Body shape trajectories are associated with birth weight, body mass index and sociodemographic conditions in participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil): a multiple correspondence analysis.

BACKGROUND: Evaluating lifelong weight trajectories is challenging due to the high costs of studies that follow individuals from childhood to adulthood. The use of silhouette scales has been a new approach to assess the body shape trajectory across life as a proxy for body weight trajectory. Depending on body shape trajectories, individuals may be more prone to develop diseases in adulthood. Therefore, identifying factors related to them is essential for public health. This study aimed to evaluate body shape trajectories across the lifespan and to verify associations between them, birth weight, body mass index, and sociodemographic conditions in a Brazilian cohort. METHODS: This is a cross-sectional analysis conducted with 14,014 participants of first follow-up data collection of Longitudinal Study of Adult Health (ELSA-Brasil). ELSA-Brasil is a multicentric prospective cohort study initiated in 2008 with civil servants of six public institutions in the Northeast, South and Southeast regions of Brazil. We applied a clustering method to longitudinal data to identify body shape trajectories from 5 to 40 years of age and assessed the associations between these trajectories and birth weight, body mass index and sociodemographic conditions (race, education, maternal education and monthly per capita family income) using multiple correspondence analysis. RESULTS: We found five body shape trajectories for women and three for men. Low birth weight was associated with a slight to moderate increase in shape. High birth weight was associated with maintaining large body size in both sexes and markedly increased body shape in women. Higher sociodemographic status and white race were associated with marked increases in body shape in men and maintenance of medium body shape in women. CONCLUSIONS: The study shows that variables related to worse lifetime weight status (evaluated by anthropometry), such as presence of obesity, are also associated with worse body shape trajectories, as assessed with silhouette scales. Our results suggest that body shape trajectories are a good indicator of body weight trajectories and may be used when cohort studies are not possible.

The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil): Factors Related to Smoking Cessation.

BACKGROUND: Smoking cessation is not an easy accomplishment. However, the benefits are several for those who do it, such as cardiovascular risk reduction 1 year after quitting smoking. This study aimed to verify the factors related to smoking cessation in civil servants of The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). METHODS: This study had a longitudinal design using data from a prospective cohort of civil servants (ELSA-Brasil). Our variable of interest was smoking cessation. The relationship between socio-demographic characteristics, job stress, health-related variables, legislation, and smoking cessation was analyzed by Cox proportional hazard models. The analyses were stratified by gender. Second-hand smoke exposure, age, education, excessive alcohol consumption, common mental disorder, and smoking control law were the variables considered in the final model. RESULTS: Information of 2020 women and 2429 men was analyzed. Individuals without second-hand smoke exposure, with up to 49 years of age, with higher education, without excessive alcohol consumption, without common mental disorders, and who initiated smoking in 1989 or after the smoking control law had a higher risk of stopping smoking. The risks magnitudes were higher for women. CONCLUSIONS: Our study reinforces the necessity of alcohol consumption regulation, the relevance of Public Health Policies, and the need for more smoking cessation measures focused on men, on people with mental disorders, alcoholism, and older adults. Also, our results did not show significant risks regarding the psychosocial working environment.

Early life socioeconomic status predicts cognition regardless of education level.

BACKGROUND AND PURPOSE: Early life socioeconomic status (SES) may impact cognitive performance later in life. We investigated the effect on cognitive performance of early life SES, education, and late life SES in the Brazilian Longitudinal Study of Adult Health. METHODS: Path analysis was used to decompose associations between SES measures across the lifespan and cognition. The model included direct paths to cognition from early life SES, education, and late life SES, and indirect paths from early life passing through education and late life SES. We investigated whether the effects of early life SES are similar across middle-aged and older adults. RESULTS: In 13,395 adults, the mean age was 51.5 (8.9) years, 54% were female, 53% were white, and 56% had at least college education. The direct path from early life SES remained significant in the presence of mediation paths through education, late life SES, or both, contributing to cognitive performance in both middle-aged and older adults. The indirect and total effect of early life SES was smaller for middle-aged compared to older adults. Early life SES continues to impact cognitive performance later in life independently of educational attainment and late life SES. The higher percent of mediation through education suggests that education may improve later life cognition even in the presence of low early life SES. CONCLUSIONS: Our results highlight the importance of public health initiatives to improve early life SES and education to foster cognitive aging in low- and middle-income countries.

