Triglyceride-glucose index demonstrates reasonable performance as a screening tool but exhibits limited diagnostic utility for insulin resistance: Data from the ELSA-Brasil cohort.

Insulin resistance (IR) is a key risk factor for chronic metabolic diseases, but its laboratory diagnosis is still costly; thus, the triglyceride-glucose (TyG) index has been proposed as a surrogate method. Our aim was to provide a detailed analysis of cutoffs and test the hypothesis that the TyG index would present reasonable performance parameters for IR screening. This is a cross-sectional study with baseline data from 12,367 eligible participants of both sexes (aged 35-74 years) from the Brazilian Longitudinal Study of Adult Health. TyG correlation and agreement with the Homeostasis Model Assessment for Insulin Resistance were analyzed. Positive and negative predictive values (PV+, PV-) and likelihood ratio (LR+, LR-) were calculated. A moderate positive correlation between TyG and Homeostasis Model Assessment for Insulin Resistance was observed (Pearson r = 0.419). The area under the receiver operating characteristic curve of TyG for IR diagnosis was 0.742 and the optimal cutoff was 4.665, reaching a kappa agreement value of 0.354. For this cutoff, a PV+ of 59.3% and PV- of 76.0%, as well as an LR+ of 2.07 and LR- of 0.45 were obtained. Alternatively, because high sensitivity is desired for screening tests, selecting a lower cutoff, such as 4.505, increases the PV- to 82.1%, despite decreasing the PV+ to 50.8%. We conclude that TyG has important performance limitations for detecting IR, but that it may still be reasonably useful to help screening for IR in adults because it can be calculated from low-cost routine blood tests.

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

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

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

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

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

Racial discrimination predicts the increase in body weight and BMI in Black individuals from ELSA-Brasil cohort / Discriminação racial prediz o aumento do peso corporal e do IMC em indivíduos pretos da coorte ELSA-Brasil

Abstract We investigated whether racial discrimination accelerates the weight and Body Mass Index (BMI) gain in Blacks and Browns participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) in four years of follow-up. We compared body weight and BMI between the 1st (2008-2010) and 2nd visit (2012-2014) of 5,983 Blacks and Browns participants. Exposure to racial discrimination and covariates (age, sex, education, and research center) were obtained at the 1st visit. Linear mixed effects models stratified by race/skin color were used. Report of racial discrimination was more frequent among Blacks (32.1%) than Browns (6.3%). During the follow-up period, Blacks and Browns gained an average of 1.4kg and 1.2kg, respectively. This increase was greater among those who reported discrimination when compared to those who did not, both in Blacks (2.1kg vs.1.0kg, p < 0.001) and Browns (1.9kg vs. 1.1kg, p < 0.05). The results of the interaction between racial discrimination and time showed that Blacks, but not Browns, who reported racial discrimination had greater weight and BMI gains between visits. Our results suggest that reducing racial discrimination would contribute to prevent and/or control obesity increase in the country.

Resumo Investigou-se se a discriminação racial acelera o ganho de peso corporal e o Índice de Massa Corporal (IMC) em pretos e pardos participantes do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil) em quatro anos de seguimento. Comparou-se o peso corporal e o IMC entre a 1ª (2008-2010) e a 2ª visita (2012-2014) de 5.983 participantes pretos e pardos. A exposição à discriminação racial e às covariáveis ​​(idade, sexo, escolaridade e centro de pesquisa) foram obtidas na 1ª visita. Foram utilizados modelos lineares de efeitos mistos estratificados por raça/cor da pele. O relato de discriminação racial foi mais frequente entre pretos (32,1%) do que em pardos (6,3%). Durante o período de acompanhamento, pretos e pardos ganharam uma média de 1,4kg e 1,2kg, respectivamente. Esse aumento foi maior entre os que relataram discriminação, quando comparados aos que não relataram, tanto em pretos (2,1 kg vs. 1,0 kg, p < 0,001) quanto em pardos (1,9kg vs. 1,1kg, p < 0,05). Após ajustes, os pretos, mas não os pardos, que relataram discriminação racial apresentaram maiores ganhos de peso e IMC entre as visitas. Nossos resultados sugerem que a redução da discriminação racial pode contribuir para prevenir e/ou controlar o aumento da obesidade no país.

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

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

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

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

Food insecurity and depressive symptoms among older adults assisted by the Family Health Strategy in the Northeast region of Brazil / Insegurança alimentar e sintomas depressivos em idosos atendidos pela Estratégia Saúde da Família na Região Nordeste do Brasil

