BACKGROUND: This study investigated cause-specific mortality rates in 12 countries during the COVID-19 pandemic in 2020 and 2021. METHODS: We collected weekly cause-specific mortality data from respiratory disease, pneumonia, cardiovascular disease (CVD) and cancer from national vital statistic databases. We calculated excess mortality for respiratory disease (excluding COVID-19 codes), pneumonia, and CVD in 2020 and 2021 by comparing observed weekly against expected mortality based on historical data (2015-2019), accounting for seasonal trends. We used multilevel regression models to investigate the association between country-level pandemic-related variables and cause-specific mortality. RESULTS: Significant reductions in cumulative mortality from respiratory disease and pneumonia were observed in 2020 and/or 2021, except for Georgia, Northern Ireland, Kazakhstan, and Ukraine, which exhibited excess mortality for one or both causes. Australia, Austria, Cyprus, Georgia, and Northern Ireland experienced excess cumulative CVD mortality in 2020 and/or 2021. Australia, Austria, Brazil, Cyprus, Georgia, Northern Ireland, Scotland and Slovenia, experienced increased crude cumulative cancer mortality during 2020 and/or 2021 compared to previous years. Among pandemic-related variables, reported COVID-19 incidence was negatively associated with increased cancer mortality, excess respiratory, (2020) and pneumonia (2021) mortality, and positively associated with respiratory and CVD mortality (2021). Stringency of control measures were negatively associated with excess respiratory disease, CVD, and increased cancer mortality (2021). CONCLUSIONS: This study provides evidence of substantial excess mortality from CVD, and notable reductions in respiratory disease and pneumonia in both years across most countries investigated. Our study also highlights the beneficial impact of stringent control measures in mitigating excess mortality from most causes in 2021.
COVID-19 , Cardiovascular Diseases , Cause of Death , Neoplasms , Humans , COVID-19/mortality , COVID-19/epidemiology , Neoplasms/mortality , Neoplasms/epidemiology , Cause of Death/trends , Cardiovascular Diseases/mortality , Cardiovascular Diseases/epidemiology , Pandemics , SARS-CoV-2 , Respiratory Tract Diseases/mortality , Respiratory Tract Diseases/epidemiology , Pneumonia/mortality , Mortality/trends , Male , Australia/epidemiology , Global Health/statistics & numerical data
OBJECTIVE: to analyze the temporal trend of Food and Nutrition Surveillance System (Sistema de Vigilância Alimentar e Nutricional - SISVAN) coverage and the nutritional status of older adults, and its correlation with indicators of social inequality in Brazil between 2008-2019. METHODS: this was an ecological study using records from SISVAN, related to the population aged 60 years and older; the temporal trend of coverage and the correlation between indicators of social inequality and increment rate of nutritional status were analyzed; slope index of inequality and concentration index were used to measure absolute and relative inequalities. RESULTS: 11,587,933 records were identified; national coverage increased from 0.1% (2008) to 2.9% (2019), with a statistically significant upward trend; a moderate inverse correlation with an annual increment rate of overweight between human development index and gross domestic product per capita, was found. CONCLUSION: there was an increasing trend in SISVAN coverage; the increase in overweight was associated with social inequality.
Nutritional Status , Overweight , Humans , Middle Aged , Aged , Brazil/epidemiology , Food , Socioeconomic Factors
Objective: To analyze the temporal trend in the coverage of the Food and Nutrition Surveillance System (SISVAN) and the nutritional status of the elderly, correlating them with indicators of social inequality. Methods: Ecological study using SISVAN records of the population aged ≥60 years. Correlation analyzes were performed between indicators of social inequality and the rate of increase in nutritional status and analyzes of absolute and relative inequalities to obtain the angular inequality index and the concentration index. Results: 11,587,933 records were identified. National coverage evolved from 0.1% in 2008 to 2.9% in 2019, with a statistically significant upward trend. A moderate inverse correlation was found with the annual increase rate of overweight for HDI and per capita GDP. Conclusion: There was a trend of growth in SISVAN coverage. The increase in overweight was associated with social inequality.