Normative Data for the ELSA-Brasil Neuropsychological Assessment and Operationalized Criterion for Cognitive Impairment for Middle-Aged and Older Adults.

OBJECTIVES: Normative data should consider sociodemographic diversity for the accurate diagnosis of cognitive impairment. This study aims to provide normative data for a brief neuropsychological battery and present diagnostic criteria for cognitive impairment that could be used in primary care settings. METHODS: We selected 9618 Brazilian middle-aged and older adults after detailed exclusion criteria to avoid subtle cognitive impairment. We analyzed age, sex, and education influence on cognitive performance. To verify the evidence of criterion validity, we compared the cognitive performance of subjects with and without a depressive episode. Additionally, we verified the percentage of spurious scores under three different cutoffs. RESULTS: Age and education had the greatest impact on cognition. Normative scores were provided according to age and education groups. Participants with a depressive episode performed poorer than control subjects. The clinical cutoff of at least two scores below the 7th percentile revealed the adequate percentage of spurious and possible clinical performance. CONCLUSIONS: The Longitudinal Study on Adult Health (ELSA-Brasil) provided normative data based on a unique selected set of cognitively normal subjects. Normative groups were selected based on age and education, and the battery was sensitive to the presence of a depressive episode. We suggested clinical cutoffs for the tests in this battery that could be used in primary care settings to improve the accurate diagnosis of cognitive impairment.

Longitudinal association between binge eating and metabolic syndrome in adults: Findings from the ELSA-Brasil cohort.

OBJECTIVE: Individuals with bulimia nervosa and binge eating disorder have greater cardiovascular morbidity than the general population. Longitudinal research on the association between binge eating and metabolic syndrome is limited. We tested the longitudinal association between binge eating and metabolic syndrome and its components in a large population sample of Brazilian adults. METHODS: We used data from Brazilian Longitudinal Study of Adult Health (ELSA-Brasil, N = 15,105). To test for the association between binge eating at baseline (2008-2010) and metabolic syndrome at follow-up (2012-2014), we used univariable and multivariable logistic regression models progressively adjusting for potential socio-demographic confounders, number of metabolic syndrome components, and body mass index (BMI) at baseline. RESULTS: In total, 13,388 participants (54.8% female; 52.2% white) had complete data on all variables of interest. Binge eating was associated with increased odds of metabolic syndrome at follow-up (odds ratio (OR):1.66, 95% confidence intervals (CI): 1.44, 1.75). However, the size of this association was attenuated after including number of metabolic syndrome components at baseline (OR:1.19, 95% CI: 1.05, 1.35) and was no longer present after adjusting for baseline BMI (OR:1.09, 95% CI: 0.96, 1.25). Binge eating was also associated with higher odds of hypertension (OR:1.14, 95% CI: 0.99, 1.37) and hypertriglyceridemia (OR:1.21, 95% CI: 1.06, 1.37) at the follow-up assessment after adjustment for all confounders. CONCLUSIONS: Individuals who binge eat are at increased risk of metabolic syndrome via increased BMI, and of hypertriglyceridemia and hypertension independently of BMI. If these are causal associations, effective interventions for binge eating could also have beneficial effects on metabolic health outcomes.

Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) participant's profile regarding self-rated health: a multiple correspondence analysis.

BACKGROUND: Self-rated health (SRH) - one of the most common health indicators used to verify health conditions - can be influenced by several types of socioeconomic conditions, thereby reflecting health inequalities. This study aimed to evaluate the participant profiles regarding the association between self-rated health and social and occupational characteristics of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). METHODS: Cross-sectional design, including 11,305 individuals. Self-rated health was categorized as good, fair, and poor. The relationship between socio-demographic, psychosocial work environment, health-related variables, and self-rated health was analyzed by multiple correspondence analysis (stratified by age: up to 49 years old and 50 years old or more). RESULTS: For both age strata, group composition was influenced by socioeconomic conditions. Poor SRH was related to lower socioeconomic conditions, being women, black self-declared race/ethnicity, being non-married/non-united, low decision authority, low skill discretion, and obesity. CONCLUSION: To promote health, interventions should focus on reducing existing socioeconomic, race, and gender inequalities in Brazil.

