Health economic impacts associated with the consumption of sugar-sweetened beverages in Brazil.

Introduction: The consumption of sugar-sweetened beverages (SSBs) is among the main risk factors for non-communicable diseases (NCDs). This study aimed to estimate the financial costs of hospitalizations and procedures of high and medium complexity for NCDs attributable to the consumption of SSBs in the Brazilian Unified Health System (SUS) in 2019. Methods: This ecological study used data from the Global Burden of Disease (GBD) 2019 and the Department of Informatics of the Unified Health System (DATASUS). The attributable costs were estimated from the population-attributable fraction (PAF) and the costs in the treatment of chronic diseases [type 2 diabetes mellitus and ischemic heart disease (IHD)], stratified by sex, age group, level of complexity of treatment, and federative units. Results: In 2019, in Brazil, US$ 14,116,240.55 were the costs of hospitalizations and procedures of high and medium complexity in the treatment of NCDs attributable to the consumption of SSBs. These values were higher in males (US$ 8,469,265.14) and the southeast and southern regions, mainly in the state of São Paulo. However, when evaluating these results at a rate per 10,000 inhabitants, it was observed that the states of Paraná, Tocantins, and Roraima had higher costs per 10,000 inhabitants. Regarding the age groups, higher costs were observed in the older age groups. Conclusion: This study revealed the high financial impact of the NCDs treatment attributed to the consumption of SSBs in Brazil and the variability among Brazilian macro-regions. The results demonstrate the urgency and need for the expansion of policies to reduce the consumption of SSBs in Brazil with strategies that consider regional particularities.

Prevalence and associated factors of diabetes in the elderly population in Viçosa, Minas Gerais, Brazil.

OBJECTIVES: To assess the prevalence and factors associated with diabetes in the elderly population and verify the correlation between the use of medications for diabetes and information about the disease. METHODS: This epidemiological cross-sectional study was conducted in Viçosa, Minas Gerais, Brazil, with 621 elderly people aged 60 years or older selected by simple random sampling. A semi-structured questionnaire was used as a research tool and included questions about socioeconomic conditions, lifestyle, health conditions, and nutritional status. The weight, height, and waist circumference were measured. The dependent variable was the self-reported diabetes. In the association analysis between explanatory variables and self-reported diabetes, the Poisson regression analysis with robust variance was used. In the bivariate analysis, a p value < 0.25 was used to include the variables for the multivariate modeling, and in the final model, the variables with p value < 0.10 association were included. RESULTS: The prevalence of diabetes was 22.4%. The multivariate hierarchical analysis showed the following factors independently and positively associated with diabetes: gender, self-reported health, history of hypertension/dyslipidemia, polypharmacy, and waist circumference. The elderly schooling was negatively associated with diabetes. CONCLUSION: The results showed the need for implementation of educational public policies to promote behavior changes of the population to prevent and control diabetes and its complications.

Stature estimation using the knee height measurement amongst Brazilian elderly.

INTRODUCTION: Stature is an important variable in several indices of nutritional status that are applicable to elderly persons. However, stature is difficult or impossible to measure in elderly because they are often unable to maintain the standing position. A alternative is the use of estimated height from measurements of knee height measure. AIMS: This study aimed to evaluate the accuracy of the formula proposed by Chumlea et al. (1985) based on the knee of a Caucasian population to estimate the height and its application in calculation of body mass index in community- dwelling older people residents in Viçosa, Minas Gerais, Brazil. METHODS: The sample included 621 elderly aged 60 years old and older, living in the community. Measures of weight, height and knee height (KH) were taken and Body Mass Index (BMI) was calculated with the measured weight and estimated. The Student`s t-test was used for comparison of measurements of height between the genders. For the comparison of estimated and measured values it was used paired t-test and also the methodology proposed by Bland and Altman to compare the difference between measurements. To evaluate the agreement between the classifications for BMI was used Cohen's Kappa. RESULTS: The average values obtained from KH were higher than those measured in the whole sample and women. There underestimation of BMI in females and also in the whole. CONCLUSIONS: The present results suggest that the equation Chumlea was not adequate to estimate the height of the sample in question, especially for women.

