Association of pulse wave velocity with body fat measures at 30 y of age.

OBJECTIVES: Pulse wave velocity (PWV) is an early marker of arterial stiffness and a strong predictor of cardiovascular disease (CVD). Body fat measures, such as body mass index (BMI), waist circumference (WC), and visceral fat, have been associated with CVD in adulthood. The aim of this study was to evaluate the association of PWV at 30 y of age using body fat measures. METHODS: In 1982, the maternity hospitals in Pelotas, Brazil, were visited daily and all live births were identified. These infants have been prospectively followed several times. At 30 y, we tried to follow the cohort; the individuals were interviewed and had PWV, anthropometric parameters, abdominal fat, and visceral fat measured. RESULTS: The present study included 1576 individuals. PWV was highly correlated with BMI, WC, visceral fat thickness, and fat mass compared with other body composition measures. In linear regression analysis, the highest regression coefficients were observed for BMI (r = 0.30; 95% confidence interval [CI], 0.25-0.35), visceral fat thickness (r = 0.30; 95% CI, 0.24-0.35), and fat mass (r = 0.30; 95% CI, 0.24-0.35), even after controlling for potential confounders (sex, race, birth weight, family income, family education, and maternal smoking during pregnancy). CONCLUSION: In the present study, BMI, visceral fat thickness, and fat mass were the strongest body fat measures related to PWV.

Associations of stunting in early childhood with cardiometabolic risk factors in adulthood.

Early life stunting may have long-term effects on body composition, resulting in obesity-related comorbidities. We tested the hypothesis that individuals stunted in early childhood may be at higher cardiometabolic risk later in adulthood. 1753 men and 1781 women participating in the 1982 Pelotas (Brazil) birth cohort study had measurements of anthropometry, body composition, lipids, glucose, blood pressure, and other cardiometabolic traits at age 30 years. Early stunting was defined as height-for-age Z-score at age 2 years below -2 against the World Health Organization growth standards. Linear regression models were performed controlling for sex, maternal race/ethnicity, family income at birth, and birthweight. Analyses were stratified by sex when p-interaction<0.05. Stunted individuals were shorter (ß = -0.71 s.d.; 95% CI: -0.78 to -0.64), had lower BMI (ß = -0.14 s.d.; 95%CI: -0.25 to -0.03), fat mass (ß = -0.28 s.d.; 95%CI: -0.38 to -0.17), SAFT (ß = -0.16 s.d.; 95%CI: -0.26 to -0.06), systolic (ß = -0.12 s.d.; 95%CI: -0.21 to -0.02) and diastolic blood pressure (ß = -0.11 s.d.; 95%CI: -0.22 to -0.01), and higher VFT/SAFT ratio (ß = 0.15 s.d.; 95%CI: 0.06 to 0.24), in comparison with non-stunted individuals. In addition, early stunting was associated with lower fat free mass in both men (ß = -0.39 s.d.; 95%CI: -0.47 to -0.31) and women (ß = -0.37 s.d.; 95%CI: -0.46 to -0.29) after adjustment for potential confounders. Our results suggest that early stunting has implications on attained height, body composition and blood pressure. The apparent tendency of stunted individuals to accumulate less fat-free mass and subcutaneous fat might predispose them towards increased metabolic risks in later life.

Pulse Wave Velocity at Early Adulthood: Breastfeeding and Nutrition during Pregnancy and Childhood.

BACKGROUND: Pulse wave velocity (PWV) is an early marker of arterial stiffness. Low birthweight, infant feeding and childhood nutrition have been associated with cardiovascular disease in adulthood. In this study, we evaluated the association of PWV at 30 years of age with birth condition and childhood nutrition, among participants of the 1982 Pelotas birth cohort. METHODS: In 1982, the hospital births in Pelotas, southern Brazil, were identified just after delivery. Those liveborn infants whose family lived in the urban area of the city were examined and have been prospectively followed. At 30 years of age, we tried to follow the whole cohort and PWV was assessed in 1576 participants. RESULTS: Relative weight gain from 2 to 4 years was positively associated with PWV. Regarding nutritional status in childhood, PWV was higher among those whose weight-for-age z-score at 4 years was >1 standard deviation above the mean. On the other hand, height gain, birthweight and duration of breastfeeding were not associated with PWV. CONCLUSION: Relative weight gain after 2 years of age is associated with increased PWV, while birthweight and growth in the first two years of life were not associated. These results suggest that the relative increase of weight later in childhood is associated with higher cardiovascular risk.

Objectively measured physical activity and sedentary-time are associated with arterial stiffness in Brazilian young adults.

