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1.
BMC Infect Dis ; 20(1): 502, 2020 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-32652939

RESUMO

BACKGROUND: Pregnant women are at high risk of influenza-related morbidity and mortality. In addition, maternal influenza infection may lead to adverse birth outcomes. However, there is insufficient data on long-term impact of maternal influenza infection. METHODS: This study was conducted to assess the impact of maternal influenza infection on birth outcomes and long-term influence on infants by merging the Korea National Health Insurance (KNHI) claims database and National Health Screening Program for Infants and Children (NHSP-IC). Mother-offspring pairs were categorized by maternal influenza infection based on the ICD-10 code. RESULTS: Multivariate analysis revealed that maternal influenza infection significantly increased the risk of preterm birth (OR 1.408) and low birth weight (OR 1.198) irrespective of gestational age. The proportion of low birth weight neonates was significantly higher in influenza-infected women compared to those without influenza. However, since the fourth health screening (30-80 months after birth), the fraction of underweight was no longer different between children from influenza-infected and non-infected mothers, whereas the rates of overweight increased paradoxically in those born to mothers with influenza infection. CONCLUSIONS: Maternal influenza infection might have long-term effects on the health of children and adolescents even after infancy.


Assuntos
Influenza Humana/complicações , Complicações Infecciosas na Gravidez/etiologia , Adulto , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Idade Gestacional , Humanos , Lactente , Recém-Nascido de Baixo Peso , Recém-Nascido , Sobrepeso/etiologia , Gravidez , Nascimento Prematuro , República da Coreia
2.
PLoS One ; 15(6): e0234570, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32569312

RESUMO

BACKGROUND: The National Family Health Surveys (NFHS) in India apply adult cutoffs of nutritional status for the estimation of undernutrition/overweight in the 15-19 age group. The prevalence of thinness in boys and girls thus estimated is 58.1% and 46.8% in NFHS-3, and 45% and 42% in NFHS-4 respectively. But the WHO recommends using age and sex-specific reference for adolescents. We reanalyzed the nutritional status of the adolescents using the WHO 2007 Growth Reference to obtain revised estimates of thinness, overweight and stunting across states, rural-urban residence, and wealth quintiles. METHODS AND FINDINGS: Demographic information, anthropometric data, and wealth index were accessed from the Demographic and Health Survey (DHS) database. We re-analyzed the anthropometric data using WHO AnthroPlus software which uses the WHO 2007 Growth reference. The revised estimates of thinness assessed by BMI-for-age z-scores in boys and girls was 22.3% (95%CI: 21.6, 23.0) and 9.9% (95%CI: 9.5, 10.3) in NFHS-3 and 16.5% (95%CI: 16.0,17.0) and 9% (95%CI: 8.9, 9.2) in NFHS-4 respectively. Stunting was found to be 32.2% (95% CI: 31.6, 32.9) in boys and 34.4% (95% CI: 34.2, 34.7) in girls in NFHS-4. This was higher than that in NFHS-3; 25.2% (95% CI: 24.4, 26) in boys and 31.2 (95% CI: 30.6, 31.8) in girls. There was a clear socioeconomic gradient as there were higher thinness and stunting in rural areas. There was wide variation among the states with pockets of a double burden of malnutrition. CONCLUSION: Using the adult cutoffs significantly overestimates thinness in adolescents in the age group of 15-19 years old in India. Stunting, which is an indicator of long term nutrition is also widely prevalent in them. Future editions of DHS and NFHS should consider adolescents as a separate age group for nutritional assessment for a better understanding of nutritional transition in the population.


Assuntos
Saúde da Família , Inquéritos Epidemiológicos , Estado Nutricional , Adolescente , Transtornos do Crescimento/epidemiologia , Transtornos do Crescimento/etiologia , Humanos , Índia , Masculino , Sobrepeso/epidemiologia , Sobrepeso/etiologia , População Rural , Fatores Sexuais , Fatores Socioeconômicos , Magreza/epidemiologia , Magreza/etiologia , Organização Mundial da Saúde , Adulto Jovem
3.
PLoS One ; 15(6): e0233876, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32479544

RESUMO

Many women with Polycystic Ovary Syndrome (PCOS) report high depression rates. The relationship between PCOS and these high depression rates is unclear. Two-component lifestyle interventions have revealed short-term effects on depression scores in this group of women. In general, 3-component interventions including diet, exercise, and cognitive behavioral therapy (CBT) are more effective in the long-term to improve emotional well-being. This has not yet been studied in women with PCOS. This study examined the effect of 20 CBT lifestyle (LS) sessions combined with a healthy diet and physical therapy with or without 9 months additional feedback through Short Message Service (SMS) via mobile phone, compared to care as usual (CAU, involving advice to lose weight). In this secondary analysis, 155 women with PCOS and a BMI above 25 kg/m2 were eligible. Depression scores decreased significantly in the LS programme compared to CAU (P = 0.045). In both the LS programme without SMS (P = 0.036) and the LS programme with SMS (P = 0.011) depression scores decreased while no change was observed in CAU (P = 0.875). Self-esteem scores improved significantly in the LS programme compared to CAU (P = 0.027). No differences in body image scores were observed in LS participants compared to CAU (P = 0.087), although body image improved significantly in both the LS without SMS (P = 0.001) and with SMS (P = 0.008) study arms. We found no significant mediating role by androgens in the relationship between LS participants and emotional well-being. Only weight-loss mediated the relationship between LS and self-esteem. To conclude, a three-component lifestyle intervention programme with or without additional SMS resulted in significant improvements in depression and self-esteem compared to CAU, in women with PCOS, obesity, and a wish to achieve a pregnancy. Testosterone, androstenedione, DHEA, insulin, HOMA-IR, and cortisol did not mediate this effect. Weight loss mediated the effects on self-esteem but not on depression and body-image. This suggests that lifestyle treatment independent of weight loss can reduce depression and body-image, but both lifestyle treatment and weight loss can improve self-esteem. Thus, a three-component lifestyle intervention based on CBT could prove successful in improving mood in women with PCOS who are overweight or obese and attempting to become pregnant.


