Maternal smoking during pregnancy and birthweight on the third generation: results from two birth cohort studies.

The purpose of this research is to investigate whether grandmother's smoking during pregnancy reduces the grandchildren's birthweight and whether maternal smoking during pregnancy modified this association. We also evaluated the effect of duration and intensity of smoking. This study included data from three generations from two birth cohorts carried out in Pelotas, a southern Brazilian city: women enrolled in the perinatal study in the 1982 and 1993 cohorts (G1); daughters (G2) of those G1 mothers who were followed to adulthood; and first children (G3) born from G2 women. Information on maternal smoking during pregnancy was obtained from women (G1) shortly after delivery of the two cohorts and from G2 in the follow-up in adulthood of the 1993 cohort. Mothers (G2) reported G3 birthweight during the follow-up visit at adulthood. Multiple linear regression was used to obtain effect measures adjusted for confounders. The study included 1602 grandmothers (G1), mothers (G2), and grandchildren (G3). Prevalence of maternal (G1) smoking during pregnancy was 43% and mean G3 birthweight was 3118.9 g (SD: 608.8). Grandmother's smoking in the pregnancy was not associated with grandchild's birthweight. However, offspring of both G1 and G2 smokers had lower mean birthweight than those whose mother and grandmother did not smoke (adjusted ß: - 223.05; 95% CI: - 415.16, - 32.76). CONCLUSION: No significant association was observed between grandmother's smoking in the pregnancy and grandchild's birthweight. But it seems that grandmother's smoking in pregnancy has an effect on grandchild's birthweight when the mother also smoked in the pregnancy. . WHAT IS KNOWN: • Most studies on the association of maternal tobacco smoking in pregnancy with offspring birthweight have been restricted to two generations, and an inverse association is well known. WHAT IS NEW: • Besides to investigate whether grandmother's smoking during pregnancy reduces the grandchildren's birthweight, we examined whether this association varied according to maternal smoking during pregnancy.

Intergenerational breastfeeding practices among parents and children: 1993 Pelotas (Brazil) birth cohort.

The objective of this study was to investigate intergenerational breastfeeding practices according to parental sex and age at delivery in the 1993 Pelotas (Brazil) birth cohort study. This is a prospective birth cohort study, and at the 22-year follow-up, a substudy with all children of the cohort members who had become parents was conducted (93Cohort-II). First generation breastfeeding data were collected at 3 months and 4-year-old follow-ups. In the 93Cohort-II, parents answered a questionnaire about their children's breastfeeding practices. Adjusted Tobit and Poisson regression models with robust variance were applied to estimate the association between predominant parental breastfeeding duration and exclusive breastfeeding duration of the children at 3 and 6 months. Out of 3,810 cohort participants, 955 (25%) had delivered at least one live-born infant, and 1,222 children were assessed. Fifty-four percent of parents were ≤19 years old. Direct effects of predominant parental breastfeeding duration on exclusive breastfeeding duration of their children were only observed when data were stratified by parental age: children born to parents aged ≥20 years old and who were predominantly breastfed for at least 3 months presented higher exclusive breastfeeding duration and higher prevalence of being exclusively breastfed for at least 3 months. When analyses were stratified by mothers and fathers, the result remained significant only among mothers. Longer predominant breastfeeding duration in the first generation was associated with longer exclusive breastfeeding duration in the second generation, but only among older mothers. Education and social support surrounding breastfeeding should be intensified among fathers and younger parents to create a positive environment supportive of breastfeeding.

Introduction to complementary feeding in the first year of life and risk of overweight at 24 months of age: changes from 2004 to 2015 Pelotas (Brazil) Birth Cohorts.

