Sugar sweetened beverages intake and risk of obesity and cardiometabolic diseases in longitudinal studies: A systematic review and meta-analysis with 1.5 million individuals.

BACKGROUND: Sugar-sweetened beverages (SSB) are associated with adverse outcomes in adults and understanding the strength, consistency and biological gradient of the association between SSB consumption and health-related outcomes is important. We aimed to examine longitudinal associations between sugar-sweetened beverages (SSB) intake and obesity and cardiometabolic diseases (type 2 diabetes, coronary heart disease and stroke) in adults. METHODS: We performed a systematic review and meta-analysis searching for articles published until December 2021 in the Pubmed, Lilacs, Web of Science, Cochrane, Embase, and Scopus databases (PROSPERO CRD42021234206). RESULTS: After screening of more than 18 thousand titles and abstracts, 27 longitudinal studies were included in the review with all of them presenting medium or high methodological quality. None of the selected studies were from low-income countries and only three were conducted in middle-income countries. Type 2 diabetes was the most investigated disease - outcome in 15 out of 27 studies. Around 80% of the studies enrolled more than 10,000 individuals in the sample, and almost half of them followed the subjects for less than 10 years. A total of 1.5 million individuals were included in the pooled analyses, and results indicated that SSB intake increased the risk of type 2 diabetes (RR = 1.20; 95% C.I. 1.13-1.28), obesity (RR = 1.17; 95% C.I. 1.10-1.25), coronary heart disease (RR = 1.15; 9% C.I. 1.06-1.25), and stroke (RR = 1.10; 9% C.I. 1.01-1.19) in adults after adjustment for all potential confounders. CONCLUSION: Our systematic review and meta-analysis demonstrated that consumption of SSB intake appears to increase the risk obesity and cardiometabolic diseases, being the strongest evidence for type 2 diabetes. Actions are needed to be taken to reduce the SSB intake and its consequences worldwide.

Intergenerational transmission of birth weight: a systematic review and meta-analysis.

The objectives of this study were (1) to systematically review the literature on the association between birth weight in children born in the first and second generation and (2) to quantify this association by performing a meta-analysis. A systematic review was carried out in six databases (PubMed, Science Direct, Web of Science, Embase, Scopus, CINAHL and LILACS), in January 2021, for studies that recorded the birth weight of parents and children. A meta-analysis using random effects to obtain a pooled effect of the difference in birth weight and the association of low birth weight (LBW) between generations was performed. Furthermore, univariable meta-regression was conducted to assess heterogeneity. Egger's tests were used to possible publication biases. Of the 9878 identified studies, seventy were read in full and twenty were included in the meta-analysis (ten prospective cohorts and ten retrospective cohorts), fourteen studies for difference in means and eleven studies for the association of LBW between generations (twenty-three estimates). Across all studies, there was no statistically significant mean difference (MD) birth weight between first and second generation (MD 19·26, 95 % CI 28·85, 67·36; P = 0·43). Overall, children of LBW parents were 69 % more likely to have LBW (pooled effect size 1·69, 95 % CI (1·46, 1·95); I2:85·8 %). No source of heterogeneity was identified among the studies and no publication bias. The average birth weight of parents does not influence the average birth weight of children; however, the proportion of LBW among the parents seems to affect the offspring's birth weight.

Physical activity and serum interleukin-6 in relation to bone density in young adults / Atividade física e interleucina-6 sérica em relação à densidade óssea em adultos jovens

Physical activity (PA) and inflammation influence bone density through multiple physiological mechanisms, but current evidence is not robust on the structure mediating these relationships. There-fore, the aim of this study was to investigate the associations of PA, and serum interleukin-6 (IL-6) on bone density. Cross-sectional analysis in the Pelotas (Brazil) 1982 Birth Cohort with participants aged 30-years old. PA was objectively measured by accelerometry. Bone mineral density (g/cm2) was evaluated for the lumbar spine and femoral neck using dual-energy X-ray absorptiometry. Crude and adjusted linear regressions and mediation analyses were performed. In both sexes, the overall PA was positively associated with femoral neck bone density, but not lumbar spine. For men, the mean of femoral neck were 0.027, 0.042, and 0.032 higher in the second, third, and fourth quartiles, respectively, compared to the first quartile (reference). Among women, higher bone density values were found in the third (0.021) and fourth (0.027) quartiles of overall PA compared to the lowest quartile. Among females, moderate-to-vigorous intensity physical activity presented a positive rela-tionship with all sites of bone density. The indirect effect through IL-6 was not significant. Physical activity was associated with gains in bone density. The findings reinforce recommendations for PA in adulthood to promote bone health

A atividade física (AF) e a inflamação influenciam a densidade óssea através de múltiplos mecanismos fisiológicos, mas a atual evidência não é robusta sobre a estrutura de mediação dessas relações. Portanto, o objetivo deste estudo foi investigar as associações de AF e interleucina-6 sérica (IL-6) na densidade óssea. Análise transversal na Coorte de Nascimentos de 1982 Pelotas (Brasil) em participantes com 30 anos de idade. AF foi medida objetivamente por acelerometria. Densidade mineral óssea (g/cm2) foi avaliada para a coluna lombar e colo do fêmur usando absorciometria de raios-X de dupla energia. Foram realizadas regressões lineares brutas e ajustadas e análises de mediação. Em ambos os sexos, a AF total foi positivamente associada à densidade óssea do colo do fêmur, mas não à coluna lombar. Para os homens, as médias do colo do fêmur foram 0,027, 0,042 e 0,032 maiores no segundo, terceiro e quarto quartis, respectivamente, em relação ao primeiro quartil (referência). Entre as mulheres, os maiores valores de densidade óssea foram encontrados no terceiro (0,021) e quarto (0,027) quartis de AF total em comparação ao quartil mais baixo. No sexo feminino, a atividade física de intensidade moderada a vigorosa apresentou relação positiva com todos os locais de densidade óssea. O efeito indireto através da IL-6 não foi significativo. A atividade física foi associada a ganhos de densidade óssea. Os achados reforçam recomendações de AF na idade adulta para promover a saúde óssea

