[Bullying victimization and associated factors among schoolchildren in a city in the south of Brazil]. / Vitimização por bullying e fatores associados entre escolares de um município do Sul do Brasil.

The objective was to assess the prevalence of bullying victimization and associated factors among adolescents in the city of Pelotas, Rio Grande do Sul. A cross-sectional school-based study was conducted with 795 ninth grade students from 25 urban municipal schools linked to the School Health Program. Bullying was assessed using questions that addressed the occurrence, frequency, location, type of violence suffered and how much it bothers the victims. Gross and adjusted analyses were performed by Poisson regression. Approximately 71% of the students reported having suffered bullying, and school was the location of greatest occurrence (86.7%). Among the types of aggression suffered, "nicknames" was the most recurrent complaint (88.4%), followed by exclusion or isolation (26.6%). Victimization was more frequent among girls (PR 1.13; 95%CI 1.02-1.27), students with non-white skin color/race (PR 1.16; 95%CI 1.05-1.29), who have already tried tobacco (PR 1.14; 95%CI 1.03-1.27), dissatisfied (PR 1.42; 95%CI 1.27-1.58) or indifferent (PR 1.21; 95%CI 1.02-1.43) about their bodies, and who were overweight (PR 1.15; 95%CI 1.04-1.27). The results show that bullying is a frequent practice in the school environment, pointing to the need for educational practices aimed at reducing and preventing this type of violence.

O objetivo foi avaliar a prevalência de vitimização por bullying e seus fatores associados entre adolescentes da cidade de Pelotas, RS. Estudo transversal de base escolar realizado com 795 alunos do 9o ano do ensino fundamental de 25 escolas municipais urbanas vinculadas ao PSE. O bullying foi avaliado por meio de perguntas que abordaram a ocorrência, a frequência, o local, o tipo de violência sofrida e o quanto isso incomoda as vítimas. Análises bruta e ajustada foram feitas por regressão de Poisson. Aproximadamente 71% dos estudantes relataram ter sofrido bullying, a escola foi o local de maior ocorrência (86,7%). Entre os tipos de agressões sofridas, "apelidos" foi a queixa mais recorrente (88,4%), seguida por exclusão ou isolamento (26,6%). A vitimização foi mais frequente entre as meninas (RP 1,13; IC95% 1,02-1,27), estudantes com cor da pele/raça não branca (RP 1,16; IC95% 1,05-1,29), que já experimentaram tabaco (RP 1,14; IC95% 1,03-1,27), insatisfeitos (RP 1,42; IC95% 1,27-1,58) ou indiferentes (RP 1,21; IC95% 1,02-1,43) em relação ao corpo e que apresentavam excesso de peso (RP 1,15; IC95% 1,04-1,27). Os resultados mostram que o bullying é uma prática frequente no ambiente escolar, apontando para a necessidade de práticas educativas voltadas para a redução e prevenção desse tipo de violência.

Vitimização por bullying e fatores associados entre escolares de um município do Sul do Brasil / Bullying victimization and associated factors among schoolchildren in a city in the south of Brazil

Resumo O objetivo foi avaliar a prevalência de vitimização por bullying e seus fatores associados entre adolescentes da cidade de Pelotas, RS. Estudo transversal de base escolar realizado com 795 alunos do 9o ano do ensino fundamental de 25 escolas municipais urbanas vinculadas ao PSE. O bullying foi avaliado por meio de perguntas que abordaram a ocorrência, a frequência, o local, o tipo de violência sofrida e o quanto isso incomoda as vítimas. Análises bruta e ajustada foram feitas por regressão de Poisson. Aproximadamente 71% dos estudantes relataram ter sofrido bullying, a escola foi o local de maior ocorrência (86,7%). Entre os tipos de agressões sofridas, "apelidos" foi a queixa mais recorrente (88,4%), seguida por exclusão ou isolamento (26,6%). A vitimização foi mais frequente entre as meninas (RP 1,13; IC95% 1,02-1,27), estudantes com cor da pele/raça não branca (RP 1,16; IC95% 1,05-1,29), que já experimentaram tabaco (RP 1,14; IC95% 1,03-1,27), insatisfeitos (RP 1,42; IC95% 1,27-1,58) ou indiferentes (RP 1,21; IC95% 1,02-1,43) em relação ao corpo e que apresentavam excesso de peso (RP 1,15; IC95% 1,04-1,27). Os resultados mostram que o bullying é uma prática frequente no ambiente escolar, apontando para a necessidade de práticas educativas voltadas para a redução e prevenção desse tipo de violência.

Abstract The objective was to assess the prevalence of bullying victimization and associated factors among adolescents in the city of Pelotas, Rio Grande do Sul. A cross-sectional school-based study was conducted with 795 ninth grade students from 25 urban municipal schools linked to the School Health Program. Bullying was assessed using questions that addressed the occurrence, frequency, location, type of violence suffered and how much it bothers the victims. Gross and adjusted analyses were performed by Poisson regression. Approximately 71% of the students reported having suffered bullying, and school was the location of greatest occurrence (86.7%). Among the types of aggression suffered, "nicknames" was the most recurrent complaint (88.4%), followed by exclusion or isolation (26.6%). Victimization was more frequent among girls (PR 1.13; 95%CI 1.02-1.27), students with non-white skin color/race (PR 1.16; 95%CI 1.05-1.29), who have already tried tobacco (PR 1.14; 95%CI 1.03-1.27), dissatisfied (PR 1.42; 95%CI 1.27-1.58) or indifferent (PR 1.21; 95%CI 1.02-1.43) about their bodies, and who were overweight (PR 1.15; 95%CI 1.04-1.27). The results show that bullying is a frequent practice in the school environment, pointing to the need for educational practices aimed at reducing and preventing this type of violence.

