Intergenerational transmission of birth weight: a systematic review and meta-analysis.

The objectives of this study were (1) to systematically review the literature on the association between birth weight in children born in the first and second generation and (2) to quantify this association by performing a meta-analysis. A systematic review was carried out in six databases (PubMed, Science Direct, Web of Science, Embase, Scopus, CINAHL and LILACS), in January 2021, for studies that recorded the birth weight of parents and children. A meta-analysis using random effects to obtain a pooled effect of the difference in birth weight and the association of low birth weight (LBW) between generations was performed. Furthermore, univariable meta-regression was conducted to assess heterogeneity. Egger's tests were used to possible publication biases. Of the 9878 identified studies, seventy were read in full and twenty were included in the meta-analysis (ten prospective cohorts and ten retrospective cohorts), fourteen studies for difference in means and eleven studies for the association of LBW between generations (twenty-three estimates). Across all studies, there was no statistically significant mean difference (MD) birth weight between first and second generation (MD 19·26, 95 % CI 28·85, 67·36; P = 0·43). Overall, children of LBW parents were 69 % more likely to have LBW (pooled effect size 1·69, 95 % CI (1·46, 1·95); I2:85·8 %). No source of heterogeneity was identified among the studies and no publication bias. The average birth weight of parents does not influence the average birth weight of children; however, the proportion of LBW among the parents seems to affect the offspring's birth weight.

Intersections between adolescent fertility and obesity-pathways and research gaps focusing on Latin American populations.

Latin America has notably elevated rates of adolescent fertility and obesity in women. Although numerous studies document associations between adolescent fertility and obesity across the life course, the pathways explaining their association are insufficiently theorized, especially regarding the factors in Latin America that may underpin both. Additionally, much of the existing research is from high-income countries, where fertility and obesity are trending down. In this paper, we review the various complex pathways linking adolescent fertility and obesity, highlighting research gaps and priorities, with a particular focus on Latin American populations. We carefully consider pregnancy's distinct impact on growth trajectories during the critical period of adolescence, as well as the cumulative effect that adolescent fertility may have over the life course. We also articulate a pathway through obesity as it may contribute to early puberty and thus, to adolescent fertility. If obesity is a cause of adolescent fertility, not a result of it, or if it is a mediator of early-life exposures to adulthood obesity, these are critical distinctions for policy aiming to prevent both obesity and early fertility. Research to better understand these pathways is essential for prevention efforts against obesity and undesired adolescent fertility in Latin America.

Consumption of ultra-processed foods and IL-6 in two cohorts from high- and middle-income countries.

This study evaluated the association between ultra-processed foods (UPF) on serum IL-6 and to investigate the mediation role of adiposity. Participants were 524 adults from the EPITeen Cohort (Porto, Portugal) and 2888 participants from the 1982 Pelotas Birth Cohort (Pelotas, Brazil). Dietary intake was collected using FFQ when participants were 21 years of age in the EPITeen and 23 years in the Pelotas Cohort. Serum IL-6 and body fat mass were evaluated when participants were 27 and 30 years old in the EPITeen and Pelotas, respectively. Generalised linear models were fitted to test main associations. Mediation of body fat mass was estimated using G-computation. After adjustment for socio-economic and behaviour variables, among females from the EPITeen, the concentration of IL-6 (pg/ml) increased with increasing intake of UPF from 1·31 (95 % CI 0·95, 1·82) in the first UPF quartile to 2·20 (95 % CI 1·60, 3·01) and 2·64 (95 % CI 1·89, 3·69) for the third and fourth UPF quartiles, respectively. A similar result was found among males in the Pelotas Cohort, IL-6 increased from 1·40 (95 % CI 1·32, 1·49) in the first UPF quartile to 1·50 (95 % CI 1·41, 1·59) and 1·59 (95 % CI 1·49, 1·70) in the two highest UPF quartiles. The P-value for the linear trend was < 0·01 in both findings. The indirect effect through fat mass was NS. Our findings suggest that the consumption of UPF was associated with an increase in IL-6 concentration; however, this association was not explained by adiposity.

Physical activity and serum interleukin-6 in relation to bone density in young adults / Atividade física e interleucina-6 sérica em relação à densidade óssea em adultos jovens

Physical activity (PA) and inflammation influence bone density through multiple physiological mechanisms, but current evidence is not robust on the structure mediating these relationships. There-fore, the aim of this study was to investigate the associations of PA, and serum interleukin-6 (IL-6) on bone density. Cross-sectional analysis in the Pelotas (Brazil) 1982 Birth Cohort with participants aged 30-years old. PA was objectively measured by accelerometry. Bone mineral density (g/cm2) was evaluated for the lumbar spine and femoral neck using dual-energy X-ray absorptiometry. Crude and adjusted linear regressions and mediation analyses were performed. In both sexes, the overall PA was positively associated with femoral neck bone density, but not lumbar spine. For men, the mean of femoral neck were 0.027, 0.042, and 0.032 higher in the second, third, and fourth quartiles, respectively, compared to the first quartile (reference). Among women, higher bone density values were found in the third (0.021) and fourth (0.027) quartiles of overall PA compared to the lowest quartile. Among females, moderate-to-vigorous intensity physical activity presented a positive rela-tionship with all sites of bone density. The indirect effect through IL-6 was not significant. Physical activity was associated with gains in bone density. The findings reinforce recommendations for PA in adulthood to promote bone health