ABSTRACT Objective This study aimed to investigate the association between depressive symptoms and food insecurity in households with older adults. Methods This is a cross-sectional, quantitative study conducted with community-dwelling older adults attended to in the Family Health Strategy in a municipality in the Brazilian Northeast. Depressive symptoms were evaluated using the Geriatric Depression Scale and food insecurity was assessed using the Brazilian Food Insecurity Scale. The chi-squared test was applied for a bivariate analysis and binary logistic regression was used to verify the association between depressive symptoms and food insecurity, adjusted for potential confounding variables. The significance level was p<0.05. Results A total of 316 older adults were evaluated, with a mean age of 70.5 (±7.5 years). The prevalence of depressive symptoms was 27.5% and that of food insecurity was 63.3%, with 25.6% of households with older adults experiencing moderate/severe insecurity. In the multivariate analysis, households experiencing mild food insecurity presented 3 times (OR: 3.02; 95% CI: 1.42-6.39) more chance of developing depressive symptoms, while in those experiencing moderate/severe food insecurity the chance was 5 times higher (OR: 5.01; 95% CI: 2.30-10.92). Conclusion An association was found between food insecurity and depressive symptoms in households with older adults of the Family Health Strategy, with more chances for those experiencing moderate/severe food insecurity.

RESUMO Objetivo Investigar a associação entre sintomas depressivos e insegurança alimentar em domicílios com idosos. Métodos Estudo transversal, quantitativo e realizado com idosos comunitários atendidos na Estratégia Saúde da Família em um município do Nordeste brasileiro. Sintomas depressivos foram avaliados pela Escala Geriátrica de Depressão; e a insegurança alimentar, com a Escala Brasileira de Insegurança Alimentar. Foi aplicado o teste qui-quadrado para análise bivariada e a regressão logística binária para verificar a associação entre sintomas depressivos e insegurança alimentar, ajustada por potenciais variáveis de confundimento. O nível de significância foi p<0,05. Resultados Foram avaliados 316 idosos, com média de idade de 70,5 (±7,5 anos). A prevalência de sintomas depressivos foi de 27,5% e a de insegurança alimentar foi de 63,3%, sendo que 25,6% dos domicílios com idosos estavam em insegurança moderada/grave. Na análise multivariada, domicílios com insegurança alimentar leve apresentaram 3 vezes (OR=3,02; IC 95%1,42-6,39) mais chances de desenvolverem sintomas depressivos, enquanto que aqueles em insegurança alimentar moderada/grave a chance foi 5 vezes maior (OR=5,01; IC 95% 2,30-10,92). Conclusão Foi encontrada associação entre insegurança alimentar e sintomas depressivos em domicílios com idosos da Estratégia Saúde da Família, com mais chances para aqueles com insegurança alimentar moderada/grave.

Fatores associados à adesão a comportamentos preventivos da COVID-19 em participantes do ELSA-Brasil / Factors associated with adherence to COVID-19 preventive behaviors in ELSA-Brasil participants / Factores asociados a la adhesión a comportamientos preventivos de COVID-19 en participantes de ELSA-Brasil

O objetivo deste estudo foi avaliar a adesão a medidas de prevenção recomendadas durante a pandemia de COVID-19 e investigar os fatores associados a essa adesão na população adulta. Por meio de delineamento transversal, utilizam-se dados do estudo complementar Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil) - COVID, realizado de 2020 a 2021, que foram analisados por meio do teste qui-quadrado e regressão logística multinomial. A amostra é composta por 5.440 participantes. A medida preventiva com maior adesão foi o uso de máscara facial (95,5%). Houve maior adesão pelo sexo feminino e menor chance de adesão pela raça/cor branca, por aqueles que consomem bebidas alcoólicas, aposentados, assim como para aqueles que moram sozinhos ou que possuem familiares que não seguiram as recomendações de ficar em casa. A maior adesão aos comportamentos preventivos foi verificada em apenas um terço da população participante, o que demonstra que havia a necessidade de uma maior conscientização quanto aos riscos em populações específicas. Os achados contribuem para melhorar o conhecimento sobre promoção da saúde e prevenção da COVID-19.

The aim of the study is to assess the adherence to recommended prevention measures during the COVID-19 pandemic and to investigate the factors associated with this adherence in the adult population. This study has a cross-sectional design and used data from the complementary study Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) - COVID, conducted from 2020 to 2021. Data were analyzed using the chi-square test and multinomial logistic regression. The sample consisted of 5,440 participants. The preventive measure with the highest adherence was the use of a face mask (95.5%). There was greater adherence by females and lower chance of adherence by white people, by those who consume alcoholic beverages, people who were retired, as well as for those who live alone or who have family members who did not follow the recommendations to stay at home. Greater adherence to preventive behaviors was observed in only one third of the participating population, which demonstrates that there was a need for greater awareness of the risks in specific populations. The findings contribute to improving our understanding about health promotion and COVID-19 prevention.

