The role of interaction between vitamin D and VDR FokI gene polymorphism (rs2228570) in sleep quality of adults.

To evaluate association of vitamin D with sleep quality in adults and the influence of VDR-gene polymorphism FokI (rs2228570;A > G). Cross-sectional population-based study in adults, conducted in Brazil. The outcome was sleep-quality, evaluated by the Pittsburgh Sleep Quality Index. Vitamin D was determined by indirect electrochemiluminescence and classified as deficiency (VDD), 25(OH)D < 20 ng/mL in a healthy population or 25(OH)D < 30 ng/mL for groups at risk for VDD. FokI polymorphism in the VDR-gene was genotyped by qPCR and classified as homozygous wild (FF or AA), heterozygous (Ff or AG), or homozygous mutant (ff or GG). Multivariate logistic analysis was used to estimate the association between vitamin D and FokI polymorphism with sleep-quality. In a total of 1674 individuals evaluated, 53.6% had poor-sleep-quality, 31.5% had VDD, and the genotype frequency of the FokI polymorphism was 9.9% FF, 44.6% Ff, and 45.5% ff. In multivariate analysis, individuals with VDD had 1.51 times the chance of poor-sleep-quality, and individuals with the ff genotype had 1.49 times the chance of poor-sleep-quality (OR:1.49;95%CI:1.05-2.12) when compared to individuals with the FF or Ff genotype. In the combined analysis, individuals with VDD and ff genotype had more chance of poor-sleep-quality than individuals with sufficient vitamin D and genotype Ff or FF (OR:2.19;95%CI:1.27-3.76). Our data suggest that VDD and VDR FokI gene polymorphism are associated with poor-sleep-quality, and combining the two factors increases the chance of poor-sleep-quality compared to separate groups.

Prevalence of helmintic infections in Brazilian Maxakali indigenous: a repeated cross-sectional design.

BACKGROUND: The prevalence of intestinal parasites is known to be high among Amerindian populations; further, there are serious problems in the healthcare of these populations in Brazil. The Maxakali, located in the northeastern region of Minas Gerais, Brazil, is an indigenous group that still preserves many of its cultural aspects. This study aimed to compare the positivity rate of schistosomiasis and soil-transmitted helminths in this ethnic group in epidemiological surveys conducted in 1972 and 2014. METHODS: Stool parasitological examinations were performed by the Kato-Katz technique during both periods in this population. In 2014, the parasitological diagnosis was also realized with the TF-Test® technique. RESULTS: In 1972, 270 inhabitants were examined. The positivity rates were 67.4% for Schistosoma mansoni, 72.9% for hookworms, 43.7% for Ascaris lumbricoides, and 23.7% for Trichuris trichiura. In 2014, 545 individuals were examined, and the positivity rates obtained were 45.7% for S. mansoni, 22.8% for hookworms, 0.6% for A. lumbricoides, and 2.8% for T. trichiura. CONCLUSIONS: The comparison of the parasitological surveys conducted in 1972 and 2014, indicates that the indigenous Maxakali remained neglected by the health and indigenous protection authorities during these four decades. The infection rate observed in 2014 for schistosomiasis and hookworm remains high, considering the current epidemiological view of these diseases in the Brazilian population.

Frequency of breakfast consumption and its associations with food consumption by degree of industrial processing and with indicators of overweight in Brazilian adolescents (EVA-JF Study).

OBJECTIVE: The aim of this study was to investigate the frequency of breakfast consumption and estimate its associations with the consumption of food at different degrees of industrial processing and with overweight indicators in Brazilian adolescents. METHODS: This cross-sectional study involved a probabilistic sample of 14- to 19-y-old adolescents enrolled in 29 public schools in the municipality of Juiz de Fora, MG, Southeast Brazil (n = 805). The frequency of breakfast consumption was evaluated via a questionnaire (classified into "do not consume", "sometimes consume", and "regularly consume"). The evaluation of food consumption involved two 24-h dietary recalls, the items of which were analyzed according to the NOVA classification system. Overweight indicators (waist circumference, body mass index for age (BMI-for-age), and body fat percentage) were evaluated according to a standard protocol. Linear regression models were performed, first without and then with adjustments for sociodemographic characteristics. RESULTS: We found that 20% of adolescents skipped breakfast, and ∼46% of the caloric intake came from ultra-processed foods. Breakfast omission was associated with a mean increase of 3.02% (95% confidence interval [CI], 0.52-5.53) in energy intake from ultra-processed foods, in addition to a mean increase of 0.28 z-score (95% CI, 0.05- 0.52) of BMI-for-age and of 1.64% (95% CI, 0.21-3.08) in body fat. CONCLUSIONS: We verified that the omission of breakfast was associated with higher consumption of ultra-processed foods, as well as a higher BMI-for-age and higher percentage of body fat, reinforcing the importance of actions to encourage the consumption of this meal and the adoption of healthy eating practices in adolescents.