Stress and the Consumption of Ultra-Processed Foods during COVID-19's Social Distancing: Are Mental Disorders Mediators in This Association? ELSA-Brasil Results.

The COVID-19 pandemic exacerbated various determinants of mental disorders. Several behavioral changes were observed given this increase, including harmful health consequences, such as excessive consumption of ultra-processed foods (UPFs). To assess this relationship, we investigated the meditational role of symptoms of mental disorders (anxiety and depression) in the association between stress resulting from social distancing during the COVID-19 pandemic and the consumption of UPFs in 3884 Brazilian public employees in a supplementary study of the ELSA-Brasil study. Structural equation models (SEMs) were estimated to assess the direct and indirect effects mediated by symptoms of mental disorders. The results suggested a significant and positive mediational effect of the symptoms of mental disorders on the association between the stress resulting from social distancing and the consumption of UPFs. These findings contribute to informing the need for policies and early interventions in potentially stressful situations, with a focus on the promotion of mental health, and may thus help prevent or reduce the consumption of unhealthy foods.

Cross-cultural adaptation of discrimination and vigilance scales in ELSA-Brasil.

OBJECTIVE: To describe the process of cross-cultural adaptation for the use in Brazil of the everyday discrimination scale (EDS) and the heightened vigilance scale (HVS) applied in the Longitudinal Study of Adult Health (ELSA-Brasil). METHODS: Conceptual, item and semantic equivalence analyses were conducted by a group of four epidemiologists; evaluation of measurement equivalence (factorial analysis of configural, metric and scalar structures, according to sociodemographic characteristics) and reliability. A total of 11,987 participants responded to the discrimination scale, and a subsample of 260 people participated in the test-retest study. In the case of HVS, 8,916 people responded, while 149 individuals did so in the test-retest study. RESULTS: The scales presented conceptual, item and semantic equivalence pertinent in the Brazilian context, in addition to adequate correspondence of referential/denotative meaning of terms and also of the general/connotative of the items. The confirmatory factor analysis of EDS revealed a unidimensional structure, with residual correlations between two pairs of items, presenting configural and metric invariance among the four subgroups evaluated. Scalar invariance was identified according to sex and age group, but it was not observed for race/color and education. Heightened vigilance showed low loads and high residuals, with inadequate adjustment indicators. For the items of the discrimination scale the weighted kappa coefficient (Kp) ranged from 0.44 to 0.78, and the intraclass correlation coefficient (ICC) was 0.87. For HVS items, the Kp ranged from 0.47 to 0.59 and the ICC was 0.83. CONCLUSIONS: Although there are correlated items, it was concluded that the EDS is a promising scale to evaluate experiences of perceived discrimination in Brazilian daily life. However, the heightened vigilance scale did not present equivalence of measurement in the current format.

A rapid qualitative methods assessment and reporting tool for epidemic response as the outcome of a rapid review and expert consultation.

During the first year of the COVID-19 pandemic, the Methods Sub-Group of the WHO COVID-19 Social Science Research Roadmap Working Group conducted a rapid evidence review of rapid qualitative methods (RQMs) used during epidemics. The rapid review objectives were to (1) synthesize the development, implementation, and uses of RQMs, including the data collection tools, research questions, research capacities, analytical approaches, and strategies used to speed up data collection and analysis in their specific epidemic and institutional contexts; and (2) propose a tool for assessing and reporting RQMs in epidemics emergencies. The rapid review covered published RQMs used in articles and unpublished reports produced between 2015 and 2021 in five languages (English, Mandarin, French, Portuguese, and Spanish). We searched multiple databases in these five languages between December 2020 and January 31, 2021. Sources employing "rapid" (under 6 months from conception to reporting of results) qualitative methods for research related to epidemic emergencies were included. We included 126 published and unpublished sources, which were reviewed, coded, and classified by the research team. Intercoder reliability was found to be acceptable (Krippendorff's α = 0.709). We employed thematic analysis to identify categories characterizing RQMs in epidemic emergencies. The review protocol was registered at PROSPERO (no. CRD42020223283) and Research Registry (no. reviewregistry1044). We developed an assessment and reporting tool of 13 criteria in three domains, to document RQMs used in response to epidemic emergencies. These include I. Design and Development (i. time frame, ii. Training, iii. Applicability to other populations, iv. Applicability to low resource settings, v. community engagement, vi. Available resources, vii. Ethical approvals, viii. Vulnerability, ix. Tool selection); II. Data Collection and Analysis (x. concurrent data collection and analysis, xi. Targeted populations and recruitment procedures); III. Restitution and Dissemination (xii. Restitution and dissemination of findings, xiii. Impact). Our rapid review and evaluation found a wide range of feasible and highly effective tools, analytical approaches and timely operational insights and recommendations during epidemic emergencies.