Assuntos
Terapia Cognitivo-Comportamental , Depressão/reabilitação , Dieta Saudável , Sobrepeso/reabilitação , Modalidades de Fisioterapia , Síndrome do Ovário Policístico/reabilitação , Adulto , Imagem Corporal , Terapia Combinada/métodos , Depressão/etiologia , Depressão/psicologia , Feminino , Humanos , Sobrepeso/etiologia , Sobrepeso/psicologia , Síndrome do Ovário Policístico/complicações , Síndrome do Ovário Policístico/psicologia , Autoimagem , Resultado do Tratamento , Perda de Peso , Saúde da Mulher
4.
BMC Public Health ; 20(1): 427, 2020 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-32238152

RESUMO

BACKGROUND: Social inequalities in bodyweight start early in life and track into adulthood. Dietary patterns are an important determinant of weight development in children, towards both overweight and underweight. Therefore, we aimed to examine weight development between age 5 and 10 years by ethnicity, SES and thereafter by BMI category at age 5, to explore its association with dietary patterns at age 5. METHODS: Participants were 1765 children from the Amsterdam Born Children and their Development (ABCD) cohort that had valid data on BMI at age 5 and 10 and diet at age 5. Linear mixed model analysis was used to examine weight development between age 5 and 10 years and to assess if four previously identified dietary patterns at age 5 (snacking, full-fat, meat and healthy) were associated with weight development. Analyses were adjusted for relevant confounders, stratified by ethnicity and SES and thereafter stratified per BMI category at age 5. RESULTS: Overall, weight decreased in Dutch and high SES children and increased in non-Dutch and low/middle SES children. Across the range of bodyweight categories at age 5, we observed a conversion to normal weight, which was stronger in Dutch and high SES children but less pronounced in non-Dutch and low/middle SES children. Overall, the observed associations between weight development and dietary patterns were mixed with some unexpected findings: a healthy dietary pattern was positively associated with weight development in most groups, regardless of ethnicity and SES (e.g. Dutch B 0.084, 95% CI 0.038;0.130 and high SES B 0.096, 95% CI 0.047;0.143) whereas the full-fat pattern was negatively associated with weight development (e.g. Dutch B -0.069, 95% CI -0.114;-0.024 and high SES B -0.072, 95% CI -0.119;-0.026). CONCLUSIONS: We observed differential weight development per ethnic and SES group. Our results indicate that each ethnic and SES group follows its own path of weight development. Associations between dietary patterns and weight development showed some unexpected findings; follow-up research is needed to understand the association between dietary patterns and weight development.


Assuntos
Índice de Massa Corporal , Peso Corporal , Dieta , Comportamento Alimentar , Obesidade/etiologia , Classe Social , Magreza/etiologia , Adulto , Criança , Pré-Escolar , Estudos de Coortes , Dieta Saudável , Gorduras na Dieta/administração & dosagem , Grupos Étnicos , Feminino , Humanos , Masculino , Países Baixos , Obesidade/etnologia , Sobrepeso/etnologia , Sobrepeso/etiologia , Fatores Socioeconômicos , Magreza/etnologia , Ganho de Peso , Perda de Peso
5.
PLoS One ; 15(3): e0230137, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32176721

RESUMO

AIMS: The aims were to investigate the association between maternal serum levels of perfluorooctane sulfonate (PFOS), perfluorooctanoic acid (PFOA), perfluorohexane sulfonate (PFHxS) and perfluorononanoic acid (PFNA) in early pregnancy and overweight in the child at 4 years and to assess potential heterogeneity in exposure effect between strata with different levels of other risk factors for overweight. METHODS: We used a case-control design and included 354 cases (ISO-BMI ≥ 18 kg/m2) and 2 controls per case (ISO-BMI ≤17 kg/m2) from child health care centers in Malmö, Sweden. Controls were selected stratified on risk scores for overweight in a propensity score framework. Maternal serum levels were analyzed in biobanked samples collected by routine around gestational week 14. Logistic regression was used to estimate odds ratios between quartiles of maternal serum levels and child overweight at age 4. RESULTS: There were no consistent monotonic exposure-response relationships. We found some significant odds ratios in specific quartiles but these were regarded as spurious findings. The absence of an effect was consistent over risk strata. CONCLUSIONS: We did not find evidence of an association between maternal serum levels of PFOS, PFOA, PFHxS and PFNA in early pregnancy and child overweight at age 4. The level of other risk factors for overweight did not affect children's susceptibility to prenatal PFAS exposure.


