Associations between biological and behavioral factors in early life and food consumption in Brazilian adolescents: Results from the ERICA study.

The aim of the present study was to determine associations between biological and behavioral factors in early life and food consumption in Brazilian adolescents. The sample was composed of 36,956 adolescents (12-17 years of age) who participated in the "Study of Cardiovascular Risk in Adolescents". Sociodemographic, biological, and behavioral variables were collected using questionnaires self-administered by the adolescents. Early-life factors were assessed using a questionnaire administered to the parents/guardians of the adolescents. Dependent variables related to food consumption (total energy intake and percentages of macronutrient intake [carbohydrates, lipids and proteins]) were measured using the 24-hour recall method and compared to dietary reference intakes. Data analysis was performed with the aid of STATA 14.0, using multiple linear regression analysis with respective ß coefficients. The level of significance was set at 5% (p ≤ 0.05). Adolescents born with low weight had lower energy intake (-94.8 kcal, 95%CI: -177.2; -12.3, p = 0.024) and 1.25% higher carbohydrate intake (95%CI: 0.15; 2.34, p = 0.025) compared to those born with adequate weight. Those who received exclusive breast breastfeeding for three to six months ingested 1.32% more lipids than those who received exclusive breast breastfeeding for less than three months (95%CI: 0.37; 2.26, p = 0.006). In conclusion, low birth weight was associated with lower energy intake and a higher percentage of carbohydrate intake, whereas breastfeeding three to six months was associated with a higher percentage of lipid intake.

Birth-related and current factors associated with physical inactivity in the leisure time in Brazilian adolescents.

BACKGROUND: To determine whether biological and sociodemographic factors at birth and current factors are associated with insufficient physical activity during leisure among Brazilian adolescents. METHODS: A school-based cross-sectional study with national coverage was conducted involving Brazilian adolescents 12 to 17 years of age in municipalities with more than 100 thousand residents. The sample consisted of 74,589 adolescents who participated in the Study of Cardiovascular Risk in Adolescents. Insufficient leisure-time physical activity was categorized based on total volume (<300 minutes/week = insufficiently active; >300 minutes/week = sufficiently active). Poisson regression models were used to assess associated factors. RESULTS: Most adolescents were classified as insufficiently active (54.8%; 95%CI: 53.7-55.9). The variables associated with insufficient physical activity during leisure were the female sex (70.4%; 95%CI: 68.8-71.9), age between 15 and 17 years (57.8%; 95%CI: 56.3-59.2), pertaining to the low or middle class (54.5%; 95%CI: 52.8-56.1), and not being overweight (55.9%; 95%CI: 54.6-57.1). CONCLUSION: Contrary to our hypothesis, birth related factors (e.g., low birth weight, preterm birth and exclusive breastfeeding until 6 months of age) are not associated with physical inactivity. The prevalence of insufficient physical activity during leisure was high among the adolescents evaluated and was associated with sociodemographic characteristics as well as nutritional status. It is necessary to implement strategies focused on physical activity at schools.

Association between early life factors and accelerometry-based physical activity measures in children aged 5-7 years old / Associação entre fatores precoces e medidas da atividade física por acelerometria em crianças de 5 a 7 anos de idade

ABSTRACT The present study aims to verify if there is an association between early life factors (birth weight, exclusive breastfeeding, birth order and preterm birth) and accelerometry-based physical activity measures in children aged 5 to 7 years old. It is a cross-sectional study carried out with children from public and private schools in Recife, Brazil. A questionnaire was applied to the children's parents. Of the 784 children participating in the study, 491 had at least three days of valid monitoring. It was possible to identify that the children classified as the fourth ones, as to birth order, or over, were 83% less likely to have a low percentage of daily time spent on moderate-intensity physical activities compared to firstborns (OR = 0.17; 0.03-0.80). Only birth order was negatively associated with low percentage of daily time spent on moderate physical activities, even after adjustment for confounding factors.

