Association between neonatal near miss and infant development: the Ribeirão Preto and São Luís birth cohorts (BRISA).

AIM: To analyze the association between neonatal near miss and infant development at two years. METHODS: Data from two birth cohorts, one conducted in Ribeirão Preto (RP)/São Paulo and the other in São Luís (SL)/Maranhão, were used. The cognitive, motor and communication development of children was evaluated using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). The following criteria were used for the definition of NNM: birth weight < 1,500 g, 5-min Apgar score < 7, gestational age < 32 weeks, and report of congenital malformations. The relationship between neonatal near miss and development was assessed using the weighted propensity score from the Inverse Probability of Treatment Weighting (IPTW). A directed acyclic graph was built to select the adjustment variables. RESULTS: A total of 1,050 mother-newborn dyads were evaluated in SL and 1,840 in RP. Regarding outcomes in SL and RP, respectively, 2.4% and 17.3% of the children were not competent in the cognitive domain, 12.1% and 13.3% in the receptive communication domain, 39.2% and 47.1% in the expressive communication domain, 20.7% and 12.6% in the fine motor domain, and 14.3% and 13.8% in the gross motor domain. The prevalence of neonatal near miss was 5.4% in SL and 4.3% in RP. Unadjusted analysis showed an association of neonatal near miss with fine motor development in SL and RP and with the cognitive, receptive communication, expressive communication, and gross motor domains only in RP. These associations remained after adjusted analysis. CONCLUSION: Neonatal near miss is a risk factor for developmental delays.

The consumption of culinary preparations and ultra-processed food is associated with handgrip strength in teenagers.

BACKGROUND: A nutrient-poor and hypocaloric diet may be associated with lower handgrip strength (HGS), whereas a high-quality or balanced diet may be associated with higher HGS. However, no study has used the NOVA system for classifying food by their degree of processing. OBJECTIVE: To analyze the association between food consumption according to the degree of food processing and HGS in Brazilian teenagers. METHODS: This cross-sectional study included teenagers aged 18 and 19 years old from the 1997/98 São Luís' birth cohort, Maranhão, Brazil. HGS (kilogram-force) was measured via a Jamar Plus + dynamometer. Food consumption was assessed using a semiquantitative food frequency questionnaire. The energy intake of culinary preparations (unprocessed or minimally processed food and processed culinary ingredients), processed, and ultra-processed foods was evaluated in percentages and categorized in tertiles. The associations between each food group intake and HGS was estimated via crude and adjusted linear regression models. A directed acyclic graph was used to identify confounding factors. RESULTS: We evaluated 2,433 teenagers, 52.1% of which were girls. For boys, adjusted analysis showed an association between the highest HGS and the 3rd tertile of culinary preparation consumption (ß: 1.95; 95%CI: 0.80; 3.10) and between the lowest HGS and the 3rd tertile of ultra-processed food consumption (ß: -2.25; 95%CI: -3.40; -1.10). Among girls, the consumption of culinary preparations in the 3rd tertile was associated with higher HGS (ß: 0.76; 95%CI: 0.05; 1.46). CONCLUSIONS: Higher consumption of culinary preparations and lower consumption of ultra-processed foods can contribute to reduce the chance of lower HGS in adult life. Interventions to promote the development and preservation of muscle strength should include dietary recommendations.

Association between violence and depression during pregnancy with perinatal outcomes: a moderated mediation analysis.

OBJECTIVE: To assess the direct, indirect, and total effects of violence during pregnancy on perinatal outcomes, and to evaluate the effect of violence as a moderator of the mediated relationship of depression with perinatal outcomes. METHODS: Data was collected from the prenatal study and follow-ups of the BRISA cohort, São Luís, Maranhão, Brazil. The perinatal outcomes investigated were: birth weight (BW), intrauterine growth restriction (IUGR) and gestational age (GA). Violence against women was evaluated using the World Health Organization Violence against Women instrument (Violence during pregnancy - regardless of the type of violence; Physical violence during pregnancy; Psychological violence during pregnancy). Depressive symptoms during pregnancy were evaluated as a mediating variable. Moderated mediation analysis was performed to estimate the effects of violence and depression on perinatal outcomes. RESULTS: Three types of violence analyzed by depression had an indirect effect in BW and GA. None of the types of violence showed an association with IUGR. All types of violence analyzed showed a moderated mediation effect with BW and GA. Only among women who experienced violence were birth weight and gestational age lower the higher the values of depressive symptoms. CONCLUSION: Violence and depression are only associated with lower BW and GA when they occur simultaneously.

