Factors associated with leisure time physical inactivity in black individuals: hierarchical model.

Background. A number of studies have shown that the black population exhibits higher levels of leisure-time physical inactivity (LTPI), but few have investigated the factors associated with this behavior. Objective. The aim of this study was to analyze associated factors and the explanatory model proposed for LTPI in black adults. Methods. The design was cross-sectional with a sample of 2,305 adults from 20-96 years of age, 902 (39.1%) men, living in the city of Salvador, Brazil. LTPI was analyzed using the International Physical Activity Questionnaire (IPAQ). A hierarchical model was built with the possible factors associated with LTPI, distributed in distal (age and sex), intermediate 1 (socioeconomic status, educational level and marital status), intermediate 2 (perception of safety/violence in the neighborhood, racial discrimination in private settings and physical activity at work) and proximal blocks (smoking and participation in Carnival block rehearsals). We estimated crude and adjusted odds ratio (OR) using logistic regression. Results. The variables inversely associated with LTPI were male gender, socioeconomic status and secondary/university education, although the proposed model explains only 4.2% of LTPI. Conclusions. We conclude that male gender, higher education and socioeconomic status can reduce LTPI in black adults.

Práticas alimentares associadas ao baixo risco cardiometabólico em mulheres obesas assistidas em ambulatórios de referência do Sistema Único de Saúde: estudo de caso-controle* / Dietary practices associated with low cardiometabolic risk in obese women attending Brazilian Public Health System outpatient referral services, Bahia, Brazil, 2006: a case-control study

Objetivo: analisar associação entre práticas alimentares (PrA) com maior ação preventiva e baixo risco cardiometabólico (RCM) em mulheres obesas. Métodos: estudo de caso-controle, com pareamento pela idade, com 306 mulheres obesas (66 casos), não hipertensas, normolipídicas e não diabéticas, realizado em ambulatórios do Sistema Único de Saúde (SUS) no município de Salvador, Bahia, Brasil, em 2006; foram obtidos dados antropométricos, laboratoriais, de pressão arterial e dieta habitual; definiu-se as PrA a partir de um índice (IPrA), baseado na pirâmide alimentar adaptada. Resultados: baixo RCM esteve associado significativamente à dieta com maior ação preventiva em mulheres obesas com nível socioeconômico mais elevado, à frequência diária de consumo de frutas (≥3) e leguminosas (≥2) e ao não consumo de gordura saturada. Conclusão: sugere-se que o aumento da ingestão de frutas, hortaliças e leguminosas e a redução do consumo de gorduras poderia apresentar algum impacto nos fatores de risco cardiometabólico em mulheres obesas.

Objective: analyze the association between dietary practices (DPr) with greater preventive action and low cardiometabolic risk (CMR) in obese women. Methods: a case-control-study, matched by age, of 306 (66 cases), non-hypertensive, normolipidemic and non-diabetic obese women, conducted in public health outpatient services. Anthropometric, laboratory, blood pressure and usual diet data were obtained. DPr were defined using an index (DPrI) based on the adapted food pyramid. Results: low CMR was significantly associated with a diet having greater preventive action, in obese women of higher socioeconomic status, and also with daily frequency of fruit (≥3) and leguminous vegetables (≥2) consumption, as well as non-consumption of saturated fat. Conclusion: it is suggested that an increase in the intake of fruit, leguminous vegetables and other greens and a reduction in fat consumption may have some impact on cardiometabolic risk factors among obese women.

[Sociodemographic factors associated with different domains of physical activity in adults of black ethnicity]. / Fatores sociodemográficos associados aos diferentes domínios da atividade física em adultos de etnia negra.

OBJECTIVE: To analyze the prevalence and sociodemographic factors associated with different domains of physical activity among adults of black ethnicity. METHODS: Cross-sectional study with a sample of 2,305 black individuals from 20-96 years of age, 902 (39.1%) of which men living in the city of Salvador, Bahia, Brazil. Sociodemographic variables analyzed were: gender, age, schooling, socioeconomic status (SES), marital status, racial discrimination at work/school (RDWE), in public (RDPUP) and private (RDPRP) places and perception of police (PPN) /violence in the neighborhood (PVN), as well as total physical activity (TPA) in its different domains: leisure time (LTPA), work (WPA), commuting (CPA) and household activity (HPA). Associations were analyzed using chi-square tests, chi-square trend and prevalence ratio (PR). We also used logistic regression analysis to estimate the odds ratio (OR) with a 95%confidence interval. RESULTS: The proportions of active individuals were 39.1% for TPA, 11.2% for LTPA, 9.6% for WPA, 23.7% for CPA and 33.7% for HPA. TPA was positively associated with higher schooling and inversely associated with male gender, age over 60 years and with no PPN. LTPA was positively associated with male gender, higher schooling and higher SES. WPA was inversely associated with age over 60 years and positively associated with male gender, higher schooling and no PPN. CPA was inversely associated with age over 60 years and positively associated with male gender. HPA was inversely associated with male gender, age over 60 years and no PPN and positively associated with higher schooling and SES. CONCLUSION: Socio-demographic factors, particularly gender, age and schooling were associated with different domains of physical activity among adults of black ethnicity.