RESUMO O presente estudo tem como objetivo verificar se existe associação entre fatores precoces (peso ao nascer, amamentação exclusiva ao seio, ordem de nascimento e nascimento pré-termo) e as medidas da atividade física por acelerometria em crianças de 5 a 7 anos. Trata-se de umestudo transversal realizado com crianças de escolas públicas e privadas do Recife. Utilizou-se um questionário com os pais/mães das crianças.Das 784 crianças participantes do estudo, 491 tiveram, pelo menos, três dias de monitoramento válido. Identificou-se que as crianças que eram classificadas como o quarto filho ou superior apresentaram 83% menos chance de ter baixo percentual de tempo diário despendido em atividades físicasem intensidade moderada quando comparadas as que eram o filho primogênito (OR= 0,17; 0,03-0,80). Verificou-se que somente a ordem de nascimento foi negativamente associada ao baixo percentual de tempo diário despendido em atividades físicasem intensidade moderada, mesmo após ajustamente para os fatores de confusão.

Padrões alimentares de mulheres em idade reprodutiva: realidade na Zona da Mata nordestina / Eating patterns among women of reproductive age: reality in the Zona Mata, Northeastern Brazil

Objetivo: Verificar os padrões alimentares e os fatores associados de mulheres em idade reprodutiva. Métodos: Trata-se de estudo transversal realizado com 322 mulheres de 12 a 49 anos, residentes em Vitória de Santo Antão, Zona da Mata de Pernambuco, através de busca ativa nos domicílios. Os setores censitários foram sorteados de forma aleatória simples, abrangendo as unidades de saúde pertencentes à Estratégia de Saúde da Família. A partir do Questionário de Frequência Alimentar, identificaram-se os padrões alimentares, categorizados em baixo consumo, 1º e 2º tercil, e alto consumo, tercil superior. As variáveis independentes analisadas foram as sociodemográficas, de estilo de vida e de saúde. Resultados: Do grupo estudado, 59,3% tinham entre 20 e 39 anos e 60,9% apresentavam excesso de peso. Verificaram-se três padrões alimentares: Saudável, Comum Típico Brasileiro e Fast-food. As mulheres com idade ≥ 40 anos consumiam aproximadamente três vezes mais alimentos do padrão Saudável, quando comparadas àquelas com idade ≤ 19 anos. Em contraste, aquelas com idade ≥ 40 anos apresentaram menor probabilidade de consumir alimentos do padrão Fast-food do que as mais jovens (≤ 19 anos). Verificou-se ainda que mulheres com escolaridade superior a oito anos tinham maior probabilidade de consumir alimentos do padrão Fast-food quando comparadas aquelas com ≤ 4 anos de estudo. Conclusões: As mulheres mais jovens e as de maior escolaridade apresentaram um consumo elevado do padrão alimentar Fast-food, em comparação às mais velhas e de menor escolaridade, respectivamente. (AU)

Objective: To analyze eating patterns and associated factors in women of reproductive age. Methods: This is a cross-sectional study conducted with 322 women aged 12 to 49 years old, residing in Vitória de Santo Antão, Pernambuco's Zona da Mata, Brazil, through active household survey. Census sectors were drawn in a simple and random manner, covering the health units belonging to the Family Health Strategy. The Eating Frequency Questionnaire allowed identifying eating patterns, categorized into low consumption, 1st and 2nd terciles, and high consumption, higher tercile. The independent variables analyzed were sociodemographic, lifestyle and health. Results: Within the studied group, 59.3% of the women were aged between 20 and 39 years old, and 60.9% had excessive weight. Three eating patterns were observed: Healthy, Brazilian-Typical Common, and Fast-Food. Women aged ≥ 40 years old consumed approximately three times more food of the Healthy pattern compared to those aged ≤ 19 years old. On the other hand, those aged ≥ 40 were less likely to consume foods of the Fast-Food pattern than the younger ones were (≤ 19 years old). Moreover, women with more than eight years of education were more likely to consume foods of the Fast-Food pattern compared to those with ≤ 4 years of education. Conclusions: Younger and better educated women presented a high consumption of foods characterizing the Fast-Food eating pattern compared to older and less educated ones, respectively. (AU)

Frequency of consumption of fruits, vegetables and soft drinks: a comparative study among adolescents in urban and rural areas.