A atividade física (AF) e a inflamação influenciam a densidade óssea através de múltiplos mecanismos fisiológicos, mas a atual evidência não é robusta sobre a estrutura de mediação dessas relações. Portanto, o objetivo deste estudo foi investigar as associações de AF e interleucina-6 sérica (IL-6) na densidade óssea. Análise transversal na Coorte de Nascimentos de 1982 Pelotas (Brasil) em participantes com 30 anos de idade. AF foi medida objetivamente por acelerometria. Densidade mineral óssea (g/cm2) foi avaliada para a coluna lombar e colo do fêmur usando absorciometria de raios-X de dupla energia. Foram realizadas regressões lineares brutas e ajustadas e análises de mediação. Em ambos os sexos, a AF total foi positivamente associada à densidade óssea do colo do fêmur, mas não à coluna lombar. Para os homens, as médias do colo do fêmur foram 0,027, 0,042 e 0,032 maiores no segundo, terceiro e quarto quartis, respectivamente, em relação ao primeiro quartil (referência). Entre as mulheres, os maiores valores de densidade óssea foram encontrados no terceiro (0,021) e quarto (0,027) quartis de AF total em comparação ao quartil mais baixo. No sexo feminino, a atividade física de intensidade moderada a vigorosa apresentou relação positiva com todos os locais de densidade óssea. O efeito indireto através da IL-6 não foi significativo. A atividade física foi associada a ganhos de densidade óssea. Os achados reforçam recomendações de AF na idade adulta para promover a saúde óssea

Omega-3 supplementation and diabetes: A systematic review and meta-analysis.

This study aimed to review the literature on studies that evaluated the effects of omega-3 supplementation on parameters of diabetes in humans. An online search was conducted in the following databases: Pubmed, LILACS, Scielo, Scopus, and Web of Science. It included experimental studies that investigated the effects of omega-3 supplementation for diabetes treatment or prevention and its relationship with fasting blood glucose, insulin resistance, and glycated hemoglobin. Observational, non-human studies and non-randomized clinical trials were excluded. The Cochrane scale assessed the quality of the studies. A meta-analysis was carried out to evaluate the effect of omega-3 on fasting blood glucose, insulin resistance, and glycated hemoglobin. Thirty studies were included in the review. Almost 70% (n = 20) demonstrated at least one significant effect of the omega-3 supplementation related to diabetes. In the meta-analysis, there was a significant effect on the reduction of fasting blood glucose [SMD: -0.48; CI95%: -0.76, -0.19; p = 0.01; I2 = 88%] and insulin resistance [SMD: -0.61; CI95%: -0.98, -0.24; p = 0.01; I2 = 90%]. For glycated hemoglobin, there was no significant effect in the meta-analysis. This systematic review with meta-analysis demonstrated that supplementation with omega-3 has protective effects on diabetes parameters.

Breastfeeding duration comparison of children enrolled in municipal preschools in 2004 and 2018 / Comparação da duração do aleitamento materno entre crianças de escolas municipais de educação infantil em 2004 e 2018

ABSTRACT Objective To describe and compare the duration of breastfeeding of children enrolled in municipal preschools in Pelotas (RS), Brazil, in 2004 and 2018, taking into account sociodemographic and health factors. Methods Cross-sectional study, with children aged zero to six years. Data collection included interview with parents and children anthropometric assessment. Data was entered on EpiData 3.1 and analyzed on Stata 14.0. Median duration of breastfeeding was assessed according to the independent variables. Two children life tables were elaborated for the years 2004 and 2018. The statistical significance of the median analysis was based on the Wilcoxon Rank Sum test for dichotomic exposure and Kruskal Wallis test for polytomous exposure. Results A total of 1902 children were studied. In 2004, the median duration of breastfeeding was five months (IQR: 2.0;12.0) which increased one month for each weight category increase at birth. In 2018, the median was six months (IQR: 2.0;17.0) and increased two months for each weight category increase at birth. The life table showed that around 20.0% of the children in 2004 and 33% of the children in 2018 continued to be breastfed after 11 months of age. Conclusion The breastfeeding median increased in the period under review. The greater the birth weight, the longer the breastfeeding median duration.