Fatores sociodemográficos associados aos diferentes domínios da atividade física em adultos de etnia negra / Sociodemographic factors associated with different domains of physical activity in adults of black ethnicity

OBJETIVO: Analisar a prevalência e os fatores sociodemográficos associados aos diferentes domínios da atividade física em adultos de etnia negra. MÉTODOS: Estudo transversal com amostra de 2.305 adultos negros de 20 a 96 anos de idade, sendo 902 (39,1%) homens, residentes na cidade de Salvador, BA, Brasil. Foram analisadas as variáveis sociodemográficas sexo, idade, escolaridade, nível socioeconômico (NSE), estado civil, discriminação racial no trabalho/escola (DRTE), em ambientes públicos (DRAPU) e privados (DRAPR) e percepção de policiamento (PPB)/violência no bairro (PVB), além da atividade física total (AFT) e em diferentes domínios: tempo livre (AFTL), trabalho (AFTR), deslocamento (AFDL) e doméstico (AFDM). As associações foram analisadas por meio dos testes qui-quadrado, qui-quadrado de tendência e razão de prevalência (RP). Utilizou-se também regressão logística para estimar a razão de chances (RC) com intervalo de confiança de 95%. RESULTADOS: As proporções de indivíduos ativos foram 39,1% para AFT, 11,2% para AFTL, 9,6% para AFTR, 23,7% para AFDL e 33,7% para AFDM. A AFT associou-se positivamente com escolaridade e inversamente com sexo masculino, idade maior que 60 anos e com não PPB. A AFTL associou-se positivamente com sexo masculino, maior escolaridade e maior NSE. A AFTR associou-se inversamente à idade maior que 60 anos e positivamente com o sexo masculino, maior escolaridade e não PPB. A AFDL associou-se inversamente à idade maior que 60 anos e positivamente ao sexo masculino. A AFDM associou-se inversamente com o sexo masculino, idade maior que 60 anos e não PPB; e positivamente com maior escolaridade e NSE. CONCLUSÕES: Os fatores sociodemográficos, principalmente sexo, idade e escolaridade se mostraram associados aos diferentes domínios da atividade física em adultos de etnia negra.

OBJECTIVE: To analyze the prevalence and sociodemographic factors associated with different domains of physical activity among adults of black ethnicity. METHODS: Cross-sectional study with a sample of 2,305 black individuals from 20-96 years of age, 902 (39.1%) of which men living in the city of Salvador, Bahia, Brazil. Sociodemographic variables analyzed were: gender, age, schooling, socioeconomic status (SES), marital status, racial discrimination at work/school (RDWE), in public (RDPUP) and private (RDPRP) places and perception of police (PPN) /violence in the neighborhood (PVN), as well as total physical activity (TPA) in its different domains: leisure time (LTPA), work (WPA), commuting (CPA) and household activity (HPA). Associations were analyzed using chi-square tests, chi-square trend and prevalence ratio (PR). We also used logistic regression analysis to estimate the odds ratio (OR) with a 95%confidence interval. RESULTS: The proportions of active individuals were 39.1% for TPA, 11.2% for LTPA, 9.6% for WPA, 23.7% for CPA and 33.7% for HPA. TPA was positively associated with higher schooling and inversely associated with male gender, age over 60 years and with no PPN. LTPA was positively associated with male gender, higher schooling and higher SES. WPA was inversely associated with age over 60 years and positively associated with male gender, higher schooling and no PPN. CPA was inversely associated with age over 60 years and positively associated with male gender. HPA was inversely associated with male gender, age over 60 years and no PPN and positively associated with higher schooling and SES. CONCLUSION: Socio-demographic factors, particularly gender, age and schooling were associated with different domains of physical activity among adults of black ethnicity.

Atividade física na prevenção das comorbidades cardiovasculares em mulheres obesas: quanto é suficiente? / Physical activity in the prevention of cardiovascular comorbidities in obese women: how much is enough?

