Consumption of ultra-processed foods and mental health of pregnant women from the South of Brazil.

The objective of this study is to evaluate the association between the consumption of ultra-processed foods (UPF) and the mental health of pregnant women from the South of Brazil. This is a cross-sectional study carried out in Criciúma, Brazil, through face-to-face interviews, from April to December 2022. Pregnant women aged 18 or older who underwent prenatal care in the 48 Basic Health Units of the municipality and who were in their third trimester of pregnancy were included. High consumption of UPF was considered as 6 or more items or subgroups of UPF consumed on the day before the interview, using the Nova-UPF screener. The mental health variables were depressive symptoms, stress, sadness, and anxiety. Crude and adjusted analyses were conducted using the Fisher's exact test and the Poisson regression with robust variance. In total, 428 pregnant women were studied; most of them were aged between 20 and 25 years and were white. Pregnant women who presented high consumption of UPF were 1.42-fold (95%CI 1.06;1.92) more likely to experience anxiety and presented a prevalence 56% (95%CI 1.18;2.07) higher of stress when compared to those who did not present high consumption of UPF. The prevalence of depressive symptoms and feelings of sadness was 1.31-fold (95%CI 1.08;1.60) and 3.41-fold (95%CI 1.77;6.58) higher among those with high consumption of UPF, respectively. The results suggest that diet quality is associated with the mental health of pregnant women. Promoting joint actions focused on food and nutritional education for pregnant women, as well as mental health, is necessary.

Inequalities in the use of health services in a municipality in Southern Brazil in 2019: a cross-sectional study.

OBJECTIVE: to assess inequalities in the use of health services in a municipality in Southern Brazil. METHODS: This was a population-based cross-sectional study conducted with adults living in the urban area of the municipality of Criciúma, state of Santa Catarina, Brazil, between March and December 2019; the research outcomes were medical consultation, dental visit, nutritional counseling and the use of the Brazilian National Health System (Sistema Único de Saúde - SUS); the exposures were age, schooling and income; inequalities were analyzed using the Slope index of inequality and equiplots. RESULTS: A total of 820 individuals were studied; medical consultation was higher (14.2 percentage points [p.p.]), and dental visit was lower (-29.5 p.p.), in older adults, when compared to young people; dental visit (41.1 p.p.) and nutritional counseling (18.0 p.p.) were higher in individuals with higher level of education, when compared to those with lower level of education; the use of SUS was higher in older adults (21.3 p.p.), with lower level of education (-61.2 p.p.) and lower income (-51.6 p.p.), when compared to their peers. CONCLUSION: in order to develop public policies, these inequalities should be taken into consideration.

Casos de HIV/AIDS durante uma década em uma cidade na região metropolitana de Porto Alegre (RS) / Cases of HIV/AIDS during a decade in a municipality in the metropolitan region of Porto Alegre, state of Rio Grande do Sul

Identificar as prevalências de HIV/AIDS em uma cidade da região metropolitana de Porto Alegre (RS) e descrever características dos indivíduos infectados. Estudo descritivo em Sapucaia do Sul com dados do Sistema de Informação de Agravos de Notificação (SINAN) de 2009 a 2018. Foram incluídas notificações de indivíduos com idade igual ou superior a 13 anos, e excluídas aquelas com preenchimento inadequado e gestantes. Tendência temporal dos casos de HIV/AIDS foi apresentada por frequência absoluta e características sociodemográficas por frequências absoluta e relativa. Foram notificados 832 casos de HIV/AIDS no município, dos quais 43,4% correspondentes à AIDS. Durante o período avaliado, a notificação de HIV aumentou 4.000%, e a de AIDS, 230%, com predominância no sexo masculino, adultos jovens, brancos e com ensino fundamental incompleto. Os resultados são relevantes no âmbito da saúde coletiva, pois contribuem para nortear e fortalecer estratégias de combate e controle da doença.

To identify HIV/AIDS prevalences in a city from the metropolitan region of Porto Alegre (RS) and describe the infected individuals' characteristics. Descriptive study in Sapucaia do Sul with data from Notifiable Diseases Information System between 2009 and 2018. Notifications from individuals aged 13 years and over were included, and observations with inadequate completion and pregnant women were excluded. Temporal trend from HIV/AIDS cases was presented through absolute frequency and sociodemographic characteristics through absolute and relative frequencies.832 cases of HIV/AIDS cases were reported in the city and 43.4% of which corresponded to AIDS. During the evaluated period, an increase of 4.000% in the notification of HIV, and of 230% of AIDS was identified, with a predominance of males, young adults, white, and with incomplete primary education. These results are extremely relevant in the public health field as they can help to guide and strengthen strategies to combat and control the disease.

Household food insecurity before and during COVID-19 pandemic and its association with perceived stress: population-based studies.

The growing prevalence of food insecurity observed in the last years, has been favored by the COVID-19 pandemic, leading to mental health issues, such as stress. We aim to analyze the prevalence of household food insecurity before and during the COVID-19 pandemic and its association with perceived stress. We analyzed data from two population-based studies conducted in 2019 and 2020-2021 in the municipality of Criciúma, State of Santa Catarina, Southern Brazil. Food insecurity and perceived stress were assessed with the Brazilian Food Insecurity Scale and the Perceived Stress Scale. The covariables were sex, age, skin color, schooling level, income, job status, marital status, household crowding, overweight, and diet quality. Crude and adjusted associations between food insecurity and perceived stress were assessed using Poisson regression. A total of 1,683 adult individuals were assessed. Prevalence of food insecurity was 25.8% in 2019, decreasing to 21.6% in 2020. Prevalence of perceived stress was about 38% for both years. Before the pandemic, food insecurity increased the prevalence of perceived stress by 29% (PR = 1.29; 95%CI: 1.02; 1.63), but no association was found during COVID-19. We found a worrying prevalence of food insecurity before and after de pandemic, nonetheless food insecurity and perceived stress were associated only in 2019. An assessment of these aspects after COVID-19 is needed to ensure basic life rights for all.

