Prolonged exposure to iron powder and other mineral dusts can threaten the health of individuals, especially those with COPD. The goal of this study was to determine how environmental exposure to metal dust from two different mining centers in Brazil affects lung mechanics, inflammation, remodeling and oxidative stress responses in healthy and elastase-exposed mice. This study divided 72 male C57Bl/6 mice into two groups, the summer group and the winter group. These groups were further divided into six groups: control, nonexposed (SAL); nonexposed, given elastase (ELA); exposed to metal powder at a mining company (SAL-L1 and ELA-L1); and exposed to a location three miles away from the mining company (SAL-L2 and ELA-L2) for four weeks. On the 29th day of the protocol, the researchers assessed lung mechanics, bronchoalveolar lavage fluid (BALF), inflammation, remodeling, oxidative stress, macrophage iron and alveolar wall alterations (mean linear intercept-Lm). The Lm was increased in the ELA, ELA-L1 and ELA-L2 groups compared to the SAL group (p < 0.05). There was an increase in the total number of cells and macrophages in the ELA-L1 and ELA-L2 groups compared to the other groups (p < 0.05). Compared to the ELA and SAL groups, the exposed groups (ELA-L1, ELA-L2, SAL-L1, and SAL-L2) exhibited increased expression of IL-1ß, IL-6, IL-10, IL-17, TNF-α, neutrophil elastase, TIMP-1, MMP-9, MMP-12, TGF-ß, collagen fibers, MUC5AC, iNOS, Gp91phox, NFkB and iron positive macrophages (p < 0.05). Although we did not find differences in lung mechanics across all groups, there were low to moderate correlations between inflammation remodeling, oxidative stress and NFkB with elastance, resistance of lung tissue and iron positive macrophages (p < 0.05). Environmental exposure to iron, confirmed by evaluation of iron in alveolar macrophages and in air, exacerbated inflammation, initiated remodeling, and induced oxidative stress responses in exposed mice with and without emphysema. Activation of the iNOS, Gp91phox and NFkB pathways play a role in these changes.
Environmental Exposure , Iron , Pancreatic Elastase , Animals , Male , Mice , Bronchoalveolar Lavage Fluid/chemistry , Environmental Exposure/adverse effects , Inflammation/metabolism , Inflammation/chemically induced , Iron/toxicity , Lung/drug effects , Lung/metabolism , Lung/pathology , Mice, Inbred C57BL , Oxidative Stress/drug effects , Pancreatic Elastase/metabolism , Pancreatic Elastase/pharmacology , Powders/toxicity
Sarcopenia (the loss of muscle mass, strength and skeletal muscle function) increases mortality and the risk of hospitalization in the older population. Although it is known that older adults with type 2 diabetes mellitus (T2DM) have a higher risk of dynapenia and sarcopenia, few studies have investigated these conditions in middle-aged populations. The objective of this study was to investigate whether T2DM, its duration, the presence of albuminuria, and glycemic control are associated with sarcopenia and its components in adults. The cross-sectional analysis was based on data from visit 2 of the Brazilian Longitudinal Study of Adult Health (2012-2014). The 2018 European Working Group on Sarcopenia in Older People criteria were used to define dynapenia, low appendicular muscle mass (LAMM), and sarcopenia (absent/probable/confirmed). The explanatory variables were: T2DM; duration of T2DM; T2DM according to the presence of albuminuria; and glycemic control (HbA1C < 7%) among people with T2DM. A total of 12,132 participants (mean age = 55.5, SD: 8.9 years) were included. The odds ratio for LAMM was greater among those with T2DM, T2DM duration from 5 to 10 years, and T2DM without albuminuria. Chances of dynapenia were higher among those with T2DM, T2DM duration > 10 years, and T2DM with and without albuminuria. The variables T2DM, T2DM ≥ 10 years, and T2DM with albuminuria increased the odds of probable sarcopenia, and T2DM duration from 5 to 10 years increased the odds of confirmed sarcopenia. The results support the importance of frequently monitoring the musculoskeletal mass and strength of individuals with T2DM to prevent sarcopenia and related outcomes.
Diabetes Mellitus, Type 2 , Sarcopenia , Humans , Middle Aged , Aged , Sarcopenia/complications , Diabetes Mellitus, Type 2/complications , Brazil/epidemiology , Cross-Sectional Studies , Longitudinal Studies , Albuminuria/complications , Hand Strength/physiology
Abstract: Sarcopenia (the loss of muscle mass, strength and skeletal muscle function) increases mortality and the risk of hospitalization in the older population. Although it is known that older adults with type 2 diabetes mellitus (T2DM) have a higher risk of dynapenia and sarcopenia, few studies have investigated these conditions in middle-aged populations. The objective of this study was to investigate whether T2DM, its duration, the presence of albuminuria, and glycemic control are associated with sarcopenia and its components in adults. The cross-sectional analysis was based on data from visit 2 of the Brazilian Longitudinal Study of Adult Health (2012-2014). The 2018 European Working Group on Sarcopenia in Older People criteria were used to define dynapenia, low appendicular muscle mass (LAMM), and sarcopenia (absent/probable/confirmed). The explanatory variables were: T2DM; duration of T2DM; T2DM according to the presence of albuminuria; and glycemic control (HbA1C < 7%) among people with T2DM. A total of 12,132 participants (mean age = 55.5, SD: 8.9 years) were included. The odds ratio for LAMM was greater among those with T2DM, T2DM duration from 5 to 10 years, and T2DM without albuminuria. Chances of dynapenia were higher among those with T2DM, T2DM duration > 10 years, and T2DM with and without albuminuria. The variables T2DM, T2DM ≥ 10 years, and T2DM with albuminuria increased the odds of probable sarcopenia, and T2DM duration from 5 to 10 years increased the odds of confirmed sarcopenia. The results support the importance of frequently monitoring the musculoskeletal mass and strength of individuals with T2DM to prevent sarcopenia and related outcomes.
Resumo: A sarcopenia (perda de massa muscular, força e função muscular esquelética) aumenta a mortalidade e o risco de hospitalização em idosos. Idosos com diabetes mellitus tipo 2 (DMT2) apresentam risco elevado de desenvolver dinapenia e sarcopenia, mas poucos estudos investigaram populações de meia-idade. O objetivo foi investigar se DMT2, sua duração, a presença de albuminúria e o controle glicêmico estão associados à sarcopenia e seus componentes em adultos. Análise transversal baseada nos dados da segunda visita do Estudo Longitudinal de Saúde do Adulto (2012-2014). Os critérios do European Working Group on Sarcopenia in Older People [Grupo de Trabalho Europeu sobre Sarcopenia em Pessoas Idosas] de 2018 foram usados para definir dinapenia, baixa massa muscular apendicular e sarcopenia (ausente/provável/confirmada). As variáveis explicativas foram: DMT2; duração do DMT2; DMT2 de acordo com a presença de albuminúria; e controle glicêmico (HbA1c < 7%) entre pessoas com DMT2. Foram incluídos 12.132 participantes (idade média de 55,5; DP: 8,9 anos). A razão de chances para baixa massa muscular apendicular foi maior entre pessoas com DMT2, duração do DMT2 entre 5 e 10 anos e DMT2 sem albuminúria. As chances de dinapenia foram maiores entre pessoas com DMT2, duração do DMT2 > 10 anos e DMT2 com e sem albuminúria. DMT2, DMT2 ≥ 10 anos e DMT2 com albuminúria aumentaram as chances de sarcopenia provável e duração do DMT2 entre 5 e 10 anos aumentaram as chances de sarcopenia confirmada. Os resultados reforçam a importância do monitoramento frequente da massa e da força muscular em indivíduos com DMT2 para prevenir a sarcopenia e desfechos relacionados.