O objetivo do estudo foi analisar a intensidade e duração de atividade física suficiente para discriminar a ausência de comorbidades cardiovasculares em mulheres obesas. O desenho foi de corte transversal com amostra constituída por 387 mulheres obesas com faixa etária de 21 a 75 anos e IMC = 31,2 kg/m². Foram construídas diversas curvas Receiver Operating Characteristic (ROC) e comparadas às áreas sob as mesmas entre diferentes intensidades de atividade física (caminhada, moderada e vigorosa) e ausência das comorbidades cardiovasculares. Verificou-se também a sensibilidade e especificidade para identificar o melhor ponto de corte para a duração da atividade física mais apropriada para predizer a ausência das comorbidades cardiovasculares. Foi utilizado o intervalo de confiança a 95%. Entre as diferentes intensidades de atividade física as maiores áreas sob a curva ROC foram encontradas na caminhada: 0,68 (0,62-0,73) com ponto de corte para duração de 150 min/semana e na atividade moderada: 0,64 (0,58-0,70), com ponto de corte para duração de 150 min/semana. A prática da atividade física deve ser sugerida para mulheres obesas na intensidade e duração suficientes visando contribuir para a ausência de comorbidades cardiovasculares nesta população.

The aim of this study was to analyze the intensity and duration of physical activity sufficient to discriminate the absence of cardiovascular comorbidities in obese women. This was a cross-sectional study, with a sample of 387 obese women, aged 21 to 75 years with body mass index = 31,2 kg/m². Different curves Receiver Operating Characteristic (ROC) were constructed and compared to areas under the same among different intensities of physical activity (walking, moderate and vigorous) and the absence of cardiovascular comorbidities. We also observed the sensitivity and specificity to identify the best cutoff for the duration of physical activity most appropriate for predicting the absence of cardiovascular comorbidities. The confidence interval at 95% was used. Among the different intensities of physical activity the major areas on the ROC curve was found in walking: 0,68 (0,62-0,73) with cutoff point for duration of 150 min/week and moderate activity: 0,64(0,58-0,70) with cutoff point for duration of 150 min/week. The physical activity should be suggested for obese women in the intensity and duration sufficient to contribute to the absence of cardiovascular comorbidities in this population.

[Adiponectin and low cardiometabolic risk in obese women]. / Adiponectina e baixo risco cardiometabólico em obesas.

OBJECTIVE: To investigate the association between elevated levels of plasmatic adiponectin (AdipoQ) and low cardiometabolic risk (CMR) in obese women (O(b)W). SUBJECTS AND METHODS: Case-control study, matched by age, of 306 O(b)W, BMI > 30 kg/m², with 66 cases (21.6%) - all non-hypertensive, normolipidemic, and non-diabetic - conducted in SUS (Brazil's Public Health System) outpatient referral services for obesity in the City of Salvador, Brazil. Secondary data were collected from medical records; primary and complementary data were obtained from a clinical pathology laboratory. Values of AdipoQ > 10.00 µg/ml (> 3(rd) quartile) were considered elevated. Descriptive, bivariate, and conditional logistic regression analyses were performed. RESULTS: A statistically significant positive association between low CMR and AdipoQ > 10.00 µg/ml in physically active (AOR = 5.1; CI95%: 1.8-14.3), non-smoking (AOR = 3.6;CI95%: 1.6-8.4) O(b)W was found. CONCLUSION: This study suggests that physically active, non-smoking O(b)W, with higher AdipoQ levels, present greater chances of a low CMR. It becomes important to reinforce encouragement of the adoption of healthy behaviors, by means of public policies.

Adiponectina e baixo risco cardiometabólico em obesas / Adiponectin and low cardiometabolic risk in obese women

OBJETIVO: Investigar a associação entre níveis elevados de adiponectina plasmática (AdipoQ) e baixo risco cardiometabólico (RCM) em obesas (MOb). SUJEITOS E MÉTODOS: Estudo caso-controle, pareado pela idade com 306 MOb, IMC > 30 kg/m², sendo 66 (21,6 por cento) casos - todos não hipertensos, normolipídicos e não diabéticos - realizados em ambulatórios referência do Sistema Único de Saúde (SUS) para obesidade em Salvador. Dados secundários foram coleta-dos dos prontuários médicos, primários e complementares em laboratório de patologia clínica. Valores de AdipoQ > 10,00 µg/mL (> 3º quartil) foram considerados elevados. Foram realizadas análises: descritiva, bivariada e regressão logística condicional. RESULTADOS: Associação positiva, estatisticamente significante (ES), entre baixo RCM e AdipoQ > 10,00 µg/mL em MOb ativas fisicamente (OR= 5,1; IC95 por cento: 1,8-14,3), não fumantes (OR= 3,6; IC95 por cento: 1,6-8,4). CONCLUSÃO: Este estudo sugere que MOb ativas fisicamente, não fumantes e com níveis mais elevados de AdipoQ apresentam mais chances de baixo RCM. Torna-se importante reforçar, por meio de políticas públicas, o estímulo à adoção de comportamentos saudáveis.

