Knee pain prevalence and associated factors in a Brazilian population study.

OBJECTIVES: To estimate the association among knee pain and central obesity. METHODS: A cross-sectional study was carried out in Salvador, Brazil, with a sample of 2,297 individuals ≥20 years of age. A standardized questionnaire was applied at home to collect data about pain, sociodemographic characteristics and abdominal circumference measurement. Unadjusted (bivariate analysis) and adjusted odds ratio (OR) and 95%CI were estimated by using backward stepwise logistic regression. RESULTS: The prevalence of knee pain was found in 11.2% of the studied sample. Unadjusted OR associations (P<0.1) were found for male (OR 2.70, CI [confidence interval] 2.01-3.63), older age (OR 2.98, CI 1.89-4.42), and obesity (OR 1.62, CI 1.22-2.15). Adjusted ORs (P<0.05) were found for obesity-married individuals (OR 4.69, CI 1.09-20.11), separated (OR 11.03, CI 2.09-58.20) or widowed (OR 7.17, CI 1.40-36.61), and male (OR 2.35, CI 1.25-4.41). The OR of nonobese men was 2.66, CI 1.74-4.06, but being married seems to protect them of knee pain (OR 0.66, CI 0.45-0.96). CONCLUSION: In this study, we found a knee pain prevalence of 11.2% and positive association with the male gender, married, separated or widowed, and a protective association for knee pain in nonobese married male. Aging, obesity, and excessive alcohol consumption were independent correlates of knee pain in the studied population sample.

[Waist-height ratio compared to other anthropometric indicators of obesity as predictors of high coronary risk]. / Razão cintura/estatura comparado a outros indicadores antropométricos de obesidade como preditor de risco coronariano elevado.

OBJECTIVE: This study compares the waist-height ratio (WHTR) with other anthropometric indicators of obesity: waist circumference (WC), waist-to-hip ratio (WHR), conicity index (Index C), and body mass index (BMI)) to discriminate the level of coronary risk (HCR). METHOD: A cross sectional study of a subgroup of participants in the project 'Monitoring of Cardiovascular Diseases and Diabetes in Brazil' (MONIT) was carried out in Salvador, Brazil (2000). The total sample comprised 968 persons (391 male and 577 female), 30 to 74 years of age. Initially the total area under the ROC curve between the Index C, WHR, WHTR, WC, BMI and HCR was identified while using a 95% confidence interval. Sensitivity and specificity were next calculated. Analyses were carried out using STATA 7.0 program. RESULTS: Areas under the ROC curves used as indicators of obesity were Index C 0.80, WHR 0.76, WHTR 0.76, WC 0.73, and BMI 0.64 for men and Index C 0.75, WHR 0.75, WHTR 0.69, WC 0.66 and BMI 0.59 for women. CONCLUSION: Indicators of abdominal obesity are better for discriminating HCR than the usual obesity indicator (BMI). Values of WHTR are closer to those found in other studies. Further, WHTR is a measurement with statistical significance whose use is justified.

The metabolic syndrome in Spanish migrants to Brazil: unexpected results.

A cross-sectional study was performed involving epidemiological and clinical features of the metabolic syndrome (MS) in Spanish migrants to Brazil and their descendants. This included 479 subjects: Group A (Spanish migrants): n=215; Group B (descendants born in Brazil of Spanish parents): n=126, Group C (mixed descendants born in Brazil with either father or mother born in Spain): n=138. MS was defined according to the original NCEP/ATP III criteria and by the revised NCEP/ATP definition (glucose>or=100mg/dl). Overall prevalence of MS according to NCEP/ATP III criteria was 26.3%. Age/sex-adjusted prevalence was 27.4%. When the revised NCEP criteria were considered, overall prevalence was 30.1% (age/sex-adjusted 31.3%). The differences between the two criteria were 3.8% and 3.9% (CI -1.9-9.4%). When stratified by groups the MS was more prevalent in Group A (37.2%) and Group B (20.6%) than in Group C (10.9%). Environmental factors may have influenced the development of MS. Reason for the apparently protective role of genetic features due to admixture between populations in the mixed descendants needs to be explored.