RESUMO Objetivo Descreve e comparar a duração do aleitamento materno de crianças matriculadas em Escolas Municipais de Educação Infantil, de Pelotas (RS) Brasil, em 2004 e 2018 segundo fatores sociodemográficos e de saúde. Métodos Estudo transversal, com crianças de zero a seis anos de idade. A coleta de dados incluiu entrevistas com os pais e avaliação antropométrica das crianças. Os dados foram digitados no EpiData 3.1 e analisados no Stata 14.0. A duração da mediana do aleitamento materno foi analisada de acordo com as variáveis independentes. Foram elaboradas duas Tábuas de vida, para as crianças de 2004 e de 2018. A significância estatística das análises de mediana, foi baseada no teste de Wilcoxon Rank Sum para as exposições dicotômicas, e no teste de Kruskal Wallis para as exposições politômicas. Resultados Foram estudadas 1902 crianças ao total. Em 2004, a mediana da duração do aleitamento materno foi de cinco meses (IIQ: 2,0;12,0) e aumentou um mês a cada aumento de categoria de peso ao nascer. Em 2018, a mediana foi de seis meses (IIQ: 2,0;17,0) e aumentou dois meses a cada aumento de categoria de peso ao nascer. A Tábua de vida mostrou que cerca de 20,0% das crianças em 2004 e 33,0% das de 2018 tiveram aleitamento materno continuado após os 11 meses de idade. Conclusão A mediana aumentou no período analisado. Quanto maior o peso ao nascer, maior a mediana de aleitamento materno

Associação entre a violência e as características socioeconômicas e reprodutivas da mulher / Association between violence and women's socioeconomic and reproductive characteristics

Resumo Introdução A violência contra a mulher consiste em um importante agravo de saúde pública, com elevada magnitude e impacto na saúde. Objetivo Verificar a associação entre a violência perpetrada por parceiro íntimo ao longo da vida e as características socioeconômicas e reprodutivas da mulher. Método Estudo transversal, realizado em 2014, em 26 unidades de saúde, no município de Vitória, Espírito Santo. Amostra com 991 mulheres, de faixa etária entre 20 e 59 anos, com parceiro íntimo nos 12 meses anteriores à entrevista. Os dados socioeconômicos, as características reprodutivas e os três tipos de violência contra a mulher (psicológica, sexual ou física) foram coletados. Na análise dos dados, foram empregados o teste qui-quadrado, com nível de significância de 5%, e a regressão de Poisson, para obter as razões de prevalência bruta e ajustada para fatores de confusão. Resultados O modelo final ajustado mostrou que a violência física, psicológica e sexual se associou à escolaridade, situação conjugal, recusa do parceiro a usar preservativo nas relações sexuais, número de parceiros sexuais no último ano e número de filhos. A primeira relação sexual forçada permaneceu associada à violência sexual, assim como a idade da coitarca com a violência física e psicológica. Conclusão Prevalências de violência contra a mulher estão associadas a fatores socioeconômicos e reprodutivos.

Abstract Background Violence against women is an important public health issue that has high magnitude and an impact on health. Objective To verify the association between intimate partner violence throughout life and women's socioeconomic and reproductive characteristics. Method Cross-sectional study carried out in 26 health units in the municipality of Vitória, state of Espírito Santo, Brazil, in 2014. Sample composed of 991 women, aged 20-59 years, having an intimate partner in the 12 months prior to the interview. Data on socioeconomic and reproductive characteristics and the three types of violence against women (psychological, sexual, or physical) were collected. The chi-squared test at a 5% significance level was used to analyze the data, and the Poisson regression was applied to obtain the crude and adjusted prevalence ratios for the confounding factors. Results The adjusted final model showed that physical, psychological and sexual violence was associated with education level, marital status, partner's refusal to use a condom during sexual intercourse, number of sexual partners in the past year, and number of children (p<0.05). The first forced sexual intercourse remained associated with sexual violence and age at first sexual intercourse was associated with physical and psychological violence. Conclusion Prevalence of violence against women is associated with socioeconomic and reproductive factors.

Methodological aspects of the anthropometric assessment in the Brazilian National Survey on Child Nutrition (ENANI-2019): a population-based household survey.

The article presents methodological aspects of anthropometric assessment of nutritional status in children under five years of age and their biological mothers. It discusses the strategies used for training and data collection in the Brazilian National Survey on Child Nutrition (ENANI-2019). ENANI-2019 is a population-based household survey conducted in 123 municipalities in Brazil's 26 states and the Federal District. The anthropometric measurements were body mass and length/stature. The equipment was purchased according to its measurement capacity and precision, portability, and cost-benefit ratio after an extensive market search. The study used internationally established procedures described in manuals, videos, and support material developed for the study by a group of experts. The interviewers were trained to perform the anthropometric measurements and were assessed according to technical measurement error, which was considered adequate (0.30cm) for the children's length/stature measurements. Measurement errors were identified, and the interviewers were retrained when necessary. Of the 14,558 children in the sample, body mass and length/stature measurements were taken in duplicate in 13,835 and 13,693 children, respectively. The standardized methodological aspects will be helpful in future population studies and were essential for obtaining greater reliability in the data for generating current evidence on the anthropometric assessment of the nutritional status of Brazilian children under five years of age, allowing new perspectives for public policy development.