Complementary feeding (CF) and overweight relationships during early childhood are inconsistent in the literature. We described the association of CF during the first year of life with risk of overweight at 24 months of age in the population-based 2004 and 2015 Pelotas (Brazil) Birth Cohorts (2004c and 2015c). CF introduction was evaluated at the 3 and 12 months' follow-ups by asking mothers using a list of foods. Risk of overweight at 24 months of age was BMI-for-age z-score above +1sd from the median of the WHO 2006 growth standards. Our analyses included 3823 (2004c) and 3689 (2015c) children. Early introduction CF (before 6 months of age) prevalence in 2004c was 93·3 (95 % CI 92·5, 94·1) % and in 2015c was 87·2 (95 % CI 86·1, 88·2) %. Tea was the item introduced earlier in both 2004c (68·8 %) and 2015c (55·7 %). At 6 months of age, vegetable mash was the most introduced food in 2004c (33·5 %) and 2015c (47·9 %). Between 2004c and 2015c, the introduction of fresh milk decreased 82·1 to 60·5 % and yogurt from 94·4 to 78·1 % during the first year. Risk of overweight prevalence at 24 months was 33·0 (95 % CI 31·6, 34·5) % in 2004c and 32·0 (95 % CI 30·5, 33·5) % in 2015c. In 2015c, the adjusted odds of risk of overweight at 24 months were increased 1·66 and 1·50 times with the early introduction of fresh/powdered milk: plus water, tea or juice, and plus semi-solid/solid food groups, respectively. It is essential to reinforce the adherence to global recommendations on timely feeding introduction and encourage exclusive breast-feeding until 6 months of age to prevent child overweight.

How different online recruitment methods impact on recruitment rates for the web-based coortesnaweb project: a randomised trial.

BACKGROUND: The number of web-based E-epidemiologic studies using online recruitment methods is increasing. However, the optimal online recruitment method in terms of maximizing recruitment rates is still unknown. Our aim was to compare the recruitment rates of three online recruitment methods and to describe how these rates differ according to individual's socioeconomic and demographic factors. METHODS: A total of 2394 members of the 1993 Pelotas birth cohort that provided an e-mail address, a Facebook name, and a WhatsApp number during a face-to-face follow-up were randomly allocated to be recruited by e-mail, Facebook or WhatsApp (798 individuals per method). This was a parallel randomised trial applying a block randomisation (block size = 3). Between January and February 2018, we sent messages inviting them to register into the web-based coortesnaweb platform. Recruitment rates were calculated for each method, and stratified according to the individual's socioeconomic and demographic characteristics. We also analysed absolute and relative inequalities on recruitment according to schooling and socioeconomic position. RESULTS: Out of the 2394 individuals analysed, 642 registered into the platform. The overall recruitment rate was 26.8%. Recruitment rates for women were almost 10 percentage points higher compared to men. Facebook was the most effective recruitment method, as 30.6% of those invited through the social network were recruited. Recruitment rates of e-mail and WhatsApp were similar (recruitment rate = 24.9%). E-mail and Facebook were the most effective recruitment methods to invite highly educated and wealthier individuals. However, sending e-mails to recruit individuals also reflected in the highest inequalities according to schooling and socioeconomic position. In contrast, the lowest inequalities according to socioeconomic position were observed using Facebook. CONCLUSIONS: Facebook was the most effective online recruitment method, also achieving the most equitable sample in terms of schooling and socioeconomic position. The effectiveness of online recruitment methods depends on the characteristics of the sample. It is important to know the profile of the target sample in order to decide which online recruitment method to use. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials, identifier: RBR-3dv7gc , retrospectively registered in 10 April 2018.

Associations between body mass index, body composition and bone density in young adults: findings from a southern Brazilian cohort.