OBJECTIVE: To compare the frequency of consumption of fruits, vegetables and soft drinks among adolescents living in urban and rural areas of Pernambuco State. METHODS: A cross-sectional study based on secondary analysis of data from a representative sample of high school students in Pernambuco (n = 4,207, 14 - 19 years) was conducted. Data were collected through a previously validated questionnaire. Adolescents who reported a daily consumption of soft drinks and occasional consumption of fruits, juices and vegetables were classified as exposed to inadequate standard of consumption of these foods. The independent variable was the place of residence (urban/rural). Data were analyzed by frequency distribution, χ2 test and binary logistic regression. RESULTS: It was observed that students residing in rural areas had a higher prevalence of occasional consumption of natural fruit juices (37.6%; 95%CI 36.1 - 39.0) than those living in urban areas (32.1%; 95%CI 30.7 - 33.6). The proportion of students exposed to daily consumption of soft drinks was higher among those who reported they lived in urban areas (65.0%; 95%CI 63.5 - 66.4) compared to those who reported living in rural areas (55.3%; 95%CI 53.8 - 56.9). CONCLUSION: Adolescent students living in rural areas had a higher prevalence of low consumption of natural fruit juices while those residing in urban areas had a higher prevalence of daily consumption of soda drinks.

Precisão do IMC em diagnosticar o excesso de gordura corporal avaliada pela bioimpedância elétrica em universitários / Accuracy of the BMI in diagnosing the excess body fat evaluated by electrical bioimpedance in university students

Introdução: Considerando-se que o excesso de gordura corporal está relacionado ao aumento da morbimortalidade, principalmente em adultos, para a sua avaliação são necessários métodos precisos e confiáveis, de baixo custo e grande aplicabilidade em estudos populacionais e na prática clínica. Objetivo: Determinar a precisão do Índice de Massa Corporal (IMC) em diagnosticar o excesso de gordura corporal avaliada pela BIA em uma população de adultos jovens. Métodos: Foi realizado estudo de delineamento transversal, sendo a amostra composta por 326 indivíduos (mediana de 21 anos), estudantes da Universidade Federal de Pernambuco. Os pontos de corte do IMC adotados foram os preconizados pela Organização Mundial de Saúde (OMS). A gordura corporal foi avaliada pela bioimpedância elétrica (BIA) e para indicar níveis acima da média, foram utilizados os valores de 16% para homens e 24% para mulheres. Resultados: 27,3% dos 66 homens e 26,8% das 220 mulheres classificados como eutróficos, segundo o IMC, apresentaram percentual de gordura corporal acima da média, e apenas três mulheres e dois homens com IMC≥25Kg/m2 apresentaram massa corporal gorda abaixo dos níveis normais. Nas análises das curvas ROC, observou-se que o valor de IMC com melhor equilíbrio entre a sensibilidade e a especificidade foi de 22Kg/m2 e 23Kg/m2 em mulheres e homens, respectivamente. Conclusão: A área sob a curva ROC foi menor no sexo feminino, indicando uma menor probabilidade dos valores do IMC em produzir um diagnóstico correto em mulheres do que em homens

Introduction: Considering that excess body fat is related to the increase of morbimortality, especially in adults, accurate and reliable methods, low cost and great applicability in population studies and in clinical practice. Goals: To determine the Body Mass Index (BMI) accuracy to diagnose the excess body fat measured by BIA in a population of young adults. Methods: A cross-sectional study was conducted being the sample consisted of 326 individuals with a median of 21 years-students from the Federal University of Pernambuco. The cutoff points of body mass index (BMI) adopted were those recommended by the World Health Organization (WHO). Body fat was measured by bioelectrical impedance analysis (BIA) and to indicate levels above the average were those higher than 16% for men and 24% for women. Results: 27.3% of 66 men and 26.8% of 220 women classified as normal, according to BMI, showed body fat percentage above the average, and only three women and two men with BMI ≥ 25Kg/m2 had body fat below normal levels. In the analysis of ROC curves was observed that the BMI value with the best balance between sensitivity and specificity was 22Kg/m2 and 23Kg/m2 in women and men, respectively. Conclusion: The area under the ROC curve was lower in females, indicating a lower probability of BMI values to produce a correct diagnosis in women than in men

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Frequency of consumption of fruits, vegetables and soft drinks: a comparative study among adolescents in urban and rural areas / Frequência de consumo de frutas, hortaliças e refrigerantes: estudo comparativo entre adolescentes residentes em área urbana e rural

