Asociación entre patrones alimentarios y factores sociodemográficos en la población adulta de Antioquia, Colombia

Objetivo: identificar los patrones alimentarios de la población adulta Antioqueña y su asociación con variables socioeconómicas. Métodos: estudio transversal con muestra aleatoria de 1.394 adultos de 18 a 59 años, derivados del estudio Perfil alimentario y nutricional de Antioquia 2019. El consumo alimentario fue evaluado con recordatorio de consumo en 24 horas (R24h) y un segundo R24h en día no consecutivo al 25% de la muestra, se cuantificó el consumo de alimentos en gramos, los patrones alimentarios se establecieron mediante análisis factorial por Componentes principales con rotación ortogonal varimax. Para verificar la asociación entre los patrones alimentarios y las variables socioeconómicas se empleó regresión de Poisson por varianza robusta. Resultados: se definieron tres patrones alimentarios que representan el 28,1% de la varianza: "Tradicional" (9,8%), "Regional" (9,7%) y "Prudente" (8,6%). Los dos primeros se asociaron con variables demográficas, como sexo, edad y etnia; mientras que el último se asoció con variables socioeconómicas como escolaridad, ingresos familiares, régimen de seguridad social y clasificación de seguridad alimentaria. Conclusiones: Los hallazgos del presente estudio muestran que la dieta de la población estudiada, sigue unos referentes de tradición alimentaria, reflejados en los patrones Tradicional y Regional, mientras que el patrón Prudente, corresponde a la parte de la población que tiene mejores condiciones socioeconómicas y probablemente lo siguen por recomendación de salud.

Objective: to identify the eating patterns of the adult population from Antioquia, Colombia, and their association with socioeconomic variables. Methods: a cross-sectional study was performed with a random sample of 1,394 adults aged 18 to 59 years, derived from the Antioquia Food and Nutritional Profile 2019 study. Food consumption was evaluated with a 24-hour consumption recall (R24h) and a second R24h on a non-consecutive day at 25% of the sample, food consumption was quantified in grams, and food patterns were established by factorial analysis by Principal Components with varimax orthogonal rotation. To verify the association between eating patterns and socioeconomic variables, Poisson regression was used for robust variance. Results: three eating patterns were defined that represent 28.1% of the variance: "Traditional" (9.8%), "Regional" (9.7%), and "Prudent" (8.6%). The first two were associated with demographic variables, such as gender, age, and ethnicity; while the latter was associated with socioeconomic variables such as schooling, family income, social security system, and food security classification. Conclusions: The findings of this study show that the diet of the population of the study, follows some references to food tradition, reflected in the Traditional and Regional patterns, while the Prudent pattern corresponds to the part of the population that has better socioeconomic conditions, and they probably follow it for health recommendation.

Course of depression during the first 2 years postpartum among Brazilian women enrolled in a conditional cash transfer program.

BACKGROUND: Women living in low- and middle-income countries are more exposed to known risk factors for depression occurrence and persistency over time. AIM: Our aim was to investigate the course of depression in the first 2 years postpartum among Brazilian women enrolled in a cash transfer program. METHOD: Longitudinal analysis of baseline (T0; mean 3.7 months postpartum) and first follow-up data (T1; mean 18.6 months postpartum) from a trial to assess the impact of a child development promotion program in 30 municipalities from six Brazilian states. The program does not include any interventions against maternal depression. The Edinburgh Postnatal Depression Scale (EPDS) at cutoff ⩾10 was applied. Women were categorized into four groups based on EPDS at T0 and T1: absence of depression, persistence, discontinuity, or emergence pattern. Adjusted Poisson regressions were run using a multilevel hierarchical model. RESULTS: Two thousand eight hundred sixty-three women were assessed. Prevalence of depression was 26.4% [24.8, 28.1] at T0 and 24.4% [22.8, 26.0] at T1. Persistence, discontinuation, and emergence were found in 14.1% [11.3, 17.6%], 12.8% [11.4, 14.3%], and 10.2% [8.0, 13.0], respectively. In adjusted analyses, the persistence pattern was directly associated with parity and inversely associated with schooling of the woman and of the child's father. Living with husband/partner and support from the child's father and family members during pregnancy were protective against persistence. The discontinuity and the emergence patterns were not associated with any of the exposure variables. CONCLUSIONS: Depressive symptoms were highly prevalent during the first 2 years postpartum. About half of the women with depression at T1 were persistent cases that could have been detected earlier. Screening for maternal depression should be an essential component in every encounter of women with health professionals in primary health care settings.