El objetivo del estudio fue evaluar la adhesión a las medidas de prevención recomendadas durante la pandemia de COVID-19 e investigar los factores asociados con esta adhesión en la población adulta. El presente estudio tiene un diseño transversal y utilizó datos del estudio complementario Estudio Longitudinal de Salud del Adulto en Brasil (ELSA-Brasil) - COVID, realizado de 2020 a 2021. Los datos se analizaron mediante la prueba de chi-cuadrado y la regresión logística multinomial. La muestra fue compuesta por 5.440 participantes. La medida preventiva con mayor adhesión fue el uso de mascarilla facial (95,5%). Hubo mayor adhesión por el sexo femenino y menor posibilidad de adhesión por la raza/color blanca, por aquellos que consumen bebidas alcohólicas, jubilados, así como para aquellos que viven solos o que tienen familiares que no siguieron las recomendaciones de quedarse en casa. Solo se comprobó una mayor adhesión a los comportamientos preventivos en un tercio de la población participante, lo que demuestra que había la necesidad de una mayor concientización en cuanto a los riesgos en poblaciones específicas. Los resultados contribuyen a mejorar el conocimiento sobre la promoción de la salud y la prevención del COVID-19.

Alimentación, estilo de vida y distanciamiento social: un estudio en el sureste brasilero durante la pandemia de COVID-19

Introducción: a raíz de la emergencia por la COVID-19, las medidas de distanciamiento social adoptadas para mitigar la tasa de infección pueden influenciar los hábitos alimentarios y otros factores de estilo de vida. El objetivo de este estudio fue evaluar la relación del distanciamiento social y los factores de estilo de vida en adultos del sureste brasilero durante la primera ola pandémica. Metodología: se trata de un estudio transversal con 1828 adultos de entre 18 y 83 años, de ambos sexos, realizado a través de un cuestionario en línea; se recolectaron y analizaron datos sociodemográficos, alimentarios, sanitarios y de estilo de vida, en función de si se guardó o no el distanciamiento social. Resultados: los resultados mostraron disminución del desayuno (12,5 %) y aumento del consumo de meriendas (24,5 % matutina y 12,5 % vespertina) y picoteos entre comidas (20,4 %), así como de la ingesta de verduras y leguminosas entre quienes estaban en distanciamiento social y de pescado y comida rápida entre los que no lo estaban; la mayoría de participantes reportó ganancia de peso a lo largo de este periodo. Las personas en confinamiento dormían más y su principal causa de ansiedad fueron las estadísticas de la enfermedad. Conclusiones: los hallazgos sugieren la necesidad de implementar estrategias de promoción de la salud acordes a circunstancias como la actual.

Introduction: In the context of the COVID-19 pandemic, measures of social distancing to reduce the rate of infection can influence eating habits and other lifestyle factors. This study aimed to assess the relationship between social distancing and lifestyle factors in adults in southeastern Brazil during the first wave of the COVID-19 pandemic. Methods:: It was a cross-sectional study with 1,828 adults between 18 and 83 years of age, of both sexes, carried out through an online questionnaire; sociodemographic, food, health, and lifestyle data were collected and analyzed based on whether or not the social distancing was carried out. Results: The results showed a decrease in breakfast consumption (12.5%) and an increase in the consumption of snacks (24.5% morning snack; 12.5% afternoon snack) and snacks between meals (20.4%) during the pandemic, as well as an increase in the consumption of vegetables and legumes among people who did social distancing and in the consumption of fish and fast food among those who did not do social distancing; most participants reported weight gain during social distancing. People who were in social distancing slept more compared to those who were not in social distancing. The main cause of anxiety among those who kept social distancing were COVID-19 statistics. Conclusion: The findings suggest the need for health promotion strategies adapted to the condition of confinement in circumstances such as the current pandemic.

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.

Multimorbidade e cuidado com a saúde de agentes comunitários de saúde em Vitória, Espírito Santo, 2019: um estudo transversal / Multimorbilidad y atención de la salud de los agentes comunitarios de salud en Vitória, Espírito Santo, Brasil, 2019: un estudio transversal / Multimorbidity and health care of community health workers in Vitória, Espírito Santo, Brazil, 2019: a cross-sectional study

Objetivo: Avaliar condições de saúde, cuidados com a saúde e hábitos de vida de agentes comunitários de saúde (ACS) de Vitória, Espírito Santo, Brasil. Métodos: Estudo transversal da linha de base de um estudo de intervenção. Foram realizados exames bioquímicos, antropométricos, hemodinâmicos e entrevistas, entre outubro de 2018 e março de 2019, em Vitória. Testes estatísticos apropriados, conforme o delineamento da amostra, foram realizados utilizando-se o software SPSS versão 21.0, e adotando-se p<0,05. Resultados: Foram avaliados 262 ACS com idade média de 46,1±9,3 anos. Observaram-se elevados percentuais de pré-diabetes (22,9%), diabetes mellitus (17,2%), hipertensão arterial (37,0%), obesidade (39,8%), hipercolesterolemia (57,3%), hipertrigliceridemia (27,1%), multimorbidade (40,8%), sedentarismo (60,9%) e uso de ansiolíticos/antidepressivos (22,5%). Cerca de 40% dos ACS apresentaram três ou mais morbidades. Conclusão: Foram observados elevados percentuais de doenças crônicas, multimorbidade, sedentarismo e uso de ansiolíticos/antidepressivos em ACS de Vitória.

