Coffee and Tea Group Contribute the Most to the Dietary Total Antioxidant Capacity of Older Adults: A Population Study in a Medium-Sized Brazilian City.

OBJECTIVE: The dietary total antioxidant capacity (TAC) has been proposed as a suitable tool to estimate the dietary antioxidant intake. However, the main foods/groups that contribute to the dietary TAC of older adults are poorly studied. We aimed to estimate the dietary TAC and to identify the main foods/groups that contribute to the dietary TAC of older adults in a medium-sized Brazilian city. METHODS: A cross-sectional population-based survey with older adults (≥60 years old) was conducted in Viçosa, Brazil. The assessment tool for food consumption was the recall of habitual consumption. A database with ferric reducing antioxidant power (FRAP) values for foods to evaluate the dietary TAC was used. RESULTS: We evaluated 620 older adults in which the majority were women. The dietary TAC mean was 11.9 (7.1) mmol/d (food only) adjusted by energy. Besides, when supplements were considered the dietary TAC increased to 35.2 (215.9) mmol/d. The food groups that contributed the most to the dietary TAC were coffee and tea, vegetables, and fruits and juices. The coffee and tea group explained most of the variability of dietary TAC (58.3%). CONCLUSIONS: We concluded that the older adults studied had a relatively low dietary TAC consumption. The coffee and tea were the food group that contribute the most to the dietary TAC. Our data show the need to implement national strategies aimed at improving the quality of the diet of older adults. We highlight the need to increase the consumption of different food groups and, consequently, the intake of different compounds with antioxidant capacity, which will contribute to a better dietary TAC with possible positive health effects.

Dietary total antioxidant capacity as a tool in health outcomes in middle-aged and older adults: A systematic review.

The dietary total antioxidant capacity (TAC) has been a useful tool in epidemiological studies. To assess whether the TAC is associated with chronic diseases in middle-aged and older adults carried out a systematic review of articles indexed in MEDLINE and Science Direct. Of the 104 articles found, nine were included to meet the inclusion criteria. There was variation among the items on the sample size, sample origin, use of statistical tests, analysis of different outcomes and the use of assays to evaluate the TAC, which brought limitations to the comparability of results on the association of TAC with the outcomes of interest. However, in six studies we found an inverse association between TAC and the risk of chronic diseases, showing that this method has great potential for clinical applications and public health.

Estimated dietary intake and major food sources of polyphenols in elderly of Viçosa, Brazil: a population-based study.

PURPOSE: Epidemiological studies have remarked the beneficial role that polyphenols may have in the elderly population such as cancer and cardiovascular disease prevention. This is particularly relevant considering the global tendency of population aging. Data on polyphenol intake in the elderly population are scarce and usually provide partial information-only for some polyphenol classes. The aim of this study was to estimate the intake of polyphenols and its major dietary contributors in the population of Viçosa. METHODS: A cross-sectional population-based survey including 620 elderly was conducted in Viçosa, Brazil. Food intake was estimated by recall of habitual consumption (RHC). Polyphenol intake was calculated by matching food consumption data from the RHC with the polyphenol content in foods listed in the Phenol-Explorer database. RESULTS: The average total polyphenol intake was 1198.6 mg/day (533.7 mg/day as aglycone). The main polyphenol classes were phenolic acids (729.5 mg/day) and flavonoids (444.7 mg/day). The main dietary contributors for total polyphenols were coffee (45.8%), beans (32.8%) and polenta (1.3%). A total of 292 polyphenols divided in 14 classes and 23 subclasses were found. The individual compounds with the highest intake were isomers of chlorogenic acid (i.e., 5-caffeoylquinic acid, 4-caffeoylquinic acid and 3-caffeoylquinic acid) among hydroxycinnamic acids that largely originated from coffee. CONCLUSIONS: The data reported here can be used to evaluate the association between the amount and type of ingested polyphenols and health outcomes in epidemiological studies in order to eventually establish nutritional recommendations.

Consumption of fruits and vegetables among older adults: findings from the ELSI-Brazil study.