Resumen: La sarcopenia (pérdida de masa muscular, fuerza y función muscular esquelética) aumenta la mortalidad y el riesgo de hospitalización en ancianos. Los ancianos con diabetes mellitus tipo 2 (DMT2) presentan un mayor riesgo de sufrir dinapenia y sarcopenia, pero pocos estudios han investigado poblaciones de mediana edad. El objetivo fue investigar si la DMT2, su duración, la presencia de albuminuria y el control glucémico están asociados con la sarcopenia y sus componentes en adultos. Análisis transversal basado en los datos de la visita 2 del Estudio Longitudinal de Salud del Adulto en Brasil (2012-2014). Se utilizaron los criterios del European Working Group on Sarcopenia in Older People [Grupo de Trabajo Europeo sobre Sarcopenia en Personas Mayores] del 2018 para definir dinapenia, baja masa muscular apendicular y sarcopenia (ausente/probable/confirmada). Las variables explicativas fueron las siguientes: DMT2; duración de la DMT2; DMT2 según la presencia de albuminuria; y control glucémico (HbA1c < 7%) entre personas con DMT2. Se incluyeron 12.132 participantes (edad media = 55,5, DE: 8,9 años). La razón de probabilidades de masa muscular apendicular baja fue mayor entre personas con DMT2, duración de la DMT2 entre 5 y 10 años y DMT2 sin albuminuria. Las probabilidades de dinapenia fueron mayores entre las personas con DMT2, duración de la DMT2 > 10 años y DMT2 con y sin albuminuria. Las condiciones de DMT2, DMT2 ≥ 10 años y DMT2 con albuminuria aumentaron las probabilidades de sarcopenia probable y la duración de la DMT2 entre 5 y 10 años las probabilidades de sarcopenia confirmada. Los resultados refuerzan la importancia del monitoreo frecuente de la masa y de la fuerza musculoesquelética en individuos con DMT2 para prevenir la sarcopenia y los desenlaces relacionados.
OBJECTIVES: to estimate the prevalence of leisure-time physical activity and sedentary behavior in adults in Brazil. METHODS: this was a cross-sectional, population-based study carried out in a sample of 88,531 Brazilians, using data from the 2019 National Health Survey; leisure-time physical activity (overall and aerobic exercise) was measured according to the World Health Organization guidelines; the weighted prevalence and respective 95% confidence intervals (95%CI) of physical activity, physical inactivity and sedentary behavior were estimated. RESULTS: according to the selected sample, 26.4% (95%CI 25.9;27.1) of Brazilian adults were physically active, 14.0% (95%CI 13.5;14.4) were insufficiently physically active and 59.5% (95%CI 58.8;60.2) were physically inactive; sedentary behavior ≥ 6 hours was reported by 30.1% (95%CI 29.5;30.8) of the population; only 8.6% (95%CI 8.2;8.9) met the recommendations for muscle-strengthening activities. CONCLUSION: most Brazilian adults were physically inactive and did not meet international recommendations for leisure-time physical activity and reduction in sedentary behavior.
Leisure Activities , Sedentary Behavior , Humans , Adult , Brazil , Cross-Sectional Studies , Exercise
Objectives: to estimate the prevalence of leisure-time physical activity and sedentary behavior in adults in Brazil. Methods: this was a cross-sectional, population-based study carried out in a sample of 88,531 Brazilians, using data from the 2019 National Health Survey; leisure-time physical activity (overall and aerobic exercise) was measured according to the World Health Organization guidelines; the weighted prevalence and respective 95% confidence intervals (95%CI) of physical activity, physical inactivity and sedentary behavior were estimated. Results: according to the selected sample, 26.4% (95%CI 25.9;27.1) of Brazilian adults were physically active, 14.0% (95%CI 13.5;14.4) were insufficiently physically active and 59.5% (95%CI 58.8;60.2) were physically inactive; sedentary behavior ≥ 6 hours was reported by 30.1% (95%CI 29.5;30.8) of the population; only 8.6% (95%CI 8.2;8.9) met the recommendations for muscle-strengthening activities. Conclusion: most Brazilian adults were physically inactive and did not meet international recommendations for leisure-time physical activity and reduction in sedentary behavior.
Objetivos: estimar la prevalencia de actividad física en el tiempo libre y comportamiento sedentario de adultos en Brasil. Métodos: estudio seccional, poblacional, de la muestra de la Encuesta Nacional de Salud de 2019 a partir de lo cual, se estimó la prevalencia ponderada (porcentaje e intervalo de confianza del 95%) de actividad física (general y aeróbica), la inactividad física y el comportamiento sedentario. Resultados: según la muestra elegida, 26,4% (IC95% 25,9;27,1) son físicamente activos, 59,5% (IC95% 58,8;60,2) son inactivos, 14,0% (IC95% 13,5;14,4) son insuficientemente activos y 30,1% (IC95% 29,5;30,8) pasan ≥6 horas sedentarios en su tiempo libre; sólo el 8,6% (IC95% 8,2;8,9) de los adultos cumple con las recomendaciones de actividad física para fortalecimiento muscular. Conclusión: la mayoría de los adultos brasileños son inactivos, no cumplen con las recomendaciones internacionales de actividad física en el tiempo libre y la restricción del tiempo sedentario.
Objetivos: estimar a prevalência de atividade física no tempo livre e comportamento sedentário em adultos no Brasil. Métodos: estudo seccional, populacional, na amostra de 88.531 brasileiros da Pesquisa Nacional de Saúde de 2019; a atividade física (geral e modalidades aeróbias) no tempo livre foi mensurada conforme as diretrizes da Organização Mundial da Saúde; estimaram-se as prevalências ponderadas, e respectivos intervalos de confiança de 95% (IC95%), de atividade física, inatividade física e tempo sedentário. Resultados: a partir da amostra selecionada, 26,4% (IC95% 25,9;27,1) dos adultos brasileiros eram fisicamente ativos, 14,0% (IC95% 13,5;14,4) eram insuficientemente ativos e 59,5% (IC95% 58,8;60,2) eram inativos; o tempo sedentário ≥ 6 horas foi relatado por 30,1% (IC95% 29,5;30,8) da população; apenas 8,6% (IC95% 8,2;8,9) atenderam às recomendações de atividade física para fortalecimento muscular. Conclusão: a maioria dos brasileiros adultos era inativa e não atendeu às recomendações internacionais de atividade física no tempo livre e restrição de tempo sedentário.
