Teresa Helena Macedo da Costa

Nível de atividade física e hábitos alimentares de universitários do 3º ao 5º semestres da área da saúde

OBJECTIVE: The aim of this work is to assess the physical activity level and nutrition habits of university students from the health area, as they will be future disseminators of such information to the community. METHODS: This was a cross-sectional study with 281 students from the health area from the Universidade de Brasilia. Anthropometric variables were evaluated, as well as food habits and physical activity level. RESULTS: A high level of inactivity was observed among the students, except for those of Physical Education who perform physical activities in their school. Low physical activity level was observed among students of low socioeconomic level. Nutrition was considered inadequate for the majority of the students (79.7%). The lowest levels regarding an adequate nutrition were observed for the group of milk derivatives (23.0%), fruits and vegetables (24.9%) and complex carbohydrates (25.9%). A high percentage of inadequate consumption of soft drinks and sweets (74.0%) was observed. The regression analysis indicated that the gender variable was significantly associated with body mass index, where men presented a higher body mass index than women (p<0,001). CONCLUSION: Although the sample was formed by health field students, who, at first, have a better knowledge of healthy lifestyle practices, a high level of inactivity and inadequate eating habits was observed among them. It is necessary to rethink the relationship between theoretical knowledge and real changes in lifestyle in order to promote health.

Validação de um questionário de freqüência de consumo alimentar para população adulta

OBJECTIVE: The aim of the present study was to investigate the validity and reproducibility of a food frequency questionnaire developed for the adult population. METHODS: Sixty-nine individuals from both genders who attended industrial restaurants from two government divisions in Brasilia, Federal District, Brazil, were interviewed on three different occasions. In the first and third interviews, a 24h recall and a food frequency questionnaire were applied, and in the second interview only a 24h recall was applied. The study lasted 181 days. Macronutrients, vitamins A and C, calcium, iron, zinc, cholesterol, fibers and total energy were analyzed using the intraclass and Pearsons correlation coefficients, this last one in a crude and deattenuated manner. RESULTS: Regarding reproducibility, the food frequency questionnaire provided adequate results, presenting correlation coefficients above 0.7 for lipid, cholesterol, energy and protein. For validity, the best deattenuated coefficients were observed for vitamin C (r=0.66), iron (r=0.58), protein (r=0.55) and carbohydrate (r=0.55) and the worst for cholesterol (r=0.32) and vitamin A (r=0.37). CONCLUSION: The expressive correlation coefficients obtained for some nutrients indicates that this food frequency questionnaire constitutes a good research instrument for epidemiological studies in the adult population, as it can supply important dietary information allowing the implementation of actions in the health and nutrition areas.

How Much Human Milk Do Infants Consume? Data from 12 Countries Using a Standardized Stable Isotope Methodology

The WHO has developed new growth curves based on breast-fed infants. Recommendations for energy intake have been adopted based on measurements of total energy expenditure. Data on human milk (HM) intake are needed to estimate the energy intake from this food source. However, objective HM data from around the world have not been available, because these measurements are difficult to obtain. Stable isotope methods have been developed to provide objective measurements over a 14-d period. A pooled analysis of 1115 data points of HM intake, obtained using the dose to the mother deuterium oxide turnover method, was undertaken in infants aged 0-24 mo from 12 countries across 5 continents. A hierarchical model was needed to estimate mean HM intake and its variance within and between countries given the complexity of the data. The overall mean HM intake was 0.78 (95% CI = 0.72, 0.84) kg/d, and the age-specific estimates indicated that intake increased over the first 3-4 mo and remained above 0.80 kg/d until 6-7 mo. The variability of intake increased in late infancy. Boys consumed 0.05 kg/d more than girls (P < 0.01). HM intake was strongly, inversely associated with non-HM water intake [r = -0.448 (95% CI -0.511 to -0.385); P < 0.0001]. These objective isotope values of HM intake improve our understanding of the magnitude and variability of HM intake within and across populations and help to estimate nutrient intakes in breast-fed infants.