Objetivo: Evaluar condiciones de salud, cuidados de la salud y hábitos de vida de los agentes comunitarios de salud (ACS) en Vitória, Espírito Santo, Brasil. Métodos: Estudio transversal de la línea de base de un estudio de intervención. Se realizaron clínicos y entrevistas entre octubre de 2018 y marzo de 2019 en Vitória. Se realizaron las pruebas estadísticas adecuadas utilizando el software SPSS versión 21.0, adoptando p<0,05. Resultados: Se evaluaron 262 ACS, con una edad promedio de 46,1±9,3 años. Hubo altas prevalencias de prediabetes (22,9%), diabetes mellitus (17,2%), hipertensión arterial (37,0%), obesidad (39,8%), hipercolesterolemia (57,3%), hipertrigliceridemia (27,1%), multimorbilidad (40,8%), inactividad física (60,9%) y uso de ansiolíticos/antidepresivos (22,5%). Aproximadamente el 40% tenía tres o más enfermedades. Conclusión: Se observaron altos porcentajes de enfermedades crónicas, multimorbilidad, sedentarismo y uso de ansiolíticos/antidepresivos en los ACS de Vitória.

Objective: To assess health conditions, health care and lifestyle habits of community health workers (CHW) in Vitória, Espírito Santo, Brazil. Methods: This was a cross-sectional study using baseline data from an intervention study. Biochemical, anthropometric and hemodynamic examinations and interviews were carried out between October 2018 and March 2019 in Vitória. Appropriate statistical tests, in accordance with the sample design, were performed using SPSS software version 21.0, adopting p<0,05. Results: We assessed 262 CHWs with a mean age of 46.1±9.3 years. High prevalence of prediabetes (22.9%), diabetes mellitus (17.2%), hypertension (37.0%), obesity (39.8%), hypercholesterolemia (57.3%), hypertriglyceridemia (27.1%), multimorbidity (40.8%), physical inactivity (60.9%) and use of anxiolytics/antidepressants (22.5%) was found. Some 40% of the CHWs had three or more morbidities. Conclusion: High percentages of chronic diseases, multimorbidity, sedentary lifestyle and use of anxiolytics/antidepressants were found in CHWs in Vitória.

Consumo de bebidas alcoólicas e obesidade abdominal: resultados da linha de base do ELSA-Brasil / Consumption of alcoholic beverages and abdominal obesity: cross-sectional analysis of ELSA-Brasil

Resumo Objetivou-se analisar a associação entre consumo de bebidas alcoólicas e adiposidade abdominal em adultos. Estudo transversal realizado com dados da linha de base do ELSA-Brasil (2008-2010). A amostra foi constituída por 15.065 servidores públicos de seis instituições de ensino e pesquisa (35 a 74 anos, ambos os sexos). Para identificar adiposidade central por meio das medidas de circunferência da cintura (CC) e relação cintura/quadril (RCQ), utilizou-se os pontos de corte preconizados pela Organização Mundial da Saúde. Para as análises estatísticas foi utilizado o teste qui-quadrado e modelos de regressão de Poisson ajustados por variáveis potencialmente confundidoras. Cerca de 40% da amostra apresentava CC e RCQ elevadas. A probabilidade de apresentar CC elevada foi 5% e 3% maior no grupo mais exposto de consumo de cerveja em homens e mulheres quando comparado ao grupo de referência [RP = 1,05 (IC 95% 1,02-1,08) e RP = 1,03 (IC 95% 1,00-1,07)]. Também foi encontrada maior probabilidade de apresentar RCQ elevada entre os maiores consumidores de cerveja [RP = 1,03 (IC 95% 1,00-1,07) em homens e RP=1,10 (IC 95% 1,04-1,15) em mulheres]. Maior número de doses/semana de bebida alcoólica aumentou a probabilidade de ocorrência de CC e RCQ elevadas, sendo mais importante a contribuição da cerveja.

Abstract The objective was to analyze the association between alcohol consumption and abdominal adiposity in adults. Cross-sectional study conducted at baseline data from ELSA-Brasil (2008- 2010). The sample consisted of 15,065 civil servants from six education and research institutions (35 to 74 years old, both sexes). To identify central adiposity by measuring waist circumference (WC) and waist-to-hip ratio (WHR), the cutoff points recommended by the World Health Organization were used. Poisson regression models adjusted for potentially confounding variables were tested. About 40% of the sample had elevated WC and WHR. The probability of having elevated WC was 5% and 3% higher in the most exposed group of beer consumption in men and women when compared to the reference group [PR= 1.05 (95% CI 1.02-1.08) and P R= 1.03 (95% CI 1.00-1.07)]. A higher probability of having a high WHR was also found among the highest beer consumers [PR = 1.03 (95% CI 1.00-1.07) in men and PR = 1.10 (95% CI 1.04-1.15) in women]. A greater number of doses/week of alcoholic drink increased the probability of occurrence of high WC and WHR, with the beer contribution being more important.