OBJECTIVE: To examine the associations between objectively measured physical activity and sedentary time with pulse wave velocity (PWV) in Brazilian young adults. METHODS: Cross-sectional analysis with participants of the 1982 Pelotas (Brazil) Birth Cohort who were followed-up from birth to 30 years of age. Overall physical activity (PA) assessed as the average acceleration (mg), time spent in moderate-to-vigorous physical activity (MVPA - min/day) and sedentary time (min/day) were calculated from acceleration data. Carotid-femoral PWV (m/s) was assessed using a portable ultrasound. Systolic and diastolic blood pressure (SBP/DBP), waist circumference (WC) and body mass index (BMI) were analyzed as possible mediators. Multiple linear regression and g-computation formula were used in the analyses. RESULTS: Complete data were available for 1241 individuals. PWV was significantly lower in the two highest quartiles of overall PA (0.26 m/s) compared with the lowest quartile. Participants in the highest quartile of sedentary time had 0.39 m/s higher PWV (95%CI: 0.20; 0.57) than those in the lowest quartile. Individuals achieving ≥30 min/day in MVPA had lower PWV (ß = -0.35; 95%CI: -0.56; -0.14). Mutually adjusted analyses between MVPA and sedentary time and PWV changed the coefficients, although results from sedentary time remained more consistent. WC captured 44% of the association between MVPA and PWV. DBP explained 46% of the association between acceleration and PWV. CONCLUSIONS: Physical activity was inversely related to PWV in young adults, whereas sedentary time was positively associated. Such associations were only partially mediated by WC and DBP.

Accuracy and adequacy of waist circumference cut-off points currently recommended in Brazilian adults.

OBJECTIVE: To evaluate the adequacy and accuracy of cut-off values currently recommended by the WHO for assessment of cardiovascular risk in southern Brazil. DESIGN: Population-based study aimed at determining the predictive ability of waist circumference for cardiovascular risk based on the use of previous medical diagnosis for hypertension, diabetes mellitus and/or dyslipidaemia. Descriptive analysis was used for the adequacy of current cut-off values of waist circumference, receiver operating characteristic curves were constructed and the most accurate criteria according to the Youden index and points of optimal sensitivity and specificity were identified. SETTING: Pelotas, southern Brazil. SUBJECTS: Individuals (n 2112) aged ≥20 years living in the city were selected by multistage sampling, since these individuals did not report the presence of previous myocardial infarction, angina pectoris or stroke. RESULTS: The cut-off values currently recommended by WHO were more appropriate in men than women, with overestimation of cardiovascular risk in women. The area under the receiver operating characteristic curve showed moderate predictive ability of waist circumference in men (0.74, 95% CI 0.71, 0.76) and women (0.75, 95% CI 0.73, 0.77). The method of optimal sensitivity and specificity showed better performance in assessing the accuracy, identifying the values of 95 cm in men and 87 cm in women as the best cut-off values of waist circumference to assess cardiovascular risk. CONCLUSIONS: The cut-off values currently recommended for waist circumference are not suitable for women. Longitudinal studies should be conducted to evaluate the consistency of the findings.

Consumo de carnes por adolescentes do Sul do Brasil / Meat consumption among Southern Brazilian adolescents

OBJETIVO: Descrever a frequência de consumo de diferentes tipos de carnes conforme variáveis sociodemográficas e nutricionais, e analisar o consumo, em adolescentes do Sul do Brasil, de dieta rica em gordura conforme os tipos de carne consumidos. MÉTODOS: Estudo transversal realizado com adolescentes pertencentes à coorte de nascimentos de 1993, em Pelotas (RS). A frequência de consumo de carnes vermelhas, brancas, vísceras e embutidos foi avaliada por um Questionário de Frequência de Consumo Alimentar, adaptado para este estudo. A ingestão de dieta rica em gordura foi avaliada a partir do instrumento proposto por Block. As variáveis independentes foram sexo, cor da pele, nível socioeconômico, escolaridade materna e estado nutricional. Nas análises estatísticas, foram utilizados testes Qui-quadrado de heterogeneidade e de tendência linear. RESULTADOS: Foram avaliados 4.325 adolescentes com idade média de 14,7, DP=0,3 anos, dos quais 51,2% eram do sexo feminino. A frequência de consumo diário de carnes vermelhas foi maior do que a de carnes brancas (43,0% e 9,7%, respectivamente). O consumo de embutidos por mais do que quatro vezes por semana foi referido por 48,5% dos indivíduos, e 81,4% relataram consumir vísceras raramente ou nunca. Adolescentes de maior nível socioeconômico e filhos de mães com maior escolaridade apresentaram maior consumo de carnes vermelhas e embutidos, enquanto aqueles em situação oposta apresentaram maior consumo de carnes brancas. Adolescentes que consomem carnes com maior frequência também consomem dieta rica em gordura. CONCLUSÃO: As carnes consumidas com maior frequência pelos adolescentes foram as vermelhas e os embutidos. No entanto, adolescentes de maior nível socioeconômico consomem carnes vermelhas com maior frequência, enquanto adolescentes menos favorecidos economicamente consomem mais carnes brancas.