Independent of body adiposity, breast-feeding has a protective effect on glucose metabolism in young adult women

The objective of the present study was to determine if any associations between reproductive experience and anthropometric or sub-clinical metabolic alterations of glucose metabolism exist. Sixty-seven women were recruited from the University of Brasilia Hospital and were evaluated at 12-18 months postpartum. Demographic, socio-economic, physical activity, anthropometric and health history (biochemical, reproductive) data were obtained. After a 12 h overnight fast, a 2 h oral glucose tolerance test was performed. Blood samples were collected at several points: at baseline, after intake of d-glucose solution (750 g/l; 100 ml) and every 30 min thereafter. Blood glucose and lipids were measured by enzymic assays. Blood insulin was measured by RIA. In multiple regression analysis four dependent logarithmically transformed (logt) variables (increased area under the glucose curve (IAUGC), increased area under the insulin curve (IAUIC), insulin peak (IP), homeostasis model of assessment (HOMA)) were adjusted for parity, age, lactation index, BMI, percentage body fat (PBF), waist circumference, superior skinfold thickness sum:inferior skinfold thickness sum ratio and oral contraceptive use. PBF was positively associated with logt-IAUIC (P=0.004) and IP (P=0.006). However, the lactation index was negatively associated with logt-IAUIC (P=0.02). IAUGC and HOMA did not present significant associations. We conclude that during the postnatal period, independent of parity, body adiposity accumulation is associated with initial alterations in insulin secretion. Furthermore, independent of body adiposity, breast-feeding has a long-lasting protective effect on insulin response.

Assessment of nutrient and water intake among adolescents from sports federations in the Federal District, Brazil

Adolescents aged 11-14 years (n 326), belonging to organized sports federations in the Federal District, Brazil were interviewed. Subjects (n 107) provided four non-consecutive days of food consumption and 219 subjects provided two non-consecutive days of intake. The objective was to assess their nutrient and water intake according to dietary reference intake values and their energy and macronutrient intake by sex and sports groups they were engaged in: endurance, strength-skill or mixed, according to the guidelines established by the American College of Sport Medicine (ACSM). Dietary data were corrected for intra-individual variation. Total energy expenditure was higher among endurance athletes (P < 0.001) following their higher training time (P < 0.001) when compared to adolescents engaged in strength-skill or mixed sports. Total energy intake was only significantly higher among endurance-engaged females (P = 0.05). Protein intake of males was above the guidelines established by the ACSM for all sports groups. All male sport groups fulfilled the intake levels of carbohydrate per kg body weight but only females engaged in endurance sports fulfilled carbohydrate guidelines. Intakes of micronutrients with low prevalence of adequate intake were: vitamins B1, E and folate, magnesium and phosphorus. Few adolescents ( < 5 %) presented adequate intake for calcium, fibre, drinking water and beverages. For micronutrients, prevalence of adequacies were lower for females than males, except for liquids and water. Nutrition guidance is needed to help adolescents fulfil specific guidelines of macronutrient intake for their sports and to improve their intake of micronutrients and water. Special attention should be given to female adolescent athletes.

Association of the maternal experience and changes in adiposity measured by BMI, waist:hip ratio and percentage body fat in urban Brazilian women.

The aim of the present study was to determine the association between the maternal experience and changes in adiposity measured by BMI, percentage body fat (PBF) and waist:hip ratio (WHR). In a cross-sectional study, 203 women were recruited at health care and educational facilities in Brasilia, Brazil. These women were divided into three groups: fifty-three nulliparous (no full-term pregnancy); sixty-three primiparous (one full-term pregnancy); eighty-seven multiparous (two or more full-term pregnancies). Socio-economic, behavioural, reproductive and dietary data were collected. All the women were measured for weight, height, skinfold thicknesses and waist and hip circumferences. Analysis of covariance was used to measure the differences among the three groups in relation to BMI, PBF, and WHR, controlling for the following covariates: age; socio-economic status; use of oral contraceptives; smoking; energy intake level; cooking oil intake; physical activity level; lactation score; parity. The three groups of women differed significantly for BMI (P = 0.04), PBF (P = 0.0008), and WHR (P = 0.0001). Multiparous women presented higher BMI (P = 0.01) and PBF (P = 0.03) compared with primi- and nulliparous groups. PBF was also associated with age and high socio-economic status. Primi- and multiparous women showed a higher WHR than nulliparous women (P < 0.0001). Age and smoking habit were also factors associated with higher WHR.

