Quality of child anthropometric data from SISVAN, Brazil, 2008-2017.

OBJECTIVE: To evaluate the quality of anthropometric data of children recorded in the Food and Nutrition Surveillance System (SISVAN) from 2008 to 2017. METHOD: Descriptive study on the quality of anthropometric data of children under five years of age admitted in primary care services of the Unified Health System, from the individual databases of SISVAN. Data quality was annually assessed using the indicators: coverage, completeness, sex ratio, age distribution, weight and height digit preference, implausible z-score values, standard deviation, and normality of z-scores. RESULTS: In total, 73,745,023 records and 29,852,480 children were identified. Coverage increased from 17.7% in 2008 to 45.4% in 2017. Completeness of birth date, weight, and height corresponded to almost 100% in all years. The sex ratio was balanced and approximately similar to the expected ratio, ranging from 0.8 to 1. The age distribution revealed higher percentages of registrations from the ages of two to four years until mid-2015. A preference for terminal digits "zero" and "five" was identified among weight and height records. The percentages of implausible z-scores exceeded 1% for all anthropometric indices, with values decreasing from 2014 onwards. A high dispersion of z-scores, including standard deviations between 1.2 and 1.6, was identified mainly in the indices including height and in the records of children under two years of age and residents in the North, Northeast, and Midwest regions. The distribution of z-scores was symmetric for all indices and platykurtic for height/age and weight/age. CONCLUSIONS: The quality of SISVAN anthropometric data for children under five years of age has improved substantially between 2008 and 2017. Some indicators require attention, particularly for height measurements, whose quality was lower especially among groups more vulnerable to nutritional problems.

Quality of child anthropometric data from SISVAN, Brazil, 2008-2017 / Qualidade dos dados antropométricos infantis do Sisvan, Brasil, 2008-2017

ABSTRACT OBJECTIVE To evaluate the quality of anthropometric data of children recorded in the Food and Nutrition Surveillance System (SISVAN) from 2008 to 2017. METHOD Descriptive study on the quality of anthropometric data of children under five years of age admitted in primary care services of the Unified Health System, from the individual databases of SISVAN. Data quality was annually assessed using the indicators: coverage, completeness, sex ratio, age distribution, weight and height digit preference, implausible z-score values, standard deviation, and normality of z-scores. RESULTS In total, 73,745,023 records and 29,852,480 children were identified. Coverage increased from 17.7% in 2008 to 45.4% in 2017. Completeness of birth date, weight, and height corresponded to almost 100% in all years. The sex ratio was balanced and approximately similar to the expected ratio, ranging from 0.8 to 1. The age distribution revealed higher percentages of registrations from the ages of two to four years until mid-2015. A preference for terminal digits "zero" and "five" was identified among weight and height records. The percentages of implausible z-scores exceeded 1% for all anthropometric indices, with values decreasing from 2014 onwards. A high dispersion of z-scores, including standard deviations between 1.2 and 1.6, was identified mainly in the indices including height and in the records of children under two years of age and residents in the North, Northeast, and Midwest regions. The distribution of z-scores was symmetric for all indices and platykurtic for height/age and weight/age. CONCLUSIONS The quality of SISVAN anthropometric data for children under five years of age has improved substantially between 2008 and 2017. Some indicators require attention, particularly for height measurements, whose quality was lower especially among groups more vulnerable to nutritional problems.

RESUMO OBJETIVOS Avaliar a qualidade dos dados antropométricos de crianças registradas no Sistema de Vigilância Alimentar e Nutricional (Sisvan) no período 2008-2017. MÉTODOS Estudo descritivo sobre a qualidade dos dados antropométricos de crianças menores de 5 anos atendidas nos serviços de atenção primária do Sistema Único de Saúde, a partir das bases de dados individuais do Sisvan. A qualidade dos dados foi avaliada anualmente por meio dos indicadores: cobertura, completude, razão entre sexos, distribuição da idade, preferência por dígitos de peso e estatura, valores de escore-z implausíveis, desvio-padrão e normalidade dos escores-z. RESULTADOS No total, 73.745.023 registros e 29.852.480 crianças foram identificados. A cobertura aumentou de 17,7% em 2008 para 45,4% em 2017. A completude da data de nascimento, peso e estatura correspondeu a quase 100% para todos os anos. A razão entre sexos foi equilibrada e aproximadamente similar a razão esperada, variando entre 0,8 e 1. A distribuição da idade revelou maiores percentuais de registros entre as idades de 2 a 4 anos até meados de 2015. Uma preferência pelos dígitos terminais "zero" e "cinco" foi identificada entre os registros de peso e estatura. As porcentagens de escores-z implausíveis excederam 1% para todos os índices antropométricos, com redução dos valores a partir de 2014. Uma alta dispersão dos escores-z, incluindo desvios-padrão entre 1,2 e 1,6, foi identificada principalmente nos índices incluindo estatura e nos registros de crianças menores de 2 anos e residentes das regiões Norte, Nordeste e Centro-Oeste. A distribuição dos escores-z foi simétrica para todos os índices e platicúrtica para estatura/idade e peso/idade. CONCLUSÕES A qualidade dos dados antropométricos do Sisvan para crianças menores de 5 anos melhorou substancialmente entre 2008 e 2017. Alguns indicadores requerem atenção, sobretudo para medidas de estatura, cuja qualidade foi principalmente inferior entre os grupos mais vulneráveis a agravos nutricionais.