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

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

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

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

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

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

Social position and anthropometric status among adults in the ELSA-Brasil study: a latent class analysis / Posição social e estado antropométrico entre adultos no estudo ELSA-Brasil: uma análise de classes latentes / Posición social y estatus antropométrico entre adultos en el estudio ELSA-Brasil: un análisis de clase latente

Abstract: The objective of the present study was to evaluate the association between social position and anthropometric status in women and men Brazilian adult. This was a cross-sectional study that used baseline data collected from 2008 to 2010 for the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil, in Portuguese), in the six major Brazilian state capital cities. A total of 15,105 active and retired civil servants aged from 35 to 74 years. Two latent variables were defined by latent class analysis, social position and anthropometric status. Both constructs and the analyses were separately evaluated by sex. Associations were assessed using multivariate logistic regression analysis with adjustment for age, self-reported skin color/race, and marital status. Around 44% of the women and 26% of the men were classified as overweight or obese. Social position tended to be lower in women (43.2%) and higher among men (40.4%). Heavier women were more likely to be black and brown-skinned, whereas slimmer women were more likely to be white. After adjustment, women's weight increased as social position decreased (OR = 1.52; 95%CI: 1.36-1.70), whereas in men weight decreased as social position decreased (OR = 0.87; 95%CI: 0.76-0.99). Social position affected the anthropometric status of women and men differently, with body patterns also being affected by ethnicity/skin color, showing the potentiality of taking the intersectional perspective when investigating the possible social determinants of the phenomenon.

Resumo: O objetivo do estudo foi avaliar a associação entre posição social e o estado antropométrico em brasileiros adultos de ambos os sexos. O estudo transversal usou dados coletados entre 2008 e 2010 pelo Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil), nas seis maiores capitais brasileiras. Um total de 15.105 funcionários públicos, ativos e aposentados, de ambos os sexos, entre 35 e 74 anos de idade. Duas variáveis latentes foram definidas pela análise de classes latentes: posição social e estado antropométrico. Os construtos e análises foram avaliados separadamente por sexo. As associações foram avaliadas com o uso de análise de regressão logística multivariada, ajustada para idade, cor/raça e estado civil. Em torno de 44% das mulheres e 26% dos homens foram classificados com sobrepeso ou obesidade. A posição social tendia a ser mais baixa nas mulheres (43,2%) e mais alta nos homens (40,4%). Houve uma proporção maior de mulheres com sobrepeso ou obesidade entre as pretas e pardas, e proporção maior de mulheres magras entre as brancas. Nas mulheres, após ajustes, o peso aumentava na medida em que a posição social diminuía (OR = 1,52; IC95%: 1,36-1,70), enquanto nos homens o peso diminuía junto com a diminuição da posição social (OR = 0,87; IC95%: 0,76-0,99). A posição social afetou de maneira diferente o estado antropométrico de mulheres e homens, com perfis corporais afetados também pela raça/cor da pele, indicando o potencial de levar em conta a perspectiva interseccional ao investigar os possíveis determinantes sociais do fenômeno.

Resumen: El objetivo de este estudio fue evaluar la asociación entre posición social y estatus antropométrico de adultos brasileños de ambos sexos. Fue un estudio transversal, realizado usando datos de referencia recogidos entre 2008 y 2010, del Estudio Longitudinal Brasileño de Salud en Adultos (ELSA-Brasil), llevado a cabo en seis de las mayores capitales de estado brasileñas. Un total de 15.105 activos y jubilados, mujeres y hombres funcionarios públicos de 35 a 74 años de edad. Se definieron dos variables latentes mediante análisis de clases latentes: posición social y estatus antropométrico. Ambos constructos y análisis fueron evaluados separadamente por sexo. Las asociaciones fueron evaluadas usando una regresión logística multivariada con ajuste por edad, color de piel/raza autoinformado y estatus marital. Alrededor de un 44% de las mujeres y un 26% de los hombres fueron clasificados como con sobrepeso u obesos. La posición social tendió a ser más baja en mujeres (43,2%) y más alta entre hombres (40,4%). Las mujeres con más peso tenían más probabilidad de ser negras y mulatas/mestizas y las mujeres más delgadas tenían más probabilidad de ser blancas. En mujeres, tras el ajuste, se incrementó más el peso cuanto mayor decrecía la posición social (OR = 1,52; IC95%: 1,36-1,70), mientras en hombres el peso decrecía al igual que la posición social (OR = 0,87; IC95%: 0,76-0,99). La posición social afectó diferentemente al estatus antropométrico de mujeres y hombres, con los patrones corporales también estando afectados por etnicidad/color de piel, mostrando su potencialidad tomando en consideración la perspectiva transversal, cuando se está investigando los posibles determinantes sociales del fenómeno.