Omega-3 supplementation and diabetes: A systematic review and meta-analysis.

This study aimed to review the literature on studies that evaluated the effects of omega-3 supplementation on parameters of diabetes in humans. An online search was conducted in the following databases: Pubmed, LILACS, Scielo, Scopus, and Web of Science. It included experimental studies that investigated the effects of omega-3 supplementation for diabetes treatment or prevention and its relationship with fasting blood glucose, insulin resistance, and glycated hemoglobin. Observational, non-human studies and non-randomized clinical trials were excluded. The Cochrane scale assessed the quality of the studies. A meta-analysis was carried out to evaluate the effect of omega-3 on fasting blood glucose, insulin resistance, and glycated hemoglobin. Thirty studies were included in the review. Almost 70% (n = 20) demonstrated at least one significant effect of the omega-3 supplementation related to diabetes. In the meta-analysis, there was a significant effect on the reduction of fasting blood glucose [SMD: -0.48; CI95%: -0.76, -0.19; p = 0.01; I2 = 88%] and insulin resistance [SMD: -0.61; CI95%: -0.98, -0.24; p = 0.01; I2 = 90%]. For glycated hemoglobin, there was no significant effect in the meta-analysis. This systematic review with meta-analysis demonstrated that supplementation with omega-3 has protective effects on diabetes parameters.

Breastfeeding duration comparison of children enrolled in municipal preschools in 2004 and 2018 / Comparação da duração do aleitamento materno entre crianças de escolas municipais de educação infantil em 2004 e 2018

ABSTRACT Objective To describe and compare the duration of breastfeeding of children enrolled in municipal preschools in Pelotas (RS), Brazil, in 2004 and 2018, taking into account sociodemographic and health factors. Methods Cross-sectional study, with children aged zero to six years. Data collection included interview with parents and children anthropometric assessment. Data was entered on EpiData 3.1 and analyzed on Stata 14.0. Median duration of breastfeeding was assessed according to the independent variables. Two children life tables were elaborated for the years 2004 and 2018. The statistical significance of the median analysis was based on the Wilcoxon Rank Sum test for dichotomic exposure and Kruskal Wallis test for polytomous exposure. Results A total of 1902 children were studied. In 2004, the median duration of breastfeeding was five months (IQR: 2.0;12.0) which increased one month for each weight category increase at birth. In 2018, the median was six months (IQR: 2.0;17.0) and increased two months for each weight category increase at birth. The life table showed that around 20.0% of the children in 2004 and 33% of the children in 2018 continued to be breastfed after 11 months of age. Conclusion The breastfeeding median increased in the period under review. The greater the birth weight, the longer the breastfeeding median duration.

RESUMO Objetivo Descreve e comparar a duração do aleitamento materno de crianças matriculadas em Escolas Municipais de Educação Infantil, de Pelotas (RS) Brasil, em 2004 e 2018 segundo fatores sociodemográficos e de saúde. Métodos Estudo transversal, com crianças de zero a seis anos de idade. A coleta de dados incluiu entrevistas com os pais e avaliação antropométrica das crianças. Os dados foram digitados no EpiData 3.1 e analisados no Stata 14.0. A duração da mediana do aleitamento materno foi analisada de acordo com as variáveis independentes. Foram elaboradas duas Tábuas de vida, para as crianças de 2004 e de 2018. A significância estatística das análises de mediana, foi baseada no teste de Wilcoxon Rank Sum para as exposições dicotômicas, e no teste de Kruskal Wallis para as exposições politômicas. Resultados Foram estudadas 1902 crianças ao total. Em 2004, a mediana da duração do aleitamento materno foi de cinco meses (IIQ: 2,0;12,0) e aumentou um mês a cada aumento de categoria de peso ao nascer. Em 2018, a mediana foi de seis meses (IIQ: 2,0;17,0) e aumentou dois meses a cada aumento de categoria de peso ao nascer. A Tábua de vida mostrou que cerca de 20,0% das crianças em 2004 e 33,0% das de 2018 tiveram aleitamento materno continuado após os 11 meses de idade. Conclusão A mediana aumentou no período analisado. Quanto maior o peso ao nascer, maior a mediana de aleitamento materno

Associação entre a violência e as características socioeconômicas e reprodutivas da mulher / Association between violence and women's socioeconomic and reproductive characteristics