Soil-Plant Relationships in Soybean Cultivated under Crop Rotation after 17 Years of No-Tillage and Occasional Chiseling.

No-tillage cover crops contribute to better soil quality, being able to replace mechanized tillage management. This observation can only be made after several years of adopting conservationist practices and through research on soil-plant relationships. The objective of the research was to verify the relationship between the production components, physiological, root development, and physical-hydric properties of the soil in the yield of soybean grown in succession to different cover crops or with soil chiseling. The experiment was carried out in a randomized block design with four replications, comparing the cultivation of sunn hemp (Crotalaria juncea) and millet (Penninsetum glaucum L.) as cover crops and a treatment with soil chiseling. The evaluations were carried out during soybean (Glycine max L.) cultivation in the 2019/20 summer crop, that is, after 17 years of experimenting started in 2003. Rotation with sunn hemp increased soybean yield by 6% and 10%, compared with millet rotation and soil chiseling. The species used in crop rotation in a long-term no-tillage system interfere with the physical and water characteristics of the soil, affecting the physiological responses and soybean yield. The rotation with sunn hemp offers greater water stability to the plants and provides greater soybean yield in succession. Future research that better addresses year-to-year variation, architecture, and continuity of pores provided by crop rotation, and evaluations of gas exchange, fluorescence, and activities of stress enzymes in soybean plants may contribute to a better understanding of soil-plant relationships in long-term no-till.

Variação temporal da ocorrência do excesso de peso e da obesidade abdominal em adolescentes da cidade de Salvador, Bahia, Brasil / Temporal variation in the incidence of overweight and abdominal obesity among adolescents in the city of Salvador, Bahia, Brazil

Resumo O objetivo do estudo foi analisar a variação temporal da ocorrência do excesso de peso e da obesidade abdominal em adolescentes de escolas públicas de uma capital do nordeste brasileiro. Trata-se de um estudo incluindo informações de três levantamentos transversais realizados nos anos de 2001, 2009 e 2017, com 2.496 escolares de 10 a 18 anos de ambos os sexos, residentes na cidade de Salvador, Bahia. O excesso de peso foi avaliado por meio do Índice de Massa Corpórea para idade (IMC/I) e obesidade abdominal foi avaliada pela circunferência da cintura e razão cintura-estatura. A regressão Pooled OLS (Ordinary Least Squares), de efeito constante foi utilizada para avaliar a variação dos indicadores antropométricos ao longo do período. Os resultados deste estudo indicam que a prevalência de excesso de peso cresceu 103% e os indicadores da obesidade abdominal cresceram 153% e 142%, respectivamente no período analisado. Aumento na média do Índice de Massa Corpórea e da Razão cintura estatura foi maior entre as adolescentes e da média do IMC e da circunferência da cintura entre aqueles de 14 a 18 anos de idade. Conclui-se que houve expressivo crescimento nas prevalências do excesso de peso e da obesidade abdominal no período de 2001 a 2017 entre os adolescentes da cidade de Salvador.

Abstract The scope of this study was to analyze the temporal variation in the incidence of overweight and abdominal obesity among adolescents from public schools in a capital in northeastern Brazil. It is a study including information from three cross-sectional surveys carried out in 2001, 2009 and 2017, with 2,496 students aged 10 to 18 years of both sexes living in the city of Salvador, Bahia. Overweight was assessed using the Body Mass Index for Age (BMI/A) and abdominal obesity was assessed using waist circumference and waist-to-height ratio. Pooled OLS (Ordinary Least Squares) regression, with constant effect, was used to assess the variation of anthropometric indicators over the period. The results of this study indicate that the prevalence of overweight increased by 103% and the indicators of abdominal obesity increased by 153% and 142%, respectively, in the period under analysis. The increase in the mean body mass index and waist-to-height ratio was greater among adolescents and in the mean BMI and waist circumference among those aged 14 to 18 years old. The conclusion reached was that there was a significant increase in the prevalence of overweight and abdominal obesity in the period 2001 to 2017 among adolescents in the city of Salvador.

[Temporal variation in the incidence of overweight and abdominal obesity among adolescents in the city of Salvador, Bahia, Brazil]. / Variação temporal da ocorrência do excesso de peso e da obesidade abdominal em adolescentes da cidade de Salvador, Bahia, Brasil.

The scope of this study was to analyze the temporal variation in the incidence of overweight and abdominal obesity among adolescents from public schools in a capital in northeastern Brazil. It is a study including information from three cross-sectional surveys carried out in 2001, 2009 and 2017, with 2,496 students aged 10 to 18 years of both sexes living in the city of Salvador, Bahia. Overweight was assessed using the Body Mass Index for Age (BMI/A) and abdominal obesity was assessed using waist circumference and waist-to-height ratio. Pooled OLS (Ordinary Least Squares) regression, with constant effect, was used to assess the variation of anthropometric indicators over the period. The results of this study indicate that the prevalence of overweight increased by 103% and the indicators of abdominal obesity increased by 153% and 142%, respectively, in the period under analysis. The increase in the mean body mass index and waist-to-height ratio was greater among adolescents and in the mean BMI and waist circumference among those aged 14 to 18 years old. The conclusion reached was that there was a significant increase in the prevalence of overweight and abdominal obesity in the period 2001 to 2017 among adolescents in the city of Salvador.