Insegurança alimentar domiciliar em um município do sul do Brasil: estudo de base populacional / Household food insecurity in a city from southern Brazil: a population-based study

Introdução: A insegurança alimentar (IA) é caracterizada pela falta de acesso a alimentos em quantidade e qualidade adequadas. Nos últimos anos, uma tendência de crescimento em sua prevalência vem sendo observada, e fatores sociodemográficos parecem influenciar a IA. Objetivo: Verificar a prevalência de IA e seus fatores associados em domicílios de um município do sul de Santa Catarina. Métodos: Estudo transversal de base populacional, conduzido em Criciúma-SC em 2019, com indivíduos com ≥18 anos. Todos os domicílios nos quais o chefe da família (indivíduo que contribuía com a maior parte da renda domiciliar) participou da pesquisa foram incluídos nas análises. A IA domiciliar foi avaliada através da Escala Brasileira de Insegurança Alimentar, e características sociodemográficas e alimentares foram avaliadas como variáveis independentes. Para avaliar as associaçõesentre IA e as variáveis independentes, foram realizadas análises ajustadas utilizando-se Regressão de Poisson, considerando nível de significância de 5%. Resultados: Participaram do estudo 439 domicílios e 562 indivíduos. A prevalência de IA foi de 25,8%, sendo maior nos domicílios com: moradores entre 18 e 29 anos (RP=1,72; IC95%1,08-2,76) e entre 30 e 39 anos (RP=2,02; IC95%1,35-3,03),de cor parda (RP=1,47; IC95% 1,01-2,13), menores de 18 anos de idade (RP=1,70; IC95% 1,16;2,47),e que realizavam 1-2 refeições diárias (RP=2,29; IC95% 1,15-4,60), todos comparados com seus pares. Ademais, a renda apresentou tendência linear inversa com a IA, isto é, conforme a diminuição da renda, maior a prevalência de IA domiciliar (<0,001). Conclusão: Um em cada quatro domicílios apresenta IA,sendo esse desfecho influenciado por fatores demográficos, socioeconômicos e nutricionais. Diante desses achados, será possível direcionar as ações e políticas públicas para agarantia da alimentação adequada à população.

Introduction: Food insecurity (FI) is characterized by the lack of access to food in adequate quantity and quality. In recent years, there has been an upward trend in FI, and sociodemographic factors seem to influence it. Objective: To verify the prevalence of FI and its associated factors in households in a municipality in southern Santa Catarina. Methods: Population-based cross-sectional study, conducted in Criciúma-SC in 2019, with individuals aged ≥18 years. The analysis included all families in which the head of the household (individual who contributed most of the household income) participated in the research. The Brazilian food insecurity scale assessed the household FI, and sociodemographic and food characteristics were evaluated as independent variables. The study performed adjusted analyses using Poisson regression, considering a significance level of 5% to evaluate the associations between FI and the independent variables. Results: Four hundred and thirty-nine households and five hundred and sixty-two individuals participated in the study. The prevalence of FI was 25.8%, being higher in households with residents between 18 and 29 years of age (PR=1.72; 95% CI 1.08-2.76) and between 30 and 39 years of age (PR=2.02; 95% CI 1.35-3.03), mixed race (PR=1.47; 95% CI 1.01-2.13), under 18 years of age (PR=1.70; 95% CI 1.16;2.47), and who ate 1-2 meals daily (PR=2.29; 95% CI 1.15-4.60), all compared with their peers. In addition, income showed an inverse linear trend with FI, which means that as income decreases, the prevalence of home FI increases (<0.001). Conclusion: One in four households is FI, and demographic, socioeconomic, and nutritional factors influence this outcome. Given these findings, it will be possible to direct public actions and policies to ensure adequate food for the population.

Effect of lingual frenotomy on the breastfeeding improvement

To evaluate breastfeeding in babies up to six months of age before and after frenotomy surgery in a reference hospital in a city from Santa Catarina state. Methods: An observational quality improvement study, carried out with babies up to six months of age undergoing frenotomy and their mothers in a reference hospital in southern Santa Catarina state. A questionnaire was applied to the mothers in two moments (before and after the surgery), with information regarding breastfeeding, sociodemographic, anthropometric and behavioral characteristics of them and of the babies. Descriptive analyzes were performed and the association between breastfeeding and the independent variables was assessed through Pearson's chi-square and Fisher's exact tests, using a 5% significance level. Results: A total of 74 children were studied, with 48 of them returning after surgery. 83.8% were breastfed before surgery and 64.9% after surgery. Before surgery, 58.1% of children effectively took the breast at once. After surgery, this prevalence was 83.3% (p=0.015). Before surgery, 75.9% of the mothers reported not feeling pain, while, after surgery, almost all of them (95.8%) reported this (p=0.004). Most mothers reported improvement in grip (83.3%), increase in the duration of breastfeeding (69.0%), improvement of baby's breathing (75.0%), and an increase in the frequency of breastfeeding (51.7%). Conclusions: There was a decrease in the prevalence of breastfeeding after frenotomy. However, there was an improvement in the babies 'grip and breathing and a reduction in the mothers' pain when breastfeeding. It is emphasized the need to implement multidisciplinary actions in both primary and hospital care to assist mothers in order to prolong the duration of exclusive breastfeeding

Household food insecurity before and during COVID-19 pandemic and its association with perceived stress: population-based studies / Insegurança alimentar domiciliar antes e durante a pandemia da COVID-19 e sua associação com o estresse percebido: estudos de base populacional / Inseguridad alimentaria de los hogares antes y durante la pandemia de COVID-19 y su asociación con el estrés percibido: estudios basados en la población

The growing prevalence of food insecurity observed in the last years, has been favored by the COVID-19 pandemic, leading to mental health issues, such as stress. We aim to analyze the prevalence of household food insecurity before and during the COVID-19 pandemic and its association with perceived stress. We analyzed data from two population-based studies conducted in 2019 and 2020-2021 in the municipality of Criciúma, State of Santa Catarina, Southern Brazil. Food insecurity and perceived stress were assessed with the Brazilian Food Insecurity Scale and the Perceived Stress Scale. The covariables were sex, age, skin color, schooling level, income, job status, marital status, household crowding, overweight, and diet quality. Crude and adjusted associations between food insecurity and perceived stress were assessed using Poisson regression. A total of 1,683 adult individuals were assessed. Prevalence of food insecurity was 25.8% in 2019, decreasing to 21.6% in 2020. Prevalence of perceived stress was about 38% for both years. Before the pandemic, food insecurity increased the prevalence of perceived stress by 29% (PR = 1.29; 95%CI: 1.02; 1.63), but no association was found during COVID-19. We found a worrying prevalence of food insecurity before and after de pandemic, nonetheless food insecurity and perceived stress were associated only in 2019. An assessment of these aspects after COVID-19 is needed to ensure basic life rights for all.