[Birth weight as predictor for the severity of neonatal brain white matter lesion]. / Peso de nascimento como preditor para a gravidade da lesão da substância branca cerebral neonatal.

To analyze the association of natal factors with the severity of neonatal brain white matter lesion (WML) by controlling the birth weight, we identified newborns with WML who were divided into: those with WML evolution towards resolution of the ultrasound image (less severe), and those who evolved with cist formation and/or ventriculomegalia and/or hemorrhage (greater severity). There were differences among the twelve variables (hyponatremia, anemia, infection, retinopathy, broncopulmonary dysplasia, hypoalbuminemia, persistence of the arterial canal, altered audiometry, early respiratory distress, birth weigh below 2,500 g, weight per category, and prematurity) between the two groups (p<0.05), being that nine variables (hyponatremia, infection, retinopathy, hypoalbuminemia, persistence of the arterial canal, early respiratory distress, low weight, prematurity, and weight per category) remained statistically different (p<0.01) after the logistic regression analysis. When the variables were analyzed by birth weight category none of them presented statistical significance. This study suggests that birth weight is the major factor--likely the only one--associated to the severity of neonatal brain white matter lesion.

Cranial Doppler resistance index measurement in preterm newborns with cerebral white matter lesion.

OBJECTIVE: To investigate whether the resistance index (RI) within the first 72 hours of life of newborn infants with cerebral white matter lesion (WML) is correlated with the adverse outcome of WML. METHODS: Retrospective study. Newborn infants with WML were identified based on cranial ultrasound results, and those with Doppler imaging and RI measurement were selected. The newborn infants were placed in three groups: low (< 0.61), normal (0.61-0.85) or high (> 0.85) RI. The sample was analyzed as a whole at first and then stratified according to birth weight. RESULTS: According to the RI, cerebral blood flow was abnormal in 46 (68.7%) patients, low in 42 (62.7%), and high in four (6%). Among those with a low RI, 15 (35.7%) had an adverse outcome, with ultrasonographic signs of cerebral atrophy in 10 (23.8%) and intraventricular hemorrhage in five (11.9%) patients. The four newborn infants with a high RI also had an adverse outcome, one (25%) with signs of cerebral atrophy and three (75%) with intraventricular hemorrhage. No statistically significant differences were observed between RI groups and the group with a fatal outcome. CONCLUSION: The study showed that abnormal RI within the first 72 hours was associated with healing complications in newborn infants with cerebral WML. Abnormal RI results were not correlated with the fatal outcome. Therefore, RI is an important parameter that should be measured in newborn infants.

[Waist-to-height ratio as a coronary risk predictor among adults]. / Razão cintura-estatura como discriminador do risco coronariano de adultos.

BACKGROUND: This study proposes to identify the sensibility, specificity and the best cut-off point for waist-to-height ratio (WHtR) as a predictor of coronary high risk (CHR). METHODS: A cross-sectional study was applied to a population comprised of 968 adults between 30 and 74 years of age, of which 391 (40.4%) were male. Receiver Operating Characteristic (ROC) curves were employed to identify the sensibility and specificity of the best cut-off point for WHtR as a predictor of CHR. The statistical significance of the area under ROC curve was also verified using a confidence interval (CI) of 95%. RESULTS: The total area under ROC curve between WHtR and coronary risk was 0.75, CI 95% (0.70-0.81) for men and 0.69, CI 95% (0.64-0.75) for women. For men, 0.52 was found to be the best cut-off point for predicting CHR (sensibility 68% and specificity 64%). Among women, 0.53 was the best cut-off point for discriminating CHR (sensibility 67% and specificity 58%). CONCLUSIONS: Results suggest that the WHtR may be employed to identify CHR and must be compared to other anthropometric indicators of obesity.

[Prevalence and variables associated with leisure-time sedentary lifestyle in adults]. / Prevalência e fatores associados ao sedentarismo no lazer em adultos.

