Eating time variation from weekdays to weekends and its association with dietary intake and BMI in different chronotypes: findings from National Health and Nutrition Examination Survey (NHANES) 2017-2018.

Evidence suggests that differences in meal timing between weekends and weekdays can disrupt the body's circadian rhythm, leading to a higher BMI. We aimed to investigate the associations between mealtime variation from weekdays to weekends (eating midpoint jetlag), dietary intake and anthropometric parameters, based on individuals' chronotype. The study utilised data from National Health and Nutrition Examination Survey 2017-2018. Food consumption was estimated by weighted average of participants' food intake on weekdays and weekends. Eating midpoint jetlag, defined as the difference between the midpoint of the first and last mealtimes on weekends and weekdays, was calculated. Chronotype was assessed by participants' mid-sleep time on weekends, adjusted for sleep debt. Linear regression analysis was conducted to investigate the associations between variables. The sample was categorised into chronotype tertiles. Among individuals in the third chronotype tertile, there was a positive association between eating midpoint jetlag and BMI (ß = 1·2; 95 % CI (1·13, 1·27)). Individuals in the first tertile showed a positive association between eating midpoint jetlag and energy (ß = 96·9; 95 % CI (92·9, 101·7)), carbohydrate (ß = 11·96; 95 % CI (11·2, 12·6)), fat (ß = 3·69; 95 % CI (3·4, 3·8)), cholesterol (ß = 32·75; 95 % CI (30·9, 34·6)) and sugar (ß = 8·84; 95 % CI (8·3, 9·3)) intake on weekends. Among individuals with an evening tendency, delaying meals on weekends appears to be linked to a higher BMI. Conversely, among individuals with a morning tendency, eating meals later on weekends is associated with higher energetic intake on weekends.

Infant feeding practices in three Latin American countries in three decades: what demographic, health, and economic factors are relevant?

Introduction: Studies in Latin America have focused either on analyzing factors associated with exclusive breastfeeding (EBF) or infant formula (IF). Purpose: Analyze the association between economic, sociodemographic, and health factors with EBF, mixed milk feeding (MixMF), and exclusive use of IF in three Latin American and Caribbean countries in the 1990s, 2000s, and 2010s. Methods: Cross-sectional time-series study using data from Demographic and Health Surveys between the 1990s and 2010s in Colombia (1995-2010), Haiti (1994-2017), and Peru (1996-2012) accounting for a sample of 12,775 infants under 6 months. Hierarchical logistic multilevel regression models were used to estimate the adjusted association between infant feeding outcomes (EBF, MixMF, exclusive use of IF) and contextual level DHS survey decade (1990s, 2000s and 2010s) and economic factors (Gross Domestic Product by purchasing power parity, female wage and salaried workers, labor force participation rate female) as well as individual level sociodemographic (maternal age, maternal education, number of children in the household, wealth index, mother living with a partner, area of residence, mother working outside of home), and health factors (breastfed in the first hour, C-section). Results: Factors associated with EBF cessation were c-section (OR: 0.76; 95%CI: 0.64, 0.92), mothers working outside of the home (OR: 0.79; 95%CI: 0.69, 0.90), families in the highest income quintile (OR: 0.64; 95%CI: 0.49, 0.84), and female wage and salaried workers (OR: 0.92; 95%CI: 0.91, 0.94). MixMF was associated with women with higher education (OR: 1.54; 95%CI: 1.21, 1.97), mother working outside of the home (OR: 1.26; 95%CI: 1.10, 1.43), c-section (OR: 1.37; 95%CI: 1.15, 1.62), families in the highest income quintiles (OR: 2.77; 2.10, 3.65). and female wage and salaried workers (OR: 1.08;95% CI: 1.05, 1.09). Exclusive use of IF was associated with a mother working outside of the home (OR: 2.09; 95%CI: 1.41, 3.08), c-section (OR: 1.65; 95%CI: 1.09, 2.51), families in the highest income quintiles (OR: 12.08; 95% CI: 4.26, 34.28), the 2010s (OR: 3.81; 95%CI: 1.86, 7.79), and female wage and salaried workers (OR: 1.12; 95%CI: 1.07, 1.16). Discussion/Conclusion: Factors related to women empowerment and gender equality jeopardized EBF and favored the exclusive use of IF in Latin America. Therefore, workplace interventions to promote, protect, and support breastfeeding practices are key to reducing exclusive use of IF.

Late meal intake is associated with abdominal obesity and metabolic disorders related to metabolic syndrome: A chrononutrition approach using data from NHANES 2015-2018.

