Trends in the prevalence of obesity, overweight, and thinness among schoolchildren aged 7-14 years from southern Brazil (2002-2019).

OBJECTIVE: To analyze the obesity, overweight, and thinness trends among Brazilian schoolchildren by sex, age group, and type of school according to World Health Organization (WHO) and International Obesity Task Force (IOTF) criteria. METHODS: We conducted four surveys between 2002 and 2018/19 involving schoolchildren aged 7-14 years from a state capital in southern Brazil. Weight status was classified using both WHO and IOTF criteria. RESULTS: In the total sample, obesity prevalence based on the IOTF and the WHO criteria were 72% and 44% higher in 2018/19 compared with 2002, respectively. Over the whole period, the obesity prevalence increased among children (WHO: 10.1% vs. 14.1%; IOTF: 5.0% vs. 8.3%), and those from public schools (WHO: 10.5% vs. 16.4%; IOTF: 5.6% vs. 10.1%). There was no significant reduction in thinness prevalence over the analyzed period. CONCLUSION: Obesity prevalence remains on an upward trend in a state capital in southern Brazil, especially among children from public schools. A higher prevalence of overweight and obesity was observed using the WHO criteria compared with IOTF criteria.

Adiposity and physical activity are among the main determinants of serum vitamin D concentrations in older adults: the EpiFloripa Aging Cohort Study.

The identification of factors associated with 25-hydroxycholecalciferol (25(OH)D) concentration can help suggest more specific interventions for older adults. In this cross-sectional study of older adults from southern Brazil, we hypothesized that some sociodemographic, behavioral, and health factors positively or negatively influence the 25(OH)D concentration in this population. This analysis was performed using data from the second wave of the EpiFloripa Aging Cohort Study (2013-2015). Serum 25(OH)D levels were classified according to the guidelines of the Endocrine Society. Multinomial logistic regression was performed to evaluate the relative risks of sociodemographic, behavioral, and health factors in each 25(OH)D category. A total of 574 older adults (aged 63-93 years) participated in this study. The prevalence of insufficiency (21-29 ng/mL) was 43.7% and that of deficiency (≤20 ng/mL) was 23.5%. In the adjusted analysis, female sex, higher levels of low-density lipoprotein cholesterol (LDL-C ≥160 mg/dL), obesity by adiposity (body fat percentage [%fat], male ≥31%; female ≥43%), and body mass index (BMI, >30 kg/m2) presented higher relative risks for insufficiency than for sufficiency. For those with deficiency, the associated factors were female sex, disability in 4 or more activities of daily living (ADLs), LDL-C ≥100 mg/dL, and obesity by %fat and BMI. A protective factor against insufficiency and deficiency was active leisure-time physical activity (PA, ≥150 min/week). Our results demonstrated that being female and having modifiable factors, such as high levels of LDL-C, obesity, and disability on ADLs, were negatively associated with hypovitaminosis D. On the other hand, leisure-time PA was positively associated with adequate serum vitamin D concentration.

Methodological aspects and characteristics of participants in the study on the prevalence of obesity in children and adolescents in Florianópolis, Southern Brazil, 2018-2019: EPOCA study.

PURPOSE: To describe the methodological aspects and characteristics of the participants of the EPOCA survey. METHODS: The study was conducted with schoolchildren aged between seven to 14 years old from 30 schools in Florianópolis, Southern Brazil. Body mass, height, girths, and skinfold thicknesses were measured. Food consumption and physical activity from the previous day were self-reported using the validated Web-CAAFE questionnaire. Adolescents completed a specific questionnaire about physical activity, meal consumption, and weight control behaviors. Parents/guardians responded to a sociodemographic and habits questionnaire. RESULTS: A total of 1671 schoolchildren participated in the study (response rate: 27.2%). About 63% of schoolchildren were enrolled in public schools. Most studied in the morning shift (54.2%), were female (53.1%) and aged between seven and 10 years (58.1%). The prevalence of overweight was 33.7% and obesity was 11.3%. CONCLUSIONS: The data obtained will allow us to assess the trend in the prevalence of overweight and obesity and associated factors when compared to other surveys performed. Descriptions of the logistics and protocols can help in the development and improvement of similar studies. It is hoped that the results of EPOCA 2018/2019 may help in the design of obesity prevention policies and programs for this population.