O objetivo do estudo foi analisar a variação temporal da ocorrência do excesso de peso e da obesidade abdominal em adolescentes de escolas públicas de uma capital do nordeste brasileiro. Trata-se de um estudo incluindo informações de três levantamentos transversais realizados nos anos de 2001, 2009 e 2017, com 2.496 escolares de 10 a 18 anos de ambos os sexos, residentes na cidade de Salvador, Bahia. O excesso de peso foi avaliado por meio do Índice de Massa Corpórea para idade (IMC/I) e obesidade abdominal foi avaliada pela circunferência da cintura e razão cintura-estatura. A regressão Pooled OLS (Ordinary Least Squares), de efeito constante foi utilizada para avaliar a variação dos indicadores antropométricos ao longo do período. Os resultados deste estudo indicam que a prevalência de excesso de peso cresceu 103% e os indicadores da obesidade abdominal cresceram 153% e 142%, respectivamente no período analisado. Aumento na média do Índice de Massa Corpórea e da Razão cintura estatura foi maior entre as adolescentes e da média do IMC e da circunferência da cintura entre aqueles de 14 a 18 anos de idade. Conclui-se que houve expressivo crescimento nas prevalências do excesso de peso e da obesidade abdominal no período de 2001 a 2017 entre os adolescentes da cidade de Salvador.

Combined association of obesity and other cardiometabolic diseases with severe COVID-19 outcomes: a nationwide cross-sectional study of 21 773 Brazilian adult and elderly inpatients.

OBJECTIVES: To investigate the combined association of obesity, diabetes mellitus (DM) and cardiovascular disease (CVD) with severe COVID-19 outcomes in adult and elderly inpatients. DESIGN: Cross-sectional study based on registry data from Brazil's influenza surveillance system. SETTING: Public and private hospitals across Brazil. PARTICIPANTS: Eligible population included 21 942 inpatients aged ≥20 years with positive reverse transcription-PCR test for SARS-CoV-2 until 9 June 2020. MAIN OUTCOME MEASURES: Severe COVID-19 outcomes were non-invasive and invasive mechanical ventilation use, intensive care unit (ICU) admission and death. Multivariate analyses were conducted separately for adults (20-59 years) and elders (≥60 years) to test the combined association of obesity (without and with DM and/or CVD) and degrees of obesity with each outcome. RESULTS: A sample of 8848 adults and 12 925 elders were included. Among adults, obesity with DM and/or CVD showed higher prevalence of invasive (prevalence ratio 3.76, 95% CI 2.82 to 5.01) and non-invasive mechanical ventilation use (2.06, 1.58 to 2.69), ICU admission (1.60, 1.40 to 1.83) and death (1.79, 1.45 to 2.21) compared with the group without obesity, DM and CVD. In elders, obesity alone (without DM and CVD) had the highest prevalence of ICU admission (1.40, 1.07 to 1.82) and death (1.67, 1.00 to 2.80). In both age groups, obesity alone and combined with DM and/or CVD showed higher prevalence in all outcomes than DM and/or CVD. A dose-response association was observed between obesity and death in adults: class I 1.32 (1.05 to 1.66), class II 1.41 (1.06 to 1.87) and class III 1.77 (1.35 to 2.33). CONCLUSIONS: The combined association of obesity, diabetes and/or CVD with severe COVID-19 outcomes may be stronger in adults than in elders. Obesity alone and combined with DM and/or CVD had more impact on the risk of COVID-19 severity than DM and/or CVD in both age groups. The study also supports an independent relationship of obesity with severe outcomes, including a dose-response association between degrees of obesity and death in adults.

Uso de chupeta e a interrupção do aleitamento materno exclusivo: estudo de coorte / Pacifier use and interruption of exclusive breastfeeding: a cohort study / Uso de chupete e interrupción de lactancia materna exclusiva: estudio de cohorte

Este estudo se propôs a averiguar a existência de associação entre o uso de chupeta e a interrupção precoce do aleitamento materno exclusivo (AME) ao longo dos quatro primeiros meses de vida da criança. Para isso, utilizaram-se dados de uma coorte composta por 1.037 mães e crianças. Para estimar a associação entre a variável desfecho e aquelas de exposição ao longo do tempo, foi utilizada a técnica de Equação de Estimação Generalizada (GEE). Foi averiguado que a interrupção precoce do AME e o uso de chupeta aumentaram gradativamente conforme a idade da criança; no quarto mês, mais da metade das crianças já estava desmamada e fazia uso de chupeta. Os resultados da estimativa obtida por meio da GEE mostraram que permaneceu significativo apenas o uso de chupeta associado à baixa escolaridade materna como risco de interrupção precoce do AME, quando ajustado para as demais covariáveis. Os resultados reforçam a interferência negativa do uso da chupeta na duração do AME e a necessidade de informar às mães sobre as desvantagens do uso de chupetas.

This study investigates the possible association between pacifier use and early termination of exclusive breastfeeding for four months following birth. Data was collected from a cohort comprising1037 mothers and children. The association between the outcome variable and the exposure variables over time was estimated using the Generalized Estimation Equation (GEE). Early weaning and pacifier use increased gradually with the child's age; by the fourth month, more than half of the children were already weaned and using a pacifier. GEE estimations showed that only pacifier use associated with low maternal schooling level remained significant as a risk of early weaning, when adjusted for the other covariates. The results reinforce the negative interference of pacifier use on EB duration and the need to inform mothers about the disadvantages of pacifier use.

