Spatial distribution of sedentary behavior and unhealthy eating habits in Belo Horizonte, Brazil: the role of the neighborhood environment.

The study aimed to analyze the spatial distribution of sedentary behavior and unhealthy eating habits, and to assess its relationship with the neighborhood environment. Cross-sectional study with data of Surveillance System of Risk and Protective Factors for Chronic Diseases, carried out in Belo Horizonte, Minas Gerais. Watching television for four hours or more per day was identified as sedentary behavior. Unhealthy eating habits were defined based on regular consumption of sodas, excess fat meat, and red meat, and irregular consumption of fruits and vegetables. Georeferenced data of places for physical activity, food establishments, population and residential density, homicide rate, mean total income, and social vulnerability index were entered into the Vigitel database. The coverage area by basic health units was used as the geographical unit of neighborhood. SaTScan was used to analyze the spatial distribution. Spatial analysis identified a significant cluster of high prevalence of sedentary behavior and unhealthy eating habits, after adjusting for sociodemographic characteristics. The comparison of environmental characteristics inside and outside clusters showed significant differences in the physical and social environment. Physical and social environment might be related to clusters of high prevalence of sedentary behavior and unhealthy eating habits.

Spatial distribution of sedentary behavior and unhealthy eating habits in Belo Horizonte, Brazil: the role of the neighborhood environment / Distribuição espacial do comportamento sedentário e do hábito alimentar não saudável em Belo Horizonte, Brasil: o papel do ambiente da vizinhança

Abstract The study aimed to analyze the spatial distribution of sedentary behavior and unhealthy eating habits, and to assess its relationship with the neighborhood environment. Cross-sectional study with data of Surveillance System of Risk and Protective Factors for Chronic Diseases, carried out in Belo Horizonte, Minas Gerais. Watching television for four hours or more per day was identified as sedentary behavior. Unhealthy eating habits were defined based on regular consumption of sodas, excess fat meat, and red meat, and irregular consumption of fruits and vegetables. Georeferenced data of places for physical activity, food establishments, population and residential density, homicide rate, mean total income, and social vulnerability index were entered into the Vigitel database. The coverage area by basic health units was used as the geographical unit of neighborhood. SaTScan was used to analyze the spatial distribution. Spatial analysis identified a significant cluster of high prevalence of sedentary behavior and unhealthy eating habits, after adjusting for sociodemographic characteristics. The comparison of environmental characteristics inside and outside clusters showed significant differences in the physical and social environment. Physical and social environment might be related to clusters of high prevalence of sedentary behavior and unhealthy eating habits.

Resumo O objetivo foi analisar a distribuição espacial do comportamento sedentário e do hábito alimentar não saudável e verificar a relação com o ambiente da vizinhança. Estudo transversal com dados do Sistema de Vigilância de fatores de risco e proteção para doenças crônicas, realizado em Belo Horizonte, Minas Gerais. Considerou-se comportamento sedentário o hábito de assistir televisão quatro ou mais horas por dia. O hábito alimentar não saudável foi avaliado pelo consumo regular de carne com excesso de gordura, refrigerante e carne vermelha e irregular de frutas e hortaliças. Informações georreferenciadas dos locais para a prática de atividade física, estabelecimentos com venda de alimentos, densidade populacional e residencial, taxa de homicídio, renda e índice de vulnerabilidade social foram inseridas na base do Vigitel. A área de abrangência da unidade básica de saúde foi usada como unidade geográfica da vizinhança. A análise espacial identificou cluster significativo de alta prevalência de comportamento sedentário e hábito alimentar não saudável, mesmo após ajuste. Os ambientes físico e social podem estar relacionados a cluster de alta prevalência de comportamento sedentário e hábito alimentar não saudável.

[Consumption of red and processed meat, insulin resistance, and diabetes in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)Consumo de carnes rojas y de carne procesada, resistencia a la insulina y diabetes en el estudio longitudinal de salud del adulto (ELSA-Brasil)]. / Consumo de carne vermelha e processada, resistência insulínica e diabetes no Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil).