Arterial hypertension in rotating shift workers: The role of hypertriglyceridemic waist and hypertriglyceridemic waist-to-height ratio phenotypes.

OBJECTIVE: To examine the association of arterial hypertension and the hypertriglyceridemic waist phenotype (HWP) and hypertriglyceridemic waist-to-height phenotype (HWHP). METHODOLOGY: This cross-sectional study was conducted with 1422 male rotating shift workers in Brazil. The HWP was defined as having a waist circumference ≥94 cm and serum triglycerides ≥150 mg/dL, whereas the HWHP was determined by having a waist-to-height ratio ≥0.5 and serum triglycerides ≥150 mg/dL. To provide a characterization of the sample, data were presented in both absolute and relative values, and Pearson's chi-square test was employed. To investigate the potential association between arterial hypertension and the presence of HWP or HWHP, multivariate logistic regression was conducted, accounting for sociodemographic, behavioral, and clinical variables. Furthermore, we conducted a stratified multivariate logistic regression analysis, considering the duration of shift work, to assess whether the results remained consistent depending on the length of work experience in shifts. RESULTS: A noteworthy association was observed between arterial hypertension and both HWP and HWHP, with HWHP exhibiting a stronger association with the disease. Furthermore, a positive association between arterial hypertension and these phenotypes was identified in workers with five or more years of shift work. CONCLUSION: We recommend the utilization of HWHP as a screening tool, as it indicates a stronger association with arterial hypertension compared to HWP. Additionally, the duration of time spent working in shifts emerged as a significant factor influencing the presence of these phenotypes.

Vitamin D deficiency and hyperglycemia in male rotating shift workers: A disturbed circadian rhythms influence.

BACKGROUND: Shift work is related to several negative impacts on the health of workers. This study aimed to evaluate the association between vitamin D deficiency (VDD) and hyperglycemia in shift workers. METHODOLOGY: This cross-sectional study included male rotating shift workers in an iron ore extraction company. Participants were classified as VDD when 25(OH)D < 20 ng/mL for a healthy population and 25(OH)D < 30 ng/mL for groups at risk for VDD. Hyperglycemia was classified when fasting glucose ≥100 mg/dL or HbA1c ≥ 5.7%. Data were compared using chi-square analysis with Cramer's V as effect size, and Bonferroni correction. Multivariate logistic regression, from a model of determination, was performed to investigate whether VDD was associated with hyperglycemia. RESULTS: The study evaluated 1411 workers, most workers were aged 30-39 years (53.2%), and 77.5% self-declared as black, brown, with up to complete high school (71.4%) and working alternate shifts for more than 5 years (76.1%). Regarding glucose and vitamin D, 32.0% and 29.1% of the workers had hyperglycemia and VDD, respectively. In multivariate analysis, controlled for confounding factors, workers with VDD had a 119% increased chance of hyperglycemia (OR: 2.19; IC95%: 1.56-3.08). Furthermore, vitamin D levels in distribution quintiles showed a dose-response gradient in relation to hyperglycemia, where increased vitamin D values were associated with a reduction in the occurrence of hyperglycemia. CONCLUSION: Rotating shift workers with vitamin D deficiency are more likely to have hyperglycemia.

The predictive values of BOAH and No-apnea score for screening obstructive sleep apnea in rotating shift worker drivers.