BACKGROUND & AIMS: Chrononutrition is an emerging area that suggests that late eating time is associated with poor nutritional and metabolic outcomes. However, epidemiological studies are scarce on this topic. The aim of this study was to characterize the chrononutrition patterns in a large and representative US population (NHANES 2015-2016 and 2017-2018) of adults and elderly and investigate their association with obesity and metabolic disorders that make up the metabolic syndrome. METHODS: A total of 7379 adults and elderly individuals were included in the analysis. Meal timing data were collected through two 24-h dietary recalls in both cycles. Poisson regression adjusted for confounders was used to evaluate the association between chrononutrition variables (eating duration and tertiles of first and last meal timing, eating midpoint and eating occasions) and obesity, abdominal obesity and metabolic parameters from metabolic syndrome. RESULTS: Adults with a longer eating duration (>12 h) had a higher prevalence of abdominal obesity (IRR, 1.15; 95% CI, 1.03-1.28) when compared with those who ate their meals in a shorter eating duration (≤12 h). In addition, adults in the third tertile of the time of the last meal (mean 22:03) had a higher prevalence of abdominal obesity (IRR, 1.12; 95% CI, 1.01-1.25) compared to first tertile. Adults with later eating midpoints (second and third tertile) had a higher prevalence of elevated fasting glucose (IRR, 1.30; 95% CI, 1.07-1.59 and IRR, 1.65; 95% CI, 1.22-2.22, respectively). Among the elderly, participants with a longer eating duration (>12 h) had a higher prevalence of elevated triglycerides (IRR, 2.74; 95% CI, 1.25-5.96) when compared with those elderly who ate their meals in a shorter eating duration (≤12 h). CONCLUSION: These findings suggest that a long eating duration and late first and last meal timing are chrononutrition patterns associated with cardiometabolic risks in free-living Americans.

Racial/ethnic disparities in the cause of death among patients with prostate cancer in the United States from 1995 to 2019: a population-based retrospective cohort study.

Background: Racial/ethnic disparities in prostate cancer are reported in the United States (US). However, long-term trends and contributors of racial/ethnic disparities in all-cause and cause-specific death among patients with prostate cancer remain unclear. We analysed the trends and contributors of racial/ethnic disparities in prostate cancer survivors according to the cause of death in the US over 25 years. Methods: In this retrospective, population-based longitudinal cohort study, we identified patients diagnosed with first primary prostate cancer between 1995 and 2019, with follow-up until Dec 31, 2019, using population-based cancer registries' data from the Surveillance, Epidemiology, and End Results (SEER) Program. We calculated the cumulative incidence of death for each racial/ethnic group (Black, white, Hispanic, Asian or Pacific Islander [API], and American Indian or Alaska Native [AI/AN] people), by diagnostic period and cause of death. We quantified absolute disparities using rate changes for the 5-year cumulative incidence of death between racial/ethnic groups and diagnostic periods. We estimated relative (Hazard ratios [HR]) racial/ethnic disparities and the percentage of potential factors contributed to racial/ethnic disparities using Cox regression models. Findings: Despite a decreasing trend in the cumulative risk of death across five racial/ethnic groups, AI/AN and Black patients consistently had the highest rate of death between 1995 and 2019 with an adjusted HR of 1.48 (1.40-1.58) and 1.40 (1.38-1.42) respectively. The disparities in all-cause mortality between AI/AN and white patients increased over time, with adjusted HR 1.32 (1.17-1.49) in 1995-1999 and 1.95 (1.53-2.49) in 2015-2019. Adjustment of stage at diagnosis, initial treatment, tumor grade, and household income explained 33% and 24% of the AI/AN-white and Black-white disparities in all-cause death among patients with prostate cancer. Interpretation: The enduring racial/ethnic disparities in patients with prostate cancer, call for new interventions to eliminate health disparities. Our study provides important evidence and ways to address racial/ethnic inequality. Funding: National Key R&D Program of China, National Natural Science Foundation of China, Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support, the Open Research Fund from Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Key Projects of Philosophy and Social Sciences Research, Ministry of Education of China.

Health-related patterns and chronic kidney disease in the Brazilian population: National Health Survey, 2019.

Objective: The aim of this study was to identify patterns related to health and their association with chronic kidney disease (CKD) in the Brazilian population. Methods: We used data from the National Health Survey (PNS), 2019. Participants were interviewed and answered questions related to socioeconomic and demographic information (gender, age, education, race/color), health conditions (presence of hypertension, diabetes mellitus, hyperlipidemia, cardiovascular disease, overweight and CKD) and lifestyle (smoking, alcohol consumption, physical activity and food consumption). To identify patterns, we used exploratory factor analysis. We performed logistic regression models to describe the association of CKD with each pattern in crude models and adjusted for gender, age group, education level and race/color. Results: A total of 90,846 individuals were evaluated. The prevalence of CKD was 1.49% (95% CI: 1.3-1.6). Three health-related patterns - metabolic factors, behavioral risk factors and behavioral protective factors - were identified by factor analysis. Metabolic factors were determined by the presence of hypertension, diabetes mellitus, hyperlipidemia and cardiovascular diseases. Behavioral risk factors were determined by smoking, alcohol consumption, regular consumption of soft drinks, sweets and artificial juices, and high salt consumption. The protective behavioral factors were established by the practice of physical activity and regular consumption of vegetables and fruits. Participants of the highest tertile for metabolic factors were more likely to have CKD in the adjusted model (OR = 3.61, 95% CI: 2.69-4.85), when compared to those of the lower tertile. Conclusion: The pattern referring to metabolic factors was associated with a higher chance of presenting CKD.

Characterization and completeness of notification sheet of violence against the older adults in Niterói-RJ, 2011-2020.