Epidemiology of interleukin-6: the 30-year follow-up of the 1982 Pelotas (Brazil) birth cohort study.

BACKGROUND: Cardiovascular diseases are the main cause of death globally. Interleukin-6 (IL-6) is a biomarker of cardiovascular risk. AIM: To investigate factors associated with IL-6 concentration in serum, from early life up to 30 years of age. SUBJECTS AND METHODS: In the 2012-2013 follow-up, IL-6 was measured in 2809 participants of the 1982 Pelotas Birth Cohort (1369 males). Multivariable linear regressions, stratified by sex, were performed to evaluate the associations of African ancestry, family income and maternal education at birth, monthly income and education at 30 years, smoking status, harmful alcohol intake, physical activity, and body composition with IL-6, considering a conceptual hierarchical framework. RESULTS: Males with low educational levels and current smokers had the highest mean IL-6. Among females, African ancestry and low monthly income were associated with the highest mean values for the outcome. Physical activity had an inverse association with IL-6 concentration among females. A direct relationship was observed between the measures of adiposity on IL-6, in both sexes. CONCLUSION: Body composition was the main predictor for the outcome evaluated in males and females. Thus, the avoidance of overweight remains an important strategy for the prevention and control of cardiovascular risk and biomarkers associated with these diseases.

Obesity and ADHD: Exploring the role of body composition, BMI polygenic risk score, and reward system genes.

The association between obesity and attention-deficit hyperactivity disorder (ADHD) has been extensively reported in the literature. However, the potential mechanisms underlying this association are not completely understood. This study aimed to evaluate the association between body composition and ADHD and explore the possible genetic mechanisms involved. We used data from the 1982 Pelotas (Brazil) Birth Cohort at age 30-year follow-up (N = 3630). We first used logistic regression analysis to test whether body mass index (BMI), fat mass (FM), and fat-free mass (FFM) were associated with ADHD. We further tested the association between BMI polygenic risk score (BMI-PRS) and ADHD and the role of the genes upregulated in the reward system using a gene-set association approach. BMI (odds ratio [OR] = 1.05; 95% confidence interval [CI], 1.00-1.09; p = 0.038) and FM (OR = 1.04; 95% CI, 1.00-1.07; p = 0.043) were associated with ADHD. The BMI-PRS was associated with ADHD (using p-value threshold (PT) = 0.4; OR = 1.65; 95% CI, 1.02-2.65) at a nominal level. In gene-set analysis, the reward system genes were associated with BMI in subjects with a high BMI-PRS score, considering PT = 0.4 (p = 0.014). The results suggest that BMI genetic components, especially those genes related to the reward system, may be involved in this association.

Food processing and cardiometabolic risk factors: a systematic review.

OBJECTIVE To systematically review the evidence for the association between food consumption according to processing and cardiometabolic factors in adults and/or the elderly. METHOD Two independent evaluators analyzed the electronic databases PubMed, Web of Science and Lilacs until December 2018. We used the following terms: (convenience foods OR food processing OR highly-processed OR industrialized foods OR minimally-processed OR prepared foods OR processed foods OR ultra-processed OR ultraprocessed OR ultra processed OR unprocessed) AND (metabolic syndrome OR hypertension OR blood pressure OR diabetes mellitus OR glucose OR glycaemia OR insulin OR cholesterol OR triglycerides OR blood lipids OR overweight OR obesity) AND (adult OR adults OR adulthood OR aged OR elderly OR old). We assessed methodological and evidence qualities, and also extracted information for the qualitative synthesis from the selected studies. RESULTS Of the 6,423 studies identified after removing duplicates, eleven met the eligibility criteria. The main food classification we used was Nova. The consumption of ultra-processed foods was positively associated with overweight and obesity, high blood pressure and metabolic syndrome. All articles included met more than 50% of the methodological quality criteria. The quality of evidence was considered moderate for the outcome overweight and obesity and weak for hypertension and metabolic syndrome. CONCLUSIONS The Nova food classification stands out in the area of nutritional epidemiology when assessing the effects of food processing on health outcomes. Although caution is required in the interpretation, the results indicated that the consumption of ultra-processed foods can have an unfavorable impact in the health of individuals.

Mental disorders, comorbidities, and suicidality at 30 years of age in a Brazilian birth cohort.