OBJECTIVE: To investigate the association between red and processed meat consumption and the occurrence of new cases of insulin resistance (IR) and diabetes mellitus (DM) in participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). METHOD: This cohort study included 15 105 civil servants (age: 35-74 years). Biochemical, anthropometric, and socioeconomic data, as well as lifestyle characteristics, were collected at baseline (2008-2010) and wave 2 (2012-2014). Meat consumption (g/day) was estimated using a food frequency questionnaire. To categorize low, medium, and high consumption, independent variables were divided into tertiles. DM was diagnosed as fasting glucose ≥ 126 mg/dL, postload glucose ≥ 200 mg/dL, or glycated hemoglobin ≥ 6.5. IR was determined by HOMA-IR with cutoff points based on the sample's 75th percentile. RESULTS: Men and participants with lower income and schooling reported higher consumption of red and processed meat. High consumption of processed meat (highest tertile, > 27.1 g/day) was associated with new cases of IR in men (OR = 1.68; 95%CI: 1.31-2.16) and women (OR = 1.23; 95%CI: 1.00-1>52). High consumption of red meat increased by 40% (95%CI: 1.04-1.96) the likelihood of new cases of DM in men. CONCLUSIONS: High consumption of red/processed meat negatively impacted the health of participants. Moderate consumption of meats may be recommended for the general population and for prevention of DM.

OBJETIVO: Investigar la relación entre el consumo de carnes rojas y de carne procesada y la incidencia de nuevos casos de resistencia a la insulina y de diabetes mellitus en los participantes en el estudio longitudinal de salud del adulto (ELSA-Brasil). MÉTODOS: Estudio de cohorte con 15 105 funcionarios públicos (de 35 a 74 años de edad). Se recopilaron datos bioquímicos, antropométricos, socioeconómicos y sobre el estilo de vida en la línea de base (2008­2010) y en la segunda fase (2012­2014). Se calculó el consumo de carne (g/día) por medio de un cuestionario sobre la frecuencia del consumo de alimentos. Para las clasificaciones de consumo bajo, mediano y alto, las variables independientes se dividieron en terciles. La diabetes mellitus se diagnosticó como glucemia en ayunas ≥ 126 mg/dl, glucosa después de una sobrecarga ≥ 200 mg/dl o glucohemoglobina ≥ 6,5. La resistencia a la insulina se determinó con el modelo homeostático HOMA-IR con puntos de corte a partir del percentil 75 de la muestra. RESULTADOS: Los hombres y los participantes de menores ingresos y menor grado de escolaridad declararon un mayor consumo de carnes rojas y de carnes procesadas. El mayor consumo de carne procesada (último tercil, > 27,1 g/día) guardó relación con nuevos casos de resistencia a la insulina en los hombres (razón de probabilidades [OR] = 1,68; IC95%: 1,31-2,16) y las mujeres (OR = 1,23; IC95%: 1,00-1,52). El consumo alto de carnes rojas aumentó un 40% (IC95%: 1,04-1,96) la posibilidad de manifestación de nuevos casos de diabetes mellitus en los hombres. CONCLUSIONES: El consumo alto de carnes rojas y de carne procesada afectó desfavorablemente la salud de los participantes. El consumo moderado de carne puede recomendarse a la población en general y para la prevención de la diabetes mellitus.

[Spatial distribution of obesity in an urban Brazilian area]. / Distribuição espacial da obesidade em área urbana no Brasil.