Resumo Introdução A violência contra a mulher consiste em um importante agravo de saúde pública, com elevada magnitude e impacto na saúde. Objetivo Verificar a associação entre a violência perpetrada por parceiro íntimo ao longo da vida e as características socioeconômicas e reprodutivas da mulher. Método Estudo transversal, realizado em 2014, em 26 unidades de saúde, no município de Vitória, Espírito Santo. Amostra com 991 mulheres, de faixa etária entre 20 e 59 anos, com parceiro íntimo nos 12 meses anteriores à entrevista. Os dados socioeconômicos, as características reprodutivas e os três tipos de violência contra a mulher (psicológica, sexual ou física) foram coletados. Na análise dos dados, foram empregados o teste qui-quadrado, com nível de significância de 5%, e a regressão de Poisson, para obter as razões de prevalência bruta e ajustada para fatores de confusão. Resultados O modelo final ajustado mostrou que a violência física, psicológica e sexual se associou à escolaridade, situação conjugal, recusa do parceiro a usar preservativo nas relações sexuais, número de parceiros sexuais no último ano e número de filhos. A primeira relação sexual forçada permaneceu associada à violência sexual, assim como a idade da coitarca com a violência física e psicológica. Conclusão Prevalências de violência contra a mulher estão associadas a fatores socioeconômicos e reprodutivos.

Abstract Background Violence against women is an important public health issue that has high magnitude and an impact on health. Objective To verify the association between intimate partner violence throughout life and women's socioeconomic and reproductive characteristics. Method Cross-sectional study carried out in 26 health units in the municipality of Vitória, state of Espírito Santo, Brazil, in 2014. Sample composed of 991 women, aged 20-59 years, having an intimate partner in the 12 months prior to the interview. Data on socioeconomic and reproductive characteristics and the three types of violence against women (psychological, sexual, or physical) were collected. The chi-squared test at a 5% significance level was used to analyze the data, and the Poisson regression was applied to obtain the crude and adjusted prevalence ratios for the confounding factors. Results The adjusted final model showed that physical, psychological and sexual violence was associated with education level, marital status, partner's refusal to use a condom during sexual intercourse, number of sexual partners in the past year, and number of children (p<0.05). The first forced sexual intercourse remained associated with sexual violence and age at first sexual intercourse was associated with physical and psychological violence. Conclusion Prevalence of violence against women is associated with socioeconomic and reproductive factors.

What is the effect of resveratrol on obesity? A systematic review and meta-analysis.

BACKGROUND & AIMS: Obesity is increasing worldwide. Resveratrol appears as a substance capable of helping with weight loss. This study aimed to investigate the resveratrol effect in the treatment of obesity in general population. METHODS: An online search was conducted in the following databases: Pubmed, LILACS, Scielo, Scopus and Web of Science. Experimental studies that investigated the effects between resveratrol supplementation for weight loss treatment, as well as its relationship with overweight and obesity were included. Observational and non-human studies were excluded. The Cochrane scale was used to assess the quality of the studies. RESULTS: Nineteen studies were included, of which only three demonstrated some type of positive effect. In the meta-analysis, there was no significant effect on weight loss [SMD: 0.03; CI95%: -0,44, 0,49; p = 0,01; I2 = 82%], and body mass index (BMI) [SMD: 0.01; CI95%: -0,39, 0,41; p = 0,01; I2 = 72%]. A small effect was found on the waist circumference [SMD: -1.04; CI95%: -1,86, -0,27; p = 0,01; I2 = 87%]. CONCLUSION: This systematic review with meta-analysis demonstrated that supplementation with resveratrol does not have an anti-obesity effect.

Epidemiology of interleukin-6: the 30-year follow-up of the 1982 Pelotas (Brazil) birth cohort study.

BACKGROUND: Cardiovascular diseases are the main cause of death globally. Interleukin-6 (IL-6) is a biomarker of cardiovascular risk. AIM: To investigate factors associated with IL-6 concentration in serum, from early life up to 30 years of age. SUBJECTS AND METHODS: In the 2012-2013 follow-up, IL-6 was measured in 2809 participants of the 1982 Pelotas Birth Cohort (1369 males). Multivariable linear regressions, stratified by sex, were performed to evaluate the associations of African ancestry, family income and maternal education at birth, monthly income and education at 30 years, smoking status, harmful alcohol intake, physical activity, and body composition with IL-6, considering a conceptual hierarchical framework. RESULTS: Males with low educational levels and current smokers had the highest mean IL-6. Among females, African ancestry and low monthly income were associated with the highest mean values for the outcome. Physical activity had an inverse association with IL-6 concentration among females. A direct relationship was observed between the measures of adiposity on IL-6, in both sexes. CONCLUSION: Body composition was the main predictor for the outcome evaluated in males and females. Thus, the avoidance of overweight remains an important strategy for the prevention and control of cardiovascular risk and biomarkers associated with these diseases.

Obesity and ADHD: Exploring the role of body composition, BMI polygenic risk score, and reward system genes.

The association between obesity and attention-deficit hyperactivity disorder (ADHD) has been extensively reported in the literature. However, the potential mechanisms underlying this association are not completely understood. This study aimed to evaluate the association between body composition and ADHD and explore the possible genetic mechanisms involved. We used data from the 1982 Pelotas (Brazil) Birth Cohort at age 30-year follow-up (N = 3630). We first used logistic regression analysis to test whether body mass index (BMI), fat mass (FM), and fat-free mass (FFM) were associated with ADHD. We further tested the association between BMI polygenic risk score (BMI-PRS) and ADHD and the role of the genes upregulated in the reward system using a gene-set association approach. BMI (odds ratio [OR] = 1.05; 95% confidence interval [CI], 1.00-1.09; p = 0.038) and FM (OR = 1.04; 95% CI, 1.00-1.07; p = 0.043) were associated with ADHD. The BMI-PRS was associated with ADHD (using p-value threshold (PT) = 0.4; OR = 1.65; 95% CI, 1.02-2.65) at a nominal level. In gene-set analysis, the reward system genes were associated with BMI in subjects with a high BMI-PRS score, considering PT = 0.4 (p = 0.014). The results suggest that BMI genetic components, especially those genes related to the reward system, may be involved in this association.