Depression is a risk factor for metabolic syndrome: Results from the ELSA-Brasil cohort study.

INTRODUCTION: Metabolic Syndrome (MetS) and depression comorbidity has been recognized, but its directionality is still uncertain. The aims of this study was to assess the association between depression (diagnosis and severity) and MetS (components, diagnosis and trajectory) in the baseline and over a 4-year follow-up period. MATERIAL AND METHODS: Baseline and follow-up data from 13,883 participants of the Brazilian Longitudinal Study of Adult Health were analyzed. The Clinical Interview Schedule Revised assessed depressive episode and its severity. MetS components and diagnosis were assessed according to the National Cholesterol Education Program Adult Treatment Panel III. Participants were grouped according to MetS trajectory as recovered, incident and persistent MetS. Logistic regression analysis was conducted estimating odds ratios (OR) and 95% confidence intervals (95%CI). RESULTS: Baseline depression was positively associated with recovered (OR = 1.59, 95%CI 1.18-2.14), incident (OR = 1.45, 95%CI 1.09-1.91) and persistent (OR = 1.70, 95%CI 1.39-2.07) MetS. Baseline depression was also associated with large waist circumference (OR = 1.47, 95%CI 1.23-1.75), high triglycerides (OR = 1.23, 95%CI 1.02-1.49), low high-density lipoprotein cholesterol (OR = 1.30, 95%CI 1.08-1.56), and hyperglycemia (OR = 1.38, 95%CI 1.15-1.66) at follow-up. Having three or more MetS components at follow-up was associated with baseline depression, with a positive dose-response effect (OR = 1.77, 95%CI 1.29-2.43; OR = 1.79, 95%CI 1.26-2.54; OR = 2.27, 95%CI 1.50-3.46, respectively). The magnitude of associations was greater in severe depression, when compared to moderate and mild. DISCUSSION: These results support that depression is a risk factor for the development of MetS and highlights the need to follow metabolic and cardiovascular alterations in the presence of depression.

Association between job stress and quality of life in nutritionists working in public hospitals in Rio de Janeiro, Brazil.

Occupational stress has been the object of research in different populations. The aim of this study is to analyze the association between psychosocial job stress and quality of life of nutritionists working in public hospitals in Rio de Janeiro, Brazil. Cross-sectional study in public hospitals with nutritionists working as civil servants and CLT. Psychosocial job stress was assessed through the Demand-Control-Support Questionnaire. Quality of life was assessed through the WHOQOL-Bref. The outcome was modeled by means of multiple linear regression and adjusted by covariates. Job demands were inversely associated with quality of life in the physical and environment domains. Job control was directly associated with quality of life in the psychological domain. High strain, in comparison to low strain, was inversely associated with quality of life in the physical and psychological domains. Social support was directly associated with all fields of quality of life domains. Psychosocial job stress, as expressed by psychological job demands and job control, affects self-assessed quality of life, especially in the physical domain.

The association between diabetes mellitus and incidence of depressive episodes is different based on sex: insights from ELSA-Brasil.