Este estudio tuvo como objetivo investigar la existencia de una asociación entre el uso de chupete y la interrupción temprana de la lactancia materna exclusiva (LME) durante los primeros cuatro meses de vida del niño. Se utilizaron datos de una cohorte, compuesta por 1.037 madres y niños. Para estimar la asociación entre la variable resultado y las de exposición en el tiempo, se utilizó la técnica de Ecuación de Estimación Generalizada (GEI). La interrupción temprana de la LME y el uso de un chupete aumentaron gradualmente conforme a la edad del niño; en el cuarto mes, más de la mitad de los niños ya habían sido destetados y usaban chupete. Los resultados de la estimación obtenida a través de GEI mostraron que solo el uso de chupetes asociado a bajos niveles de educación materna permaneció significativo como riesgo de interrupción temprana de la LME, cuando se ajustó con las otras covariables. Los resultados apuntan la interferencia negativa del uso de chupete en la duración de la LME y la necesidad de informar a las madres sobre las desventajas del uso de chupete.

Symptoms of asthma and associated factors in adolescents from Salvador, Bahia. / Sintomas de asma e fatores associados em adolescentes de Salvador, Bahia.

OBJECTIVE: Identify the factors associated with asthma symptoms in adolescents. METHODS: Cross-sectional study with the participation of 1,176 students between the ages of 11 and 17 years old, in Salvador, Bahia, Brazil. The asthma symptoms were identified by using the standardized questionnaire from The International Study of Asthma and Allergies in Childhood Program (ISAAC), phase III. The subjects' food intake data were collected by a semiquantitative food frequency questionnaire (FFQ) comprised of 97 food items. All of the information was collected during a single interview. Anthropometric, socioeconomic, and demographic data were collected from the study population. The robust Poisson model was adopted to obtain the raw and adjusted PR (prevalence ratio). RESULTS: From the total number of adolescents, 57.6% are female and 83.71% of them were between 13 and 17 years old. The prevalence of asthma symptoms was of 7.6%, being higher among males (9.62%). The prevalence of wheezing in the last 12 months was 8.6%. Among the adolescents with rhinitis and eczema, the prevalence of asthma symptoms was of 15.2 and 14.3%, respectively. After an adjusted analysis, the following factors were identified: females PR = 0.64 (95%CI 0.42 - 0.96), rhinitis PR = 3.23 (95%CI 2.17 - 4.83) and the 2nd tertile of the healthy pattern (moderate consumption) PR = 0.61 (95%CI 0.37 - 0.99). CONCLUSION: Rhinitis and eczema were presented as risk factors for asthma symptoms. The healthy food intake pattern that had been stratified in tertiles, presented the 2nd tertile as a protector for asthma symptoms.

Sintomas de asma e fatores associados em adolescentes de Salvador, Bahia / Symptoms of asthma and associated factors in adolescents from Salvador, Bahia

RESUMO: Objetivo: Identificar os fatores associados a sintomas de asma em adolescentes. Métodos: Estudo transversal, com a participação de 1.176 alunos com idade entre 11 e 17 anos, em Salvador, Bahia, Brasil. Os sintomas de asma foram identificados utilizando-se o questionário padronizado do The International Study of Asthma and Allergies in Childhood Program (ISAAC), fase III. A avaliação do consumo alimentar dos adolescentes foi obtida por meio de questionário da frequência alimentar (QFA) semiquantitativo, com 97 itens alimentares, sendo as informações coletadas em uma única entrevista com os estudantes. Foram coletados dados antropométricos, socioeconômicos e demográficos da população do estudo. O modelo de Poisson robusto foi adotado para obtenção da razão de prevalência (RP) bruta e ajustada. Resultados: Do total de adolescentes, 57,6% são do sexo feminino e 83,7% tinham de 13 a 17 anos de idade. A prevalência de sintomas de asma encontrada foi de 7,6%, sendo mais elevada no sexo masculino (9,62%). A prevalência de chiado nos últimos 12 meses foi de 8,6%. Entre os adolescentes que tinham rinite e eczema a prevalência de sintomas de asma foi de 15,2 e 14,3% respectivamente. Após análise ajustada, os seguintes fatores se associaram à asma: sexo feminino RP = 0,64 (IC95% 0,42 - 0,96), rinite RP = 3,23 (IC95% 2,17 - 4,83) e o 2o tercil do padrão saudável (consumo moderado) RP = 0,61 (IC95% 0,37 - 0,99). Conclusão: Rinite e eczema apresentaram-se como fatores de risco para sintomas de asma. O padrão alimentar saudável estratificado em tercil apresentou o segundo tercil como protetor para sintomas de asma.