OBJECTIVE: To investigate the association between elevated levels of plasmatic adiponectin (AdipoQ) and low cardiometabolic risk (CMR) in obese women (ObW). SUBJECTS AND METHODS: Case-control study, matched by age, of 306 ObW, BMI > 30 kg/m², with 66 cases (21.6 percent) - all non-hypertensive, normolipidemic, and non-diabetic - conducted in SUS (Brazil's Public Health System) outpatient referral services for obesity in the City of Salvador, Brazil. Secondary data were collected from medical records; primary and complementary data were obtained from a clinical pathology laboratory. Values of AdipoQ > 10.00 µg/ml (> 3rd quartile) were considered elevated. Descriptive, bivariate, and conditional logistic regression analyses were performed. RESULTS: A statistically significant positive association between low CMR and AdipoQ > 10.00 µg/ml in physically active (AOR = 5.1; CI95 percent: 1.8-14.3), non-smoking (AOR = 3.6;CI95 percent: 1.6-8.4) ObW was found. CONCLUSION: This study suggests that physically active, non-smoking ObW, with higher AdipoQ levels, present greater chances of a low CMR. It becomes important to reinforce encouragement of the adoption of healthy behaviors, by means of public policies.

Knee pain prevalence and associated factors in a Brazilian population study.

OBJECTIVES: To estimate the association among knee pain and central obesity. METHODS: A cross-sectional study was carried out in Salvador, Brazil, with a sample of 2,297 individuals ≥20 years of age. A standardized questionnaire was applied at home to collect data about pain, sociodemographic characteristics and abdominal circumference measurement. Unadjusted (bivariate analysis) and adjusted odds ratio (OR) and 95%CI were estimated by using backward stepwise logistic regression. RESULTS: The prevalence of knee pain was found in 11.2% of the studied sample. Unadjusted OR associations (P<0.1) were found for male (OR 2.70, CI [confidence interval] 2.01-3.63), older age (OR 2.98, CI 1.89-4.42), and obesity (OR 1.62, CI 1.22-2.15). Adjusted ORs (P<0.05) were found for obesity-married individuals (OR 4.69, CI 1.09-20.11), separated (OR 11.03, CI 2.09-58.20) or widowed (OR 7.17, CI 1.40-36.61), and male (OR 2.35, CI 1.25-4.41). The OR of nonobese men was 2.66, CI 1.74-4.06, but being married seems to protect them of knee pain (OR 0.66, CI 0.45-0.96). CONCLUSION: In this study, we found a knee pain prevalence of 11.2% and positive association with the male gender, married, separated or widowed, and a protective association for knee pain in nonobese married male. Aging, obesity, and excessive alcohol consumption were independent correlates of knee pain in the studied population sample.

Associação entre atividade física no tempo livre e pressão arterial em adultos / Relationship between leisure-time physical activity and blood pressure in adults / Asociación entre actividad física en el tiempo libre y presión arterial en adultos

FUNDAMENTO: A pressão arterial (PA) elevada é encontrada em níveis epidêmicos em adultos das sociedades industrializadas favorecendo o aumento do risco de desenvolvimento de numerosas patologias cardiovasculares. OBJETIVO: Verificar se existe associação entre atividade física no tempo livre (AFTL) e pressão arterial sistólica (PAS)/ pressão arterial diastólica (PAD) elevadas em adultos na cidade de Salvador-Bahia. MÉTODOS: O estudo foi de corte transversal, em amostra de 2.292 adultos de ambos os sexos com idades > 20 anos. Aqueles que participavam de atividades físicas nos momentos de lazer foram considerados como ativos no tempo livre. Utilizou-se análise de regressão logística para estimar a razão de chances (RC), com intervalo de confiança de 95 por cento. RESULTADOS: Após ajustamento para idade e estratificação por sexo, as associações entre AFTL e PAS/PAD foram: PAS = 0,86 (0,85 - 0,87) para o sexo feminino e 0,65 (0,64 - 0,66) para o sexo masculino; PAD = 0,94 (0,92-0,95) para o sexo feminino e 0,64 (0,63-0,65) para o sexo masculino. CONCLUSÃO: Os resultados deste estudo são importantes para a saúde pública e devem ser utilizados para conscientizar a população sobre a relevância da AFTL visando à prevenção de níveis elevados de PAS/PAD.

BACKGROUND: High blood pressure (BP) is found at epidemic levels in adults of industrialized societies, thereby favoring an increase in the risk of development of numerous cardiovascular pathologies. OBJECTIVE: To investigate the relationship between leisure-time physical activity (LTPA) and high systolic blood pressure (SBP)/diastolic blood pressure (DBP) in adults, in the city of Salvador, state of Bahia. METHODS: A cross-sectional study was conducted with a sample of 2,292 adults of both sexes, aged > 20 years. Those who engaged in physical activity during their leisure time were considered to be active in their free time. We used logistic regression analysis to estimate the odds ratio (OR), with confidence interval of 95 percent. RESULTS: After the adjustment for age and stratification by sex, the relationships between LTPA and SBP/DBP were: SBP = 0.86 (0.85 to 0.87) for females and 0.65 (0.64 to 0.66) for males; DBP = 0.94 (0.92 to 0.95) for females and 0.64 (0.63 to 0.65) for males. CONCLUSION: The results of this study are important to public health and they must be used to raise awareness of the relevance of LTPA to prevent high levels of SBP/DBP.