Food processing and cardiometabolic risk factors: a systematic review.

OBJECTIVE To systematically review the evidence for the association between food consumption according to processing and cardiometabolic factors in adults and/or the elderly. METHOD Two independent evaluators analyzed the electronic databases PubMed, Web of Science and Lilacs until December 2018. We used the following terms: (convenience foods OR food processing OR highly-processed OR industrialized foods OR minimally-processed OR prepared foods OR processed foods OR ultra-processed OR ultraprocessed OR ultra processed OR unprocessed) AND (metabolic syndrome OR hypertension OR blood pressure OR diabetes mellitus OR glucose OR glycaemia OR insulin OR cholesterol OR triglycerides OR blood lipids OR overweight OR obesity) AND (adult OR adults OR adulthood OR aged OR elderly OR old). We assessed methodological and evidence qualities, and also extracted information for the qualitative synthesis from the selected studies. RESULTS Of the 6,423 studies identified after removing duplicates, eleven met the eligibility criteria. The main food classification we used was Nova. The consumption of ultra-processed foods was positively associated with overweight and obesity, high blood pressure and metabolic syndrome. All articles included met more than 50% of the methodological quality criteria. The quality of evidence was considered moderate for the outcome overweight and obesity and weak for hypertension and metabolic syndrome. CONCLUSIONS The Nova food classification stands out in the area of nutritional epidemiology when assessing the effects of food processing on health outcomes. Although caution is required in the interpretation, the results indicated that the consumption of ultra-processed foods can have an unfavorable impact in the health of individuals.

Mental disorders, comorbidities, and suicidality at 30 years of age in a Brazilian birth cohort.

BACKGROUND: Studies on mental disorders prevalence and comorbidity, including suicidality, are scarce in low and middle-income settings. We aimed to describe the pattern of comorbidity between mental disorders and their association with suicidality. METHODS: In 1982, all hospital deliveries in Pelotas (Southern Brazil) were identified (n = 5914) and have been prospectively followed. Participants were evaluated for the presence of common mental disorders (CMD) at the ages of 18-19, 23 and 30 years. In 2012-13 (30 years of age), trained psychologists evaluated 3657 individuals for disorders using the Mini International Neuropsychiatric Interview. RESULTS: Prevalence of suicidal wishing, suicidal planning and lifetime suicidal attempt was 4.9%, 3.8% and 6.6%, respectively. Suicidal wishing was most strongly associated with having joint major depressive episode (MD) and lifetime suicidal attempt (OR = 26.4, 95%CI:13.9-50.4) with comorbid MD with mania/hypomania (OR = 21.2, 95%CI:6.93-65.1). Suicidal planning was most strongly associated with having joint MD and lifetime suicidal attempt (OR = 44.7, 95%CI:22.6-88.4), with comorbid MD and social anxiety disorder (OR = 30.6, 95%CI:13.0-72.0), and joint social anxiety disorder with lifetime suicidal attempt (OR = 26.3, 95%CI:8.33-82.7). Independently of other disorders, prospective and cross-sectional measures of CMD were associated with higher rates of suicidality. LIMITATIONS: We do not have data on suicide deaths in follow-up and the diagnostic instrument used at 30 years of age was not used in all previous follow-up. CONCLUSION: MD and social anxiety have independent and combined associations with suicidality, and also with they occur with lifetime suicidal attempt and other mental disorders.

Violence against women in life: study among Primary Care users. / Violência contra a mulher na vida: estudo entre usuárias da Atenção Primária.

This article aims to estimate the prevalence and factors associated with intimate partner violence among primary care users. Cross-sectional study with women aged 20 to 59 years. Physical, sexual and psychological violence was screened by the World Health Organization instrument. Poisson regression was used for crude and adjusted analysis. Nine hundred ninety-one women participated in the study. The prevalence of violence throughout the lifespan was: psychological 57.6% (95%CI 54.6-60.7); physical 39.3% (95%CI 36.2-42.3) and sexual 18.0% (95%CI 15.7-20.5). Women with up to eight years of schooling, divorced or separated, whose mothers suffered intimate partner violence, who reported drug use and experienced sexual violence in childhood showed a higher prevalence of the three types of violence. Religion was associated with psychological and sexual violence and the use of cigarettes to physical and psychological violence. Participants with lower household income had a higher prevalence of physical violence. A high prevalence of intimate partner violence was identified among users. Worse socioeconomic conditions, risk behaviors and a history of assault are associated with greater occurrence of this problem.

Common Mental Disorders and Contemporary Factors: 1982 Birth Cohort.