Objective: To evaluate the BOAH (Body mass index, Observed apnea, Age, and Hypertension) and No-apnea score's diagnostic values for detecting obstructive sleep apnea (OSA) risk in shift workers. Methods: Cross-sectional study with male rotating shift workers and drivers of heavy off-road machinery. The BOAH score is based on body mass index, witnessed apneas during sleep, age, and hypertension. The No-apnea score is based on neck circumference and age. Based on the apnea-hypopnea index (AHI), the severity of OSA was categorized as least mild OSA (AHI ≥5/h), moderate to severe OSA (AHI ≥15/h), and severe OSA (AHI ≥30/h). Sensitivity, specificity, positive predictive value, negative predictive value, and areas under the curve (AUC) were calculated. Results: Among 119 workers evaluated, 84.0% had AHI ≥5, 46.2% had AHI ≥15, and 14.3% had AHI ≥30. BOAH score with 2 points for AHI ≥5, the AUC was 0.679, and sensitivity and specificity were 41.0% and 94.7%, respectively. No-apnea score with 3 points AHI ≥5, the AUC was 0.692, and sensitivity and specificity were 70.0% and 68.4%, respectively. Furthermore, using at least one of the positive scores, the AUC was higher when compared to the single tests for AHI ≥5 (AUC = 0.727). And when both scores were positive, the AUC was higher for AHI ≥30 (AUC = 0.706). Conclusion: In rotating shift workers and drivers of heavy off-road machinery, BOAH, and No-apnea scores can be helpful tools in identifying individuals at risk for sleep apnea. In addition, matching the scores may increase the prediction of OSA.

Rotating shift work time is directly associated with excess body adiposity.

OBJECTIVE: To analyze the association between changes in body adiposity and length of service on a schedule of rotating shifts. METHODS: The study was a cross-sectional investigation conducted during the years 2012, 2015, and 2018, involving individuals engaged in rotating shifts at a company involved in iron ore extraction situated within the Iron Quadrangle region of Minas Gerais and the southeastern region of Pará, Brazil. Sociodemographic and behavioral data were collected along with anthropometric parameters in order to calculate body mass index (BMI) and the waist-to-height ratio (WHtR). For data analysis, a multivariate logistic regression was employed to explore potential associations between indicators of body adiposity and the duration of shift work, employing a hierarchical determination model. RESULTS: The findings showed that in the multivariate model, controlling for confounding factors, workers with 5 to 10, 10 to 15, and more than 15 years of shift work had 41 to 96% greater odds of being overweight (BMI > 25.0 kg/m2), 71 to 82% of having altered neck circumference (> 40 cm), 33 to 120% of altered WC (>102 cm), and 57 to 214% of having altered WHtR (> 0.5 cm). CONCLUSION: The findings suggest that time spent in work has a significant effect on anthropometric indicators of body adiposity, especially if the worker has a previously established comorbidity such as dyslipidemia or hypertension and is frequently exposed to night work.

The Program for the Control of Visceral Leishmaniasis in Brazil: The Effect of the Systematic Euthanasia of Seropositive Dogs as a Single Control Action in Porteirinha, a Brazilian City with an Intense Transmission of Visceral Leishmaniasis.

BACKGROUND: Porteirinha is endemic for visceral leishmaniasis (VL), with intense disease transmission of the disease. We evaluated the impact of canine euthanasia as a single control measure on the incidence of VL in humans and canines. METHODS: A prospective observational cohort study was carried out over four years (1998-2002) in 8 of the 12 neighborhoods of the city. The dynamics of canine visceral leishmaniasis (CVL) transmission were evaluated for 2 years, before beginning the screening-culling intervention. The comparative morbidity index (CMI) was used to stratify areas with the greatest risk of CVL, and the spatial distribution of human and canine VL cases was compared using univariate and bivariate K-functions. RESULTS: Human cases conglomerated in three neighborhoods. Spatial clusters were detected for CVL in 1998, 2000, and 2001, but not in 1999, when greater spatial dispersion occurred. The screening and culling intervention reduced the number of human VL cases and decreased the incidence of CVL, mainly in neighborhoods with a high CMI. CONCLUSIONS: The systematic euthanasia of seropositive dogs was shown to be an effective control action of the Program for Control of Visceral Leishmaniasis (PCLV) in Brazil. The fundamental role of domestic dogs in the epidemiological chain of VL was reaffirmed.

Poor Sleep Quality and Working From Home Influence the Prevalence of Leisure Time Physical Inactivity During the COVID-19 Pandemic: COVID-Inconfidentes Study.