OBJECTIVE: to analyze the profile of violence against the elderly and the degree of completeness of event notification forms in Niterói, Rio de Janeiro, Brazil. METHODS: this was a descriptive study having as its data source violence notification forms held on the Notifiable Health Conditions Information System for the period 2011-2020; analysis of form completeness was performed according to criteria proposed by the Ministry of Health. RESULTS: of the 486 registered cases, physical violence was the most reported type of violence (48.1%), followed by psychological violence (22.2%) and self-harm (21.4%); the fields with the highest degree of incompleteness were victim's level of schooling (32.8%) and repeat violence (41.5%). CONCLUSION: despite the increase in notifications in the period, predominantly of physical violence, completeness of some of the form fields continues to be poor, which reinforces the importance of training professionals to improve the reporting process and data quality.

Association between health risk behaviors and food consumption in adolescents.

The study aims to evaluate the association between substance use and social isolation with food consumption in adolescents. A cross-sectional study was conducted with 2,040 adolescents from a medium-sized city in Brazil. The exposures assessed were the use of alcohol, tobacco, and other substances, and social isolation. The outcomes were the regular consumption (≥5 times/week) of beans, fruit/fruit salad, candies, and soft drinks, and an unhealthy eating score. The association between health risk behaviors and food consumption was assessed through logistic and linear regressions. Regular users of alcohol were more likely to have regular consumption of candies and soft drinks, and those who used tobacco regularly were less likely to have regular bean consumption and more likely to have regular candies consumption. The use of at least one substance was negatively associated with regular bean consumption and positively associated with regular consumption of sweets and soft drinks. Socially isolated adolescents were less likely to have regular bean consumption. Substance use was positively associated with the unhealthy eating score. In conclusion, substance use and social isolation were associated with less regular consumption of healthy food markers and greater regular consumption of unhealthy food markers.

Characterization of violence against the elderly and completeness of event notification forms in Niterói-RJ, 2011-2020 / Caracterización de la violencia contra los ancianos y completitud de las fichas de notificación de eventos en Niterói-RJ, 2011-2020 / Caracterização da violência contra a pessoa idosa e completitude das fichas de notificação do evento em Niterói, Rio de Janeiro, 2011-2020

Objective: to analyze the profile of violence against the elderly and the degree of completeness of event notification forms in Niterói, Rio de Janeiro, Brazil. Methods: a descriptive study that used as a data source the notification forms of violence obtained through the Notifiable Health Conditions Information System, 2011-2020; the analysis of completeness was performed according to criteria proposed by the Ministry of Health. Results: of the 486 registered cases, the most reported type of violence was physical violence (48.1%), followed by psychological (22.2%) and self-harm (21.4%); the fields with the highest degree of incompleteness were victim's education (32.8%) and repeat violence (41.5%). Conclusion: despite the increase in notifications in the period, predominantly of physical violence, some fields in the form persist with lowcompleteness, which reinforces the importance of training professionals to improve the reporting process and the quality of the data.

Objetivo: analizar el perfil de la violencia contra los ancianos y el grado de integridad de los formularios de notificación de eventos en Niterói, Rio de Janeiro, Brasil. Métodos: estudio descriptivo con fuente de datos las fichas de notificación de violencia obtenidas en Sistema de Información de Agravios de Notificación, 2011-2020; análisis de la exhaustividad se realizó según criterios propuestos por el Ministerio de Sanidad. Resultados: de 486 casos registrados, el tipo de violencia más notificado fue física (48,1%), seguida psicológica (22,2%) y autolesión (21,4%); campos con mayor grado de incompletitud fueron: educación de la víctima (32,8%) y reincidencia en la violencia (41,5%). Conclusión: a pesar del aumento de notificaciones en el periodo, predominantemente violencia física, persisten algunos campos importantes con bajacompletitud, lo que refuerza la importancia de la capacitación de los profesionales para mejorar el proceso de notificación y la calidad de los datos.

Objetivo: analisar o perfil da violência contra a pessoa idosa e o grau de completitude das fichas de notificação do evento em Niterói, Rio de Janeiro, Brasil. Métodos: estudo descritivo, utilizando como fonte de dados as fichas de notificação de violência obtidas do Sistema de Informação de Agravos de Notificação, 2011-2020; a análise da completitude realizou-se segundo critérios propostos pelo Ministério da Saúde. Resultados: dos 486 casos registrados, o tipo de violência mais notificada foi a violência física (48,1%), seguida das violências psicológica (22,2%) e autoprovocada (21,4%); os campos com maior grau de incompletitude corresponderam à escolaridade da vítima (32,8%) e à violência de repetição (41,5%). Conclusão: apesar do aumento das notificações no período, predominantemente de violência física, alguns campos importantes das fichas persistem com baixa completitude, o que reforça a importância do treinamento dos profissionais visando melhorar o processo de notificação e a qualidade dos dados.

Association between Community Violence, Disorder and School Environment with Bullying among School Adolescents in Sao Paulo - Brazil.

