[Consumption of red and processed meat, insulin resistance, and diabetes in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)Consumo de carnes rojas y de carne procesada, resistencia a la insulina y diabetes en el estudio longitudinal de salud del adulto (ELSA-Brasil)]. / Consumo de carne vermelha e processada, resistência insulínica e diabetes no Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil).

OBJECTIVE: To investigate the association between red and processed meat consumption and the occurrence of new cases of insulin resistance (IR) and diabetes mellitus (DM) in participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). METHOD: This cohort study included 15 105 civil servants (age: 35-74 years). Biochemical, anthropometric, and socioeconomic data, as well as lifestyle characteristics, were collected at baseline (2008-2010) and wave 2 (2012-2014). Meat consumption (g/day) was estimated using a food frequency questionnaire. To categorize low, medium, and high consumption, independent variables were divided into tertiles. DM was diagnosed as fasting glucose ≥ 126 mg/dL, postload glucose ≥ 200 mg/dL, or glycated hemoglobin ≥ 6.5. IR was determined by HOMA-IR with cutoff points based on the sample's 75th percentile. RESULTS: Men and participants with lower income and schooling reported higher consumption of red and processed meat. High consumption of processed meat (highest tertile, > 27.1 g/day) was associated with new cases of IR in men (OR = 1.68; 95%CI: 1.31-2.16) and women (OR = 1.23; 95%CI: 1.00-1>52). High consumption of red meat increased by 40% (95%CI: 1.04-1.96) the likelihood of new cases of DM in men. CONCLUSIONS: High consumption of red/processed meat negatively impacted the health of participants. Moderate consumption of meats may be recommended for the general population and for prevention of DM.

OBJETIVO: Investigar la relación entre el consumo de carnes rojas y de carne procesada y la incidencia de nuevos casos de resistencia a la insulina y de diabetes mellitus en los participantes en el estudio longitudinal de salud del adulto (ELSA-Brasil). MÉTODOS: Estudio de cohorte con 15 105 funcionarios públicos (de 35 a 74 años de edad). Se recopilaron datos bioquímicos, antropométricos, socioeconómicos y sobre el estilo de vida en la línea de base (2008­2010) y en la segunda fase (2012­2014). Se calculó el consumo de carne (g/día) por medio de un cuestionario sobre la frecuencia del consumo de alimentos. Para las clasificaciones de consumo bajo, mediano y alto, las variables independientes se dividieron en terciles. La diabetes mellitus se diagnosticó como glucemia en ayunas ≥ 126 mg/dl, glucosa después de una sobrecarga ≥ 200 mg/dl o glucohemoglobina ≥ 6,5. La resistencia a la insulina se determinó con el modelo homeostático HOMA-IR con puntos de corte a partir del percentil 75 de la muestra. RESULTADOS: Los hombres y los participantes de menores ingresos y menor grado de escolaridad declararon un mayor consumo de carnes rojas y de carnes procesadas. El mayor consumo de carne procesada (último tercil, > 27,1 g/día) guardó relación con nuevos casos de resistencia a la insulina en los hombres (razón de probabilidades [OR] = 1,68; IC95%: 1,31-2,16) y las mujeres (OR = 1,23; IC95%: 1,00-1,52). El consumo alto de carnes rojas aumentó un 40% (IC95%: 1,04-1,96) la posibilidad de manifestación de nuevos casos de diabetes mellitus en los hombres. CONCLUSIONES: El consumo alto de carnes rojas y de carne procesada afectó desfavorablemente la salud de los participantes. El consumo moderado de carne puede recomendarse a la población en general y para la prevención de la diabetes mellitus.

[Development and validation of the food quality score in ELSA-Brasil]. / Desarrollo y validación de la puntuación de calidad alimentaria en el ELSA-Brasil.

Introduction: miology.Introduction: nutritional epidemiology seeks to understand the relationship between food consumption and the occurrence of diseases. During the COVID-19 pandemic, the Longitudinal Study of Adult Health (ELSA-Brasil) used a reduced Food Frequency Questionnaire (FFQ) to compare diet quality between cohort stages. Objective: to develop and validate an index created using a food quality score (FQS) using the FFQ of ELSA-Brasil. Methods: a cross-sectional study carried out between August 2020 and March 2021 with 4262 participants. For each frequency of consumption of healthy and unhealthy food markers, a score was given. Validity and reliability were tested using Pearson's correlation, principal component analysis (PCA) and Cronbach's alpha. Tests were performed to verify differences between individual characteristics and FQS. Results: the PCA indicated a total variability of 42.5 %. Women and individuals with higher age, physical activity and per capita income had a higher FQS, while those who reported higher consumption of alcohol and being smokers had a lower score. Cronbach's alpha was 0.47. Conclusion: the FQS showed a satisfactory validity and reliability and was associated with socioeconomic and lifestyle data. Therefore, it is a useful tool for comparing dietary information, thus contributing to nutritional epidemiology.