Objetivo: Analizar la tendencia temporal de cobertura del Sistema de Vigilancia Alimentaria y Nutricional (SISVAN), y estado nutricional de adultos mayores, correlacionándolos con indicadores de desigualdad social. Métodos: Estudio ecológico mediante registros SISVAN de la población ≥60 años. Se realizaron análisis de correlación entre indicadores de desigualdad social y la tasa de incremento del estado nutricional y análisis de desigualdades absolutas y relativas para obtener el índice de desigualdad angular y el índice de concentración. Resultados: Se identificaron 11.587.933 registros. La cobertura nacional evolucionó del 0,1% en 2008 al 2,9% en 2019, con una tendencia ascendente estadísticamente significativa. Se encontró una correlación inversa moderada con la tasa de incremento anual de sobrepeso para IDH y PIB per cápita. Conclusión: Hubo una tendencia de crecimiento en la cobertura del SISVAN. El aumento del sobrepeso se asoció con la desigualdad social.
Objetivo: analisar a tendência temporal da cobertura do Sistema de Vigilância Alimentar e Nutricional (SISVAN) e do estado nutricional de idosos, e sua correlação com indicadores de desigualdade social no Brasil, no período 2008-2019. Métodos: estudo ecológico, sobre registros do SISVAN relativos à população na idade de 60 anos ou mais; analisaram-se a tendência temporal da cobertura e a correlação entre indicadores de desigualdade social e taxa de incremento do estado nutricional; os índices angular e de concentração foram utilizados para medir desigualdades absolutas e relativas. Resultados: foram identificados 11.587.933 registros de idosos; a cobertura nacional evoluiu de 0,1% (2008) para 2,9% (2019), com tendência de aumento estatisticamente significativa; foi encontrada correlação inversa moderada com taxa de incremento anual de sobrepeso, para índice de desenvolvimento humano e produto interno bruto per capita. Conclusão: houve tendência de crescimento da cobertura do SISVAN; o aumento de sobrepeso esteve associado à desigualdade social.
Objective: to analyze the temporal trend of Food and Nutrition Surveillance System (Sistema de Vigilância Alimentar e Nutricional - SISVAN) coverage and the nutritional status of older adults, and its correlation with indicators of social inequality in Brazil between 2008-2019. Methods: this was an ecological study using records from SISVAN, related to the population aged 60 years and older; the temporal trend of coverage and the correlation between indicators of social inequality and increment rate of nutritional status were analyzed; slope index of inequality and concentration index were used to measure absolute and relative inequalities. Results: 11,587,933 records were identified; national coverage increased from 0.1% (2008) to 2.9% (2019), with a statistically significant upward trend; a moderate inverse correlation with an annual increment rate of overweight between human development index and gross domestic product per capita, was found. Conclusion: there was an increasing trend in SISVAN coverage; the increase in overweight was associated with social inequality.
Objetivo: analizar la tendencia temporal de cobertura del Sistema de Vigilancia Alimentaria y Nutricional (SISVAN), y el estado nutricional de adultos mayores, correlacionándolos con indicadores de desigualdad social, en el período 2008-2019. Métodos: estudio ecológico mediante registros del SISVAN sobre la población ≥60 años. Se realizaron análisis de correlación entre indicadores de desigualdad social y la tasa de incremento del estado nutricional y análisis de desigualdades absolutas y relativas para obtener el índice de desigualdad angular y el índice de concentración. Resultados: se identificaron 11.587.933 registros. La cobertura nacional evolucionó del 0,1% en 2008 al 2,9% en 2019, con una tendencia ascendente estadísticamente significativa. Se encontró una correlación inversa moderada con la tasa de incremento anual de sobrepeso para IDH y PIB per cápita. Conclusión: hubo una tendencia de crecimiento en la cobertura del SISVAN. El aumento del sobrepeso se asoció con la desigualdad social.