Healthy eating markers among adolescents from the municipal school system in Pelotas, Rio Grande do Sul, Brazil, 2019: a cross-sectional study.

MAIN RESULTS: Around 3% of the students regularly consumed the five healthy eating markers, with beans being the most frequently consumed; strong association was found between healthy eating markers and behavioral variables. Implications for services: The results obtained can contribute for interventions, programs and actions, particularly in the school environment, aimed at promoting an adequate and healthy diet. PERSPECTIVES: Better targeting of interventions, programs and actions developed in the school environment, seeking to increase consumption of fresh and minimally processed food, along with the adoption of healthy behaviors. OBJECTIVE: to analyze the consumption of healthy eating markers among adolescent students in Pelotas, Rio Grande do Sul, Brazil, in 2019. METHODS: this was a cross-sectional study carried out in schools taking part in the Health at School Program. Consumption of the five markers (beans, milk, fruit, cooked vegetables and raw salads) within five days prior to the study, obtained through a self-administered questionnaire, was defined as regular. Association between demographic, socioeconomic and behavioral variables and the outcomes was analyzed using Poisson regression. RESULTS: among the 797 respondents, 2.8% (95%CI 1.8;4.1) reported regular consumption. Beans were the most regularly consumed food (48.3%); fruit, cooked vegetables and raw salads were consumed regularly by less than 30% of the students. Doing physical activities, having breakfast and having meals with the family were associated with regular consumption of the foods assessed. CONCLUSION: regular consumption of healthy foods was low in this population, and was associated with behavioral factors.

Marcadores de alimentação saudável entre adolescentes da rede municipal de ensino de Pelotas, Rio Grande do Sul, 2019: estudo transversal / Healthy eating markers among adolescents from the municipal school system in Pelotas, Rio Grande do Sul, Brazil, 2019: a cross-sectional study / Marcadores de alimentación saludable entre adolescentes del sistema escolar municipal de Pelotas, Rio Grande do Sul, Brasil, 2019: estudio transversal

Objetivo: analisar o consumo de marcadores de alimentação saudável entre adolescentes escolares de Pelotas, Rio Grande do Sul, Brasil, em 2019. Métodos: estudo transversal, realizado nas escolas vinculadas ao Programa Saúde na Escola; o consumo dos cinco marcadores (feijão, leite, frutas, vegetais cozidos, saladas cruas) em até cinco dias antecedentes ao estudo, obtido mediante questionário autoaplicado, foi definido como regular; a associação de variáveis demográficas, socioeconômicas e comportamentais com os desfechos foi analisada por regressão de Poisson. Resultados: entre os 797 entrevistados, 2,8% (IC95% 1,8;4,1) referiram consumo regular; o feijão foi o alimento mais consumido regularmente (48,3%); frutas, vegetais cozidos e saladas cruas foram consumidos regularmente por menos de 30% dos escolares; praticar atividade física, tomar café da manhã e realizar refeições com a família estiveram associados ao consumo regular dos alimentos avaliados. Conclusão: o consumo regular de alimentos saudáveis, encontrado baixo nessa população, associou-se com fatores comportamentais.

Objective: to analyze the consumption of healthy eating markers among adolescent students in Pelotas, Rio Grande do Sul, Brazil, in 2019. Methods: this was a cross-sectional study carried out in schools taking part in the Health at School Program. Consumption of the five markers (beans, milk, fruit, cooked vegetables and raw salads) within five days prior to the study, obtained through a self-administered questionnaire, was defined as regular. Association between demographic, socioeconomic and behavioral variables and the outcomes was analyzed using Poisson regression. Results: among the 797 respondents, 2.8% (95%CI 1.8;4.1) reported regular consumption. Beans were the most regularly consumed food (48.3%); fruit, cooked vegetables and raw salads were consumed regularly by less than 30% of the students. Doing physical activities, having breakfast and having meals with the family were associated with regular consumption of the foods assessed. Conclusion: regular consumption of healthy foods was low in this population, and was associated with behavioral factors.

Objetivo: analizar el consumo de marcadores de alimentación saludable entre estudiantes adolescentes de Pelotas, Rio Grande do Sul, Brasil, en 2019. Métodos: estudio transversal realizado en escuelas vinculadas al Programa Salud en la Escuela. Se definió como regular el consumo de los cinco marcadores (porotos, leche, frutas, vegetales cocidos y ensaladas crudas) dentro de los cinco días previos al estudio, obtenidos a través de un cuestionario autoadministrado. La asociación entre variables demográficas, socioeconómicas y conductuales con los resultados se analizó mediante la regresión de Poisson. Resultados: entre los 797 encuestados, el 2,8% (IC95% 1,8; 4,1) informó un consumo regular. Los porotos fueron el alimento más consumido (48,3%). Frutas, verduras cocidas y ensaladas crudas fueron consumidas regularmente por menos del 30% de los estudiantes. La práctica de actividad física, el desayuno y las comidas en familia se asociaron con mayor consumo de los alimentos evaluados. Conclusión: el consumo regular de alimentos saludables fue bajo en esta población y se asoció con factores conductuales.