Impacto da capacitação de agentes comunitários de saúde em educação alimentar: aspectos metodológicos e potencialidades / Impact of the training of community health workers on food education: methodological aspects and potentialities / Impacto de la formación de agentes de salud de la comunidad en la educación alimentaria: aspectos metodológicos y potencialidades

Objetivo: analisar os aspectos metodológicos e as potencialidades do estudo "Impacto da capacitação de Agentes Comunitários de Saúde (ACS) em educação alimentar (EA) - Vitória/ES". Métodos: os ACS de 25 Unidades de Saúde (US) foram convidados e avaliados em Centro de Investigação Cardiovascular. Foram realizadas quatro etapas: Avaliação da saúde e nutrição dos ACS; Estudo qualitativo; Capacitação em EA; Reavaliação. Resultados: foram coletados dados bioquímicos e antropométricos, de consumo alimentar, exames clínicos, eletrólitos urinários e testes físicos. Estudo qualitativo realizado para levantamento da percepção dos ACS sobre o estudo. As US foram randomizadas em dois grupos (intervenção e controle). O grupo intervenção participou de uma capacitação em EA, tendo como base o Guia Alimentar para a População Brasileira. Ao final da capacitação, os ACS foram reavaliados para identificar mudanças nas condições de saúde. Conclusão: este estudo pode contribuir para o planejamento, monitoramento e avaliação de ações específicas na atenção primária

Objective: to analyze the methodological aspects and the potentialities of the study "Impact of Training of Community Health Workers (CHW) in Food Education (FE) - Vitória/ES". Methods: the CHW of 25 Health Units (HU) were invited and evaluated at the Cardiovascular Research Center. Four steps were performed: Health and nutrition assessment of CHW; Qualitative study; Training in FE; Revaluation. Results:biochemical and anthropometric data, food consumption, clinical exams, urinary electrolytes and physical tests were collected. Qualitative study was done to survey the perception of CHW about the study. HU were randomized into two groups (intervention and control). The intervention group participated in a training in FE, based on the Food Guide for the Brazilian Population. At the end of the training, all CHW were reevaluated to identify changes in health conditions. Conclusion: this study can contribute to the planning, implementation, monitoring and evaluation of specific actions in primary care

Objetivo: analizar los aspectos metodológicos y las potencialidades del estudio "Impacto de la capacitación de Agentes Comunitarios de Salud (ACS) en educación alimentaria (EA) - Vitória/ES". Métodos: el ACS de 25 Unidades de Salud fue invitado y evaluado en el Centro de Investigación Cardiovascular. Se dieron cuatro pasos: Evaluación de la salud y nutrición; Estudio cualitativo; Entrenamiento en EA; Reevaluación. Resultados:se recogieron datos bioquímicos y antropométricos, consumo de alimentos, exámenes clínicos, electrolitos urinarios y pruebas físicas. Se realizó un estudio cualitativo para evaluar la percepción de la ACS sobre el estudio. Se aleatorizaron en dos grupos (intervención y control). El grupo de intervención participó en un entrenamiento basado en la Guía de Alimentos para la Población Brasileña. Al final de la capacitación, los ACS fueron reevaluados para identificar cambios en las condiciones de salud. Conclusión: este estudio puede contribuir a la planificación, monitoreo y evaluación de acciones en atención primaria

Mortality, sarcopenic obesity, and sarcopenia: Frailty in Brazilian Older People Study - FIBRA - RJ

ABSTRACT OBJECTIVE To investigate the risk of mortality associated with sarcopenic obesity (SO), obesity (OB), and sarcopenia in elderlies. METHODS We analyzed longitudinal data from 270 participants > 65 years of age of Phase III of the Study on Frailty in Brazilian Older People (FIBRA-RJ-2012). Socioeconomic, demographic, lifestyle, morbidity, and functional data were collected by home based interviews. DXA and body composition assessment was conducted in a laboratory. In women, OB was diagnosed when body fat percentage ≥ 38% and sarcopenia by an Appendicular Lean Mass Index (ALMI) < 6.00 kg/m2 and muscle strength < 16 Kgf. In men, OB was diagnosed when body fat percentage ≥ 27%, and sarcopenia was diagnosed with ALMI < 7.00 kg/m2 and muscle strength < 27 Kgf. SO was assessed by combining variables used to diagnose obesity and sarcopenia. The probabilistic linkage method was used to obtain deaths in the 2012-January 2017 period from the Brazilian Mortality Registry. Cox regression models were tested, and crude and adjusted hazard ratio calculations were conducted. RESULTS After adjusting for sex, age, race/skin color, walking as an exercise, and hypertension, individuals with sarcopenia were 5.7 times more likely to die (95%CI: 1.17-27.99) than others without sarcopenia and obesity. CONCLUSION A high risk of death was observed in individuals with sarcopenia. These results show the need for preventive strategies of early detection and treatment in order to increase survival employing multimodal interventions.

