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1.
Nutrition ; 67-68: 110521, 2019 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-31446214

RESUMO

OBJECTIVE: To examine whether dietary patterns (DP) are associated with endothelial dysfunction (ED) markers in an Argentinian population. RESEARCH METHODS & PROCEDURES: Cross-sectional study. The sample belonged to 1,983 subjects from two mid-sized cities of Argentina, involved in CESCAS I Study. To define DP, a food-frequency questionnaire was applied. In a subsample randomly selected from the primary cohort, serum concentrations of C-reactive protein (hs-CRP), soluble vascular cell adhesion molecule-1 (sVCAM-1), soluble intercellular adhesion molecule-1 (sICAM-1), and soluble E selectin (sSELE) were determined. Correlations and multiple linear regression models were used to assess the relation between each quartile of DP adherence score and ED markers (Q1 lowest adherence; Q4 highest adherence). RESULTS: Three DPs were identified: Traditional (TDP), Prudent (PDP), and Convenience and processed (CDP). TDP was characterized by higher intake of refined grains, red meat, whole fat dairy products, vegetable oils, and "mate", a traditional South American infused drink; PDP was characterized by higher intake of vegetables, fruit, low-fat dairy products, whole grains, and legumes; and CDP consisted mainly of processed meat, snacks, pizza, and "empanadas", a stuffed bread served baked or fried. Lower scores (Q2, Q3) in TDP were inversely associated to concentrations of sSELE (P < 0.0001 and P < 0.05, respectively). In PDP, higher scores were inversely associated with hs-CRP, whereas lower scores showed a positive relation with sSELE (P < 0.05). Contrariwise, higher scores in CDP were directly associated with sSELE concentrations (P < 0.05). CONCLUSION: Adherence for each DP identified is differentially related to ED markers in the studied population.

2.
Health Promot Int ; 2019 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-31302691

RESUMO

The Healthy Municipalities and Communities Strategy (HMCS) was developed by the Pan American Health Organization in 1990. Evaluation and monitoring are fundamental components of health promotion policies. The aim of this study is to explore the indicators used in Latin America and the Caribbean (LAC) countries to assess the performance of HMCS. We searched MEDLINE, EMBASE, LILACS, BVSDE and Google Advanced Search for documents published between January 2000 and April 2016. We included only documents with assessment indicators of the strategy. All articles were independently assessed for eligibility by pairs of reviewers. We classified the indicators with a supporting framework proposed by O'Neill and Simard (Choosing indicators to evaluate Healthy Cities projects: a political task? Health Promot Int 2006, 21, 145-152.). Local level indicators figured far more prominently among countries and were distributed both in projects and specific activities. Regarding the evolution of the HMCS, indicators were reported in the five levels of analysis (local projects and activities, provincial, national and international networks). Empowerment was represented through the presence of active community organizations and different methods of community participation (forums, open hearing and participation maps). Public policies (such as for tobacco cessation) and bylaws adherence and changes in school's curricula regarding healthy eating were frequently mentioned. However, this review demonstrated that impact indicators related to lifestyle changes or built environment are not clearly defined and there is a lack of indicators to measure progress in achieving change in long-term outcomes in LAC. We highlight the importance of designing validated indicators for measuring the impact of health promotion policies in partnership with each country involved.

3.
Rev. argent. salud publica ; 39(9): 19-24, Julio 2019. Tab
Artigo em Espanhol | LILACS, BINACIS, ARGMSAL | ID: biblio-1007688

RESUMO

INTRODUCCIÓN: Los cánceres de mama (CM) y colorrectal (CCR) presentan una elevada carga de enfermedad en Argentina, por lo que el estudio de la epidemiología de estos tumores constituye una prioridad en salud pública. El objetivo del presente trabajo fue describir la prevalencia de antecedentes familiares de CM y CCR, y estimar la incidencia de los tumores en adultos de 35 a 74 años de dos ciudades de Argentina: Bariloche y Marcos Paz. MÉTODOS: En el marco de la cohorte prospectiva de población general CESCAS I (Estudio de detección y seguimiento de enfermedad cardiovascular y factores de riesgo en el Cono Sur de Latinoamérica), se recolectó información individual sobre antecedentes familiares de CM y CCR en una muestra representativa de las ciudades de Bariloche y Marcos Paz. Los casos de cáncer fueron investigados mediante documentación médica respaldatoria. RESULTADOS: Durante 2016-2017 se obtuvo información de 3245 participantes. El 8,4% de la población reportó antecedente familiar de CCR, y el 15,2% de las mujeres, de CM. La incidencia anual para el período 2011-2017 fue de 55,2/100 000 mujeres de 35 a 74 años (IC95%: 22,8-133,7) para CM y 8,5/100 000 adultos de 35 a 74 años (IC95%: 15,3-96,8) para CCR. CONCLUSIONES: Además de garantizar el acceso universal a los programas de tamizaje, se debe tener en cuenta la importancia de indagar sobre los antecedentes familiares de cáncer para identificar pacientes con riesgo aumentado, que requieren algoritmos particulares de detección temprana y vigilancia.