Association between lower serum vitamin D (25-hydroxy-cholecalciferol) concentrations and cognitive impairment in older adults: data from a populational-based cohort study in a middle-income country.

OBJECTIVE: To investigate the association between serum vitamin D (25-hydroxy-cholecalciferol) (25(OH)D) concentrations and cognitive impairment in older adults living in Southern Brazil. DESIGN: Cross-sectional analysis using data from the second follow-up wave of the populational-based EpiFloripa Aging Cohort Study was collected in 2013-2014. SETTING: Cognitive impairment was evaluated using the Mini-Mental State Examination (MMSE). Blood samples were collected to measure serum vitamin D concentrations using a chemiluminescent microparticle immunoassay. Vitamin D concentrations were distributed in quartiles (Q1: 4·0-20·7 ng/ml; Q2: 20·8-26·6 ng/ml; Q3: 26·7-32·0 ng/ml and Q4: 32·1-60·1 ng/ml), and its association with cognitive impairment was tested by crude and adjusted logistic regression (sociodemographic, behavioural and health aspects) using Q4 as a reference group. PARTICIPANTS: 200 men and 371 women aged 60 years or older participated in this study. RESULTS: The prevalence of probable cognitive impairment was 21·7 %. Those without cognitive impairment had a higher mean of vitamin D serum concentrations (26·8 v. 24·6, P = 0·014). In the crude analysis, only individuals in Q2 of vitamin D presented an increased risk for probable cognitive impairment compared with Q4 (highest quartile) (OR 2·65, 95 % CI 1·46, 4·81), remaining significant in the adjusted analysis (OR 6·04, 95 % CI 2·78, 13·13). While Q1 (lowest quartile) was not associated in the crude analysis, but when adjusted, an increased risk of cognitive impairment was observed. CONCLUSION: The lowest quartile of vitamin D was directly associated with probable cognitive impairment in older adults in Southern Brazil. More studies are needed to investigate whether maintaining adequate serum levels may represent a significant factor in preventing age-related neurological disorders as well as to verify the need for new cutoff points for this age group.

Association between sleep duration and cardiometabolic factors in adolescents.

BACKGROUND: The sleep reduction can change healthy people's hemodynamic control and cardiovascular regulation through increased inflammatory response and altered endothelial function. The objective the study to analyze the association between sleep duration and cardiometabolic risk factors in adolescents in the birth cohort of São Luís (1997/98). METHODS: This is a cross-sectional study with adolescents participating in the birth cohort of São Luís (1997/98). Sleep duration was evaluated using accelerometer data (Actigraph wGT3X-BT). Glycemia, systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol, low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c) and triglycerides were considered cardiometabolic factors. The Directed Acyclic Graph (DAG) was used to identify the minimum set of adjustment for confounding. RESULTS: Out of 1,268 adolescents, 50.3% of them were male. The prevalence of sleep duration of less than 6 h per day was 31.1%. The mean glycemia value was 91.8 mg/dL (± 15.9), DBP was 71.3 mmHg (± 7.5), SBP was 114.9 mmHg (± 12.3), HDL was 48.5 mg/dL (± 11.6), LDL was 89.0 mg/dL (± 25.7), the total cholesterol was 156.0 mg/dL (± 31.1), and triglycerides was 93.6 mg/dL (± 47.2). The crude analysis showed an association between sleep duration and SBP and LDL-c. In the adjusted analysis, the associations did not remain. CONCLUSION: Our study showed no association between sleep duration and cardiometabolic outcomes in adolescents.

Lower serum 25-hydroxycholecalciferol is associated with depressive symptoms in older adults in Southern Brazil.