The role of contextual-level factors in bullying is still not clear, and evidence is mostly from high-income countries. Our objective was to investigate the association between community violence, disorder, school environment and bullying among school adolescents. We used data from a representative sample of 9th grade Brazilian adolescents (n = 2108) from the Sao Paulo Project for the social development of children and adolescents (SP - PROSO). Multilevel logistic regression models stratified by sex were used to assess the association between variables at student and school/neighbourhood level and bullying victimization or perpetration. For both sexes, we found that adolescents who perceived high violence between students and high school disorder were more likely to be bullies and victims. Boys who perceived high community violence and disorder in their neighbourhood were more likely to be bullies (OR3tertile = 2.73 CI95%: 1.57-4.74). Girls attending schools where the principal reported high community violence and disorder in the neighbourhood (ORhigh = 10.24 CI95%: 2.11-49.59) and inside the school (ORhigh = 6.83 CI95%: 1.48-31.56) were more likely to be bullies. Boys from schools whose principal perceived violence between students were less likely to be victims (ORhigh = 0.35 CI95%: 0.16-0.78) and bullies (ORhigh = 0.21 CI95%: 0.07-0.64). Girls attending schools with signs or posters about tolerance/gender equality and about violence were less (OR = 0.12 CI95%: 0.03-0.50) and more likely (OR = 25.88 CI95%: 4.28-156.63) to report being bullies, respectively. Community violence, disorder and school environment were associated with bullying victimization and perpetration among adolescents. Sex-specific associations should be further investigated. Prevention and management of school violence in adolescence should consider contextual-level characteristics.

Caracterização e completitude das fichas de notificação de violência contra a pessoa idosa em Niterói-RJ, 2011-2020 / Caracterización y completitud de las fichas de notificación de violencia contra las personas mayores en Niterói-RJ, 2011-2020 / Characterization and completeness of notification sheet of violence against the older adults in Niterói-RJ, 2011-2020

Objetivo: analisar o perfil da violência contra a pessoa idosa e o grau de completitude das fichas de notificação do evento em Niterói, Rio de Janeiro, Brasil. Métodos: estudo descritivo, utilizando como fonte de dados as fichas de notificação de violência obtidas do Sistema de Informação de Agravos de Notificação, 2011-2020; a análise da completitude realizou-se segundo critérios propostos pelo Ministério da Saúde. Resultados: dos 486 casos registrados, o tipo de violência mais notificada foi a violência física (48,1%), seguida das violências psicológica (22,2%) e autoprovocada (21,4%); os campos com maior grau de incompletitude corresponderam à escolaridade da vítima (32,8%) e à violência de repetição (41,5%). Conclusão: apesar do aumento das notificações no período, predominantemente de violência física, alguns campos importantes das fichas persistem com baixa completitude, o que reforça a importância do treinamento dos profissionais visando melhorar o processo de notificação e a qualidade dos dados.

Objetivo: Analizar el perfil de la violencia contra los ancianos y el grado de integridad de los formularios de notificación de eventos en Niterói, Rio de Janeiro, Brasil. Métodos: estudio descriptivo con fuente de datos las fichas de notificación de violencia obtenidas en Sistema de Información de Agravios de Notificación, 2011-2020; análisis de la exhaustividad se realizó según criterios propuestos por el Ministerio de Sanidad. Resultados: De 486 casos registrados, el tipo de violencia más notificado fue física (48,1%), seguida psicológica (22,2%) y autolesión (21,4%); campos con mayor grado de incompletitud fueron: educación de la víctima (32,8%) y reincidencia en la violencia (41,5%). Conclusiones: A pesar del aumento de notificaciones en el periodo, predominantemente violencia física, persisten algunos campos importantes con baja completitud, lo que refuerza la importancia de la capacitación de los profesionales para mejorar el proceso de notificación y la calidad de los datos.

Objective: to analyze the profile of violence against the elderly and the degree of completeness of event notification forms in Niterói, Rio de Janeiro, Brazil. Methods: this was a descriptive study having as its data source violence notification forms held on the Notifiable Health Conditions Information System for the period 2011-2020; analysis of form completeness was performed according to criteria proposed by the Ministry of Health. Results: of the 486 registered cases, physical violence was the most reported type of violence (48.1%), followed by psychological violence (22.2%) and self-harm (21.4%); the fields with the highest degree of incompleteness were victim's level of schooling (32.8%) and repeat violence (41.5%). Conclusion: despite the increase in notifications in the period, predominantly of physical violence, completeness of some of the form fields continues to be poor, which reinforces the importance of training professionals to improve the reporting process and data quality.

Educational inequality in consumption of in natura or minimally processed foods and ultra-processed foods: The intersection between sex and race/skin color in Brazil.

Background: It remains uncertain how the intersection between educational, gender, and race/skin color inequalities influences food consumption in Brazil. In this study, we examined the educational inequality in the consumption of in natura/minimally processed and ultra-processed foods by Brazilians with an intersectional perspective between sex and race/color. Methods: We used cross-sectional data from the Telephone Surveillance System (VIGITEL 2019), comprising 52,443 participants ≥ 18 years. Daily food consumption was considered high when consumption of ≥5 foods for each food group was reported the day before the survey. Educational inequality in food consumption was assessed by the slope index of inequality (SII) and the relative index of inequality (RII) according to sex and race/color (White; Black/Brown). Positive SII and RII values > 1.0 indicate higher food consumption among more educated participants. Results: The consumptions of in natura/minimally processed and ultra-processed foods were more prevalent in those with the highest level of education (≥12 years) and intermediate education (9-11 years), respectively. However, highly educated White women had higher consumption of in natura/minimally processed foods than Black women with the same education level, and White men in low and intermediate school levels had higher consumption of these foods than Black men with the same education levels. We found higher absolute educational inequality for in natura/minimally processed foods among White women (SII 21.8, 95% CI 15.3, 28.4) and Black/Brown men (SII 19.3, 95% CI 12.5, 26.1). Black/Brown men (SII 7.3, 95% CI 0.5, 14.0) and Black/Brown women (SII 5.6, 95% CI 1.0, 10.2) had higher absolute educational inequality than White men (SII -3.3, 95% CI -10.9, 4.3; P = 0.04) in the consumption of ultra-processed foods. Conclusion: Educational inequalities influenced the consumption of in natura/minimally processed more than ultra-processed foods, and, for the latter, inequalities were greater among Black/Brown men and women than among White men.