INTRODUCTION: Breast cancer (BC) and colorectal cancer (CRC) both present a high burden of disease in Argentina. Hence, studying the epidemiology of these tumors constitutes a public health priority. The objective of this study was to describe the prevalence of family history of BC and CRC and to estimate the incidence of these tumors in adults aged between 35 and 74 years from two cities in Argentina: Bariloche and Marcos Paz. METHODS: As part of the prospective population-based cohort CESCAS I (Study of detection and monitoring of cardiovascular disease and risk factors in the Southern Cone of Latin America), individual information on family history of BC and CRC was collected from a representative sample of the cities of Bariloche and Marcos Paz. Cancer cases were investigated using supporting medical documentation. RESULTS: During 2016-2017, information from 3245 participants was obtained. Family history of CRC was reported by 8.4% of the population, and 15.2% of women reported a family history of BC. The annual incidence for the 2011-2017 period was 55.2/100 000 women aged 35 to 74 years (95%CI: 22.8-133.7) for BC and 38.5/100 000 adults aged 35 to 74 years (95%CI: 15.3-96.8) for CRC.CONCLUSIONS: Besides guaranteeing universal access to screening programs, it is important to evaluate family history of cancer to identify patients with increased risk, who require specific early detection and surveillance algorithms.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Neoplasias da Mama/epidemiologia , Neoplasias Colorretais/epidemiologia , Argentina/epidemiologia , Coleta de Dados/métodos , Anamnese/métodos
4.
Artigo em Inglês | MEDLINE | ID: mdl-30649400

RESUMO

Background: Using data from general adult population, this study aims to describe epidemiology of alcohol consumption patterns and their association with cardiovascular risk. Methods: CESCAS I is a population-based study from four mid-sized cities in Argentina, Chile and Uruguay. Associations between diabetes, hypertension, dyslipidemia, cardiovascular disease (CVD) risk and history of CVD and drinking patterns were assessed using crude prevalence odds ratios (ORs) and adjusted OR. Results: A total of 37.2% of the studied population never drank and 18.3% reported to be former drinkers. Among current drinkers, moderate drinking was the most frequent pattern (24.2%). For women with light and moderate consumption, the odds of having >20% CVD risk was ~40% lower than that of never drinkers. The odds of having a history of CVD was 50% lower in those with moderate consumption. For men with heavy consumption, the odds of having >20% CVD risk was about twice as high as for never drinkers. Conclusions: A harmful association was observed between heavy drinking and having >20% CVD risk for men. However, for women, an apparently protective association was observed between light and moderate drinking and having >20% CVD risk and between moderate drinking and having a history of CVD.

5.
Artigo em Inglês | MEDLINE | ID: mdl-30646502

RESUMO

Background: Obesogenic environments promote sedentary behavior and high dietary energy intake. The objective of the study was to identify barriers and facilitators to the implementation and impact evaluation of projects oriented to promote physical activity and healthy diet at community level. We analyzed experiences of the projects implemented within the Healthy Municipalities and Communities Program (HMCP) in Argentina. Methods: A mixed methods approach included (1) in-depth semi-structured interviews, with 44 stakeholders; and (2) electronic survey completed by 206 individuals from 96 municipalities across the country. Results: The most important barriers included the lack of: adequate funding (43%); skilled personnel (42%); equipment and material resources (31%); technical support for data management and analysis (20%); training on project designs (12%); political support from local authorities (17%) and acceptance of the proposed intervention by the local community (9%). Facilitators included motivated local leaders, inter-sectorial participation and seizing local resources. Project evaluation was mostly based on process rather than outcome indicators. Conclusions: This study contributes to a better understanding of the difficulties in the implementation of community-based intervention projects. Findings may guide stakeholders on how to facilitate local initiatives. There is a need to improve project evaluation strategies by incorporating process, outcome and context specific indicators.


Assuntos
Participação da Comunidade , Exercício , Promoção da Saúde/métodos , Adolescente , Adulto , Idoso , Argentina , Assistência à Saúde , Feminino , Dieta Saudável , Humanos , Masculino , Pessoa de Meia-Idade , Motivação , Inquéritos e Questionários , Adulto Jovem
6.
Rev Panam Salud Publica ; 42, sep. 2018. Special Issue Alma-Ata.
Artigo em Espanhol | PAHO-IRIS | ID: phr-49465

RESUMO

[RESUMEN]. Objetivo. Explorar las motivaciones y expectativas de los usuarios del Programa de Estaciones Saludables en la Ciudad Autónoma de Buenos Aires y evaluar su potencial impacto sanitario. Métodos. Se realizaron entrevistas en profundidad (n = 34) y una encuesta autoadministrada (n = 605) a usuarios del programa. Se desarrolló un modelo epidemiológico para estimar el impacto del programa sobre los eventos cardiovasculares y los años de vida ajustados por discapacidad (AVAD). Resultados. Los principales factores motivadores para el uso de las estaciones saludables fueron la accesibilidad geográfica, económica (servicios gratuitos) y la satisfacción con la atención recibida. El 14,4% (intervalos de confianza del 95% [IC95%] 10,3–18,5%) de los usuarios hipertensos y el 24,8% (IC95% 17,6–32,0%) de los diabéticos informó haberse enterado de sus valores alterados en las estaciones saludables. Más de la mitad de los encuestados reportó alguna mejora de conocimientos sobre los beneficios de realizar actividad física y una alimentación saludable; esto fue más frecuente entre los usuarios más jóvenes, de menor nivel educativo, usuarios del sistema público de salud, usuarios de estaciones saludables de la zona sur y los que tenían algún factor de riesgo cardiometabólico (p<0.05). Se estimó que debido a la existencia de estaciones saludables se evitarían 12,5 eventos cardiovasculares y cerebrovasculares por año en la población asistida (4,75 eventos/100 000 personas) y 47,75 AVAD por estas causas. Conclusiones. Las estaciones saludables resultan un espacio propicio para la implementación de acciones de promoción de la salud y prevención, contribuyendo en la detección y facilitando el monitoreo de los factores de riesgo, con potencialidad para prevenir eventos cardiovasculares y sus consecuencias.