OBJECTIVE: To describe the association between common mental disorders and socio-demographic variables, smoking habits and stressful events among the 30-year-old members of a 1982 cohort. METHOD: Mental disorder was analyzed by the Self-Reporting Questionnaire (SRQ-20). Poisson regression was used to analyze the unadjusted and adjusted associations. RESULTS: Low level of education and stressful events increased the prevalence of mental disorders for both genders. Lower income for women and unemployment for men also remained associated with CMD. CONCLUSION: It was possible to describe the association between contemporary factors and mental disorders in a young population, to which prevention and control measures, through public policies proposed to the areas of Primary Care, Mental Health and Education, can represent a better quality of life and health.

Food consumption of children enrolled in five municipal schools according to socio-demographics characteristics / Consumo alimentar de crianças matriculadas em cinco escolas municipais de educação infantil por características sociodemográficas

ABSTRACT Objective To describe children food consumption in the five municipal schools in Pelotas, Rio Grande do Sul, and their main characteristics. Methods Cross-sectional study of children enrolled in five municipal schools. The mothers were interviewed at the school. The questionnaire about habitual food consumption was based on the guidelines of the Food and Nutrition Surveillance System. The data were entered in EpiData 3.1 and reviewed in Stata 14.0. The consumption frequency was reported according to each exposure category. Statistical tests based on Chi-Square test with 5% significance level and adjusted analyses through Poisson regression were used. Results A total of 548 children were included. Females represented 51.1% of the total sample; the average age was 48.3 months. Children up to two years of age were those who consumed the most fruits and vegetables while sweets were mostly consumed by older children, aged between three and four years. Unhealthy foods had a high frequency of consumption, with sweet being the most consumed (58.8%), followed by packet snacks (53.3%). In the adjusted analysis, eating meals in front of the screens remained associated with lower consumption of vegetables. Conclusion Eating meals in front of the screens reduces children's vegetables consumption. At the same time, the child's age and maternal education seem to have some influence on the consumption of unhealthy foods, indicating the need for nutritional education interventions.

RESUMO Objetivo Descrever o consumo alimentar de crianças de cinco escolas municipais de Pelotas, Rio Grande do Sul, e suas principais características. Métodos Estudo transversal, incluindo crianças de cinco escolas da rede municipal de educação infantil de Pelotas, Rio Grande do Sul. As mães foram entrevistadas na escola, sendo que as perguntas sobre consumo alimentar habitual foram elaboradas a partir das orientações do Sistema de Vigilância Alimentar e Nutricional. Os dados foram digitados no EpiData 3.1 e analisados no Stata 14.0. A frequência de consumo foi apresentada de acordo com cada categoria de exposição, e foram elaborados testes estatísticos baseados no qui-quadrado, sendo 5% o nível de significância e análise ajustada por meio de regressão de Poisson. Resultados Foram incluídas 548 crianças, dentre as quais o sexo feminino representou 51,1% e a média de idade foi de 48,3 meses. Crianças com até dois anos de idade são as que mais consomem frutas e legumes, e as com três e quatro anos são as que mais consomem doces. Os alimentos não saudáveis apresentaram elevada frequência de consumo, sendo o doce o mais consumido (58,8%), seguido do salgadinho de pacote (53,3%). Na análise ajustada, fazer refeições em frente às telas se manteve associado ao menor consumo de legumes. Conclusão Fazer as refeições em frente às telas diminui o consumo de legumes pelas crianças. Ao mesmo tempo, a idade da criança e a escolaridade materna parecem ter alguma influência no consumo de alimentos não saudáveis, indicando a necessidade de intervenções de educação nutricional.

Common Mental Disorders and Contemporary Factors: 1982 Birth Cohort / Trastornos mentales comunes y factores contemporáneos: cohorte de nacimientos de 1982 / Transtornos mentais comuns e fatores contemporâneos: coorte de nascimentos de 1982

ABSTRACT Objective: To describe the association between common mental disorders and socio-demographic variables, smoking habits and stressful events among the 30-year-old members of a 1982 cohort. Method: Mental disorder was analyzed by the Self-Reporting Questionnaire (SRQ-20). Poisson regression was used to analyze the unadjusted and adjusted associations. Results: Low level of education and stressful events increased the prevalence of mental disorders for both genders. Lower income for women and unemployment for men also remained associated with CMD. Conclusion: It was possible to describe the association between contemporary factors and mental disorders in a young population, to which prevention and control measures, through public policies proposed to the areas of Primary Care, Mental Health and Education, can represent a better quality of life and health.

RESUMEN Objetivo: describir la asociación de trastornos mentales comunes a los 30 años en los miembros de cohorte de 1982 con variables sociodemográficas, tabaquismo y eventos estresores. Método: los trastornos mentales se identificaron mediante el Cuestionario de Autorreporte de Síntomas (SRQ-20). La Regresión de Poisson se utilizó para analizar las asociaciones brutas y ajustadas. Resultados: la poca escolarización y los eventos estresores aumentaron la frecuencia de trastornos en ambos sexos. Los ingresos familiares bajos de las mujeres y la falta de trabajo de los hombres también estaban relacionados. Conclusión: Existe una asociación entre los factores contemporáneos y los trastornos mentales padecidos por los jóvenes, en los que las medidas de prevención y control, a través de políticas públicas en las áreas de Atención Primaria, de Salud Mental y de Educación, pueden representar una mejoría en la calidad de vida e influenciar notablemente en su salud.