Existing methods for assessing food consumption are subject to measurement errors, especially the underreporting of energy intake, characterized by reporting energy intake below the minimum necessary to maintain body weight. This study aimed to compare the identification of energy intake underreporters using different predictive equations and instruments to collect dietary data. The study was conducted with 101 selected participants in the third wave of the Longitudinal Study of Adult Health (ELSA-Brasil) at the University Hospital of the University of São Paulo. For the dietary assessment, we applied a food frequency questionnaire (FFQ), two 24-hour diet recall (24hR) using the GloboDiet software, and two 24hR using the Brasil-Nutri software. The energy intake underreport obtained from the FFQ was 13%, 16%, and 1% using the equations proposed by Goldberg et al. (1991), Black (2000), and McCrory et al. (2002), respectively. With these same equations, the 24hR described an underreport of 9.9%, 14.9%, and 0.9% respectively with the GloboDiet software and 14.7%, 15.8%, and 1.1% respectively with the Brasil-Nutri software. We verified a low prevalence of underreported energy intake among the three self-report-based dietary data collection methods (FFQ, 24hR with GloboDiet, and Brasil-Nutri). Though no statistically significant differences were found among three methods, the equations for each method differed among them. The agreement of energy intake between the methods was very similar, but the best was between GloboDiet and Brasil-Nutri.
Diet , Energy Intake , Adult , Brazil , Diet Records , Diet Surveys , Humans , Longitudinal Studies , Surveys and Questionnaires
Repeated cognitive assessment in longitudinal studies favors the occurrence of retest effects, usually increasing the scores obtained at the follow-up assessments when compared to baseline. Therefore, retest effects can compromise the evaluation of cognitive decline in older adults. Objectives: We aimed to verify the occurrence of the retest effect and the impact of sociodemographic characteristics on the follow-up scores in a sample of 5,592 participants with a diverse sociodemographic profile, who were assessed twice during 4 years of follow-up. Methods: We tested two possible approaches to correct the retest effect and calculated the Reliable Change Index. Results: We observed increased scores at the follow-up assessment after 4 years, but the results indicate a modest occurrence of retest effects. The regression difference correction successfully generated follow-up corrected scores, while the mean difference did not provide effective corrections. Sociodemographic characteristics had a minor impact on the retest. Conclusions: We recommend the regression difference correction for retest effects. The absence of this methodological approach might lead to biased results using longitudinal cognitive scores.
Avaliações cognitivas repetidas em estudos longitudinais favorecem a ocorrência de efeitos de retestagem ou de prática, geralmente aumentando os escores obtidos nas avaliações de acompanhamento quando comparados aos da primeira avaliação. Sendo assim, os efeitos do retestagem podem comprometer a verificação do declínio cognitivo em idosos. Objetivos: Objetivamos verificar a ocorrência do efeito de prática e o impacto das características sociodemográficas nos escores de seguimento em uma amostra de 5.592 participantes com perfil sociodemográfico diverso, avaliada duas vezes durante quatro anos de seguimento. Métodos: Testamos duas abordagens possíveis para corrigir o efeito de prática e calculamos o índice de mudança confiável. Resultados: Observamos escores sutilmente maiores na avaliação de seguimento após quatro anos, o que sugere a ocorrência de efeitos de retestagem. A correção pela diferença da regressão gerou escores corrigidos de acompanhamento satisfatórios, enquanto a correção pela diferença média não forneceu correções eficazes. As características sociodemográficas tiveram impacto mínimo no efeito de prática. Conclusões: Recomendamos a forma de correção pela diferença da regressão para efeitos de retestagem. A ausência dessa abordagem metodológica, quando utilizamos escores cognitivos longitudinais, pode levar a resultados enviesados.
ABSTRACT. Repeated cognitive assessment in longitudinal studies favors the occurrence of retest effects, usually increasing the scores obtained at the follow-up assessments when compared to baseline. Therefore, retest effects can compromise the evaluation of cognitive decline in older adults. Objectives: We aimed to verify the occurrence of the retest effect and the impact of sociodemographic characteristics on the follow-up scores in a sample of 5,592 participants with a diverse sociodemographic profile, who were assessed twice during 4 years of follow-up. Methods: We tested two possible approaches to correct the retest effect and calculated the Reliable Change Index. Results: We observed increased scores at the follow-up assessment after 4 years, but the results indicate a modest occurrence of retest effects. The regression difference correction successfully generated follow-up corrected scores, while the mean difference did not provide effective corrections. Sociodemographic characteristics had a minor impact on the retest. Conclusions: We recommend the regression difference correction for retest effects. The absence of this methodological approach might lead to biased results using longitudinal cognitive scores.
RESUMO. Avaliações cognitivas repetidas em estudos longitudinais favorecem a ocorrência de efeitos de retestagem ou de prática, geralmente aumentando os escores obtidos nas avaliações de acompanhamento quando comparados aos da primeira avaliação. Sendo assim, os efeitos do retestagem podem comprometer a verificação do declínio cognitivo em idosos. Objetivos: Objetivamos verificar a ocorrência do efeito de prática e o impacto das características sociodemográficas nos escores de seguimento em uma amostra de 5.592 participantes com perfil sociodemográfico diverso, avaliada duas vezes durante quatro anos de seguimento. Métodos: Testamos duas abordagens possíveis para corrigir o efeito de prática e calculamos o índice de mudança confiável. Resultados: Observamos escores sutilmente maiores na avaliação de seguimento após quatro anos, o que sugere a ocorrência de efeitos de retestagem. A correção pela diferença da regressão gerou escores corrigidos de acompanhamento satisfatórios, enquanto a correção pela diferença média não forneceu correções eficazes. As características sociodemográficas tiveram impacto mínimo no efeito de prática. Conclusões: Recomendamos a forma de correção pela diferença da regressão para efeitos de retestagem. A ausência dessa abordagem metodológica, quando utilizamos escores cognitivos longitudinais, pode levar a resultados enviesados.
Humans , Aged , Cognition , Data Accuracy , Cognitive Dysfunction
Existing methods for assessing food consumption are subject to measurement errors, especially the underreporting of energy intake, characterized by reporting energy intake below the minimum necessary to maintain body weight. This study aimed to compare the identification of energy intake underreporters using different predictive equations and instruments to collect dietary data. The study was conducted with 101 selected participants in the third wave of the Longitudinal Study of Adult Health (ELSA-Brasil) at the University Hospital of the University of São Paulo. For the dietary assessment, we applied a food frequency questionnaire (FFQ), two 24-hour diet recall (24hR) using the GloboDiet software, and two 24hR using the Brasil-Nutri software. The energy intake underreport obtained from the FFQ was 13%, 16%, and 1% using the equations proposed by Goldberg et al. (1991), Black (2000), and McCrory et al. (2002), respectively. With these same equations, the 24hR described an underreport of 9.9%, 14.9%, and 0.9% respectively with the GloboDiet software and 14.7%, 15.8%, and 1.1% respectively with the Brasil-Nutri software. We verified a low prevalence of underreported energy intake among the three self-report-based dietary data collection methods (FFQ, 24hR with GloboDiet, and Brasil-Nutri). Though no statistically significant differences were found among three methods, the equations for each method differed among them. The agreement of energy intake between the methods was very similar, but the best was between GloboDiet and Brasil-Nutri.