Objetivo: analisar a tendência temporal da cobertura do Sistema de Vigilância Alimentar e Nutricional (SISVAN) e do estado nutricional de idosos, e sua correlação com indicadores de desigualdade social no Brasil, no período 2008-2019. Métodos: estudo ecológico, sobre registros do SISVAN relativos à população na idade de 60 anos ou mais; analisaram-se a tendência temporal da cobertura e a correlação entre indicadores de desigualdade social e taxa de incremento do estado nutricional; os índices angular e de concentração foram utilizados para medir desigualdades absolutas e relativas. Resultados: foram identificados 11.587.933 registros de idosos; a cobertura nacional evoluiu de 0,1% (2008) para 2,9% (2019), com tendência de aumento estatisticamente significativa; foi encontrada correlação inversa moderada com taxa de incremento anual de sobrepeso, para índice de desenvolvimento humano e produto interno bruto per capita. Conclusão: houve tendência de crescimento da cobertura do SISVAN; o aumento de sobrepeso esteve associado à desigualdade social.
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Food and Nutritional Surveillance , State Health Care Coverage/organization & administration , Health of the Elderly , Socioeconomic Factors , Brazil , Overweight , Social Determinants of Health
BACKGROUND: This study aimed to investigate overall and sex-specific excess all-cause mortality since the inception of the COVID-19 pandemic until August 2020 among 22 countries. METHODS: Countries reported weekly or monthly all-cause mortality from January 2015 until the end of June or August 2020. Weekly or monthly COVID-19 deaths were reported for 2020. Excess mortality for 2020 was calculated by comparing weekly or monthly 2020 mortality (observed deaths) against a baseline mortality obtained from 2015-2019 data for the same week or month using two methods: (i) difference in observed mortality rates between 2020 and the 2015-2019 average and (ii) difference between observed and expected 2020 deaths. RESULTS: Brazil, France, Italy, Spain, Sweden, the UK (England, Wales, Northern Ireland and Scotland) and the USA demonstrated excess all-cause mortality, whereas Australia, Denmark and Georgia experienced a decrease in all-cause mortality. Israel, Ukraine and Ireland demonstrated sex-specific changes in all-cause mortality. CONCLUSIONS: All-cause mortality up to August 2020 was higher than in previous years in some, but not all, participating countries. Geographical location and seasonality of each country, as well as the prompt application of high-stringency control measures, may explain the observed variability in mortality changes.
COVID-19 , Female , France , Humans , Italy , Male , Mortality , Pandemics , SARS-CoV-2
Resumo Introdução Apesar do conhecimento sobre a etiologia multifatorial do crescimento intrauterino restrito, há escassez de estudos nacionais. Objetivo Estimar a adequação do peso ao nascer para idade gestacional e investigar fatores associados ao recém-nascido pequeno para idade gestacional (RN-PIG), com destaque para tabagismo e pré-natal. Método Estudo seccional em maternidades públicas no Rio de Janeiro e em Niterói, em 2011, com 1.771 nascidos vivos. Foram realizadas entrevistas com puérperas e consultas em prontuários. Estimaram-se prevalências e intervalos de confiança (IC95%) de recém-nascido pequeno para idade gestacional (RN-PIG), recém-nascido adequado para idade gestacional (RN-AIG) e recém-nascido grande para idade gestacional (RN-GIG), usando a curva INTERGROWTH-21st , segundo características maternas, da gestação e do recém-nascido. Utilizou-se regressão de Poisson, com o desfecho sendo nascer PIG. Resultados As prevalências foram de 9,3% para PIG e de 15,9% para GIG. Cor parda (RP = 1,4), baixa escolaridade (RP = 1,3), inadequação de pré-natal (RP = 1,3), tabagismo (redução/cessação: RP = 1,7; continuidade: RP = 2,4) e hipertensão arterial (RP = 1,3) foram associados ao PIG na análise univariada (p < 0,20), e apenas tabagismo manteve-se associado no modelo final (redução/cessação: RP = 1,7 e continuidade: RP = 2,3; p < 0,05). Conclusão A prevalência de PIG mostrou um efeito dose-resposta com o tabagismo. Estratégias populacionais antitabaco devem intensificar a prevenção direcionada às mulheres em idade fértil e, particularmente, às gestantes, com ações específicas para estímulo à cessação no pré-natal.