BACKGROUND: Studies on mental disorders prevalence and comorbidity, including suicidality, are scarce in low and middle-income settings. We aimed to describe the pattern of comorbidity between mental disorders and their association with suicidality. METHODS: In 1982, all hospital deliveries in Pelotas (Southern Brazil) were identified (n = 5914) and have been prospectively followed. Participants were evaluated for the presence of common mental disorders (CMD) at the ages of 18-19, 23 and 30 years. In 2012-13 (30 years of age), trained psychologists evaluated 3657 individuals for disorders using the Mini International Neuropsychiatric Interview. RESULTS: Prevalence of suicidal wishing, suicidal planning and lifetime suicidal attempt was 4.9%, 3.8% and 6.6%, respectively. Suicidal wishing was most strongly associated with having joint major depressive episode (MD) and lifetime suicidal attempt (OR = 26.4, 95%CI:13.9-50.4) with comorbid MD with mania/hypomania (OR = 21.2, 95%CI:6.93-65.1). Suicidal planning was most strongly associated with having joint MD and lifetime suicidal attempt (OR = 44.7, 95%CI:22.6-88.4), with comorbid MD and social anxiety disorder (OR = 30.6, 95%CI:13.0-72.0), and joint social anxiety disorder with lifetime suicidal attempt (OR = 26.3, 95%CI:8.33-82.7). Independently of other disorders, prospective and cross-sectional measures of CMD were associated with higher rates of suicidality. LIMITATIONS: We do not have data on suicide deaths in follow-up and the diagnostic instrument used at 30 years of age was not used in all previous follow-up. CONCLUSION: MD and social anxiety have independent and combined associations with suicidality, and also with they occur with lifetime suicidal attempt and other mental disorders.

Uric acid is independent and inversely associated to glomerular filtration rate in young adult Brazilian individuals.

BACKGROUND AND AIMS: Uric acid, the end-product of human purine metabolism, is associated with hypertension, diabetes and obesity. It has also been independently associated with the onset of chronic kidney disease in several populations. In this study, the association between serum uric acid (SUA) level and estimated glomerular filtration rate (eGFR) was investigated in healthy individuals belonging to two Brazilian birth cohorts. METHODS AND RESULTS: Data from 3541 to 3482 individuals, aged 30 and 22-years old, respectively, was included. eGFR was calculated using Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation based on creatinine measurement. Regression analyses were sex-stratified due to interaction between SUA and sex (p < 0.001) and adjusted for perinatal, cardiometabolic and behavioral variables. We observed an inverse association between eGFR and SUA even after adjustment. In the highest tertile (3rd) of SUA, the eGFR coefficients at 30-years were-0.21 (95%CI -0.24;-0.18) for men and -0.20 (95%CI -0.23; -0.17) for women; at 22-years, were -0.09 (95%CI -0.12;-0.05) for men and -0.13 (95%CI -0.15; -0.10) for women. Higher differences among exponential means (95% CI) of eGFR between the 1st and the 3rd tertile of SUA were seen in older participants, being more pronounced in men. At 22-years, the highest difference was found in women. CONCLUSIONS: In young healthy individuals from a low-middle income country, SUA level was inversely associated with eGFR. Gender-related differences in eGFR according tertiles of SUA were higher in men at 30-years and in women at 22-years.

Violence against women in life: study among Primary Care users. / Violência contra a mulher na vida: estudo entre usuárias da Atenção Primária.

This article aims to estimate the prevalence and factors associated with intimate partner violence among primary care users. Cross-sectional study with women aged 20 to 59 years. Physical, sexual and psychological violence was screened by the World Health Organization instrument. Poisson regression was used for crude and adjusted analysis. Nine hundred ninety-one women participated in the study. The prevalence of violence throughout the lifespan was: psychological 57.6% (95%CI 54.6-60.7); physical 39.3% (95%CI 36.2-42.3) and sexual 18.0% (95%CI 15.7-20.5). Women with up to eight years of schooling, divorced or separated, whose mothers suffered intimate partner violence, who reported drug use and experienced sexual violence in childhood showed a higher prevalence of the three types of violence. Religion was associated with psychological and sexual violence and the use of cigarettes to physical and psychological violence. Participants with lower household income had a higher prevalence of physical violence. A high prevalence of intimate partner violence was identified among users. Worse socioeconomic conditions, risk behaviors and a history of assault are associated with greater occurrence of this problem.

Common Mental Disorders and Contemporary Factors: 1982 Birth Cohort.

OBJECTIVE: To describe the association between common mental disorders and socio-demographic variables, smoking habits and stressful events among the 30-year-old members of a 1982 cohort. METHOD: Mental disorder was analyzed by the Self-Reporting Questionnaire (SRQ-20). Poisson regression was used to analyze the unadjusted and adjusted associations. RESULTS: Low level of education and stressful events increased the prevalence of mental disorders for both genders. Lower income for women and unemployment for men also remained associated with CMD. CONCLUSION: It was possible to describe the association between contemporary factors and mental disorders in a young population, to which prevention and control measures, through public policies proposed to the areas of Primary Care, Mental Health and Education, can represent a better quality of life and health.

Age at menarche associated with subsequent educational attainment and risk-taking behaviours: the Pelotas 1982 Birth Cohort.