OBJECTIVE: The aim of the study is to explore possible associations according to quality of sleep and work from home (WFH) with physical inactivity (PI) during the COVID-19 pandemic. METHODS: This is a cross-sectional study in two Brazilian cities (>18 years), by probability sampling. Leisure-time physical activity was self-reported and classified according to guidelines. Sleep was by applying the Pittsburgh Sleep Quality Index. Work from home was classified as: total WFH or no WFH. RESULTS: A total of 1750 adults were analyzed, 69.1% were physically inactive, 51.9% had poor sleep quality, and 79.8% were not in WFH. PI was associated with poor sleep quality and non-WFH. Compared with those who reported WFH and good sleep quality, those who reported non-WFH and poor sleep quality had 4 times the prevalence of PI. CONCLUSIONS: Poor sleep quality, and not WFH, is associated with leisure PI. These factors combined increase the probability of PI.

Sedentary behavior is associated with poor sleep quality during the COVID-19 pandemic, and physical activity mitigates its adverse effects.

BACKGROUND: We aimed to evaluate the association of sedentary behavior (SB) and moderate to vigorous leisure-time physical activity (MVPA) with sleep quality during the COVID-19 pandemic. METHODS: Cross-sectional, population-based study in adults, conducted from October to December 2020 in the Iron Quadrangle region, Brazil. The outcome was sleep quality, evaluated with the Pittsburgh Sleep Quality Index. SB was assessed by self-report of total sitting time, before and during the pandemic. Individuals with ≥ 9 h of total sitting time were classified as SB. In addition, the ratio of time spent in MVPA to time in SB was analyzed. A contrasted directed acyclic graph (DAG) model was constructed to adjust logistic regression models. RESULTS: A total of 1629 individuals were evaluated, the prevalence of SB before the pandemic was 11.3% (95%CI: 8.6-14.8), and during the pandemic 15.2% (95%CI: 12.1-18.9). In multivariate analysis, the chance of poor sleep quality was 77% higher in subjects with SB ≥ 9 h per day (OR: 1.77; 95% CI: 1.02-2.97). Furthermore, a one-hour increase in SB during the pandemic, increased the chance of poor sleep quality by 8% (OR: 1.08; 95%CI 1.01-1.15). In the analysis of the ratio of MVPA per SB in individuals with SB ≥ 9 h, practicing 1 min of MVPA per hour of SB reduces the chance of poor sleep quality by 19% (OR: 0.84; 95%CI: 0.73-0.98). CONCLUSION: SB during the pandemic was a factor associated with poor sleep quality, and the practice of MVPA can reduce the effects of SB.

Association of Hypovitaminosis D with Sleep Parameters in Rotating Shift Worker Drivers.

Objective To evaluate the association between sleep parameters and hypovitaminosis D in rotating shift drivers. Material and Methods We conducted a cross-sectional study on 82 male rotating shift workers (24-57 years old) with at least one cardiovascular risk factor (such as hyperglycemia, dyslipidemia, abdominal obesity, physical inactivity, hypertension, and smoking). Polysomnography was used to evaluate sleep parameters. Logistic regression was used to model the association between hypovitaminosis D and sleep parameters after adjustment for relevant covariates. Results Hypovitaminosis D (< 20 ng/mL) was seen in 30.5% of the workers. Shift workers with hypovitaminosis D had lower sleep efficiency (odds ratio [OR]: 3.68; 95% confidence interval [CI]: 1.95-5.53), lower arterial oxygen saturation (OR: 5.35; 95% CI: 3.37-6.12), and increased microarousal index (OR: 3.85; 95% CI: 1.26-5.63) after adjusting. Conclusion We suggest that hypovitaminosis D is associated with greater sleep disturbances in rotating shift workers.

High Levels of Glycated Hemoglobin (HbA1c) Are Associated with Physical Inactivity, and Part of This Association Is Mediated by Being Overweight.