Assuntos
Fluorcarbonetos , Sobrepeso/etiologia , Efeitos Tardios da Exposição Pré-Natal , Ácidos Alcanossulfônicos/sangue , Ácidos Alcanossulfônicos/toxicidade , Caprilatos/sangue , Caprilatos/toxicidade , Estudos de Casos e Controles , Pré-Escolar , Poluentes Ambientais/sangue , Poluentes Ambientais/toxicidade , Feminino , Fluorcarbonetos/sangue , Fluorcarbonetos/toxicidade , Humanos , Masculino , Exposição Materna , Obesidade Pediátrica/etiologia , Gravidez , Suécia
6.
PLoS One ; 15(3): e0229883, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32163485

RESUMO

BACKGROUND: Malnutrition especially undernutrition is the main problem that is seen over people living with HIV/AIDS and can occur at any age. Multiple factors contributed to undernutrition of HIV/AIDS patients and it need immediate identification and prompt action. The objective of this study was to assess the nutritional status of patients and identify factors associated with undernutrition among HIV/AIDS patients on follow-up care in Jimma medical center, Southwest Ethiopia. METHODS: A cross-sectional study design was conducted from March-April 2016. Data were collected retrospectively from clinical records of HIV/AIDS patients enrolled for follow up care in ART clinic from June 2010 to January 2016. Bivariate and multivariate logistic regression analysis were performed to identify independent predictor of undernutrition. RESULTS: Data of 1062 patients were included in the study. The prevalence of undernutrition (BMI<18.5 kg/m2) and overweight or obesity were 34% and 9%, respectively. Out of undernourished patients, severely malnourished patients (BMI<16 kg/m2) accounted of 9%. Undernutrition was more likely among widowed patients (AOR = 1.7, 95% CI, 1.03-2.79), patients with no access to water supply (AOR = 1.69, 95% CI, 1.16-2.47) and patients in the WHO clinical stage of three (AOR = 2.0, 95% CI, 1.33-2.97) and four (AOR = 3.0, 95% CI, 1.74-5.07). Moreover, the odds of undernutrition was more likely among patients with CD4 cell count of <200 cells/mm3 (AOR = 2.0, 95% CI, 1.38-2.47) and patients with a functional status of bedridden (AOR = 3.6, 95% CI, 1.55-8.35) and ambulatory (AOR = 2.4, 95% CI, 1.66-3.51), respectively. CONCLUSION: Both undernutrition and overweight or obesity were prevalent among HIV/AIDS patients in Jimma Medical Center, Ethiopia. Undernutrition was significantly associated with clinical outcome of patients. Hence, nutritional assessment, care and support should be strengthened. Critical identification of malnourished patients and prompt interventions should be undertaken.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/complicações , Desnutrição/epidemiologia , Avaliação Nutricional , Sobrepeso/epidemiologia , Adolescente , Adulto , Assistência ao Convalescente/estatística & dados numéricos , Contagem de Linfócito CD4 , Estudos Transversais , Etiópia/epidemiologia , Feminino , Infecções por HIV/sangue , Infecções por HIV/tratamento farmacológico , Humanos , Masculino , Desnutrição/diagnóstico , Desnutrição/etiologia , Pessoa de Meia-Idade , Estado Nutricional , Sobrepeso/diagnóstico , Sobrepeso/etiologia , Prevalência , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Centros de Atenção Terciária/estatística & dados numéricos , Adulto Jovem
7.
Biomed Environ Sci ; 33(2): 133-137, 2020 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-32131960

RESUMO

This study aimed to examine the association between famine exposure in different stages of life and the risk of overweight/obesity and abdominal obesity in laterlife. A total of 12,458 participants were categorized into non-exposure and four direct exposures, including fetal, childhood, adolescence, and adult exposure. Only risk of being overweight or obesity in adolescence exposure [odds ratio ( OR), 1.45; 95% confidence interval ( CI), 1.08-1.94] was significantly higher than in non-exposure. Childhood ( OR, 1.27; 95% CI, 1.05-1.54) and adolescence ( OR, 1.53; 95% CI, 1.15-2.05) exposures had significantly an increased risk of abdominal obesity compared with non-exposure. Additionally, different famine severity exposures had different influences on the development of overweight/obesity and abdominal obesity. Famine exposure in adolescence, which was a behavior formative period, can increase the risk of overweight/obesity and abdominal obesity in adulthood, specifically in famine severely affect area.


Assuntos
Fome Epidêmica , Sobrepeso/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Criança , Pré-Escolar , China , Estudos Transversais , Feminino , Feto/fisiopatologia , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Obesidade/etiologia , Obesidade Abdominal/epidemiologia , Obesidade Abdominal/etiologia , Sobrepeso/etiologia , Fatores de Risco , Adulto Jovem
8.
Nat Commun ; 11(1): 561, 2020 02 11.
Artigo em Inglês | MEDLINE | ID: mdl-32047148

RESUMO

Parabens are preservatives widely used in consumer products including cosmetics and food. Whether low-dose paraben exposure may cause adverse health effects has been discussed controversially in recent years. Here we investigate the effect of prenatal paraben exposure on childhood overweight by combining epidemiological data from a mother-child cohort with experimental approaches. Mothers reporting the use of paraben-containing cosmetic products have elevated urinary paraben concentrations. For butyl paraben (BuP) a positive association is observed to overweight within the first eight years of life with a stronger trend in girls. Consistently, maternal BuP exposure of mice induces a higher food intake and weight gain in female offspring. The effect is accompanied by an epigenetic modification in the neuronal Pro-opiomelanocortin (POMC) enhancer 1 leading to a reduced hypothalamic POMC expression. Here we report that maternal paraben exposure may contribute to childhood overweight development by altered POMC-mediated neuronal appetite regulation.