Age at menarche and its association with overweight including obesity and socio-economic conditions of Brazilian schoolgirls: A time-trend analysis.

This study aims to describe the time trend of age at menarche in Brazilian schoolgirls evaluated in 2007, 2012/2013 and 2018/2019, and to assess its association with having overweight, including obesity and socio-economic conditions. Three cross-sectional studies were carried out in 2007, 2012/2013 and 2018/2019 in schoolchildren enrolled between the second and ninth years of elementary school and comprising 838, 688 and 326 schoolgirls, respectively. Body mass index Z scores were calculated and categorised as either without overweight or with overweight (including obesity). The type of school (a proxy of socio-economic condition) was categorised as either public or private. Menarche data were collected using the status quo and recall methods. The mean age at menarche was estimated by survival analysis. Differences in age at menarche according to the year of survey, weight status and type of school were verified by the Log-Rank test and Cox's univariate and multiple regression. There was an increase in the prevalence of overweight in girls throughout the surveys, with 21.4% in 2007, 27.2% in 2012 and 28.5% in 2018 (p = 0.007) having overweight. There was a decrease in the mean age at menarche between 2007 and 2018/2019 (12.3 vs. 11.9 years, respectively). The mean age at menarche in girls with overweight was lower in the three time periods when compared to girls without overweight (11.9, 11.8 and 11.5 vs. 12.4, 12.4 and 12.1, respectively). Girls with overweight were more likely to have had earlier age at menarche than girls without overweight (Hazard Ratio 1.57; 95% CI 1.36; 1.80). There were no differences in the age at menarche according to the type of school. The increase in the prevalence of girls with overweight (including obesity) may be associated with the age at menarche. Girls with overweight had a higher risk of earlier age at menarche than girls without overweight.

Association between lifestyle patterns and overweight and obesity in adolescents: a systematic review.

The purpose of this systematic review was to summarize the evidence from observational studies regarding the association between lifestyle patterns and overweight and obesity in adolescents. To our knowledge, no review study has analyzed this association in this age group. A systematic search was conducted in LILACS, Scopus, PubMed Central, and Web of Science databases, with no language or time restrictions. Studies that included adolescents (10-19 years old) were selected using data-driven methods that combined the diet domain with at least one of the following behavioral domains: physical activity, sedentary behavior, and sleep. Twenty-one articles met all eligibility criteria. Of these, 12 studies were used for synthesizing the results. Studies differed in many aspects, such as sample size, behavioral assessment tools, and lifestyle pattern and weight status indicators. Overall, cross-sectional studies found no association between lifestyle patterns and overweight and obesity, even when the data were stratified by sex. However, when analyzing the results stratified by risk of bias, a positive association between predominantly unhealthy and mixed lifestyle patterns with overweight/obesity was identified in cross-sectional studies with moderate risk of bias. A prospective study revealed an increase in body mass index over time associated with mixed and predominantly unhealthy lifestyle patterns. Current findings regarding the association between lifestyle patterns and overweight and obesity in adolescents are inconsistent. More studies are needed to clarify possible associations.

Association between lower serum vitamin D (25-hydroxy-cholecalciferol) concentrations and cognitive impairment in older adults: data from a populational-based cohort study in a middle-income country.