Time trends and projected obesity epidemic in Brazilian adults between 2006 and 2030.

We examined time trends and projected obesity epidemic in Brazilian adults between 2006 and 2030 by sex, race/skin color, educational attainment, and state capitals. Self-reported body weight and height of 730,309 adults (≥ 18 years) from the Vigitel study were collected by telephone interview between 2006 and 2019. A multinomial logistic regression model was used to predict the prevalence of body mass index (BMI) categories as a function of time by 2030. The prevalence of obesity increased from 11.8% in 2006 to 20.3% in 2019. The projected prevalences by 2030 are estimated to be 68.1% for overweight, 29.6% for obesity, and 9.3% for obesity classes II and III. Women, black and other minority ethnicities, middle-aged adults, adults with ≤ 7 years of education, and in Northern and Midwestern capitals are estimated to have higher obesity prevalence by 2030. Our findings indicate a sustained increase in the obesity epidemic in all sociodemographic subgroups and across the country. Obesity may reach three out of 10 adults by 2030.

Individual and Contextual Characteristics Associated With Alcohol Use Among Brazilian Adolescents.

Objective: To analyze the association between individual and contextual characteristics with alcohol indicators of experimentation, use in the last 30 days and drunkenness in Brazilian adolescents. Methods: Cross-sectional study based on data from 100,914 student attending 9th grade from the 2015 National School Health Survey. Multilevel logistic regression models were performed for the outcomes: alcohol experimentation; use in the last 30 days and drunkenness; and exposures, adjusted for adolescents' sociodemographic characteristics. Results: Girls were more likely to experiment alcohol (OR = 1.09; 95% CI = 1.05-1.12), use it in the last 30 days (OR = 1.09; 95% CI = 1.00-1.13) and less prone to drunkenness (OR = 0.90; 95% CI = 0.87-0.93). A higher proportion of public-school students reported drinking. There was a positive association of substance use by parents, peers and the adolescents themselves with the outcomes. Having a policy of banning alcohol consumption at school was associated with a greater chance of alcohol experimentation in public schools. Conclusion: Exposure to legal and illegal substances by friends, family members and a prohibitive school environment favored the outcomes.

Association between parental supervision and bullying victimization and perpetration in Brazilian adolescents, Brazilian National Survey of Student's Health 2015. / Associação entre supervisão parental, vitimização e perpetração de bullying em adolescentes brasileiros, Pesquisa Nacional de Saúde do Escolar 2015.

OBJECTIVE: To analyze the association between parental supervision characteristics and different bullying roles among Brazilian adolescent school students. METHODS: This was a cross-sectional study using data from the National School Student Health Survey (PeNSE) 2015. Frequent meals with parents/guardians, knowing about students' free time activities and checking their homework were the parental practices assessed. Logistic regression was used for association between these practices and bullying (perpetration and victimization), presented as odds ratio (OR) and 95% confidence intervals (95%CI). RESULTS: Among 102,072 school students, frequent meals with parents or guardians [ORvictim = 0.86 (95%CI 0.84;0.89); ORperp = 0.85 (95%CI 0.82;0.88)], checking homework [ORvictim = 0.95 (95%CI 0.92;0.97); ORperp = 0.76 (95%CI - 0.74;0.78)], and parents' or guardians' knowledge about students' free time activities [ORperp = 0.70 (95%CI 0.68;0.73] were inversely associated with bullying. CONCLUSION: Greater parental supervision reduced the odds of bullying victimization and perpetration among adolescent school students.

Association Between Dietary Patterns and Bullying Among Adolescents in Sao Paulo-Brazil.

Previous studies have assessed the association between food consumption and bullying perpetration, but most of them have not broadly assessed food consumption, neither the distinction between forms of bullying. The aim of the study was to evaluate the association between dietary patterns with bullying roles and its different types of bullying perpetration among adolescents. Data on a representative sample of ninth-grade students (N = 2,163; mean age = 14.8 years) taken from Sao Paulo Project for the social development of children and adolescents (SP-PROSO) were used. The independent variables were healthy and unhealthy dietary patterns obtained by exploratory factor analysis. The dependent variables were bullying role (victim-only, bully-only, bully-victim) and bullying perpetration (any type, social exclusion, psychological/verbal aggression, physical aggression, property destruction, sexual harassment). Multinomial and logistic regression models were performed for the total sample and stratified by sex (only for association with sexual harassment), adjusting for covariates. Adolescents who engaged in a healthy dietary pattern were less likely to be bullies (RR 0.67 [0.49, 0.92]), while adolescents with an unhealthy dietary pattern were more likely to be bully-victims (RR 1.29 [1.12, 1.48]). Unhealthy dietary pattern was associated with any type of bullying perpetration (OR 1.24 [1.12, 1.38]), mainly with sexual harassment and physical aggression. Boys who had an unhealthy dietary pattern were more likely to sexually harass another adolescent (OR 2.10 [1.20, 3.66]). In conclusion, adolescents who had a healthy dietary pattern were less likely to perpetrate bullying. Unhealthy dietary pattern was associated with bullying perpetration, especially with sexual harassment by boys.