Introducción: Introducción: la epidemiología nutricional busca comprender la relación entre el consumo de alimentos y la ocurrencia de enfermedades. Durante la pandemia de COVID-19, el Estudio Longitudinal de Salud del Adulto (ELSA-Brasil) utilizó un Cuestionario de Frecuencia de Alimentos (CFA) reducido para comparar la calidad de la dieta en diferentes etapas de la cohorte. Objetivo: desarrollar y validar un índice creado a partir de un score (o puntuación) de calidad alimentaria (SCA) utilizando el CFA del ELSA-Brasil. Métodos: estudio transversal realizado entre agosto de 2020 y marzo de 2021 con 4262 participantes. Para cada categoría de frecuencia de consumo de alimentos indicadores de alimentación saludable y no saludable, se otorgó una puntuación. La validez y la fiabilidad se estimaron mediante el coeficiente de correlación de Pearson, el análisis de componentes principales (ACP) y la alfa de Cronbach. Se realizaron pruebas para verificar las diferencias entre las características individuales y la SCA. Resultados: el ACP indicó una variabilidad total del 42,5 %. Las mujeres y los individuos con mayor edad, actividad física e ingreso per cápita obtuvieron un valor de SCA más alto, mientras que aquellos que reportaron un mayor consumo de alcohol y tabaquismo obtuvieron una puntuación más baja. La alfa de Cronbach fue de 0,47. Conclusión: la SCA mostró una validez y confiabilidad satisfactorias y se asoció con datos socioeconómicos y de estilo de vida. Por lo tanto, es una herramienta útil para comparar la información dietética, contribuyendo a los futuros análisis en epidemiología nutricional.

Consumption of processed meat but not red meat is associated with the incidence of hypertension: ELSA-Brasil cohort.

OBJECTIVES: To verify the association between the consumption of red and processed meats and the incidence of hypertension in participants of the Longitudinal Study of Adult Health. METHODS: This was a cohort with data from the baseline (2008-2010) and second wave (2012-2014) with 8,089 public workers of both sexes and different racial groups, with mean age of 49 ± 8 years (35-74 years old). Meat consumption (g/d) was estimated using a food frequency questionnaire and was divided into consumption tertiles. Hypertension was defined as systolic blood pressure ≥140 mm Hg and/or diastolic ≥90 mm Hg and/or antihypertensive medication. Cox proportional hazards models were used to estimate adjusted Hazard Ration (HRs) and 95% confidence interval (CI) for incident hypertension. RESULTS: A total of 1186 incident cases of hypertension were identified. Even adjusting for confounders, such as urinary Na/K (sodium/potassium) ratio and BMI (body mass index), participants in the second (HR:1.19; 95% CI 1.03-1.30) and third (HR:1.30; 95% CI:1.11-1.53) tertile of processed meat consumption had a higher risk of developing hypertension than those in the first tertile. We did not find a significant association between red meat consumption and hypertension. CONCLUSIONS: The increased risk of developing hypertension is associated with moderate and high consumption of processed meats but not with consumption of red meat.

Impact of socioeconomic factors on lifestyle changes among employees of public higher education institutions in ELSA-Brasil during COVID-19 pandemic.