ABSTRACT: Objective: Identify the factors associated with asthma symptoms in adolescents. Methods: Cross-sectional study with the participation of 1,176 students between the ages of 11 and 17 years old, in Salvador, Bahia, Brazil. The asthma symptoms were identified by using the standardized questionnaire from The International Study of Asthma and Allergies in Childhood Program (ISAAC), phase III. The subjects' food intake data were collected by a semiquantitative food frequency questionnaire (FFQ) comprised of 97 food items. All of the information was collected during a single interview. Anthropometric, socioeconomic, and demographic data were collected from the study population. The robust Poisson model was adopted to obtain the raw and adjusted PR (prevalence ratio). Results: From the total number of adolescents, 57.6% are female and 83.71% of them were between 13 and 17 years old. The prevalence of asthma symptoms was of 7.6%, being higher among males (9.62%). The prevalence of wheezing in the last 12 months was 8.6%. Among the adolescents with rhinitis and eczema, the prevalence of asthma symptoms was of 15.2 and 14.3%, respectively. After an adjusted analysis, the following factors were identified: females PR = 0.64 (95%CI 0.42 - 0.96), rhinitis PR = 3.23 (95%CI 2.17 - 4.83) and the 2nd tertile of the healthy pattern (moderate consumption) PR = 0.61 (95%CI 0.37 - 0.99). Conclusion: Rhinitis and eczema were presented as risk factors for asthma symptoms. The healthy food intake pattern that had been stratified in tertiles, presented the 2nd tertile as a protector for asthma symptoms.

Risk Factors for Adopting Extreme Weight-Control Behaviors among Public School Adolescents in Salvador, Brazil: A Case-Control Study.

OBJECTIVE: This study identifies the risk factors for extreme weight-control behaviors among adolescents in public school in Salvador, northeastern Brazil. METHODS: A case-control study nested to a cross-sectional study, including 252 adolescents of both sexes, age between 11 to 17 years, with 84 cases and 168 age-matched controls was conducted. The variable outcome is represented by extreme weight-control behaviors, integrated by following the variables: self-induced vomiting and the use of laxatives, diuretics, or diet pills. Covariables included body image dissatisfaction, dieting, prolonged fasting, and self-perception of body weight. The study also investigated the demographic and anthropometric variables and economic conditions of the students' families. Conditional logistic regression was used to identify risk factors for the adoption of extreme weight-control behaviors among adolescents. RESULTS: Among the adolescents investigated, the conditional logistic regression explained 22% the occurrence of extreme weight-control behaviors and showed that these behaviors were positively associated to overweight (odds ratio [OR] = 3.61; 95% confidence interval [CI], 1.42-9.17), body image dissatisfaction (OR = 3.87; 95% CI, 1.75-8.54), and the adoption of a restrictive diet (OR = 2.83; 95% CI, 1.16-6.91). CONCLUSIONS: The results of this study suggest that among adolescents, overweight, body image dissatisfaction, and restrictive diet are important risk factors to adoption of extreme weight-control behaviors.

The prevalence of overweight and obesity in adolescents in Bahia, Brazil.

AIM: A cross-sectional study was conducted with 1,477 middle school students enrolled in the public school network in Salvador, Bahia, Brazil to assess the prevalence of overweight and obesity. METHODS: The sample was determined using a two-stage cluster sampling technique for selecting schools and classes. A posteriori error was estimated. The students were classified as overweight or obese according to the World Health Organization's 2007 classifications. They were also classified according to age, stage of sexual maturity, socioeconomic class and the presence of abdominal obesity. RESULTS: Overall, 9.3% of the students were overweight and 6.4% were obese; therefore, 15.7% of the students were considered to have excess weight (obesity + overweight), at a 95% confidence interval. Abdominal obesity was found in 12.9% of all students and in 13% of those of normal weight. An association was found between excess weight and age < 14 years (p = 0.030) and abdominal obesity (p = 0.001). CONCLUSIONS: Intervention programs should be implemented to prevent and treat obesity in childhood and adolescence. In addition, professionals working with individuals in this age group should be sensitized to this problem. The need to standardize the anthropometric indicators used in the different studies is also emphasized.

Objetivo: Un estudio transversal se llevó a cabo con 1477 estudiantes de primaria matriculados en las escuelas públicas de Salvador, Bahía, Brasil, para evaluar la prevalencia del sobrepeso y la obesidad. Métodos: La muestra se determinó por la técnica de muestreo por conglomerados en dos etapas para la selección de escuelas y clases. Más tarde, posteriori error se calculó. Los estudiantes fueron clasificados como sobrepeso u obesos de acuerdo con la clasificación de la Organización Mundial de la Salud, 2007. Ellos también fueron clasificados de acuerdo a la edad, la etapa de maduración sexual, y la presencia de obesidad abdominal. Resultados: En general, el 9,3% de los estudiantes tenían sobrepeso y el 6,4% eran obesos, por lo tanto, el 15,7% de los alumnos se considera que tienen exceso de peso (sobrepeso + obesidad), con un intervalo de confianza del 95%. De la población total estudiada el 12,9% presentaron obesidad abdominal, esta condición se observa en el 13% de su peso normal. Se encontró asociación entre el sobrepeso y la edad < 14 AÑOs (p = 0,030) y obesidad abdominal (p = 0,001). Conclusiones: Los programas de intervención deben ser implementados para prevenir y tratar la obesidad en la infancia y la adolescencia. Además, los profesionales que trabajan con las personas en este grupo de edad deben ser sensibles a este problema. La necesidad de estandarizar los indicadores antropométricos utilizados en los diferentes estudios se enfatiza también.