OBJECTIVE: To investigate the association between serum vitamin D (25-hydroxy-cholecalciferol) (25(OH)D) concentrations and cognitive impairment in older adults living in Southern Brazil. DESIGN: Cross-sectional analysis using data from the second follow-up wave of the populational-based EpiFloripa Aging Cohort Study was collected in 2013-2014. SETTING: Cognitive impairment was evaluated using the Mini-Mental State Examination (MMSE). Blood samples were collected to measure serum vitamin D concentrations using a chemiluminescent microparticle immunoassay. Vitamin D concentrations were distributed in quartiles (Q1: 4·0-20·7 ng/ml; Q2: 20·8-26·6 ng/ml; Q3: 26·7-32·0 ng/ml and Q4: 32·1-60·1 ng/ml), and its association with cognitive impairment was tested by crude and adjusted logistic regression (sociodemographic, behavioural and health aspects) using Q4 as a reference group. PARTICIPANTS: 200 men and 371 women aged 60 years or older participated in this study. RESULTS: The prevalence of probable cognitive impairment was 21·7 %. Those without cognitive impairment had a higher mean of vitamin D serum concentrations (26·8 v. 24·6, P = 0·014). In the crude analysis, only individuals in Q2 of vitamin D presented an increased risk for probable cognitive impairment compared with Q4 (highest quartile) (OR 2·65, 95 % CI 1·46, 4·81), remaining significant in the adjusted analysis (OR 6·04, 95 % CI 2·78, 13·13). While Q1 (lowest quartile) was not associated in the crude analysis, but when adjusted, an increased risk of cognitive impairment was observed. CONCLUSION: The lowest quartile of vitamin D was directly associated with probable cognitive impairment in older adults in Southern Brazil. More studies are needed to investigate whether maintaining adequate serum levels may represent a significant factor in preventing age-related neurological disorders as well as to verify the need for new cutoff points for this age group.

Assessment of the median ages at sexual maturation stages of Brazilian schoolchildren according to overweight status and type of school over a 5-year period: 2007-2012/2013.

OBJECTIVES: A secular trend of earlier puberty has been observed in girls, and, although more uncertain in boys, is associated with an increasing trend in the prevalence of overweight and obesity. We aimed to compare the median ages of sexual maturation stages in schoolchildren from a city in southern Brazil over a 5-year period, according to weight status and type of school. METHODS: Two cross-sectional studies were performed in 2007 and 2012/2013, including 2215 and 1614 schoolchildren, respectively. Body mass index z-scores were calculated and categorized as either nonoverweight or overweight (including obesity). The type of school was categorized as either public or private. Sexual maturation was self-assessed according to the Tanner stages. Mann-Whitney and Kruskal-Wallis tests were performed to compare the median ages of sexual maturation stages. RESULTS: The median age decreased for almost all stages over the 5-year period in both sexes. In boys, the decrease ranged from 0.3 to 1.0 years (stages 2, 3, 4, and 5 for genitalia, and stages 2 and 4 for pubic hair), and from 0.3 to 0.7 years (stages 2, 3, and 4 for breast, and stages 3, 4, and 5 for pubic hair). In 2012, overweight students had lower median ages for most stages compared to those in 2007, especially in girls. Differences by type of school were balanced across years. CONCLUSIONS: The median age of Tanner's stages after 5 years was reduced in both sexes. In overweight girls, the reduction was more pronounced. The results by type of school were inconsistent.

Impact of social isolation by Coronavirus disease 2019 in food: a narrative review / Impacto do isolamento social pela Coronavirus disease 2019 na alimentação: uma revisão narrativa

ABSTRACT The objective of this narrative review, with a systematic survey, was to investigate the impact of social isolation on food (eating habits) during the 2019 Coronavirus disease pandemic. A retrieval of studies published from January 1st, 2019 to June 18th, 2020 was carried out in the PubMed, Web of Science and Embase databases. The screening was structured using the terms corresponding to Coronavirus disease 2019, social isolation and food. All steps were carried out independently by three reviewers. Twelve studies were included, totaling 20,789 people assessed, with a predominance of cross-sectional studies of adult population. The studies reviewed had been carried out in Italy (n=4), Spain (n=2), Poland (n=1), China (n=1), India (n=1), United States of America (n=1), South Africa (n=1) and in a continental multicenter (n=1). The analysis of the studies included showed that most people reported that they did not change their usual diet; in addition, an increase in cooking habits, consumption of fruits and vegetables and a decrease in the consumption of alcoholic beverages was observed. A decrease in fish consumption and an increase in comfort foods were also reported. It was found that food habits changed in times of social isolation. We suggest that new investigations be carried out in different socioeconomic and demographic frameworks. We propose to continue the study on this theme, with a systematic review with or without meta-analysis.