This study aimed to assess the prevalence of recommended consumption of fruits and vegetables and their associated factors in a national sample representative of the Brazilian population aged 60 or over. Baseline data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil), conducted from 2015 to 2016, including 4,982 older individuals, were used. The recommended consumption of fruits and vegetables was assessed based on questions on the weekly and daily frequency of fruits, natural fruit juice, and vegetables. Intake of five or more servings of these foods on five or more days per week was considered as recommended consumption. Exploratory variables included socio-demographic characteristics, health behaviors, health conditions, and use of health services. Univariate and multiple logistic regression were used to examine the factors associated with the recommended consumption of fruits and vegetables. The prevalence of recommended consumption of fruits and vegetables was 12.9% (95%CI: 11.5-14.3). This consumption showed associations with gender (women - OR = 1.40; 95%CI: 1.08-1.82), age group (80 years or older - OR = 1.66; 95%CI: 1.16-2.37), education level (8 years or more - OR = 2.07; 95%CI: 1.51-2.86), smoking (former smokers - OR = 0.69; 95%CI: 0.55-0.85 and current smokers - OR = 0.50; 95%CI: 0.33-0.77) and medical appointments in the previous 12 months (OR = 1.88; 95%CI: 1.31-2.71). Our findings showed a low prevalence of the recommended consumption of fruits and vegetables among older Brazilian adults, drawing attention to the need for policies aimed at increasing this consumption in the studied population.

Healthcare access, utilization, and quality after a disaster: results from the Brumadinho Health Project.

OBJECTIVE: In January 2019 a dam at the Córrego do Feijão mine suffered a catastrophic failure that killed 270 people and caused extensive damage. It is unknown how exposure to such a disaster might affect healthcare utilization. METHODS: We assessed survey data from the Brumadinho Health Project, a cohort study that includes people who were exposed to the dam failure and two comparison groups: people unexposed to mining or the disaster and people from a mining community, but not exposed to the disaster. Main outcomes include any doctor visit or hospitalization in the past year, having a usual source of healthcare, having blood pressure and blood sugar checked, and being up to date with vaccinations, for adults 18 years and over. We used survey-weighted robust Poisson regression to assess differences between those exposed and the two comparison groups while controlling for confounders. RESULTS: In multivariable models, the exposed group had a 15% higher chance of having a doctor visit than the unexposed group. For hospitalization and reports of blood pressure and blood sugar assessments, there was no significant difference among any of the groups. The exposed group had a 24% higher chance and the unexposed mining community had a 143% higher chance of being up to date with immunizations, as compared to the unexposed group. CONCLUSION: There were some differences in healthcare utilization among individuals exposed to the dam failure. Continued monitoring of the situation is warranted, as the full consequences of such a traumatic event may take considerable time to unfold.

Sociodemographic and residential factors associated with multimorbity: results of Brumadinho Health Project.

OBJECTIVE: To evaluate the prevalence of multimorbidity and sociodemographic and residential factors associated with this condition among adults living in Brumadinho, Minas Gerais. METHODS: Cross-sectional study with baseline data from the Brumadinho Health Project, conducted in 2021 and comprising 2,777 individuals aged 18 years and over. The outcome variable was multimorbidity, defined by the existence of two or more of 20 chronic diseases. The exploratory variables were sex, age group, educational level, skin color and area of residence according to the dam failure. The association between exploratory variables and multimorbidity was assessed by logistic regression. RESULTS: The prevalence of multimorbidity was 53.8% (95%CI 50.6-56.9). A greater chance of multimorbidity was found among women (adjusted OR=2.5; 95%CI 1.9-3.2), in participants aged between 40 and 59 (adjusted OR=2.8; 95%CI 1.8-4.3) or 60 years and older (adjusted OR=7.9; 95%CI 4.7-13.4) and in residents of the areas that were directly affected by the dam failure (adjusted OR=1.6; 95%CI 1.3-2.0). CONCLUSION: The burden of multimorbidity on the population of Brumadinho requires effective preventive measures and actions to the whole population, but mainly to the most vulnerable groups, that is, women, middle-aged and older individuals, and those directly affected by the dam failure, in addition to a timely provision of health care to reverse this situation.

Brumadinho Health Project: food and nutrition insecurity versus socioeconomic statuses and dimensions of the food system after the dam rupture.

OBJECTIVE: To describe the situation of food insecurity of families according to the socioeconomic characteristics and dimensions of the food system in Brumadinho, state of Minas Gerais, Brazil, after the dam rupture in Córrego do Feijão mine. METHODS: This is a descriptive study focused on households carried out from the baseline of the Brumadinho Health Project. Food insecurity, the main outcome, was assessed by the short version of the Brazilian Food Insecurity Scale. Other investigated variables were: socioeconomic data; geographic stratum of the households; family's assets; income; expenses; cultivation of food and animal husbandry for consumption. Descriptive analyses were performed comparing the food insecurity of the household according to the other variables by the χ2 test to compare the proportions. RESULTS: Of the investigated households (n=1,441), 35.1% were facing food insecurity. facing food insecurity had: lower prevalence of masonry households with coating (91.4%; 95%CI 87.7%-94.1% vs. 96.7%; 95%CI 94.9%-97.8%); highest proportion of rudimentary cesspit (16.9%; 95%CI 13.3%-21.2% vs. 9.4%; 95%CI 7.4-11.9); lower prevalence of own and paid-off homes (63.9%; 95%CI 56.8-70.5 vs. 77.3%; 95%CI 72.3-81.7); and income reduction after the dam rupture (33.0%; 95%CI 27.1-39.6 vs. 14.1%; 95%CI 11.2-17.6), when compared with those in a food security situation. CONCLUSION: The prevalence of food insecurity was high, with report of a reduction in household income after the dam rupture. Moreover, most of the households had worse structural quality and sewage outfall. These results evidence the vulnerability of families and possible violation of the human right to adequate food, denoting the urgency of continuous reparative actions.