This study focused on the prevalence and determinants of leisure-time sedentary lifestyle in the city of Salvador, Bahia, Brazil. A cross-sectional design was used in a sample of 2,292 adults > or = 20 years of age, of whom 1,271 (55.0%) were females. Leisure-time sedentary lifestyle was defined by individuals who, in a live interview, stated that they performed no physical activity during their leisure time in a normal week. Initially, total prevalence of leisure-time sedentary lifestyle in the study population was calculated by variables associated and stratified by sex. Then, the prevalence ratio between leisure-time sedentary lifestyle, age, schooling, and marital status stratified by sex was calculated. A 95% confidence interval was used. Prevalence of leisure-time sedentary lifestyle was 72.5% and was more frequent in women 40-50 years of age and men over 60, individuals with limited schooling, and married, separated, and widowed individuals. The findings are relevant for public health, since they can be used both to identify high levels of leisure-time sedentary lifestyle in the Brazilian population as well as the determinants, thus allowing new intervention strategies to be implemented.

[Anthropometric indexes of obesity as an instrument of screening for high coronary risk in adults in the city of Salvador--Bahia]. / Indicadores antropométricos de obesidade como instrumento de triagem para risco coronariano elevado em adultos na cidade de Salvador--Bahia.

OBJECTIVE: To compare some anthropometric indexes of obesity and identify among them which one best discriminates the high coronary risk (HCR). METHODS: A cross-section study, with sample consisting of 968 adults, between 30 and 74 years old, being 391 (40.4%) men. Many Receiver Operating Characteristic (ROC) curves were obtained and compared to areas under them among the conicity index (C index), body mass index (BMI), waist-hip circumference ratio (WHCR), waist circumference (WC) and HCR. The sensitivity and specificity to identify and compare the best cut-off point among the many indexes of obesity to discriminate the HCR were also identified. A confidence interval of 95% was used. RESULTS: The largest area under ROC curve was found between the C index and the HCR, in individuals of male sex, 0.80 (0.74-0.85), significantly differing from the other indexes of obesity. In women, the largest area found under the ROC curve was 0.76 (0.71-0.81), being equal between C, WHCR and HCR indexes. CONCLUSION: Those results show that C and WHCR indexes are the best indexes of obesity to discriminate HCR. WC has intermediate discriminatory power and the BMI was the least suitable anthropometric index of obesity to discriminate HCR. Those data suggest that the indexes of abdominal obesity are better to discriminate HCR than the indexes of general obesity.

Social inequality and depressive disorders in Bahia, Brazil: interactions of gender, ethnicity, and social class.

We conducted a study of the association between gender, race/ethnicity, and social class and prevalence of depressive disorders in an urban sample (N = 2302) in Bahia, Brazil. Individual mental health status was assessed by the PSAD/QMPA scale. Family SES and head of household's schooling and occupation were taken as components for a 4-level social class scale. Race/ethnicity (white, moreno, mulatto, black) was assessed with a combination of self-designation and a system of racial classification. The overall 12-month prevalence of depressive symptoms was 12%, with a female:male ratio of 2:1. Divorced/widowed persons showed the highest prevalence and single the lowest. There was a negative correlation with education: the ratio college educated:illiterate was 4:1. This gradient was stronger for women than men. There was no F:M difference in depression among Whites, upper-middle classes, college-educated, or illiterate. Prevalence ratios for single, widowed and Blacks were well above the overall pattern. Regarding race/ethnicity, higher prevalences of depression were concentrated in the Moreno and Mulatto subgroups. There was a consistent social class and gender interaction, along all race/ethnicity strata. Three-way interaction analyses found strong gender effect for poor and working-class groups, for all race/ethnicity strata but Whites. Black poor yielded the strongest gender effect of all (up to nine-fold). We conclude that even in a highly unequal context such as Bahia, Blacks, Mulattos and women were protected from depression by placement into the local dominant classes; and that the social meaning of ethnic-gender-generation diversity varies with being unemployed or underemployed, poor or miserable, urban or rural, migrant or non-migrant.