BACKGROUND: This study aimed to evaluate the association of body composition components and obesity with bone density. METHODS: Prospective study with data on 2968 members of the 1993 Pelotas Birth Cohort from follow-ups at 18 and 22 years of age. Areal bone mineral density (aBMD, g/cm2) was evaluated for whole body, lumbar spine, and femoral neck at 22 years using dual-energy X-ray absorptiometry. Simple and multiple linear regression, stratified by sex, were used to assess the effect of BMI, fat mass (FMI) and lean mass index (LMI), evaluated at 18 and 22 years, and obesity trajectories classified by FMI and categorized as "never", "only at 18 years", "only at 22 years" or "always" on aBMD. RESULTS: Among men, the largest coefficients were observed for BMI, followed by lean mass and fat mass. Compared to fat mass, lean mass presented the largest coefficients for all sites, with the strongest associations observed for the femoral neck (ß: 0.035 g/cm2; 95% CI: 0.031; 0.039 for both follow-ups), while the largest effect for FMI was observed for whole-body aBMD at 18 years (ß: 0.019 g/cm2; 95% CI: 0.014; 0.024). Among women, the strongest associations were observed for LMI. The largest coefficients for LMI and FMI were observed for femoral neck at age 18, presented ß: 0.030 g/cm2, 95% CI: 0.026, 0.034 for LMI and ß: 0.012 g/cm2; 95% CI: 0.009; 0.015) for FMI. Men who were "always obese" according to FMI had smallest aBMD for spine (ß: -0.014; 95%CI: - 0.029; - 0.001). Women who were obese "only at 18 years" had smallest aBMD for the whole-body (ß: -0.013; 95%CI: - 0.023; - 0.002), whereas those who were obese "only at 22 years" had larger whole-body and femoral neck aBMD (ß: 0.013; 95%CI: 0.009; 0.017 and ß: 0.027; 95%CI: 0.016; 0.038, respectively) and those "always obese" for whole-body aBMD (ß: 0.005; 95%CI: 0.001; 0.011) compared to the reference category. CONCLUSIONS: The indexes were positively associated with aBMD in this sample. Fat mass had smaller positive influence on these outcomes than lean mass, suggesting the most important body composition component for bone density is the lean mass.

Dietary patterns are associated with blood lipids at 18-year-olds: a cross-sectional analysis nested in the 1993 Pelotas (Brazil) birth cohort.

BACKGROUND: Evidence regarding the deleterious effects of diet on blood lipids in adolescence has been inconsistent, and few studies have investigated this association using a dietary pattern approach. We examined whether dietary pattern of adolescents are associated with blood lipid concentrations. METHODS: Cross-sectional analysis of 3524 18-year-old participants in the 1993 Pelotas (Brazil) Birth Cohort Study. A semi-quantitative food frequency questionnaire was administered. Dietary patterns were established using principal component analysis and analysed as tertiles of factor scores. Independent associations between each dietary pattern tertile and blood lipid values (total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides) were tested using adjusted linear regression models stratified by sex. Triglycerides were log-transformed due to their skewed distribution, and the beta coefficients should be interpreted as the % change (increase or decrease). RESULTS: Four dietary patterns were derived: Meat Products and Fast Foods; Fruits and Vegetables; Candies, Sodas and Dairy Products; and Common Brazilian Foods. In the adjusted models, which compared the highest and lowest tertiles of dietary pattern scores, we observed that among girls: 1) the third tertile of the Meat Products and Fast Foods pattern was associated with 1.5 mg/dL (95% CI -3.05; -0.04) lower HDL-cholesterol; 2) the second and third tertile of the Candies, Sodas and Dairy Products pattern was associated with 5% and 10% higher triglycerides (ß 1.05, 95% CI 1.01; 1.09, ß 1.10, 95% CI 1.05; 1.16), respectively; 3) the second and third tertiles of the Common Brazilian Foods pattern were associated with 4 mg/dL (ß - 4.30, 95% CI -7.75; -0.85, ß - 4.95, 95% CI -8.53; -1.36, respectively) lower total cholesterol and 6% lower triglycerides (ß 0.94, 95% CI 0.90; 0.99, ß 0.93, 95% CI 0.89; 0.98, respectively). For boys, 4) the third tertile of the Common Brazilian Foods was associated with 4.6 mg/dL (95% CI -7.91; -1.37) lower total cholesterol and 3.8 mg/dL (95% CI -6.51; - 1.13) lower LDL-cholesterol. CONCLUSIONS: Dietary patterns were more closely associated with blood lipids among girls than boys at age 18. Higher scores for the Common Brazilian Foods pattern were associated with lower total cholesterol in both sexes.

Consumption of ultra-processed foods and body fat during childhood and adolescence: a systematic review.

OBJECTIVE: To review the available literature on the association between consumption of ultra-processed foods and body fat during childhood and adolescence. DESIGN: A systematic review was conducted in the PubMed, Web of Science and LILACS databases. Studies that evaluated the association between consumption of ultra-processed food (exposure) and body fat (outcome) during childhood and adolescence were eligible. SUBJECTS: Healthy children and adolescents. RESULTS: Twenty-six studies that evaluated groups of ultra-processed foods (such as snacks, fast foods, junk foods and convenience foods) or specific ultra-processed foods (soft drinks/sweetened beverages, sweets, chocolate and ready-to-eat cereals) were selected. Most of the studies (n 15) had a cohort design. Consumption was generally evaluated by means of FFQ or food records; and body composition, by means of double indirect methods (bioelectrical impedance analysis and skinfolds). Most of the studies that evaluated consumption of groups of ultra-processed foods and soft drinks/sweetened beverages found positive associations with body fat. CONCLUSIONS: Our review showed that most studies have found positive associations between consumption of ultra-processed food and body fat during childhood and adolescence. There is a need to use a standardized classification that considers the level of food processing to promote comparability between studies.