Food consumption of Brumadinho Health Project participants.

OBJECTIVE: To analyze the food consumption patterns of residents of Brumadinho, Minas Gerais, Brazil, according to sociodemographic characteristics, neighborhood and area of residence. METHODS: Cross-sectional study with baseline data from the Brumadinho Health Project, conducted with 2,805 adult individuals. The healthy food consumption markers analyzed were: fruits and vegetables (FV), beans and fish; the unhealthy markers were: sweets and soda/artificial juices, whole-fat milk and red meat with visible fat or chicken with skin. Prevalence values and 95% confidence intervals were calculated for the total sample and according to sociodemographic characteristics, presence of commercial establishments with varieties of FV in the neighborhood and area of residence affected by the dam failure. RESULTS: Among the healthy food consumption markers, the most common was beans (81.6%), and among the unhealthy ones, whole-fat milk (68.8%) and red meat with visible fat/chicken with skin (61.1%). Women were more prone to higher consumption of FV, while men, of beans and fish; the prevalence of these markers was higher among individuals with higher education degrees and higher incomes. Unhealthy eating markers were more prevalent among men, younger people, individuals with lower educational level and lower incomes, and residents in an area directly affected by the dam failure or in a mining region. CONCLUSION: Less than half of the participants were considered to follow regular or recommended consumption of healthy eating markers, except for beans. Individual characteristics and area of residence were associated with individuals' food consumption patterns and should be taken into account in actions to promote adequate and healthy eating.

Chronic respiratory diseases and respiratory symptoms after a mining dam rupture: Brumadinho Health Project.

OBJECTIVE: To identify factors associated with asthma and chronic obstructive pulmonary disease (COPD) and respiratory symptoms, in Brumadinho, state of Minas Gerais, Brazil, after a dam rupture. METHODS: This is a cross-sectional study, including a representative sample of adults (aged 18 years and over) in the municipality. Associations were assessed between dependent variables (medical diagnosis of asthma and COPD; symptoms of wheezing, dry cough, and nose irritation) and exploratory variables (sex, age group, smoking habit, having worked at Vale S.A. company before the dam rupture, time and area of residence in relation to the dam rupture). Logistic regression models with odds ratio (OR) calculation and 95% confidence interval were used. RESULTS: We identified a prevalence of 7.2% of asthma; 3.5% of COPD; 8.8% of wheezing; 23.6% of dry cough; and 31.8% of nose irritation. We observed a greater chance of asthma among women and residents in the affected and mining regions, while a greater chance of COPD was observed in smokers and in those with longer time of residence in the municipality. Among the symptoms, we verified a higher chance of nose irritation among women, while a higher chance of wheezing and dry cough were found among smokers (current and former). Residents of regions affected by the mud reported a greater chance of presenting all the analyzed symptoms. Conversely, level of education was negatively associated with wheezing and dry cough. CONCLUSION: We found respiratory changes and identified the groups most vulnerable to developing them, which could contribute to directing actions to reduce the population's respiratory problems.

Association between "a body shape index" and mortality: Bambuí Cohort Study of Aging, Brazil.

This article aims to evaluate the joint and separate association between abdominal and general adiposity indicators and mortality. Data was collected from 1,366 older adults in the Bambuí Cohort Study of Aging with complete information for all variables of interest. The outcome variable was all-cause time until death; exposure variables were a body shape index (ABSI), waist circumference (WC), waist-to-height ratio (WHtR) and body mass index (BMI), assessed at the beginning of the study, and at the 3rd, 5th and 11th year of follow-up. Association between the quartiles of anthropometric indicators and mortality was calculated using an extended Cox proportional hazards model and adjusted for socioeconomic and behavioral confounding factors. Older adults in the 4th ABSI quartile had a higher risk of mortality regardless of BMI (1.27; 95%CI: 1.01-1.58), but this association was not observed in sensitivity analyses. Older adults in the 2nd, 3rd and 4th BMI quartiles had a lower risk of mortality, even when adjusted for WC or ABSI. WC and WHtR showed no association consistent with all-cause mortality after adjustment for confounding factors. Considering the loss of significance in the sensitivity analyses, ABSI's predictive capacity for mortality is still weak. Thus, adopting ABSI in clinical practice or in epidemiological surveys, in conjunction or replacing BMI and WC, requires more in-depth studies.