The COVID-19 pandemic has generated substantial changes in the lives of the population, such as increased physical inactivity, which can lead to being overweight and, consequently, repercussions on glucose homeostasis. A cross-sectional study based on the adult population of Brazil was conducted by stratified, multistage probability cluster sampling (October and December 2020). Participants were classified as physically active or inactive during leisure time according to the recommendations of the World Health Organization. HbA1c levels were categorized as normal (≤6.4%) or with glycemic changes (≥6.5%). The mediating variable was being overweight (overweight and obese). Descriptive, univariate, and multivariate logistic regression analyses examined the association between physical inactivity and glycemic changes. Mediation was analyzed using the Karlson-Holm-Breen method to verify the influence of being overweight on the association. We interviewed 1685 individuals, mostly women (52.4%), 35-59 years old (45.8%), race/ethnicity brown (48.1%), and overweight (56.5%). The mean HbA1c was 5.68% (95% CI: 5.58-5.77). Mediation analysis verified that physically inactive participants during leisure time were 2.62 times more likely to have high levels of HbA1c (OR: 2.62, 95% CI: 1.29-5.33), and 26.87% of this effect was mediated by over-weight (OR: 1.30: 95% CI: 1.06-1.57). Physical inactivity at leisure increases the chances of high levels of HbA1c, and part of this association can be explained by being overweight.

The combined consumption of fresh/minimally processed food and ultra-processed food on food insecurity: COVID Inconfidentes, a population-based survey.

OBJECTIVE: To investigate whether the combined consumption of fresh/minimally processed and ultra-processed food is associated with food insecurity (FI) during the COVID-19 pandemic. DESIGN: Cross-sectional observational study was derived from a survey using a population-based search of a complex sample. FI was assessed using the validated Brazilian Food Insecurity Scale. Food consumption was assessed using a qualitative FFQ and the NOVA classification for fresh/minimally processed food and ultra-processed food. A scoring system was used to evaluate combined food consumption according to the extent and purpose of processing, considering the weekly consumption of the two groups (according to the NOVA classification). Higher punctuation reflects worse diet quality (higher consumption of ultra-processed foods and lower consumption of fresh/minimally processed foods). A theoretical causality model was constructed using a directed acyclic graph, and multivariate analysis was performed using Poisson regression to test the association between FI and food consumption. SETTING: Ouro Preto and Mariana, Brazil, between October and December 2020. PARTICIPANTS: An epidemiological household survey was conducted with 1753 individuals selected through a stratified and clustered sampling design in three stages. RESULTS: Those with food consumption scores in the fourth quartile had a 60 % higher prevalence ratio (PR) for FI (PR: 1·60 and 95 % CI: 1·06 - 2·40). Also, the increased consumption of fresh/minimally processed foods and low consumption of ultra-processed foods presented a 45 % lower prevalence ratio of FI (PR: 0·55 and 95 % CI: 0·40 - 0·80). CONCLUSION: These results indicate an inverse association between FI and diet quality.

Influence of sunlight on the association between 25-hydroxyvitamin D levels and sleep quality in Brazilian adults: A population-based study.

OBJECTIVES: This study aimed to evaluate the association of vitamin D with sleep quality during the COVID-19 pandemic and the influence of daily sunlight on this association. METHODS: This cross-sectional, population-based study among adults stratified by multistage probability cluster sampling was conducted from October to December 2020 in the Iron Quadrangle region of Brazil. The outcome was sleep quality, evaluated by the Pittsburgh Sleep Quality Index. Vitamin D (25-hydroxyvitamin D) concentrations were determined by indirect electrochemiluminescence and a deficiency was classified as 25(OH)D < 20 ng/mL. To assess sunlight, the average daily sunlight exposure was calculated and was classified as insufficient when less than 30 min/d. Multivariate logistic analysis was used to estimate the association between vitamin D and sleep quality. A directed acyclic graph was used to select minimal and sufficient sets of adjustment variables for confounding from the backdoor criterion. RESULTS: In a total of 1709 individuals evaluated, the prevalence of vitamin D deficiency was 19.8% (95% CI, 15.5-24.9%), and the prevalence of poor sleep quality was 52.5% (95% CI, 48.6-56.4%). In multivariate analysis, vitamin D was not associated with poor sleep quality in individuals with sufficient sunlight. Moreover, in individuals with insufficient sunlight, vitamin D deficiency was associated with poor sleep quality (odds ratio [OR], 2.02; 95% CI, 1.10-3.71). Furthermore, each 1-ng/mL increase in vitamin D levels reduced the chance of poor sleep quality by 4.2% (OR, 0.96; 95% CI, 0.92-0.99). CONCLUSIONS: Vitamin D deficiency was associated with poor sleep quality in individuals with insufficient exposure to sunlight.