A pandemia da COVID-19 favoreceu a tendência crescente de insegurança alimentar observada nos últimos anos, causando consequências na saúde mental, como o estresse. Nosso objetivo foi analisar a prevalência de insegurança alimentar domiciliar antes e durante a pandemia da COVID-19 e a sua associação com o estresse percebido. Analisamos dados de dois estudos de base populacional conduzidos em 2019 e 2020 a 2021 com adultos em Criciúma, Estado de Santa Catarina, Sul do Brasil. A insegurança alimentar e o estresse percebido foram avaliados usando a Escala Brasileira de Insegurança Alimentar e da Escala de Estresse Percebido. As covariáveis foram sexo, idade, raça, escolaridade, renda, situação profissional, estado civil, aglomeração domiciliar, excesso de peso e qualidade da dieta. Associações brutas e ajustadas entre insegurança alimentar e estresse percebido foram avaliadas usando a regressão de Poisson. Foram avaliados 1.683 indivíduos. A prevalência de insegurança alimentar foi de 25,8% em 2019, diminuindo para 21,6% em 2020. A prevalência de estresse percebido foi de aproximadamente 38% nos dois anos. Antes da pandemia, a insegurança alimentar aumentava a prevalência de estresse percebido em 29% (RP = 1,29; IC95%: 1,02; 1,63), mas nenhuma associação foi encontrada durante a pandemia da COVID-19. Identificamos uma prevalência preocupante de insegurança alimentar antes e depois da pandemia, no entanto, a insegurança alimentar e o estresse percebido foram associados apenas em 2019. Uma avaliação desses aspectos após a pandemia da COVID-19 é necessária para garantir direitos básicos de vida para todos.

La creciente tendencia a la inseguridad alimentaria observada en los últimos años se ha visto favorecida por la pandemia de COVID-19, provocando consecuencias en la salud mental, tales como el estrés. Nuestro objetivo fue analizar la prevalencia de inseguridad alimentaria en el hogar antes y durante la pandemia de COVID-19 y su asociación con el estrés percibido. Analizamos datos de dos estudios poblacionales realizados en 2019 y 2020-2021 con adultos en Criciúma, Santa Catarina, Sur de Brasil. La inseguridad alimentaria y el estrés percibido se evaluaron con la Escala Brasileña de Inseguridad Alimentaria y la Escala de Estrés Percibido. Las covariables fueron sexo, edad, color de piel, escolaridad, ingresos, situación laboral, estado civil, hacinamiento en el hogar, sobrepeso y calidad de la dieta. Las asociaciones crudas y ajustadas entre la inseguridad alimentaria y el estrés percibido se evaluaron mediante regresión de Poisson. Se evaluó a un total de 1.683 personas. La prevalencia de la inseguridad alimentaria fue del 25,8% en 2019, disminuyendo al 21,6% en 2020. La prevalencia del estrés percibido fue de alrededor del 38% en ambos años. Antes de la pandemia, la inseguridad alimentaria aumentaba la prevalencia del estrés percibido en un 29% (RP = 1,29; IC95%: 1,02; 1,63), pero no se encontró ninguna asociación con COVID-19. Encontramos una prevalencia preocupante de inseguridad alimentaria antes y después de la pandemia, aunque la inseguridad alimentaria y el estrés percibido solo se asociaron en 2019. Es necesaria una evaluación de estos aspectos después del COVID-19 para garantizar los derechos básicos vitales para todos.

Desigualdades no uso dos serviços de saúde em um município no Sul do Brasil em 2019: estudo transversal / Inequalities in the use of health services in a municipality in Southern Brazil in 2019: a cross-sectional study / Desigualdades en el uso de los servicios de salud en un municipio del Sur de Brasil en 2019: estudio transversal

Objective: to assess inequalities in the use of health services in a municipality in Southern Brazil. Methods: This was a population-based cross-sectional study conducted with adults living in the urban area of the municipality of Criciúma, state of Santa Catarina, Brazil, between March and December 2019; the research outcomes were medical consultation, dental visit, nutritional counseling and the use of the Brazilian National Health System (Sistema Único de Saúde − SUS); the exposures were age, schooling and income; inequalities were analyzed using the Slope index of inequality and equiplots. Results: A total of 820 individuals were studied; medical consultation was higher (14.2 percentage points [p.p.]), and dental visit was lower (-29.5 p.p.), in older adults, when compared to young people; dental visit (41.1 p.p.) and nutritional counseling (18.0 p.p.) were higher in individuals with higher level of education, when compared to those with lower level of education; the use of SUS was higher in older adults (21.3 p.p.), with lower level of education (-61.2 p.p.) and lower income (-51.6 p.p.), when compared to their peers. Conclusion: in order to develop public policies, these inequalities should be taken into consideration.

Objetivo: Evaluar desigualdades en el uso de los servicios de salud en un municipio del sur de Brasil. Métodos: Estudio transversal de base poblacional con adultos residentes en área urbana de la ciudad de Criciúma, estado de Santa Catarina, Brasil, entre marzo y diciembre de 2019. Variables de resultado fueron citas médicas y dentales, consejería nutricional y uso del Sistema Único de Salud (Sistema Único de Saúde − SUS). Exposiciones fueron edad, educación, ingreso. Desigualdad se presentó por Índice de desigualdad de la pendiente y gráficos equiplots. Resultados: Se estudiaron 820 individuos. Cita médica fue mayor (14.2 puntos porcentuales [p.p.]) y cita dental menor (-29,5 p.p.) en ancianos, en comparación con jóvenes. Cita dental (41,1 p.p.) y consejería nutricional (18,0 p.p.) fueron mayores en más educados en comparación con menos educados. Uso del SUS fue mayor en ancianos (21,3 p.p.), menos educados (-61,2 p.p.) y con menores ingresos (-51,6 p.p.) en comparación con sus pares. Conclusiones: Desigualdades evidenciadas demuestran que políticas públicas deben considerarlas en su desarrollo.

Objetivo: avaliar desigualdades no uso dos serviços de saúde em um município do Sul do Brasil. Métodos: estudo transversal de base populacional com adultos residentes na área urbana do município de Criciúma, no estado de Santa Catarina, Brasil, entre março e dezembro de 2019; desfechos do estudo foram consulta médica, consulta odontológica, orientação nutricional e uso do Sistema Único de Saúde (SUS); exposições foram idade, escolaridade e renda; desigualdades foram analisadas pelo índice absoluto de desigualdade e gráficos equiplots. Resultados: foram incluídos 820 indivíduos; realização de consulta médica foi maior (14,2 pontos percentuais [p.p.]), e de consulta odontológica, menor (-29,5 p.p.), em idosos, comparados a jovens; realização de consulta odontológica (41,1 p.p.) e orientação nutricional (18,0 p.p.) foi maior nos mais escolarizados, comparados aos menos escolarizados; uso do SUS foi maior em idosos (21,3 p.p.), menos escolarizados (-61,2 p.p.) e com menor renda (-51,6 p.p.), comparados a seus pares. Conclusão: para seu desenvolvimento, as políticas públicas devem considerar essas desigualdades.