Assuntos
Exposição Materna/efeitos adversos , Sobrepeso/etiologia , Parabenos/efeitos adversos , Efeitos Tardios da Exposição Pré-Natal/etiologia , Conservantes Farmacêuticos/efeitos adversos , Animais , Criança , Pré-Escolar , Ingestão de Alimentos , Feminino , Humanos , Hipotálamo/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Sobrepeso/genética , Sobrepeso/metabolismo , Sobrepeso/fisiopatologia , Parabenos/análise , Gravidez , Efeitos Tardios da Exposição Pré-Natal/genética , Efeitos Tardios da Exposição Pré-Natal/metabolismo , Efeitos Tardios da Exposição Pré-Natal/fisiopatologia , Conservantes Farmacêuticos/análise , Pró-Opiomelanocortina/genética , Pró-Opiomelanocortina/metabolismo , Urina/química , Ganho de Peso
9.
Artigo em Inglês | MEDLINE | ID: mdl-31947530

RESUMO

A severely cold climate has a significant impact on cardiovascular health, involving temperature, air environment, exercise and diet. Existing studies have revealed that green space, as an important health resource, may play a positive role in promoting cardiovascular health through the air environment and exercise. Studies focusing on the correlation between green space and cardiovascular health are rarely carried out in winter cities. The purpose of this paper is to take a winter city in China as an empirical case to explore the correlation between green space in a neighbourhood and cardiovascular health in a representative sample at the neighbourhood level, combining the results with Urban Residential Area Planning and Design Standards (GB50180-2018) in China and the existing research. The results showed that green space characteristics of a neighbourhood were related to cardiovascular disease and some of its risk factors. In neighbourhoods with a Green Space Ratio lower than 28%, residents had a higher risk of physical inactivity, overweight or obesity, hypertension and stroke. In neighbourhoods with a Green View Index lower than 15%, residents had a higher risk of physical inactivity, overweight/obesity, hypertension, dyslipidemia and stroke. A correlation was found between evergreen tree configuration type and the prevalence of overweight/obesity and hypertension. No correlation was found between the type of sports field and cardiovascular disease and its risk factors, except for hypertension. Residents' cardiovascular health scores also showed significant differences among neighbourhoods with different green space characteristics. Intervention efforts may benefit from emphasising the importance of improving the Green Space Ratio and Green View Index effectively in a neighbourhood to reduce the risk of cardiovascular disease.


Assuntos
Hipertensão/epidemiologia , Sobrepeso/epidemiologia , Características de Residência/estatística & dados numéricos , Árvores , Adulto , Idoso , Idoso de 80 Anos ou mais , Ambiente Construído/estatística & dados numéricos , China/epidemiologia , Cidades , Estudos Transversais , Feminino , Humanos , Hipertensão/etiologia , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Obesidade/etiologia , Sobrepeso/etiologia , Prevalência , Adulto Jovem
10.
Ann Epidemiol ; 41: 14-20, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31901410

RESUMO

PURPOSE: While high levels of obesity prevalence and incidence have been well documented, there is less research on obesity dynamics over time. In this article, we sought to understand the body mass index (BMI) trajectories in and out of obesity from adolescence to adulthood. METHODS: We used the National Longitudinal Study of Adolescent to Adult Health to explore American obesity dynamics from mean ages 15-28 years. We analyzed six BMI trajectories from 1994 to 2008 and examined their contextual sociodemographic correlates using ordinal logistic regression models. RESULTS: More than 50% of adolescents with normal BMI moved to overweight/obesity by adulthood; only 8% of overweight and 2% of obese adolescents achieved normal BMI in adulthood. While some sociodemographic characteristics such as sex, race/ethnicity, place of residence, and parents' education were associated with being in certain BMI trajectories among adolescents with normal BMI, they were not so associated among adolescents starting at obesity. CONCLUSIONS: Transitioning to higher BMI categories was common, whereas the opposite direction was rare. Pathways to obesity prevention might be easier to identify than those to reversal, as contextual factors had more explanatory power for youths with normal BMI than for those with obese BMI.