RESUMO Objetivo: Descrever a associação de transtorno mental comum aos 30 anos nos membros da coorte de 1982 com variáveis sociodemográficas, tabagismo e eventos estressores. Método: Transtorno mental foi identificado pelo Self-Reporting Questionnaire (SRQ-20). Regressão de Poisson foi utilizada para analisar as associações brutas e ajustadas. Resultados: A baixa escolaridade e os eventos estressores aumentaram a frequência de transtorno em ambos os sexos. A menor renda familiar para mulheres e a falta de trabalho para homens também se mantiveram associadas. Conclusão: Permitiu descrever a associação de fatores contemporâneos com os transtornos mentais em população jovem, na qual as medidas de prevenção e controle, por meio de políticas públicas propostas nas áreas de Atenção Básica, Saúde Mental e Educação, podem representar uma melhor qualidade de vida e de saúde.

Food processing and cardiometabolic risk factors: a systematic review / Processamento de alimentos e fatores de risco cardiometabólicos: revisão sistemática

ABSTRACT OBJECTIVE To systematically review the evidence for the association between food consumption according to processing and cardiometabolic factors in adults and/or the elderly. METHOD Two independent evaluators analyzed the electronic databases PubMed, Web of Science and Lilacs until December 2018. We used the following terms: (convenience foods OR food processing OR highly-processed OR industrialized foods OR minimally-processed OR prepared foods OR processed foods OR ultra-processed OR ultraprocessed OR ultra processed OR unprocessed) AND (metabolic syndrome OR hypertension OR blood pressure OR diabetes mellitus OR glucose OR glycaemia OR insulin OR cholesterol OR triglycerides OR blood lipids OR overweight OR obesity) AND (adult OR adults OR adulthood OR aged OR elderly OR old). We assessed methodological and evidence qualities, and also extracted information for the qualitative synthesis from the selected studies. RESULTS Of the 6,423 studies identified after removing duplicates, eleven met the eligibility criteria. The main food classification we used was Nova. The consumption of ultra-processed foods was positively associated with overweight and obesity, high blood pressure and metabolic syndrome. All articles included met more than 50% of the methodological quality criteria. The quality of evidence was considered moderate for the outcome overweight and obesity and weak for hypertension and metabolic syndrome. CONCLUSIONS The Nova food classification stands out in the area of nutritional epidemiology when assessing the effects of food processing on health outcomes. Although caution is required in the interpretation, the results indicated that the consumption of ultra-processed foods can have an unfavorable impact in the health of individuals.

RESUMO OBJETIVO Revisar sistematicamente as evidências da associação entre consumo de alimentos de acordo com o processamento e fatores cardiometabólicos em adultos e idosos. MÉTODOS Dois avaliadores independentes analisaram as bases de dados eletrônicas PubMed, Web of Science e Lilacs até dezembro de 2018. Os seguintes termos foram utilizados: (convenience foods OR food processing OR highly-processed OR industrialized foods OR minimally-processed OR prepared foods OR processed foods OR ultra-processed OR ultraprocessed OR ultra processed OR unprocessed) AND (metabolic syndrome OR hypertension OR blood pressure OR diabetes mellitus OR glucose OR glycaemia OR insulin OR cholesterol OR triglycerides OR blood lipids OR overweight OR obesity) AND (adult OR adults OR adulthood OR aged OR elderly OR old). Nos estudos incluídos foram avaliadas as qualidades metodológica e de evidência, além de extraídas informações para a síntese qualitativa. RESULTADOS Dos 6.423 estudos identificados após a remoção das duplicatas, onze preencheram os critérios de elegibilidade. A principal classificação de alimentos utilizada foi a Nova. O consumo de alimentos ultraprocessados foi positivamente associado com excesso de peso e obesidade, hipertensão arterial e síndrome metabólica. Todos os artigos incluídos preencheram mais de 50% dos critérios de qualidade metodológica. A qualidade de evidência foi considerada moderada para o desfecho excesso de peso e obesidade e fraca para hipertensão arterial e síndrome metabólica. CONCLUSÕES A classificação de alimentos Nova se destaca na área da epidemiologia nutricional ao avaliar os efeitos do processamento de alimentos sobre desfechos em saúde. Embora seja necessária prudência na interpretação, os resultados indicam que o consumo de alimentos ultraprocessados pode ter impacto desfavorável sobre a saúde dos indivíduos.

[Association of excess weight and obesity and mortality in Brazilian state capitals and Argentine provinces]. / Associação entre excesso de peso e obesidade e mortalidade em capitais brasileiras e províncias argentinas.

This study aimed to assess the association between prevalence of excess weight and obesity and overall and disease-specific mortality rates in Brazilian state capitals and Argentine provinces. This was an ecological study with secondary data, where the principal exposures were prevalence rates for excess weight and obesity, estimated with data from Brazil's Vigitel survey (Risk and Protective Factors Surveillance System for Chronic Non-Communicable Diseases Through Telephone Interveiew) in 2014 and Argentina's National Risk Factor Survey in 2013. Overall and specific mortality rates for the year 2015 were obtained from the Brazilian Mortality Information System in the Brazilian Health Informatics Department and the Division of Health Statistics and Information of the Argentine Ministry of Health. Brazilian mortality rates were standardized with the age structure of the Argentine population as the standard. Crude and adjusted linear regressions were used to assess the association between the prevalence rates for excess weight and obesity and the overall and specific mortality rates. After adjusting for potential confounding factors, prevalence of obesity was positively associated with the overall mortality rate both in Brazil (ß = 0.18; 95%CI: 0.01; 0.35) and in Argentina (ß = 0.06; 95%CI: 0.01; 0.13). There was no association with the specific cardiovascular and cancer mortality rates. We conclude that the Brazilian state capitals and Argentine provinces with the highest prevalence of obesity present higher overall mortality rates, while this association was inconsistent for the specific rates.