Sleep disorders are associated with both morning temporal and jaw pain among adults and elderly: a population-based study in Brazil / Distúrbios do sono estão associados à dor temporal matinal e à dor na mandíbula em adultos e idosos: um estudo de base populacional

Objective Purpose: To assess the influence of sleep disorders on temporal and jaw pain in the morning in adults and elderly people. Methods: Population-based study with representative individuals aged 18 years or over. Individuals were selected using a multistage sampling procedure. The outcomes of morning jaw pain and morning temporal pain were assessed. Sleep bruxism, obstructive sleep apnea, and sleep quality were evaluated as exposure variables. Adjusted analysis was conducted using Poisson regression. All analysis was sex stratified. Results: 820 individuals were studied. Female with sleep bruxism were 1.37 times more likely to have morning temporal pain (p=0.041). Male and female with bruxism had a prevalence 160% and 97%, respectively, higher of morning jaw pain (male: p=0.003; female: p<0.001). Women with obstructive sleep apnea were 1.52 times more likely to have morning temporal pain (p=0.023). Men with poor sleep quality had a prevalence 190% higher of morning temporal pain (p=0.005). Conclusion: Morning craniofacial pain is more frequent in individuals with sleep disorders, and there are differences between sexes. Since more than one sleep disorder can be present in the same individual, studies that adjust the analyses for possible confounders are important to avoiding possible overlap between them.

RESUMO Objetivo: Avaliar a influência dos distúrbios do sono nas dores temporais e mandibulares pela manhã em adultos e idosos. Métodos: Estudo de base populacional realizado com uma amostra representativa de indivíduos com 18 anos ou mais. Os participantes foram selecionados por meio de um processo amostral com múltiplos estágios. Os desfechos avaliados foram a dor matinal na mandíbula e a dor temporal matinal. Apneia obstrutiva do sono, bruxismo do sono e qualidade do sono foram as variáveis de exposição avaliadas. Análise ajustada foi realizada através da Regressão de Poisson e todas as análises foram estratificadas por sexo. Resultados: Foram estudados 820 indivíduos. Mulheres com bruxismo do sono tiveram 1,37 vezes mais chance de ter dor temporal matinal (p=0,041). Homens e mulheres com bruxismo tiveram uma prevalência 160% e 97%, respectivamente, maior de dor matinal na mandíbula (homens: p=0,003; mulheres: p<0,001). Mulheres com apneia obstrutiva do sono tiveram 1,52 vezes mais chance de ter dor temporal matinal (p=0,023). Homens com má qualidade do sono tiveram prevalência 190% maior de dor temporal matinal (p=0,005). Conclusão: Dor craniofacial matinal é mais frequente em indivíduos com distúrbios do sono e há diferenças entre os sexos. Uma vez que mais de um distúrbio do sono pode estar presente no mesmo indivíduo, estudos que ajustem as análises para possíveis confundidores são importantes para evitar uma possível sobreposição entre eles.

Associação entre o consumo de alimentos ultraprocessados e a composição corporal de adolescentes / Association between ultraprocessed food consumption and body composition of adolescents / Asociación entre el consume de alimentos ultraprocesados y la composición corporal de los adolescentes

O processo de transição nutricional vem elevando o consumo de alimentos ultraprocessados na população. Esses alimentos apresentam alta densidade energética e baixas propriedades nutricionais, afetando o estado nutricional e a composição corporal, inclusive dos adolescentes. Este trabalho visa avaliar a associação entre o consumo de alimentos ultraprocessados e a composição corporal de adolescentes. Este é um estudo transversal, realizado com adolescentes matriculados em uma instituição filantrópica de ensino. Foram coletados dados sociodemográficos, antropométricos e de consumo de alimentos ultraprocessados. Foi realizada uma análise de associação entre o consumo regular de alimentos ultraprocessados e o excesso de peso, por meio do teste qui-quadrado de Pearson, com nível de significância de 5%. Para as análises estatísticas, foi utilizado o programa IBM SPSS versão 22.0. Cerca de um terço da amostra apresentava excesso de peso (índice de massa corporal: 27,2%; pregas cutâneas: 33,9%; bioimpedância: 29,6%). O consumo regular de alimentos ultraprocessados esteve presente em 64,2% da amostra e foi associado ao excesso de peso avaliado pela bioimpedância (p = 0,016) e pelas pregas cutâneas (p = 0,008). Os indivíduos que apresentaram maior prevalência de excesso de peso não consumiam regularmente alimentos ultraprocessados. Destaca-se a necessidade de realização de outros estudos, principalmente longitudinais, para avaliar e compreender a associação entre o consumo de alimentos ultraprocessados e a composição corporal dos adolescentes.

The nutritional transition has been increasing the consumption of ultraprocessed foods in the population. These foods have high energy and low nutritional properties, affecting the nutritional status and body composition, including of adolescents. This study aims to evaluate the association between ultraprocessed food consumption and body composition in adolescents. This is a cross sectional study carried out with adolescents enrolled in a philanthropic education institution. Sociodemographic, anthropometric, and ultraprocessed food consumption data were collected. An analysis of association between regular ultraprocessed food consumption and overweight was performed using Pearson's Chi-square test, with a significance level of 5%. The program IBM SPSS version 22.0 was used for statistical analyzes. About one-third of the sample was overweight (body mass index: 27.2%; skin folds: 33.9%; bioimpedance: 29.6%). Regular ultraprocessed food consumption was found in 64.2% of the sample and was associated with overweight assessed by bioimpedance (p = 0.016) and skin folds (p = 0.008). The individuals who had higher prevalence of overweight did not consume ultraprocessed food regularly. Carrying out other studies, especially longitudinal studies, to evaluate and understand how the association between ultraprocessed food intake and body composition occurs in adolescents is necessary.

El proceso de transición nutricional ha incrementado el consumo de alimentos ultraprocesados en la población. Estos alimentos tienen alta densidad energética y bajas propriedades nutricionales, afectando el estado nutricional y la composición corporal, incluso de los adolescentes. Este trabajo pretende evaluar la asociación entre el consumo de alimentos ultraprocesados y la composición corporal de adolescentes. Este es un estudio transversal realizado con adolescentes matriculados en una institución educativa filantrópica. Se recogieron datos sociodemográficos, antropométricos y de consumo de alimentos ultraprocesados. El análisis de la asociación entre el consumo regular de los ultraprocesados y el exceso de peso se realizó mediante la prueba de chi-cuadrado de Pearson, con nivel de significancia del 5%. Para el análisis estadístico se utilizó el programa IBM SPSS, versión 22.0. Casi un tercio de la muestra tenía exceso de peso (índice de masa corporal: 27,2%; pliegues cutáneos: 33,9%; bioimpedancia: 29,6%). El consumo habitual de alimentos ultraprocesados estuvo presente en el 64,2% de la muestra y se asoció con el exceso de peso evaluado por bioimpedancia (p=0,016) y pliegues cutáneos (p=0,008). Las personas que tenían una mayor prevalencia de exceso de peso no consumían regularmente alimentos ultraprocesados. Se necesitan más estudios, principalmente longitudinales, para evaluar y comprender la asociación entre el consumo de los ultraprocesados y la composición corporal en adolescentes.

