Dietary patterns and prevalence of multimorbidity in women in southern Brazil.

OBJECTIVE: This study aimed to investigate the association between dietary patterns and prevalence of multimorbidity in women. METHODS: This population-based cross-sectional study was conducted in 2015 and included 1,128 women aged 20 to 69 years living in the urban area of São Leopoldo municipality, southern Brazil. Multimorbidity was defined as the presence of two or more chronic conditions, among the 26 identified. Poisson regression with robust variance was used to investigate the association between the three dietary patterns (healthy, risk, and Brazilian), using different models adjusted for sociodemographic, behavioral, and nutritional status variables. RESULTS: The results showed differences in the prevalence of adherence to different dietary patterns and multimorbidity across age groups, with a prevalence of multimorbidity and a healthy dietary pattern showing a direct linear trend with age, whereas the risk dietary pattern showed an inverse linear trend with age. The prevalence of the Brazilian dietary pattern remained constant despite differences in age. After adjustment, we found that women with greater adherence to the Brazilian dietary pattern showed a 40% reduction in the prevalence of multimorbidity compared with those with less adherence (prevalence ratio, 0.60; 95% confidence interval, 0.40-0.86). CONCLUSION: The results revealed that the prevalence of multimorbidity was significantly lower in women with greater adherence to the Brazilian dietary pattern and highlight the importance of dietary interventions in early adulthood as a way to prevent multimorbidity in women.

Does sleep quality modify the relationship between common mental disorders and chronic low back pain in adult women?

OBJECTIVE: This study explored the association between common mental disorders (CMD) and chronic low back pain (CLBP) in women, while considering poor sleep quality as a potential effect modifier of this relationship. METHODS: A cross-sectional population-based study was conducted with a representative sample of 1068 women (age 20-69 years) living in the urban area of São Leopoldo, RS, Brazil. CLBP was defined as pain lasting for ≥3 months; CMD was assessed using the Self-Reporting Questionnaire (SRQ-20; score ≥8); poor sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI; score ≥5). Poisson regression with robust variance was used to estimate the prevalence ratios (PR) with 95% confidence intervals (CI). RESULTS: The prevalence of CLBP, CMD, and poor sleep quality was 46.8% (95% CI: 43.8-49.8), 33.5% (95% CI: 30.3-36.3), and 42.3% (95% CI: 39.3-45.2), respectively. Poor sleep quality was a significant modifier of the association between CMD and CLBP. Among women with poor sleep quality, women with CMD had a 48% higher probability of having CLBP compared to women without CMD and after adjustment for confounders (PR = 1.48; 95% CI: 1.23-1.77; p < 0.001). The relationship between CMD and CLBP was not statistically significant in women with good sleep quality. CONCLUSIONS: This study revealed a significant relationship between CMD and CLBP, wherein poor sleep quality acted as an effect modifier. Women with CMD and poor sleep quality were more vulnerable to CLBP.

The Impact of Diabetes on Mortality Among Elderly Patients Admitted for Treatment at a Hospital for Cardiovascular Disease in Southern Brazil.

BACKGROUND: Diabetes has been shown to be associated with increased mortality and morbidity worldwide. This study explored whether diabetes significantly impacts on outcomes among elderly adults with cardiovascular disease (CVD) admitted to a specialist hospital in Southern Brazil. DESIGN: A prospective cohort study of 411 patients admitted to hospital after a cardiac event between 2008 and 2010. METHODS: The primary end point was death by all causes during the follow up period of 6 months from admission. All hospital death reports matched those reported by the Brazilian Public Health Death Records. Cumulative probability of survival by Kaplan-Meier plot and log rank tests compared hospital admissions with or without diabetes. Adjusted and unadjusted hazard ratios (HR) for overall mortality were calculated. RESULTS AND CONCLUSIONS: The mean ± SD age of the subjects was 69.8 years ± 14 and 50% were men. Overall study mortality was 8.7%. Half of the deaths occurred in patients &#8805;80 years (p=0.001). Diabetes was associated with 53% of the overall mortality (p<0.01) and 79% of the CVD-related deaths (p<0.03). The adjusted HR was 2.88 (95% CI 1.42-5.84) for diabetic patients aged &#8805;80 years. In conclusion, the results suggest that elderly patients of European origin with diabetes residing in Southern Brazil admitted to hospital for specialist CVD treatment have poorer survival and higher risk of further CVD events 6 months after hospital discharge compared with those without. We recommend that better strategies for managing CVD risk factors among elderly diabetic patients from similar patient cohorts in Brazil are necessary.

Association between work shift and the practice of physical activity among workers of a poultry processing plant in Southern Brazil.

INTRODUCTION: The regular practice of physical activity (PA) has been associated with better health. In addition, job characteristics may determine the PA behaviours of employees, including the work shift. However, relatively few studies have examined the PA behaviour among shift workers. OBJECTIVE: This study aimed to investigate the association between work shift and the practice of PA among workers of a poultry processing plant in Southern Brazil. METHODS: A cross-sectional study was conducted with 1206 workers (786 females), ages 18 to 50, working in shifts on a production line that operates 24 hours/day. Workers who engaged in more than 150 minutes/week of PA were considered active. Multivariate analyses were conducted using Poisson regression and all analyses were stratified by gender. RESULTS: Of the total participants studied, 36% (95%CI: 33-39) were considered active and the sociodemographic characteristics associated with PA differed among males and females. Regarding work shift, night shift workers had higher prevalence of PA. However, increased PA was significantly associated with work shift particularly among females. After controlling for potential confounders, women who worked during the night shift were approximately 30% more active than those who worked during the day (PR[prevalence ratio]= 1.32;95%CI: 1.07-1.62;p=0.010). CONCLUSIONS: This study found a low prevalence of PA among the workers and indicated a significantly association between work shift and PA. Working at night was positively associated with regular PA, particularly among females. These results contribute for initiatives that aim to increase PA among the workers, take into account the job characteristics and gender differences.