Rotating shift workers with vitamin D deficiency have a higher risk of obstructive sleep apnea.

OBJECTIVES: The study aimed to evaluate the association between obstructive sleep apnea (OSA) and vitamin D deficiency (VDD) in shift workers. METHODS: This cross-sectional study included male rotating shift workers in an iron ore extraction company. Participants were classified as VDD when 25(OH)D < 20 ng/mL for a healthy population and 25(OH)D < 30 ng/mL for groups at risk for VDD. Risk of developing OSA was classified by Berlin questionnaire (BQ) and NoSAS score. Data were compared using chi-square analysis with Cramer's V as effect size, and Bonferroni correction. Multivariate logistic regression analysis was performed to investigate whether or not VDD was associated with OSA risk assessment. RESULTS: Among 1423 male workers, mostly younger, aged 30 to 39 years (53%), worked shifts for more than 5 years (76%). The prevalence of high risk of OSA by BQ was 16%, and 33% by NoSAS score. Additionally, 29% had VDD. In multivariate analysis, controlled for confounding factors, workers with VDD had a 52% increased chance of OSA by BQ (OR 1.52; CI95% 1.06-2.18) and a 64% increased chance of OSA by NoSAS score (OR 1.64; CI95% 1.09-2.48). After subgroup analyses, similar results were not observed in workers aged 20-29 and 30-39 years. CONCLUSION: Rotating shift workers with vitamin D deficiency are more likely to have obstructive sleep apnea, assessed by the Berlin questionnaire and NoSAS score.

Determinants of poor sleep quality in adults during the coronavirus disease pandemic: COVID-Inconfidentes, a population-based study

ABSTRACT BACKGROUND: The coronavirus disease (COVID-19) pandemic has adversely affected the health of the global population, with sleep quality being one of the affected parameters. OBJECTIVES: To evaluate sleep quality and its associated factors in adults during the COVID-19 pandemic in Brazil. DESIGN AND SETTING: A population-based cross-sectional serological survey of 1,762 adults in the Iron Quadrangle region of Brazil. METHODS: The Pittsburgh Sleep Quality Index was used to assess sleep quality. Sociodemographic variables, health conditions, health-related behaviors, anxiety, vitamin D levels, weight gain/loss, and pandemic characteristics were assessed using a structured questionnaire. Univariate and multivariate analyses using Poisson regression with robust variance were performed to identify factors associated with sleep quality. RESULTS: More than half of the participants reported poor sleep quality (52.5%). Multivariate analysis revealed that the factors associated with poor sleep quality included living alone (prevalence ratio [PR] = 1.34; 95% confidence interval [CI]: 1.04-1.73), anxiety disorder (PR = 1.32; 95% CI: 1.08-1.62), 5.0% weight loss (PR = 1.21; 95% CI: 1.02-1.44), 5.0% weight gain (PR = 1.27; 95% CI: 1.03-1.55), vitamin D deficiency (PR = 1.16; 95% CI: 1.01-1.35), and COVID-19 symptoms (PR = 1.29; 95% CI: 1.10-1.52). CONCLUSIONS: Our study revealed that more than half of the participants experienced poor sleep quality during the COVID-19 pandemic. Factors associated with poor sleep quality included vitamin D deficiency and weight changes related to the pandemic.

Multiple health risk behaviors, including high consumption of ultra-processed foods and their implications for mental health during the COVID-19 pandemic.