The spatial distribution of a disease is important for the diagnosis and epidemiological understanding of the health situation and trends, enabling a better grasp of the factors that determine the health status of populations. The scope of the study was to analyze the spatial distribution of obesity in adults in Belo Horizonte. This cross-sectional study was developed by Telephone Survey from the database for 2008 to 2010 of the Surveillance of Risk and Protective Factors for Chronic Diseases. Obesity was defined as body mass index 30 kg/m2. A georeferenced base with the environmental data of addresses and zip codes of the location was developed and spatial scan statistics were employed. A comparative analysis of environmental variables related to clusters of higher and lower prevalence of obesity was conducted. A cluster of obese individuals without statistical significance was found in the central area of the city. Also, a significant cluster of non-obese individuals was found in the eastern area of the city. These findings suggest that reasons for low prevalence of obesity in urban Brazilian areas could be related to better social organization and high availability of places for food stores and the practice of physical activity.

Distribuição espacial da obesidade em área urbana no Brasil / Spatial distribution of obesity in an urban Brazilian area

ResumoA distribuição espacial de uma doença é importante para o diagnóstico e o conhecimento epidemiológico da situação e das tendências de saúde, permitindo uma melhor compreensão acerca dos fatores que determinam o estado de saúde das populações. O objetivo do estudo foi analisar a distribuição espacial da obesidade em adultos em Belo Horizonte, a partir da base de dados do Sistema de Vigilância de Fatores de Risco e de Proteção para Doenças Crônicas por Inquérito Telefônico de 2008 a 2010. A obesidade foi definida como índice de massa corporal 30 kg/m2. Foi desenvolvida uma base georreferenciada com os dados ambientais a partir do endereço e CEP do local. Empregou-se a estatística de varredura espacial. Uma análise comparativa das variáveis ambientais referentes aos conglomerados de maior e menor prevalência de obesidade foi realizada. Foi encontrado um conglomerado de indivíduos obesos na área central da cidade, sem significância estatística. Verificou-se, também, agrupamento significativo de indivíduos não obesos no leste da cidade. Esses resultados sugerem que as razões para a baixa prevalência de obesidade em áreas urbanas brasileiras podem estar relacionadas à melhor organização social e alta disponibilidade de comércios de alimentos e de locais para a prática de atividade física.

AbstractThe spatial distribution of a disease is important for the diagnosis and epidemiological understanding of the health situation and trends, enabling a better grasp of the factors that determine the health status of populations. The scope of the study was to analyze the spatial distribution of obesity in adults in Belo Horizonte. This cross-sectional study was developed by Telephone Survey from the database for 2008 to 2010 of the Surveillance of Risk and Protective Factors for Chronic Diseases. Obesity was defined as body mass index 30 kg/m2. A georeferenced base with the environmental data of addresses and zip codes of the location was developed and spatial scan statistics were employed. A comparative analysis of environmental variables related to clusters of higher and lower prevalence of obesity was conducted. A cluster of obese individuals without statistical significance was found in the central area of the city. Also, a significant cluster of non-obese individuals was found in the eastern area of the city. These findings suggest that reasons for low prevalence of obesity in urban Brazilian areas could be related to better social organization and high availability of places for food stores and the practice of physical activity.

Diagnóstico situacional: perfil sociodemográfico e clínico de pacientes internados em unidade de clínica médica / Diagnóstico situacional: perfil sociodemográfico y clínico de pacientes ingresados en unidades de clínica médica / Situational diagnosis: sociodemographic and clinical profile of patients admitted to a clinical medicine unit

O Diagnóstico Situacional de Enfermagem e de Saúde (DSES) é um método de identificação e análise de uma realidade, que visa à elaboração de propostasde organização. A caracterização da população atendida por determinado serviço de saúde consiste em uma das importantes etapas do DSES. Trata-se deestudo quantitativo, descritivo, transversal, que teve como objetivo caracterizar os pacientes internados em Unidades de Clínica Médica de um HospitalUniversitário de Belo Horizonte, MG, Brasil. A amostra do estudo foi constituída de 442 pacientes com 18 anos ou mais, internados em um dos 67 leitos dasUnidades de Clínica Médica até as 24h do dia anterior à coleta de dados, no período de maio a novembro de 2012. Verificou-se predomínio do sexo feminino(N = 243), com faixa etária entre 46 e 60 anos (N =140), a maioria de cor de pele branca (N = 213), de eutróficos (N = 179) e não fumantes (N = 225). Emrelação aos medicamentos em uso contínuo pelos pacientes, a classe mais prescrita foi a dos anticoagulantes (N = 261). Em relação às doenças de base, houve predomínio das doenças neurológicas e mentais...