O objetivo deste trabalho foi avaliar a associação da prevalência de excesso de peso e obesidade com as taxas de mortalidade total e específica nas capitais brasileiras e províncias argentinas. Estudo ecológico com dados secundários, em que as exposições principais foram as prevalências de excesso de peso e obesidade estimadas com base em dados da pesquisa Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (Vigitel) de 2014 (Brasil) e da Pesquisa Nacional de Fatores de Risco de 2013 (Argentina). As taxas de mortalidade geral e específicas para o ano de 2015 foram obtidas no Sistema de Informações sobre Mortalidade do Departamento de Informática do SUS (Brasil) e na Direção de Estatísticas e Informações de Saúde do Ministério da Saúde (Argentina). As taxas de mortalidade brasileiras foram padronizadas considerando-se a estrutura etária da população argentina como padrão. Regressão linear bruta e ajustada foi utilizada para avaliar a associação das prevalências de excesso de peso e obesidade com as taxas de mortalidade geral e específicas. Após o ajuste para os potenciais fatores de confusão, a prevalência de obesidade se associou positivamente com a taxa de mortalidade geral tanto no Brasil (ß = 0,18; IC95%: 0,01; 0,35) quanto na Argentina (ß = 0,06; IC95%: 0,01; 0,13). Para as demais taxas de mortalidade (cardiovascular e por câncer) não houve associação. Conclui-se que as capitais brasileiras e províncias argentinas com maiores prevalências de obesidade apresentam maiores taxas de mortalidade geral, sendo esta associação inconsistente para as taxas específicas.

El objetivo de este estudio fue evaluar la asociación de la prevalencia de exceso de peso y obesidad con las tasas de mortalidad total y específica en capitales brasileñas y provincias argentinas. Estudio ecológico con datos secundarios, donde las exposiciones principales fueron las prevalencias de exceso de peso y obesidad, estimados a partir de datos de la Vigilancia de Factores de Riesgo y Protección para Enfermedades Crónicas No Transmisibles por Entrevista Telefónica (Vigitel) de 2014 (Brasil) y de la Encuesta Nacional de Factores de Riesgo de 2013 (Argentina). Las tasas de mortalidad general y específicas del año 2015 se obtuvieron del Sistema de Información sobre Mortalidad del Departamento de Informática del SUS (Brasil) y de la Dirección de Estadística e Información de Salud del Ministerio de Salud de Argentina. Las tasas de mortalidad brasileñas fueron estandarizadas considerando la estructura etaria de la población argentina como patrón. Se utilizó la regresión lineal bruta y ajustada para evaluar la asociación de las prevalencias de exceso de peso y obesidad con tasas de mortalidad general y específicas. Tras el ajuste de los potenciales factores de confusión, la prevalencia de obesidad se asoció positivamente con la tasa de mortalidad general, tanto en Brasil (ß = 0,18; IC95%: 0,01; 0,35), como en Argentina (ß = 0,06; IC95%: 0,01; 0,13). Para las demás tasas de mortalidad (cardiovascular y por cáncer), no hubo asociación. Se concluye que las capitales brasileñas y provincias argentinas con mayores prevalencias de obesidad presentan mayores tasas de mortalidad general, siendo esta asociación inconsistente en el caso de las tasas específicas.

Violence against women and its association with the intimate partner's profile: a study with primary care users. / Violência contra a mulher e sua associação com o perfil do parceiro íntimo: estudo com usuárias da atenção primária.

OBJECTIVE: To verify the association between the history of violence against women and the socio-demographic and behavioral characteristics of intimate partners. METHODS: A cross-sectional study was carried out with 938 women using basic health care, aged between 20 and 59 years, who at the time of the interview had an intimate partner. Information about the sociodemographic and behavioral characteristics of the intimate partner were collected, as well as the WHO VAW Study instrument for tracking the psychological, physical and sexual violence experienced in the past year. A bivariate analysis was performed using the Pearson c2 test and multivariate analysis using Poisson regression with robust variance. RESULTS: The highest prevalences of psychological, physical and sexual violence were significantly associated with partners who had no occupation and who refused to use condoms in sexual relationships. Men who were considered controllers and who consumed alcoholic beverages were associated with greater perpetration of psychological and physical violence (p < 0.05). Partners with up to eight years of schooling present a higher frequency of psychological violence (PR = 1.32, 95%CI 1.05 - 1.66), while sexual violence was significantly higher among women whose partners smoked: 1.94, 95%CI 1.11 - 3.38). CONCLUSIONS: These data highlight the importance of health professionals, work together in other sectors such as education and safety, dealing with alcohol and other drugs, as well as addressing issues of gender.