Birth weight and body fat mass in adults assessed by bioimpedance in the ELSA-Brasil study / Peso ao nascer e adiposidade em adultos avaliados com bioimpedância no estudo ELSA-Brasil / Peso al nacer y masa de grasa corporal en adultos evaluados por bioimpedancia en el estudio ELSA-Brasil

Intrauterine life is a critical period for the development of body fat and metabolic risk. This study investigated associations between birth weight and total and truncal body fat in adults. To do so, we analyzed data on 10,011 adults participating in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) who self-reported birth weight as < 2.5kg, 2.5-4.0kg, or > 4.0kg at baseline (2008-2010) and underwent bioimpedance in the next follow-up visit (2012-2014). Greater mean total and truncal fat mass were seen in those with high birth weight compared with adequate birth weight (p < 0.001) in both sexes (total fat: 25.2 vs. 23.1kg in men and 31.4 vs. 27.7kg in women, and truncal fat: 13.5 vs. 12.4kg in men and 15.9 vs. 14.2kg in women). U-shaped patterns were observed in restricted cubic-spline analyses in the subset of 5,212 individuals reporting exact birth weights, although statistically significant only for those with high birth weight. In the whole sample, in comparing high to adequate birth weight, the latter predicted having a large (> 85 percentile) total and truncal fat mass, respectively: OR = 1.76, 95%CI: 1.37-2.25 (men) and OR = 1.86, 95%CI: 1.42-2.44 (women); OR = 1.68, 95% CI: 1.31-2.16 (men) and OR = 1.73, 95%CI: 1.31-2.28 (women). However, low birth weight predicted having a large (> 85 percentile) % truncal fat only in women (OR = 1.40, 95%CI: 1.03-1.91). In conclusion, in these men and women born in a period in which fetal malnutrition was prevalent, birth weight showed complex, frequently non-linear associations with adult body fat, highlighting the need for interventions to prevent low and high birth weight during pregnancy.

A vida intrauterina é um período crítico para o desenvolvimento da gordura corporal e risco metabólico. O estudo investigou as associações entre peso ao nascer e gordura corporal total e de tronco em adultos. Analisamos os dados de 10.011 participantes do Estudo Longitudinal de Saúde no Adulto (ELSA-Brasil), com peso ao nascer de < 2,5kg, 2,5-4,0kg ou > 4,0kg, autorrelatado na linha de base (2008-2010) e que fizeram exame de bioimpedância na visita seguinte (2012-2014). A gordura corporal total e de tronco mais elevada estava associada com peso ao nascer elevado, quando comparado ao peso adequado (p < 0,001) em ambos os sexos (gordura total: 25,2 vs. 23,1 kg em homens e 31,4 vs. 27,7kg em mulheres, e gordura de tronco: 13,5 vs. 12,4kg em homens e 15,9 vs. 14,2kg em mulheres). Foram observados padrões em "U" nas análises de splines cúbicos restritos, no subconjunto de 5.212 indivíduos que informaram o peso ao nascer com exatidão, embora com significância estatística apenas para aqueles com peso ao nascer alto. Na amostra total, o peso ao nascer alto (comparado com o adequado) predizia (> percentil 85) gordura corporal total e de tronco, respectivamente: OR = 1,76, IC95%: 1,37-2,25 (homens) e OR = 1,86, IC95%: 1,42-2,44 (mulheres); OR = 1,68, IC95%: 1,31-2,16 (homens) e OR = 1,73, IC95%: 1,31-2,28 (mulheres). Entretanto, baixo peso ao nascer predizia gordura de tronco elevada (> percentil 85) apenas nas mulheres (OR = 1,40, IC95%: 1,03-1,91). O estudo conclui que nesse grupo de homens e mulheres que nasceram numa época em que a desnutrição fetal era prevalente, o peso ao nascer mostrou associações complexas, frequentemente não lineares, com a gordura corporal na idade adulta, o que enfatiza a necessidade de intervenções para prevenir, durante a gestação, o baixo e alto peso ao nascer.

La vida intrauterina es un periodo crítico para el desarrollo de la masa de grasa corporal y riesgo metabólico. Investigamos las asociaciones entre peso al nacer y la grasa total y troncal en adultos. Analizamos datos de 10.011 adultos que participaron en el Estudio Longitudinal de Salud en Adultos (ELSA-Brasil) quienes autoinformaron de un peso al nacer < 2,5kg, 2,5-4,0kg, o > 4,0kg en la base de referencia (2008-2010) y experimentaron bioimpedancia en la siguiente visita de seguimiento (2012-2014). La mayor media de masa grasa total y troncal se observó en quienes tuvieron un alto peso al nacer, en comparación con quienes tuvieron un adecuado peso al nacer (p < 0,001) en ambos sexos (grasa total: 25,2 vs. 23,1kg en hombres y 31,4 vs. 27,7kg en mujeres, y grasa troncal: 13,5 vs. 12,4kg en hombres y 15,9 vs. 14,2kg en mujeres). Se observaron patrones en forma de "U" en análisis spline cúbicos restringidos en el subconjunto de 5.212 personas que informaron de sus pesos exactos al nacer, pese a que eran estadísticamente significativos solamente quienes tenían un alto peso al nacer. En toda la muestra con alto peso al nacer, comparada con el adecuado peso al nacer, se pronosticó contar con más masa grasa total y troncal (> percentil 85), respectivamente: OR = 1,76, IC95%: 1,37-2,25 (hombres) y OR = 1,86, IC95%: 1,42-2,44 (mujeres); OR = 1,68, IC95%: 1,31-2,16 (hombres) y OR = 1,73, IC95%: 1,31-2,28 (mujeres). No obstante, contar con un bajo peso al nacer predispuso a contar con más masa grasa troncal solamente en mujeres (> percentil 85) % (OR = 1,40, IC95%: 1,03-1,91). En conclusión, en estos hombres y mujeres nacidos durante un período en el que la malnutrición fetal era prevalente, el peso al nacer mostró frecuentemente asociaciones no lineales complejas, con grasa corporal en la etapa adulta, resaltando la necesidad de intervenciones para prevenir el bajo y el alto peso al nacer durante el embarazo.