The prevalence of overweight and obesity in adolescents in Bahia, Brazil / La prevalencia de sobrepeso y obesidad en adolescentes de Bahía, Brasil

Aim: A cross-sectional study was conducted with 1,477 middle school students enrolled in the public school network in Salvador, Bahia, Brazil to assess the prevalence of overweight and obesity. Methods: The sample was determined using a two-stage cluster sampling technique for selecting schools and classes. A posteriori error was estimated. The students were classified as overweight or obese according to the World Health Organization's 2007 classifications. They were also classified according to age, stage of sexual maturity, socioeconomic class and the presence of abdominal obesity. Results: Overall, 9.3% of the students were overweight and 6.4% were obese; therefore, 15.7% of the students were considered to have excess weight (obesity + overweight), at a 95% confidence interval. Abdominal obesity was found in 12.9% of all students and in 13% of those of normal weight. An association was found between excess weight and age < 14 years (p = 0.030) and abdominal obesity (p = 0.001). Conclusions: Intervention programs should be implemented to prevent and treat obesity in childhood and adolescence. In addition, professionals working with individuals in this age group should be sensitized to this problem. The need to standardize the anthropometric indicators used in the different studies is also emphasized (AU)

Objetivo: Un estudio transversal se llevó a cabo con 1477 estudiantes de primaria matriculados en las escuelas públicas de Salvador, Bahía, Brasil, para evaluar la prevalencia del sobrepeso y la obesidad. Métodos: La muestra se determinó por la técnica de muestreo por conglomerados en dos etapas para la selección de escuelas y clases. Más tarde, posteriori error se calculó. Los estudiantes fueron clasificados como sobrepeso u obesos de acuerdo con la clasificación de la Organización Mundial de la Salud, 2007. Ellos también fueron clasificados de acuerdo a la edad, la etapa de maduración sexual, y la presencia de obesidad abdominal. Resultados: En general, el 9,3% de los estudiantes tenían sobrepeso y el 6,4% eran obesos, por lo tanto, el 15,7% de los alumnos se considera que tienen exceso de peso (sobrepeso + obesidad), con un intervalo de confianza del 95%. De la población total estudiada el 12,9% presentaron obesidad abdominal, esta condición se observa en el 13% de su peso normal. Se encontró asociación entre el sobrepeso y la edad < 14 años (p = 0,030) y obesidad abdominal (p = 0,001). Conclusiones: Los programas de intervención deben ser implementados para prevenir y tratar la obesidad en la infancia y la adolescencia. Además, los profesionales que trabajan con las personas en este grupo de edad deben ser sensibles a este problema. La necesidad de estandarizar los indicadores antropométricos utilizados en los diferentes estudios se enfatiza también (AU)

The prevalence of wheezing and its association with body mass index and abdominal obesity in children.

OBJECTIVE: To evaluate the relative importance of body mass index (BMI) and abdominal obesity in the prevalence of wheezing in Brazilian children. MATERIALS AND METHODS: This is a cross-sectional study of male and female students, 6-12 years old, from the public elementary schools of São Francisco do Conde, Bahia, Northeast Brazil. Reports of wheezing in the past 12 months were collected using a questionnaire from the International Study of Asthma and Allergies in Childhood Program (ISAAC) phase III, adapted to Portuguese. Anthropometric, demographic, and socioeconomic information was collected. Multivariate logistic regression analyses were used to assess the associations of interest. RESULTS: Of the children surveyed, 10.6% reported wheezing. Excess weight was observed in 16.2%, 10.5%, and 7.9% of the sample, measured by BMI, waist circumference (WC), and the waist-to-height ratio (WHtR), respectively. The percentage of patients with wheezing attributable to BMI ≥ 85th percentile (8.2%) slightly exceeded those identified with abdominal obesity, WC ≥ 80th percentile (7.3%) and WHtR > 0.5 (7.1%). CONCLUSION: The results suggest that an excess of fat deposits, either in the abdominal region or elsewhere in the body, increased the risk of wheezing. Since obesity is an important public health problem worldwide, control of this problem may partially reduce the occurrence of wheezing in youth.

Fatores associados à inatividade física em adolescentes de 10-14 anos de idade, matriculados na rede pública de ensino do município de Salvador, BA / Factors associated with physical inactivity in adolescents aged 10-14 years, enrolled in the public school network of the city of Salvador, Brazil

OBJETIVO: Investigar os fatores associados à inatividade física em adolescentes de Salvador, BA. MÉTODOS: Trata-se de um estudo transversal, realizado com 803 jovens de 10 a 14 anos, matriculados na rede pública de ensino da cidade de Salvador, BA. Foram coletados dados referentes ao nível de atividade física (variável dependente), hábitos sedentários, dados demográficos, socioeconômicos, maternos e antropométricos (variáveis independentes). Optou-se pela análise de Poisson multivariada para as análises estatísticas de interesse. RESULTADOS: A prevalência da inatividade física foi de 49,6% (IC 95% 46,14 - 53,06); sendo maior entre as moças (feminino: 59,9%; masculino: 39%, p < 0,001). Em análise multivariada, verificou-se a associação inversa e estatisticamente significante entre inatividade física e condição econômica das famílias classificadas em Classe D/E Piores condições econômicas, tanto para os participantes do sexo masculino (RP = 0,73 IC 95% 0,54 - 0,046) quanto para os do sexo feminino (RP = 0,79 IC95% 0,66 - 0,96) . Em análise complementar por desmembramento dos domínios verificou-se tendência significativamente decrescente da inatividade física, representado pelo deslocamento, com o declínio das condições financeiras dos adolescentes em ambos os sexos (Rapazes - Classes B1/B2/C1 = 20,6,%, C2 = 11,0%, D/E = 6,0%, p=0,001; Moças - Classes B1/B2/C1 = 26,7%, C2 = 12,5%, D/E = 10,8%, p = 0,003). CONCLUÕES A prevalência de inatividade física é alta entre os adolescentes investigados. Jovens de baixo nível econômico são mais ativos em comparação com seus pares de melhor nível econômico. Contudo, a direção da associação entre atividade física e nível econômico é dependente dos domínios da atividade física avaliados.