Diet quality among adolescents in the public education system in a municipality in Southern Brazil: a cross-sectional study, 2019. / Qualidade da dieta de adolescentes da rede pública de ensino de um município do sul do Brasil: estudo transversal, 2019.

OBJECTIVE: To identify the factors associated with the diet quality among 9th grade students in the municipal education system of Pelotas, state of Rio Grande do Sul, Brazil. METHODS: This was a cross-sectional study, conducted in 2019. Food information was collected using a food frequency questionnaire, and diet quality was assessed through an index developed by the authors. Diet was classified as low, intermediate or high quality. The association was assessed using multinomial logistic regression. RESULTS: The 808 adolescents evaluated obtained a mean score of 16.0 points (deviation-standard=4.1) according to the developed index. The high diet quality was associated with tobacco experimentation [odds ratio (OR) 2.92; 95% confidence interval (95%CI) 1.74;4.92] and leisure-time physical activity (OR=1.65; 95%CI 1.15;2.38). CONCLUSION: We highlighted the importance of encouraging physical activity practice, monitoring risk behaviors among adolescents and promoting the consumption of healthy food.

Quality of diet of adolescents from the public school system of a municipality in southern Brazil: a cross-sectional study, 2019 / Calidad de la dieta de los adolescentes del sistema de escuelas públicas de un municipio del sur de Brasil: estudio transversal, 2019 / Qualidade da dieta de adolescentes da rede pública de ensino de um município do sul do Brasil: estudo transversal, 2019

Objective: Identify factors associated with the quality of diet of 9th grade students from the municipal school system in Pelotas, Rio Grande do Sul. Methods: Cross-sectional study, carried out in 2019. Dietary information was adapted by the Food Frequency Form and the quality of diet evaluated by an index developed by the authors. Higher frequency of consumption of healthy foods considered higher scores, being lower when unhealthy. Total score, in tertiles, classified diet as low, intermediate and high quality. Association 4 was investigated using multinomial logistic regression. Results: The 808 adolescents evaluated had a mean of 16.0 points. High dietary quality was associated with tobacco experimentation [OR=2.92 ­ confidence interval of 95% (95%CI) 1,74;4,92] and the practice of leisure-time physical activity (OR=1.65 ­ 95%CI 1.15;2.38). Conclusion: The importance of encouraging the practice of physical activity, monitoring of risk behaviors in adolescents and promoting the consumption of healthy foods is highlighted.

Objetivo: Identificar factores asociados a calidad de la dieta de estudiantes de 9° ano del escuelas municipales de Pelotas, Rio Grande do Sul. Métodos: Estudio transversal, realizado en 2019. Información dietética se recopiló mediante Formulario de Frecuencia de Alimentos y calidad de dieta se evaluó mediante índice desarrollado. Mayor consumo de alimentos saludables recibió puntajes más altos, siendo menor cuando no es saludable. Puntuación total, en terciles, clasificó en calidad baja, intermedia y alta. Asociación se investigó mediante regresión logística multinomial. Resultados: Los 808 adolescentes evaluados tuvieron media de 16,0 puntos. La alta calidad de la dieta se asoció con experimentación del tabaco [OR=2,92; intervalo de confianza del 95% (IC95%) 1,74;4,92] y práctica de actividad física en el tiempo libre (OR=1,65 ­ IC95% 1,15;2,38). Conclusión: Se destaca la importancia de fomentar la práctica de actividad física, el seguimiento de conductas de riesgo en adolescentes y promover el consumo de alimentos saludables.

Objetivo: Identificar os fatores associados à qualidade da dieta de estudantes do nono ano da rede municipal de ensino de Pelotas, Rio Grande do Sul, Brasil. Métodos: Estudo transversal, realizado em 2019. As informações alimentares foram coletadas por formulário de frequência alimentar, e a qualidade da dieta avaliada mediante índice desenvolvido pelos autores. A dieta foi classificada como de baixa, intermediária ou alta qualidade. A associação foi avaliada por regressão logística multinomial. Resultados: Os 808 adolescentes avaliados obtiveram média de 16,0 pontos (desvio-padrão=4,1) no índice desenvolvido. A alta qualidade da dieta mostrou-se associada a experimentação de tabaco [razão de chances, ou odds ratio (OR) 2,92 ­ intervalo de confiança de 95% (IC95%) 1,74;4,92] e prática de atividade física no lazer (OR=1,65 ­ IC95% 1,15;2,38). Conclusão: Destaca-se a importância do incentivo à prática de atividade física, monitoramento de comportamentos de riscos nos adolescentes e promoção do consumo de alimentos considerados saudáveis.

Ultra-processed food and risk of type 2 diabetes: a systematic review and meta-analysis of longitudinal studies.