Alcohol drinking patterns by gender, ethnicity, and social class in Bahia, Brazil.

OBJECTIVE: To study patterns of alcohol consumption and prevalence of high-risk drinking. METHODS: A household survey was carried out in a sample of 2,302 adults in Salvador, Brazil. Cases of High-Risk Drinking (HRD) were defined as those subjects who referred daily or weekly binge drinking plus episodes of drunkenness and those who reported any use of alcoholic beverages but with frequent drunkenness (at least once a week). RESULTS: Fifty-six per cent of the sample acknowledged drinking alcoholic beverages. Overall consumption was significantly related with gender (male), marital status (single), migration (non-migrant), better educated (college level), and social class (upper). No significant differences were found regarding ethnicity, except for cachaça (Brazilian sugarcane liquor) and other distilled beverages. Overall 12-month prevalence of high-risk drinking was 7%, six times more prevalent among males than females (almost 13% compared to 2.4%). A positive association of HRD prevalence with education and social class was found. No overall relationship was found between ethnicity and HRD. Male gender and higher socioeconomic status were associated with increased odds of HRD. Two-way stratified analyses yielded consistent gender effects throughout all strata of independent variables. CONCLUSIONS: The findings suggest that social and cultural elements determine local patterns of alcohol-drinking behavior. Additional research on long-term and differential effects of gender, ethnicity, and social class on alcohol use and misuse is needed in order to explain their role as sources of social health inequities.

Trends in productive years of life lost to premature mortality due to coronary heart disease.

OBJECTIVE: To estimate the number of productive years of life lost to premature death due to coronary heart disease in Brazil and to report their trends over a 20-year period. METHODS: The Brazilian Ministry of Health raw database on death due to coronary heart disease from 1979-1998 was used. The productive years of life lost to premature death were estimated using 20 and 59 years of age as the cut points for the productive years, replacing the potential years of 1 and 70 of the original formula. A descriptive analysis was provided with adjustments, means, proportions, ratios, percentages of increase or reduction, and mobile means. RESULTS: A 35.8% increase in death for males and 51.3% for females was observed, +43.3% being the relative difference for females. The annual means of the productive years of life prematurely lost were analyzed in 140,865 males and 58,559 females, with the differential ratio between the age groups ranging from 2.3 to 2.5. The annual means were less favorable for males. Within each group (intragroup), the ratios decreased with the increase in age, and the age means at the time of death remained constant. The raw tendencies decreased in the 20- to 29-year age group and increased in the 40- to 59-year age group for females and the 40- to 49-year age group for males. When adjusted, the raw tendencies decreased. CONCLUSION: The 43.3% increase in the number of female deaths as compared with that of males and the ascending tendency in the productive years of life lost in the 40- to 59-year age group point to the influence of unfavorable changes in female lifestyles and suggest a deficiency in programs for prevention and control of risk factors and in their treatment in both sexes.

Medical care and deaths due to coronary artery disease in Brazil, 1980-1999.

OBJECTIVE: To estimate the frequency of medical care preceding deaths due to coronary artery diseases (CAD) in different Brazilian regions and capitals and to describe trends in medical care from 1980 to 1999. METHODS: Information on medical care preceding deaths due to coronary artery diseases/acute myocardial infarction in adults > 20 years from 1980 to 1999 was collected in the DATASUS, the databank of the Brazilian Health Ministry. Sex, states, and capitals selected for 1999 were analyzed in the study. Medical care was stratified as follows: with, without, and ignored medical care. The descriptive analysis comprised frequencies, ratios of frequency, test for proportions, and increments or reductions in frequencies. RESULTS: Acute myocardial infarction (AMI) represented 75 to 85% of the CAD in the period; the frequency of deaths with medical care ranged from 48.9 to 63%, and that of ignored medical care ranged from 27.2 to 41.5%. The frequency of other CAD with medical care ranged from 56 to 76%. The frequency of deaths preceded by medical care decreased by 17.8%, and that with ignored medical care increased by 36.5% (RF=2). The values for the other CAD were -20.2% and +64.6% (RF=44.4). Deaths preceded by medical care were more frequent in females at all ages and in all Brazilian regions. CONCLUSION: The results show a high frequency of sudden death and suggest errors in diagnosis or codification and overestimation of the statistics about mortality. Validation of the death certificate diagnosis and frequent surveillance are required.