BACKGROUND: Older adults are one of the most susceptible populations to depression, especially those living in low- and middle-income countries. As well, they are also considering a risk group for vitamin D deficiency. Low serum vitamin D has been associated with an increased risk of brain neuropsychiatry disorders. We aimed to investigate the association between serum 25-hydroxycholecalciferol concentrations and depressive symptoms in adults aged 60 years and over from southern Brazil. METHODS: A cross-sectional analysis was performed using data collected during 2013-2014 from the populational-based longitudinal EpiFloripa Aging Study (n = 1197). Serum 25-hydroxycholecalciferol concentrations were analyzed and classified according to the Endocrine Society reference values [sufficiency (≥ 30 ng/mL), insufficiency (21-29 ng/mL), and deficiency (≤ 20 ng/mL)]. Depressive symptoms were evaluated using the Geriatric Depression Scale (15-item GDS). Logistic regression was performed to assess depressive symptoms in each vitamin D category. The analysis was adjusted for sex, age, skin color, family income, leisure-time physical activities, social or religious groups attendance, morbidities, cognitive impairment, and dependence in activities of daily living. RESULTS: A total of 557 participants with complete data for exposure and outcome were enrolled in the analysis. Most of the sample participants were female (63.1%), age-range 60-69 years (42.2%), white skin color (85.1%), and vitamin D serum level samples were collected in autumn (50.7%). Depressive symptoms were present in 15.8% of the participants, and the prevalence was higher in individuals classified as deficient in vitamin D (23.2, 95% confidence interval [CI] = 15.6;32.9) and insufficiency (17.2, 95%CI = 11.0;25.9). The crude analysis showed that vitamin D deficient participants had 3.08 (CI = 1.53;6.20) times higher odds to present depressive symptoms compared to vitamin D sufficiency. After adjusting, the association was maintained [OR 2.27 (95%CI = 1.05;4.94). CONCLUSIONS: Serum 25-hydroxycholecalciferol deficiency was positively associated with depressive symptoms in older adults from southern Brazil.

Influence of instrumental activities of daily living on the cognitive impairment: EpiFloripa study.

Objective: To investigate the influence of instrumental activities of daily living (IADL) on cognitive impairment of the older adults' population in southern Brazil.Methods: A longitudinal, population-based and home-based study that evaluates the older adults population (60 years or older) living in the city of Florianópolis, Southern Brazil. The sample at the baseline (2009/2010) was composed by 1,702 older adults. Cognitive impairment and IADL disability were investigated. A multilevel logistic model was used, in which the analyzed variables were included as the first level and time (baseline and follow-up interviews) as the second level variable.Results: The prevalence of cognitive impairment increased from baseline to follow-up. There was an increase in the chance of the older adults presenting cognitive impairment among those with low (OR: 1.5, 95% CI: 1.0-2.3) and moderate/severe disability (OR: 3.2, 95% CI: 2.1-4.9). Adjusted probability of presenting the outcome almost doubled among those with mild disability, and were nearly four times higher among the older adults with moderate/severe disability when compared to those without disability.Conclusions: IADL disability can be considered an indicator of risk for clinical diagnosis of cognitive impairment. Its evaluation and follow-up are of paramount importance, especially in the older adults with mild disability, in order to avoid the progression of functional and cognitive impairment over time.

Intimate partner violence during pregnancy and quality of life in Southern Brazil: a cross-sectional study, 2022.

OBJECTIVE: To analyze the association between intimate partner violence during pregnancy (IPVP) and quality of life (QOL). METHODS: A cross-sectional study was conducted with pregnant women receiving care in Primary Health Care in the municipality of Criciúma, Santa Catarina state, Brazil, in 2022; QOL was assessed in the physical, psychological, social relationship and environmental domains using WHOQOL-Bref instrument; IPVP was evaluated by means of the World Health Organization Violence Against Women; Crude and adjusted linear regression analyses were performed. RESULTS: A total of 389 pregnant women were evaluated; IPVP was observed in 13.6% of cases; in the adjusted analysis, IPVP remained associated with physical, psychological and social relationship domains; pregnant women who experienced IPVP had a reduction in their QOL score by 9.77, 11.07 and 8.95 points, respectively, when compared to those who did not experience IPVP. CONCLUSION: IPVP was associated with poorer QOL in the physical, psychological and social relationships domains. Health services equipped to address and prevent violence against pregnant women are essential. MAIN RESULTS: Intimate partner violence (IPV) was observed in 13.6% of pregnant women and was associated with poorer quality of life in the physical, psychological and social relationship domains. IMPLICATIONS FOR SERVICES: The results emphasize the need for an intersectoral approach in addressing the issue, with specialized healthcare centers for situations of violence integrated with social assistance and public security. PERSPECTIVES: Development of intersectoral policies and actions that strengthen existing ones and ensure social and healthcare assistance to pregnant women victims of violence and their children, given the negative impact of IPVP on quality of life.

Is There an Association between Food Consumption According to the Degree of Processing and Body Image (Dis)satisfaction in Adolescents?