[ABSTRACT]. Objective. To explore the motivations and expectations of the users of the Program for Healthy Centers in the Autonomous City of Buenos Aires and to evaluate its potential health impact. Methods. In-depth interviews were conducted (n = 34) and a self-administered survey was sent to users of the program (n = 605). An epidemiological model was developed to estimate the impact of the program on cardiovascular events (CVE) and disability-adjusted life years (DALYs). Results. The main motivating factors for using the healthy centers were geographic and economic accessibility (free services) and satisfaction with the care received. 14.4% (95% CI, 10.3-18.5%) of hypertensive users and 24.8% (95% CI, 17.6-32.0%) of diabetic users reported having learned of their altered values in the healthy center. More than half of the respondents reported some improvement in their knowledge about the benefits of physical activity and healthy eating; this was more frequent among those who were younger, of lower educational level, users of the public health system, users of a healthy center in the South zone and those who had a cardiometabolic risk factor (p<0.05). It was estimated that the healthy centers would prevent 12.5 cardiovascular and cerebrovascular events per year in the assisted population (4.75 events/100 000) and 47.75 DALYs due to these causes. Conclusions. The healthy centers are a favorable space for the implementation of health promotion and prevention actions, contributing to the detection of and facilitating the monitoring of risk factors, with a potential to prevent cardiovascular events and its consequences.


[RESUMO]. Objetivo. Explorar as motivações e expectativas dos usuários do Programa Estações Saudáveis na Cidade Autônoma de Buenos Aires e avaliar seu impacto potencial na saúde. Métodos. Foram realizadas entrevistas em profundidade (n = 34) e uma pesquisa auto-administrada (n = 605) a usuários do programa. Um modelo epidemiológico foi desenvolvido para estimar o impacto do programa em eventos cardiovasculares e anos de vida ajustados por incapacidade (DALY). Resultados. Os principais fatores motivadores para o uso do estações saudáveis foram a acessibilidade geográfica, econômica (serviços gratuitos) e a satisfação com o atendimento recebido. 14,4% (intervalo de confiança de 95% [IC95%] 10,3-18,5%) de usuários hipertensos e 24,8% (IC95% 17,6-32,0%) dos diabéticos relataram ter aprendido sobre seus valores alterados na estação saudável. Mais da metade dos entrevistados relataram alguma melhora no conhecimento sobre os benefícios da atividade física e da alimentação saudável, com maior freqüência entre os mais jovens, de menor escolaridade, usuários do sistema público de saúde, usuários de estações saudáveis na zona sul e aqueles que apresentaram algum fator de risco cardiometabólico (p<0,05). Estimou-se que, devido à existência de estações saudáveis, 12,5 eventos cardiovasculares e cerebrovasculares por ano seriam evitados na população atendida (4,75 eventos/100 000) e 47,75 DALY por essas causas. Conclusões. As estações saudáveis são um espaço propício para a implementação de ações de promoção e prevenção da saúde, contribuindo para a detecção e facilitação do monitoramento dos fatores de risco, com potencial para prevenir os eventos cardiovasculares e suas consequências.


Assuntos
Promoção da Saúde , Prevenção Primária , Estilo de Vida Saudável , Conhecimentos, Atitudes e Prática em Saúde , Doenças Cardiovasculares , Avaliação em Saúde , Argentina , Promoção da Saúde , Prevenção Primária , Estilo de Vida Saudável , Conhecimentos, Atitudes e Prática em Saúde , Doenças Cardiovasculares , Avaliação em Saúde , Promoção da Saúde , Prevenção Primária , Estilo de Vida Saudável , Conhecimentos, Atitudes e Prática em Saúde , Doenças Cardiovasculares , Avaliação em Saúde
7.
J Occup Environ Med ; 60(9): e470-e475, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30020215

RESUMO

OBJECTIVE: We explore the association between occupational physical activity (OPA) and cardiovascular risk factors in four cities of the Southern Cone. METHODS: Robust multivariable linear regression models were used to examine the associations. RESULTS: The working population was constituted by 1868 men and 1672 women. Men performing high levels of OPA showed higher levels of high-density lipoprotein (HDL; mean adj. diff. = 2.24 mg/dL; P = 0.004), lower levels of triglycerides (-24.59 mg/dL; P = 0.006), and total cholesterol (TC)/HDL ratio values (-0.21; P = 0.015) than reference. Women in the highest category of OPA had higher levels of HDL (2.85 mg/dL; P = 0.006), lower TC/HDL (0.27; P = 0.001), and low-density lipoprotein/HDL ratios (-0.18; P = 0.003) than sedentary activities. CONCLUSION: Individuals who performed high levels of OPA did not exhibit a worse cardiovascular risk profile and an improvement on selected biomarkers was observed when compared with those performing sedentary activities.