Background: Earlier age at menarche (AAM), a marker of puberty timing in females, has been associated with a higher likelihood of adolescent risk-taking behaviours and variably associated with educational attainment.Aim: To examine the association between AAM and educational attainment in the Pelotas, Brazil, 1982 Birth Cohort.Subjects and methods: AAM was categorised as Early (7-11 years), Average (12-13 years), or Late (14+ years). Primary outcome: years of education (age 30). Secondary outcomes: risk-taking behaviours, adult income and school grade failure.Results: In adjusted models, compared to Average AAM, Late AAM was associated with 0.64 fewer years of education (95% CI: -1.15, -0.13). Early AAM was associated with earlier age at first sexual intercourse (-0.25 years; 95% CI: -0.39, -0.12), whereas Late AAM was associated with 17% lower adult income (0.83; 95% CI: 0.71, 0.95) and 0.31 years older age at first alcohol consumption (95% CI: 0.10, 0.52).Conclusions: Our findings confirm the association between earlier puberty timing in females and a greater likelihood of risk-taking behaviours in this setting of recent secular changes towards earlier puberty. However, the association between Late AAM and lower education was surprising and may support a psychosocial rather than biological link between puberty timing and educational outcomes.

Food processing and cardiometabolic risk factors: a systematic review / Processamento de alimentos e fatores de risco cardiometabólicos: revisão sistemática

ABSTRACT OBJECTIVE To systematically review the evidence for the association between food consumption according to processing and cardiometabolic factors in adults and/or the elderly. METHOD Two independent evaluators analyzed the electronic databases PubMed, Web of Science and Lilacs until December 2018. We used the following terms: (convenience foods OR food processing OR highly-processed OR industrialized foods OR minimally-processed OR prepared foods OR processed foods OR ultra-processed OR ultraprocessed OR ultra processed OR unprocessed) AND (metabolic syndrome OR hypertension OR blood pressure OR diabetes mellitus OR glucose OR glycaemia OR insulin OR cholesterol OR triglycerides OR blood lipids OR overweight OR obesity) AND (adult OR adults OR adulthood OR aged OR elderly OR old). We assessed methodological and evidence qualities, and also extracted information for the qualitative synthesis from the selected studies. RESULTS Of the 6,423 studies identified after removing duplicates, eleven met the eligibility criteria. The main food classification we used was Nova. The consumption of ultra-processed foods was positively associated with overweight and obesity, high blood pressure and metabolic syndrome. All articles included met more than 50% of the methodological quality criteria. The quality of evidence was considered moderate for the outcome overweight and obesity and weak for hypertension and metabolic syndrome. CONCLUSIONS The Nova food classification stands out in the area of nutritional epidemiology when assessing the effects of food processing on health outcomes. Although caution is required in the interpretation, the results indicated that the consumption of ultra-processed foods can have an unfavorable impact in the health of individuals.

RESUMO OBJETIVO Revisar sistematicamente as evidências da associação entre consumo de alimentos de acordo com o processamento e fatores cardiometabólicos em adultos e idosos. MÉTODOS Dois avaliadores independentes analisaram as bases de dados eletrônicas PubMed, Web of Science e Lilacs até dezembro de 2018. Os seguintes termos foram utilizados: (convenience foods OR food processing OR highly-processed OR industrialized foods OR minimally-processed OR prepared foods OR processed foods OR ultra-processed OR ultraprocessed OR ultra processed OR unprocessed) AND (metabolic syndrome OR hypertension OR blood pressure OR diabetes mellitus OR glucose OR glycaemia OR insulin OR cholesterol OR triglycerides OR blood lipids OR overweight OR obesity) AND (adult OR adults OR adulthood OR aged OR elderly OR old). Nos estudos incluídos foram avaliadas as qualidades metodológica e de evidência, além de extraídas informações para a síntese qualitativa. RESULTADOS Dos 6.423 estudos identificados após a remoção das duplicatas, onze preencheram os critérios de elegibilidade. A principal classificação de alimentos utilizada foi a Nova. O consumo de alimentos ultraprocessados foi positivamente associado com excesso de peso e obesidade, hipertensão arterial e síndrome metabólica. Todos os artigos incluídos preencheram mais de 50% dos critérios de qualidade metodológica. A qualidade de evidência foi considerada moderada para o desfecho excesso de peso e obesidade e fraca para hipertensão arterial e síndrome metabólica. CONCLUSÕES A classificação de alimentos Nova se destaca na área da epidemiologia nutricional ao avaliar os efeitos do processamento de alimentos sobre desfechos em saúde. Embora seja necessária prudência na interpretação, os resultados indicam que o consumo de alimentos ultraprocessados pode ter impacto desfavorável sobre a saúde dos indivíduos.

Common Mental Disorders and Contemporary Factors: 1982 Birth Cohort / Trastornos mentales comunes y factores contemporáneos: cohorte de nacimientos de 1982 / Transtornos mentais comuns e fatores contemporâneos: coorte de nascimentos de 1982

ABSTRACT Objective: To describe the association between common mental disorders and socio-demographic variables, smoking habits and stressful events among the 30-year-old members of a 1982 cohort. Method: Mental disorder was analyzed by the Self-Reporting Questionnaire (SRQ-20). Poisson regression was used to analyze the unadjusted and adjusted associations. Results: Low level of education and stressful events increased the prevalence of mental disorders for both genders. Lower income for women and unemployment for men also remained associated with CMD. Conclusion: It was possible to describe the association between contemporary factors and mental disorders in a young population, to which prevention and control measures, through public policies proposed to the areas of Primary Care, Mental Health and Education, can represent a better quality of life and health.