Lifestyle factors and multimorbidity among older adults (ELSI-Brazil).

The objective of the study was to evaluate the association between unhealthy lifestyle factors (individual and combined) and multimorbidity stratified by sex, in a national sample representative of Brazilians aged 50 years or older. Data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil) baseline, conducted in 2015-2016, were used. Multimorbidity was defined by the existence of two or more of the 19 chronic diseases. Four unhealthy lifestyle factors were considered: (1) at-risk alcohol consumption, (2) current or past smoking, (3) insufficient physical activity and (4) below-recommended consumption of fruits and vegetables. The association between unhealthy lifestyle factors, individual and combined, was assessed by logistic regression. Among the 7918 study participants, the prevalence of multimorbidity was 75.8% (95% CI 73.7-77.7) among women and 58.7% (95% CI 56.0-61.3) among men. Among women, none of the analyzed behaviors presented an independent and statistically significant association (p < 0.05) with multimorbidity. Among men, at-risk alcohol consumption was associated with lower odds of multimorbidity. On the other hand, current or past smoking and insufficient physical activity were associated with greater odds of this condition. In addition, the presence of three or four unhealthy lifestyle factors was associated with greater odds of multimorbidity among men. The results reinforce the need for interventions to promote healthy behaviors among older men with two or more chronic diseases. In addition, it is evident that the health services need to act in an attempt to modify unhealthy behaviors after medical diagnosis of chronic diseases to reduce the risk of future complications.

Health behaviours and the adoption of individual protection measures during the new coronavirus pandemic: the ELSI-COVID-19 initiative. / Comportamentos em saúde e adoção de medidas de proteção individual durante a pandemia do novo coronavírus: iniciativa ELSI-COVID-19.

The objective of this study was to evaluate whether healthy behaviours determine the adoption of individual protective measures to fight COVID-19. The data were obtained from the ELSI-COVID-19 initiative, a telephone survey conducted among participants in the Brazilian Longitudinal Study of Aging (ELSI-Brazil), which includes a national sample representative of the population aged 50 years or older. The outcomes evaluated were three protective measures (not having left home in the past week, wearing a mask when leaving home, and sanitizing hands when returning home), and the explanatory variables were health behaviours (smoking, alcohol consumption, consumption of fruits and vegetables, and physical activity). The associations were evaluated by logistic models, considering adjustments for potential confounding factors. A total of 5,827 individuals participated in the analysis; 32.2% did not leave home in the last week, and among those who left home, 97.5% used a face mask, and 97.3% sanitized their hands when they returned home. The practice of physical activity at the recommended levels was associated with a lower chance of not leaving home in the previous week. Ex-smokers were more likely to use a mask, and those who practised physical activity were less likely to adopt this protective measure. Individuals with low-risk alcohol consumption had a higher chance of sanitizing their hands. Actions aimed at increasing the adoption of protective measures to fight the new coronavirus should consider the existence of vulnerable groups, which can be identified by the distribution of other health behaviours in the population.

O objetivo deste estudo foi avaliar se os comportamentos saudáveis determinam a adoção de medidas protetivas individuais para o combate à COVID-19. Os dados foram obtidos da iniciativa ELSI-COVID-19, inquérito telefônico conduzido entre os participantes do Estudo Longitudinal da Saúde dos Idosos Brasileiros (ELSI-Brasil), que inclui amostra nacional representativa da população com 50 anos ou mais. Os desfechos avaliados foram três medidas protetivas (não ter saído de casa na última semana, usar máscara quando saiu de casa e higienizar as mãos quando retornou para casa) e as variáveis explicativas foram os comportamentos em saúde (tabagismo, consumo de bebidas alcoólicas, consumo de frutas e hortaliças e prática de atividade física). As associações foram avaliadas por modelos logísticos, considerando-se o ajuste por potenciais fatores de confusão. Participaram da análise 5.827 indivíduos; 32,2% não saíram de casa na última semana; e entre os que saíram de casa, 97,5% usaram máscara facial e 97,3% higienizaram as mãos quando retornaram ao domicílio. A prática de atividade física nos níveis recomendados foi associada com menor chance de não sair de casa na semana anterior. Os ex-fumantes apresentaram maior chance de usar máscara e aqueles que praticavam atividade física tinham menor chance de adotar esta medida protetiva. Indivíduos com consumo de baixo risco de bebidas alcoólicas apresentaram maior chance de higienizar as mãos. Ações que visem ao aumento da adoção das medidas protetivas para o combate ao novo coronavírus devem considerar a existência de grupos vulneráveis, que podem ser identificados pela distribuição de outros comportamentos em saúde na população.