Assuntos
Obesidade/epidemiologia , Adolescente , Adulto , Afro-Americanos/estatística & dados numéricos , Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Grupo com Ancestrais do Continente Asiático , Índice de Massa Corporal , Grupo com Ancestrais do Continente Europeu , Feminino , Hispano-Americanos/estatística & dados numéricos , Humanos , Incidência , Estudos Longitudinais , Masculino , Obesidade/etnologia , Obesidade/etiologia , Sobrepeso/epidemiologia , Sobrepeso/etnologia , Sobrepeso/etiologia , Prevalência , População Rural , Fatores Sexuais , Fatores Socioeconômicos , Estados Unidos/epidemiologia , População Urbana , Adulto Jovem
11.
Occup Environ Med ; 77(2): 107-114, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31801799

RESUMO

OBJECTIVES: Transportation noise has been associated with markers of obesity. We aimed to investigate whether road traffic and railway noise were associated with weight gain during and after pregnancy. METHODS: Among the women participating in the Danish National Birth Cohort, 74 065 reported on weight before and during the pregnancy (gestational week 30) and 52 661 reported on weight before and 18 months after pregnancy. Residential address history from conception to 18 months after pregnancy was obtained in national registers, and road traffic and railway noise were modelled for all addresses. Associations between noise and gestational weight gain (GWG) and postpartum weight retention (PPWR) were analysed using the linear and log-binomial regression. RESULTS: A 10 dB(A) higher road traffic noise was associated with an increase in GWG of 3.8 g/week (95% CI 2.3 to 5.3) and PPWR of 0.09 kg (95% CI 0.02 to 0.16). For PPWR, this association seemed confined to women who were overweight (0.17 kg, 95% CI 0.02 to 0.32) or obese (0.49 kg, 95% CI 0.26 to 0.73) before pregnancy. Further adjustment by nitrogen dioxide reduced GWG risk estimates and slightly increased PPWR risk estimates. Railway noise ≥65 dB(A) was associated with an increase in GWG of 4.5 g/week (95% CI -2.7 to 11.6) and PPWR of 0.26 kg (95% CI -0.09 to 0.60) compared with levels <55 dB(A). CONCLUSIONS: Our findings suggest that road traffic noise is associated with weight gain during and after the pregnancy, which adds to the literature linking transportation noise to adiposity.


Assuntos
Índice de Massa Corporal , Exposição Ambiental/efeitos adversos , Ganho de Peso na Gestação , Ruído dos Transportes/efeitos adversos , Obesidade/etiologia , Período Pós-Parto , Adiposidade , Adulto , Estudos de Coortes , Feminino , Humanos , Veículos Automotores , Sobrepeso/etiologia , Gravidez , Complicações na Gravidez , Trimestres da Gravidez , Ferrovias , Fatores de Risco , Perda de Peso
12.
Lancet ; 395(10218): 142-155, 2020 01 11.
Artigo em Inglês | MEDLINE | ID: mdl-31852603

RESUMO

Actions to address different forms of malnutrition are typically managed by separate communities, policies, programmes, governance structures, and funding streams. By contrast, double-duty actions, which aim to simultaneously tackle both undernutrition and problems of overweight, obesity, and diet-related non-communicable diseases (DR-NCDs) have been proposed as a way to effectively address malnutrition in all its forms in a more holisitic way. This Series paper identifies ten double-duty actions that have strong potential to reduce the risk of both undernutrition, obesity, and DR-NCDs. It does so by summarising evidence on common drivers of different forms of malnutrition; documenting examples of unintended harm caused by some undernutrition-focused programmes on obesity and DR-NCDs; and highlighting examples of double-duty actions to tackle multiple forms of malnutrition. We find that undernutrition, obesity, and DR-NCDs are intrinsically linked through early-life nutrition, diet diversity, food environments, and socioeconomic factors. Some evidence shows that programmes focused on undernutrition have raised risks of poor quality diets, obesity, and DR-NCDs, especially in countries undergoing a rapid nutrition transition. This Series paper builds on this evidence to develop a framework to guide the design of double-duty approaches and strategies, and defines the first steps needed to deliver them. With a clear package of double-duty actions now identified, there is an urgent need to move forward with double-duty actions to address malnutrition in all its forms.


Assuntos
Doenças não Transmissíveis/prevenção & controle , Política Nutricional/legislação & jurisprudência , Estado Nutricional , Medicina Baseada em Evidências , Qualidade dos Alimentos , Humanos , Desnutrição/etiologia , Desnutrição/prevenção & controle , Obesidade/etiologia , Obesidade/prevenção & controle , Sobrepeso/etiologia , Sobrepeso/prevenção & controle , Fatores Socioeconômicos
13.
Lancet ; 395(10217): 65-74, 2020 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-31852602

RESUMO

The double burden of malnutrition (DBM), defined as the simultaneous manifestation of both undernutrition and overweight and obesity, affects most low-income and middle-income countries (LMICs). This Series paper describes the dynamics of the DBM in LMICs and how it differs by socioeconomic level. This Series paper shows that the DBM has increased in the poorest LMICs, mainly due to overweight and obesity increases. Indonesia is the largest country with a severe DBM, but many other Asian and sub-Saharan African countries also face this problem. We also discuss that overweight increases are mainly due to very rapid changes in the food system, particularly the availability of cheap ultra-processed food and beverages in LMICs, and major reductions in physical activity at work, transportation, home, and even leisure due to introductions of activity-saving technologies. Understanding that the lowest income LMICs face severe levels of the DBM and that the major direct cause is rapid increases in overweight allows identifying selected crucial drivers and possible options for addressing the DBM at all levels.