RESUMEN Objetivo: describir la asociación de trastornos mentales comunes a los 30 años en los miembros de cohorte de 1982 con variables sociodemográficas, tabaquismo y eventos estresores. Método: los trastornos mentales se identificaron mediante el Cuestionario de Autorreporte de Síntomas (SRQ-20). La Regresión de Poisson se utilizó para analizar las asociaciones brutas y ajustadas. Resultados: la poca escolarización y los eventos estresores aumentaron la frecuencia de trastornos en ambos sexos. Los ingresos familiares bajos de las mujeres y la falta de trabajo de los hombres también estaban relacionados. Conclusión: Existe una asociación entre los factores contemporáneos y los trastornos mentales padecidos por los jóvenes, en los que las medidas de prevención y control, a través de políticas públicas en las áreas de Atención Primaria, de Salud Mental y de Educación, pueden representar una mejoría en la calidad de vida e influenciar notablemente en su salud.

RESUMO Objetivo: Descrever a associação de transtorno mental comum aos 30 anos nos membros da coorte de 1982 com variáveis sociodemográficas, tabagismo e eventos estressores. Método: Transtorno mental foi identificado pelo Self-Reporting Questionnaire (SRQ-20). Regressão de Poisson foi utilizada para analisar as associações brutas e ajustadas. Resultados: A baixa escolaridade e os eventos estressores aumentaram a frequência de transtorno em ambos os sexos. A menor renda familiar para mulheres e a falta de trabalho para homens também se mantiveram associadas. Conclusão: Permitiu descrever a associação de fatores contemporâneos com os transtornos mentais em população jovem, na qual as medidas de prevenção e controle, por meio de políticas públicas propostas nas áreas de Atenção Básica, Saúde Mental e Educação, podem representar uma melhor qualidade de vida e de saúde.

Food consumption of children enrolled in five municipal schools according to socio-demographics characteristics / Consumo alimentar de crianças matriculadas em cinco escolas municipais de educação infantil por características sociodemográficas

ABSTRACT Objective To describe children food consumption in the five municipal schools in Pelotas, Rio Grande do Sul, and their main characteristics. Methods Cross-sectional study of children enrolled in five municipal schools. The mothers were interviewed at the school. The questionnaire about habitual food consumption was based on the guidelines of the Food and Nutrition Surveillance System. The data were entered in EpiData 3.1 and reviewed in Stata 14.0. The consumption frequency was reported according to each exposure category. Statistical tests based on Chi-Square test with 5% significance level and adjusted analyses through Poisson regression were used. Results A total of 548 children were included. Females represented 51.1% of the total sample; the average age was 48.3 months. Children up to two years of age were those who consumed the most fruits and vegetables while sweets were mostly consumed by older children, aged between three and four years. Unhealthy foods had a high frequency of consumption, with sweet being the most consumed (58.8%), followed by packet snacks (53.3%). In the adjusted analysis, eating meals in front of the screens remained associated with lower consumption of vegetables. Conclusion Eating meals in front of the screens reduces children's vegetables consumption. At the same time, the child's age and maternal education seem to have some influence on the consumption of unhealthy foods, indicating the need for nutritional education interventions.

RESUMO Objetivo Descrever o consumo alimentar de crianças de cinco escolas municipais de Pelotas, Rio Grande do Sul, e suas principais características. Métodos Estudo transversal, incluindo crianças de cinco escolas da rede municipal de educação infantil de Pelotas, Rio Grande do Sul. As mães foram entrevistadas na escola, sendo que as perguntas sobre consumo alimentar habitual foram elaboradas a partir das orientações do Sistema de Vigilância Alimentar e Nutricional. Os dados foram digitados no EpiData 3.1 e analisados no Stata 14.0. A frequência de consumo foi apresentada de acordo com cada categoria de exposição, e foram elaborados testes estatísticos baseados no qui-quadrado, sendo 5% o nível de significância e análise ajustada por meio de regressão de Poisson. Resultados Foram incluídas 548 crianças, dentre as quais o sexo feminino representou 51,1% e a média de idade foi de 48,3 meses. Crianças com até dois anos de idade são as que mais consomem frutas e legumes, e as com três e quatro anos são as que mais consomem doces. Os alimentos não saudáveis apresentaram elevada frequência de consumo, sendo o doce o mais consumido (58,8%), seguido do salgadinho de pacote (53,3%). Na análise ajustada, fazer refeições em frente às telas se manteve associado ao menor consumo de legumes. Conclusão Fazer as refeições em frente às telas diminui o consumo de legumes pelas crianças. Ao mesmo tempo, a idade da criança e a escolaridade materna parecem ter alguma influência no consumo de alimentos não saudáveis, indicando a necessidade de intervenções de educação nutricional.