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

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

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

Construção, desenvolvimento e avaliação de ações educativas via Mobile Health com foco na redução do consumo de sódio em uma instituição de ensino / Construction, development, and evaluation of educational actions via Mobile Health focusing on reduction of sodium consumption in an educational institution

Objetivo: Descrever o processo de construção e desenvolvimento de ações educativas via mHealth para redução de sódio e realizar avaliação do ponto de vista do receptor. Método: Estudo de intervenção com 155 adultos (20-59 anos) de uma instituição de ensino em Vitória-ES. Os participantes foram contatados por exposição a banner, convite face to face e mídia eletrônica. Após primeira coleta de dados, os participantes foram randomizados em dois grupos: Intervenção (GI) e Controle (GC). Dados socioeconômicos, de saúde e práticas alimentares foram obtidos antes e após a intervenção. Foram elaboradas 21 mensagens e três vídeos focados na redução de sódio, enviadas por aplicativo WhatsApp® ou e-mail, durante três meses. Testes adequados, segundo o delineamento da amostra, foram aplicados utilizando o software SPSS 23, adotando-se nível de significância de 5%. Resultados: Na linha de base, não foram observadas diferenças significativas entre grupos de alocação. Cerca de 70% dos participantes do GI relataram que as mensagens foram úteis, claras e objetivas; 50% relataram que as mensagens ajudaram a realizar escolhas alimentares mais saudáveis e 47% disseram que seguiram as sugestões propostas. Mais de 60% do GI relataram que adotaram hábitos alimentares mais saudáveis, enquanto no GC as respostas foram associadas à prática de "dietas da moda". Esses resultados mostram a importância da utilização de ações educativas baseadas em conhecimento científico e na adoção de práticas alimentares saudáveis. Conclusão: A maioria dos participantes identificou a estratégia mHealth como de fácil compreensão e útil, bem como foram mais expostos à informação sobre alimentação saudável. (AU)

Objective: Describe the process of construction and development of educational actions through mHealth aiming sodium reduction and accomplishment of evaluation from the receptor's point of view. Methods: Interventional study accomplished within 155 adults from 20 to 59 years old from a public institution in Vitória-ES. The participants were approached through banners, face to face invitations and electronic medias. After the first data collection the participants were randomized into two groups: Intervention (GI) and control (GC). Socioeconomic data about health and eating habits were obtained before and after the intervention. 21 messages and 3 videos focusing on the sodium reduction were prepared and sent via Whatsapp or email for 3 months. Appropriate tests, according to the sample's design, were applied using the software SPSS 23 with a significance level of 5%. Results: On the baseline were not observed significant differences between the allocation groups. Nearly 70% of the GI participants reported that the information was useful, clear and objective; 50% reported that the messages helped them to do healthier eating choices and 47% claimed that they followed the suggestions that were proposed to them. More than 60% of GI reported that they have adopted healthier eating habits while in GC the reports were related to the execution of ''trending diets''. These results show the importance of the use of educational actions based on scientific knowledge and adoption of healthy eating habits. Conclusion: Most of the participants classified the mHealth strategy as a useful and easy understanding one, as well as they were exposed to health eating information. (AU)

Amount of physical activity necessary for a normal level of high-sensitivity C-reactive protein in ELSA-Brasil: a cross-sectional study

ABSTRACT BACKGROUND: Studies have shown that physical activity levels can be inversely associated with high-sensitivity C-reactive protein (hs-CRP) levels. However, the amount of physical activity required to maintain normal hs-CRP levels is still a matter for speculation. OBJECTIVE: To identify the amount of physical activity necessary to discriminate the hs-CRP levels in adults. DESIGN AND SETTING: Cross-sectional study at six teaching and research institutions. METHODS: The study sample comprised 10,231 adults aged 35 to 74 years who were participants in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Receiver operating characteristic (ROC) curves were constructed to compare the amount of physical activity in two domains (leisure time and commuting) with hs-CRP levels. The sensitivity and specificity were calculated to identify the best cutoff for physical activity level that would be needed to maintain normal levels of hs-CRP (< 3 mg/l). RESULTS: The area under the ROC curve was only statistically significant for discriminating normal levels of hs-CRP according to the amount of physical activity when the two study domains were added together. The accumulated physical activity level of 200 minutes/week was the best cutoff for discriminating normal levels of hs-CRP in adults of both sex. CONCLUSIONS: Physical activity in the leisure-time and commuting domains together, of duration 200 minutes/week, was associated with normal hs-CRP values.