Devices and techniques for blood pressure measurement and criteria for hypertension adopted by Brazilian physicians: exploratory study.

OBJECTIVE: To determine technical procedures and criteria used by Brazilian physicians for measuring blood pressure and diagnosing hypertension. METHODS: A questionnaire with 5 questions about practices and behaviors regarding blood pressure measurement and the diagnosis of hypertension was sent to 25,606 physicians in all Brazilian regions through a mailing list. The responses were compared with the recommendations of a specific consensus and descriptive analysis. RESULTS: Of the 3,621 (14.1%) responses obtained, 57% were from the southeastern region of Brazil. The following items were reported: use of an aneroid device by 67.8%; use of a mercury column device by 14.6%; 11.9% of the participants never calibrated the devices; 35.7% calibrated the devices at intervals < 1 year; 85.8% measured blood pressure in 100% of the medical visits; 86.9% measured blood pressure more than once and on more than one occasion. For hypertension diagnosis, 55.7% considered the patient's age, and only 1/3 relied on consensus statements. CONCLUSION: Despite the adequate frequency of both practices, it was far from that expected, and some contradictions between the diagnostic criterion for hypertension and the number of blood pressure measurements were found. The results suggest that, to include the great majority of the medical professionals, disclosure of consensus statements and techniques for blood pressure measurement should go beyond the boundaries of medical events and specialized journals.

Factors associated with leisure time physical inactivity in black individuals: hierarchical model.

Background. A number of studies have shown that the black population exhibits higher levels of leisure-time physical inactivity (LTPI), but few have investigated the factors associated with this behavior. Objective. The aim of this study was to analyze associated factors and the explanatory model proposed for LTPI in black adults. Methods. The design was cross-sectional with a sample of 2,305 adults from 20-96 years of age, 902 (39.1%) men, living in the city of Salvador, Brazil. LTPI was analyzed using the International Physical Activity Questionnaire (IPAQ). A hierarchical model was built with the possible factors associated with LTPI, distributed in distal (age and sex), intermediate 1 (socioeconomic status, educational level and marital status), intermediate 2 (perception of safety/violence in the neighborhood, racial discrimination in private settings and physical activity at work) and proximal blocks (smoking and participation in Carnival block rehearsals). We estimated crude and adjusted odds ratio (OR) using logistic regression. Results. The variables inversely associated with LTPI were male gender, socioeconomic status and secondary/university education, although the proposed model explains only 4.2% of LTPI. Conclusions. We conclude that male gender, higher education and socioeconomic status can reduce LTPI in black adults.

[Sociodemographic factors associated with different domains of physical activity in adults of black ethnicity]. / Fatores sociodemográficos associados aos diferentes domínios da atividade física em adultos de etnia negra.