8.
Health Promot Int ; 33(4): 695-712, 2018 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-28137729

RESUMO

In Argentina, cardiovascular disease (CVD) accounts for 30% of deaths and more than 600 000 disability-adjusted life years. However, no reviews describing local studies on interventions to address CVD risk factors have been identified. The purpose of this study is to characterize those population-based interventions and public policies implemented in Argentina to reduce the burden of cardiovascular disease with an adequate evaluation of their impact on population health. We conducted a systematic review of studies that assessed interventions in health promotion and/or primary prevention conducted in adult populations of Argentina, addressing specific CVD factors, from 1999 to 2016. We searched major bibliographic databases, grey literature, ministries and secretariats of health, and academic national libraries. Key informants, non-governmental organizations, universities, hospitals and experts were also contacted. We applied specific inclusion criteria. We assessed the methodological quality of the studies and reported the effectiveness and impact of population interventions and policies, as well as process evaluations' characteristics. After removing duplicates we identified 1686 references from databases. After reviewing title and abstracts 18 studies were selected, five of them corresponded to evaluations of public policies-all addressing tobacco smoking. We presented a structured review of each experience. Most of the studies were deemed to entail moderate or high risk of bias. We summarized the findings and characteristics of these studies, including implementation strategies, process and impact evaluation. This is the first systematic review of interventions focused on primary prevention and health promotion to counter CVD and diabetes in Argentina.

9.
Rev. panam. salud pública ; 42: e150, 2018. tab
Artigo em Espanhol | LILACS | ID: biblio-961831

RESUMO

RESUMEN Objetivo Explorar las motivaciones y expectativas de los usuarios del Programa de Estaciones Saludables en la Ciudad Autónoma de Buenos Aires y evaluar su potencial impacto sanitario. Métodos Se realizaron entrevistas en profundidad (n = 34) y una encuesta autoadministrada (n = 605) a usuarios del programa. Se desarrolló un modelo epidemiológico para estimar el impacto del programa sobre los eventos cardiovasculares y los años de vida ajustados por discapacidad (AVAD). Resultados Los principales factores motivadores para el uso de las estaciones saludables fueron la accesibilidad geográfica, económica (servicios gratuitos) y la satisfacción con la atención recibida. El 14,4% (intervalos de confianza del 95% [IC95%] 10,3-18,5%) de los usuarios hipertensos y el 24,8% (IC95% 17,6-32,0%) de los diabéticos informó haberse enterado de sus valores alterados en las estaciones saludables. Más de la mitad de los encuestados reportó alguna mejora de conocimientos sobre los beneficios de realizar actividad física y una alimentación saludable; esto fue más frecuente entre los usuarios más jóvenes, de menor nivel educativo, usuarios del sistema público de salud, usuarios de estaciones saludables de la zona sur y los que tenían algún factor de riesgo cardiometabólico (p<0.05). Se estimó que debido a la existencia de estaciones saludables se evitarían 12,5 eventos cardiovasculares y cerebrovasculares por año en la población asistida (4,75 eventos/100 000 personas) y 47,75 AVAD por estas causas. Conclusiones Las estaciones saludables resultan un espacio propicio para la implementación de acciones de promoción de la salud y prevención, contribuyendo en la detección y facilitando el monitoreo de los factores de riesgo, con potencialidad para prevenir eventos cardiovasculares y sus consecuencias.


ABSTRACT Objective To explore the motivations and expectations of the users of the Program for Healthy Centers in the Autonomous City of Buenos Aires and to evaluate its potential health impact. Methods In-depth interviews were conducted (n = 34) and a self-administered survey was sent to users of the program (n = 605). An epidemiological model was developed to estimate the impact of the program on cardiovascular events (CVE) and disability-adjusted life years (DALYs). Results The main motivating factors for using the healthy centers were geographic and economic accessibility (free services) and satisfaction with the care received. 14.4% (95% CI, 10.3-18.5%) of hypertensive users and 24.8% (95% CI, 17.6-32.0%) of diabetic users reported having learned of their altered values in the healthy center. More than half of the respondents reported some improvement in their knowledge about the benefits of physical activity and healthy eating; this was more frequent among those who were younger, of lower educational level, users of the public health system, users of a healthy center in the South zone and those who had a cardiometabolic risk factor (p<0.05). It was estimated that the healthy centers would prevent 12.5 cardiovascular and cerebrovascular events per year in the assisted population (4.75 events/100 000) and 47.75 DALYs due to these causes. Conclusions The healthy centers are a favorable space for the implementation of health promotion and prevention actions, contributing to the detection of and facilitating the monitoring of risk factors, with a potential to prevent cardiovascular events and its consequences.