Abstract Background There are few national studies despite the knowledge about the multifactorial etiology of restricted intrauterine growth. Objective To estimate the adequacy of birth weight for gestational age and investigate factors associated with the newborns small for the gestational age (NB-SGA). Method This is a cross-sectional study in public maternity hospitals in Rio de Janeiro and Niterói, RJ, in 2011 (1,771 live births). Data sources was through interviews with the mothers and medical records. The prevalence of NB-SGA, adequate (NB-AGA) and large (NB-LGA) for gestational age newborn were estimated (INTERGROWTH21st) according to maternal, gestational and newborn characteristics. Poisson regression was used (outcome SGA). Results The prevalence rates were: 9.3% SGA and 15.9% LGA. Brown skin color (prevalence rate - PR = 1.4), low scholarship (RP=1.3), prenatal inadequacy (RP = 1.3), smoking (reduction/cessation: RP = 1.7, continuity: RP = 2.4) and arterial hypertension (RP = 1.3) were associated with SGA in the univariate analysis (p<0.20) and only smoking remained in the final model (reduction/cessation: RP = 1.7 and continuity: RP = 2.3, p<0.05). Conclusion SGA prevalence showed dose-response relationship with smoking. Population-based anti-smoking strategies should be intensified for women of childbearing age, and particularly for pregnant women, promoting prenatal care smoking-cessation practices.
OBJECTIVE: To describe the methodological features of a study on the association between restricted intrauterine growth and prevalence of overweight, obesity and hypertension in school aged children. METHODS: The study was conducted in two stages in two public schools in Niterói (RJ), from June through December 2010. All students aged 6 to 14 years were eligible to participate. The first stage consisted of an interview to collect information on demographic variables, diet and other variables. A sample was selected for the second stage, in order to conduct an equivalent of a case-cohort study. There was an interval of about 15 days between the two stages. Cases were overweight students, defined as a Z-score for BMI/age/sex > +1.00 in the first stage. Controls were selected by using a random schedule in which the sample frame was the whole cohort. Bioelectrical impedance analysis, carotid ultrasound to measure intimal-medial thickness, blood measurements and interviews were obtained. Gestational age and weight at birth were used to define proxy variables of restricted intrauterine growth. Early health information was obtained from medical registers. RESULTS: The study participation was 76.4% (n = 795) out of 1,040 eligible to participate). 85.1% of parent's questionnaires were returned. 62.5% of the eligible children participated in the case-control study (case: control ratio = 1:1.8). Early life health information was obtained from 292 children. CONCLUSION: The present study has the potential to provide important information about multiple outcomes and exposures related to restricted intrauterine growth and metabolic abnormalities.
Fetal Development/physiology , Fetal Growth Retardation/epidemiology , Hypertension/epidemiology , Metabolic Diseases/epidemiology , Overweight/epidemiology , Pediatric Obesity/epidemiology , Adolescent , Case-Control Studies , Child , Cohort Studies , Female , Humans , Male , Prevalence , Research Design
RESUMO: Objetivo: Descrever a metodologia de um estudo sobre associações entre crescimento intrauterino restrito (CIUR) e prevalência de sobrepeso, obesidade e hipertensão arterial em escolares. Métodos: O estudo, conduzido em dois estágios, foi desenvolvido em 2 escolas municipais de Niterói (RJ) de junho a dezembro de 2010, sendo elegíveis todos os escolares de 6 a 14 anos. O primeiro estágio consistiu em um inquérito nutricional e de potenciais fatores de risco. Foram aplicados questionários aos responsáveis e adolescentes. Concomitantemente, foram selecionados os participantes de um estudo caso-controle, com casos prevalentes definidos como todos os escolares que apresentaram excesso de peso (Z-score de índice de massa corporal -IMC/idade/sexo > +1,00). O grupo controle consistiu em uma amostra aleatória da população de estudo do inquérito, o que permitiu o cálculo de razões de prevalências. Foram realizados bioimpedância elétrica, exames de sangue, ultrassonografia da carótida e entrevistas. As variáveis proxy de CIUR foram definidas a partir de informações sobre peso ao nascer (PN) e idade gestacional (IG). Adicionalmente, foram coletadas informações sobre os dois primeiros anos de vida dos escolares a partir de seus prontuários médicos. Resultado s: Entre os 1.040 escolares elegíveis, participaram do estudo 795 escolares (76,4%). A taxa de retorno do questionário enviado para os responsáveis foi de 85,1%. Para o estudo caso-controle, 62,5% (n = 363) dos selecionados participaram, resultando em uma razão caso:controle de 1:1,8. Foram localizados 55,8% (n = 444) dos prontuários, dos quais em 65,7% (n = 292) foram coletadas informações dos primeiros anos de vida. Conclusão: O presente estudo permitirá a análise de múltiplos desfechos e exposições relacionados ao CIUR e alterações metabólicas.