OBJECTIVE: To analyze the prevalence and sociodemographic factors associated with different domains of physical activity among adults of black ethnicity. METHODS: Cross-sectional study with a sample of 2,305 black individuals from 20-96 years of age, 902 (39.1%) of which men living in the city of Salvador, Bahia, Brazil. Sociodemographic variables analyzed were: gender, age, schooling, socioeconomic status (SES), marital status, racial discrimination at work/school (RDWE), in public (RDPUP) and private (RDPRP) places and perception of police (PPN) /violence in the neighborhood (PVN), as well as total physical activity (TPA) in its different domains: leisure time (LTPA), work (WPA), commuting (CPA) and household activity (HPA). Associations were analyzed using chi-square tests, chi-square trend and prevalence ratio (PR). We also used logistic regression analysis to estimate the odds ratio (OR) with a 95%confidence interval. RESULTS: The proportions of active individuals were 39.1% for TPA, 11.2% for LTPA, 9.6% for WPA, 23.7% for CPA and 33.7% for HPA. TPA was positively associated with higher schooling and inversely associated with male gender, age over 60 years and with no PPN. LTPA was positively associated with male gender, higher schooling and higher SES. WPA was inversely associated with age over 60 years and positively associated with male gender, higher schooling and no PPN. CPA was inversely associated with age over 60 years and positively associated with male gender. HPA was inversely associated with male gender, age over 60 years and no PPN and positively associated with higher schooling and SES. CONCLUSION: Socio-demographic factors, particularly gender, age and schooling were associated with different domains of physical activity among adults of black ethnicity.

[Adiponectin and low cardiometabolic risk in obese women]. / Adiponectina e baixo risco cardiometabólico em obesas.

OBJECTIVE: To investigate the association between elevated levels of plasmatic adiponectin (AdipoQ) and low cardiometabolic risk (CMR) in obese women (O(b)W). SUBJECTS AND METHODS: Case-control study, matched by age, of 306 O(b)W, BMI > 30 kg/m², with 66 cases (21.6%) - all non-hypertensive, normolipidemic, and non-diabetic - conducted in SUS (Brazil's Public Health System) outpatient referral services for obesity in the City of Salvador, Brazil. Secondary data were collected from medical records; primary and complementary data were obtained from a clinical pathology laboratory. Values of AdipoQ > 10.00 µg/ml (> 3(rd) quartile) were considered elevated. Descriptive, bivariate, and conditional logistic regression analyses were performed. RESULTS: A statistically significant positive association between low CMR and AdipoQ > 10.00 µg/ml in physically active (AOR = 5.1; CI95%: 1.8-14.3), non-smoking (AOR = 3.6;CI95%: 1.6-8.4) O(b)W was found. CONCLUSION: This study suggests that physically active, non-smoking O(b)W, with higher AdipoQ levels, present greater chances of a low CMR. It becomes important to reinforce encouragement of the adoption of healthy behaviors, by means of public policies.

[Relationship between leisure-time physical activity and blood pressure in adults]. / Associação entre atividade física no tempo livre e pressão arterial em adultos.

BACKGROUND: high blood pressure (BP) is found at epidemic levels in adults of industrialized societies, thereby favoring an increase in the risk of development of numerous cardiovascular pathologies. OBJECTIVE: to investigate the relationship between leisure-time physical activity (LTPA) and high systolic blood pressure (SBP)/diastolic blood pressure (DBP) in adults, in the city of Salvador, state of Bahia. METHODS: a cross-sectional study was conducted with a sample of 2,292 adults of both sexes, aged > 20 years. Those who engaged in physical activity during their leisure time were considered to be active in their free time. We used logistic regression analysis to estimate the odds ratio (OR), with confidence interval of 95%. RESULTS: after the adjustment for age and stratification by sex, the relationships between LTPA and SBP/DBP were: SBP = 0.86 (0.85 to 0.87) for females and 0.65 (0.64 to 0.66) for males; DBP = 0.94 (0.92 to 0.95) for females and 0.64 (0.63 to 0.65) for males. CONCLUSION: the results of this study are important to public health and they must be used to raise awareness of the relevance of LTPA to prevent high levels of SBP/DBP.

[Factors associated with low cardiometabolic risk in obese women]. / Fatores associados ao baixo risco cardiometabólico em mulheres obesas.