RESUMO Objetivo Explorar as motivações e expectativas dos usuários do Programa Estações Saudáveis na Cidade Autônoma de Buenos Aires e avaliar seu impacto potencial na saúde. Métodos Foram realizadas entrevistas em profundidade (n = 34) e uma pesquisa auto-administrada (n = 605) a usuários do programa. Um modelo epidemiológico foi desenvolvido para estimar o impacto do programa em eventos cardiovasculares e anos de vida ajustados por incapacidade (DALY). Resultados Os principais fatores motivadores para o uso do estações saudáveis foram a acessibilidade geográfica, econômica (serviços gratuitos) e a satisfação com o atendimento recebido. 14,4% (intervalo de confiança de 95% [IC95%] 10,3-18,5%) de usuários hipertensos e 24,8% (IC95% 17,6-32,0%) dos diabéticos relataram ter aprendido sobre seus valores alterados na estação saudável. Mais da metade dos entrevistados relataram alguma melhora no conhecimento sobre os benefícios da atividade física e da alimentação saudável, com maior freqüência entre os mais jovens, de menor escolaridade, usuários do sistema público de saúde, usuários de estações saudáveis na zona sul e aqueles que apresentaram algum fator de risco cardiometabólico (p<0,05). Estimou-se que, devido à existência de estações saudáveis, 12,5 eventos cardiovasculares e cerebrovasculares por ano seriam evitados na população atendida (4,75 eventos/100 000) e 47,75 DALY por essas causas. Conclusões As estações saudáveis são um espaço propício para a implementação de ações de promoção e prevenção da saúde, contribuindo para a detecção e facilitação do monitoramento dos fatores de risco, com potencial para prevenir os eventos cardiovasculares e suas consequências.


Assuntos
Prevenção Primária , Doenças Cardiovasculares , Estilo de Vida Saudável , Promoção da Saúde/organização & administração , Argentina/epidemiologia , Avaliação em Saúde
10.
Nutrients ; 9(9)2017 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-28858263

RESUMO

The maximum content of sodium in selected processed foods (PF) in Argentina was limited by a law enacted in 2013. Data about intake of these and other foods are necessary for policy planning, implementation, evaluation, and monitoring. We examined data from the CESCAS I population-based cohort study to assess the main dietary sources among PF and frequency of discretionary salt use by sex, age, and education attainment, before full implementation of the regulations in 2015. We used a validated 34-item FFQ (Food Frequency Questionnaire) to assess PF intake and discretional salt use. Among 2127 adults in two Argentinean cities, aged 35-76 years, mean salt intake from selected PFs was 4.7 g/day, higher among male and low education subgroups. Categories of foods with regulated maximum limits provided near half of the sodium intake from PFs. Use of salt (always/often) at the table and during cooking was reported by 9% and 73% of the population, respectively, with higher proportions among young people. Reducing salt consumption to the target of 5 g/day may require adjustments to the current regulation (reducing targets, including other food categories), as well as reinforcing strategies such as education campaigns, labeling, and voluntary agreement with bakeries.


Assuntos
Cloreto de Sódio na Dieta/administração & dosagem , Sódio na Dieta/administração & dosagem , Adulto , Idoso , Criança , Inquéritos sobre Dietas , Educação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos
11.
PLoS One ; 12(9): e0183953, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28877254

RESUMO

AIMS: To determine the prevalence, treatment and control of diabetes mellitus (DM) and impaired fasting glucose (IFG) as well as associated factors in the adult population of four cities of the Southern Cone of Latin America (SCLA). METHODS: This is a cross-sectional population-based study that included 7407 adults between 35 and 74 years old in four cities of the SCLA: Temuco (Chile), Marcos Paz and Bariloche (Argentina), and Pando-Barros Blancos (Uruguay). DM was defined as fasting plasma glucose ≥126 mg/dL or self-reported history of diabetes. Awareness, treatment, and control of DM were defined as subjects self-reporting a DM previous diagnosis, the use of a prescription medication or nonpharmacological intervention for DM, and fasting plasma glucose <126 mg/dl, respectively. RESULTS: Prevalence of DM varied among cities, between 8.4% in Bariloche and 14.3% in Temuco. Prevalence of IFG varied at different sites, from 3.5% in Barros Blancos to 6.8% in Marcos Paz. Of the total number of people with diabetes, 20% were newly diagnosed at the time of the study. Overall, 79.8% of patients with diabetes were aware of their condition. The treatment and control rate were 58.8% and 46.2%, respectively. Older age, family history of diabetes, lower educational attainment, overweight, obesity, central obesity, low physical activity, hypertension, hypercholesterolemia and hypertriglyceridemia were all significantly associated with an increased risk of diabetes. CONCLUSIONS: The prevalence of DM and IFG in the adult population of the SCLA is high and varies among cities. These conditions represent a public health challenge since the rates of awareness, treatment, and control are still low.


Assuntos
Diabetes Mellitus/epidemiologia , Estado Pré-Diabético/epidemiologia , Adulto , Idoso , Argentina/epidemiologia , Glicemia/análise , Chile/epidemiologia , Estudos Transversais , Diabetes Mellitus/psicologia , Diabetes Mellitus/terapia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Estado Pré-Diabético/psicologia , Estado Pré-Diabético/terapia , Prevalência , Fatores de Risco , Uruguai/epidemiologia
12.
Br J Nutr ; 117(4): 548-555, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-28382894

RESUMO

Several previous epidemiological studies from developed countries have shown that an unhealthy dietary pattern affects plasma lipid levels and inflammation biomarkers. We assessed the cross-sectional associations between dietary patterns and cardiovascular risk factors among 961 adults from a multi-city cohort in South America. We conducted a principal component analysis to derive dietary patterns. As outcomes, we examined plasma levels of apo A-I, apo B, high-sensitivity C-reactive protein (hs-CRP), LDL-, HDL- and serum total cholesterol and TAG. The crude and adjusted changes in each outcome were estimated for quartiles of dietary patterns using multivariable linear regression models. The prudent pattern (PP) characterised by higher intake of fruits, vegetables, fish, seafood, whole cereal and low-fat dairy products was associated with reduced plasma concentrations of apo B (-8·5 mg/l), total cholesterol (-18·8 mg/dl) and LDL-cholesterol (-16·5 mg/dl) and hs-CRP (-1·6 mg/l) in men. In women also reduced plasma concentrations of apo B (-6·6 mg/l), total (-12·0 mg/dl) and LDL (-9·3 mg/dl). The 'Western-like' pattern characterised by higher intake of eggs, pastry and cakes, pizza, snacks, refined grains, red meat, vegetable oils and poultry was not significantly associated with any of the selected serum lipid or inflammatory biomarkers. The explained variances were 10·3 and 7·4 %, respectively. The PP was associated with better lipid profile, mainly lower atherogenic particles (apo B) and LDL-cholesterol and serum total cholesterol. This study provides possible evidence of a prudent diet in South American populations to help reduce the burden of CVD.