Caesarean section and adiposity at 6, 18 and 30 years of age: results from three Pelotas (Brazil) birth cohorts.

BACKGROUND: Association between caesarian section (C-section) and obesity is controversial and mostly based on body mass index (BMI), which has inherent limitations. Using direct estimates of body fat mass, we aimed to assess the association between C-section and adiposity using fat mass index and BMI z-score in three birth cohort studies from Pelotas, Brazil. METHODS: We measured weight, height and fat mass (using dual X-ray absorptiometry (DXA)) at ages 6, 18 and 30 years among participants in the 2004, 1993 and 1982 population-based Pelotas Birth Cohort Studies, respectively. We used multiple linear regression analysis to examine the crude and adjusted association between C-section and the body composition indicators. We also modelled height as an outcome to explore the presence of residual confounding. RESULTS: We observed that fat mass index and BMI z-score were strongly and positively associated with C-section in the crude analysis. However, when we adjusted for socioeconomic characteristics, maternal BMI, parity, age and smoking during pregnancy, effect estimates were attenuated towards the null, except for 30-year-old women. In those women from the 1982 cohort, C-section remained associated with fat mass index (ß = 0.82; CI95% 0.32;1.32) and BMI z-score (ß = 0.15; CI95% 0.03;0.28), even after adjusting for all potential confounders, suggesting an increase in fat mass index and BMI at 30 years among those born by C-section. CONCLUSION: We found no consistent association of C-section with fat mass index measured by DXA and BMI z-score in individuals aged 6, 18 and 30 years, except for women in the latter group, which might be explained by residual confounding. Confounding by socioeconomic and maternal characteristics accounted for all the other associations.

Dietary intake patterns of children aged 6 years and their association with socioeconomic and demographic characteristics, early feeding practices and body mass index.

BACKGROUND: Dietary intake patterns of children from the 2004 Pelotas birth cohort study have been described at 12, 24 and 48 months of age, but there is no information about dietary patterns of these children at 6 years. Then, we aimed to identify and describe dietary intake patterns of children aged 6 years as well as to assess their association with socioeconomic and demographic characteristics, early feeding practices and BMI z-score at 6 years. METHODS: We used principal components analysis to identify dietary intake patterns of 3,427 children from the 2004 Pelotas (Brazil) birth cohort study. We used multiple linear regression models to evaluate whether socioeconomic and demographic characteristics (socioeconomic position, mother's age at birth, and child's sex and skin colour), early feeding practices (exclusive breastfeeding duration and age of introduction of complementary foods), and BMI z-score at 6 years were associated with dietary intake patterns. RESULTS: We identified seven dietary components of children's dietary intake patterns, namely: fruits and vegetables, snacks and treats, coffee and bread, milk, cheese and processed meats, rice and beans and carbohydrates. Dietary patterns were socially patterned, since six dietary components were associated with socioeconomic position. Moreover, high intake of snacks and treats and less fruits and vegetables were associated with children born to teenage mothers, with those exclusively breastfed for less than one month, and with those who started on complementary feeding before 4 months. Finally, overweight and obese children at 6 years presented lower intake of four out of seven dietary components, but we need to be cautious in interpretation due to limitations on food consumption reporting and due to possible reverse causality. CONCLUSION: Dietary intake patterns in children are strongly influenced by socioeconomic characteristics. Other factors such as younger maternal age at birth, and both early weaning and early introduction of complementary feeding appear to be related with 'unhealthier' patterns. Overweight and obese children presented lower intake of four out of seven dietary components, but further studies would be interesting to understand the longitudinal effect of children's feeding practices on BMI and adiposity.

Impact of the age at menarche on body composition in adulthood: results from two birth cohort studies.