BACKGROUND: The consumption of some food groups is associated with the risk of diabetes. However, there is no evidence from meta-analysis which evaluates the consumption of ultra-processed products in the risk of diabetes. This study aimed to review the literature assessing longitudinally the association between consumption of ultra-processed food and the risk of type 2 diabetes and to quantify this risk through a meta-analysis. METHODS: We conducted a systematic review and meta-analysis with records from PubMed, Latin American and Caribbean Literature in Health Sciences (LILACS), Scielo, Scopus, Embase, and Web of Science. We included longitudinal studies assessing ultra-processed foods and the risk of type 2 diabetes. The review process was conducted independently by two reviewers. The Newcastle Ottawa scale assessed the quality of the studies. A meta-analysis was conducted to assess the effect of moderate and high consumption of ultra-processed food on the risk of diabetes. RESULTS: In total 2272 records were screened, of which 18 studies, including almost 1.1 million individuals, were included in this review and 72% showed a positive association between ultra-processed foods and the risk of diabetes. According to the studies included in the meta-analysis, compared with non-consumption, moderate intake of ultra-processed food increased the risk of diabetes by 12% [relative risk (RR): 1.12; 95% confidence interval (CI): 1.06-1.17, I2 = 24%], whereas high intake increased risk by 31% (RR: 1.31; 95% CI: 1.21-1.42, I2 = 60%). CONCLUSIONS: The consumption of ultra-processed foods increased the risk for type 2 diabetes as dose-response effect, with moderate to high credibility of evidence.

Omega-3 supplementation and diabetes: A systematic review and meta-analysis.

This study aimed to review the literature on studies that evaluated the effects of omega-3 supplementation on parameters of diabetes in humans. An online search was conducted in the following databases: Pubmed, LILACS, Scielo, Scopus, and Web of Science. It included experimental studies that investigated the effects of omega-3 supplementation for diabetes treatment or prevention and its relationship with fasting blood glucose, insulin resistance, and glycated hemoglobin. Observational, non-human studies and non-randomized clinical trials were excluded. The Cochrane scale assessed the quality of the studies. A meta-analysis was carried out to evaluate the effect of omega-3 on fasting blood glucose, insulin resistance, and glycated hemoglobin. Thirty studies were included in the review. Almost 70% (n = 20) demonstrated at least one significant effect of the omega-3 supplementation related to diabetes. In the meta-analysis, there was a significant effect on the reduction of fasting blood glucose [SMD: -0.48; CI95%: -0.76, -0.19; p = 0.01; I2 = 88%] and insulin resistance [SMD: -0.61; CI95%: -0.98, -0.24; p = 0.01; I2 = 90%]. For glycated hemoglobin, there was no significant effect in the meta-analysis. This systematic review with meta-analysis demonstrated that supplementation with omega-3 has protective effects on diabetes parameters.

Qualidade da dieta de adolescentes da rede pública de ensino de um município do sul do Brasil: estudo transversal, 2019 / Calidad de la dieta de los adolescentes del sistema de escuelas públicas de un municipio del sur de Brasil: estudio transversal, 2019 / Diet quality among adolescents in the public education system in a municipality in Southern Brazil: a cross-sectional study, 2019

Objetivo: Identificar os fatores associados à qualidade da dieta de estudantes do 9º ano da rede municipal de ensino de Pelotas, Rio Grande do Sul, Brasil. Métodos: Estudo transversal, realizado em 2019. As informações alimentares foram coletadas por formulário de frequência alimentar, e a qualidade da dieta foi avaliada mediante índice desenvolvido pelos autores. A dieta foi classificada como de baixa, intermediária ou alta qualidade. A associação foi avaliada por regressão logística multinomial. Resultados: Os 808 adolescentes avaliados obtiveram média de 16,0 pontos (desvio-padrão=4,1) no índice desenvolvido. A alta qualidade da dieta mostrou-se associada a experimentação de tabaco [razão de chances, ou odds ratio (OR) 2,92; intervalo de confiança de 95% (IC95%) 1,74;4,92] e prática de atividade física no lazer (OR=1,65; IC95% 1,15;2,38). Conclusão: Destaca-se a importância do incentivo à prática de atividade física, monitoramento de comportamentos de riscos nos adolescentes e promoção do consumo de alimentos considerados saudáveis.

Objetivo: Identificar factores asociados a calidad de la dieta de estudiantes de 9º ano de escuelas municipales de Pelotas, Rio Grande do Sul. Métodos: Estudio transversal, realizado en 2019. La información dietética se recopiló mediante Formulario de Frecuencia de Alimentos y la calidad de la dieta se evaluó mediante índice desarrollado por los autores. La dieta fue clasificada como de baja, intermedia o de alta calidad. La asociación se investigó mediante regresión logística multinomial. Resultados: Los 808 adolescentes evaluados tuvieron en media 16,0 puntos (desvío-estándar=4,1) en el índice desarrollado. La alta calidad de la dieta se asoció con experimentación de tabaco [OR=2,92; intervalo de confianza del 95% (IC95%) 1,74;4,92] y práctica de actividad física en el tiempo libre (OR=1,65; IC95% 1,15;2,38). Conclusión: Se destaca la importancia de fomentar la práctica de actividad física, el seguimiento de conductas de riesgo en adolescentes y promover el consumo de alimentos saludables.