Fatores associados à atividade física em adultos, Brasília, DF

OBJECTIVE To describe physical activity practice in adults and to identify associated factors. METHODS A cross-sectional study was performed with cluster sampling from the four areas of the city of Brasília, Central-West Brazil, in 2006-2007. A sample comprised of 469 adults was obtained from 250 randomly selected households. Sociodemographic data, weight and height were obtained during a household interview. The short version of the International Physical Activity Questionnaire (IPAQ) was used to measure physical activity. A multivariate linear regression analysis was made to assess the effect of sex, body mass index (BMI), socioeconomic classification and marital status on physical activity scores. RESULTS The majority of the sample was comprised of women (57%). The percentage of individuals who achieved 150 minutes of weekly physical activity practice was 52% (95% CI: 47; 56), while that of inactive individuals was 21.5% (95% CI: 17.8; 25.3). An inverse association between physical activity and BMI was only found in men. Types of physical activity reported differed between sexes: walking and doing household chores among women; cycling, running, swimming and weight-lifting among men. There was a strong interaction between male sex and BMI in terms of the association with physical activity scores: the higher the BMI, the lower the physical activity score. CONCLUSIONS The portion of inactive individuals in Brasília can be considered low, when compared to estimates from other Brazilian cities. Differences in BMI and physical activity score found between sexes are associated with the type of physical activity practiced.OBJETIVO: Descrever a pratica de atividade fisica por adultos e identificar fatores associados. METODOS: Estudo transversal com amostragem por conglomerados das quatro regioes de Brasilia, DF, em 20062007. A amostra de 469 adultos foi obtida em 250 domicilios selecionados aleatoriamente. Dados sociodemograficos, peso e altura foram obtidos durante uma entrevista no domicilio. O questionario internacional de atividade fisica (Ipaq), versao curta, foi utilizado para a mensuracao da atividade fisica. Para se avaliar o efeito do sexo, indice de massa corporal (IMC), classificacao socioeconomica e estado civil sobre o escore de atividade fisica, foi realizada uma analise de regressao linear multivariavel. RESULTADOS: A maioria da amostra era composta por mulheres (57%). O percentual de individuos que atingiu 150 minutos semanais de pratica de atividade fisica foi de 52% (IC 95%: 47; 56) e de inativos de 21,5% (IC 95%: 17,8;25,3). Somente nos homens foi observada uma associacao inversa entre atividade fisica e IMC. Os tipos de atividades fisicas relatados diferiram entre os sexos: entre mulheres, caminhar e fazer servicos domesticos; entre os homens, pedalar, correr, nadar e fazer exercicios com pesos. Houve uma forte interacao entre sexo masculino e IMC para a associacao com o escore de atividade fisica: quanto maior o IMC, menor o escore de atividade fisica. CONCLUSOES: A parcela de individuos inativos em Brasilia pode ser considerada baixa, em contraste com estimativas de outras cidades brasileiras. Diferencas entre sexos em relacao a IMC e escore de atividade fisica estao associadas ao tipo de atividade fisica praticada.

Concentration of fat protein lactose and energy in milk of mothers using hormonal contraceptives.