BACKGROUND: Evidence suggests that early menarche is positively associated with adiposity in adulthood. However, it is important to assess whether this association is due to early menarche or to the association of adiposity in late childhood with age at menarche. We evaluated the association between age at menarche and body composition in adolescence and adulthood, among subjects who have been prospectively followed in two Brazilian birth cohort studies. METHODS: In 1982 and 1993, the hospitals births in Pelotas were identified, and these subjects have been followed for several times. Information on age at menarche was obtained from the women (1982 cohort) and their mothers (1993 cohort). At 30 and 18 years, the following body composition measures were evaluated: body mass index, waist circumference, fat-free mass index and fat mass index measured by dual-energy x-ray absorptiometry, and thickness of the abdominal visceral fat layer measured by ultrasound. The analyses were adjusted for: birth weight, maternal pregestational weight, gestational age, family income, household score index, maternal schooling, weight-for-height z-score at 4 years (1982), and body mass index at 11 years (1993). RESULTS: At 30 and 18 years, 2045 and 2092 women were evaluated, respectively. The prevalence of early menarche (≤11 years of age) was 24.7 % in the 1982 and 27.6 % in the 1993 cohort. In the 1982 cohort, early menarche was positively associated with all body composition variables compared to those with late menarche (≥14 years of age) even after adjusting for confounders (fat mass index: 2.33 kg/m2, 95 % Confidence interval: 1.64; 3.02). However, in the 1993 cohort, after adjusting for body mass index at 11 years, the regression coefficient for the association with fat mass index decreased from 2.2 kg/m2 (95 % Confidence interval: 1.7; 2.6) to 0.26 (95 % Confidence interval: -0.08; 0.60). CONCLUSIONS: The association between age at menarche and body composition in adulthood is strongly explained by pre-pubertal adiposity.

Body mass index at 11 years and bone mass at age 18: path analysis within the 1993 Pelotas (Brazil) birth cohort study.

BACKGROUND: We investigated whether Body Mass Index (BMI) at 11 years old has a direct effect on bone mass at age 18 operating through alterations to bone growth and development, or whether the association is mediated by concurrent BMI, fat mass (FM), and fat free mass (FFM). METHODS: Path analysis was used to explore the association between BMI at age 11 and whole-body bone mineral content (BMC) and bone mineral density (BMD) assessed by dual-energy x-ray absorptiometry (DXA) at age 18 in a prospective birth cohort study comprising 3,307 adolescents; we also evaluated the degree to which this association was mediated by BMI, FM (kg) and FFM (kg) assessed by plethysmography (BOD POD) at age 18. RESULTS: We found a positive association between BMI at age 11 and BMC (males [ß = 179.7 g, 95% CI 161.4; 198.0]; females [ß = 179.9 g, 95% CI 165.3; 194.6]) and BMD (males [ß = 0.030 g/cm2, 95% CI 0.024; 0.035]; females [ß = 0.029 g/cm2, 95% CI 0.025; 0.033]) at age 18. This association was largely mediated by BMI and FFM at age 18 in both female and male adolescents. FM at age 18 was not an important mediator. CONCLUSIONS: Concurrent BMI and FFM were the main mediators of the association between BMC/BMD in late adolescence and BMI in early adolescence.

Early age at menarche and metabolic cardiovascular risk factors: mediation by body composition in adulthood.

Evidence suggests that early menarche increases cardiometabolic risk, and adiposity would be a possible mediator of this association. We assessed the association between age at menarche and metabolic cardiovascular risk factors and estimated the indirect effect of body composition in adulthood. In 1982, all hospital births in the city of Pelotas/Brazil, were identified and live births were examined and have been prospectively followed. At 30 years, information on age at menarche and metabolic cardiovascular risk factors was available for 1680 women. Mediation analysis was performed using G-computation to estimate the direct effect of age at menarche and the indirect effect of body composition. The prevalence of age at menarche < 12 years was 24.5% and was associated with higher mean diastolic blood pressure [ß: 1.98; 95% CI: 0.56, 3.40], total cholesterol (ß: 8.28; 95% CI: 2.67, 13.88), LDL-cholesterol (ß: 6.53; 95% CI: 2.00, 11.07), triglycerides (ß: 0.11; 95% CI: 0.03, 0.19). For diastolic blood pressure, total cholesterol, LDL-cholesterol, triglycerides, body composition assessed by fat mass index captured from 43.8 to 98.9% of the effect of early menarche, except to systolic blood pressure, HDL-cholesterol, C-reactive-protein. Suggesting that the effect of menarche age < 12 years on some metabolic cardiovascular risk factors is mediated partially by body composition in adulthood.