Promotion of exclusive breast-feeding at scale within routine health services: impact of breast-feeding counselling training for community health workers in Recife, Brazil.

OBJECTIVE: Breast-feeding counselling has been identified as the intervention with the greatest potential for reducing child deaths, but there is little experience in delivering breast-feeding counselling at scale within routine health systems. The study aim was to compare rates of exclusive breast-feeding associated with a breast-feeding counselling intervention in which community health agents (CHA) received 20 h of training directed at counselling and practical skills with rates pre-intervention when CHA received 4 h of didactic teaching. DESIGN: Cross-sectional surveys of breast-feeding practices were conducted pre- and post-intervention in random samples of 1266 and 1245 infants aged 0-5.9 months, respectively. SETTING: Recife, Brazil, with a population of 2 million. SUBJECTS: CHA (n 1449) of Brazil's Family Health Programme were trained to provide breast-feeding counselling at home visits. RESULTS: Rates of exclusive breast-feeding improved when CHA were trained to provide breast-feeding counselling and were significantly higher by 10-13 percentage points at age 3-5.9 months when compared with pre-intervention rates (P < 0.05). Post-intervention point prevalence of exclusive breast-feeding for infants aged <4 months was 63% and for those aged <6 months was 50%. CONCLUSIONS: Multifunctional CHA were able to deliver breast-feeding counselling at scale within a routine health service and this was associated with a significant increase in rates of exclusive breast-feeding. The study reinforces the need to focus training on counselling and practical skills; a key component was an interactive style that utilized the knowledge and experience of CHA. The findings are relevant to the call by international organizations to scale up breast-feeding counselling.

Características e fatores associados à assistência à saúde de crianças menores de um ano com muito baixo peso ao nascer / Characteristics and factors associated with health care in children younger than 1 year with very low birth weight

OBJETIVOS: Identificar as características da assistência à saúde de lactentes com muito baixo peso ao nascer no primeiro ano de vida e os fatores associados a esta atenção. MÉTODOS: Estudo descritivo com componente analítico foi realizado na cidade de Maceió, Nordeste do Brasil, com uma amostra de 53 crianças com idade mediana de cinco meses na época da entrevista, e suas respectivas mães. As mães foram entrevistadas no domicílio,quanto às condições socioeconômicas, demográficas e de assistência à saúde da criança. A atenção à saúde foi avaliada com a elaboração de um índice utilizando 16 variáveis relacionadas às ações preconizadas para esta assistência. RESULTADOS: A análise de regressão linear multivariada mostrou que a escolaridade materna e a renda familiar foram as variáveis que, juntas, melhor explicaram a variação do Índice de Atenção à Saúde (18,9%), seguidas da paridade (6,6%) e da prática do aleitamento materno na época da entrevista (6,9%). CONCLUSÕES: Considerando que as famílias com piores condições socioeconômicas e as mulheres com maior número de filhos e que não amamentaram foram os fatores associados a uma assistência inadequada à saúde de crianças nascidas com muito baixo peso, os mesmos deveriam ser contemplados nas ações de planejamento da saúde pública.

OBJECTIVES: To identify the characteristics of health care in infants with very low birth weight during the first year of life and the factors associated with this care. METHODS: This was a descriptive study with an analytical component conducted in the city of Maceió, Northeastern Brazil, with a sample of 53 children with a median age of five months at the time of the interview, and their mothers. The mothers were interviewed at home regarding socioeconomic and demographic data and health care provided for the child. Health care was assessed through an index using 16 variables related to the recommended actions for this type of care. RESULTS: Multivariate linear regression analysis showed that maternal education and family income were the variables that best explained the health care index variation (18.9%), followed by parity (6.6%), and breastfeeding at the time of the interview (6.9%). CONCLUSIONS: Considering that families with lower socioeconomic status, women with a higher number of children, and women who did not breastfeed were factors associated with poor health care of children born with very low birth weight, these variables should be included in measures of public health planning.