Os métodos existentes para avaliar consumo alimentar estão sujeitos a erros de medição, especialmente à subnotificação de ingestão calórica, que descreve a ingestão calórica abaixo do mínimo necessário para manter o peso corporal. Este estudo buscou comparar a identificação de subnotificações de ingestão calórica através de diferentes equações preditivas e instrumentos para coletar dados dietéticos. Este estudo foi realizado com 101 participantes selecionados na terceira onda do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil) do Hospital Universitário da Universidade de São Paulo. A partir da avaliação dietética, aplicamos um questionário de frequência alimentar (QFA), dois recordatórios de 24 horas (24hR) pelo software GloboDiet e dois 24hR utilizando o software Brasil-Nutri. A subnotificação de ingestão calórica obtida pelo QFA foi de 13%, 16% e 1%, utilizando-se as equações propostas por Goldberg et al. (1991), Black (2000) e McCrory et al. (2002), respectivamente. Com essas mesmas equações, o 24hR achou uma subnotificação de 9,9%, 14,9% e 0,9%, respectivamente, com o software GloboDiet e de 14,7%, 15,8% e 1,1%, respectivamente, com o software Brasil-Nutri. Verificou-se baixa prevalência de ingestão calórica subnotificada entre os três métodos de captação de dados dietéticos por autorrelato (FFQ e 24hR com GloboDiet e Brasil-Nutri). As equações para cada método diferem entre si embora não tenhamos encontrado diferenças estatisticamente significativas entre os três métodos. A concordância de ingestão calórica entre os métodos foi muito semelhante, mas a melhor foi entre a GloboDiet e a Brasil-Nutri.
Los métodos existentes para evaluar el consumo de alimentos están sujetos a errores de medición, especialmente la infradeclaración de la ingesta de energía, caracterizada por la notificación de la ingesta de energía por debajo del mínimo necesario para mantener el peso corporal. El objetivo de este estudio era comparar la identificación de las infradeclaraciones de ingesta energética utilizando diferentes ecuaciones de predicción e instrumentos de recogida de datos dietéticos. El estudio se realizó con 101 participantes seleccionados en la tercera ola del Estudio Longitudinal de Salud del Adulto (ELSA-Brasil) en el Hospital Universitario de la Universidad de São Paulo. Para la evaluación de la dieta, se aplicó un cuestionario de frecuencia de alimentos (QFA), dos recordatorios de dieta de 24 horas (24hR) utilizando el software GloboDiet, y dos 24hR utilizando el software Brasil-Nutri. La infradeclaración de la ingesta energética obtenida del QFA fue del 13%, el 16% y el 1,0% utilizando las ecuaciones propuestas por Goldberg et al. (1991), Black (2000) y McCrory et al. (2002), respectivamente. Con estas mismas ecuaciones, el 24hR describió una infradeclaración del 9,9%, el 14,9% y el 0,9% respectivamente con el software GloboDiet y del 14,7%, el 15,8% y el 1,1% respectivamente con el software Brasil-Nutri. Se verificó una baja prevalencia de ingesta de energía subdeclarada entre los tres métodos de recogida de datos dietéticos basados en el autoinforme (QFA, 24hR con GloboDiet y Brasil-Nutri). Aunque no se encontraron diferencias estadísticamente significativas entre los tres métodos, las ecuaciones de cada uno de ellos diferían entre sí. La concordancia de la ingesta de energía entre los métodos fue muy similar, pero la mejor fue entre GloboDiet y Brasil-Nutri.
Humans , Adult , Energy Intake , Diet , Brazil , Diet Records , Diet Surveys , Surveys and Questionnaires , Longitudinal Studies
ABSTRACT BACKGROUND: Cardiovascular risk factors can mediate the association between depression and cardiovascular diseases. OBJECTIVE: To evaluate cardiovascular risk factors in adult individuals with and without histories of major depression in the metropolitan region of São Paulo, Brazil. DESIGN AND SETTING: Cross-sectional study in São Paulo (SP), Brazil. METHODS: This study evaluated 423 individuals without any lifetime diagnosis of major depression and 203 individuals with a previous diagnosis of major depression (n = 626). The participants underwent a psychiatric evaluation using a structured clinical interview (SCID-1), an anthropometric evaluation and a clinical evaluation that included blood pressure measurement and assessment of fasting blood glucose, lipid profile and physical activity levels. RESULTS: Individuals with histories of major depression were more likely to be female (P < 0.0001). Individuals with lifetime diagnoses of major depression were more likely to be current smokers (odds ratio, OR 1.61; 95% confidence interval, CI 1.01-2.59) and to have diabetes (OR 1.79; 95% CI 1.01-3.21); and less likely to be obese (OR 0.58; 95% CI 0.35-0.94). CONCLUSION: Individuals with major depression had higher odds of presenting tobacco smoking and diabetes, and lower odds of being obese. Healthcare professionals need to be aware of this, so as to increase the rates of diagnosis and treatment in this population.
Humans , Male , Female , Adult , Cardiovascular Diseases/etiology , Cardiovascular Diseases/epidemiology , Depressive Disorder, Major/epidemiology , Brazil/epidemiology , Cross-Sectional Studies , Risk Factors , Heart Disease Risk Factors
BACKGROUND: Cardiovascular risk factors can mediate the association between depression and cardiovascular diseases. OBJECTIVE: To evaluate cardiovascular risk factors in adult individuals with and without histories of major depression in the metropolitan region of São Paulo, Brazil. DESIGN AND SETTING: Cross-sectional study in São Paulo (SP), Brazil. METHODS: This study evaluated 423 individuals without any lifetime diagnosis of major depression and 203 individuals with a previous diagnosis of major depression (n = 626). The participants underwent a psychiatric evaluation using a structured clinical interview (SCID-1), an anthropometric evaluation and a clinical evaluation that included blood pressure measurement and assessment of fasting blood glucose, lipid profile and physical activity levels. RESULTS: Individuals with histories of major depression were more likely to be female (P < 0.0001). Individuals with lifetime diagnoses of major depression were more likely to be current smokers (odds ratio, OR 1.61; 95% confidence interval, CI 1.01-2.59) and to have diabetes (OR 1.79; 95% CI 1.01-3.21); and less likely to be obese (OR 0.58; 95% CI 0.35-0.94). CONCLUSION: Individuals with major depression had higher odds of presenting tobacco smoking and diabetes, and lower odds of being obese. Healthcare professionals need to be aware of this, so as to increase the rates of diagnosis and treatment in this population.