Introducción: La práctica regular de actividad física (AF) se ha asociado con una mejor salud. Además, las características del trabajo se pueden determinar las conductas de la AF de los trabajadores, incluyendo el turno de trabajo. Sin embargo, relativamente pocos estudios han examinado el comportamiento AF entre los trabajadores por turnos. Objetivo: Este estudio tuvo como objetivo investigar la asociación entre turno de trabajo y la práctica de la AF entre los trabajadores de una planta de procesamiento de aves en el sur de Brasil. Métodos: Un estudio transversal se llevó a cabo con 1.206 trabajadores (786 mujeres), con edades entre 18 a 50 años, trabajando en turnos de una línea de producción que funciona las 24 horas/día. Los trabajadores que han participado en más de 150 minutos/semana de AF se consideraron activos. Se realizó un análisis multivariante mediante regresión de Poisson y todos los análisis se estratificó por sexo. Resultados: De los participantes en el estudio, el 36% (IC del 95%: 33-39) se consideraron activas y las características sociodemográficas asociadas con AF difirieron entre machos y hembras. En cuanto a los turnos de trabajo, los trabajadores del turno de noche tenían mayor prevalencia de la AF. Sin embargo, el aumento de la AF se asoció significativamente con el trabajo por turnos sobre todo entre las mujeres. Después de ajustar por factores de confusión, las mujeres que trabajaban en el turno de la noche fueron aproximadamente un 30% más activos que los que han trabajado durante el día (PR[razón de prevalencia]=1,32;IC del 95%: 1,07-1,62;p=0,010). Conclusiones: Este estudio encontró una baja prevalencia de PA entre los trabajadores e indicó una asociación significativa entre el trabajo por turnos y AF. Trabajar de noche se asoció positivamente con la AF regular, especialmente entre las mujeres. Estos resultados contribuyen a las iniciativas para aumentar la AF entre los trabajadores, teniendo en cuenta las características de las diferencias laborales y de género.

Epidemiologia da obesidade abdominal em mulheres adultas residentes no sul do Brasil / Adbominal obesity epidemiology amongst adult women resident in saothern Brazil

Foi realizado um estudo transversal de base populacional com uma amostra representativa de 981 mulheres de 20 a 60 anos residentes no sul do Brasil para investigar o efeito de fatores socioeconômicos, demográficos e do estilo de vida na ocorrência de obesidade abdominal. Adiposidade abdominal foi avaliada através da circunferência da cintura (CC) em centímetros (cm). Para descrever a amostra CC foi agrupada em três categorias:adequeada (CC<80 cm)adiposidade abdominal nível I (circunferêencia da cintura: 80 = CC = 87,9 cm) e adiposidade abdominal nível II (circunferência da cintura: CC = 88 cm) - cansiderada como obesidade abdominal. Para as outras análises, CC foi tratada como dicotômica: ausência ou presença de obesidade abdominal, respectivamente, CC < 88 cm e CC = 88 cm. A análise multivariada foi realizada com Regressão de Poisson. As prevalências de adiposidade abdominal foram 23 por cento (IC 95 por cento: 20,5-25,8) e 23,3 por cento (IC 95 por cento: 20,7-26,0), respectivamente, nível I e nivel II. Ter baixa escolaridade, não estar trabalhando, idade superior a 40 anos, história de obesidade familiar e estar casada/união foram factores de risco para obesidade abdominal. Houve maior risco também para a presença de hipertenão arterial (Prevalence Ratio - PR= 2,06; CI 95 por cento: 1,58-2,69) e mulheres com maior número de filhos (PR= 1,17; CI 95 por cento 1,00-1,37). Menarca tardia, aos 12-13 anos e aos 14 anos, foi fator protetor para obesidade abdominal comparada com mulheres que tiveram menarca entre 8 e 11 anos de idade, respectivamente, proteções de 31 por cento e 46 por cento. A compreensão de como a obesidadeabdominal se distribui na populacão permite o planejamento de ações mais efetivas para a redução permite o planejamento de nutrição e saúde pública.

[Prevalence of systemic hypertension and associated factors: a population-based study among women in the South of Brazil]. / Prevalência de hipertensão arterial sistêmica e fatores associados: um estudo de base populacional em mulheres no Sul do Brasil.

A cross-sectional study was carried out among women 20 to 60 years of age living in São Leopoldo, Rio Grande do Sul State, Brazil, to determine the prevalence of hypertension and associated factors. Census tract sampling was used, and the outcome was defined by the presence of arterial pressure >or= 140/90mmHg and/or use of anti-hypertensive drugs. Among 1,020 interviewed people, 267 (26.2%; 95%CI: 23.5-28.9) presented hypertension. Poisson regression showed a statistically significant association with age, skin color, marital status, family history, educational background, and nutritional status. The highest attributable fractions were observed among women with schooling