Assuntos
Desnutrição/epidemiologia , Obesidade/epidemiologia , Sobrepeso/epidemiologia , África ao Sul do Saara/epidemiologia , Qualidade dos Alimentos , Humanos , Indonésia/epidemiologia , Desnutrição/etiologia , Estado Nutricional , Valor Nutritivo , Obesidade/etiologia , Sobrepeso/etiologia , Pobreza , Prevalência , Fatores Socioeconômicos
14.
Pediatr Obes ; 15(3): e12588, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31845544

RESUMO

BACKGROUND: Maternal diet and chronic inflammation may influence early-life offspring health. No comparative data regarding intergenerational associations between dietary inflammation and offspring growth exist. OBJECTIVE: To investigate potential associations between parental and grandparental dietary inflammatory index (DII®) scores with offspring birth outcomes and childhood adiposity. METHODS: This analysis of the Lifeways Study includes 1082 mother-child pairs, 333 index-child's fathers and 707 grandparents. Energy-adjusted DII (E-DII) scores were derived from a validated FFQ for all adults. Birth outcomes were abstracted from hospital records. Childhood BMI was determined at age 5 and 9. Logistic regression and mediation analyses using the PROCESS macro for SPSS were performed. RESULTS: Higher maternal E-DII scores, reflecting a more pro-inflammatory diet, were associated with increased risk of low birthweight (LBW), BW < 2500 g (OR:1.20, 95%CI:1.02-1.47, p = 0.03). Higher maternal grandmothers' (MGM) E-DII scores were associated with increased risk of macrosomia (OR:1.35, 95% CI:1.02-1.79, p = 0.03) and with increased risk of an overweight grandchild at age 9 (OR:1.47, 95% CI:1.26-1.72, p = 0.02). Results from the mediation analyses revealed a significant total effect between MGMs' E-DII scores and grandchild's BW. Higher father's and paternal grandmothers' (PGM) E-DII scores were associated with greater risk of childhood overweight/obesity at 5 years (OR:1.03, 95%CI:1.01-1.19, p = 0.04 and OR:1.07, 95%CI:1.05-1.09, p = 0.01, respectively). The association with the PGMs' E-DII persisted at age 9 (OR:1.13, 95%CI:1.01-1.90, p = 0.04). CONCLUSIONS: Dietary inflammation is associated with adverse offspring birth outcomes and childhood adiposity. A more pro-inflammatory maternal line diet appears to influence early-life growth, whereas paternal line dietary inflammation appears to influence childhood obesity.


Assuntos
Dieta , Inflamação/complicações , Sobrepeso/etiologia , Obesidade Pediátrica/etiologia , Adulto , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Avós , Humanos , Recém-Nascido de Baixo Peso , Masculino , Pais
15.
J. pediatr. (Rio J.) ; 95(6): 705-712, Nov.-Dec. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1056657

RESUMO

ABSTRACT Objective: This study examined the growth status and physical development of Brazilian children with autism spectrum disorders from 4 to 15 years of age. Furthermore, it was examined whether variation in growth patterns and weight status was influenced by the use of psychotropic medications. Methods: One-hundred and twenty children aged 3.6-12.1 years at baseline (average = 7.2 years, SD = 2.3 years) diagnosed with autism spectrum disorders were measured on three repeated occasions across a 4-year period. Stature, body mass, and body mass index were considered. Bayesian multilevel modeling was used to describe the individual growth patterns. Results: Growth in stature was comparable to the age-specific 50th percentile for Centers for Disease Control and Prevention reference data until approximately 8 years, but a substantial decrease in growth rate was observed thereafter, reaching the age-specific 5th percentile at 15 years of age. Both body mass and body mass index values were, on average, higher than both the Brazilian and Centers for Disease Control and Prevention age-specific 95th percentile reference until 8 years, but below the 50th specific-age percentile at the age of 15 years. Conclusions: Brazilian boys with autism spectrum disorders between 4 and 15 years appear to have impaired growth in stature after 8-9 years of age, likely impacting pubertal growth. A high prevalence of overweight and obesity was observed in early childhood, although a trend of substantial decrease in body mass and body mass index was apparent when children with autism spectrum disorders entered the years of pubertal development.


RESUMO Objetivo: Este estudo examinou o estado de crescimento e o desenvolvimento físico de crianças brasileiras com transtornos do espectro autista entre 4 e 15 anos. Adicionalmente, examinamos se a variação nos padrões de crescimento e na massa corporal foi influenciada pelo uso de medicamentos psicotrópicos. Métodos: 120 crianças com idades entre 3,6 e 12,1 anos no início do estudo (média = 7,2 anos, DP = 2,3 anos) diagnosticadas com transtornos do espectro autista foram avaliadas em três ocasiões repetidas em um período de 4 anos. Foram considerados estatura, massa corporal e índice de massa corporal. O modelo multinível bayesiano foi utilizado para descrever os padrões de crescimento individual. Resultados: O crescimento em estatura foi comparável ao percentil 50 específico para a idade para os dados de referência do Centro de Controle e Prevenção de Doenças dos Estados Unidos até cerca de 8 anos. Porém, foi observada uma redução substancial na taxa de crescimento depois dos 8 anos, atingindo o percentil 5 específico para a idade aos 15 anos de idade. Tanto os valores de massa corporal quanto de índice de massa corporal foram, em média, maiores comparativamente ao percentil 95 específico para a idade até aos 8 anos da referência brasileira e do Centro de Controle e Prevenção de Doenças dos Estados Unidos, porém abaixo do percentil 50 específico para a idade aos 15 anos de idade. Conclusões: Os meninos brasileiros com transtornos do espectro autista entre 4 e 15 anos parecem ter retardo do crescimento na estatura após os 8-9 anos, provavelmente afeta o crescimento púbere. Foi observada uma alta prevalência de sobrepeso e obesidade na primeira infância, apesar de uma tendência de redução substancial na massa corporal e no índice de massa corporal ter sido aparente quando as crianças com transtornos do espectro autista entraram nos anos de desenvolvimento púbere.