RESUMO Trata-se de revisão narrativa com busca sistemática, tendo por objetivo investigar o impacto do isolamento social na alimentação (hábitos alimentares) durante a pandemia da Coronavirus Disease 2019. Foi realizado rastreio de estudos publicados no período de 1º de janeiro de 2019 a 18 de junho de 2020 nas bases PubMed, Web of Science e Embase. A busca foi estruturada utilizando os unitermos correspondentes a Coronavirus Disease 2019, isolamento social e alimentação. Todas as etapas foram executadas de forma independente por três revisores. Foram incluídos 12 estudos, totalizando 20.789 pessoas pesquisadas, com a predominância de estudos de corte transversal na população adulta. Os estudos analisados foram desenvolvidos na Itália (n=4), Espanha (n=2), Polônia (n=1), China (n=1), Índia (n=1), Estados Unidos da América (n=1), África do Sul (n=1) e multicêntrico continental (n=1). A análise dos estudos incluídos evidenciou que a maioria das pessoas relatou não mudar a dieta habitual, observando-se também o aumento do hábito de cozinhar, consumir frutas, legumes e verduras e a diminuição do consumo de bebidas alcoólicas. Constatou-se diminuição do consumo de peixes e aumento das chamadas comfort foods. Verificou-se que a alimentação sofreu alterações em tempos de isolamento social. Sugerimos que novas pesquisas sejam realizadas em diferentes contextos socioeconômicos e demográficos. Propomos a continuidade do estudo desta temática, com realização de revisão sistemática com ou sem metanálise.

Lower serum 25-hydroxycholecalciferol is associated with depressive symptoms in older adults in Southern Brazil.

BACKGROUND: Older adults are one of the most susceptible populations to depression, especially those living in low- and middle-income countries. As well, they are also considering a risk group for vitamin D deficiency. Low serum vitamin D has been associated with an increased risk of brain neuropsychiatry disorders. We aimed to investigate the association between serum 25-hydroxycholecalciferol concentrations and depressive symptoms in adults aged 60 years and over from southern Brazil. METHODS: A cross-sectional analysis was performed using data collected during 2013-2014 from the populational-based longitudinal EpiFloripa Aging Study (n = 1197). Serum 25-hydroxycholecalciferol concentrations were analyzed and classified according to the Endocrine Society reference values [sufficiency (≥ 30 ng/mL), insufficiency (21-29 ng/mL), and deficiency (≤ 20 ng/mL)]. Depressive symptoms were evaluated using the Geriatric Depression Scale (15-item GDS). Logistic regression was performed to assess depressive symptoms in each vitamin D category. The analysis was adjusted for sex, age, skin color, family income, leisure-time physical activities, social or religious groups attendance, morbidities, cognitive impairment, and dependence in activities of daily living. RESULTS: A total of 557 participants with complete data for exposure and outcome were enrolled in the analysis. Most of the sample participants were female (63.1%), age-range 60-69 years (42.2%), white skin color (85.1%), and vitamin D serum level samples were collected in autumn (50.7%). Depressive symptoms were present in 15.8% of the participants, and the prevalence was higher in individuals classified as deficient in vitamin D (23.2, 95% confidence interval [CI] = 15.6;32.9) and insufficiency (17.2, 95%CI = 11.0;25.9). The crude analysis showed that vitamin D deficient participants had 3.08 (CI = 1.53;6.20) times higher odds to present depressive symptoms compared to vitamin D sufficiency. After adjusting, the association was maintained [OR 2.27 (95%CI = 1.05;4.94). CONCLUSIONS: Serum 25-hydroxycholecalciferol deficiency was positively associated with depressive symptoms in older adults from southern Brazil.