Objective: To investigate the association between diabetes mellitus (DM) and incidence of depressive episodes among men and women. Methods: Data were used from 12,730 participants (5866 men and 6864 women) at baseline (2008-2010) and follow-up 1 (2012-2014) of the Longitudinal Study of Adult Health (ELSA-Brasil), a multicenter cohort of Brazilian civil servants. Participants were classified for diabetes using self-reported and clinical information, and evaluated for presence of depressive episodes by the Clinical Interview Schedule-Revised (CIS-R). Associations were estimated by means of logistic regression models (crude and adjusted for socio-demographic variables). Results: Women classified as with DM prior to the baseline were at 48% greater risk (95% confidence interval (CI) = 1.03-2.07) of depressive episodes in the crude model and 54% greater risk (95% CI = 1.06-2.19) in the final adjusted model compared to women classified as non-DM. No significant associations were observed for men. The regression models for duration of DM and incidence of depressive episodes (n = 2143 participants; 1160 men and 983 women) returned no significant associations. Conclusion: In women classified as with prior DM, the greater risk of depressive episodes suggests that more frequent screening for depression may be beneficial as part of a multi-factorial approach to care for DM.

Consumption of Omega-3 and Maintenance and Incidence of Depressive Episodes: The ELSA-Brasil Study.

Depression affects 264 million persons in the world, accounting for some 4.3% of the global burden of disease. Current studies indicate that the decrease in the consumption of omega-3 food sources is associated with the increasing incidence of depression. The study aims to assess the association between the consumption of omega-3 and the maintenance and incidence of depressive episodes in adults (39−64 years) and elderly adults (>65 years). This was a longitudinal study using data from the baseline and first follow-up wave of the Longitudinal Study of Adult Health (ELSA-Brasil). Depressive episodes were obtained with the Clinical Interview Schedule Revised (CIS-R), and food consumption was measured with the Food Frequency Questionnaire (FFQ). Logistic regression was used to analyze associations between the consumption of omega-3 and depressive episodes. Fatty acids from the omega-3 family showed a protective effect against the maintenance of depressive episodes. In relation to incidence, the estimates suggest that the higher the consumption of omega-3 acids, the lower the risk of developing depressive episodes, and significant associations were found between the consumption of omega-3 and alpha-linolenic acid. Dietary consumption of omega-3, DHA, EPA, DPA, and alpha linolenic fatty acids may have a protective effect against the maintenance and incidence of depressive episodes.

Is work-family conflict a pathway between job strain components and binge eating? A cross-sectional analysis from the ELSA-Brasil study.

BACKGROUND: Job strain has been reported as a trigger for binge eating, yet the underlying mechanisms have been unclear. The aim of this study was to evaluate whether work-family conflict is a pathway in the association between job strain and binge eating, considering the possible effect-modifying influence of body mass index (BMI). METHODS: This cross-sectional analysis included 12,084 active civil servants from the multicenter Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Job strain was assessed using the Demand-Control-Support Questionnaire. Work-family conflict was considered as a latent variable comprising three items. Binge eating was defined as eating a large amount of food in less than 2 h at least twice a week in the last six months with a sense of lack of control over what and how much was eaten. Structural equation modelling was used to test the role of work-family conflict in the association between job strain and binge eating, stratifying for BMI. RESULTS: For individuals of normal weight, positive associations were found between skill discretion and binge eating (standardized coefficient [SC] = 0.209, 95%CI = 0.022-0.396), and between psychological job demands and work-family conflict (SC = 0.571, 95%CI = 0.520-0.622), but no statistically significant indirect effect was found. In overweight individuals, psychological job demands, skill discretion, and work-family conflict were positively associated with binge eating (SC = 0.099, 95%CI = 0.005-0.193; SC = 0.175, 95%CI = 0.062-0.288; and SC = 0.141, 95%CI = 0.077-0.206, respectively). Also, work-family conflict was observed to be a pathway on the associations of psychological job demands and decision authority with binge eating (SC = 0.084, 95%CI = 0.045-0.122; and SC = - 0.008, 95%CI = - 0.015- - 0.001, respectively). CONCLUSIONS: Work-family conflict partly explains effects of high levels of psychological job demands and low levels of decision authority on binge eating among overweight individuals. Moreover, skill discretion is positively associated with binge eating, regardless of BMI category.

Recent studies have found work-family conflict (i.e., incompatible work and family demands) to link between work issues and physical and mental health. Accordingly, this study investigated whether the relationship between job strain and binge eating is explained by work-family conflict, by body mass index (BMI), in a large sample of Brazilian civil servants. Overall, this study demonstrated that, among overweight individuals, excessive job demands and low decision authority (over what to do at work and how) contribute to binge eating by increasing work-family conflict. Also, excessive skill discretion at work, including opportunities to acquire and use specific job skills, is related to binge eating, regardless of BMI, which deserves further investigation. In conclusion, the results indicate that work-family conflict is a potential mechanism through which job strain can affect eating behavior among overweight individuals.