Assuntos
Humanos , Masculino , Pré-Escolar , Criança , Adolescente , Estatura , Transtorno do Espectro Autista/complicações , Índice de Massa Corporal , Desenvolvimento Infantil , Estudos Longitudinais , Teorema de Bayes , Sobrepeso/etiologia , Obesidade/etiologia
16.
Rev. enferm. UERJ ; 27: e38673, jan.-dez. 2019. tab
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1005410

RESUMO

Objetivo: identificar os fatores clínico-comportamentais associados ao excesso ponderal (EP) em adultos jovens estudantes. Método: estudo transversal, realizado com 560 adultos jovens de 26 escolas de uma capital do nordeste brasileiro. Após obtenção dos dados pela aplicação de questionários específicos, utilizou-se a regressão logística múltipla para identificação dos fatores associados ao EP. Resultados: o EP acometeu mais de um terço dos adultos jovens e, na análise bivariada, apresentou associação estatística significativa com as variáveis: peso na infância, peso na adolescência, história familiar de excesso ponderal, uso de fármacos obesogênicos e exposição ao álcool. No modelo final da regressão, permaneceram as variáveis: peso na adolescência, história familiar de EP e exposição ao álcool. Conclusão: a frequência de casos de EP é alta e o histórico de ganho de peso na adolescência, o histórico familiar de EP e a exposição ao álcool explicam o agravo em questão, ratificando a relação do EP com fatores genéticos e comportamentais


Objective: to identify clinical-behavioral factors associated with overweight in young adult students. Methods: a cross-sectional study was conducted with 560 young adults from 26 schools in a state capital in northeast Brazil. After obtaining the data by applying specific questionnaires, multiple logistic regression was used to identify the factors associated with overweight. Results: overweight affected more than a third of the young adult students and, in bivariate analysis, showed statistically significant associations with the variables: weight in childhood, weight in adolescence, family history of overweight, use of obesogenic drugs and exposure to alcohol. The variables retained in the final regression model were: weight in adolescence, family history of overweight and alcohol exposure. Conclusion: frequency of overweight was high, and a history of weight gain in adolescence, family history of overweight and exposure to alcohol explained the problem in question, confirming the relationship of overweight with genetic and behavioral factors.


Objetivo: identificar los factores clínico-conductuales asociados al exceso ponderal (EP) en adultos jóvenes estudiantes. Método: estudio transversal, realizado junto a 560 adultos jóvenes de 26 escuelas de una capital del nordeste brasileño. Después de obtener los datos por la aplicación de cuestionarios específicos, se utilizó la regresión logística múltiple para identificación de los factores asociados al EP. Resultados: el EP afecta a más de un tercio de los adultos jóvenes y, en el análisis bivariado, presentó asociación estadística significativa con las variables: peso en la infancia, peso en la adolescencia, historia familiar de exceso ponderal, uso de fármacos obesogénicos y exposición al alcohol. En el modelo final de la regresión, permanecieron las variables: peso en la adolescencia y exposición al alcohol. Conclusión: la frecuencia de casos de EP es alta y la historia de aumento de peso en la adolescencia, el historial familiar de EP y la exposición al alcohol explican el agravio en cuestión, ratificando la relación del EP con factores genéticos y conductuales.


Assuntos
Humanos , Masculino , Feminino , Adulto , Adulto Jovem , Instituições Acadêmicas , Sobrepeso/psicologia , Adulto Jovem , Obesidade/psicologia , Estudos Transversais , Sobrepeso/etiologia , Nutrição do Adolescente , Adulto Jovem/psicologia
18.
BMC Complement Altern Med ; 19(1): 332, 2019 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-31752830

RESUMO

BACKGROUND: Weight gain is common after breast cancer (BC) treatment and may increase the risk of disease recurrence. Complementary medicine (CM) use is high amongst BC patients. This paper describes the use of CM from a cross-sectional self-administered survey on prevalence and management of weight after BC. METHODS: Use of CM was assessed using a question modified from the I-CAM Questionnaire. Participants were asked to rate perceived effectiveness, advantages and disadvantages, and which CM they were willing to use for weight management if there was evidence for effectiveness. The survey was emailed to members of the Breast Cancer Network Australia Survey and Review Group, the largest consumer advocacy group in Australia for people with breast cancer. RESULTS: There were a total of 309 responses. Three quarters had used CM in the past 12 months. One third had tried CM for weight loss. Yoga, meditation and pilates were perceived to be effective for weight loss. Perceived advantages of CMs for weight loss were the ability to improve general wellbeing, relaxation, and being non-pharmacological while disadvantages were financial cost, finding a reliable practitioner, and lack of research for effectiveness. Three quarters would be willing to try CM for weight loss if there was evidence for effectiveness, with the most popular CMs being acupuncture, relaxation, yoga, supplements, and meditation. CONCLUSIONS: The high use of CM in this group is consistent with previous research. Our research suggests that BC survivors would use acupuncture, meditation, supplements and yoga for weight loss if supported by scientifically-credible evidence. Research into the effectiveness of these treatments on weight loss after BC is warranted.