Energy, protein, lactose and fat were studied in the milk of mothers who were using different types of contraceptives. One hundred and eleven mothers made up the following groups. C: control (barrier and natural methods, or sterilization), n = 22; combined pill: LDP (low dose pill (levonorgestrel 0.15 mg + ethinylestradiol 0.03 mg)), n = 12 and MDP (medium dose pill (levonorgestrel 0.25 mg + ethinylestradiol 0.05 mg)), n = 13; MP (minipill (norethindrone 0.35 mg)), n = 37; DMPA (injectable progesterone (depot medroxiprogesterone acetate 150 mg)), n = 17; and IUD (plastic or copper intrauterine device), n = 10. The mean stages of lactation were, respectively, 15, 17, 5, 9, 5 and 9 weeks. The mean duration of observation for the study groups ranged from 2 to 4 weeks. Milk samples were collected before and after initiation of treatment (mean = 20 days; range = 14-103 days). The stage of lactation and the interval of nursing before sampling were recorded so that statistical account could be taken of these uncontrollable sources of variability. When incorporated as covariates, they showed that no significant differences existed between the groups tested, either before or after treatment.

Validade de peso, altura e indice de massa corporal autorreferidos na populacao adulta de Brasilia

OBJECTIVE: To assess the validity of self-reported weight, height and body mass index (BMI) estimates from adults in Brasilia and to identify factors associated to differences between measured and self-reported values. METHODS: In a cluster sampling 250 household´s were selected and weight and height were measured in all adults after an interview. Bland & Altman (B&A) was used to determined agreement between measured and self-reported parameters. The multiple analysis of variance was used to determine the associated factors. Sensitivity and specificity were used for excess weight (BMI ≥ 25 kg/m2). RESULTS: Interviews and measurements were done in 469 individuals. B&A showed bias (difference between measured and self-reported values) was not significant for weight (- 0.17 kg, p = 0.1) and significant for height (- 1 cm, p < 0.001). The limits of agreement (LA) were wide: from ± 4 kg for weight and - 6 cm to 4 cm for height. BMI presented a non significant bias of - 0.06 kg/m2 (p = 0.08) and LA of - 1.5 to + 1.4 kg/m2. Men with a BMI < 25 kg/m2 overestimated weight, while overweight or obese men underestimated it (p < 0.01). Men older than 60y of age (p = 0.037) and women with less than 12y of study (p < 0.01) overestimated height. The sensitivity and specificity to detect excess weight were for men and women, respectively: 94%, 88% and 90%, 98%. Sensitivity to detect excess weight was 77% for 60 or over years old women and 75% for women between 9 to 11 years of study, while. specificity was 78% for men between 30 e 39 years old. CONCLUSION: In Brasilia, self-reported height can be used for subgroups of women with more than 12y of study and men under 60y of age. Men with adequate BMI over estimate their weight when compared to overweight and obese men. Self-reported measures can be used for excess weight population follow-up.

Association of Moderate Coffee Intake with Self-Reported Diabetes among Urban Brazilians

Coffee has been associated with reductions in the risk of non-communicable chronic diseases (NCCD), including diabetes mellitus. Because differences in food habits are recognizable modifying factors in the epidemiology of diabetes, we studied the association of coffee consumption with type-2 diabetes in a sample of the adult population of the Federal District, Brazil. This cross-sectional study was conducted by telephone interview (n = 1,440). A multivariate analysis was run controlling for socio-behavioural variables, obesity and family antecedents of NCCD. A hierarchical linear regression model and a Poisson regression were used to verify association of type-2 diabetes and coffee intake. The independent variables which remained in the final model, following the hierarchical inclusion levels, were: first level—age and marital status; second level—diabetes and dyslipidaemias in antecedents; third level—cigarette smoking, supplement intake, body mass index; and fourth level—coffee intake (≤100 mL/d, 101 to 400 mL/day, and >400 mL/day). After adjusting hierarchically for the confounding variables, consumers of 100 to 400 mL of coffee/day had a 2.7% higher (p = 0.04) prevalence of not having diabetes than those who drank less than 100 mL of coffee/day. Compared to coffee intake of ≤100 mL/day, adults consuming >400 mL of coffee/day showed no statistically significant difference in the prevalence of diabetes. Thus, moderate coffee intake is favourably associated with self-reported type-2 diabetes in the studied population. This is the first study to show a relationship between coffee drinking and diabetes in a Brazilian population.