FUNDAMENTO: La presión arterial (PA) elevada es encontrada en niveles epidémicos en adultos de las sociedades industrializadas favoreciendo el aumento del riesgo de desarrollo de numerosas patologías cardiovasculares. OBJETIVO: Verificar si existe asociación entre actividad física en el tiempo libre (AFTL) y presión arterial sistólica (PAS)/presión arterial diastólica (PAD) elevadas en adultos en la ciudad de Salvador-Bahia. MÉTODOS: El estudio fue de corte transversal, en muestra de 2.292 adultos de ambos sexos con edades > 20 años. Aquellos que participaban en actividades físicas en los momentos de ocio fueron considerados como activos en el tiempo libre. Se utilizó análisis de regresión logística para estimar la razón de posibilidades (RP), con intervalo de confianza de 95 por ciento. RESULTADOS: Después de ajuste para edad y estratificación por sexo, las asociaciones entre AFTL y PAS/PAD fueron: PAS = 0,86 (0,85 - 0,87) para el sexo femenino y 0,65 (0,64 - 0,66) para el sexo masculino; PAD = 0,94 (0,92 - 0,95) para el sexo femenino y 0,64 (0,63-0,65) para el sexo masculino. CONCLUSIÓN: Los resultados de este estudio son importantes para la salud pública y deben ser utilizados para concientizar a la población sobre la relevancia de la AFTL procurando la prevención de niveles elevados de PAS/PAD.

[Relationship between leisure-time physical activity and blood pressure in adults]. / Associação entre atividade física no tempo livre e pressão arterial em adultos.

BACKGROUND: high blood pressure (BP) is found at epidemic levels in adults of industrialized societies, thereby favoring an increase in the risk of development of numerous cardiovascular pathologies. OBJECTIVE: to investigate the relationship between leisure-time physical activity (LTPA) and high systolic blood pressure (SBP)/diastolic blood pressure (DBP) in adults, in the city of Salvador, state of Bahia. METHODS: a cross-sectional study was conducted with a sample of 2,292 adults of both sexes, aged > 20 years. Those who engaged in physical activity during their leisure time were considered to be active in their free time. We used logistic regression analysis to estimate the odds ratio (OR), with confidence interval of 95%. RESULTS: after the adjustment for age and stratification by sex, the relationships between LTPA and SBP/DBP were: SBP = 0.86 (0.85 to 0.87) for females and 0.65 (0.64 to 0.66) for males; DBP = 0.94 (0.92 to 0.95) for females and 0.64 (0.63 to 0.65) for males. CONCLUSION: the results of this study are important to public health and they must be used to raise awareness of the relevance of LTPA to prevent high levels of SBP/DBP.

[Influence of the self-reported skin color on the prevalence of metabolic syndrome in an urban Brazilian population]. / Influência da cor de pele auto-referida na prevalência da síndrome metabólica numa população urbana do Brasil.

BACKGROUND: The metabolic syndrome (MS) has a high prevalence in different parts of the world, with variations between different ethnic groups. OBJECTIVE: This study aims at exploring the influence of the self-reported skin color on the prevalence of MS Methods: Cross-sectional study, carried out in a population subgroup (n=1,439 adults) in Salvador, Brazil. The self-reported skin color (white, mulatto or black) was used as well as the MS criterion of ATP-III. The Chi-square test for tendency was used to analyze the prevalence gradient between the groups and logistic regression, for association analysis. RESULTS: The general prevalence of MS, adjusted for potentially confounder variables, did not differ among whites (23.3%), mulattos (23.3%) and blacks (23.4%). The analysis by sex showed, among men, a reduction in the MS prevalence of whites (26.2%, 95%CI: 20.7-31.7), in comparison to blacks (17.5%, 95%CI: 12.3-22.8) and an intermediate prevalence among mulattos, 21.9%, 95%CI: 18.6-25.1, p tend. = 0.002. Among the women, the tendency was the opposite, being higher among the blacks, 27.0%, 95%CI: 22.2-31.8, and lower among the whites, 20.5%, 95%CI: 15.6-25.4, p tend. = 0.02. The multivariate analysis of the association between skin color and MS (white = group of reference) showed that the black color of the skin was a protective factor among black men, with a prevalence ratio (PR) = 0.60 (0.36-0.97), whereas it tended to be a risk factor among black women, with a PR = 1.33 (0.94-1.78). CONCLUSION: The prevalence of MA presented an inverse variation according to the color of skin between men and women. To be black was a protective factor among men and a risk factor among women.