The Situational Diagnosis of Nursing and Health (DSES) is a method for the identification and analysis of a reality and its needs. It istherefore usefulto design organization/reorganization proposals. The characterization of the population served by a particular health service is one of the availableways of making a DSES. This is a quantitative, descriptive and cross-sectional study. We aimed to identify the characteristics of patients admitted tothe functional unit of Clinical Medicine of a university hospital in Belo Horizonte, MG, Brazil. The study sample was composed of 442 adult patients,who were 18 years old or older, and had been admitted to one of the 67 beds of the functional units until 12 pm of the day before data collection.Data collection took place from May through November 2012. There was a predominance of females (N = 243), aged between 46 and 60 years (N= 140), of white ethnicity (N = 213), eutrophic (N = 179) and nonsmokers (N = 225). In this study, the most prescribed continuous-use drugs wereanticoagulants (N = 261). As for baseline diseases, there was a predominance of neurological and mental diseases (N = 81). We also analyzed the incidence of PU, since it is an indicator of quality of care...

El Diagnostico Situacional de Enfermeria y de Salud (DSES) es un método de diagnostico de identificación y analisis de una realidad, que tiene comoobjetivo la elaboración de propuestas de organización. La caracterización de la población atendida por un servicio de salud en particular es una delas etapas importantes de los DSES. Se trata de un estudio cuantitativo, descriptivo, transversal, que tenía como objetivo caracterizar a los pacientesinternados en Unidades de Clínica Médica del Hospital Universitario de Belo Horizonte, MG, Brasil. La muestra consistió en 442 pacientes de 18 añoso más, ingresados en una de las 67 camas de dichas unidades hasta las 24 del día antes de la recogida de datos, entre mayo y noviembre de 2012.Predominó el sexo femenino (N = 243), con edad entre 46 y 60 años (N = 140), la mayoría blancos (N = 213), de eutróficos (N = 179) y no fumadores...

A pesquisa de campo na área da epidemiologia das doenças e agravos não transmissíveis: uma experiência em área rural da região do vale do Jequitinhonha, Minas Gerais / El estudio de campo en el ámbito de la epidemiología de enfermedades no transmisibles: una investigación en la área rural de la región del valle del Jequitinhonha, Minas Gerais / Field work in epidemiology of non transmissible diseases research: an experience in a rural area of Jequitinhonha valley, Minas Gerais

Neste estudo, discorre-se sobre a experiência de trabalhar com pesquisa de campo sobre as doenças e agravos não transmissíveis com os moradores de comunidades rurais do Vale do Jequitinhonha-MG. Os pesquisadores relatam a riqueza da experiência dos profissionais de saúde durante o trabalho de campo com essa população, as dificuldades enfrentadas no dia a dia deste trabalho e seus desdobramentos perante a equipe de saúde local.

This study reports the experienceofafield research in non-communicablediseases in rural communities of JequitinhonhaValley,Minas Gerais. The research reports the wealth of experienceof the healthcare team in the course of the researchwhen dealing with the area’s residents, pointing out the day to day difficulties, and the experiences when workingwith the local healthcare professionals.

Este estudio narra la experiencia del trabajo de investigación decampode enfermedadesnotransmisibles conhabitantesde comunidades rurales del Valle de Jequitinhonha, Estado de Minas Gerais. Los investigadores narran la riqueza de laexperiencia de los profesionales de salud durante estas tareas con las comunidades locales, las dificultades enfrentadasen el día a día y las experiencias de trabajo con el equipo de salud local.

Temporal variation in the prevalence of weight and obesity excess in adults: Brazil, 2006 to 2009.