Background and aim: The growing increase in diet- and behavior-related illnesses has drawn the attention of many epidemiologists who attribute such changes to the epidemiological and nutritional transition. Thus, this study aims to evaluate the association between the combined occurrence of health risk behaviors, such as sedentary lifestyles, high weekly consumption of ultra-processed foods (UPFs), and non-daily consumption of fruits and vegetables, and symptoms of anxiety or depression in adults. Methods: This is a cross-sectional study based on an epidemiological survey in two Brazilian cities. The outcome, anxiety, and depression symptoms were assessed using the Generalized Anxiety Disorder 7-item (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9). Food consumption was assessed using a qualitative food frequency questionnaire (FFQ) with reference to consumption in the last 3 months and categorized into the consumption of fruits and vegetables and the consumption of UPFs according to the NOVA classification. Sedentary behavior was assessed by considering the amount of sitting or reclining time per day reported by participants and categorized as less than 9 h of sitting or reclining and 9 h or more. For the analysis, adjusted Poisson regression (PR) was used to estimate the prevalence ratio and the 95% confidence interval (CI). Results: Those with the health risk behaviors, non-daily consumption of fruits and vegetables, and high consumption of UPFs had a 2.6 higher prevalence ratio for symptoms of mental disorder (PR: 2.6 and 95%CI: 1.1-6.5), as well as those with all three health risk behaviors, had a 2.8 higher prevalence ratio for symptoms of mental disorder (PR: 2.8 and 95%CI: 1.3-6.1). Conclusion: This study revealed that the existence of a combination of two and three health risk behaviors led to a higher prevalence of symptoms of anxiety or depression.

Determinants of poor sleep quality in adults during the coronavirus disease pandemic: COVID-Inconfidentes, a population-based study.

BACKGROUND: The coronavirus disease (COVID-19) pandemic has adversely affected the health of the global population, with sleep quality being one of the affected parameters. OBJECTIVES: To evaluate sleep quality and its associated factors in adults during the COVID-19 pandemic in Brazil. DESIGN AND SETTING: A population-based cross-sectional serological survey of 1,762 adults in the Iron Quadrangle region of Brazil. METHODS: The Pittsburgh Sleep Quality Index was used to assess sleep quality. Sociodemographic variables, health conditions, health-related behaviors, anxiety, vitamin D levels, weight gain/loss, and pandemic characteristics were assessed using a structured questionnaire. Univariate and multivariate analyses using Poisson regression with robust variance were performed to identify factors associated with sleep quality. RESULTS: More than half of the participants reported poor sleep quality (52.5%). Multivariate analysis revealed that the factors associated with poor sleep quality included living alone (prevalence ratio [PR] = 1.34; 95% confidence interval [CI]: 1.04-1.73), anxiety disorder (PR = 1.32; 95% CI: 1.08-1.62), 5.0% weight loss (PR = 1.21; 95% CI: 1.02-1.44), 5.0% weight gain (PR = 1.27; 95% CI: 1.03-1.55), vitamin D deficiency (PR = 1.16; 95% CI: 1.01-1.35), and COVID-19 symptoms (PR = 1.29; 95% CI: 1.10-1.52). CONCLUSIONS: Our study revealed that more than half of the participants experienced poor sleep quality during the COVID-19 pandemic. Factors associated with poor sleep quality included vitamin D deficiency and weight changes related to the pandemic.

Profile of natural Trypanosoma cruzi infection among dogs from rural areas of southern Espírito Santo, Brazil.

BACKGROUND: The emergence of Trypanosoma cruzi infection via oral transmission has a habitual character in its primitive endemic cycle. Recent findings revealed the first death by oral transmission of T. cruzi in the state of Espírito Santo, Brazil, in 2012, which was recorded in the rural area of Guarapari. This study evaluated the characteristics related to the occurrence of natural T. cruzi infection among dogs from the rural areas of Alegre and Iconha, municipalities of Espírito Santo. METHODS: Logistic regression analysis of factors contributing to serological detection of T. cruzi in dogs was performed in environments where Espírito Santo's Department of Health Surveillance had previously notified triatomines positive for Trypanosoma spp. from 2014 to 2017. RESULTS: A total of 36 dogs were analyzed, of which 10 (27.77%) tested positive, one was borderline (2.79%), and 25 tested negative (69.44%) for T. cruzi infection. São Caetano, a district from the Iconha municipality, presented a 25 times greater chance for the detection of positive tests (OR:25; 95% CI; 2.37->100). Dogs with updated mandatory vaccination presented with a lower risk of positive serodiagnosis (OR:0.12; 95% CI: 0.02-0.63). CONCLUSIONS: Our results highlight for the first time the occurrence of natural T. cruzi canine infection, detected in the municipality of Iconha, mainly among dogs with un-updated mandatory vaccines in the district of São Caetano.