[Factors associated with low cardiometabolic risk in obese women]. / Fatores associados ao baixo risco cardiometabólico em mulheres obesas.

OBJECTIVE: To identify factors associated with low cardiometabolic risk (CMR) in obese women (O(b)W) seen at outpatient specialty clinics of SUS (Brazilian Social Security Health System), in the City of Salvador, Bahia, Brazil. SUBJECTS AND METHODS: Case-control study, matched by age, of 306 O(b)W (BMI > or = 30 kg/m(2)), including 66 (21. 6%) cases - normotensive, normolipidemic and nondiabetic patients - and 240 (78.4%) controls. Secondary data were obtained from clinical records, and primary data were collected by means of a household survey and laboratory assays. Descriptive, bivariate, and conditional logistic regression analyses were conducted. RESULTS: A positive, statistically significant association was found between low CMR and a diet containing the desirable ingestion of fruit (AOR = 20. 1, CI 95% 5.6-71.9); 1st CRP quartile (AOR = 4. 1, CI 95% 2.0-8. 3), and 3rd and 4th AdipoQ quartiles (AOR = 2.3, CI 95% 1.1-4. 8). CONCLUSION: This study suggests that a diet rich in soluble fibers as well as lower levels of CRP, and higher levels of AdipoQ, encumber, retard or impede the emergence of other metabolic risk factors or metabolic diseases in O(b)W.

Fatores associados ao baixo risco cardiometabólico em mulheres obesas / Factors associated with low cardiometabolic risk in obese women

OBJETIVO: Identificar fatores associados ao baixo risco cardiometabólico (RCM) em mulheres obesas (MOb) atendidas em ambulatórios especializados do Sistema Único de Saúde (SUS), Salvador, Bahia, Brasil. SUJEITOS E MÉTODOS: Estudo caso-controle, pareado pela idade com 306 MOb, índice de massa corporal (IMC) > 30 kg/m², sendo 66 (21,6 por cento) casos - todos não hipertensos, normolipídicos e não diabéticos e 240 (78,4 por cento) controles. Dados secundários foram obtidos dos prontuários médicos e primários por meio de inquérito domiciliar e exames laboratoriais. Foram realizadas análises descritiva, bivariada e regressão logística condicional. RESULTADOS: Associações positivas, estatisticamente significantes, foram detectadas entre baixo RCM e consumo de frutas (> 3 porções/dia) (ORaj= 20,1; IC 95 por cento: 5,6-71,9); PCR do 1º. quartil (ORaj= 4,1; IC 95 por cento: 2,0-8,3) e da adiponectina plasmática (AdipoQ) a partir do 3º. quartil (ORaj = 2,3; IC 95 por cento: 1,1-4,8). CONCLUSÃO: Este estudo sugere que dieta rica em fibras solúveis (> 3 porções de frutas/dia), valores da PCR < 3,70 mg/L e da AdipoQ > 10,00 µg/mL podem dificultar, retardar ou impedir o aparecimento de outros fatores de risco ou doenças metabólicas em MOb.

OBJECTIVE: To identify factors associated with low cardiometabolic risk (CMR) in obese women (ObW) seen at outpatient specialty clinics of SUS (Brazilian Social Security Health System), in the City of Salvador, Bahia, Brazil. SUBJECTS AND METHODS: Case-control study, matched by age, of 306 ObW (BMI > 30 kg/m²), including 66 (21. 6 percent) cases - normotensive, normolipidemic and nondiabetic patients - and 240 (78.4 percent) controls. Secondary data were obtained from clinical records, and primary data were collected by means of a household survey and laboratory assays. Descriptive, bivariate, and conditional logistic regression analyses were conducted. RESULTS: A positive, statistically significant association was found between low CMR and a diet containing the desirable ingestion of fruit (AOR = 20. 1, CI 95 percent 5.6-71.9); 1st CRP quartile (AOR = 4. 1, CI 95 percent 2.0-8. 3), and 3rd and 4th AdipoQ quartiles (AOR = 2.3, CI 95 percent 1.1-4. 8). CONCLUSION: This study suggests that a diet rich in soluble fibers as well as lower levels of CRP, and higher levels of AdipoQ, encumber, retard or impede the emergence of other metabolic risk factors or metabolic diseases in ObW.