(1) Background: Adolescence is characterized by changes in eating habits, with increased consumption of ultra-processed foods and reduced intake of unprocessed or minimally processed foods, which can affect body image satisfaction. Thus, this study aims to verify the association of food consumption according to the degree of processing with body image (dis)satisfaction in adolescents from the 1997/1998 birth cohort of São Luís, Maranhão. (2) Methods: A cross-sectional study was conducted with 2515 adolescents aged between 18 and 19. Food consumption was stratified based on the NOVA classification in culinary preparations, processed foods, and ultra-processed foods, categorized into tertiles. Body image (dis)satisfaction was evaluated based on the Stunkard Body Scale and was classified as satisfaction, dissatisfaction with thinness, and dissatisfaction with excess weight. Multinomial logistic regression was used for associations. (3) Results: Among the adolescents, 77% considered themselves dissatisfied with their body image, with 42.8% dissatisfied with being thin and 34.2% dissatisfied with excess weight. However, food consumption, according to the degree of processing, was not associated with body image (dis)satisfaction. (4) Conclusion: This work highlighted the prevalence of body image dissatisfaction among adolescents but found no association between body (dis)satisfaction and food consumption according to the degree of processing.

[Do depressive symptoms, anxiety and stressful symptoms during pregnancy affect gestational weight gain?] / Sintomas depressivos, ansiedade e os sintomas estressantes durante a gravidez afetam o ganho de peso gestacional?

The scope of this article is to estimate the effects of symptoms of mental disorders during pregnancy (depressive symptoms, anxiety and stress) on gestational weight gain (kg). It is a longitudinal study, carried out with data from the BRISA Birth Cohort, which was launched in 2010 in São Luís, Maranhão. Gestational weight gain was classified according to the Institute of Medicine. The independent variable was a construct (latent variable) referred to as symptoms of mental disorders, made up of the depressive symptoms, anxiety and stressful symptoms variables (all on an ongoing basis). Structural equation modeling was used to investigate the association between mental health and weight gain. Regarding the association between symptoms of mental disorders and weight gain during pregnancy, no total effect was found (PC=0.043; p=0.377). Regarding indirect effects, no effect was found either through risk behaviors (PC=0.03; p=0.368) or through physical activity (PC=0.00; p=0.974). Finally, the data did not show a direct effect of symptoms of mental disorders during pregnancy such as gestational weight gain (PC=0.050; p=0.404). Gestational weight gain had no direct, indirect or total effect on symptoms of mental disorders in pregnant women.

O objetivo deste artigo é estimar os efeitos dos sintomas de transtornos mentais na gravidez (sintomas depressivos, ansiedade e estresse) no ganho de peso gestacional. Estudo longitudinal, realizado com dados da Coorte de nascimento BRISA, iniciada em 2010 em São Luís, Maranhão. O ganho de peso gestacional foi classificado de acordo com Institute of Medicine. A variável independente foi um construto (variável latente) nomeado de sintomas de transtornos mentais, englobando as variáveis sintomas depressivos, a ansiedade e os sintomas estressantes (todas de forma contínua). Utilizou-se modelagem de equações estruturais, a fim de investigar a associação entre a saúde mental e ganho de peso. Em relação a associação entre sintomas de transtornos mentais e ganho de peso na gestação, não se encontrou efeito total (CP=0,043; p=0,377). Em relação aos efeitos indiretos, também não se encontrou efeito através dos comportamentos de risco (CP=0,03; p=0,368) e através da atividade física (CP=0,00; p=0,974). Finalmente os dados não evidenciaram efeito direto dos sintomas de transtornos mentais durante a gravidez como o ganho de peso gestacional (CP=0,050; p=0,404). O ganho de peso gestacional não apresentou efeito direto, indireto e total nos sintomas de transtornos mentais de gestantes.

High Consumption of Sugar-Sweetened Beverages Is Associated with Low Bone Mineral Density in Young People: The Brazilian Birth Cohort Consortium.