Cardiovascular Diseases , Depressive Disorder, Major , Adult , Brazil/epidemiology , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/etiology , Cross-Sectional Studies , Depressive Disorder, Major/epidemiology , Female , Heart Disease Risk Factors , Humans , Male , Risk Factors
This study aimed to identify the sociodemographic and lifestyle factors associated with magnesium intake and describe the main food sources in the Brazilian Longitudinal Study of Adult Health (ELSA-Brazil). This observational, cross-sectional study was conducted using the baseline data from the ELSA-Brazil (2008-2010). Associations between usual magnesium intake and sociodemographic and lifestyle factors were analyzed using multiple linear regression. Food sources were identified by calculating the percentage contribution of each FFQ item to the amount of magnesium provided by all foods. The analysis was performed using Stata® software (version 12), assuming a statistical significance level of 5%. The top food sources to magnesium intake were as follows: beans, oats, nuts, white rice, orange, French bread, cooked fish, boneless meat, whole milk, and whole wheat bread. There were positive associations between magnesium intake and female sex; age ≥60 years; self-reported black, indigenous, or brown skin colors; per capita income ≥3 minimum wages, and moderate or vigorous physical activity levels. Sociodemographic and lifestyle factors were associated with magnesium intake among the evaluated individuals.
Energy Intake , Magnesium , Adult , Animals , Brazil , Cross-Sectional Studies , Diet , Female , Humans , Longitudinal Studies , Middle Aged
OBJETIVO: investigar o efeito do consumo de álcool em geral e do tipo de bebida alcoólica consumida, em diferentes medidas lipídicas. MÉTODO: o efeito do consumo de álcool foi investigado, bem como do tipo de bebida alcoólica, em diferentes medidas lipídicas, em ambos os sexos de população do Estudo Longitudinal de Saúde do Adulto. RESULTADOS: foram realizadas análises em relação ao tipo e quantidade de consumo de bebida alcoólica por sexo. O consumo baixo-a-moderado de álcool, independentemente do tipo de bebida alcoólica consumida, resultou em níveis mais elevados de HDL-colesterol, HDL2-colesterol e HDL3-colesterol em homens e mulheres. Não houve participantes da pesquisa que consumiam quantidade baixa a moderada de bebidas alcoólicas destiladas. Os triglicerídeos tiveram efeitos inversos para homens e mulheres no perfil lipídico. Para homens, bebidas destiladas contribuíram para melhor perfil dos triglicerídeos, enquanto para mulheres foi o contrário. Homens que consumiam bebidas alcoólicas destiladas tiveram níveis menores de triglicerídeos e mulheres que consumiam bebidas alcóolicas destiladas tiveram níveis maiores. Nossos resultados estão de acordo com os de estudos anteriores. CONCLUSÃO: o consumo de álcool resultou em níveis diferentes de medidas lipídicas séricas em homens e mulheres. Dessa forma, conclui-se que a resposta ao álcool tem diferenças biológicas.
OBJECTIVE: to investigate the effect of general alcohol consumption and of the type of alcoholic beverage consumed, in different lipid measurements. METHOD: the effect of alcohol consumption as well as that of the type of alcoholic beverage consumed were investigated, in different lipid measurements, for the participants in the Longitudinal Study on Adults' Health for both sexes. RESULTS: analyses were conducted on the type and amount of alcoholic beverage consumed by sex. Low-to-moderate alcohol consumption, regardless of the type of alcoholic beverage, resulted in higher levels of HDL-cholesterol, HDL2- cholesterol and HDL3-cholesterol in males and females. No participants in the study consumed low-to-moderate amounts of spirits. Triglycerides showed inverse effects for men and women according to the lipid profile. For men, spirits contributed to a better triglyceride profile while for women it was the opposite. Men who consumed spirits showed lower triglyceride levels, and women who consumed that beverage type had higher levels. Our results are in agreement with those of previous studies. CONCLUSION: alcohol consumption resulted in different levels of serum lipid measurements in men and women. Thus, it is concluded that response to alcohol has biological differences.
OBJETIVO: investigar el efecto del consumo de alcohol general, así como el tipo de bebida alcohólica consumida, en diferentes medidas lipídicas. MÉTODO: el efecto del consumo de alcohol fue investigado, así como el tipo de bebida alcohólica, en diferentes medidas lipídicas en ambos sexos de población del Estudio Longitudinal de Salud del Adulto. RESULTADOS: se realizaron análisis en relación al tipo y cantidad de consumo de bebida alcohólica por sexo. El consumo bajo a moderado de alcohol, independientemente del tipo de bebida alcohólica consumida, resultó en niveles más altos de HDL-colesterol, HDL2-colesterol y HDL3-coleseterol en hombres y mujeres. No hubo participantes de investigación que consumían en cantidad baja a moderada de bebidas alcohólicas destiladas. Los triglicéridos tuvieron efectos inversos para hombres y mujeres en el perfil lipídico. Para los hombres, las bebidas destiladas contribuyeron a un mejor perfil de los triglicéridos, mientras que para las mujeres fue lo contrario. Los hombres que consumían bebidas alcohólicas destiladas tenían niveles más pequeños de triglicéridos y las mujeres que consumían bebidas alcohólicas destiladas tuvieron niveles más altos. Nuestros resultados están de acuerdo con estudios anteriores. CONCLUSIÓN: el consumo de alcohol resultó en niveles significativamente mayores de HDL-colesterol, HDL2-colesterol y HDL3-colesterol, tanto en mujeres como en hombres. De esta forma, se concluye que la respuesta al alcohol tiene diferencias biológicas.
Humans , Male , Female , Adult , Middle Aged , Aged , Triglycerides , Alcohol Drinking , Cholesterol , Adult Health , Longitudinal Studies , Sex Distribution , Substance-Related Disorders , Alcoholism , Lipoproteins, HDL , Cholesterol, HDL
BACKGROUND: The mechanisms that underlie the link between migraine and cardiovascular diseases are not clear and arterial stiffness could play a role in that association. We analyzed the association between migraine and vascular stiffness measured by carotid-to-femoral pulse wave velocity (PWV-cf). METHODS: In a cross-sectional analysis of a well-defined population from the Longitudinal Study of Adult Health (ELSA-Brasil) with complete and validated information about migraine and aura according to the International Headache Society criteria, the association between arterial stiffness measured by PWV-cf was tested with multiple linear regression models [ß (95% CI)] comparing migraine without aura (MO) and migraine with aura (MA) to the reference group no-migraine (NM). Subsequent adjustments were made for mean arterial pressure, age, sex, education level, physical activity, alcohol use, diabetes mellitus, smoking, antihypertensive medication, body mass index, waist circumference, triglycerides, and LDL-c level to test the independence of the association between migraine status and pulse wave velocity. RESULTS: We studied 4,649 participants, 2,521 women (25.7% MO and 15% MA) and 2,128 men (11% MO and 4.3% MA). In NM, MO, and MA standard PWV-cf were 8.67 (±1.71) 8.11 (±1.31) and 8.01 (±1.47) m/s, respectively. Unadjusted PWV-cf differed between NM, MA, and MO (Pâ <â 0.001). After adjustment for mean arterial pressure PWV-cf in NM did not differ anymore from MA (Pâ =â 0.525) and MO (Pâ =â 0.121), respectively. Fully adjusted models also yielded nonsignificant coefficients ß (95% CI) -0.079 (-0.280; 0.122) and -0.162 (-0.391; 0.067) for MO and MA, respectively. CONCLUSION: In this large cohort of middle-aged adults, aortic PWV was not associated with migraine.