El objetivo de este estudio fue evaluar si los comportamientos saludables determinan la adopción de medidas protectoras individuales para combatir la COVID-19. Los datos se obtuvieron del iniciativa ELSI COVID-19, encuesta telefónica llevada a cabo entre los participantes del Estudio Brasileño Longitudinal del Envejecimiento (ELSI-Brasil), que incluye una muestra nacional representativa de la población con 50 años o más. Los desenlaces evaluados fueron tres medidas protectoras: no haber salido de casa en la última semana, usar mascarilla cuando se salió de casa e higienizar las manos cuando se volvió a casa. Asimismo, las variables explicativas fueron los comportamientos en salud (tabaquismo, consumo de bebidas alcohólicas, consumo de frutas y hortalizas, así como la práctica de actividad física). Las asociaciones fueron evaluadas mediante modelos logísticos, considerando el ajuste por potenciales factores de confusión. Participaron en el análisis 5.827 individuos; un 32,2% no salió de casa en la última semana, entre quienes salieron de casa un 97,5% usaron mascarilla facial y un 97,3% se higienizaron las manos, cuando regresaron al domicilio. La práctica de actividad física en los niveles recomendados estuvo asociada con una menor oportunidad de no salir de casa en la semana anterior. Los exfumadores presentaron una mayor oportunidad de usar mascarilla y aquellos que practicaban actividad física tenían una menor oportunidad de adoptar esta medida protectora. Individuos con un consumo de bajo riesgo de bebidas alcohólicas presentaron una mayor oportunidad de higienizar sus manos. Las acciones que tengan como objetivo el aumento de la adopción de medidas protectoras para combatir al nuevo coronavirus deben considerar la existencia de grupos vulnerables, que pueden ser identificados por la distribución de otros comportamientos en salud dentro de la población.

[Alcohol consumption patterns and associated factors among elderly Brazilians: National Health Survey (2013)]. / Padrões de consumo de álcool e fatores associados entre idosos brasileiros: Pesquisa Nacional de Saúde (2013).

The scope of this study was to analyze the pattern of alcohol consumption among elderly Brazilians (60 years and over) and their association with sociodemographic factors, lifestyle habits and health conditions. This is a cross-sectional study of 10,537 elderly (90.1%) participants from the National Health Survey of 2013. The consumption of alcoholic beverages was classified as non-use, mild / moderate use and risk use. The multinomial regression model was used to study the associated factors. The prevalence for mild / moderate and risk use was 9.4% (95% CI: 8.4- 10.6%) and 4.6% (95%CI: 4.0-5.3%), respectively. The two consumption patterns were inversely associated with age and more frequent among men, better schooling, smokers and physical activity practitioners. Mild / moderate consumption was less frequent among non-whites and those with a history of stroke and diabetes, whereas risk use was less frequent among the elderly diagnosed for heart disease and more frequent among those suffering from depression. This result identifies profiles of greater vulnerability, with small differences between two patterns of consumption. This information should be considered in the preparation of proposals to promote healthy habits and control of alcohol use among the elderly.

O objetivo foi analisar o padrão de consumo de álcool entre idosos (60 anos ou mais) brasileiros e sua associação com fatores sociodemográficos, hábitos de vida e condições de saúde. Trata-se de um estudo transversal, realizado com 10.537 idosos (90,1%) participantes da Pesquisa Nacional de Saúde de 2013. O consumo de bebidas alcoólicas foi classificado em não uso, uso leve/ moderado e uso de risco. Utilizou-se o modelo de regressão multinomial para o estudo dos fatores associados. A prevalência para uso leve/moderado e de risco foi de 9,4% (IC95%: 8,4-10,6%) e 4,6% (IC95%:4,0-5,3%), respectivamente. Os dois padrões de consumo foram inversamente associados à idade, mais frequentes entre homens, mais escolarizados, fumantes e que praticavam atividade física. O consumo leve/moderado foi menos frequente entre não brancos e entre aqueles com relato de AVC e diabetes, enquanto o consumo de risco foi menos frequente entre idosos com diagnóstico para doenças do coração e mais frequentes entre os que reportaram depressão. Esse resultado identifica perfis de maior vulnerabilidade, com pequenas diferenças entre os padrões de consumo. Essas informações devem ser consideradas na elaboração de propostas para promoção de hábitos saudáveis e controle do abuso de álcool em idosos.