ABSTRACT: Objective: To describe the methodological features of a study on the association between restricted intrauterine growth and prevalence of overweight, obesity and hypertension in school aged children. Methods: The study was conducted in two stages in two public schools in Niterói (RJ), from June through December 2010. All students aged 6 to 14 years were eligible to participate. The first stage consisted of an interview to collect information on demographic variables, diet and other variables. A sample was selected for the second stage, in order to conduct an equivalent of a case-cohort study. There was an interval of about 15 days between the two stages. Cases were overweight students, defined as a Z-score for BMI/age/sex > +1.00 in the first stage. Controls were selected by using a random schedule in which the sample frame was the whole cohort. Bioelectrical impedance analysis, carotid ultrasound to measure intimal-medial thickness, blood measurements and interviews were obtained. Gestational age and weight at birth were used to define proxy variables of restricted intrauterine growth. Early health information was obtained from medical registers. Results: The study participation was 76.4% (n = 795) out of 1,040 eligible to participate). 85.1% of parent's questionnaires were returned. 62.5% of the eligible children participated in the case-control study (case: control ratio = 1:1.8). Early life health information was obtained from 292 children. Conclusion: The present study has the potential to provide important information about multiple outcomes and exposures related to restricted intrauterine growth and metabolic abnormalities.
Humans , Male , Female , Child , Adolescent , Fetal Development/physiology , Fetal Growth Retardation/epidemiology , Hypertension/epidemiology , Metabolic Diseases/epidemiology , Overweight/epidemiology , Pediatric Obesity/epidemiology , Case-Control Studies , Cohort Studies , Prevalence , Research Design
BACKGROUND: The purpose of this study was to investigate the association between mean body mass index (BMI) and prevalence of obesity in adult populations living in Brazilian State capitals. METHODS: An ecological study was conducted, using data from the National Household Budget Survey conducted in July 2002 through June 2003, including a representative sample of 48.470 households. Pearson's correlation and linear regression coefficients were estimated in order to define the relationships of mean BMI and sex-specific, age standardized obesity prevalence (BMI ≥ 30.0 kg/m(2)) in adults aged 20 to 59 years. RESULTS: Stronger correlations between BMI and prevalence of obesity were observed in women (r = 0.9; p < 0.001) than in men (r = 0.6; p = 0.001) in all analyzes. A reduction of one unit in mean BMI predicted a decline in the prevalence of obesity of about 4.0% (95% CI: 1.7-6.3) in men, and 3.4% (95% CI: 2.6-4.3) in women. CONCLUSION: We found a correlation between BMI and prevalence of obesity, particularly among women, suggesting that population-based strategies would be effective to reduce the prevalence of obesity in adult populations living in Brazilian state capitals.