Objective: To compare the frequency of consumption of fruits, vegetables and soft drinks among adolescents living in urban and rural areas of Pernambuco State. Methods: A cross-sectional study based on secondary analysis of data from a representative sample of high school students in Pernambuco (n = 4,207, 14 - 19 years) was conducted. Data were collected through a previously validated questionnaire. Adolescents who reported a daily consumption of soft drinks and occasional consumption of fruits, juices and vegetables were classified as exposed to inadequate standard of consumption of these foods. The independent variable was the place of residence (urban/rural). Data were analyzed by frequency distribution, χ2 test and binary logistic regression. Results: It was observed that students residing in rural areas had a higher prevalence of occasional consumption of natural fruit juices (37.6%; 95%CI 36.1 - 39.0) than those living in urban areas (32.1%; 95%CI 30.7 - 33.6). The proportion of students exposed to daily consumption of soft drinks was higher among those who reported they lived in urban areas (65.0%; 95%CI 63.5 - 66.4) compared to those who reported living in rural areas (55.3%; 95%CI 53.8 - 56.9). Conclusion: Adolescent students living in rural areas had a higher prevalence of low consumption of natural fruit juices while those residing in urban areas had a higher prevalence of daily consumption of soda drinks. .

Objetivo: Comparar a frequência de consumo de frutas, hortaliças e refrigerantes entre adolescentes residentes na área urbana e rural do Estado de Pernambuco. Métodos: Estudo transversal baseado na análise secundária de dados de uma amostra representativa dos estudantes do ensino médio em Pernambuco (n = 4.207, 14 - 19 anos). Os dados foram coletados através de um questionário previamente validado. Os adolescentes que relataram um consumo diário de refrigerantes e consumo ocasional de frutas, sucos naturais de frutas e hortaliças foram classificados como expostos a um padrão inadequado de consumo desses alimentos. A variável independente foi o local de residência (urbana/rural). Os dados foram analisados através de distribuição de frequências, Teste do χ2 e regressão logística binária. Resultados: Observou-se que os estudantes residentes em área rural (37,6%; IC95% 36,1 - 39,0) apresentaram uma maior prevalência de consumo ocasional de suco de frutas em comparação aos residentes em urbana (32,1%; IC95% 30,7 - 33,6). A proporção de estudantes expostos ao consumo diário de refrigerantes foi maior entre aqueles que residiam na área urbana (65,0%; IC95% 63,5 - 66,4) em comparação aos da área rural (55,3%; IC95% 53,8 - 56,9). Conclusão: Estudantes adolescentes residentes em área rural apresentaram maior prevalência de exposição a baixo consumo de sucos de frutas, enquanto aqueles residentes em área urbana apresentaram maior prevalência de exposição a consumo diário de refrigerantes. .

Participação nas aulas de educação física e indicadores de atitudes relacionadas à atividade física em adolescentes / Participation in physical education classes and indicators of attitudes toward physical activity in adolescents

O objetivo deste estudo foi analisar a associação entre participação nas aulas de educação física (PAEF) e atitudes relacionadas à atividade física (gostar de fazer atividade física e preferir atividades de lazer fisicamente ativas) em adolescentes. Trata-se de um estudo epidemiológico transversal, a partir de uma amostra representativa de adolescentes (n = 4.207, 14-19 anos) estudantes do ensino médio da rede pública estadual de Pernambuco. Dados foram coletados através de um questionário previamente validado. Observou-se que entre os adolescentes que relataram participar das aulas de educação física a chance de gostar de fazer atividade física foi 73% maior nos rapazes e 93% superior nas moças em comparação àqueles que não participam das aulas. A chance de preferir atividades de lazer fisicamente ativas foi 97% e 72% superior nos rapazes e nas moças que PAEF, respectivamente. Concluiu-se que a PAEF está diretamente associada aos indicadores que expressam atitudes dos adolescentes em relação à atividade física.

The objective of this study was to analyze the association between the participation in physical education classes (PPEC) and attitudes towards physical activity (to enjoy physical activity and to prefer active leisure activities) in adolescents. This is a cross-sectional epidemiological study from a representative sample of adolescents (n = 4207, 14-19 years) high school students of public schools from Pernambuco. Data were collected using a previously validated questionnaire. It was found that among adolescents who reported PPEC the chance to enjoy physical activity was 73% higher in boys and 93% higher in girls compared to those who do not participate in the classes. The chance of to prefer active leisure activities was 97% and 72% higher in boys than in girls and PPEC, respectively. It was concluded that the PPEC is directly associated with the indicators that express attitudes of adolescents in relation to physical activity.