"A body shape index" and its association with arterial hypertension and diabetes mellitus among Brazilian older adults: National Health Survey (2013).

The aim was to evaluate the separate and joint association of abdominal adiposity indicators (a body shape index - ABSI, waist circumference - WC, waist-to-height ratio - WHtR) and body mass index (BMI) with arterial hypertension and diabetes mellitus, in Brazilian older adults. Data from the 2013 Brazilian National Health Survey (PNS 2013) were used for the population aged 60 years or older (10,537 older adults). Arterial hypertension and diabetes mellitus outcomes were self-reported and the following anthropometric indices were evaluated by direct measurement: a ABSI, BMI, WC and WHtR. Associations were assessed by logistic regression, with adjustments for confounding factors. The results of this study evidenced a higher strength of association between the report of arterial hypertension and diabetes mellitus with BMI, WC and WHtR in the Brazilian population of older adults in separate analyses, when compared to ABSI. When adjusted for BMI, ABSI showed a greater strength of association with the outcomes, but it was not superior to the performance of WC and WHtR. Considering the lower strength of association, in separate and joint analyses, between the new index (ABSI) and the chronic conditions assessed, BMI, WC and WHtR probably remain as useful indices in public health, at least in relation to arterial hypertension and diabetes mellitus in Brazilian older adults.

Consumption of fruits and vegetables among older adults: findings from the ELSI‐Brazil study / Consumo de frutas e hortaliças em idosos: achados do estudo ELSI-Brasil / Consumo de frutas y verduras en ancianos: hallazgos del estudio Elsi-Brasil

Abstract This study aimed to assess the prevalence of recommended consumption of fruits and vegetables and their associated factors in a national sample representative of the Brazilian population aged 60 or over. Baseline data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil), conducted from 2015 to 2016, including 4,982 older individuals, were used. The recommended consumption of fruits and vegetables was assessed based on questions on the weekly and daily frequency of fruits, natural fruit juice, and vegetables. Intake of five or more servings of these foods on five or more days per week was considered as recommended consumption. Exploratory variables included socio-demographic characteristics, health behaviors, health conditions, and use of health services. Univariate and multiple logistic regression were used to examine the factors associated with the recommended consumption of fruits and vegetables. The prevalence of recommended consumption of fruits and vegetables was 12.9% (95%CI: 11.5-14.3). This consumption showed associations with gender (women - OR = 1.40; 95%CI: 1.08-1.82), age group (80 years or older - OR = 1.66; 95%CI: 1.16-2.37), education level (8 years or more - OR = 2.07; 95%CI: 1.51-2.86), smoking (former smokers - OR = 0.69; 95%CI: 0.55-0.85 and current smokers - OR = 0.50; 95%CI: 0.33-0.77) and medical appointments in the previous 12 months (OR = 1.88; 95%CI: 1.31-2.71). Our findings showed a low prevalence of the recommended consumption of fruits and vegetables among older Brazilian adults, drawing attention to the need for policies aimed at increasing this consumption in the studied population.

Resumo O objetivo deste estudo foi avaliar a prevalência do consumo recomendado de frutas e hortaliças e seus fatores associados em uma amostra nacional representativa da população brasileira com 60 anos ou mais. Foram utilizados dados da linha de base do Estudo Longitudinal da Saúde dos Idosos Brasileiros (ELSI-Brasil), realizado entre 2015 e 2016 com 4.982 idosos. O consumo recomendado de frutas e hortaliças foi avaliado com base em questões sobre a frequência semanal e diária de frutas, sucos naturais e hortaliças. A ingestão de cinco ou mais porções desses alimentos em cinco ou mais dias por semana foi considerada como consumo recomendado. As variáveis exploratórias incluíram características sociodemográficas, comportamentos de saúde, condições de saúde e o uso de serviços de saúde. A regressão logística univariada e múltipla foi utilizada para examinar os fatores associados ao consumo recomendado de frutas e hortaliças. A prevalência do consumo recomendado de frutas e hortaliças foi de 12,9% (IC95%: 11,5-14,3). Esse consumo apresentou associação com sexo (feminino - OR = 1,40; IC95%: 1,08-1,82), faixa etária (80 anos ou mais - OR = 1,66; IC95%: 1,16-2,37), escolaridade (8 anos ou mais - OR = 2,07; IC95%: 1,51-2,86), tabagismo (ex-fumantes - OR = 0,69; IC95%: 0,55-0,85; e fumantes - OR = 0,50; IC95%: 0,33-0,77) e número de consultas médicas nos últimos 12 meses (OR = 1,88; IC95%: 1,31-2,71). Os resultados deste estudo mostraram uma baixa prevalência do consumo recomendado de frutas e hortaliças entre idosos brasileiros, chamando a atenção para a necessidade de políticas voltadas para o aumento desse consumo na população estudada.