[Influence of sleep and chrononutrition on hypertension and diabetes: a population-based study]. / Influência do sono e da crononutrição na hipertensão e diabetes: um estudo de base populacional.

The objective is to evaluate the influence of sleep and chrononutrition on hypertension and diabetes in the adult population (18 years or older) in a municipality in Southern Brazil. This is a population-based cross-sectional study, developed in Criciúma, State of Santa Catarina, in 2019. The exposure variables were sleep duration and quality, and two of the main aspects of chrononutrition, the number of daily meals and the presence of breakfast. The outcomes studied were diabetes mellitus and systemic arterial hypertension. Crude and adjusted Poisson regression with robust variance was used to evaluate the associations between exposures and outcomes. For all analyses, the effect of the sample design was considered, and the significance level adopted was 5%. In total, 820 patients were evaluated. The prevalence of diabetes and hypertension was of 19.9% and 44.1%, respectively. Individuals with worse sleep quality had a higher prevalence of 33% for diabetes and 17% for hypertension, compared to those with good quality of sleep. Those who had four or more meals per day had a 16% lower prevalence of hypertension, when compared to those who had less than four meals. We concluded that the quality of sleep and the number of daily meals, a feeding behavior related to chrononutrition, were related to hypertension and diabetes. These results highlight the importance of public health actions that address new strategies for coping with these diseases focused on sleep quality and chrononutrition.

O objetivo foi avaliar a influência do sono e da crononutrição na hipertensão e diabetes na população adulta (18 anos ou mais) em um município do Sul do Brasil. Trata-se de um estudo transversal de base populacional, desenvolvido em Criciúma, Santa Catarina, em 2019. As variáveis de exposição foram duração e qualidade do sono, e dois dos principais aspectos da crononutrição, o número de refeições diárias e a realização do café da manhã. Os desfechos estudados foram diabetes mellitus e hipertensão arterial sistêmica. Regressão de Poisson bruta e ajustada com variância robusta foi utilizada para avaliar as associações entre as exposições e os desfechos. Para todas as análises, considerou-se o efeito do desenho amostral, e o nível de significância utilizado foi de 5%. Foram estudados 820 indivíduos. As prevalências de diabetes e hipertensão foram 19,9% e 44,1%, respectivamente. Indivíduos com pior qualidade do sono tiveram prevalência 33% maior de diabetes e 17% maior de hipertensão, comparados àqueles com boa qualidade do sono. Os que realizaram quatro ou mais refeições ao dia apresentaram prevalência 16% menor de hipertensão quando comparados aos que fizeram menos de quatro refeições. Conclui-se que a qualidade do sono e o número de refeições diárias, um comportamento alimentar relacionado à crononutrição, estiveram relacionados à hipertensão e ao diabetes. Tais resultados destacam a importância de ações de saúde pública que abordem novas estratégias para o enfrentamento dessas doenças, voltadas à qualidade do sono e à crononutrição.

El objetivo fue evaluar la influencia del sueño y la crononutrición sobre la hipertensión arterial y la diabetes en la población adulta (18 años o más) en un municipio del Sur de Brasil. Se trata de un estudio transversal de base poblacional, desarrollado en Criciúma, Santa Catarina, en el 2019. Las variables de exposición fueron la duración y la calidad del sueño, y dos de los principales aspectos de la crononutrición, el número de comidas diarias y el consumo de desayuno. Los desenlaces estudiados fueron la diabetes mellitus e la hipertensión arterial sistémica. Se utilizó la regresión de Poisson cruda y ajustada con varianza robusta para evaluar las asociaciones entre las exposiciones y los desenlaces. Para todos los análisis, se consideró el efecto del diseño de la muestra y el nivel de significación utilizado fue del 5%. Se estudiaron 820 individuos. Las prevalencias de diabetes e hipertensión fueron de 19,9% y del 44,1%, respectivamente. Las personas con peor calidad del sueño tuvieron una prevalencia de diabetes un 33% mayor y una prevalencia de hipertensión un 17% mayor, en comparación con las personas con una buena calidad del sueño. Los que efectuaron cuatro o más comidas al día presentaron una prevalencia de hipertensión un 16% menor en comparación con los que efectuaron menos de cuatro comidas. Se concluye que la calidad del sueño y el número de comidas diarias, una conducta alimentaria relacionada con la crononutrición, están relacionados con la hipertensión arterial y la diabetes. Estos resultados destacan la importancia de acciones de salud pública que aborden nuevas estrategias de enfrentamiento a estas enfermedades, centradas en la calidad del sueño y en la crononutrición.

Perfil dos usuários e atendimento das Unidades Básicas de Saúde do município de Criciúma (SC) / Profile of users and services of Basic Health Units in the municipality of Criciúma (SC) / Perfil de usuarios y atención de unidades básicas de salud en el municipio de Criciúma (SC)

O objetivo deste estudo foi avaliar as características dos usuários e dos atendimentos realizados nas Unidades Básicas de Saúde do município de Criciúma/SC. Foram avaliados todos atendimentos realizados no ano de 2018, através da coleta de dados secundários no sistema de informação em saúde (CELK Saúde) do município. As variáveis analisadas foram: idade, sexo, escolaridade, situação de moradia, encaminhamentos realizados à atenção secundária, classificação e tipos de atendimentos registrados durante as consultas e os principais procedimentos executados. Foram realizadas análises descritivas das variáveis estudadas, com a apresentação das frequências absolutas e relativas. Dentre os 452.605 atendimentos avaliados, observou-se que 64,57% dos atendimentos foram realizados pelo sexo feminino e pelos indivíduos com 60 anos ou mais. A maior prevalência de atendimentos foi na classificação saúde mental. Em relação aos tipos de atendimento, notou-se predominância de consulta médica em todos os distritos. Quanto aos encaminhados realizados à atenção secundária, os mais prevalentes foram a oftalmologia e a ortopedia. Os resultados encontrados neste estudo podem orientar os gestores em saúde no desenvolvimento de estratégias e alternativas de intervenções efetivas na atenção básica, melhorando a qualidade e otimizando os serviços públicos ofertados.

The aim of this study was to evaluate the characteristics of users and services provided at Basic Health Units in the municipality of Criciúma/SC. All consultations performed in 2018 were evaluated, through the collection of secondary data in the health information system (CELK Saúde) of the municipality. The following variables were analyzed: age, sex, education, housing situation, referrals to secondary care, classification and types of care recorded during consultations and the main procedures performed. Among the 452,605 consultations evaluated, it was observed that 64.57% of the visits were made by females and by individuals aged 60 or older. The highest prevalence of appointments was in mental health classification. Regarding the types of care, there was a predominance of medical appointments in all districts. As for those referred to secondary care, the most prevalent were ophthalmology and orthopedics. The results found in this study can guide health managers in the municipality, in developing strategies and alternatives for effective interventions in primary care, improving quality and optimizing the public services offered.