OBJECTIVE: To investigate the factors associated to the physical inactivity among teenagers in Salvador, BA. METHODOLOGY: A cross-sectional study was made with 803 teenagers from 10 to 14 years old, enrolled in public high schools in Salvador, BA. Information concerning physical activity levels (dependent variable), sedentary behavior, demographic, anthropometric, socioeconomic and maternal characteristics (independent variables) were collected. The Poisson multivariate analysis was chosen to analyze the statistical data. RESULTS: The prevalence of physical inactivity was 49,6% (CI 95% 46,14 - 53,06); with higher standards between females (girls: 59,9%; boys: 39%, p < 0,001). With the multivariate analyses, it was verified a inverse association between physical inactivity and family economical condition that was classified in D/E worse economical levels either among males (PR = 0,73, CI 95%, 0,54 - 0,046), as among females (PR = 0,79; CI 95%; 0,66 - 0,96). In complementary analysis according to domains of physical activity, It was observed a significant decrease of physical inactivity in displacement domain between teenagers of lower economical levels (Boys - Classes B1/B2/C1 = 20,6%, C2 = 11%, D/E = 6%, p = 0,001; Girls - Classes B1/B2/C1 = 26,7%, C2 = 12,5%, D/E = 10,8%, p = 0,003). CONCLUSIONS: The prevalence of physical inactivity is high among the studied teenagers. Youths with lower economical levels are more active comparing with those with higher economical standards. Moreover, the association between physical activity and economical condition is influenced by physical activity domain that was investigated.

Iniquidades socioeconômicas na conformação dos padrões alimentares de crianças e adolescentes / Socioeconomic inequality shaping the dietary patterns of children and teens

OBJETIVO: Identificar e quantificar a influência dos fatores socioeconômicos sobre os padrões alimentares. MÉTODOS: Estudo transversal de base populacional com amostra de 1.136 crianças e adolescentes de 7 a 14 anos de idade, de ambos os sexos, matriculados na rede pública de Salvador (BA), Brasil. O consumo alimentar foi medido por meio do questionário qualitativo de frequência alimentar. Os padrões de consumo foram identificados por meio de análise de componentes principais. Para o estudo da influência dos indicadores socioeconômicos na conformação dos padrões alimentares, foram utilizados modelos de regressão quantílica. RESULTADOS: Os padrões alimentares extraídos foram classificados em padrão obesogênico e padrão tradicional. Nos modelos de regressão quantílica, ajustados por faixa etária e por sexo, o menor grau de instrução materna esteve associado negativamente, em níveis significantes, na maioria dos percentis, ao consumo de alimentos que integram o padrão obesogênico. A baixa renda associou-se negativamente aos maiores percentis (p>95). Os dados indicam não haver influência dos indicadores socioeconômicos sobre o consumo de alimentos que integram o padrão tradicional. CONCLUSÃO: Conclui-se que há influência dos fatores socioeconômicos na adesão ao padrão obesogênico de consumo. Esse conjunto de resultados requer a atenção dos gestores públicos para a identificação de um padrão de consumo ocidental, visualizado amplamente nos estudos em que se avaliam padrões de consumo adotados na atualidade pela população brasileira - sobretudo por crianças e adolescentes -, caracterizados por englobar componentes alimentares de risco para as doenças crônicas não transmissíveis.

OBJECTIVE: The present study identified and quantified the influence of socioeconomic factors on dietary patterns. METHODS: This cross-sectional, population-based study investigated the food habits of 1136 children and adolescents of both genders, aged 7 to 14 years, enrolled in public schools of Salvador (BA), Brazil, using the qualitative food frequency questionnaire. Intake patterns were identified by principal component analysis. Quantile regression models were used to study the influence of socioeconomic indicators on dietary patterns. RESULTS: The sample’s eating patterns were classified into obesogenic or traditional. Quantile regression models adjusted for age and gender showed that, for most percentiles, low maternal education level was significantly negatively associated with consumption of foods included in the obesogenic pattern. Low income was negatively associated with the highest percentiles (p>95). The data showed that socioeconomic indicators do not influence the consumption of foods included in the traditional pattern. CONCLUSION: Socioeconomic factors promote adherence to obesogenic eating patterns. These results indicate that public authorities need to identify the Western consumption pattern, commonly observed in studies that assess the current consumption patterns of the Brazilian population, especially of children and adolescents, characterized by foods that promote non-communicable chronic diseases.