Cardiovascular Diseases/epidemiology , Migraine with Aura/epidemiology , Migraine without Aura/epidemiology , Vascular Stiffness , Adult , Aged , Arterial Pressure , Brazil/epidemiology , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/physiopathology , Carotid-Femoral Pulse Wave Velocity , Cross-Sectional Studies , Female , Humans , Longitudinal Studies , Male , Middle Aged , Migraine with Aura/diagnosis , Migraine with Aura/physiopathology , Migraine without Aura/diagnosis , Migraine without Aura/physiopathology , Prospective Studies , Risk Assessment , Risk Factors
The study's objectives: compare self-report measures of weight and height with direct measures; assess the impact of these discrepancies on body mass index (BMI) and prevalence of overweight and obesity; and apply correction models to the self-report measures and assess the degree of improvement in the corrected measures produced with the use of these models. A cross-sectional study was performed, assessing 4,151 adults (18 to 60 years) participating in the São Paulo Megacity Epidemiological Study. Linear regression models stratified by sex were proposed for correction of self-reported measures. Agreement was assessed with the intraclass correlation coefficient for the direct measures, self-report measures, and corrected measures, and kappa coefficient for BMI classification categories. Self-reported weight and the resulting BMI were underestimated, while height was overestimated, compared to direct measures. With all the correction models, the corrected measures were closer to the direct measures. Prevalence rates for excess weight, calculated by self-report measures, were underestimated by 24% in men and by 28% in women; with corrections, the underestimation decreased to 8% and 10%, respectively. The results showed moderate agreement for self-report measures and substantial agreement for corrected measures compared to direct measures. The use of correction equations for self-report data proved to be a useful method for producing more trustworthy estimates of prevalence of overweight and obesity in the general population, usually estimated from self-report measures of weight and height in population surveys.
Os objetivos deste artigo são: (i) comparar medidas autorrelatadas de peso e estatura com medidas aferidas; (ii) avaliar o impacto dessas discrepâncias sobre o índice de massa corporal (IMC) e as prevalências de sobrepeso e obesidade; e (iii) aplicar modelos de correção das medidas autorrelatadas e avaliar o grau de melhoria das medidas corrigidas produzidas pelo uso desses modelos. Realizou-se estudo transversal, com avaliação de 4.151 adultos (18 a 60 anos) participantes do Estudo Epidemiológico dos Transtornos Mentais São Paulo Megacity. Foram propostos e testados modelos de regressão linear estratificados por sexo, para a correção das medidas autorrelatadas. Para avaliar a concordância, usou-se o coeficiente de correlação intraclasse para as medidas aferidas, medidas autorrelatadas e medidas corrigidas, bem como o coeficiente kappa para as categorias de classificação do IMC. O peso autorrelatado e o IMC resultantes foram subestimados, ao passo que a estatura foi superestimada, comparados às medidas aferidas. Com todos os modelos de correção, as medidas corrigidas tornaram-se mais próximas às medidas aferidas. As prevalências de excesso de peso, quando calculadas a partir das medidas autorrelatadas, estavam subestimadas em 24% em homens e 28% em mulheres. Com as correções, a subestimativa diminuiu para 8% e 10%, respectivamente. Identificou-se concordância moderada para as medidas autorrelatadas e concordância substancial para as medidas corrigidas, quando comparadas às medidas reais. O uso de equações de correção para dados autorrelatados mostrou-se um método útil para produzir estimativas mais fidedignas da prevalência de excesso de peso e obesidade na população geral, geralmente estimadas a partir de medidas de peso e estatura autorrelatadas nos inquéritos populacionais.
Los objetivos fueron: comparar medidas autoinformadas de peso y estatura con medidas evaluadas; evaluar el impacto de estas discrepancias sobre el índice de masa corporal (IMC) y las prevalencias de sobrepeso y obesidad; y aplicar modelos de corrección de las medidas autoinformadas y evaluar el grado de mejoría de las medidas corregidas, producidas por el uso de esos modelos. Se realizó un estudio transversal evaluando a 4.151 adultos (18 a 60 años), participantes en el Estudio Epidemiológico São Paulo Megacity. Se propusieron y probaron modelos de regresión lineal estratificados por sexo para la corrección de las medidas autoinformadas. Para evaluar la concordancia, se usó el coeficiente de correlación intraclase para las medidas evaluadas, medidas autoinformadas y medidas corregidas, y el coeficiente kappa para las categorías de clasificación del IMC. El peso autoinformado y el IMC resultantes fueron subestimados mientras la estatura fue sobrestimada, comparados con las medidas evaluadas. Con todos los modelos de corrección, las medidas corregidas se convirtieron en más cercanas a las medidas evaluadas. Las prevalencias de exceso de peso, cuando se calculan a partir de las medidas autoinformadas, estaban subestimadas en un 24% en hombres y un 28% en las mujeres; con las correcciones, la infravaloración disminuyó a un 8% y un 10%, respectivamente. Se identificó una concordancia moderada para las medidas autoinformadas y una concordancia sustancial para las medidas corregidas, cuando se compararon con las medidas reales. El uso de ecuaciones de corrección para dados autoinformados se mostró un método útil para producir estimaciones más fidedignas de la prevalencia de exceso de peso y obesidad en la población general, generalmente estimadas a partir de medidas de peso y estatura autoinformadas en las encuestas poblacionales.
Body Weights and Measures/methods , Obesity/diagnosis , Overweight/diagnosis , Adolescent , Adult , Algorithms , Body Height , Body Mass Index , Body Weight , Brazil/epidemiology , Epidemiologic Methods , Female , Humans , Male , Middle Aged , Obesity/epidemiology , Overweight/epidemiology , Young Adult
Abstract Background: The association of subclinical thyroid dysfunction (STD) with cardiac arrhythmias remains controversial, particularly in the non-elderly population. Objective: To investigate whether STD was associated with cardiac arrhythmias in a cohort of middle-aged and older adults. Methods: Baseline data of the Longitudinal Study of Adult Health, ELSA-Brasil (35-74 years) were collected from 2008 to 2010. After exclusion of clinical hypothyroidism and hyperthyroidism, participants were categorized as euthyroidism (TSH = 0.4-4.0 µU/mL), subclinical hypothyroidism (TSH > 4.0 µU/mL; FT4 = 0.8-1.9 ng/dL), and subclinical hyperthyroidism (TSH < 0.4 µU/mL; FT4 = 0.8-1.9 ng/dL). The prevalence rates of tachycardia (HR > 100) and bradycardia (HR < 60), atrial fibrillation/flutter, conduction disorders, extrasystoles, low QRS voltage, prolonged QT intervals, and persistent supraventricular rhythms were compared between groups after adjusting for age, sex, comorbidities, lifestyle, body mass index and medications. Results: The HR data of 13,341 participants (52% female; median age, 51 years) and the electrocardiogram readings of 11,795 were analyzed; 698 participants (5.23%) were classified as subclinical hypothyroidism, 193 (1.45%) as subclinical hyperthyroidism, and 12,450 (93.32%) as euthyroidism. The prevalence of rhythm and conduction disorders was similar, as were HR medians, even in the subgroups with TSH < 0.01 UI/mL or > 10.0 UI/mL or in older adults. Conduction disorders were less prevalent in older adults with subclinical hypothyroidism (adjusted OR = 0.44; 95% CI 0.24 to 0.80). Conclusion: In this large, multicenter and cross-sectional study, STD was not associated with cardiac arrhythmias, but a longitudinal assessment is necessary.