Resumen El objetivo de este estudio fue evaluar la prevalencia del consumo recomendado de frutas y verduras y sus factores asociados en una muestra nacional representativa de la población brasileña con 60 años o más. Se utilizaron datos de línea de base del Estudio Longitudinal Brasileño sobre el Envejecimiento (ELSI-Brasil), realizado entre 2015 y 2016 con 4.982 ancianos. El consumo recomendado de frutas y verduras se evaluó en función de preguntas sobre la frecuencia semanal y diaria de frutas, jugos naturales y verduras. La ingesta de cinco o más porciones de estos alimentos en cinco o más días a la semana se consideró como consumo recomendado. Las variables exploratorias incluyeron características sociodemográficas, comportamientos de salud, condiciones de salud y el uso de servicios de salud. La regresión logística univariada y múltiple se utilizó para examinar los factores asociados con el consumo recomendado de frutas y verduras. La prevalencia de la ingesta recomendada de frutas y verduras fue del 12,9% (IC95%: 11,5-14,3). Ese consumo presentó asociaciones con sexo (femenino - OR = 1,40; IC95%: 1,08-1,82), grupo de edad (80 años o más - OR = 1,66; IC95%: 1,16-2,37), escolaridad (8 años o más; OR = 2,07; IC95%: 1,51-2,86), tabaquismo (exfumadores - OR = 0,69; IC95%: 0,55-0,85; y fumadores - OR = 0,50; IC95%: 0,33-0,77) y consultas médicas en los últimos 12 meses (OR = 1,88; IC95%: 1,31-2,71). Los resultados de este estudio mostraron una baja prevalencia del consumo recomendado de frutas y verduras entre los ancianos brasileños, llamando la atención sobre la necesidad de políticas destinadas a aumentar ese consumo en la población estudiada.

Brumadinho Health Project: food and nutrition insecurity versus socioeconomic statuses and dimensions of the food system after the dam rupture / Projeto Saúde Brumadinho: insegurança alimentar e nutricional versus condições socioeconômicas e dimensões do sistema alimentar após desastre

ABSTRACT Objective: To describe the situation of food insecurity of families according to the socioeconomic characteristics and dimensions of the food system in Brumadinho, state of Minas Gerais, Brazil, after the dam rupture in Córrego do Feijão mine. Methods: This is a descriptive study focused on households carried out from the baseline of the Brumadinho Health Project. Food insecurity, the main outcome, was assessed by the short version of the Brazilian Food Insecurity Scale. Other investigated variables were: socioeconomic data; geographic stratum of the households; family's assets; income; expenses; cultivation of food and animal husbandry for consumption. Descriptive analyses were performed comparing the food insecurity of the household according to the other variables by the χ2 test to compare the proportions. Results: Of the investigated households (n=1,441), 35.1% were facing food insecurity. facing food insecurity had: lower prevalence of masonry households with coating (91.4%; 95%CI 87.7%−94.1% vs. 96.7%; 95%CI 94.9%−97.8%); highest proportion of rudimentary cesspit (16.9%; 95%CI 13.3%−21.2% vs. 9.4%; 95%CI 7.4−11.9); lower prevalence of own and paid-off homes (63.9%; 95%CI 56.8−70.5 vs. 77.3%; 95%CI 72.3−81.7); and income reduction after the dam rupture (33.0%; 95%CI 27.1−39.6 vs. 14.1%; 95%CI 11.2−17.6), when compared with those in a food security situation. Conclusion: The prevalence of food insecurity was high, with report of a reduction in household income after the dam rupture. Moreover, most of the households had worse structural quality and sewage outfall. These results evidence the vulnerability of families and possible violation of the human right to adequate food, denoting the urgency of continuous reparative actions.