Objective:To identify the factors associated with the diet quality among 9th grade students in the municipal education system of Pelotas, state of Rio Grande do Sul, Brazil. Methods: This was a cross-sectional study, conducted in 2019. Food information was collected using a food frequency questionnaire, and diet quality was assessed through an index developed by the authors. Diet was classified as low, intermediate or high quality. The association was assessed using multinomial logistic regression. Results:The 808 adolescents evaluated obtained a mean score of 16.0 points (deviation-standard=4.1) according to the developed index. The high diet quality was associated with tobacco experimentation [odds ratio (OR) 2.92; 95% confidence interval (95%CI) 1.74;4.92] and leisure-time physical activity (OR=1.65; 95%CI 1.15;2.38). Conclusion: We highlighted the importance of encouraging physical activity practice, monitoring risk behaviors among adolescents and promoting the consumption of healthy food.

What is the effect of resveratrol on obesity? A systematic review and meta-analysis.

BACKGROUND & AIMS: Obesity is increasing worldwide. Resveratrol appears as a substance capable of helping with weight loss. This study aimed to investigate the resveratrol effect in the treatment of obesity in general population. METHODS: An online search was conducted in the following databases: Pubmed, LILACS, Scielo, Scopus and Web of Science. Experimental studies that investigated the effects between resveratrol supplementation for weight loss treatment, as well as its relationship with overweight and obesity were included. Observational and non-human studies were excluded. The Cochrane scale was used to assess the quality of the studies. RESULTS: Nineteen studies were included, of which only three demonstrated some type of positive effect. In the meta-analysis, there was no significant effect on weight loss [SMD: 0.03; CI95%: -0,44, 0,49; p = 0,01; I2 = 82%], and body mass index (BMI) [SMD: 0.01; CI95%: -0,39, 0,41; p = 0,01; I2 = 72%]. A small effect was found on the waist circumference [SMD: -1.04; CI95%: -1,86, -0,27; p = 0,01; I2 = 87%]. CONCLUSION: This systematic review with meta-analysis demonstrated that supplementation with resveratrol does not have an anti-obesity effect.

Epidemiology of interleukin-6: the 30-year follow-up of the 1982 Pelotas (Brazil) birth cohort study.

BACKGROUND: Cardiovascular diseases are the main cause of death globally. Interleukin-6 (IL-6) is a biomarker of cardiovascular risk. AIM: To investigate factors associated with IL-6 concentration in serum, from early life up to 30 years of age. SUBJECTS AND METHODS: In the 2012-2013 follow-up, IL-6 was measured in 2809 participants of the 1982 Pelotas Birth Cohort (1369 males). Multivariable linear regressions, stratified by sex, were performed to evaluate the associations of African ancestry, family income and maternal education at birth, monthly income and education at 30 years, smoking status, harmful alcohol intake, physical activity, and body composition with IL-6, considering a conceptual hierarchical framework. RESULTS: Males with low educational levels and current smokers had the highest mean IL-6. Among females, African ancestry and low monthly income were associated with the highest mean values for the outcome. Physical activity had an inverse association with IL-6 concentration among females. A direct relationship was observed between the measures of adiposity on IL-6, in both sexes. CONCLUSION: Body composition was the main predictor for the outcome evaluated in males and females. Thus, the avoidance of overweight remains an important strategy for the prevention and control of cardiovascular risk and biomarkers associated with these diseases.

Food processing and cardiometabolic risk factors: a systematic review.

OBJECTIVE To systematically review the evidence for the association between food consumption according to processing and cardiometabolic factors in adults and/or the elderly. METHOD Two independent evaluators analyzed the electronic databases PubMed, Web of Science and Lilacs until December 2018. We used the following terms: (convenience foods OR food processing OR highly-processed OR industrialized foods OR minimally-processed OR prepared foods OR processed foods OR ultra-processed OR ultraprocessed OR ultra processed OR unprocessed) AND (metabolic syndrome OR hypertension OR blood pressure OR diabetes mellitus OR glucose OR glycaemia OR insulin OR cholesterol OR triglycerides OR blood lipids OR overweight OR obesity) AND (adult OR adults OR adulthood OR aged OR elderly OR old). We assessed methodological and evidence qualities, and also extracted information for the qualitative synthesis from the selected studies. RESULTS Of the 6,423 studies identified after removing duplicates, eleven met the eligibility criteria. The main food classification we used was Nova. The consumption of ultra-processed foods was positively associated with overweight and obesity, high blood pressure and metabolic syndrome. All articles included met more than 50% of the methodological quality criteria. The quality of evidence was considered moderate for the outcome overweight and obesity and weak for hypertension and metabolic syndrome. CONCLUSIONS The Nova food classification stands out in the area of nutritional epidemiology when assessing the effects of food processing on health outcomes. Although caution is required in the interpretation, the results indicated that the consumption of ultra-processed foods can have an unfavorable impact in the health of individuals.