Resumo Fundamento: A associação de disfunção tireoidiana subclínica (DST) com arritmias cardíacas permanece controversa, particularmente na população não idosa. Objetivo: Investigar se a DST está associada a arritmias cardíacas em uma coorte de adultos de meia-idade e idosos. Métodos: Dados da linha de base do Estudo Longitudinal de Saúde do Adulto, ELSA-Brasil (35-74 anos) foram coletados de 2008 a 2010. Após exclusão de hipo e hipertireoidismo clínicos, os participantes foram categorizados como eutireoidismo (TSH = 0,4 a 4,0 µU/mL), hipotireoidismo subclínico (TSH > 4,0 µU/mL; T4L = 0,8-1,9 ng/dL) e hipertireoidismo subclínico (TSH <0,4 µU/mL; T4L = 0,8 a 1,9 ng/dL). As prevalências de taquicardia (Frequência cardíaca [FC] > 100) e bradicardia (FC < 60), fibrilação atrial/flutter, distúrbios de condução, extrassístoles, baixa voltagem do QRS, intervalos QT prolongados e ritmo supraventricular persistente foram comparadas entre os grupos após ajuste por idade, sexo, comorbidades, estilo de vida, índice de massa corporal e uso de medicamentos. Resultados: Foram analisados os dados da FC de 13.341 participantes (52% do sexo feminino; idade média de 51 anos) e das leituras de 11.795 ECG; 698 participantes (5,23%) foram classificados como hipotireoidismo subclínico, 193 (1,45%) como hipertireoidismo subclínico e 12.450 (93,32%) como eutireoidismo. A prevalência de distúrbios de ritmo e condução foi semelhante, assim como as médias de FC, mesmo nos subgrupos com TSH < 0,01 UI/mL ou > 10,0 UI/mL ou em idosos. Distúrbios de condução foram menos prevalentes em idosos com hipotireoidismo subclínico (OR ajustado = 0,44; IC95% 0,24-0,80). Conclusão: Neste grande estudo multicêntrico e transversal, a DST não foi associada a arritmias cardíacas, mas uma avaliação longitudinal é necessária.
Humans , Male , Female , Arrhythmias, Cardiac/physiopathology , Heart Rate/physiology , Hyperthyroidism/physiopathology , Hypothyroidism/physiopathology , Brazil , Cross-Sectional Studies , Longitudinal Studies , Middle Aged
BACKGROUND: The association of subclinical thyroid dysfunction (STD) with cardiac arrhythmias remains controversial, particularly in the non-elderly population. OBJECTIVE: To investigate whether STD was associated with cardiac arrhythmias in a cohort of middle-aged and older adults. METHODS: Baseline data of the Longitudinal Study of Adult Health, ELSA-Brasil (35-74 years) were collected from 2008 to 2010. After exclusion of clinical hypothyroidism and hyperthyroidism, participants were categorized as euthyroidism (TSH = 0.4-4.0 µU/mL), subclinical hypothyroidism (TSH > 4.0 µU/mL; FT4 = 0.8-1.9 ng/dL), and subclinical hyperthyroidism (TSH < 0.4 µU/mL; FT4 = 0.8-1.9 ng/dL). The prevalence rates of tachycardia (HR > 100) and bradycardia (HR < 60), atrial fibrillation/flutter, conduction disorders, extrasystoles, low QRS voltage, prolonged QT intervals, and persistent supraventricular rhythms were compared between groups after adjusting for age, sex, comorbidities, lifestyle, body mass index and medications. RESULTS: The HR data of 13,341 participants (52% female; median age, 51 years) and the electrocardiogram readings of 11,795 were analyzed; 698 participants (5.23%) were classified as subclinical hypothyroidism, 193 (1.45%) as subclinical hyperthyroidism, and 12,450 (93.32%) as euthyroidism. The prevalence of rhythm and conduction disorders was similar, as were HR medians, even in the subgroups with TSH < 0.01 UI/mL or > 10.0 UI/mL or in older adults. Conduction disorders were less prevalent in older adults with subclinical hypothyroidism (adjusted OR = 0.44; 95% CI 0.24 to 0.80). CONCLUSION: In this large, multicenter and cross-sectional study, STD was not associated with cardiac arrhythmias, but a longitudinal assessment is necessary.
Arrhythmias, Cardiac/physiopathology , Heart Rate/physiology , Hyperthyroidism/physiopathology , Hypothyroidism/physiopathology , Brazil , Cross-Sectional Studies , Female , Humans , Longitudinal Studies , Male , Middle Aged
A discussão acerca da parte ética de pesquisas com seres humanos sempre privilegiou estudos experimentais; entretanto, estudos observacionais também envolvem riscos variados e suscitam questões importantes. O objetivo deste artigo foi apresentar e discutir os aspectos éticos no desenvolvimento do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil). O ELSA-Brasil é um estudo longitudinal e multicêntrico, com financiamento público, no qual os participantes de pesquisa e pesquisadores pertencem às mesmas instituições. Foi descrita a casuística que orientou as ações do ELSA-Brasil, segundo os princípios norteadores da Resolução CNS n. 466 de 2012. Em seguida, foram apresentados os eventos imprevistos e as ações corretivas para tais.
The discussion about the ethical part of research with human always privileged experimental studies; however, observational studies also involve varied risks and raise important questions. The objective of this article was to present and discuss the ethical aspects in the development of the Longitudinal Study of Adult Health (ELSABrazil). ELSA-Brazil is a longitudinal, multicenter, publicly funded study in which research participants and researchers belong to the same institutions. It was described the casuistry that guided the actions of ELSA-Brazil according to the guiding principles of Resolution CNS n. 466 from 2012. Then, unforeseen events and corrective actions were presented to them.