Working from home, work-time control and mental health: Results from the Brazilian longitudinal study of adult health (ELSA-Brasil).

This cross-sectional study investigated the association between work-time control (WTC), independently and in combination with hours worked (HW), and four mental health outcomes among 2,318 participants of the Longitudinal Study of Adult Health (ELSA-Brasil) who worked from home during the COVID-19 pandemic. WTC was assessed by the WTC Scale, and mental health outcomes included depression, anxiety, stress (measured by the Depression, Anxiety and Stress Scale, DASS-21), and self-rated mental health. Logistic regression models were used to determine odds ratios (ORs) and 95% confidence intervals (CIs). Among women, long HW were associated with stress (OR = 1.56; 95% CI = 1.11-2.20) and poor self-rated mental health (OR = 1.64; 95% CI = 1.13-2.38), whereas they were protective against anxiety among men (OR = 0.59; 95% CI = 0.37-0.93). In both sexes, weak WTC was associated with all mental health outcomes. Among women, the long HW/weak WTC combination was associated with all mental health outcomes, and short HW/weak WTC was associated with anxiety and stress. Among men, long HW/strong WTC was protective against depression and stress, while short HW/strong WTC and short HW/weak WTC was associated with all mental health outcomes. In both sexes, weak WTC, independently and in combination with HW, was associated with all mental health outcomes. WTC can improve working conditions, protect against mental distress, and fosterwork-life balance for those who work from home.

Increased Prevalence of Depression and Anxiety Among Subjects With Metabolic Syndrome in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

BACKGROUND: Metabolic syndrome (MetS) and common mental disorders are prevalent conditions. However, the relationship of MetS and its components with depression, anxiety, and common mental disorders has not been sufficiently addressed in low-/middle-income countries. OBJECTIVE: To investigate whether depression, anxiety, and common mental disorders are associated with MetS and its components in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). METHODS: A cross-sectional analysis of the ELSA-Brasil baseline visit (2008-2010) was performed. Adults without cardiovascular diseases had their MetS status defined by the National Cholesterol Education Program's Adult Treatment Panel III criteria. We assessed mental disorders using the Clinical Interview Schedule-Revised. We employed multiple logistic regression models adjusted for sociodemographic and behavioral factors. The dependent variables were mental disorders, and the independent variables were MetS and its components. We also performed analyses stratified by age and gender. RESULTS: Our sample included 12,725 participants (54.9% women, mean age of 51.8 ± 8.9 y). MetS and depressive disorders were significantly associated (odds ratio [OR] = 1.55, 95% confidence interval [CI] 1.30-1.85). Increased abdominal circumference (OR = 1.54, 95% CI 1.29-1.84), diabetes mellitus (OR = 1.24, 95% CI 1.02-1.50), hypertriglyceridemia (OR = 1.33, 95% CI 1.11-1.60), and low high-density lipoprotein cholesterol (only when adjusted for sociodemographic factors) (OR = 1.25, 95% CI 1.02-1.52) were also associated with depression. This association remained significant for all stratified analyses. Finally, MetS was also significantly associated with anxiety disorders (OR = 1.19, 95% CI 1.07-1.32) and common mental disorders (OR = 1.27, 95% CI 1.17-1.39). CONCLUSIONS: Our cross-sectional findings suggested that depression, anxiety, and common mental disorder are associated with MetS. Depression was also associated with abdominal obesity, elevated blood glucose, elevated triglycerides, and reduced high-density lipoprotein cholesterol, but not with hypertension.