Assuntos
Neoplasias da Mama , Terapias Complementares , Conhecimentos, Atitudes e Prática em Saúde , Sobrepeso , Ganho de Peso , Adulto , Idoso , Austrália , Peso Corporal/fisiologia , Neoplasias da Mama/complicações , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/terapia , Terapias Complementares/psicologia , Terapias Complementares/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Sobrepeso/epidemiologia , Sobrepeso/etiologia , Sobrepeso/psicologia , Sobrepeso/terapia , Prevalência
19.
BMC Public Health ; 19(1): 1512, 2019 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-31718605

RESUMO

BACKGROUND: Due to the high prevalence and adverse consequences, overweight and obesity in children continues to be a major public health concern worldwide. Socioeconomic background and health-related behaviours (such as diet, physical activity and sedentary behaviors) are important factors associated with weight status in children. Using a series of height and weight assessments from the Australian Capital Territory Physical Activity and Nutrition Survey (ACTPANS), trends in prevalence of overweight and obesity by socioeconomic status were examined in ACT Year 6 school children between 2006 and 2018. METHODS: The ACTPANS has been conducted every 3 years since 2006. A total of 6729 children were surveyed. Complete data on height and weight were available for 6384 (94.9%) participants. Trends in the prevalence of overweight and obesity and associations between weight status and risk factors (such as socioeconomic status, physical activity, screen time and consumption of sugar-sweetened soft drinks (SSD)) were examined using logistic regression. RESULTS: The prevalence of overweight and obesity remained stable in girls (from 22.5% in 2006 to 21.6% in 2018) but declined in boys (from 27.8 to 17.9%). During the same period, levels of physical activity increased slightly, while screen time and the consumption of fast food and SSD decreased. Socioeconomic gradient, based on the school-level Index of Community Socio-Educational Advantage (ICSEA), was highly associated with prevalence of overweight and obesity. Since 2006, the estimated prevalence of overweight and obesity has remained high in the lowest SES groups, but a concurrent downward trend was observed in the highest SES group, leading to increasing disparity between SES groups. Children in the lowest ICSEA quintile were more likely to be overweight or obese compared to those in the moderate and highest ICSEA quintiles. Children in lower ICSEA quintiles also reported lower levels of physical activity, higher levels of screen time, and higher levels of fast food and SSD consumption compared to those in higher ICSEA quintiles. CONCLUSIONS: While recent trends in overweight and obesity in ACT children are encouraging, the prevalence remains unacceptably high, especially in those from low socioeconomic backgrounds. Additional prevention efforts are required to address the socioeconomic disparity.


Assuntos
Comportamento do Adolescente , Comportamento Infantil , Comportamentos Relacionados com a Saúde , Obesidade Pediátrica/epidemiologia , Classe Social , Adolescente , Território da Capital Australiana/epidemiologia , Peso Corporal , Criança , Dieta , Exercício Físico , Feminino , Disparidades nos Níveis de Saúde , Humanos , Modelos Logísticos , Masculino , Sobrepeso/epidemiologia , Sobrepeso/etiologia , Obesidade Pediátrica/etiologia , Prevalência , Fatores de Risco , Instituições Acadêmicas , Tempo de Tela , Comportamento Sedentário , Inquéritos e Questionários
20.
Artigo em Inglês | MEDLINE | ID: mdl-31671822

RESUMO

Mexican migrant farm workers are one of the poorest and most marginalized social groups within the country. They face the double burden of malnutrition, food insecurity, as well as harsh living and labor conditions. Objective: To examine the relationship between household food insecurity (HFI) and obesity in a population of migrant farm workers in highly modernized agribusiness areas of Northwest Mexico. Methods: This was a cross-sectional study with a concentric (site) (n = 146 households) and systematic selection of participants (adult men and women). Methods included questionnaires regarding socio-demographic characteristics, food security, diet (two non-consecutive 24-h recalls), and physical activity (PA). Anthropometric data included height, weight, and waist circumference. Data analysis covered descriptive statistics, multivariate linear and logistic regression. Results: Sample showed 75% prevalence of overweight and obesity, while 87% of households reported some level of HFI. Mild HFI resulted in five times more probability of farm workers' obesity (OR = 5.18, 95% CI: 1.37-19.58). However, there was a protective effect of HFI for obesity among men (OR 0.089, 95% CI: 0.01-0.58) in a context of intense labor-related PA. Conclusion: There is a difference by gender in the relationship of HFI with obesity prevalence related perhaps to the energy expenditure of male agricultural migrant workers.


Assuntos
Doenças dos Trabalhadores Agrícolas/etiologia , Fazendeiros/estatística & dados numéricos , Abastecimento de Alimentos/estatística & dados numéricos , Obesidade/etiologia , Migrantes/estatística & dados numéricos , Adulto , Doenças dos Trabalhadores Agrícolas/epidemiologia , Estudos Transversais , Feminino , Humanos , Modelos Lineares , Modelos Logísticos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Sobrepeso/etiologia , Prevalência , Fatores de Risco , Fatores Socioeconômicos , Adulto Jovem
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