Overweight and obesity are public health issues that affect an important part of the world population. This study aims at describing the trends in overweight and obesity prevalence rates from 2006 to 2009, by means of telephone surveys in 27 Brazilian cities, with a population aged 18 years or older. The body mass index (BMI) was calculated by the reported height and weight; overweight and obesity were considered as BMI >25 kg/m² and >30 kg/m², respectively. Temporal variation in overweight and obesity prevalence is presented for men and women, according to age group, schooling, stable relationship, and skin color. Poisson regression was used for the analysis. Overweight prevalence was 43.0, 42.7, 44.2 and 46.6%,for each year of the period from 2006 to 2009, respectively. For obesity, in the same period, the trend was: 11.4, 12.7, 13.2 and 13.8%. The temporal trend varied in relation to some demographic and socioeconomic variables. The prevalence was higher among women and young adults. The temporal trend was independent of the relationship status of the interviewees, but the prevalence was higher among white women and those with less years of schooling. The results in this study confirmed the urgent need for effective prevention and control measures, as the increasing trend is occurring in a short period of time, especially among youngsters.

Variação temporal na prevalência do excesso de peso e obesidade em adultos: Brasil, 2006 a 2009 / Temporal variation in the prevalence of weight and obesity excess in adults: Brazil, 2006 to 2009

Excesso de peso e obesidade são problemas de saúde pública que atingem parcela importante da população mundial. Este estudo tem o objetivo de descrever as tendências nas prevalências do excesso de peso e da obesidade, no período de 2006 e 2009, obtidas por meio de entrevistas telefônicas em 27 cidades brasileiras com uma população de 18 anos ou mais. O índice de massa corporal (IMC) foi calculado a partir do peso e altura referidos; o excesso de peso e obesidade foram definidos por IMC >25 kg/m² e >30 kg/m², respectivamente. A variação temporal das prevalências do excesso e peso e de obesidade é apresentada para homens e mulheres, de acordo com grupo etário, escolaridade, união estável e cor da pele. A regressão de Poisson foi utilizada na análise. As prevalências do excesso de peso foram 43,0, 42,7, 44,2 e 46,6 por cento, para cada ano do período de 2006 a 2009, respectivamente. Para obesidade, no mesmo período, foram encontradas as seguintes prevalências: 11,4, 12,7, 13,2 e 13,8 por cento. A tendência temporal variou em relação às variáveis demográficas e econômicas. O aumento nas prevalências ocorreu nas mulheres e entre os mais jovens. A tendência temporal foi independente do estado civil dos entrevistados, mas o aumento nas prevalências ocorreu em mulheres brancas e com menor escolaridade. Os resultados do presente estudo confirmam a urgência da necessidade de medidas efetivas de prevenção e controle, uma vez que a tendência do aumento está ocorrendo em um curto intervalo de tempo, especialmente entre os jovens.

Overweight and obesity are public health issues that affect an important part of the world population. This study aims at describing the trends in overweight and obesity prevalence rates from 2006 to 2009, by means of telephone surveys in 27 Brazilian cities, with a population aged 18 years or older. The body mass index (BMI) was calculated by the reported height and weight; overweight and obesity were considered as BMI >25 kg/m² and >30 kg/m², respectively. Temporal variation in overweight and obesity prevalence is presented for men and women, according to age group, schooling, stable relationship, and skin color. Poisson regression was used for the analysis. Overweight prevalence was 43.0, 42.7, 44.2 and 46.6 percent,for each year of the period from 2006 to 2009, respectively. For obesity, in the same period, the trend was: 11.4, 12.7, 13.2 and 13.8 percent. The temporal trend varied in relation to some demographic and socioeconomic variables. The prevalence was higher among women and young adults. The temporal trend was independent of the relationship status of the interviewees, but the prevalence was higher among white women and those with less years of schooling. The results in this study confirmed the urgent need for effective prevention and control measures, as the increasing trend is occurring in a short period of time, especially among youngsters.