This study aimed to identify lifestyle changes and associated sociodemographic factors in women and men participating in the Brazilian Longitudinal Study for Adult Health (ELSA-Brasil) cohort during the COVID-19 pandemic. Longitudinal study with 3,776 (aged 58.8 years; SD ± 8.5) employees of public higher education institutions in the second follow-up and the wave-COVID of ELSA-Brasil. Data collected using structured questionnaires. An exploratory analysis was performed using binary and multinomial logistic regression on the dependent variables with two and three categories, respectively, by obtaining crude and adjusted odds ratio estimates in SPSS 20.0, considering a p-value < 0.05. There was a reduction in physical activity of 195.5 (SD ± 1,146.4) metabolic equivalents per week in women and 240.5 (SD ± 1,474.2) in men, and in smoking by 15.2%. There was an increase in alcohol consumption in men and women (434.2 ± 5,144.0; and 366.1 ± 4,879.0, respectively), in the food quality score (0.8 ± 3.7, women; 0.5 ± 3.7, men), sleeping time (0.4 ± 1.2, women; 0.5 ± 1.1, men), screen time (1.7 ± 2.4, women; 1.4 ± 2.3, men), and sitting time (1.7 ± 2.6, women; 1.5 ± 2.4, men) (hours/day). In total, 18.6% increased the purchase of ultra-processed foods and 36% increased the purchase of natural foods. Age and work activity contributed to increase the chance of purchasing ultra-processed foods, and age and adherence to social distancing influenced the shift to a more sedentary behavior, while income and active work favored the increase in alcoholic beverage consumption. These factors should be considered when developing public policies to avoid individual behaviors that are harmful to health during pandemics.

Overweight and obesity prevalence trend in Espírito Santo, Brazil: an ecological study, 2009-2018. / Tendência da prevalência do sobrepeso e obesidade no Espírito Santo: estudo ecológico, 2009-2018.

OBJECTIVE: To analyze trends in the prevalence of overweight and obesity in the state of Espírito Santo, Brazil, between 2009 and 2018. METHODS: This was an ecological study, with data from the Food and Nutritional Surveillance System (SISVAN). Overweight and obesity were classified as recommended by the World Health Organization. Prais-Winsten regression was used to estimate the trend of the prevalence. RESULTS: There was an increasing trend of overweight (5.5 to 8.6%) and obesity (4.4 to 8.3%), in both sexes and in different regions of the state. In the stratified analysis, there was an increase in overweight and obesity in children, adolescents and adult women (4.2 to 8.6%; p<0.05). Obesity increased among male adolescents, in the south, central and north regions of the state, while in the south region, in all age groups (5.1% growth; p=0.01). CONCLUSION: There was an increase in overweight and obesity in Espírito Santo, from 2009 to 2018.

Impact of socioeconomic factors on lifestyle changes among employees of public higher education institutions in ELSA-Brasil during COVID-19 pandemic / Impacto de fatores socioeconômicos na mudança do estilo de vida de funcionários de instituições públicas de Ensino Superior no ELSA-Brasil durante a pandemia de COVID-19 / Impacto de los factores socioeconómicos en el cambio del estilo de vida de los funcionarios en instituciones públicas de educación superior en ELSA-Brasil durante la pandemia de la COVID-19

Abstract: This study aimed to identify lifestyle changes and associated sociodemographic factors in women and men participating in the Brazilian Longitudinal Study for Adult Health (ELSA-Brasil) cohort during the COVID-19 pandemic. Longitudinal study with 3,776 (aged 58.8 years; SD ± 8.5) employees of public higher education institutions in the second follow-up and the wave-COVID of ELSA-Brasil. Data collected using structured questionnaires. An exploratory analysis was performed using binary and multinomial logistic regression on the dependent variables with two and three categories, respectively, by obtaining crude and adjusted odds ratio estimates in SPSS 20.0, considering a p-value < 0.05. There was a reduction in physical activity of 195.5 (SD ± 1,146.4) metabolic equivalents per week in women and 240.5 (SD ± 1,474.2) in men, and in smoking by 15.2%. There was an increase in alcohol consumption in men and women (434.2 ± 5,144.0; and 366.1 ± 4,879.0, respectively), in the food quality score (0.8 ± 3.7, women; 0.5 ± 3.7, men), sleeping time (0.4 ± 1.2, women; 0.5 ± 1.1, men), screen time (1.7 ± 2.4, women; 1.4 ± 2.3, men), and sitting time (1.7 ± 2.6, women; 1.5 ± 2.4, men) (hours/day). In total, 18.6% increased the purchase of ultra-processed foods and 36% increased the purchase of natural foods. Age and work activity contributed to increase the chance of purchasing ultra-processed foods, and age and adherence to social distancing influenced the shift to a more sedentary behavior, while income and active work favored the increase in alcoholic beverage consumption. These factors should be considered when developing public policies to avoid individual behaviors that are harmful to health during pandemics.