OBJECTIVE: The present study investigated the consumption frequency of various meats according to sociodemographic and nutritional variables and analyzed the consumption of high-fat diets according to type of meat by southern Brazilian adolescents. METHODS: This cross-sectional study included the 1993 birth cohort from Pelotas (RS). The consumption frequency of red, white and organ meats and sausage were investigated by a food frequency questionnaire adapted for this study. Dietary fat content was determined as proposed by Block. The independent variables were gender, skin color, socioeconomic level, maternal education level and nutritional status. The statistical analyses included the Chi-square linear tendency test and the Chi-square test of homogeneity. RESULTS: A total of 4,325 adolescents with a mean age of 14.7 years, SD=0.3 years, were assessed, of which 51.2% were females. Red meat was consumed more frequently daily than white meat (43.0% and 9.7%, respectively). Sausage consumption frequency greater than 4 times per week was reported by 48.5% of the sample, and 81.4% reported to consume organ meats rarely or never. Adolescents of higher socioeconomic levels and of mothers with higher education levels consumed more red meats and sausages, while those in the opposite situation consumed more white meats. Adolescents who consumed meats more frequently also consumed a high-fat diet. CONCLUSION: Red meats and sausages were the meats most frequently consumed by the study adolescents. However, adolescents of higher socioeconomic levels consumed red meats more often, while those of lower socioeconomic levels consumed white meats more often.

[Aspirin use in cardiovascular disease prevention: a population-based study]. / Utilização de ácido acetilsalicílico (AAS) na prevenção de doenças cardiovasculares: um estudo de base populacional.

The objective of this study was to estimate the prevalence of aspirin use in primary and secondary prevention of cardiovascular disease. A population-based cross-sectional study was conducted in Pelotas, Rio Grande do Sul State, Brazil, from January to May 2010. The study had two outcomes: 1) aspirin use in primary prevention (individuals > 40 years of age with at least two risk factors: hypertension, diabetes mellitus, and/or hyperlipidemia) and 2) aspirin use in secondary prevention (history of stroke and/or angina/myocardial infarction). The outcomes were analyzed based on demographic, socioeconomic, and lifestyle variables. Prevalence of aspirin use was 24.8% for primary prevention and 34.3% for secondary prevention. In primary prevention, aspirin use was more common in non-whites and older individuals and among those with worse self-rated health. For secondary prevention, aspirin use was more frequent among older and higher-income individuals and former smokers. Prevalence of aspirin use was well below recommended levels for prevention of cardiovascular diseases.

Utilização de ácido acetilsalicílico (AAS) na prevenção de doenças cardiovasculares: um estudo de base populacional / Aspirin use in cardiovascular disease prevention: a population-based study

O objetivo foi estimar a prevalência de uso de ácido acetilsalicílico (AAS) na prevenção das doenças cardiovasculares (DCV). Estudo transversal de base populacional, realizado em Pelotas, Rio Grande do Sul, Brasil, em 2010. Dois desfechos foram considerados: uso de AAS na prevenção primária (indivíduos > 40 anos com pelo menos dois fatores de risco (hipertensão arterial sistêmica, diabetes mellitus e/ou dislipidemia) e uso de AAS na prevenção secundária (história de angina/infarto e/ou acidente vascular encefálico). Os desfechos foram analisados de acordo com variáveis demográficas, socioeconômicas e de estilo de vida. A prevalência de uso de AAS foi de 24,8% na prevenção primária e 34,3% na prevenção secundária. Na prevenção primária o uso de AAS foi maior nos indivíduos de cor não branca, maior faixa etária e com pior autopercepção de saúde. Na prevenção secundária, a prevalência de uso foi maior nos indivíduos com maior faixa etária, maior classe social e ex-fumantes. As prevalências de uso de AAS encontradas estão muito abaixo do recomendado para prevenção das DCV.

The objective of this study was to estimate the prevalence of aspirin use in primary and secondary prevention of cardiovascular disease. A population-based cross-sectional study was conducted in Pelotas, Rio Grande do Sul State, Brazil, from January to May 2010. The study had two outcomes: 1) aspirin use in primary prevention (individuals > 40 years of age with at least two risk factors: hypertension, diabetes mellitus, and/or hyperlipidemia) and 2) aspirin use in secondary prevention (history of stroke and/or angina/myocardial infarction). The outcomes were analyzed based on demographic, socioeconomic, and lifestyle variables. Prevalence of aspirin use was 24.8% for primary prevention and 34.3% for secondary prevention. In primary prevention, aspirin use was more common in non-whites and older individuals and among those with worse self-rated health. For secondary prevention, aspirin use was more frequent among older and higher-income individuals and former smokers. Prevalence of aspirin use was well below recommended levels for prevention of cardiovascular diseases.