Sugar-sweetened beverages (SSB) consumption may be associated with a reduction in bone mineral density (BMD). The aim of this study was to evaluate the association between the consumption of SSB and BMD among young people. We performed a cross-sectional study that evaluated 6620 young people (18-23 years of age) from three Brazilian birth cohorts (Ribeirão Preto, Pelotas, and São Luís). We analyzed the daily frequency and the amount and energy contribution of the SSB, which were obtained through a food frequency questionnaire. Total body and lumbar spine BMD (g/cm2), measured by dual-energy X-ray absorptiometry, were the outcomes. Unadjusted linear regression models, adjusted for sex, socioeconomic class, physical activity, smoking, alcohol consumption, and body mass index were used. The highest tertile of SSB consumption frequency (2.1-16.7 times/day) was associated with a lower lumbar spine BMD (ß = -0.009; 95% CI: -0.017; -0.001; standardized ß = -0.03). This association persisted after adjustment for confounders (ß = -0.008; 95% CI: -0.016; -0.001; standardized ß = -0.03). No association was observed between SSB consumption frequency and total body BMD or between the amount and energy contribution of SSB and total body or lumbar spine BMD. A high frequency of SSB consumption was associated with a low lumbar spine BMD.

Sleep characteristics and excessive daytime sleepiness in adolescents and adults: results from the birth cohorts of three Brazilian cities - RPS Consortium.

OBJECTIVE: To describe the prevalence of insufficient sleep duration, long sleep latency, terminal or maintenance insomnia, subjective sleep quality, and excessive daytime sleepiness among participants of birth cohorts conducted in three Brazilian cities, and to evaluate differences in prevalence rates within cohorts according to sociodemographic characteristics. METHODS: Cross-sectional analyses involving adolescents and adults participating in four birth cohorts conducted in Ribeirão Preto (RP78 and RP94), Pelotas (PEL93) and São Luís (SL97/98). Sleep duration, latency, terminal or maintenance insomnia, and subjective sleep quality were obtained through the Pittsburgh Sleep Quality Index; and excessive daytime sleepiness was assessed using the Epworth Sleepiness Scale. Differences in the prevalence of the outcomes were analyzed in each cohort according to sociodemographic characteristics (skin color, marital status, socioeconomic status, study and working at the time of the interview) stratified by sex. RESULTS: Insufficient sleep duration was the most common outcome at the four cohorts, with higher frequency among men. Long latency was more frequently reported by young adult women in RP94 and PEL93 cohorts, and insomnia by women of the four cohorts, when compared to men of the same age. Women generally suffered more from excessive daytime sleepiness and evaluated the quality of their sleep more negatively than men. In addition to sex, being a student and working were associated with the largest number of outcomes in both sexes. CONCLUSION: Sleep disorders are more prevalent in women, reinforcing the need for greater investment in sleep health in Brazil, without disregarding gender and socioeconomic determinants.

Association between the consumption of omega-3-rich fish and depressive symptoms in older adults living in a middle-income country: EpiFloripa Aging cohort study.

This study aimed to verify the association between the consumption of omega-3-rich (n-3) fish and depressive symptoms in older adults living in Southern Brazil. This is a cross-sectional analysis with data from the second wave of the EpiFloripa Aging cohort study (2013/2014) including 1,130 individuals aged 60 years or older. The presence of depressive symptoms was measured by the 15-items Geriatric Depression Scale (GDS-15), and the consumption of n-3-rich fish by a question of weekly frequency. The minimum set of variables for adjustment was defined using directed acyclic graph (DAG). Poisson regression with robust error variance was applied (adjusted by Model 1: demographic and socioeconomic variables, Model 2: added behavioral variables, Model 3: added health variables). We identified the prevalence of depressive symptoms in 19% of older adults and 51.8% reported eating n-3-rich fish once a week. Models 1 and 3 showed an inverse association between n-3-rich fish and depressive symptoms. However, the association was reduced when behavioral factors (leisure-time physical activity) were included in Model 2. These findings suggest that n-3-rich fish intake tends to be associated with depressive symptoms in older adults. However, other factors, such as physical exercise, are as pivotal as n-3 fatty acids in preventing the development of depressive symptoms.

Association between physical activity and vitamin D is partially mediated by adiposity in older adults: EpiFloripa Aging Cohort Study.