Resumo: O objetivo do estudo é identificar mudanças no estilo de vida e fatores sociodemográficos associados em mulheres e homens participantes da coorte Estudo Longitudinal da Saúde do Adulto (ELSA-Brasil) durante a pandemia de COVID-19. Estudo longitudinal com 3.776 (58,8 anos; DP ± 8,5) funcionários de instituições públicas de Ensino Superior no segundo acompanhamento e na onda COVID do ELSA-Brasil. Os dados foram coletados por meio de questionários estruturados. Foi realizada análise exploratória por meio de regressão logística binária e multinomial nas variáveis dependentes com duas e três categorias, respectivamente, obtendo-se estimativas brutas e ajustadas de odds ratio no SPSS 20.0, considerando um valor de p < 0,05. Houve redução da atividade física de 195,5 (DP ± 1.146,4) equivalentes metabólicos por semana nas mulheres e de 240,5 (DP ± 1.474,2) nos homens, e do tabagismo de 15,2%. Houve aumento do consumo de álcool em homens e mulheres (434,2 ± 5.144,0 e 366,1 ± 4.879,0, respectivamente), do escore de qualidade alimentar (0,8 ± 3,7, mulheres; 0,5 ± 3,7, homens), do tempo de sono (0,4 ± 1,2, mulheres; 0,5 ± 1,1, homens), do tempo de tela (1,7 ± 2,4, mulheres; 1,4 ± 2,3, homens) e do tempo sentado (1,7 ± 2,6, mulheres; 1,5 ± 2,4, homens) (horas/dia). Além disso, 18,6% aumentaram a compra de alimentos ultraprocessados e 36% aumentaram a compra de alimentos naturais. A idade e a atividade laboral contribuíram para aumentar a chance de compra de alimentos ultraprocessados, e a idade e a adesão ao distanciamento social influenciaram a mudança para um comportamento mais sedentário, enquanto a renda e o trabalho ativo favoreceram o aumento do consumo de bebidas alcoólicas. Estes fatores devem ser considerados na elaboração de políticas públicas a fim de evitar comportamentos individuais deletérios à saúde em períodos de pandemia.

Resumen: El objetivo de este estudio es identificar los cambios en el estilo de vida y los factores sociodemográficos asociados en mujeres y hombres que participan en la cohorte Estudio Longitudinal de Salud del Adulto en Brasil (ELSA-Brasil) durante la pandemia de la COVID-19. Estudio longitudinal con 3.776 (58,8 años; DE ± 8,5) funcionarios en instituciones públicas de educación superior en el segundo seguimiento y en la ola COVID de ELSA-Brasil. Los datos se recopilaron de cuestionarios estructurados. El análisis exploratorio se realizó mediante regresión logística binaria y multinomial en variables dependientes con dos y tres categorías, respectivamente, en la cual se obtuvieron estimaciones brutas y ajustadas de odds ratios en SPSS 20.0, teniendo en cuenta un valor de p < 0,05. Hubo una reducción en la actividad física de 195,5 (DE ± 1.146,4) equivalentes metabólicos por semana en mujeres y de 240,5 (DE ± 1.474,2) en hombres, y del tabaquismo del 15,2%. Hubo un aumento en el consumo de alcohol en hombres y mujeres (434,2 ± 5.144,0 y 366,1 ± 4.879,0, respectivamente), en el puntaje de calidad de los alimentos (0,8 ± 3,7, mujeres; 0,5 ± 3,7, hombres), en el tiempo de sueño (0,4 ± 1,2, mujeres; 0,5 ± 1,1, hombres), en el tiempo frente a la pantalla (1,7 ± 2,4, mujeres; 1,4 ± 2,3, hombres) y en el tiempo sentado (1,7 ± 2,6, mujeres; 1,5 ± 2,4, hombres) (horas/día). Además, el 18,6% aumentó la compra de alimentos ultraprocesados y el 36% la compra de alimentos.

Tendência da prevalência do sobrepeso e obesidade no Espírito Santo: estudo ecológico, 2009-2018 / Tendencia en la prevalencia de sobrepeso y obesidad en Espírito Santo, Brasil: un estudio ecológico, 2009-2018 / Overweight and obesity prevalence trend in Espírito Santo, Brazil: an ecological study, 2009-2018

