysis, body mass index (BMI) and diastolic blood pressure remained in the model. CONCLUSIONS BMI was the most important factor in determining arterial stiffness in children aged 9-10 years.

Comparison of a short version of the Food Frequency Questionnaire with its long version - a cross-sectional analysis in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

CONTEXT AND OBJECTIVE The food frequency questionnaire (FFQ) is the preferred instrument for obtaining dietary information in epidemiological studies. A short form of the FFQ was compared with the original version that was used in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), and also with three 24-hour dietary recalls. DESIGN AND SETTING Cross-sectional study carried out in six Brazilian state capitals. METHODS Multiple linear regression was used to reduce the original food and drink list of the FFQ, which had contained 114 food items. The frequency of consumption and nutritional composition of the foods were also taken into consideration. To assess the validity of the shortened FFQ, the energy and nutrients values of the 24-hour dietary recalls were deattenuated and log-transformed. RESULTS The list of the FFQ of ELSA-Brasil was reduced to 76 food items. The intraclass correlation coefficients in the validation study ranged from 0.17 (selenium) to 0.66 (calcium). CONCLUSIONS The number of items was reduced by 33%, while still maintaining relatively good capacity to measure energy and selected nutrients.

Use of the Method of Triads in the Validation of Sodium and Potassium Intake in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Introduction Biomarkers are a good choice to be used in the validation of food frequency questionnaire due to the independence of their random errors. Objective To assess the validity of the potassium and sodium intake estimated using the Food Frequency Questionnaire ELSA-Brasil. Subjects/Methods A subsample of participants in the ELSA-Brasil cohort was included in this study in 2009. Sodium and potassium intake were estimated using three methods: Semi-quantitative food frequency questionnaire, 12-hour nocturnal urinary excretion and three 24-hour food records. Correlation coefficients were calculated between the methods, and the validity coefficient was calculated using the method of triads. The 95% confidence intervals for the validity coefficient were estimated using bootstrap sampling. Exact and adjacent agreement and disagreement of the estimated sodium and potassium intake quintiles were compared among three methods. Results The sample consisted of 246 participants, aged 53±8 years, 52% of women. Validity coefficient for sodium were considered weak (рfood frequency questionnaire actual intake = 0.37 and рbiomarker actual intake = 0.21) and moderate (рfood records actual intake 0.56). The validity coefficient were higher for potassium (рfood frequency questionnaire actual intake = 0.60; рbiomarker actual intake = 0.42; рfood records actual intake = 0.79). Conclusions: The Food Frequency Questionnaire ELSA-Brasil showed good validity in estimating potassium intake in epidemiological studies. For sodium validity was weak, likely due to the non-quantification of the added salt to prepared food.

Fatores de proteção para a amamentação na primeira hora de vida

Objectives: To identify the factors associated to breastfeeding in the first hour (BFH) among children of pregnant women enrolled in Family Health Units (FHU) in Vitoria-ES. Methods: Longitudinal, observational and descriptive study. Socioeconomic and health data of women in third trimester of pregnancy enrolled in FHU were collected in home visits from October to December 2009. A further visit was made 30 days after delivery, to collect data on the childbirth and breastfeeding conditions. The prevalence of BFH was calculated and analyzed according to socioeconomic and health variables, using the chi-square or Fischer’s exact test. The associated factors were identified through multivariate logistic regression. Results: The study obtained data from 169 puerperal women and their babies. The prevalence of BFH was about 63% (107). Statistically significant association was found between BFH and type of delivery (p=0.007), rooming-in (p<0.001), maternal educational level (p=0.03), apprehension/fear of breastfeeding (p=0.06) and educational level of the householder (p=0.02). Conclusions: The variables that were associated with BFH were vaginal delivery and rooming-in. Breastfeeding in the first hour of life should be encouraged in maternity wards, mainly with rooming-in practice, since it can positively influence the total time of breastfeeding. doi:10.5020/18061230.2013.p274

Sweetened Soft Drinks Consumption Is Associated with Metabolic Syndrome: Cross-sectional Analysis from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Objective: To estimate the association between regular consumption of sweetened soft drinks, natural fruit juice, and coconut water with metabolic syndrome (MetS). Methods: This was a cross-sectional study including men and women aged 35–74 years from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) Study, excluding patients with type 2 diabetes. The main explanatory variables were beverage consumption and the outcome variable was metabolic syndrome (Adult Treatment Panel III). Results: After adjustments, a daily intake of 250 ml of soft drink increased the chance of metabolic syndrome (odds ratio [OR] = 1.95; 95% confidence interval [CI], 1.60–2.38). There was no association between coconut water and MetS. Moderate consumption of fruit juices has low odds of MetS compared to no consumption. Conclusion: Our results add evidence to potential negative effects of sweetened soft drinks on cluster metabolic abnormalities in middle-income countries.

Validation of single measurement of 12-hour urine excretion for estimation of sodium and potassium intake. A longitudinal study

BACKGROUND Evaluation of sodium and potassium intake can be carried out using different methods. Biological markers are able to capture intra and inter-individual variability and are used as separate measurements of consumption. The aim of this study was to test the validity of a single measurement of urinary sodium and potassium excretion as representative of habitual intake. DESIGN AND SETTING Longitudinal study, federal university. METHODS Food consumption data from a sample of adult university students and public servants (25 to 74 years old) were collected through 24-hour records and 12-hour urinary sodium and potassium excretion at five different times over a one-year period. The dietary data were entered into a nutritional research data software system and the sodium and potassium intakes were estimated. The variables were tested for normal distribution using the Kolmogorov-Smirnov test. One-way analysis of variance or the Kruskal-Wallis test was used to evaluate means. Correlations between measurements using Pearson or Spearman coefficients were calculated. The degree of agreement between the five measurements was given by the intraclass correlation coefficient. RESULTS Satisfactory agreement was found between the five measurements of urinary sodium and potassium excretion over a year, with little variability in consumption. CONCLUSION A single measurement of urinary sodium and potassium accurately estimated the usual average consumption of these electrolytes. This can be used in population-based studies.