Studies have found that physical activity (PA) could be a protective factor and adiposity a risk factor for low serum 25-hydroxycholecalciferol (25(OH)D) concentration. This cross-sectional study hypothesized that PA could have a direct effect on 25(OH)D, and adiposity could be a mediating factor. Data from the second wave of the EpiFloripa Aging longitudinal study, collected during 2013 and 2014 (n = 1197) in Florianopolis, Santa Catarina, Brazil, was used. PA was measured using an accelerometer and classified as light PA (LPA), moderate and vigorous PA (MVPA), and total PA (TPA); 25(OH)D levels were measured using the microparticle chemiluminescence method. Body fat composition (%fat) was assessed using dual-energy X-ray absorptiometry. Structural equation modeling was performed to analyze the total, direct, and indirect effects of PA on %fat and 25(OH)D levels, presented using the standardized coefficient (ß). Participants with complete data were included in the analysis (n = 574, 66.7% female). MVPA showed a direct (ß = 0.11; P < .05) and total positive effect on 25(OH)D (ß = 0.12; P < .05). All models of PA had a direct negative effect on %fat. Additionally, a direct negative effect of %fat on 25(OH)D was observed in all models. A marginal and partial effect of %fat as a mediator of the relationship between MVPA and 25(OH)D was noted (ß = 0.01, P = .09). Our results show that PA presents a direct effect on serum 25(OH)D. %fat has a small contribution as a mediator of this relationship. These data suggest that an increase in MVPA and a decrease in %fat could be strategies to increase 25(OH)D levels in older adults.

Is environment perception associated with change in leisure-time physical activity in Brazilian older adults? Results of EpiFloripa Idoso cohort study.

This study aims to analyze the association between perceived characteristics of the neighborhood environment and changes in leisure-time physical activity in Brazilian older adults. Longitudinal analysis was performed considering a population-based study carried out in 2009/2010 with follow-up in 2013/2014. Changes in leisure-time physical activity, obtained with the International Physical Activity Questionnaire during both waves, were associated with data of environment perception with the Neighborhood Environment Walkability Scale - Abbreviated (baseline only) performing multinomial logistic regression. In total, 1,162 older adults (65.2% women, mean age = 73.7 years) participated. Older adults who perceived flat streets, bicycle paths, and high flow of vehicles in the neighborhood were more likely to remain active in leisure time walking. Those who noticed the presence of flat streets also had a greater chance of becoming active than those who did not notice it. Older adults who perceived bicycle paths and sports events were more likely to maintain moderate and vigorous physical activity during leisure time. Furthermore, older adults who noticed parks and squares close to their residence were 0.49 times less likely to become insufficiently active. Brazilian older adults are more active in neighborhoods with more favorable attributes regarding leisure-time physical activity.

Association between perceived discrimination and physical activity among adolescents. / Associação entre discriminação percebida e atividade física entre adolescentes.

Perceived discrimination is a major producer of stress and social trauma and can have negative effects on the physical and mental health of those exposed to it. This study aims to analyze the direct and indirect association between perceived discrimination and physical activity, mediated by common mental disorders in adolescents. This is a cross-sectional study with 2,484 adolescents (aged 18 and 19 years old) from a cohort in São Luís, Maranhão. Structural equation models were used to verify the direct effect of perceived discrimination on physical activity (PA) and its indirect effect mediated by common mental disorders (CMD). The potential of sex to act as an effect-modifying variable was also tested. Discrimination was associated with higher levels of PA in women (SC - Standardized Coefficient direct =0.105, p-value=0.005), and indirectly associated with lower PA via CMT among men (SCindirect =-0.024, p-value=0.017) and women (SCindirect =-0.024, p-value=0.015). Our findings show the association between perceived discrimination and PA in this population of adolescents, attesting that its effects can alter health behaviors and that gender can modify the relation between these variables.

A discriminação percebida é um importante produtor de estresse e trauma social e pode ter efeitos negativos sobre a saúde física e mental das pessoas expostas a ela. Este estudo visa analisar a associação direta e indireta entre discriminação percebida e prática de atividade física, mediada por transtornos mentais comuns de adolescentes. Trata-se de pesquisa transversal, com 2.484 adolescentes (18 e 19 anos) de uma coorte de São Luís, Maranhão. Modelos de equações estruturais foram utilizados para verificar o efeito direto da discriminação percebida sobre a atividade física (AF) e seu efeito indireto mediado pelos Transtornos Mentais Comuns (TMC). O potencial do sexo como variável modificadora de efeitos também foi testado. A discriminação percebida esteve associada a maiores níveis de AF nas mulheres (CP - Coeficiente padronizado direto =0,105, p-valor=0,005), e associada a menor AF por via indireta pelos TMC entre homens (CPindireto =-0,024, p-valor=0,017) e mulheres (CPindireto =-0,024, p-valor=0,015). Os achados mostram que nesta população de adolescentes houve associação entre discriminação percebida e AF, demonstrando que seus efeitos podem alterar comportamentos de saúde e o sexo pode modificar a relação entre essas variáveis.