Objetivo: Analisar tendências nas prevalências do sobrepeso e obesidade no estado do Espírito Santo, Brasil, entre 2009 e 2018. Métodos: Estudo ecológico, com dados do Sistema de Vigilância Alimentar e Nutricional. O sobrepeso e a obesidade foram classificados conforme preconiza a Organização Mundial da Saúde. Realizou-se regressão linear (Prais-Winsten) para estimar a tendência da prevalência. Resultados: Observou-se tendência crescente de sobrepeso (5,5 a 8,6%) e obesidade (4,4 a 8,3%), em ambos os sexos e nas diferentes regiões do estado. Na análise estratificada, houve aumento de sobrepeso e obesidade em crianças, adolescentes e adultos do sexo feminino (4,2 a 8,6%; p<0,05). No sexo masculino, nas regiões norte, central e sul do estado, a obesidade cresceu entre adolescentes, enquanto na região sul, em todas as faixas etárias (crescimento de 5,1%; p=0,01). Conclusão: Houve aumento do sobrepeso e da obesidade no Espírito Santo, de 2009 a 2018.

Objetivo: Analizar tendencias en la prevalencia de sobrepeso y obesidad en el estado de Espírito Santo, Brasil, de 2009-2018. Métodos: Estudio ecológico utilizando datos del Sistema de Vigilancia Alimentaria y Nutricional. El sobrepeso y la obesidad se clasificaron según recomendaciones de la Organización Mundial de la Salud. Se realizó regresión lineal (Prais-Winsten) para estimar la tendencia de prevalencia. Resultados: Se observó una tendencia creciente al sobrepeso (5,5 a 8,6%) y a la obesidad (4,4 a 8,3%), en ambos sexos y regiones. En el análisis estratificado, hubo aumento de sobrepeso y obesidad en niños, adolescentes y mujeres adultas (4,2 a 8,6%; p<0,05). En los hombres, la obesidad aumentó entre los adolescentes de las regiones norte, centro y sur del estado y hubo un aumento de la obesidad (5,1%; p=0,01) en todas las edades en la región sur. Conclusión: Hubo un aumento del sobrepeso y la obesidad de 2009 a 2018 en Espírito Santo.

Objective To analyze trends in the prevalence of overweight and obesity in the state of Espírito Santo, Brazil, between 2009 and 2018. Methods This was an ecological study, with data from the Food and Nutritional Surveillance System (SISVAN). Overweight and obesity were classified as recommended by the World Health Organization. Prais-Winsten regression was used to estimate the trend of the prevalence. Results There was an increasing trend of overweight (5.5 to 8.6%) and obesity (4.4 to 8.3%), in both sexes and in different regions of the state. In the stratified analysis, there was an increase in overweight and obesity in children, adolescents and adult women (4,2 a 8,6%; p<0,05). Obesity increased among male adolescents, in the south, central and north regions of the state, while in the south region, in all age groups (5.1% growth; p=0.01). Conclusion There was an increase in overweight and obesity in Espírito Santo, from 2009 to 2018.

Consumo de bebidas açucaradas e estado nutricional em adultos: um estudo de intervenção / Sugary drink consumption and nutritional status in adults: an intervention study

Objetivou-se avaliar mudanças no consumo de bebidas açucaradas e estado nutricional de adultos vinculados a uma instituição federal de ensino localizada em Vitória (ES), após um programa de intervenção. Foram coletadas medidas antropométricas e dados de consumo de bebidas açucaradas de todos os participantes, os quais foram randomizados e alocados em dois grupos, intervenção (ações mHealth) e controle. Posteriormente, foi realizada uma reavaliação. Os desfechos foram avaliados em relação aos grupos e aos momentos inicial e final com auxílio do software SPSS versão 21.0, adotando-se valor de p < 0,05. Foram avaliados 200 indivíduos com média de idade de 33,8±11,3 anos. As médias de circunferência da cintura e índice de massa corporal em cada momento do grupo controle foram estatisticamente diferentes, havendo aumento das medidas. A respeito do consumo de bebidas açucaradas não foram observadas diferenças estatisticamente significativas em ambos os grupos.

This study aimed to evaluate changes in the consumption of sugar sweetened soft drinks and nutritional status of adults linked to a federal educational institution located in Vitória (ES), after an intervention program. Anthropometric measurements and sugary drink intake data were collected from all participants, who were randomized and allocated into two groups, intervention (mHealth actions) and control. After that, a reevaluation was performed. The outcomes were evaluated in relation to the groups and the initial and final moments, using SPSS version 21.0, adopting p <0.05. We evaluated 200 individuals with a mean age of 33.8 ± 11.3 years. The means for waist circumference and body mass index at each moment, for the control group, were statistically different, with an increase in measurements. Regarding the consumption of sugary drinks, there were no statistically significant differences in the two groups.