Assuntos
Apolipoproteínas/sangue , Proteína C-Reativa/metabolismo , Doenças Cardiovasculares/etiologia , Colesterol/sangue , Dieta , Inflamação/sangue , Biomarcadores/sangue , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/prevenção & controle , LDL-Colesterol/sangue , Cidades , Estudos de Coortes , Estudos Transversais , Feminino , Dieta Saudável , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Componente Principal , América do Sul , Triglicerídeos/sangue
13.
Rev Fac Cien Med Univ Nac Cordoba ; 74(3): 263-270, 2017 09 08.
Artigo em Espanhol | MEDLINE | ID: mdl-29890102

RESUMO

The promotion of healthy feeding for the child and family is essential to support the growth and the prevention and treatment of chronic no communicable diseases. Factors influencing food choices are varied. In childhood, although not exclusively, the mother essentially transmits food education. The objective was: to describe the reasons that consider a group of women-mothers of Buenos Aires when selecting food. A structured, self-administered food choice questionnaire with 39 motives was used and a principal component analysis was carried out to synthesize them into groups. Were detected 10 groups of motives. The main factors that women-mothers have considered in the choice of food were: nutritional value, followed by sensory attractiveness and price. Knowing these elections can be useful to facilitate the development of healthy eating habits and / or implementation of interventions to improve them.


Assuntos
Comportamento de Escolha , Preferências Alimentares , Mães/estatística & dados numéricos , Valor Nutritivo , Adulto , Argentina , Estudos Transversais , Inquéritos sobre Dietas , Feminino , Humanos , Fatores Socioeconômicos , Inquéritos e Questionários
14.
PLoS One ; 11(10): e0163727, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27741247

RESUMO

BACKGROUND: Obesity is a major determinant of cardiovascular disease in South America. However, population-based data are limited. METHODS: A total of 7,524 women and men, aged 35 to 74 years old, were randomly selected from 4 cities in the Southern Cone of Latin America between February 2010 and December 2011. Obesity clinical measurements and cardiovascular risk factors were measured using standard methodology. RESULTS: The prevalence of obesity and central obesity were 35.7% and 52.9%, respectively. The prevalence of obesity and central obesity were higher in women, and even higher in women with lower education compared with women with higher education. In men and women obesity was associated with a higher prevalence of diabetes, odds ratio (OR) 2.38 (95% Confidence Interval [CI]: 1.86 to 3.05) and 3.01 (95%CI 2.42 to 3.74) respectively, hypertension (OR 2.79 (95%CI 2.32 to 3.36) and 2.40 (95%CI 2.05 to 2.80) respectively, dyslipidemia (OR 1.83 (95%CI 1.50 to 2.24) and 1.69 (95%CI 1.45 to 1.98), respectively, low physical activity (OR 1.38(95%CI 1.14 to 1.68) and 1.38 (95%CI 1.18 to 1.62) respectively and a lower prevalence of smoking (OR, 0.65 (95%CI 0.53 to 0.80) and 0.58(95%CI 0.48 to 0.70) respectively. CONCLUSIONS: Obesity and central obesity are highly prevalent in the general population in the Southern Cone of Latin America and are strongly associated with cardiovascular risk factor prevalence. These data suggest that efforts toward prevention, treatment, and control of obesity should be a public health priority in the Southern Cone of Latin America.


Assuntos
Obesidade Abdominal/epidemiologia , Obesidade/epidemiologia , Adulto , Idoso , Índice de Massa Corporal , Doenças Cardiovasculares/etiologia , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/etiologia , Dislipidemias/epidemiologia , Dislipidemias/etiologia , Escolaridade , Exercício , Feminino , Humanos , Hipertensão/epidemiologia , Hipertensão/etiologia , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade Abdominal/complicações , Razão de Chances , Prevalência , Fatores de Risco , Fumar/epidemiologia , América do Sul
15.
Rev. argent. salud publica ; 6(25): 7-13, dic. 2015. tab
Artigo em Espanhol | LILACS | ID: biblio-869550

RESUMO

INTRODUCCIÓN: la ingesta de altos niveles de sal y grasas trans está fuertemente relacionada con la ocurrencia de enfermedades cardiovasculares. OBJETIVOS: Describir los conocimientos, comportamientos y prácticas socioculturales de diferentes grupos de población, con relación al consumo de sal y grasas trans en Argentina. MÉTODOS: Se efectuó un estudio cualitativo con diseño exploratorio descriptivo. Participaron varones y mujeres mayores de 18 años. Se realizaron entrevistas en profundidad y grupos focales en tres zonas geográficas diferentes del país. RESULTADOS: Los participantes desconocen que el sodio es un componente de la sal. Se observó una tendencia a considerar que el consumo en exceso de sal es perjudicial para la salud principalmente en adultos mayores, mujeres embarazadas y en personas con enfermedades cardiovasculares. A su vez, se evidenció un total desconocimiento acerca de las grasas trans, en qué alimentos se encuentran y su impacto sobre la salud. CONCLUSIONES: Las percepciones acerca del consumo personal de sal hacen referencia a un consumo moderado. La reducción del consumo de sal ocurre predominantemente ante eventos de salud de familiares, no como conducta preventiva personal. Existe un escaso conocimiento acerca de las grasas trans.