[Factors associated with early breastfeeding cessation: a birth cohort study in two municipalities in the Recôncavo region, Bahia State, Brazil]. / Fatores associados à interrupção precoce do aleitamento materno: um estudo de coorte de nascimento em dois municípios do Recôncavo da Bahia, Brasil.

This study aimed to identify the median duration of breastfeeding and associated factors in a cohort of 531 infants in two municipalities in the Recôncavo region, Bahia State, Brazil. Breastfeeding duration was estimated by survival analysis and its associations by the Cox multivariate model. Median duration of exclusive breastfeeding, mixed breastfeeding with complementary feeding, and total breastfeeding was 74.73, 211.25, and 432.63 days, respectively. Lack of prenatal care increased the risk of shortening exclusive breastfeeding by 173% (HR = 2.73; 95%CI: 1.89-3.93), [corrected] of adopting mixed breastfeeding with complementary feeding by 83% (HR = 1.83; [corrected] 95%CI: 1.06-3.16), and of discontinuing breastfeeding entirely by 38% (HR = 1.38; 95%CI: 1.06-1.81). Both maternal employment and residence in an urban area increased the risk of early breastfeeding cessation. Expansion of access to prenatal care and the safety network for employed mothers living in urban areas could increase breastfeeding duration in the target region.

Fatores associados à interrupção precoce do aleitamento materno: um estudo de coorte de nascimento em dois municípios do Recôncavo da Bahia, Brasil / Factors associated with early breastfeeding cessation: a birth cohort study in two municipalities in the Recôncavo region, Bahia State, Brazil

Este estudo objetivou identificar a duração mediana e os fatores associados à interrupção precoce do aleitamento materno. Envolveu uma coorte de nascimento de 531 crianças acompanhadas até os dois anos de idade em dois municípios do Recôncavo da Bahia, Brasil. Utilizaram-se a análise de sobrevivência e o modelo multivariado de Cox. A duração mediana foi de 74,73, 211,25 e 432,63 dias, respectivamente, para o aleitamento materno exclusivo, misto complementado e total. A ausência materna ao pré-natal elevou em 173% (HR = 2,73; IC95%: 1,89-3,93) o risco de diminuir a duração do aleitamento materno exclusivo, em 83% (HR = 1,83; IC95%: 1,06-3,16) o risco da adoção do aleitamento misto complementado e em 38% (HR = 1,38; IC95%: 1,06-1,81) o risco da descontinuidade do aleitamento materno. O trabalho materno fora do domicílio e a área de residência urbana aumentaram o risco para interrupção precoce do aleitamento materno. A ampliação do acesso ao pré-natal e da rede de proteção às mães que trabalham fora do domicilio e àquelas que residem na área urbana poderia aumentar a duração da amamentação no Recôncavo da Bahia.

This study aimed to identify the median duration of breastfeeding and associated factors in a cohort of 531 infants in two municipalities in the Recôncavo region, Bahia State, Brazil. Breastfeeding duration was estimated by survival analysis and its associations by the Cox multivariate model. Median duration of exclusive breastfeeding, mixed breastfeeding with complementary feeding, and total breastfeeding was 74.73, 211.25, and 432.63 days, respectively. Lack of prenatal care increased the risk of shortening exclusive breastfeeding by 167% (HR = 2.67; 95%CI: 1.85-3.83), of adopting mixed breastfeeding with complementary feeding by 82% (HR = 1.82; 95%CI: 1.06-3.16), and of discontinuing breastfeeding entirely by 38% (HR = 1.38; 95%CI: 1.06-1.81). Both maternal employment and residence in an urban area increased the risk of early breastfeeding cessation. Expansion of access to prenatal care and the safety network for employed mothers living in urban areas could increase breastfeeding duration in the target region.

Factors associated with physical inactivity in adolescents aged 10-14 years, enrolled in the public school network of the city of Salvador, Brazil.

OBJECTIVE: To investigate the factors associated to the physical inactivity among teenagers in Salvador, BA. METHODOLOGY: A cross-sectional study was made with 803 teenagers from 10 to 14 years old, enrolled in public high schools in Salvador, BA. Information concerning physical activity levels (dependent variable), sedentary behavior, demographic, anthropometric, socioeconomic and maternal characteristics (independent variables) were collected. The Poisson multivariate analysis was chosen to analyze the statistical data. RESULTS: The prevalence of physical inactivity was 49,6% (CI 95% 46,14 - 53,06); with higher standards between females (girls: 59,9%; boys: 39%, p < 0,001). With the multivariate analyses, it was verified a inverse association between physical inactivity and family economical condition that was classified in D/E worse economical levels either among males (PR = 0,73, CI 95%, 0,54 - 0,046), as among females (PR = 0,79; CI 95%; 0,66 - 0,96). In complementary analysis according to domains of physical activity, It was observed a significant decrease of physical inactivity in displacement domain between teenagers of lower economical levels (Boys - Classes B1/B2/C1 = 20,6%, C2 = 11%, D/E = 6%, p = 0,001; Girls - Classes B1/B2/C1 = 26,7%, C2 = 12,5%, D/E = 10,8%, p = 0,003). CONCLUSIONS: The prevalence of physical inactivity is high among the studied teenagers. Youths with lower economical levels are more active comparing with those with higher economical standards. Moreover, the association between physical activity and economical condition is influenced by physical activity domain that was investigated.