Influência da cor de pele auto-referida na prevalência da síndrome metabólica numa população urbana do Brasil / Influence of the self-reported skin color on the prevalence of metabolic syndrome in an urban Brazilian population / Influencia del color de la piel autodeclarado en la prevalencia del síndrome metabólico en una población urbana de Brasil

Fundamento: A síndrome metabólica tem uma elevada prevalência em diferentes partes do mundo, com variações entre diferentes grupos étnicos. Objetivo: Este estudo pretende explorar a influência da cor de pele auto-referida sobre a prevalência da SM. Métodos: Estudo transversal, realizado em subgrupo populacional em Salvador, Brasil. Utilizou-se auto-definição de cor de pele (branca, parda e negra) e o critério de SM do ATP-III. Foi usado o quiquadrado para tendência a fim de analisar gradiente das prevalências entre os grupos e a regressão logística para análises de associações. Resultados: A prevalência geral da SM, ajustada por variáveis potencialmente confundidoras, não diferiu entre brancos (23,3 por cento), pardos (23,3 por cento) e negros (23,4 por cento,). A análise por sexo mostrou entre os homens redução da prevalência da SM dos brancos, 26,2 por cento IC95 por cento(20,7-31,7), em comparação aos negros, 17,5 por cento IC95 por cento (12,3-22,8), e uma prevalência intermediária entre os pardos, 21,9 por cento IC95 por cento (18,6 - 25,1), p tend= 0,002. Entre as mulheres, a tendência foi inversa, maior nas negras, 27,0 por cento IC95 por cento (22,2-31,8), e menor nas brancas, 20,5 por cento IC95 por cento(15,6-25,4), p tend= 0,02. Na análise multivariada da associação entre cor de pele e SM (branco=grupo de referência), a cor negra entre os homens foi fator de proteção, razão de prevalência (RP)= 0,60 (0,36 - 0,97), enquanto que nas mulheres tendeu a ser fator de risco, RP= 1,33 (0,94 - 1,78). Conclusão: A prevalência da SM variou em função da cor de pele de modo inverso entre homens e mulheres. Ser negro foi fator de proteção entre homens e de risco nas mulheres.

Background: The metabolic syndrome (MS) has a high prevalence in different parts of the world, with variations between different ethnic groups. Objective: This study aims at exploring the influence of the self-reported skin color on the prevalence of MS. Methods: Cross-sectional study, carried out in a population subgroup (n=1,439 adults) in Salvador, Brazil. The self-reported skin color (white, mulatto or black) was used as well as the MS criterion of ATP-III. The Chi-square test for tendency was used to analyze the prevalence gradient between the groups and logistic regression, for association analysis. Results: The general prevalence of MS, adjusted for potentially confounder variables, did not differ among whites (23.3 percent), mulattos (23.3 percent) and blacks (23.4 percent). The analysis by sex showed, among men, a reduction in the MS prevalence of whites (26.2 percent, 95 percentCI: 20.7-31.7), in comparison to blacks (17.5 percent, 95 percentCI: 12.3-22.8) and an intermediate prevalence among mulattos, 21.9 percent, 95 percentCI: 18.6-25.1, p tend. = 0.002. Among the women, the tendency was the opposite, being higher among the blacks, 27.0 percent, 95 percentCI: 22.2-31.8, and lower among the whites, 20.5 percent, 95 percentCI: 15.6-25.4, p tend. = 0.02. The multivariate analysis of the association between skin color and MS (white = group of reference) showed that the black color of the skin was a protective factor among black men, with a prevalence ratio (PR) = 0.60 (0.36-0.97), whereas it tended to be a risk factor among black women, with a PR = 1.33 (0.94-1.78). Conclusion: The prevalence of MA presented an inverse variation according to the color of skin between men and women. To be black was a protective factor among men and a risk factor among women.

Fundamento: El síndrome metabólico tiene una elevada prevalencia en diferentes partes del mundo, con variaciones entre diferentes grupos étnicos. Objetivo: Este estudio pretende explorar la influencia del color de la piel autodeclarado sobre la prevalencia del SM. Métodos: ESTUDio transversal, realizado en subgrupo poblacional en Salvador, Brasil. Se utilizó la autodefinición de color de la piel (blanca, parda y negra) y el criterio de SM del ATP-III. Se usó el test chi-cuadrado para tendencia a fin de analizar gradiente de las prevalencias entre los grupos y la regresión logística para análisis de asociaciones. Resultados: La prevalencia general del SM, ajustado por variables potencialmente confusas, no difirió entre blancos (23,3 por ciento), pardos (23,3 por ciento) y negros (23,4 por ciento,). El análisis por sexo mostró entre los hombres reducción de la prevalencia del SM de los blancos, el 26,2 por ciento IC95 por ciento(20,7-31,7), en comparación con los negros, 17,5 por ciento IC95 por ciento (12,3-22,8), y una prevalencia intermedia entre los pardos, 21,9 por ciento IC95 por ciento (18,6 - 25,1), p tend= 0,002. Entre las mujeres, la tendencia fue inversa, mayor en las negras, 27,0 por ciento IC95 por ciento (22,2-31,8), y menor en las blancas, 20,5 por ciento IC95 por ciento(15,6-25,4), p tend= 0,02. En el análisis multivariado de la asociación entre color de la piel y SM (blanco=grupo de referencia), el color negro entre los hombres fue factor de protección, razón de prevalencia (RP)= 0,60 (0,36-0,97), mientras que en las mujeres tendió a ser factor de riesgo, RP= 1,33 (0,94-1,78). Conclusión: LA Prevalencia del SM varió en función del color de la piel de modo inverso entre hombres y mujeres. Ser negro fue factor de protección entre hombres y de riesgo en las mujeres.