OBJETIVO: Verificar associação entre a história de violência contra a mulher e características sociodemográficas e comportamentais do parceiro íntimo. MÉTODOS: Estudo transversal realizado com 938 mulheres usuárias da atenção básica de saúde, com idade entre 20 e 59 anos e que no momento da entrevista possuíam parceiro íntimo. Foram coletadas informações sobre as características sociodemográficas e comportamentais, do parceiro íntimo, bem como foi aplicado o instrumento World Health Organization Violence Against Woman (WHO VAW Study) para o rastreamento da violência psicológica, física e sexual vivenciada no último ano. Foi realizada análise bivariada, por meio do teste do c2 de Pearson, e multivariada usando regressão de Poisson com variância robusta. RESULTADOS: As maiores prevalências de violência psicológica, física e sexual estiveram significativamente associadas aos parceiros que não possuíam ocupação e que recusaram o uso do preservativo nas relações sexuais. Homens que foram considerados controladores e que ingeriam bebida alcoólica estiveram associados a maior perpetração de violência psicológica e física (p < 0,05). Parceiros com até 8 anos de escolaridade apresentam maior frequência de prática de violência psicológica (RP = 1,32; IC95% 1,05 - 1,66), enquanto a violência sexual foi significativamente maior entre as mulheres cujos parceiros fumavam (RP = 1,94; IC95% 1,11 - 3,38). CONCLUSÕES: Esses dados evidenciam a importância de os profissionais de saúde atuarem juntamente a outros setores, tais como educação e segurança, no enfrentamento ao álcool e outras drogas, bem como na abordagem das questões de gênero.

The community health worker as interlocutor in complementary feeding in Pelotas, Rio Grande do Sul, Brazil. / O agente comunitário de saúde como interlocutor da alimentação complementar em Pelotas, RS, Brasil.

This paper evaluates the knowledge of community health workers in complementary feeding and their association with sociodemographic characteristics, work routines and describes the resources available in primary care facilities to master this topic. We applied questionnaires to the responsible for health services and to community health workers, the latter consisting of a knowledge test that allowed the calculation of scores according to the number of correct answers in multiple-choice questions. There was a positive association with age, length of service, home visits to children under 24 months, providing guidance or seeking information about complementary feeding with the knowledge in feeding in the first 24 months of life. There were discrepant responses by health services and the community health workers regarding training, government materials and child growth monitoring. Greater mastery was noted in breastfeeding in relation to complementary feeding. Therefore, primary care facilities should provide support and resources to increase knowledge in complementary feeding through training and access to government materials.

Este artigo avalia o conhecimento dos agentes comunitários de saúde em alimentação complementar e sua associação com características sociodemográficas, rotinas de trabalho e descreve os recursos disponíveis nas unidades básicas de saúde para que tenham domínio neste tema. Foi aplicado um questionário ao responsável do serviço de saúde e outro aos agentes comunitários de saúde, este último composto pelo teste de conhecimento que permitiu o cálculo de escores conforme o número de acertos em questões de múltipla escolha. Houve associação positiva com idade, tempo de profissão, visitas domiciliares a crianças com até 24 meses, realizar orientações e buscar informações sobre alimentação complementar com o conhecimento em alimentação nos primeiros 24 meses de vida. Evidenciou-se desacordo entre as respostas do serviço de saúde e dos agentes comunitários de saúde quanto a treinamentos, materiais governamentais e acompanhamento do crescimento infantil. Verificou-se maior domínio em aleitamento materno em relação à alimentação complementar, portanto, a unidade básica de saúde deve oferecer respaldo e recursos que ampliem o conhecimento em alimentação complementar, mediante treinamentos e acesso facilitado aos materiais governamentais.

O agente comunitário de saúde como interlocutor da alimentação complementar em Pelotas, RS, Brasil / The community health worker as interlocutor in complementary feeding in Pelotas, Rio Grande do Sul, Brazil

Resumo Este artigo avalia o conhecimento dos agentes comunitários de saúde em alimentação complementar e sua associação com características sociodemográficas, rotinas de trabalho e descreve os recursos disponíveis nas unidades básicas de saúde para que tenham domínio neste tema. Foi aplicado um questionário ao responsável do serviço de saúde e outro aos agentes comunitários de saúde, este último composto pelo teste de conhecimento que permitiu o cálculo de escores conforme o número de acertos em questões de múltipla escolha. Houve associação positiva com idade, tempo de profissão, visitas domiciliares a crianças com até 24 meses, realizar orientações e buscar informações sobre alimentação complementar com o conhecimento em alimentação nos primeiros 24 meses de vida. Evidenciou-se desacordo entre as respostas do serviço de saúde e dos agentes comunitários de saúde quanto a treinamentos, materiais governamentais e acompanhamento do crescimento infantil. Verificou-se maior domínio em aleitamento materno em relação à alimentação complementar, portanto, a unidade básica de saúde deve oferecer respaldo e recursos que ampliem o conhecimento em alimentação complementar, mediante treinamentos e acesso facilitado aos materiais governamentais.

Abstract This paper evaluates the knowledge of community health workers in complementary feeding and their association with sociodemographic characteristics, work routines and describes the resources available in primary care facilities to master this topic. We applied questionnaires to the responsible for health services and to community health workers, the latter consisting of a knowledge test that allowed the calculation of scores according to the number of correct answers in multiple-choice questions. There was a positive association with age, length of service, home visits to children under 24 months, providing guidance or seeking information about complementary feeding with the knowledge in feeding in the first 24 months of life. There were discrepant responses by health services and the community health workers regarding training, government materials and child growth monitoring. Greater mastery was noted in breastfeeding in relation to complementary feeding. Therefore, primary care facilities should provide support and resources to increase knowledge in complementary feeding through training and access to government materials.