Association of Food Intake with Sleep Durations in Adolescents from a Capital City in Northeastern Brazil.

(1) Background: During adolescence, there are significant changes in food consumption, such as reducing the consumption of in natura or minimally processed foods and increasing the consumption of ultra-processed foods. Thus, eating habits can influence sleep duration and, consequently, affect the quality of life of young people. This study thus aims to estimate the association of consumption of in natura or minimally processed, processed, and ultra-processed foods with sleep durations in adolescents. (2) Methods: This is a cross-sectional study including 964 adolescents (18 to 19 years old) from the 1997 to 1998 birth cohort in São Luís, Maranhão. Food consumption was assessed using the food frequency questionnaire (FFQ) and stratified based on the NOVA classification. Sleep duration was verified using accelerometry in hours. The analysis of the association between the consumption of in natura or minimally processed, processedand ultra-processed foods with sleep durations in adolescents used crude and adjusted linear regression (by gender, age, skin color, education, economic class, work, consumption of alcohol, smoking, screen time, physical activity, use of illicit drugs, anxiety, depressive symptoms, and lean and fat mass). A directed acyclic graph (DAG) was used to determine the minimum set of adjustment factors. (3) Results: Of the 964 individuals evaluated, 52.0% were female. The mean sleep duration was 6 h (± 0.95). In the crude and adjusted analyses, no association was observed between food consumption according to the degree of processing and adolescent sleep durations. (4) Conclusion: There was no association between the consumption of in natura or minimally processed, processed, and ultra-processed foods with sleep durations.

[Associations between sleep duration and fat mass, lean mass, and body mass index in adolescents in São Luís, Maranhão State, Brazil]. / Associações entre duração de sono e índices de massa gorda, muscular e corporal em adolescentes de São Luís, Maranhão, Brasil.

The study aimed to assess the association between sleep duration and body composition in adolescents. A cross-sectional study was performed with 1,269 adolescents from the 1997/1998 birth cohort in São Luís, Maranhão State, Brazil, 18 and 19 years of age. Sleep duration was assessed with accelerometry data. Body composition was assessed with fat mass index (FMI), lean mass index (LMI), and body mass index (BMI). Confounding factors were identified in a directed acyclic graph in DAGitty 3.0. Descriptive analyses were performed for all variables, followed by linear regression, with estimation of crude and adjusted regression coefficient with respective 95% confidence intervals (95%CI). In adolescent boys, each additional hour of sleep was associated with reductions of 0.30kg/m2 in LMI (95%CI: -0.45; -0.15), 0.26kg/m2 in FMI (95%CI: -0.48; -0.03), and 0.61kg/m2 in BMI (95%CI: -0.93; -0.30). In adolescent girls, each additional hour of sleep was associated with a reduction of 0.22kg/m2 in LMI (95%CI: -0.36; -0.07). Longer duration of sleep was associated with lower LMI in both sexes and lower FMI and BMI in boys, evidencing the importance of adequate hours of sleep for improving body composition indices.

O objetivo do estudo foi avaliar a associação entre duração de sono e composição corporal em adolescentes. Estudo transversal, com 1.269 adolescentes de 18 e 19 anos da coorte de nascimentos de 1997/1998 de São Luís, Maranhão, Brasil. A duração do sono foi avaliada a partir dos dados registrados por acelerometria. A composição corporal foi avaliada pelo o índice de massa gorda (IMG), índice de massa muscular (IMM) e índice de massa corporal (IMC). Os fatores de confusão foram identificados em gráfico acíclico direcionado no programa DAGitty 3.0. Foram realizadas análises descritivas para todas as variáveis e, posteriormente, regressão linear, com estimativa dos coeficientes de regressão brutos e ajustados, com os respectivos intervalos de 95% de confiança (IC95%). Nos adolescentes do sexo masculino, cada hora a mais de sono associou-se a reduções de 0,30kg/m2 do IMM (IC95%: -0,45; -0,15), de 0,26kg/m2 do IMG (IC95%: -0,48; -0,03) e 0,61kg/m2 do IMC (IC95%: -0,93; -0,30). Nas adolescentes, cada hora a mais de sono associou-se à redução de 0,22kg/m2 do IMM (IC95%: -0,36; -0,07). A maior duração do sono associou-se a menor IMM em ambos os sexos e menor IMG e IMC no sexo masculino, o que evidencia a importância de ter adequadas horas de sono para melhorar os índices de composição corporal.