[Physical activity in the prevention of diabetes in black ethnicity: how much is required?]. / Atividade física na prevenção de diabetes em etnia negra: quanto é necessário?

OBJECTIVE: Analyze how much total physical activity (intensity and duration) is required and its different domains (work, commuting, household, and leisure time) as predictors of absence of diabetes in the black ethnicity population. METHODS: The design was cross-sectional with a sample of 2305 adults from 20 to 96 years of age, 902 (39.1%) male, living in the city of Salvador, Brazil. Receiver Operating Characteristic curves (ROC) were constructed to compare the areas of amount of physical activity in their different domains with absence of diabetes. Sensitivity and specificity were also established to identify the best cutoffs for the amount of physical activity related to absence of diabetes. Based on these cutoff points, a multivariate model was constructed to identify the association between physical activity and diabetes. RESULTS: Among the different amounts of physical activity greater significance was found in areas under the ROC curve for total physical activity, moderate activities performed during leisure time and work among men and commuting among women. Walking by itself was not a good predictor of absence of diabetes among men. It was also observed that 185 minutes/week of physical activity accumulated in different domains for men and 215 minutes/week for women were the best cutoffs for predicting absence of diabetes. CONCLUSION: Physical activity accumulated in different domains should be suggested in amounts suitable for a black ethnicity population in order to contribute to diabetes prevention.

Atividade física na prevenção de diabetes em etnia negra: quanto é necessário? / Physical activity in the prevention of diabetes in black ethnicity: how much is required?

OBJETIVO: Analisar a quantidade (intensidade e duração) de atividade física total e em seus diferentes domínios (trabalho, deslocamento, atividade doméstica e tempo livre) como preditores da ausência de diabetes em população de etnia negra. MÉTODOS: Estudo transversal com amostra de 2305 adultos negros de 20 anos a 96 anos de idade, sendo 902 (39,1 por cento) homens, residentes na cidade de Salvador, Bahia, Brasil. Foram construídas curvas Receiver Operating Characteristic (ROC) e comparadas às áreas entre a quantidade de atividade física em seus diferentes domínios e a ausência de diabetes. Verificou-se também a sensibilidade e especificidade para identificar os melhores pontos de corte da quantidade de atividade física para a ausência de diabetes. Com base nestes pontos de corte, construiu-se modelo multivariado para identificar associação entre atividade física e diabetes. RESULTADOS: Entre as diferentes quantidades de atividade física encontrou-se maior significância estatística nas áreas sob a curva ROC na atividade física total, nas atividades moderadas realizados no tempo livre e no trabalho entre os homens, e no deslocamento entre as mulheres. A caminhada isoladamente não foi bom preditor da ausência de diabetes entre homens. Observou-se também que 185 minutos/semana de atividade física acumulada nos diferentes domínios para homens e 215 minutos/semana para mulheres foram os melhores pontos de corte para predizer a ausência de diabetes, porém após análise multivariada encontrou-se associação entre atividade física e diabetes apenas entre os homens. CONCLUSÃO: A atividade física acumulada nos diferentes domínios deve ser sugerida em quantidades adequadas para a população de etnia negra visando contribuir para a prevenção do diabetes.

OBJECTIVE: Analyze how much total physical activity (intensity and duration) is required and its different domains (work, commuting, household, and leisure time) as predictors of absence of diabetes in the black ethnicity population. METHODS: The design was cross-sectional with a sample of 2305 adults from 20 to 96 years of age, 902 (39.1 percent) male, living in the city of Salvador, Brazil. Receiver Operating Characteristic curves (ROC) were constructed to compare the areas of amount of physical activity in their different domains with absence of diabetes. Sensitivity and specificity were also established to identify the best cutoffs for the amount of physical activity related to absence of diabetes. Based on these cutoff points, a multivariate model was constructed to identify the association between physical activity and diabetes. RESULTS: Among the different amounts of physical activity greater significance was found in areas under the ROC curve for total physical activity, moderate activities performed during leisure time and work among men and commuting among women. Walking by itself was not a good predictor of absence of diabetes among men. It was also observed that 185 minutes/week of physical activity accumulated in different domains for men and 215 minutes/week for women were the best cutoffs for predicting absence of diabetes. CONCLUSION: Physical activity accumulated in different domains should be suggested in amounts suitable for a black ethnicity population in order to contribute to diabetes prevention.