[Association of excess weight and obesity and mortality in Brazilian state capitals and Argentine provinces]. / Associação entre excesso de peso e obesidade e mortalidade em capitais brasileiras e províncias argentinas.

This study aimed to assess the association between prevalence of excess weight and obesity and overall and disease-specific mortality rates in Brazilian state capitals and Argentine provinces. This was an ecological study with secondary data, where the principal exposures were prevalence rates for excess weight and obesity, estimated with data from Brazil's Vigitel survey (Risk and Protective Factors Surveillance System for Chronic Non-Communicable Diseases Through Telephone Interveiew) in 2014 and Argentina's National Risk Factor Survey in 2013. Overall and specific mortality rates for the year 2015 were obtained from the Brazilian Mortality Information System in the Brazilian Health Informatics Department and the Division of Health Statistics and Information of the Argentine Ministry of Health. Brazilian mortality rates were standardized with the age structure of the Argentine population as the standard. Crude and adjusted linear regressions were used to assess the association between the prevalence rates for excess weight and obesity and the overall and specific mortality rates. After adjusting for potential confounding factors, prevalence of obesity was positively associated with the overall mortality rate both in Brazil (ß = 0.18; 95%CI: 0.01; 0.35) and in Argentina (ß = 0.06; 95%CI: 0.01; 0.13). There was no association with the specific cardiovascular and cancer mortality rates. We conclude that the Brazilian state capitals and Argentine provinces with the highest prevalence of obesity present higher overall mortality rates, while this association was inconsistent for the specific rates.

O objetivo deste trabalho foi avaliar a associação da prevalência de excesso de peso e obesidade com as taxas de mortalidade total e específica nas capitais brasileiras e províncias argentinas. Estudo ecológico com dados secundários, em que as exposições principais foram as prevalências de excesso de peso e obesidade estimadas com base em dados da pesquisa Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (Vigitel) de 2014 (Brasil) e da Pesquisa Nacional de Fatores de Risco de 2013 (Argentina). As taxas de mortalidade geral e específicas para o ano de 2015 foram obtidas no Sistema de Informações sobre Mortalidade do Departamento de Informática do SUS (Brasil) e na Direção de Estatísticas e Informações de Saúde do Ministério da Saúde (Argentina). As taxas de mortalidade brasileiras foram padronizadas considerando-se a estrutura etária da população argentina como padrão. Regressão linear bruta e ajustada foi utilizada para avaliar a associação das prevalências de excesso de peso e obesidade com as taxas de mortalidade geral e específicas. Após o ajuste para os potenciais fatores de confusão, a prevalência de obesidade se associou positivamente com a taxa de mortalidade geral tanto no Brasil (ß = 0,18; IC95%: 0,01; 0,35) quanto na Argentina (ß = 0,06; IC95%: 0,01; 0,13). Para as demais taxas de mortalidade (cardiovascular e por câncer) não houve associação. Conclui-se que as capitais brasileiras e províncias argentinas com maiores prevalências de obesidade apresentam maiores taxas de mortalidade geral, sendo esta associação inconsistente para as taxas específicas.

El objetivo de este estudio fue evaluar la asociación de la prevalencia de exceso de peso y obesidad con las tasas de mortalidad total y específica en capitales brasileñas y provincias argentinas. Estudio ecológico con datos secundarios, donde las exposiciones principales fueron las prevalencias de exceso de peso y obesidad, estimados a partir de datos de la Vigilancia de Factores de Riesgo y Protección para Enfermedades Crónicas No Transmisibles por Entrevista Telefónica (Vigitel) de 2014 (Brasil) y de la Encuesta Nacional de Factores de Riesgo de 2013 (Argentina). Las tasas de mortalidad general y específicas del año 2015 se obtuvieron del Sistema de Información sobre Mortalidad del Departamento de Informática del SUS (Brasil) y de la Dirección de Estadística e Información de Salud del Ministerio de Salud de Argentina. Las tasas de mortalidad brasileñas fueron estandarizadas considerando la estructura etaria de la población argentina como patrón. Se utilizó la regresión lineal bruta y ajustada para evaluar la asociación de las prevalencias de exceso de peso y obesidad con tasas de mortalidad general y específicas. Tras el ajuste de los potenciales factores de confusión, la prevalencia de obesidad se asoció positivamente con la tasa de mortalidad general, tanto en Brasil (ß = 0,18; IC95%: 0,01; 0,35), como en Argentina (ß = 0,06; IC95%: 0,01; 0,13). Para las demás tasas de mortalidad (cardiovascular y por cáncer), no hubo asociación. Se concluye que las capitales brasileñas y provincias argentinas con mayores prevalencias de obesidad presentan mayores tasas de mortalidad general, siendo esta asociación inconsistente en el caso de las tasas específicas.