El objetivo de este estudio fue evaluar las características de los usuarios y la atención realizada en las Unidades Básicas de Salud del municipio de Criciúma/SC. Toda la atención brindada en 2018 fue evaluada a través de la recolección de datos secundarios en el sistema de información de salud (CELK Saúde) del municipio. Las variables analizadas fueron: edad, sexo, escolaridad, situación habitacional, derivaciones a atención secundaria, clasificación y tipos de atención registrados durante las consultas y los principales procedimientos realizados. Se realizaron análisis descriptivos de las variables estudiadas, con la presentación de frecuencias absolutas y relativas. Entre las 452.605 visitas evaluadas, se observó que el 64,57% de las visitas fueron realizadas por mujeres e individuos de 60 años o más. La mayor prevalencia de atención fue en la clasificación de salud mental. En cuanto a los tipos de atención, hubo un predominio de la consulta médica en todos los distritos. En cuanto a los referidos a cuidados secundarios, los más prevalentes fueron oftalmología y ortopedia. Los resultados encontrados en este estudio pueden orientar a los gestores sanitarios en el desarrollo de estrategias y alternativas para intervenciones eficaces en atención primaria, mejorando la calidad y optimizando los servicios públicos ofrecidos.

[Inequalities in risk behaviors for chronic noncommunicable diseases: Vigitel, 2019]. / Desigualdades nos comportamentos de risco para doenças crônicas não transmissíveis: Vigitel, 2019.

This study analyzes the economic, racial, and geographic inequalities in risk behaviors for chronic non-communicable diseases of Brazilian adults. This is a cross-sectional study conducted with data from the 2019 Vigitel (Risk and Protective Factors Surveillance System for Chronic Noncomunicable Diseases Through Telephone Interview). The analyzed risk behaviors were smoking, alcohol abuse, physical inactivity, overweight, regular consumption of soft drinks or artificial juice drinks, and non-regular consumption of fruits, legumes, and vegetables. Inequalities in risk behaviors were assessed considering Brazilian's schooling level and their dwelling region, via the slope index of inequality (SII). Equiplots graphs were also built to better illustrate the inequalities. Stata svy command was used for all analyses due to the complexity of the sampling process. In total, 52,395 patients were evaluated. Significant inequalities in risk behaviors for chronic non-communicable diseases were observed: most risk behaviors were concentrated in those with low schooling. Smoking and soft drinks consumption were more observed in the Southern region of Brazil. Public policies are necessary to reduce the inequalities found, allowing for improvement in health indicators of the Brazilian population.

O objetivo foi analisar as desigualdades econômica, racial e geográfica nos comportamentos de risco para doenças crônicas não transmissíveis dos adultos brasileiros. Estudo transversal realizado com os dados do Vigitel (Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico) de 2019. Os comportamentos de risco analisados foram tabagismo, consumo abusivo de álcool, inatividade física, excesso de peso, consumo regular de refrigerante ou suco artificial e consumo não regular de frutas, legumes e verduras. As desigualdades nos comportamentos de risco foram avaliadas considerando escolaridade e macrorregião de moradia dos brasileiros, por meio do índice de desigualdade absoluta (slope index of inequality - SII). Gráficos equiplots também foram construídos para melhor ilustrar as desigualdades. Para todas as análises, foi utilizado o comando svy do Stata devido à complexidade do processo amostral. Foram avaliados 52.395 indivíduos. Desigualdades importantes nos comportamentos de risco para doenças crônicas não transmissíveis foram observadas: ter baixa escolaridade concentrou a grande maioria dos comportamentos de risco. Tabagismo e consumo de refrigerante foram mais observados na Macrorregião Sul do país. São necessárias políticas públicas que visem reduzir as desigualdades encontradas, permitindo a melhoria nos indicadores de saúde da população brasileira.

El objetivo fue analizar las desigualdades económicas, raciales y geográficas en los comportamientos de riesgo sobre las enfermedades crónicas no transmisibles entre los adultos brasileños. Estudio transversal, realizado con los datos de Vigitel (Vigilancia de Factores de Riesgo y Protección para Enfermedades Crónicas No Transmisibles por Entrevista Telefónica) 2019. Los comportamientos de riesgo analizados fueron el tabaquismo, el abuso del alcohol, la inactividad física, el sobrepeso, el consumo habitual de refrescos o zumos artificiales y el consumo no habitual de frutas, verduras y legumbres. Las desigualdades en los comportamientos de riesgo se evaluaron teniendo en cuenta la educación y el macrorregión de residencia de los brasileños, mediante el índice de inequidad absoluto (slope index of inequality - SII). También se construyeron gráficos equiplot para ilustrar mejor las desigualdades. Para todos los análisis, se utilizó el comando svy de Stata debido a la complejidad del proceso de muestreo. Se evaluó a un total de 52.395 personas. Se observaron importantes desigualdades en los comportamientos de riesgo para las enfermedades crónicas no transmisibles: tener un bajo nivel educativo concentró la gran mayoría de los comportamientos de riesgo. El tabaquismo y el consumo de refrescos se observaron más en la región Sur del país. Se necesitan políticas públicas para reducir las desigualdades encontradas, permitiendo la mejora de los indicadores de salud de la población brasileña.

Fear of Covid-19 and health-related outcomes: results from two Brazilian population-based studies.

Fear is a reaction that can influence multiple aspects of health and life. During the Covid-19 pandemic, there have been serious pathophysiological, social, behavioral and mental consequences that can be related to fear. This study aimed to assess the fear of Covid-19 and its association with sociodemographic, behavioral and health variables. Data were gathered from two cross-sectional population-based studies conducted in 2020 with adults from two cities from Southern Brazil. The Fear of Covid-19 scale was used to evaluate fear of Covid. Exposure variables were socioeconomic, demographic, health and pandemic-related factors. Adjusted Poisson regression was performed to assess the association between fear of Covid-19 and the exposure variables. A total of 2,152 subjects were assessed. Higher fear of Covid-19 was found among women and in individuals with symptoms of Covid-19. Living alone, being richer, and testing positive for Covid-19 were associated with lower prevalence of fear. Higher prevalence of fear of Covid-19 was related to worse sleep quality, worse health perception, sadness, higher stress, depressive symptoms, and suicidal ideation. There was a linear association between fear of Covid-19 and health outcomes. The results provide evidence that fear of Covid-19 seems to be associated with socioeconomic, demographic, health and pandemic-related factors.

Relationship between sleep duration and quality and mental health before and during COVID-19 pandemic: Results of population-based studies in Brazil.