Evolution of breastfeeding indicators and early introduction of foods in Latin American and Caribbean countries in the decades of 1990, 2000 and 2010.

BACKGROUND: Early introduction of liquid/solid food before 6 months of age is one of the major barriers to exclusive breastfeeding. Our objective was to analyze the evolution of infant feeding practices for infants under 6 months of age in Latin American and Caribbean countries in the decades of 1990, 2000 and 2010. METHOD: Cross-sectional time series study with data from Demographic and Health Surveys carried out between 1990 and 2017 in six Latin America and Caribbean countries: Bolivia (1994 to 2008), Colombia (1995 to 2010), Dominican Republic (1996 to 2013), Guatemala (1995 to 2015), Haiti (1994/1995 to 2016/2017), Peru (1996 to 2018). Pooled sample comprised of 22,545 infants under the age of 6 months. Surveys were grouped in three decades: 1990s for surveys from 1990 to 1999, 2000s for surveys from 2000 to 2009, and 2010s for surveys from 2010 to 2017. Exclusive breastfeeding (EBF), predominant breastfeeding (PBF), mixed breastfeeding (mixed BF), supplemented breastfeeding (supplemented BF) and non-breastfeeding (non-BF), and individual foods (water, liquids, milk, infant formula, semi-solid/solid) were analyzed. Prevalence of breastfeeding and food indicators were calculated in pooled sample, according to the infant monthly age groups, decade of survey and residence area(rural/urban). RESULTS: Between 1990s and 2010s, there was an increase in the exclusive breastfeeding prevalence (1990s = 38.1%, 2010s = 46.6%) and a reduction in the PBF prevalence (1990s = 51.7%, 2010 s = 43.1%). There was a decrease in the liquids (1990s = 40.7%, 2010s = 15.8%) and milk prevalence (1990s = 20.4%, 2010s = 8.3%) and an increase in water (1990s = 32.3%, 2010s = 37.6%), and infant formula (1990s = 16.6%, 2010s = 25.5%) prevalence. All breastfeeding indicators, except exclusive breastfeeding, progressively increased according to the monthly age group in three decades, and EBF prevalence sharply decreased from 2 to 3 months of age in all decades. Exclusive breastfeeding prevalence was higher in rural area in the three decades (1990s rural = 43.8%, 1990s urban = 32.4%, 2010s rural = 51.1%, 2010s urban = 42.4%) and infant formula prevalence was higher in urban area (1990s rural = 8.6%, 1990s urban = 24.6%, 2010s rural = 15.9%, 2010s urban = 34.1%). CONCLUSIONS: In the last three decades, in all age groups, there was an increase in exclusive breastfeeding prevalence, as well as a significant reduction in liquids and milk. In the rural area, EBF prevalence remains higher than in urban. Increased water and infant formula feeding are the main barriers to achieving the Global Nutrition Target 2025 for exclusive breastfeeding.

Association Between Maternal Work and Exclusive Breastfeeding in Countries of Latin America and Caribbean.

OBJECTIVE: The aim of this study was to estimate the association between individual and contextual characteristics related to maternal work and exclusive breastfeeding (EBF) in Latin America and the Caribbean. METHODS: A cross-sectional study, conducted with data from the Demographic and Health Survey of Bolivia (2008), Brazil (2006), Colombia (2010), the Dominican Republic (2007), Guatemala (2015), Haiti (2017), Honduras (2011) and Peru (2011). The sample included infants who were under 6 months of age and their mothers. The outcome was EBF (yes/no), individual predictors were maternal employment status (employed/not employed), type of occupation, and type of employment (formal/informal), and contextual predictors were gross domestic product, maternity leave, and percentage of women in the labor force. The association between maternal employment status and EBF was performed using multilevel Poisson analysis adjusted for maternal education level, presence of partner, place of residence, maternal age, type of childbirth, primiparity, wealth index and breastfeeding in the first hour of life. RESULTS: The prevalence of EBF was 58.0% in Bolivia, 41.1% in Brazil, 39.2% in Colombia, 7.6% in the Dominican Republic, 50.8% in Guatemala, 39.7% in Haiti, 31.1% in Honduras, and 68.1% in Peru. The percentage of employed women ranged from 19.1% in the Dominican Republic to 46.1% in Bolivia. Maternal employment was negatively associated with EBF (Prevalence Ratio [PR] = 0.77; 95% CI 0.73, 0.82), while the highest percentage of women in the labor force of the country was positively associated with EBF (PR = 1.03; 95% CI 1.01, 1.06), with an increase in the PR value after the inclusion of gross domestic product in the model. CONCLUSIONS: The prevalence of EBF was lower in infants whose mothers were employed. However, the prevalence of EBF was higher in countries with a larger percentage of women in the labor force.

Availability and consumption of ultra-processed foods in schools in the municipality of São Paulo, Brazil: results of the SP-Proso. / Disponibilidade e consumo de ultraprocessados em escolas do Município de São Paulo, Brasil: resultados do SP-Proso.