Introducción: La estatura es una variable importante en varios índices del estado nutricional que son aplicables a las personas mayores. Sin embargo, la estatura es difícil o imposible de medir en la edad avanzada, ya que a menudo son incapaces de mantener la posición de pie. Una alternativa es el uso de altura estimada a partir de mediciones de medida de altura de la rodilla. Objetivos: Este estudio tuvo como objetivo evaluar la exactitud de la fórmula propuesta por Chumlea et al. (1985), basado en la altura de la rodilla de una población caucásica para estimar la altura y su aplicación en el cálculo del índice de masa corporal en las personas mayores residentes en la comunidad de Viçosa, Minas Gerais, Brasil. Métodos: La muestra incluyó a 621 adultos mayores de 60 anõs y más, que viven en la comunidad. Se tomaron medidas de peso, talla y altura de la rodilla (AR) y el Índice de Masa Corporal (IMC) se calculó con el peso medido y estimado. Se utilize la prueba T del estudiante para la comparación de las mediciones de altura entre los géneros. Para la comparación de los valores estimados y medidos se utilizó la prueba T pareada y también la metodología propuesta por Bland y Altman para comparar la diferencia entre las mediciones. Para evaluar el acuerdo entre las clasificaciones para el IMC se utilizó el Kappa de Cohen. Resultados: Los valores medios obtenidos a partir de AR fueron más altos que los medidos en la muestra completa y mujeres. Hay subestimación de IMC en mujeres y también en el conjunto. Conclusiones: Los resultados sugieren que la ecuación Chumlea no era adecuado para estimar la altura de la muestra en cuestión, especialmente para las mujeres.

Prevalence and factors associated with physical inactivity among the elderly: a population-based study / Prevalência e fatores associados à inatividade física em idosos: um estudo de base populacional

Abstract Objectives: To determine the prevalence of physical inactivity among elderly individuals in the municipality of Viçosa, Minas Gerais and identify associated factors. Method: A cross-sectional population-based study of 621 elderly persons was conducted in Viçosa, Minas Gerais. The dependent variable was physical inactivity, defined by the question "Do you practice some kind of physical activity?" The definition of the term "physical activity" was restricted to activities performed regularly, for at least 20 minutes, three times a week, disregarding domestic, industrial and transportation activities. The independent variables were age; gender; education; self-rated health; functional capacity; history of diabetes, hypertension, dyslipidemia and osteoporosis; overweight; risk of metabolic disorders; smoking; number of medical appointments; history of hospitalizations in the last year and private health insurance. Descriptive analysis and multiple Poisson regression were used. Results: The prevalence of physical inactivity was 70.1% (95% CI: 66.0%-74.0%). The associated factors were the male gender, aged over 80 years, less educated, low functional capacity, smokes and did not have private health insurance. Conclusion: The high prevalence of physical inactivity and its associated factors indicate the need to develop systematic approaches to improve public policies directed at this age group.

Resumo Objetivos: Determinar a prevalência de inatividade física entre idosos do município de Viçosa-MG e identificar seus fatores associados. Método: Estudo transversal de base populacional conduzido no município de Viçosa-MG com 621 idosos. Considerou-se como variável dependente a inatividade física, definida pela questão: "O(a) senhor(a) pratica alguma atividade física?" A prática de atividade física considerada restringiu-se àquela realizada regularmente, por pelo menos 20 minutos, três vezes por semana, desconsiderando-se as atividades domésticas, laborais e no deslocamento. As variáveis independentes foram: idade; sexo; escolaridade; autopercepção da saúde; capacidade funcional; história de diabetes, hipertensão, dislipidemias e osteoporose; excesso de peso; risco de alteração metabólica; tabagismo; número de consultas; história de internação hospitalar no último ano e possuir plano privado de saúde. Realizou-se análise descritiva e análise de regressão de Poisson múltipla. Resultados: A prevalência de inatividade física foi de 70,1% (IC 95%: 66,0%-74,0%). Os fatores associados foram sexo masculino, ter idade acima de 80 anos, menor escolaridade, capacidade funcional inadequada, fumar e não possuir plano de saúde privado. Conclusão: A alta prevalência de inatividade física e seus fatores associados indicam a necessidade de desenvolvimento de estratégias sistemáticas para aprimorar as políticas públicas direcionadas para esse grupo etário.