OBJECTIVE: This study aimed to evaluate the association between sleep duration and quality and mental health before and amid the COVID-19 pandemic. METHODS: Data from two population-based cross-sectional studies conducted in 2019 and 2020 with adults in Criciúma, Southern Brazil. The Patient Health Questionnaire-9 (PHQ-9) was used to screen major depressive episodes, while the perceived stress scale was used to assess perceived stress. Sleep was evaluated through self-reported duration and quality. Crude and adjusted Poisson regression models were used to assess the association between sleep and mental health disorders. RESULTS: A total of 820 (in 2019) and 863 subjects (in 2020) were assessed. Sleep quality presented significant associations with depression and stress in both years, and the magnitude of the association with depression increased amid COVID-19 pandemic. In individuals with poor/very poor sleep quality, the risk of depression in 2019 was 2.14 (95%IC 1.48;3.09) higher when compared to those with good/very good sleep quality. This risk increased to 2.26 (95%IC 1.49;3.40) in 2020. The risk of stress was 1.90 (95%IC 1.42;2.55) in 2019 and 1.66 (95%IC1.34;2.07) in 2020. The sleep duration was not associated with mental health disorders in the adjusted analyses. CONCLUSION: The results provide important evidence that sleep quality can influence mental health of adults. The COVID-19 pandemic seems to have had a considerable impact on this association.

Alcohol Consumption and Smoking During Covid-19 Pandemic: Association with Sociodemographic, Behavioral, and Mental Health Characteristics.

The Covid-19 pandemic is related to increased alcohol consumption and smoking. These behaviors may be related to several sociodemographic, behavioral and mental health factors. Thus, the aim of this study was to assess the association between alcohol consumption and cigarette smoking with sociodemographic, behavioral and mental health characteristics. This study used data from two population-based studies conducted in two cities from Southern Brazil amid the Covid-19 pandemic. Individuals aged 18 years or older were included and selected using a multistage sampling procedure. Alcohol consumption and smoking and changes in such consumption during the Covid-19 pandemic were evaluated. Sociodemographic, behavioral, pandemic-related, and mental health variables were also included. A hierarchical model was used to conduct the adjusted analyses, and Poisson regression with robust adjustment was used for variance. A total of 2170 individuals were studied. The prevalence of alcohol consumption and smoking were 9.3% and 14.2%, respectively. The rates of increase in alcohol consumption and smoking during the Covid-pandemic were about 20% and 30%, respectively. They were higher among those with depressive symptoms, feeling of sadness and self-reported stress. Those with poor diet quality had higher prevalence of alcohol consumption (PR: 1.82) and were 1.58 times more likely to smoke. The findings may help stakeholders in health and political systems to better understand the consequences of the Covid-19 pandemic and develop strategies to mitigate these consequences in Brazil and elsewhere.

Desigualdades nos comportamentos de risco para doenças crônicas não transmissíveis: Vigitel, 2019 / Inequalities in risk behaviors for chronic noncommunicable diseases: Vigitel, 2019 / Desigualdades en los comportamientos de riesgo sobre las enfermedades crónicas no transmisibles: Vigitel, 2019

O objetivo foi analisar as desigualdades econômica, racial e geográfica nos comportamentos de risco para doenças crônicas não transmissíveis dos adultos brasileiros. Estudo transversal realizado com os dados do Vigitel (Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico) de 2019. Os comportamentos de risco analisados foram tabagismo, consumo abusivo de álcool, inatividade física, excesso de peso, consumo regular de refrigerante ou suco artificial e consumo não regular de frutas, legumes e verduras. As desigualdades nos comportamentos de risco foram avaliadas considerando escolaridade e macrorregião de moradia dos brasileiros, por meio do índice de desigualdade absoluta (slope index of inequality - SII). Gráficos equiplots também foram construídos para melhor ilustrar as desigualdades. Para todas as análises, foi utilizado o comando svy do Stata devido à complexidade do processo amostral. Foram avaliados 52.395 indivíduos. Desigualdades importantes nos comportamentos de risco para doenças crônicas não transmissíveis foram observadas: ter baixa escolaridade concentrou a grande maioria dos comportamentos de risco. Tabagismo e consumo de refrigerante foram mais observados na Macrorregião Sul do país. São necessárias políticas públicas que visem reduzir as desigualdades encontradas, permitindo a melhoria nos indicadores de saúde da população brasileira.

This study analyzes the economic, racial, and geographic inequalities in risk behaviors for chronic non-communicable diseases of Brazilian adults. This is a cross-sectional study conducted with data from the 2019 Vigitel (Risk and Protective Factors Surveillance System for Chronic Noncomunicable Diseases Through Telephone Interview). The analyzed risk behaviors were smoking, alcohol abuse, physical inactivity, overweight, regular consumption of soft drinks or artificial juice drinks, and non-regular consumption of fruits, legumes, and vegetables. Inequalities in risk behaviors were assessed considering Brazilian's schooling level and their dwelling region, via the slope index of inequality (SII). Equiplots graphs were also built to better illustrate the inequalities. Stata svy command was used for all analyses due to the complexity of the sampling process. In total, 52,395 patients were evaluated. Significant inequalities in risk behaviors for chronic non-communicable diseases were observed: most risk behaviors were concentrated in those with low schooling. Smoking and soft drinks consumption were more observed in the Southern region of Brazil. Public policies are necessary to reduce the inequalities found, allowing for improvement in health indicators of the Brazilian population.

El objetivo fue analizar las desigualdades económicas, raciales y geográficas en los comportamientos de riesgo sobre las enfermedades crónicas no transmisibles entre los adultos brasileños. Estudio transversal, realizado con los datos de Vigitel (Vigilancia de Factores de Riesgo y Protección para Enfermedades Crónicas No Transmisibles por Entrevista Telefónica) 2019. Los comportamientos de riesgo analizados fueron el tabaquismo, el abuso del alcohol, la inactividad física, el sobrepeso, el consumo habitual de refrescos o zumos artificiales y el consumo no habitual de frutas, verduras y legumbres. Las desigualdades en los comportamientos de riesgo se evaluaron teniendo en cuenta la educación y el macrorregión de residencia de los brasileños, mediante el índice de inequidad absoluto (slope index of inequality - SII). También se construyeron gráficos equiplot para ilustrar mejor las desigualdades. Para todos los análisis, se utilizó el comando svy de Stata debido a la complejidad del proceso de muestreo. Se evaluó a un total de 52.395 personas. Se observaron importantes desigualdades en los comportamientos de riesgo para las enfermedades crónicas no transmisibles: tener un bajo nivel educativo concentró la gran mayoría de los comportamientos de riesgo. El tabaquismo y el consumo de refrescos se observaron más en la región Sur del país. Se necesitan políticas públicas para reducir las desigualdades encontradas, permitiendo la mejora de los indicadores de salud de la población brasileña.