Associations of depression and intake of antioxidants and vitamin B complex: Results of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

BACKGROUND: Optimum functioning of the central nervous system is dependent on a wide range of nutrients, so mental illness can be impacted by diet via several mechanisms. We aimed to investigate the associations of antioxidants (vitamin A, C and E, and selenium and zinc) and vitamin B complex (B6, folate and B12) intake with depression in 14,737 subjects of the Brazilian Longitudinal Study of Adult Health. METHODS: Baseline cross-sectional data was analyzed. Micronutrients intake was measured using the Food Frequency Questionnaire, and depression was assessed using the Clinical Interview Schedule Revised. Logistic regression models were built using daily intake quintiles of micronutrients. RESULTS: A significant inverse relationship was observed between depression and higher intake of selenium, zinc, vitamins B6 and B12 for the total sample. Among women, a similar pattern of associations was observed, in addition to the higher intake of vitamins A and C. Among men, a significant inverse relationship between depression was observed only with the intake of vitamins B12 and B6. Higher total antioxidant intake was significantly associated with lower odds of depression and an inverse dose-response effect between total antioxidant intake and clinical severity of depression was observed among women, in adjusted models. LIMITATIONS: Recall bias in assessing diet. Misclassification bias regarding current depression. CONCLUSIONS: Depression is associated with lower intake of antioxidants and B vitamins. Higher intake of selected micronutrients may contribute to reduce depression occurrence and severity.

Social Capital and Depressive Episodes: Gender Differences in the ELSA-Brasil Cohort.

Introduction: The association between social capital and depression is a frequent research topic in developed countries, often with inconclusive results. Furthermore, for both social capital and depression, there are gender differences established in the literature. This study investigates gender differences in the association of social capital with the incidence and maintenance of depressive episodes. Methods: Baseline and second wave data (4 years of follow-up) from the Longitudinal Study of Adult Health (ELSA-Brasil), a multicenter cohort of civil servants with 15,105 workers aged 35-74 years, were used. Social capital was assessed using the Resource Generator, a scale composed of two different dimensions: "social support" and "prestige and education." Depressive episodes were assessed using the Clinical Interview Schedule - Revised (CIS-R). The statistical analysis was performed using multinomial regression with adjustments for possible confounding factors. Results: Among men, low social capital in the "social support" dimension was associated with the incidence of depressive episodes (RR = 1.66; 95% CI: 1.01-2.72). Among women, social support was associated with the maintenance of depressive episodes (RR = 2.66; 95% CI: 1.61-4.41). Social capital was not associated with the incidence or maintenance of depressive episodes in the "prestige and education" dimension in both genders. Conclusion: The results highlight the importance of the dimension "social support" in both genders in its association with mental health. The resource-based social capital approach proved to be adequate for investigating mental health and confirms the idea that social networks can be useful in the treatment and prevention of depressive episodes.

Association Between Posterior Segment Eye Diseases, Common Mental Disorders, and Depression: Cross-Sectional and Longitudinal Analyses of Brazilian Longitudinal Study of Adult Health Cohort.

BACKGROUND: Posterior segment eye diseases, such as glaucoma and retinal diseases (such as diabetic retinopathy, age-related macular degeneration, and retinal detachment), are chronic diseases that are among the major causes of visual impairment. OBJECTIVE: We investigated the prevalence of anxiety disorders, depressive disorders, and common mental disorders in these patients and also the incidence of depression. METHODS: We examined baseline (2008-2010) and follow-up (2012-2014) data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). We used the Clinical Interview Schedule-Revised (CIS-R) to perform International Classification of Diseases-10-based diagnoses of anxiety and depressive disorders. Common mental disorder was defined as a Clinical Interview Schedule-Revised >11. We used multinomial logistic regression models to investigate associations between eye diseases and mental disorders, adjusted by age, gender, educational level, self-reported ethnicity, cardiovascular conditions, and self-reported quality of vision. RESULTS: Out of 10,775 subjects, 249 (2.3%), 303 (2.8%), and 30 (0.3%) reported having retinal diseases, glaucoma, or both, respectively. Patients with retinal diseases and those with glaucoma and retinal diseases presented a higher prevalence of common mental disorders (relative-risk ratios of 1.7 and 3.7, respectively, P < 0.001). These patients also presented a higher incidence of depression at follow-up (relative-risk ratios of 3.0 and 5.9, respectively, P < 0.001). Patients with glaucoma presented neither a higher prevalence nor a higher incidence of mental disorders or depression. CONCLUSIONS: Retinal diseases but not glaucoma were associated with mental disorders, indicating that patients with posterior segment eye diseases require distinct management of psychiatric morbidity according to the underlying pathology.