Prevalência e fatores associados ao diabetes em idosos no município de Viçosa, Minas Gerais / Prevalence and associated factors of diabetes in the elderly population in Viçosa, Minas Gerais, Brazil

RESUMO: Objetivo: Avaliar a prevalência e os fatores associados ao diabetes em idosos, bem como verificar a concordância entre o uso de medicamentos para diabetes e a informação referida sobre a doença. Métodos: Estudo epidemiológico transversal realizado na cidade de Viçosa, Minas Gerais, com 621 idosos com 60 anos ou mais, selecionados a partir de amostragem aleatória simples. Utilizou-se como instrumento de pesquisa um questionário semiestruturado que constava de perguntas sobre condições sociodemográficas, estilo de vida, condições de saúde e estado nutricional. Foram aferidos peso e altura, além do perímetro da cintura. A variável dependente do estudo foi o diabetes autorreferido. A análise da associação entre as diversas variáveis explicativas e a presença de diabetes foi feita por meio da regressão de Poisson com variância robusta simples e múltipla. Nas análises bivariadas foi utilizado o valor p < 0,25 para inclusão das variáveis na análise de regressão múltipla hierarquizada e, no modelo final, permaneceram as associações cujas variáveis apresentaram associação com o desfecho com valor p < 0,05. Resultados: A prevalência de diabetes foi de 22,4%. A análise múltipla hierarquizada evidenciou como fatores independentemente e positivamente associados ao diabetes: gênero, autopercepção da saúde, história de hipertensão e/ou dislipidemias, polifarmácia e obesidade abdominal. A escolaridade se manteve negativamente associada à presença de diabetes. Conclusão: Os resultados obtidos são similares aos de outros estudos conduzidos no país, sugerindo que os fatores associados ao diabetes entre idosos são semelhantes em todo o país. Ainda, observou-se moderada concordância entre o uso de medicamentos para diabetes e a informação referida sobre a doença, o que sugere o uso da última como método alternativo de investigação quando não se dispuser de outra forma de avaliação.

ABSTRACT: Objectives: To assess the prevalence and factors associated with diabetes in the elderly population and verify the correlation between the use of medications for diabetes and information about the disease. Methods: This epidemiological cross-sectional study was conducted in Viçosa, Minas Gerais, Brazil, with 621 elderly people aged 60 years or older selected by simple random sampling. A semi-structured questionnaire was used as a research tool and included questions about socioeconomic conditions, lifestyle, health conditions, and nutritional status. The weight, height, and waist circumference were measured. The dependent variable was the self-reported diabetes. In the association analysis between explanatory variables and self-reported diabetes, the Poisson regression analysis with robust variance was used. In the bivariate analysis, a p value < 0.25 was used to include the variables for the multivariate modeling, and in the final model, the variables with p value < 0.10 association were included. Results: The prevalence of diabetes was 22.4%. The multivariate hierarchical analysis showed the following factors independently and positively associated with diabetes: gender, self-reported health, history of hypertension/dyslipidemia, polypharmacy, and waist circumference. The elderly schooling was negatively associated with diabetes. Conclusion: The results showed the need for implementation of educational public policies to promote behavior changes of the population to prevent and control diabetes and its complications.

Aspectos metodológicos na construção de projetos de pesquisa em Nutrição Clínica / Methodological aspects in the development of research projects in Clinical Nutrition

O objetivo deste texto é fomentar a reflexão e a crítica no processo de elaboração de projetos de pesquisa em nutrição clínica. São apresentados aspectos relativos a evidências, validade e confiabilidade dos resultados dos estudos nesse campo. É imprescindível que ocorra adequado planejamento da pesquisa, desde a definição do delineamento e do tipo do experimento, passando pelos aspectos éticos, escolha da população e cálculo do tamanho amostral até a avaliação da factibilidade dos riscos envolvidos na sua condução. Após a coleta das informações, as etapas seguintes correspondem à descrição dos resultados, análise estatística, verificação da consistência desses resultados e, ao final, sua adequada interpretação.

This text aims to foster the reflection and criticism in the process of developing research projects in clinical nutrition. We present aspects regarding the evidence, validity, and reliability of results of studies in this field. Appropriate study planning is critical, from defining the design and type of experiment, going through the ethical aspects, population choice, and calculation of sample size, to the assessment of the feasibility of the risks involved in study execution. Once the information is collected, the next stages correspond to the description of the results, statistical analyses, verification of the consistency of these results, and ultimately their correct interpretation.