INTRODUCTION: the consumption of high levels of salt and trans fats is strongly associated with cardiovasculardiseases. OBJECTIVES: To describe knowledge, behaviors and socio-cultural practices of different population groups in relation to consumption of salt and trans fats in Argentina. METHODS: A qualitative study was conducted, with an exploratory-descriptive design and the participation of men and women older than 18. In-depth interviews and focus groups were carried out in threedifferent regions of the country. RESULTS: Participants do not know that sodium is a component of salt. There was a tendency to consider that the consumption of too much salt is unhealthy mainly in older adults, pregnant women and people with cardiovascular diseases. There was also complete ignorance regarding trans fats, their impact on health and which foods are rich in them.CONCLUSIONS: Participants consider that they have a moderateconsumption of salt. The reduction of salt intake mainly occurs after family health events, not as personal preventive behavior. There is very little knowledge about trans fats.


Assuntos
Humanos , Saúde , Sódio , Ácidos Graxos Trans
16.
Bull World Health Organ ; 93(9): 614-22, 2015 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-26478625

RESUMO

OBJECTIVE: To estimate the impact of Argentine policies to reduce trans fatty acids (TFA) on coronary heart disease (CHD), disability-adjusted life years (DALYs) and associated health-care costs. METHODS: We estimated the baseline intake of TFA before 2004 to be 1.5% of total energy intake. We built a policy model including baseline intake of TFA, the oils and fats used to replace artificial TFAs, the clinical effect of reducing artificial TFAs and the costs and DALYs saved due to averted CHD events. To calculate the percentage of reduction of CHD, we calculated CHD risks on a population-based sample before and after implementation. The effect of the policies was modelled in three ways, based on projected changes: (i) in plasma lipid profiles; (ii) in lipid and inflammatory biomarkers; and (iii) the results of prospective cohort studies. We also estimated the present economic value of DALYs and associated health-care costs of coronary heart disease averted. FINDINGS: We estimated that projected changes in lipid profile would avert 301 deaths, 1066 acute CHD events, 5237 DALYs and 17 million United States dollars (US$) in health-care costs annually. Based on the adverse effects of TFA intake reported in prospective cohort studies, 1517 deaths, 5373 acute CHD events, 26 394 DALYs and US$ 87 million would be averted annually. CONCLUSION: Even under the most conservative scenario, reduction of TFA intake had a substantial effect on public health. These findings will help inform decision-makers in Argentina and other countries on the potential public health and economic impact of this policy.


Assuntos
Doença das Coronárias/economia , Doença das Coronárias/epidemiologia , Efeitos Psicossociais da Doença , Gorduras na Dieta/efeitos adversos , Indústria Alimentícia , Ácidos Graxos Trans/efeitos adversos , Ácidos Graxos Trans/provisão & distribução , Argentina/epidemiologia , Doença das Coronárias/induzido quimicamente , Doença das Coronárias/mortalidade , Feminino , Humanos , Masculino , Anos de Vida Ajustados por Qualidade de Vida , Fatores de Risco
17.
Int J Cardiol ; 183: 82-8, 2015 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-25662056

RESUMO

BACKGROUND: Cardiovascular disease is a major cause of death, and its mortality is increasing in Latin America. However, population-based data on cardiovascular disease risk factors are sparse in these countries. METHODS: A total of 7524 men and women, aged 35 to 74 years old, were recruited between February 2010 and December 2011 from randomly selected samples in 4 cities (Bariloche and Marcos Paz, Argentina; Temuco, Chile; and Pando-Barros Blancos, Uruguay) in the Southern Cone of Latin America. Cardiovascular risk factors were measured using standard methods by trained and certified observers. RESULTS: Approximately 85.5% of adults ate less than five servings of fruit or vegetables per day, 35.2% engaged in low physical activity, and 29.7% currently smoked cigarettes. The prevalences of obesity, central obesity, hypertension, chronic kidney disease, dyslipidemia, diabetes, and metabolic syndrome were 35.7%, 52.9%, 40.8%, 2.0%, 58.4%, 12.4%, and 37.4%, respectively. The proportion of individuals with ≥3 cardiovascular risk factors, including low intake of fruit and vegetables, low physical activity, current cigarette smoking, obesity or central obesity, hypertension, chronic kidney disease, dyslipidemia, and diabetes, was 68.3%, and the proportion of individuals with ≥3 cardiometabolic risk factors, including obesity or central obesity, hypertension, chronic kidney disease, dyslipidemia, and diabetes, was 22.9%. CONCLUSIONS: Cardiovascular disease risk factors are highly prevalent in the general population in the Southern Cone of Latin America. These data suggest that national efforts on the prevention, treatment, and control of cardiovascular risk factors should be a public health priority in the Southern Cone of Latin America.