Food processing and cardiometabolic risk factors: a systematic review / Processamento de alimentos e fatores de risco cardiometabólicos: revisão sistemática

ABSTRACT OBJECTIVE To systematically review the evidence for the association between food consumption according to processing and cardiometabolic factors in adults and/or the elderly. METHOD Two independent evaluators analyzed the electronic databases PubMed, Web of Science and Lilacs until December 2018. We used the following terms: (convenience foods OR food processing OR highly-processed OR industrialized foods OR minimally-processed OR prepared foods OR processed foods OR ultra-processed OR ultraprocessed OR ultra processed OR unprocessed) AND (metabolic syndrome OR hypertension OR blood pressure OR diabetes mellitus OR glucose OR glycaemia OR insulin OR cholesterol OR triglycerides OR blood lipids OR overweight OR obesity) AND (adult OR adults OR adulthood OR aged OR elderly OR old). We assessed methodological and evidence qualities, and also extracted information for the qualitative synthesis from the selected studies. RESULTS Of the 6,423 studies identified after removing duplicates, eleven met the eligibility criteria. The main food classification we used was Nova. The consumption of ultra-processed foods was positively associated with overweight and obesity, high blood pressure and metabolic syndrome. All articles included met more than 50% of the methodological quality criteria. The quality of evidence was considered moderate for the outcome overweight and obesity and weak for hypertension and metabolic syndrome. CONCLUSIONS The Nova food classification stands out in the area of nutritional epidemiology when assessing the effects of food processing on health outcomes. Although caution is required in the interpretation, the results indicated that the consumption of ultra-processed foods can have an unfavorable impact in the health of individuals.

RESUMO OBJETIVO Revisar sistematicamente as evidências da associação entre consumo de alimentos de acordo com o processamento e fatores cardiometabólicos em adultos e idosos. MÉTODOS Dois avaliadores independentes analisaram as bases de dados eletrônicas PubMed, Web of Science e Lilacs até dezembro de 2018. Os seguintes termos foram utilizados: (convenience foods OR food processing OR highly-processed OR industrialized foods OR minimally-processed OR prepared foods OR processed foods OR ultra-processed OR ultraprocessed OR ultra processed OR unprocessed) AND (metabolic syndrome OR hypertension OR blood pressure OR diabetes mellitus OR glucose OR glycaemia OR insulin OR cholesterol OR triglycerides OR blood lipids OR overweight OR obesity) AND (adult OR adults OR adulthood OR aged OR elderly OR old). Nos estudos incluídos foram avaliadas as qualidades metodológica e de evidência, além de extraídas informações para a síntese qualitativa. RESULTADOS Dos 6.423 estudos identificados após a remoção das duplicatas, onze preencheram os critérios de elegibilidade. A principal classificação de alimentos utilizada foi a Nova. O consumo de alimentos ultraprocessados foi positivamente associado com excesso de peso e obesidade, hipertensão arterial e síndrome metabólica. Todos os artigos incluídos preencheram mais de 50% dos critérios de qualidade metodológica. A qualidade de evidência foi considerada moderada para o desfecho excesso de peso e obesidade e fraca para hipertensão arterial e síndrome metabólica. CONCLUSÕES A classificação de alimentos Nova se destaca na área da epidemiologia nutricional ao avaliar os efeitos do processamento de alimentos sobre desfechos em saúde. Embora seja necessária prudência na interpretação, os resultados indicam que o consumo de alimentos ultraprocessados pode ter impacto desfavorável sobre a saúde dos indivíduos.

The community health worker as interlocutor in complementary feeding in Pelotas, Rio Grande do Sul, Brazil. / O agente comunitário de saúde como interlocutor da alimentação complementar em Pelotas, RS, Brasil.

This paper evaluates the knowledge of community health workers in complementary feeding and their association with sociodemographic characteristics, work routines and describes the resources available in primary care facilities to master this topic. We applied questionnaires to the responsible for health services and to community health workers, the latter consisting of a knowledge test that allowed the calculation of scores according to the number of correct answers in multiple-choice questions. There was a positive association with age, length of service, home visits to children under 24 months, providing guidance or seeking information about complementary feeding with the knowledge in feeding in the first 24 months of life. There were discrepant responses by health services and the community health workers regarding training, government materials and child growth monitoring. Greater mastery was noted in breastfeeding in relation to complementary feeding. Therefore, primary care facilities should provide support and resources to increase knowledge in complementary feeding through training and access to government materials.

Este artigo avalia o conhecimento dos agentes comunitários de saúde em alimentação complementar e sua associação com características sociodemográficas, rotinas de trabalho e descreve os recursos disponíveis nas unidades básicas de saúde para que tenham domínio neste tema. Foi aplicado um questionário ao responsável do serviço de saúde e outro aos agentes comunitários de saúde, este último composto pelo teste de conhecimento que permitiu o cálculo de escores conforme o número de acertos em questões de múltipla escolha. Houve associação positiva com idade, tempo de profissão, visitas domiciliares a crianças com até 24 meses, realizar orientações e buscar informações sobre alimentação complementar com o conhecimento em alimentação nos primeiros 24 meses de vida. Evidenciou-se desacordo entre as respostas do serviço de saúde e dos agentes comunitários de saúde quanto a treinamentos, materiais governamentais e acompanhamento do crescimento infantil. Verificou-se maior domínio em aleitamento materno em relação à alimentação complementar, portanto, a unidade básica de saúde deve oferecer respaldo e recursos que ampliem o conhecimento em alimentação complementar, mediante treinamentos e acesso facilitado aos materiais governamentais.