Socioeconomic status and body mass index life course models: the 1993 Pelotas (Brazil) birth cohort.

This article aims to assess the relationship between an individual's socioeconomic status over their life-course and their body mass index (BMI) at 22 years of age, according to the hypotheses generated by risk accumulation, critical period, and social mobility models. This was a population-based prospective study based on the Pelotas (Brazil) 1993 birth cohort. The risk accumulation, critical period, and social mobility models were tested in relation to a saturated model and compared with a partial F-test. After the best model was chosen, linear regression was carried out to determine the crude and adjusted regression coefficients of the association between socioeconomic status over the life-course and BMI at 22 years of age. The sample was comprised of 3,292 individuals (53.3% women). We found dose-response effect for both men and women, although the results were opposite. Among men, a lower score in socioeconomic status accumulation model led to a lower BMI average at 22 years of age; whereas among women, a lower score in socioeconomic status accumulation model caused an increase in BMI at 22 years of age.

Role of ultra-processed food in fat mass index between 6 and 11 years of age: a cohort study.

BACKGROUND: Ultra-processed food consumption and obesity have been highlighted as an important relationship to public health. We aimed to evaluate the association between ultra-processed food consumption and body fat from 6 to 11 years of age. METHODS: We assessed the association between ultra-processed food consumption (from food frequency questionnaires) and body fat (measured by air displacement plethysmography) between 6 and 11 years of age among participants of the Pelotas-Brazil 2004 Birth Cohort. The NOVA classification was used to classify foods according to the processing degree. Body fat was evaluated relative to the height using fat mass index (FMI). Generalized estimating equations were used to answer the main research question and mediation analyses were run to assess the direct and indirect effect of ultra-processed food in body fat. RESULTS: At fully adjusted analysis, an increase of 100 g in contribution from ultra-processed food to daily food intake at between 6 and 11 years of age was associated with a gain of 0.14 kg/m² in FMI in the same period; 58% of the total effect of ultra-processed food intake at 6 years (in grams) over the change in FMI from 6 to 11 years was mediated by its calorie content. CONCLUSIONS: Ultra-processed food consumption was associated with an increase in body fat from childhood to early adolescence, and this association was not just due to the effect of ultra-processed food on calorie content.

Traumatic dental injuries in primary dentition: epidemiological study among preschool children in South Brazil.

AIM: To estimate the prevalence of traumatic injury in primary dentition among children aged 12-71 months old, as well as to evaluate the distribution of traumatic injuries, type of trauma and associated factors. MATERIAL AND METHODS: After the research project approval by the Ethics Research Committee, a cross-sectional study was carried out including 571 preschool children--both from public and private schools--in the city of Pelotas, Southern Brazil. Data were collected by means of anterior teeth examination, and by the administration of a structured questionnaire to parents. The classification proposed by Andreasen & Andreasen was used, and crown discoloration and fistula were added to this criterion. RESULTS AND CONCLUSIONS: The prevalence of dental trauma was 36.6% (95% CI 32.7-40.5), with no significant differences between boys and girls. Trauma were more frequent among older children (P = 0.001). No associations were found for maternal schooling, income and type of school. The most frequent trauma was enamel fracture, and the most affected tooth was number 61. A significant statistical association was observed between the presence of dental trauma during clinical examination and parental report of trauma occurrence. The percentage of parents who looked for dental treatment was higher among children from private schools (P = 0.001). The most frequent place of occurrence was home, and the most frequently reported etiology was child's own-height fall. CONCLUSIONS: Dental trauma in primary teeth is characterized as an accident that occurs due to the children's development stage, even when they are cared for by mothers of higher schooling and income. Parents should search for assistance right after trauma occurrence to minimize sequelae.

Vegetarianism among first-year students at a public university in Southern Brazil, 2018. / Vegetarianismo entre ingressantes de uma universidade pública no sul do Brasil, 2018.