Ultra-processed foods are markers of unhealthy eating patterns, and their consumption is high among adolescents. Characteristics of the school eating environment associate with student eating practices. This study aims to investigate the association between the presence of school canteens and the availability of ultra-processed foods in school canteens with the consumption of these foods, inside the school, among adolescents of the 9th grade (14 years) of the public and private schools of the city of São Paulo, Brazil. We conducted a cross-sectional study with SP-Proso data, in a sample of 2,680 adolescents. We elaborated multilevel linear regression models to evaluate associations between the exposures: presence of school canteens and availability of ultra-processed foods with outcomes of consumption frequency of ultra-processed foods in the school. We found an association between the presence of school canteens and the higher frequency of consumption of sausages (0.46; 95%CI: 0.24; 0.68), package snacks (0.50; 95%CI: 0.19; 0.80), goodies (0.82; 95%CI: 0.55; 1.09), and sugary drinks (0.34; 95%CI: 0.06; 0.62), as well as a score of consumption frequency of ultra-processed foods (2.37; 95%CI: 1.25; 3.48). The availability of package snacks, goodies, and sugary drinks in school canteens increased the frequency of consumption of these foods. We observed a dose-response effect between the diversity of ultra-processed foods in canteens and the frequency of consumption of these foods. A school food environment with greater availability of ultra-processed products is associated with their higher consumption in school, indicating the need to regulate the sale of food within these institutions.

Alimentos ultraprocessados são marcadores de padrões alimentares não saudáveis e seu consumo é elevado entre os adolescentes. Características do ambiente alimentar escolar se associam a práticas alimentares de estudantes. O objetivo do estudo foi investigar a associação entre a presença de cantinas e a disponibilidade de alimentos ultraprocessados nas cantinas com o consumo destes alimentos, dentro da escola, entre adolescentes do 9º ano do Ensino Fundamental das redes pública e particular do Município de São Paulo, Brasil. Foi realizado um estudo transversal com dados do SP-Proso, em amostra de 2.680 adolescentes. Foram feitos modelos de regressão linear multinível para avaliar as associações entre as exposições presença de cantinas nas escolas e disponibilidade de alimentos ultraprocessados com desfechos de frequência de consumo de ultraprocessados na escola. A presença de cantinas esteve associada à maior frequência de consumo de embutidos (0,46; IC95%: 0,24; 0,68), salgadinhos de pacote (0,50; IC95%: 0,19; 0,80), guloseimas (0,82; IC95%: 0,55; 1,09) e bebidas açucaradas (0,34; IC95%: 0,06; 0,62), bem como um escore de frequência de consumo de ultraprocessados (2,37; IC95%: 1,25; 3,48). A disponibilidade de salgadinhos de pacote, guloseimas e bebidas açucaradas nas cantinas aumentou a frequência de consumo desses alimentos. Foi observado um efeito dose/resposta entre a diversidade de ultraprocessados nas cantinas e a frequência de consumo destes alimentos. Um ambiente alimentar escolar com maior disponibilidade de ultraprocessados está associado ao maior consumo dos mesmos na escola, o que aponta para a necessidade de regulamentar o comércio de alimentos dentro destas instituições.

Los alimentos ultraprocesados son marcadores de patrones alimentarios no saludables y su consumo es elevado entre los adolescentes. Características del entorno alimentario escolar se asocian a prácticas alimentarias de estudiantes. El objetivo del estudio fue investigar la asociación entre la presencia de cantinas, y la disponibilidad de alimentos ultraprocesados en las mismas, con el consumo de estos alimentos dentro de la escuela, entre adolescentes del 9º año de la enseñanza fundamental de las redes pública y privada del Municipio de São Paulo, Brasil. Se realizó un estudio transversal con datos del SP-Proso, en una muestra de 2.680 adolescentes. Se realizaron modelos de regresión lineal multinivel para evaluar las asociaciones entre las exposiciones presencia de cantinas en las escuelas y disponibilidad de alimentos ultraprocesados con resultados de frecuencia de consumo de ultraprocesados en la escuela. La presencia de cantinas estuvo asociada a una mayor frecuencia de consumo de embutidos (0,46; IC95%: 0,24; 0,68), aperitivos de bolsa (0,50; IC95%: 0,19; 0,80), golosinas (0,82; IC95%: 0,55; 1,09) y bebidas azucaradas (0,34; IC95%: 0,06; 0,62), así como un marcador de frecuencia de consumo de ultraprocesados (2,37; IC95%: 1,25; 3,48). La disponibilidad de aperitivos de bolsa, golosinas y bebidas azucaradas en las cantinas aumentó la frecuencia de consumo de esos alimentos. Se observó un efecto dosis/respuesta entre la diversidad de ultraprocesados en las cantinas y la frecuencia de consumo de estos alimentos. Un ambiente alimentario escolar con mayor disponibilidad de ultraprocesados está asociado a un mayor consumo de los mismos en la escuela, lo que apunta a la necesidad de regular el comercio de alimentos dentro de estas instituciones.