Body Mass Index , Obesity/epidemiology , Urban Health , Adult , Brazil/epidemiology , Empirical Research , Female , Humans , Male , Middle Aged , Population Surveillance , Prevalence , Young Adult
OBJECTIVE: To investigate the correlation between the consumption of refined carbohydrates and fats and the prevalence of obesity in the state capitals of Brazil. DESIGN: An ecological evaluation of obesity and dietary risk factors was carried out in twenty-six state capitals of Brazil. SETTING: Analysis was based on the age-standardized prevalence of obesity (BMI >or= 30.0 kg/m2) among adults aged 20-59 years. Both intake and obesity prevalence were obtained from the last National Family Household Budget Survey (HBS). The survey was conducted from July 2002 to June 2003, based on a probabilistic national sample of 48 470 households. In each household, during seven consecutive days, all monetary and non-monetary expenses for food and beverages for family consumption were transformed into energy. The relative contribution of foods and food groups was expressed as the proportion (%) of total energy. Fruits and vegetables were also measured by the quantity bought in grams. RESULTS: Prevalence of obesity varied from 5.1 % to 13.6 % among women and from 5.2 % to 17.6 % among men. For women, there were statistically significant correlations between obesity and intake of sugar and soft drinks (rS = 0.60; P = 0.001), ready-to-eat meals (rS = 0.39; P = 0.05) and potatoes (rS = 0.40; P = 0.04). For men there were no such associations. CONCLUSIONS: Increasing intake of refined carbohydrates, mainly soft drinks, may play a role in the prevalence of obesity among women in Brazil. Effecting changes in family purchase patterns may be a strategy to reduce obesity.
Diet/adverse effects , Energy Intake , Obesity/etiology , Adult , Brazil/epidemiology , Carbonated Beverages/adverse effects , Diet/economics , Diet Surveys , Dietary Carbohydrates/administration & dosage , Dietary Carbohydrates/adverse effects , Dietary Sucrose/administration & dosage , Dietary Sucrose/adverse effects , Female , Humans , Male , Middle Aged , Obesity/epidemiology , Prevalence , Risk Factors , Sex Factors , Solanum tuberosum , Statistics, Nonparametric , Young Adult
As alterações que vêm ocorrendo no cenário epidemiológico brasileiro, nas últimas décadas, resultam de profundas modificações sociais e econômicas que incluem, entre outros aspectos, mudanças nos hábitos de alimentação. No Brasil, o único estudo que investigou o consumo alimentar da família com abrangência nacional foi o Estudo Nacional sobre Despesa Familiar, em 1974-1975. Embora sejam de utilidade incontestável, estudos nacionais de consumo alimentar são onerosos e poucos países conseguem desenvolvê-los regularmente. Por outro lado, as pesquisas de orçamentos familiares são importantes fontes de dados de disponibilidade de alimentos no domicílio, a qual é inferida a partir do registro da compra de produtos alimentícios. As recentes modificações nos hábitos de consumo, particularmente, a realização de refeições fora do domicílio constituem limitações para a utilização de dados das pesquisas brasileira de orçamentos familiares como estimativa do consumo alimentar. Assim, o governo brasileiro propôs que a próxima pesquisa de orçamento familiar, a ser desenvolvida em 2008-2009, incluísse um módulo de consumo alimentar individual. As informações sobre o consumo dietético individual serão utilizadas para completar os dados sobre compra de alimentos. O objetivo deste trabalho é relatar a construção e o desenvolvimento da metodologia a ser utilizada no módulo de consumo alimentar individual da pesquisa de orçamento familiar 2008-2009. Os dados a serem obtidos serão combinados com as informações de disponibilidade de alimentos no domicílio para estimar o consumo alimentar usual individual.
The changes that have been happening in the Brazilian epidemiological scenario in the last decades result from deep social and economic modifications that include, among other things, changes in dietary habits. In Brazil, the only study that investigated family food consumption nationally was the National Family Expenditure Study done from 1974 to 1975. Although useful, national food consumption studies are expensive and only a few countries can conduct them regularly. Nonetheless, household budget surveys are important sources of data on the availability of food at home determined by records of foods purchased. Recent changes in consumption habits, particularly eating out, limit the use of data from household budget surveys to estimate food intake. Thus, the Brazilian government suggested that the next household budget survey to be done in 2008-2009 include a module on individual food consumption. Information on individual food intake will be used to supplement the data regarding food purchases. The objective of this study is to report the development of the methodology to be used in the module of individual food consumption of the household budget survey of 2008-2009. Budget data will be combined with intake data to estimate the usual individual food consumption.
Humans , Eating , Nutritional Epidemiology , Nutrition Surveys , Budgets/methods