O agente comunitário de saúde como interlocutor da alimentação complementar em Pelotas, RS, Brasil / The community health worker as interlocutor in complementary feeding in Pelotas, Rio Grande do Sul, Brazil

Resumo Este artigo avalia o conhecimento dos agentes comunitários de saúde em alimentação complementar e sua associação com características sociodemográficas, rotinas de trabalho e descreve os recursos disponíveis nas unidades básicas de saúde para que tenham domínio neste tema. Foi aplicado um questionário ao responsável do serviço de saúde e outro aos agentes comunitários de saúde, este último composto pelo teste de conhecimento que permitiu o cálculo de escores conforme o número de acertos em questões de múltipla escolha. Houve associação positiva com idade, tempo de profissão, visitas domiciliares a crianças com até 24 meses, realizar orientações e buscar informações sobre alimentação complementar com o conhecimento em alimentação nos primeiros 24 meses de vida. Evidenciou-se desacordo entre as respostas do serviço de saúde e dos agentes comunitários de saúde quanto a treinamentos, materiais governamentais e acompanhamento do crescimento infantil. Verificou-se maior domínio em aleitamento materno em relação à alimentação complementar, portanto, a unidade básica de saúde deve oferecer respaldo e recursos que ampliem o conhecimento em alimentação complementar, mediante treinamentos e acesso facilitado aos materiais governamentais.

Abstract This paper evaluates the knowledge of community health workers in complementary feeding and their association with sociodemographic characteristics, work routines and describes the resources available in primary care facilities to master this topic. We applied questionnaires to the responsible for health services and to community health workers, the latter consisting of a knowledge test that allowed the calculation of scores according to the number of correct answers in multiple-choice questions. There was a positive association with age, length of service, home visits to children under 24 months, providing guidance or seeking information about complementary feeding with the knowledge in feeding in the first 24 months of life. There were discrepant responses by health services and the community health workers regarding training, government materials and child growth monitoring. Greater mastery was noted in breastfeeding in relation to complementary feeding. Therefore, primary care facilities should provide support and resources to increase knowledge in complementary feeding through training and access to government materials.

Self-perceived health among adult and elderly users of Primary Health Care. / Autopercepção da saúde entre adultos e idosos usuários da Atenção Básica de Saúde.

A cross-sectional study was conducted with 1,246 adults and senior men and women in Pelotas (RS), Brasil to evaluate the negative self-perception of health among Primary Health Care users. The prevalence of negative self-perception of health was reported by 41.6% of respondents. Women, those who were unemployed, who reported a diagnosis of three or more chronic noncommunicable diseases, who were food insecure and did not engage in physical activity reported a higher proportion of negative self-perceived health. Users with at least higher education level and those whose households had four or more residents were less predisposed to the outcome. The high prevalence of negative self-perceived health in this population, as well as the associations found, indicate the need for a better understanding of the influence of these factors on the search for care and, consequently, on adherence to treatment.

Com o objetivo de avaliar a autopercepção negativa da saúde entre usuários da atenção básica de saúde, foi realizado um estudo transversal com 1246 adultos e idosos, de ambos os sexos, em Pelotas, RS. A prevalência da autopercepção negativa da saúde foi referida por 41,6% dos entrevistados. As mulheres, aqueles que não estavam trabalhando, que referiram diagnóstico de três ou mais doenças crônicas não transmissíveis, que estavam em insegurança alimentar e não praticavam atividade física relataram em maior proporção, a autopercepção negativa da saúde. Enquanto que os usuários com no mínimo o ensino superior e aqueles cujos domicílios tinham quatro ou mais moradores foram menos predispostos ao desfecho. A elevada prevalência de autopercepção negativa da saúde nessa população, bem como as associações encontradas, indicam a necessidade de maior entendimento sobre a influência desses fatores na procura pelo atendimento e, consequentemente, na adesão ao tratamento.

Autopercepção da saúde entre adultos e idosos usuários da Atenção Básica de Saúde / Self-perceived health among adult and elderly users of Primary Health Care

Resumo Com o objetivo de avaliar a autopercepção negativa da saúde entre usuários da atenção básica de saúde, foi realizado um estudo transversal com 1246 adultos e idosos, de ambos os sexos, em Pelotas, RS. A prevalência da autopercepção negativa da saúde foi referida por 41,6% dos entrevistados. As mulheres, aqueles que não estavam trabalhando, que referiram diagnóstico de três ou mais doenças crônicas não transmissíveis, que estavam em insegurança alimentar e não praticavam atividade física relataram em maior proporção, a autopercepção negativa da saúde. Enquanto que os usuários com no mínimo o ensino superior e aqueles cujos domicílios tinham quatro ou mais moradores foram menos predispostos ao desfecho. A elevada prevalência de autopercepção negativa da saúde nessa população, bem como as associações encontradas, indicam a necessidade de maior entendimento sobre a influência desses fatores na procura pelo atendimento e, consequentemente, na adesão ao tratamento.

Abstract A cross-sectional study was conducted with 1,246 adults and senior men and women in Pelotas (RS), Brasil to evaluate the negative self-perception of health among Primary Health Care users. The prevalence of negative self-perception of health was reported by 41.6% of respondents. Women, those who were unemployed, who reported a diagnosis of three or more chronic noncommunicable diseases, who were food insecure and did not engage in physical activity reported a higher proportion of negative self-perceived health. Users with at least higher education level and those whose households had four or more residents were less predisposed to the outcome. The high prevalence of negative self-perceived health in this population, as well as the associations found, indicate the need for a better understanding of the influence of these factors on the search for care and, consequently, on adherence to treatment.