Influência do sono e da crononutrição na hipertensão e diabetes: um estudo de base populacional / Influence of sleep and chrononutrition on hypertension and diabetes: a population-based study / Influencia del sueño y de la crononutrición en la hipertensión y la diabetes: un estudio de base poblacional

O objetivo foi avaliar a influência do sono e da crononutrição na hipertensão e diabetes na população adulta (18 anos ou mais) em um município do Sul do Brasil. Trata-se de um estudo transversal de base populacional, desenvolvido em Criciúma, Santa Catarina, em 2019. As variáveis de exposição foram duração e qualidade do sono, e dois dos principais aspectos da crononutrição, o número de refeições diárias e a realização do café da manhã. Os desfechos estudados foram diabetes mellitus e hipertensão arterial sistêmica. Regressão de Poisson bruta e ajustada com variância robusta foi utilizada para avaliar as associações entre as exposições e os desfechos. Para todas as análises, considerou-se o efeito do desenho amostral, e o nível de significância utilizado foi de 5%. Foram estudados 820 indivíduos. As prevalências de diabetes e hipertensão foram 19,9% e 44,1%, respectivamente. Indivíduos com pior qualidade do sono tiveram prevalência 33% maior de diabetes e 17% maior de hipertensão, comparados àqueles com boa qualidade do sono. Os que realizaram quatro ou mais refeições ao dia apresentaram prevalência 16% menor de hipertensão quando comparados aos que fizeram menos de quatro refeições. Conclui-se que a qualidade do sono e o número de refeições diárias, um comportamento alimentar relacionado à crononutrição, estiveram relacionados à hipertensão e ao diabetes. Tais resultados destacam a importância de ações de saúde pública que abordem novas estratégias para o enfrentamento dessas doenças, voltadas à qualidade do sono e à crononutrição.

The objective is to evaluate the influence of sleep and chrononutrition on hypertension and diabetes in the adult population (18 years or older) in a municipality in Southern Brazil. This is a population-based cross-sectional study, developed in Criciúma, State of Santa Catarina, in 2019. The exposure variables were sleep duration and quality, and two of the main aspects of chrononutrition, the number of daily meals and the presence of breakfast. The outcomes studied were diabetes mellitus and systemic arterial hypertension. Crude and adjusted Poisson regression with robust variance was used to evaluate the associations between exposures and outcomes. For all analyses, the effect of the sample design was considered, and the significance level adopted was 5%. In total, 820 patients were evaluated. The prevalence of diabetes and hypertension was of 19.9% and 44.1%, respectively. Individuals with worse sleep quality had a higher prevalence of 33% for diabetes and 17% for hypertension, compared to those with good quality of sleep. Those who had four or more meals per day had a 16% lower prevalence of hypertension, when compared to those who had less than four meals. We concluded that the quality of sleep and the number of daily meals, a feeding behavior related to chrononutrition, were related to hypertension and diabetes. These results highlight the importance of public health actions that address new strategies for coping with these diseases focused on sleep quality and chrononutrition.

El objetivo fue evaluar la influencia del sueño y la crononutrición sobre la hipertensión arterial y la diabetes en la población adulta (18 años o más) en un municipio del Sur de Brasil. Se trata de un estudio transversal de base poblacional, desarrollado en Criciúma, Santa Catarina, en el 2019. Las variables de exposición fueron la duración y la calidad del sueño, y dos de los principales aspectos de la crononutrición, el número de comidas diarias y el consumo de desayuno. Los desenlaces estudiados fueron la diabetes mellitus e la hipertensión arterial sistémica. Se utilizó la regresión de Poisson cruda y ajustada con varianza robusta para evaluar las asociaciones entre las exposiciones y los desenlaces. Para todos los análisis, se consideró el efecto del diseño de la muestra y el nivel de significación utilizado fue del 5%. Se estudiaron 820 individuos. Las prevalencias de diabetes e hipertensión fueron de 19,9% y del 44,1%, respectivamente. Las personas con peor calidad del sueño tuvieron una prevalencia de diabetes un 33% mayor y una prevalencia de hipertensión un 17% mayor, en comparación con las personas con una buena calidad del sueño. Los que efectuaron cuatro o más comidas al día presentaron una prevalencia de hipertensión un 16% menor en comparación con los que efectuaron menos de cuatro comidas. Se concluye que la calidad del sueño y el número de comidas diarias, una conducta alimentaria relacionada con la crononutrición, están relacionados con la hipertensión arterial y la diabetes. Estos resultados destacan la importancia de acciones de salud pública que aborden nuevas estrategias de enfrentamiento a estas enfermedades, centradas en la calidad del sueño y en la crononutrición.

Double Burden of Malnutrition and Inequalities in the Nutritional Status of Adults: A Population-Based Study in Brazil, 2019.

Objective: To describe the inequalities in the double burden of malnutrition (DBM) in the adult population. Methods: Study carried out with data from the VIGITEL study, conducted in 2019 in all Brazilian capitals. Underweight and excess weight were evaluated on the basis of years of schooling and age. Multi-level analysis was performed including Human Development Index of each capital and individual-level variables. The inequality slope index was used to assess the magnitude of the inequalities found. All analyses considered the svy command owing to the complexity of the sampling process. Results: 47.119 individuals were studied. Men with no education had 6 percentage points more underweight compared to those with higher education. Higher prevalence of excess weight was found among men with higher education and women with no education. In women, the difference was 18 percentage points between extreme categories. Elderly people with no education had 10 percentage points more excess weight than those with higher education. Conclusions: The findings suggest the need for intersectoral actions that can cope with the social inequalities and help confronting with the DBM in Brazil.

Regional and social inequalities in mammography and Papanicolaou tests in Brazilian state capitals in 2019: a cross-sectional study. / Desigualdades regionais e sociais na realização de mamografia e exame citopatológico nas capitais brasileiras em 2019: estudo transversal.

OBJECTIVE: To assess regional and social inequalities in mammography and Papanicolaou tests. METHODS: This was a cross-sectional study with data from the 2019 Chronic Disease Risk and Protective Factors Surveillance Telephone Survey (Vigitel). The outcome variables were mammography and cytopathology test. The exposure variables were race/skin color, schooling and region of residence in Brazil. Absolute inequality measurements were presented using the slope index of inequality (SII) and equiplots. RESULTS: 23,339 women were included in this study. Having a mammography was 5.2 percentage points higher in women with higher levels of education, while having a cytopathology test was 5.3 percentage points lower in women of Black race/skin color.Having mammography and cytopathology tests was 3.9 and 11.2 percentage points higher, respectively, in the Southern region. CONCLUSION: Social and regional inequalities persist in Brazil and affect mainly women of Black race/skin color, with low education levels and living in the Northeast region of the country.