El objetivo fue evaluar la asociación entre duración del sueño y composición corporal en adolescentes. Estudio transversal, con 1.269 adolescentes de 18 y 19 años de la cohorte de nacimientos de 1997/1998 de São Luís, Maranhão, Brasil. La duración del sueño se evaluó a partir de los datos registrados por acelerometría. La composición corporal se evaluó por el índice de masa grasa (IMG), índice de masa muscular (IMM) e índice de masa corporal (IMC). Los factores de confusión se identificaron en un gráfico acíclico dirigido en el programa DAGitty 3.0. Se realizaron análisis descriptivos para todas las variables y, posteriormente, regresión lineal, con estimación de los coeficientes de regresión brutos y ajustados, con los respectivos intervalos de 95% de confianza (IC95%). En los adolescentes del sexo masculino, cada hora más de sueño se asoció con reducciones de 0,30kg/m2 del IMM (IC95%: -0,45; -0,15), de 0,26kg/m2 del IMG (IC95%: -0,48; -0,03) y 0,61kg/m2 del IMC (IC95%: -0,93; -0,30). En las adolescentes, cada hora más de sueño se asoció a la reducción de 0,22kg/m2 del IMM (IC95%: -0,36; -0,07). La mayor duración del sueño se asoció a un menor IMM en ambos sexos y menor IMG e IMC en el sexo masculino, lo que evidencia la importancia de tener adecuadas horas de sueño para mejorar los índices de composición corporal.

Is sleep time associated with handgrip strength in adolescents from the 1997/1998 São Luís Birth Cohort?

This article aims to analyze the association between sleep time and handgrip strength in adolescents belonging to the 1997/1998 São Luís Birth Cohort. This was a cross-sectional study nested in a birth cohort study. One thousand two hundred sixty-nine individuals (18 and 19 years) wore an Actigraph® GTX3+ accelerometer on their wrist 24 hr/day for 7 consecutive days. Handgrip strength was measured using a digital hand dynamometer. We used directed acyclic graphs (DAG) to identify confounding variables. This sample of adolescents was mostly composed of men, with brown skin color, economic class C, which did not work, did not consume alcohol, did not smoke, and never used drugs. The mean value of handgrip strength was 28.2 (±9.3) kgf, and the mean of sleep time was 6 (±1.0) hours per day. The crude analysis showed an association between sleep time and muscle strength. An increase of one hour of sleep reduced the handgrip strength by 1.95 kgf (95%CI:-2.51;-1.39). However, after adjustment for confounders, the association was not maintained (ß:-0.07; 95%CI:-0.48;0.36). Sleep time is not associated with handgrip strength in adolescents in São Luís.

The Frequency of Daily Consumption of Sugar-Sweetened Beverages Is Associated with Reduced Muscle Mass Index in Adolescents.

The consumption of sugar-sweetened beverages (SSBs) has increased in recent years and has become a cause of concern because these beverages pose a risk to human health. Thus, we evaluated the association between SSBs consumption and muscle mass index (MMI) in adolescents. This cross-sectional study evaluated 2393 adolescents (18/19-years-old). Consumption of SSBs was analyzed based on the frequency of daily consumption and energy contribution categorized into tertiles. MMI was examined using the ratio of muscle mass (kilograms) to height (meters squared). The highest tertile of the frequency of daily SSB intake was associated with a reduced MMI in men (ß = -0.31; 95%CI: -0.60, -0.01) and women (ß = -0.24; 95%CI: -0.45, -0.02). However, these associations were not observed after adjusting for sugar contained in SSBs in men (ß = -0.26; 95%CI: -0.69, 0.17) and for carbohydrate, lipid, and protein intake in women (ß = -0.19; 95%CI: -0.42, 0.04). The highest energy contribution tertile of SSBs was associated with a reduced MMI in male adolescents (ß = -0.34; 95%CI: -0.64, -0.04). This association was not observed after adjusting for intake of sugar in SSBs (ß = -0.38; 95%CI: -0.75, 0.01). The frequency of daily consumption of SSBs was considered a risk factor for decreased MMI in both sexes, and the energy contribution of these drinks was a risk factor for MMI reduced only in male adolescents.