Assuntos
Doenças Cardiovasculares/epidemiologia , Síndrome Metabólica/epidemiologia , Adulto , Idoso , Argentina/epidemiologia , Doenças Cardiovasculares/prevenção & controle , Chile/epidemiologia , Comportamento Alimentar , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Estilo de Vida , Masculino , Síndrome Metabólica/prevenção & controle , Pessoa de Meia-Idade , Fatores de Risco , Uruguai/epidemiologia
18.
Public Health Nutr ; 18(1): 59-67, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24476763

RESUMO

OBJECTIVE: To assess the reproducibility and validity among adults in the Southern Cone of Latin America (Argentina, Chile and Uruguay) of a self-administered FFQ to be used in the CESCAS I Study, an ongoing observational prospective cohort study to detect and follow up CVD and their risk factors, as well as in other epidemiological studies. DESIGN: Relative validity of the FFQ was evaluated by comparing nutrient and selected food group intakes with those from three 24 h recalls (24HR) administered over 6 months. The FFQ was administered at baseline (FFQ1) and again after 3 months (FFQ2). SETTING: Primary-care centres in Argentina, Chile and Uruguay. SUBJECTS: Adults (n 147) aged 21-74 years. RESULTS: Reproducibility (FFQ1 v. FFQ2): the intra-class correlation coefficients for nutrients ranged from 0·52 (potassium) to 0·74 (fat). Validity (FFQ1 v. the average of three 24HR): the Pearson correlations for energy-adjusted nutrients ranged from 0·39 (thiamin and cholesterol) to 0·59 (carbohydrate). Joint classification: overall, 66 % of participants in the lowest 24HR quintile were in the lowest one or two FFQ1 quintiles, and 62 % of those in the highest 24HR quintile were in the highest one or two FFQ1 quintiles. On average, only 4 % were misclassified into extreme quintiles. CONCLUSIONS: The FFQ version for the Southern Cone seems to present moderate to acceptable relative validity and reliability for its use in the CESCAS I Study to measure dietary exposure.


Assuntos
Dieta/etnologia , Política Nutricional , Inquéritos Nutricionais/métodos , Cooperação do Paciente , Adulto , Idoso , Argentina/epidemiologia , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etnologia , Doenças Cardiovasculares/etiologia , Chile/epidemiologia , Estudos de Coortes , Dieta/efeitos adversos , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Cooperação do Paciente/etnologia , Atenção Primária à Saúde , Estudos Prospectivos , Reprodutibilidade dos Testes , Fatores de Risco , Autorrelato , Uruguai/epidemiologia , Adulto Jovem
19.
Public Health Nutr ; 18(4): 695-704, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24848764

RESUMO

OBJECTIVE: The purpose of the present study was to determine whether elevated dietary Na intake could be associated with CVD mortality. DESIGN: We performed a systematic review and meta-analysis of prospective studies representing the general population. The adjusted relative risks and their 95 % confidence intervals were pooled by the inverse variance method using random-effects models. Heterogeneity, publication bias, subgroup and meta-regression analyses were performed. Settings MEDLINE (since 1973), Embase (since 1975), the Cochrane Library (since 1976), ISI Web of Science, Google Scholar (until September 2013) and secondary referencing were searched for inclusion in the study. Subject Eleven prospective studies with 229 785 participants and average follow-up period of 13.37 years (range 5.5-19 years). RESULTS: Higher Na intake was significantly associated with higher CVD mortality (relative risk=1.12; 95 % CI 1.06, 1.19). In the sensitivity analysis, the exclusion of studies with important relative weights did not significantly affect the results (relative risk=1.08; 95 % CI 1.01, 1.15). The meta-regression analysis showed that for every increase of 10 mmol/d in Na intake, CVD mortality increased significantly by 1 % (P=0.016). Age, hypertensive status and length of follow-up were also associated with increased CVD mortality. CONCLUSIONS: Higher Na intake was associated with higher CVD mortality in the general population; this result suggests a reduction in Na intake to prevent CVD mortality from any cause.


Assuntos
Doenças Cardiovasculares/mortalidade , Sódio na Dieta/efeitos adversos , Humanos , Estudos Prospectivos , Sódio na Dieta/administração & dosagem
20.
Value Health Reg Issues ; 8: 69-79, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29698174

RESUMO

OBJECTIVE: The objective of this study was to evaluate the burden of malaria in Latin America and the Caribbean countries through a systematic review and meta-analysis of published literature, gray literature, and information from countries' public health authorities for the period 1990 to 2009. METHODS: The random-effects meta-analysis of the prospective studies, carried out in very highly endemic areas, showed an annual incidence rate of 409.0 malaria episodes/1000 person-years (95% confidence interval [CI] 263.1-554.9), considering all ages, which was 40-fold the one estimated from areas with passive surveillance only. RESULTS: Overall, the most prevalent species was Plasmodium vivax (77.5%; 95% CI 75.6-79.4) followed by Plasmodium falciparum (20.8%; 95% CI 19.0-22.6) and Plasmodium malariae (0.08%; 95% CI 0.07-0.010). Data from regional ministries of health yielded an estimated pooled crude annual mortality rate of 6 deaths/100,000 people, mainly associated with P. falciparum. CONCLUSION: This study represents the first systematic review of the burden of malaria in Latin America and the Caribbean, with data from 21 countries.

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