Reception of nutrition information by adult and older adult users of Primary Healthcare: Occurrence, associated factors, and sources of information / Informações sobre nutrição entre adultos e idosos usuários da Atenção Primária de Saúde: ocorrência, fatores associados e fontes de informação

ABSTRACT Objective: To investigate reception of nutrition information (outcome), associated factors, and types of sources. Methods: This cross-sectional study, conducted in 2013, included 1,246 adult and older adult users of the Primary Healthcare network of Pelotas, Rio Grande do Sul, Brazil. The sample was characterized by reception of nutrition information, its sources, and demographic, socioeconomic, health, knowledge, and life habit variables. Prevalence ratios and their respective 95% confidence intervals investigated associations between reception of nutrition information and independent variables. Results: More than one-third of the sample (37.6%) received nutrition information (95%CI=34.9-40.3). Older adults, individuals with positive self-perceived diet, those who received health information, and those who were physically active were more likely to receive nutrition information, and normal weight individuals were less likely. The outcome differed by income strata, being highest in the highest quintile. There was a linear trend for education level and for following the Ten Steps to Healthy Eating: the outcome was more likely in individuals with at least higher education and those who followed at least four steps. The most cited sources of nutrition information were television shows (56.2%), other (46.2%), physician (41.2%), Internet (25.1%), and family members (20.9%), which did not differ by sex. Conclusion: Primary healthcare users received little nutrition information, and television could be a useful tool for the institutions responsible for the sector to disseminate the official nutritional recommendations.

RESUMO Objetivo: Investigar o recebimento de informações sobre nutrição, fatores associados e tipos de fontes. Métodos: Estudo transversal, realizado em 2013, com 1.246 adultos e idosos usuários da Atenção Primária de Saúde de Pelotas, Rio Grande do Sul. A amostra foi caracterizada quanto ao recebimento de informações sobre nutrição, suas fontes, e variáveis demográficas, socioeconômicas, de saúde, de conhecimento e de hábitos de vida. A associação das variáveis independentes com o recebimento de informações sobre nutrição foi verificada por meio das razões de prevalências e seus intervalos de confiança. Resultados: A prevalência do recebimento de informações sobre nutrição foi de 37,6% (IC95=34,9-40,3) e a probabilidade de sua ocorrência foi maior entre idosos, entre aqueles com autopercepção positiva da alimentação, que recebiam informações sobre saúde e fisicamente ativos e, menor entre eutróficos. Observaram-se diferenças entre estratos de renda, sendo a probabilidade do desfecho maior no quintil mais elevado. Verificou-se tendência linear para escolaridade e seguimento dos 10 Passos da Alimentação Saudável, sendo a probabilidade do desfecho maior entre usuários com no mínimo ensino superior e entre os que seguiam no mínimo 4 passos. Quanto às fontes de informações sobre nutrição, as mais citadas foram programa de televisão (56,2%), outra (46,2%), médico (41,2%), Internet (25,1%) e familiares (20,9%) e não foram observadas diferenças conforme o sexo. Conclusão: Os usuários da Atenção Primária de Saúde pouco recebiam informações sobre nutrição e, fazer uso da televisão como ferramenta para divulgar as recomendações alimentares oficiais, poderia ser útil às instituições responsáveis pelo setor.

Change in body weight and body image in young adults: a longitudinal study.

BACKGROUND: The goal of this study was to identify the effect of the change in body mass index (BMI) from childhood to adulthood on body image satisfaction at 23 years of age in members of the 1982 Pelotas Birth Cohort in Pelotas, RS, Brazil. METHODS: The study used data from the 1986 and 2004-5 follow-up studies. Body shape satisfaction was evaluated using the Stunkard scale. Body shape dissatisfaction was defined as the difference between the figures chosen for the current and ideal body size. BMI z-score changes were calculated as the difference between z-score values at 4 and 23 years of age, using the population internal z-score as standard. The analysis was stratified by sex, and multinomial logistic regression was used in crude and adjusted analyses. RESULTS: A total of 1963 men and 1739 women were analyzed. The mean age of the participants in 2004-5 was 22.7 years. Of the participants exhibiting increased BMI z-scores, 17% perceived themselves as thinner than ideal, whereas 48% perceived themselves as fatter than ideal. The prevalence of dissatisfaction was higher in women because they perceived themselves as fatter than ideal on the three categories of z-score change (≥ + 0.5 sd; -0.49 to + 0.49 sd and ≤ -0.5 sd); 81% of women exhibiting an increased BMI z-score reported dissatisfaction. The analysis adjusted for confounding factors revealed that women with increased BMI z-scores were less prone to feel thinner than ideal. Additionally, the increased risk of dissatisfaction due to perceiving oneself as fatter than ideal was similar between men and women (RRR = 3.52 95% CI: 2.17 to 4.56 and RRR = 4.08 95% CI: 3.00 to 5.56, respectively) using -0.49 to +0.49 sd as the reference category. CONCLUSIONS: Individuals exhibiting increased BMI z-scores between 4 and 23 years of age reported higher risks of body dissatisfaction at 23 years of age. This finding is important because body dissatisfaction can cause psychological, social, self-esteem problems, and well-being.