Objective To identify vegetarianism prevalence and associated factors among students at a public university in Southern Brazil. Methods This was a cross-sectional study carried out in 2017-2018 with first-year university students. A questionnaire was administered to assess diet type (omnivorous or vegetarian). Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (95%CI). Results Of 2,706 eligible individuals, 1,841 formed part of the sample. The predominant type of diet was omnivorous (93.6%), followed by lacto-ovo vegetarian (5.4%), strict vegetarian (0.7%), ovo vegetarian (0.2%) and lacto vegetarian (0.1%). Females (OR=0.58 - 95%CI 0.38;0.89), students reporting harmful use of alcohol (OR=2.02 - 95%CI 1.34;3.04) and students enrolled in Linguistics, Modern Languages and Arts courses - compared to those enrolled in Applied Social Sciences and Humanities courses (OR=2.59 - 95%CI 1.42;4.71) - were more likely to be vegetarians. Conclusion Vegetarian diet was associated with the female sex, alcohol use, and taking linguistics, modern language and arts courses.

[Dietary patterns of elderly Brazilians and associated determinants: a population-based study in the south of Brazil]. / Padrões alimentares de idosos e seus determinantes: estudo de base populacional no sul do Brasil.

This cross-sectional study sought to assess the effect of demographic and socioeconomic factors, chronic diseases, and health counseling on dietary patterns of the elderly. Food consumption was assessed by means of a reduced eating frequency questionnaire distributed to 1,426 elderly residents in Pelotas, State of Rio Grande do Sul, Brazil, and dietary patterns were obtained using main component analysis. Two dietary patterns were identified: healthy diet (wholegrain food, fruits, vegetables, and milk) and Western diet (sweet snacks, fried foods, frozen foods, processed meats, and fast food). Females, non-smokers, and alcohol-free individuals tended more toward the healthy diet, whereas males, smokers, alcohol-dependent, and overweight individuals tended more toward the Western diet. Higher income and schooling were associated with a higher tendency toward both diets, and chronic diseases were not associated with either diet. Receiving counseling for adopting healthy habits was associated with a higher tendency toward a healthy diet and a lower tendency toward the Western diet. There is a need to increase effective guidance on healthy habits by health services to promote healthier eating practices, with special attention to elderly males, smokers, alcohol-dependent and overweight individuals.

Este estudo teve como objetivo avaliar o efeito de fatores demográficos e socioeconômicos, de doenças crônicas e do recebimento de orientações em saúde no padrão alimentar de idosos. O consumo alimentar foi avaliado por meio de questionário de frequência alimentar reduzido aplicado a 1.426 idosos residentes em Pelotas, RS, Brasil e os padrões alimentares foram obtidos por análise de componentes principais. Dois padrões foram identificados: saudável (alimentos integrais, frutas, legumes/verduras e leite) e ocidental (doces, frituras, alimentos congelados, embutidos e "fast food"). Mulheres, não fumantes e não dependentes alcoólicos aderiam mais ao padrão saudável, enquanto que homens, fumantes, dependentes alcóolicos e indivíduos com sobrepeso aderiam mais ao padrão ocidental. Maior renda e escolaridade estiveram associadas à maior adesão de ambos os padrões e a presença de doenças crônicas não esteve associada a nenhum padrão. O recebimento de orientações para hábitos saudáveis esteve associado à maior adesão ao padrão saudável e menor ao padrão ocidental. Há necessidade do fortalecimento de orientações eficazes sobre hábitos saudáveis nos serviços de saúde, com especial atenção para idosos do sexo masculino, tabagistas, dependentes alcoólicos e indivíduos com sobrepeso.

Growth from birth to adolescence and bone mineral density in young adults: The 1993 Pelotas birth cohort.