Association between parental supervision and bullying victimization and perpetration in Brazilian adolescents, Brazilian National Survey of Student's Health 2015 / Asociación entre la supervisión de los padres y la victimización y perpetración de la intimidación en adolescentes brasileños, Encuesta Nacional de Salud Estudiantil 2015 / Associação entre supervisão parental e vitimização e perpetração de bullying em adolescentes brasileiros, Pesquisa Nacional de Saúde do Escolar 2015

Objective: To analyze the association between parental supervision characteristics and different bullying roles among Brazilian school adolescents. Methods: Cross-sectional study that used data from the National School Health Survey (PeNSE) 2015. Frequent meals with parents/guardians, knowledge about free time, and checking homework were the parental practices assessed. Logistic regression was used for association between 4 these practices and bullying (perpetration and victimization), presented as oddsratio (OR) and 95% confidence intervals (95%CI). Results: Among 102,072 school adolescents, frequent meals with parents or guardians [ORvitim=0.86 (95%CI 0.84;0.89); ORperp=0.85 (95%CI 0.82;0.88)], checking homework [ORvitim=0.95 (95%CI 0.92;0.97); ORperp=0.76 (95%CI:0.74;0.78)], and parents or guardian's knowledge of students' free time [ORperp=0.70 (95%CI 0.68;0.73] were inversely associated with bullying. Conclusion: Greater parental supervision reduced the chance of victimization and perpetration bullying among adolescents.

Objetivo: Analizar la asociación entre las características de la supervisión parental y los diferentes roles del bullying entre adolescentes brasileños. Métodos: Estudio transversal con datos de la Encuesta Nacional de Salud Escolar de Adolescentes (PeNSE) 2015. Las comidas frecuentes con los padres/tutores, el conocimiento sobre el tiempo libre y la verificación de la tarea fueron las prácticas parentales evaluadas. Se utilizo regresión logística para la asociación entre prácticas y bullying (perpetración y victimización), presentada como razón de probabilidades (RP) e intervalos de confianza del 95% (IC95%). Resultados: Entre102.072 estudiantes, comidas frecuentes [RPvitim=0,86 (IC95%0,84;0,89); RPperp=0,85 (IC95% 0,82;0,88)] y verificación de la tarea [RPvitim=0,95 (IC95% 0,92;0,97); ORperp=0,76 (IC95% 0,74;0,78)] y conocimiento de los padres/tutores sobre el tiempo libre [RPperp=0,70 (IC95% 0,68;0,73)] se asociaron inversamente con el acoso. Conclusión: Una mayor supervisión de los padres redujo el acoso en los estudiantes.

Objetivo: Analisar associação entre características de supervisão parental e diferentes papéis de bullying entre adolescentes escolares brasileiros. Métodos: Estudo transversal, com dados da Pesquisa Nacional de Saúde do Escolar 2015. Realização frequente de refeições com os pais ou responsáveis, conhecimento sobre o tempo livre e verificação dos deveres de casa foram as práticas parentais avaliadas. Utilizou-se regressão logística para associação entre essas práticas e bullying (perpetração e vitimização), apresentada como razão de odds (RO) e intervalos de confianças de 95% (IC95%). Resultados: Entre 102.072 escolares, a realização frequente de refeições com os pais ou responsáveis [ROvitim=0,86 (IC95% 0,84;0,89); ROperp=0,85 (IC95% 0,82;0,88)], a verificação dos deveres de casa [ROvitim=0,95 (IC95% 0,92;0,97); ROperp=0,76 (IC95% 0,74;0,78)] e o conhecimento dos pais ou responsáveis sobre o tempo livre dos escolares [ROperp=0,70 (IC95% 0,68;0,73)] foram inversamente associadas ao bullying. Conclusão: Maior supervisão parental reduziu a chance de vitimização e perpetração do bullying entre adolescentes escolares.

Changes in socioeconomic inequalities in food consumption among Brazilian adults in a 10-years period.

Objective: To evaluate changes in socioeconomic inequalities in food consumption in Brazil over a 10-year period. Methods: Data on 24-h recalls of adults (aged 20 years or more) from the 2008/9 (n = 26,327) and 2017/8 (n = 37,689). Brazilian Dietary Survey were analyzed. We used the Nova classification system to group food items and estimate the percentage of total energy from ultra-processed foods and plant-based natural or minimally processed foods. For sex and area of residence, we calculated the percentage points (p.p.) difference between the estimates for women and men, and rural and urban populations. Negative values indicate higher consumption among men or urban residents, positive values indicate higher consumption among women or rural residents, and zero indicates equality. For education and wealth levels we calculated the slope index of inequality (SII). The SII varies from -100 to 100, with positive values indicating higher consumption among more educated or wealthiest groups, negative values indicating higher consumption among less educated or poorest groups, and zero equality. Results: Over the period, we observed a reduction in the percentage of total energy from plant-based natural/minimally processed foods from 13.0 to 12.2% and an increase in that of ultra-processed foods from 17.0 to 18.3%. The urban population and those in the wealthier and more educated groups presented higher consumption of ultra-processed foods and lower consumption of plant-based natural/minimally processed foods in both survey years. Over the 10-year period, there was an overall reduction of the socioeconomic inequalities, mainly explained by the greater increase in ultra-processed food consumption by the rural population and those from the poorest and less educated groups (difference for area -7.2 p.p. in 2008/9 and -5.9 p.p. in 2017/8; SII for education 17.7 p.p. in 2008/9 and 13.8 p.p. in 2017/8; SII for wealth 17.0 p.p. in 2008/9 and 11.2 p.p. in 2017/8). Conclusion: Socioeconomic inequalities in food consumption decreased in Brazil, but it may lead to the overall deterioration of the dietary quality of the more vulnerable groups.