OBJECTIVE: To identify factors associated with low cardiometabolic risk (CMR) in obese women (O(b)W) seen at outpatient specialty clinics of SUS (Brazilian Social Security Health System), in the City of Salvador, Bahia, Brazil. SUBJECTS AND METHODS: Case-control study, matched by age, of 306 O(b)W (BMI > or = 30 kg/m(2)), including 66 (21. 6%) cases - normotensive, normolipidemic and nondiabetic patients - and 240 (78.4%) controls. Secondary data were obtained from clinical records, and primary data were collected by means of a household survey and laboratory assays. Descriptive, bivariate, and conditional logistic regression analyses were conducted. RESULTS: A positive, statistically significant association was found between low CMR and a diet containing the desirable ingestion of fruit (AOR = 20. 1, CI 95% 5.6-71.9); 1st CRP quartile (AOR = 4. 1, CI 95% 2.0-8. 3), and 3rd and 4th AdipoQ quartiles (AOR = 2.3, CI 95% 1.1-4. 8). CONCLUSION: This study suggests that a diet rich in soluble fibers as well as lower levels of CRP, and higher levels of AdipoQ, encumber, retard or impede the emergence of other metabolic risk factors or metabolic diseases in O(b)W.

[Influence of the self-reported skin color on the prevalence of metabolic syndrome in an urban Brazilian population]. / Influência da cor de pele auto-referida na prevalência da síndrome metabólica numa população urbana do Brasil.

BACKGROUND: The metabolic syndrome (MS) has a high prevalence in different parts of the world, with variations between different ethnic groups. OBJECTIVE: This study aims at exploring the influence of the self-reported skin color on the prevalence of MS Methods: Cross-sectional study, carried out in a population subgroup (n=1,439 adults) in Salvador, Brazil. The self-reported skin color (white, mulatto or black) was used as well as the MS criterion of ATP-III. The Chi-square test for tendency was used to analyze the prevalence gradient between the groups and logistic regression, for association analysis. RESULTS: The general prevalence of MS, adjusted for potentially confounder variables, did not differ among whites (23.3%), mulattos (23.3%) and blacks (23.4%). The analysis by sex showed, among men, a reduction in the MS prevalence of whites (26.2%, 95%CI: 20.7-31.7), in comparison to blacks (17.5%, 95%CI: 12.3-22.8) and an intermediate prevalence among mulattos, 21.9%, 95%CI: 18.6-25.1, p tend. = 0.002. Among the women, the tendency was the opposite, being higher among the blacks, 27.0%, 95%CI: 22.2-31.8, and lower among the whites, 20.5%, 95%CI: 15.6-25.4, p tend. = 0.02. The multivariate analysis of the association between skin color and MS (white = group of reference) showed that the black color of the skin was a protective factor among black men, with a prevalence ratio (PR) = 0.60 (0.36-0.97), whereas it tended to be a risk factor among black women, with a PR = 1.33 (0.94-1.78). CONCLUSION: The prevalence of MA presented an inverse variation according to the color of skin between men and women. To be black was a protective factor among men and a risk factor among women.

[Physical activity in the prevention of diabetes in black ethnicity: how much is required?]. / Atividade física na prevenção de diabetes em etnia negra: quanto é necessário?

OBJECTIVE: Analyze how much total physical activity (intensity and duration) is required and its different domains (work, commuting, household, and leisure time) as predictors of absence of diabetes in the black ethnicity population. METHODS: The design was cross-sectional with a sample of 2305 adults from 20 to 96 years of age, 902 (39.1%) male, living in the city of Salvador, Brazil. Receiver Operating Characteristic curves (ROC) were constructed to compare the areas of amount of physical activity in their different domains with absence of diabetes. Sensitivity and specificity were also established to identify the best cutoffs for the amount of physical activity related to absence of diabetes. Based on these cutoff points, a multivariate model was constructed to identify the association between physical activity and diabetes. RESULTS: Among the different amounts of physical activity greater significance was found in areas under the ROC curve for total physical activity, moderate activities performed during leisure time and work among men and commuting among women. Walking by itself was not a good predictor of absence of diabetes among men. It was also observed that 185 minutes/week of physical activity accumulated in different domains for men and 215 minutes/week for women were the best cutoffs for predicting absence of diabetes. CONCLUSION: Physical activity accumulated in different domains should be suggested in amounts suitable for a black ethnicity population in order to contribute to diabetes prevention.