BACKGROUND: The study examined the association of body size (weight and length) at birth and gain in height and weight during childhood and adolescence with areal bone mineral density (aBMD) in adulthood for women and men. METHODS: 756 members (335 men and 421 women) of the 1993 Pelotas (Brazil) Birth cohort were studied. Data on weight and length/height were obtained at birth and subsequent follow-ups at 1, 4, 11, 15, 18, and 22 years of age and specific z scores were calculated by sex. The outcome was whole body aBMD (g/cm²) measured at 22 years of age using dual-energy X-ray absorptiometry (DXA). The effects of exposures, weight and length/height gain, were analyzed using conditional relative weight (CWh) and conditional length/height (CH). Linear regression models were adjusted for multiple confounders, including mother's educational level, family income, maternal smoking during pregnancy, gestational age, breastfeeding and skin color. RESULTS: In the adjusted models, among men greater height gain at 4, 11, and 18 years of age was associated with higher whole body aBMD, and the result with greatest magnitude was at 11 years of age (ß 0.018 g/cm²; 95%CI 0.006; 0.030). Among women, aBMD was associated with height gain at all assessments from 1-15 years, with greatest effect size at 4 years of age (ß 0.017 g/cm²; 95%CI 0.007; 0.027). Regarding to body weight, among men, greater weight at 4 and 15 years were associated with higher aBMD, with the highest coefficients for 15 years of age (ß 0.015 g/cm²; 95%CI 0.003; 0.027); for women, except at birth, all weight gain variables were associated with aBMD and the highest coefficients were observed at 4 years (ß 0.025 g/cm²; 95%CI 0.015; 0.035). CONCLUSIONS: In this birth cohort, height and weight gain, especially from 4 to 15 years have important positive implications for aBMD to early adulthood.

Longitudinal Association Between Diet Quality and Asthma Symptoms in Early Adult Life in a Brazilian Birth Cohort.

BACKGROUND: The role of diet in the etiology of asthma is still inconclusive. This paper evaluated the longitudinal association between diet quality and chest wheezing in young adults. METHODS: This is a longitudinal study with follow-up information from 18- and 22-year-olds (18y and 22y) of the 1993 Pelotas (Brazil) Birth Cohort. Chest wheezing occurrence and number of events in the last year were reported at 22y. Diet quality was measured with a revised version of the Healthy Eating Index (IQD-R) for the Brazilian population at 18y and 22y by food frequency questionnaire referring to the last 12 months. The diet quality continuity was classified as good (always 1st IQD-R tertile), intermediate (always 2nd tertile/change tertile) and poor (always 3rd tertile). RESULTS: A total of 2986 young individuals were evaluated; 51.4% were female. Prevalence of wheezing at 22y was 10.1% (95% CI: 9.1-11.2), and of these patients, 10% reported at least one event in the past year. Better IQD-R score, both at 18y and at 22y, the lower the odds of wheezing in the past year. Regarding the diet quality continuity from 18y to 22y, staying on a poor diet increased by more than three-fold the odds of chest wheezing (OR=3.28; 95% CI: 1.84-5.84) and of wheezing events (OR=3.32; 95% CI: 1.89-5.85) compared to staying on a good diet, after adjustment for confounding variables. CONCLUSION: The overall quality of the diet seems to be more important than the individual components in the effect on asthma symptoms. Low-quality diet persistence increased the odds of chest wheezing and the number of events.

Maternal anthropometry is associated with the body mass index and waist:height ratio of offspring at 23 years of age.

Obesity is considered a public health problem worldwide. Evidence from epidemiologic studies has shown that early undernutrition may be a determinant of obesity later in life. Longitudinal studies are scarce in the setting of low- and middle-income countries. In Pelotas, southern Brazil, a birth cohort has been followed since 1982. Between 2004 and 2005, 4297 members of this cohort were interviewed. The aim of this study is to describe the association between maternal anthropometry and offspring BMI and waist:height ratio (WHtR) at 23 y of age in individuals from the 1982 Pelotas birth cohort. Independent variables included maternal prepregnancy BMI and maternal height, obtained in 1982. The BMI and WHtR of the offspring at 23 y of age were the outcomes. The analysis was stratified by sex and restricted to those cohort members belonging to the lower income group. Multivariable linear regression was adjusted for potential confounding or mediating factors according to a hierarchical framework. For each unit of maternal prepregnancy BMI, the offspring BMI increased 0.65 and 0.63 kg/m(2) in men and women, respectively (P < 0.001). Maternal prepregnancy BMI was directly associated with offspring WHtR in both sexes (P < 0.001). On the other hand, maternal height was not associated with offspring BMI or WHtR. In conclusion, our study suggests that maternal anthropometry is associated with the offspring BMI and WHtR at 23 y of age.