Humans , Male , Female , Adult , Middle Aged , Aged , Adult Health , Longitudinal Studies , Multicenter Studies as Topic , Ethics, Research , Informed Consent/ethics
Os objetivos deste artigo são: (i) comparar medidas autorrelatadas de peso e estatura com medidas aferidas; (ii) avaliar o impacto dessas discrepâncias sobre o índice de massa corporal (IMC) e as prevalências de sobrepeso e obesidade; e (iii) aplicar modelos de correção das medidas autorrelatadas e avaliar o grau de melhoria das medidas corrigidas produzidas pelo uso desses modelos. Realizou-se estudo transversal, com avaliação de 4.151 adultos (18 a 60 anos) participantes do Estudo Epidemiológico dos Transtornos Mentais São Paulo Megacity. Foram propostos e testados modelos de regressão linear estratificados por sexo, para a correção das medidas autorrelatadas. Para avaliar a concordância, usou-se o coeficiente de correlação intraclasse para as medidas aferidas, medidas autorrelatadas e medidas corrigidas, bem como o coeficiente kappa para as categorias de classificação do IMC. O peso autorrelatado e o IMC resultantes foram subestimados, ao passo que a estatura foi superestimada, comparados às medidas aferidas. Com todos os modelos de correção, as medidas corrigidas tornaram-se mais próximas às medidas aferidas. As prevalências de excesso de peso, quando calculadas a partir das medidas autorrelatadas, estavam subestimadas em 24% em homens e 28% em mulheres. Com as correções, a subestimativa diminuiu para 8% e 10%, respectivamente. Identificou-se concordância moderada para as medidas autorrelatadas e concordância substancial para as medidas corrigidas, quando comparadas às medidas reais. O uso de equações de correção para dados autorrelatados mostrou-se um método útil para produzir estimativas mais fidedignas da prevalência de excesso de peso e obesidade na população geral, geralmente estimadas a partir de medidas de peso e estatura autorrelatadas nos inquéritos populacionais.
The study's objectives: compare self-report measures of weight and height with direct measures; assess the impact of these discrepancies on body mass index (BMI) and prevalence of overweight and obesity; and apply correction models to the self-report measures and assess the degree of improvement in the corrected measures produced with the use of these models. A cross-sectional study was performed, assessing 4,151 adults (18 to 60 years) participating in the São Paulo Megacity Epidemiological Study. Linear regression models stratified by sex were proposed for correction of self-reported measures. Agreement was assessed with the intraclass correlation coefficient for the direct measures, self-report measures, and corrected measures, and kappa coefficient for BMI classification categories. Self-reported weight and the resulting BMI were underestimated, while height was overestimated, compared to direct measures. With all the correction models, the corrected measures were closer to the direct measures. Prevalence rates for excess weight, calculated by self-report measures, were underestimated by 24% in men and by 28% in women; with corrections, the underestimation decreased to 8% and 10%, respectively. The results showed moderate agreement for self-report measures and substantial agreement for corrected measures compared to direct measures. The use of correction equations for self-report data proved to be a useful method for producing more trustworthy estimates of prevalence of overweight and obesity in the general population, usually estimated from self-report measures of weight and height in population surveys.
Los objetivos fueron: comparar medidas autoinformadas de peso y estatura con medidas evaluadas; evaluar el impacto de estas discrepancias sobre el índice de masa corporal (IMC) y las prevalencias de sobrepeso y obesidad; y aplicar modelos de corrección de las medidas autoinformadas y evaluar el grado de mejoría de las medidas corregidas, producidas por el uso de esos modelos. Se realizó un estudio transversal evaluando a 4.151 adultos (18 a 60 años), participantes en el Estudio Epidemiológico São Paulo Megacity. Se propusieron y probaron modelos de regresión lineal estratificados por sexo para la corrección de las medidas autoinformadas. Para evaluar la concordancia, se usó el coeficiente de correlación intraclase para las medidas evaluadas, medidas autoinformadas y medidas corregidas, y el coeficiente kappa para las categorías de clasificación del IMC. El peso autoinformado y el IMC resultantes fueron subestimados mientras la estatura fue sobrestimada, comparados con las medidas evaluadas. Con todos los modelos de corrección, las medidas corregidas se convirtieron en más cercanas a las medidas evaluadas. Las prevalencias de exceso de peso, cuando se calculan a partir de las medidas autoinformadas, estaban subestimadas en un 24% en hombres y un 28% en las mujeres; con las correcciones, la infravaloración disminuyó a un 8% y un 10%, respectivamente. Se identificó una concordancia moderada para las medidas autoinformadas y una concordancia sustancial para las medidas corregidas, cuando se compararon con las medidas reales. El uso de ecuaciones de corrección para dados autoinformados se mostró un método útil para producir estimaciones más fidedignas de la prevalencia de exceso de peso y obesidad en la población general, generalmente estimadas a partir de medidas de peso y estatura autoinformadas en las encuestas poblacionales.
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Body Weights and Measures/methods , Overweight/diagnosis , Obesity/diagnosis , Body Height , Body Weight , Algorithms , Brazil/epidemiology , Body Mass Index , Epidemiologic Methods , Overweight/epidemiology , Obesity/epidemiology
BACKGROUND: Despite evidence that diet is very important in relation to chronic kidney disease (CKD) progression, studies in this field are scarce and have focused only on some specific nutrients. We evaluated the energy, macronutrient and micronutrient intakes and dietary patterns of non-dialysis CKD participants in the PROGREDIR study. DESIGN AND SETTING: Cross-sectional study; CKD cohort, São Paulo, Brazil. METHODS: Baseline data on 454 participants in the PROGREDIR study were analyzed. Dietary intake was evaluated through a food frequency questionnaire. Dietary patterns were derived through principal component analysis. Energy and protein intakes were compared with National Kidney Foundation recommendations. Linear regression analysis was performed between energy and nutrient intakes and estimated glomerular filtration rate (eGFR), and between sociodemographic and clinical variables and dietary patterns. RESULTS: Median energy and protein intakes were 25.0 kcal/kg and 1.1 g/kg, respectively. In linear regression, protein intake (ß = -3.67; P = 0.07) was related to eGFR. Three dietary patterns (snack, mixed and traditional) were retained. The snack pattern was directly associated with male gender (ß = 0.27; P = 0.006) and inversely with diabetes (ß = -0.23; P = 0.02). The traditional pattern was directly associated with male gender (ß = 0.27; P = 0.007) and schooling (ß = 0.40; P < 0.001) and inversely with age (ß = -0.01; P = 0.001) and hypertension (ß = -0.34; P = 0.05). CONCLUSIONS: We identified low energy and high protein intake in this population. Protein intake was inversely related to eGFR. Dietary patterns were associated with age, gender, schooling level, hypertension and diabetes.
Eating , Energy Intake , Nutritional Status/physiology , Renal Insufficiency, Chronic , Age Factors , Aged , Cross-Sectional Studies , Diabetes Complications/complications , Diet Records , Dietary Proteins/administration & dosage , Educational Status , Female , Glomerular Filtration Rate/physiology , Humans , Hypertension/complications , Linear Models , Male , Middle Aged , Renal Insufficiency, Chronic/physiopathology , Sex Factors , Snacks , Socioeconomic Factors