RESUMO Objetivo: Descrever a situação de insegurança alimentar das famílias segundo as características socioeconômicas e dimensões do sistema alimentar em Brumadinho, Minas Gerais, Brasil, após desastre. Métodos: Estudo descritivo com foco no domicílio realizado pela linha de base do Projeto Saúde Brumadinho. A insegurança alimentar, desfecho principal, foi avaliada pela Escala Brasileira de Insegurança Alimentar curta. Outras variáveis investigadas foram: socioeconômicas; estrato geográfico do domicílio; ativos (bens); renda; despesas familiares; cultivo de alimentos e criação de animais para consumo. Foram realizadas análises descritivas comparando a insegurança alimentar do domicílio segundo as demais variáveis pelo teste χ2 para comparação das proporções. Resultados: Dos domicílios investigados (n=1.441), 35,1% estavam em situação de insegurança alimentar. As famílias em insegurança alimentar apresentavam: menores prevalências de domicílios de alvenaria com revestimento (91,4%; IC95% 87,7%−94,1% vs. 96,7%; IC95% 94,9%−97,8%); maior proporção de fossa rudimentar (16,9%; IC95% 13,3%−21,2% vs. 9,4%; IC95% 7,4−11,9); menor prevalência de domicílios próprios e quitados (63,9%; IC95% 56,8−70,5 vs. 77,3%; IC95% 72,3−81,7); e redução da renda após o rompimento da barragem (33,0%; IC95% 27,1−39,6 vs. 14,1%; IC95% 11,2−17,6), quando comparadas àquelas em segurança alimentar. Conclusão: A prevalência de insegurança alimentar foi elevada, com relato de redução da renda das famílias após o rompimento da barragem. Ademais, boa parte dos domicílios apresentava pior qualidade estrutural e escoamento de esgoto. Esses resultados evidenciam a vulnerabilidade das famílias e possível violação do direito humano à alimentação adequada, denotando a urgência de ações reparadoras contínuas.

Healthcare access, utilization, and quality after a disaster: results from the Brumadinho Health Project / Acesso, utilização e qualidade dos serviços de saúde após um desastre: resultados do Projeto Saúde Brumadinho

ABSTRACT Objective: In January 2019 a dam at the Córrego do Feijão mine suffered a catastrophic failure that killed 270 people and caused extensive damage. It is unknown how exposure to such a disaster might affect healthcare utilization. Methods: We assessed survey data from the Brumadinho Health Project, a cohort study that includes people who were exposed to the dam failure and two comparison groups: people unexposed to mining or the disaster and people from a mining community, but not exposed to the disaster. Main outcomes include any doctor visit or hospitalization in the past year, having a usual source of healthcare, having blood pressure and blood sugar checked, and being up to date with vaccinations, for adults 18 years and over. We used survey-weighted robust Poisson regression to assess differences between those exposed and the two comparison groups while controlling for confounders. Results: In multivariable models, the exposed group had a 15% higher chance of having a doctor visit than the unexposed group. For hospitalization and reports of blood pressure and blood sugar assessments, there was no significant difference among any of the groups. The exposed group had a 24% higher chance and the unexposed mining community had a 143% higher chance of being up to date with immunizations, as compared to the unexposed group. Conclusion: There were some differences in healthcare utilization among individuals exposed to the dam failure. Continued monitoring of the situation is warranted, as the full consequences of such a traumatic event may take considerable time to unfold.

RESUMO Objetivo: Em janeiro de 2019, uma barragem da mina Córrego do Feijão sofreu um rompimento catastrófico que matou 270 pessoas e causou danos extensos. Não se sabe como a exposição a tal desastre pode afetar a utilização dos serviços de saúde. Métodos: Avaliamos os dados do Projeto Saúde Brumadinho, estudo de coorte que incluiu pessoas expostas ao rompimento da barragem e dois grupos de comparação: pessoas não expostas à mineração ou ao desastre e pessoas de uma comunidade mineira, mas não expostas ao desastre. Os desfechos avaliados foram consulta médica ou hospitalização no último ano, fonte habitual de cuidados, pressão arterial e glicemia verificadas e haver recebido vacinas recomendadas, entre adultos de 18 anos ou mais. A regressão de Poisson robusta ponderada foi usada para avaliar as diferenças entre os expostos e os dois grupos de comparação, controlando por fatores de confusão. Resultados: indivíduos expostos tiveram uma razão de prevalência (RP) 15% maior de relatar uma consulta médica do que os não expostos. Para hospitalização e medidas de pressão arterial e glicemia, não houve diferença significativa entre os grupos. O grupo exposto teve RP 24% maior, e a comunidade mineira RP 143% maior de haver recebido imunizações preventivas em relação ao grupo não exposto. Conclusão: Houve diferenças na utilização dos serviços de saúde entre os indivíduos expostos ao rompimento da barragem. O monitoramento contínuo da situação é necessário, pois as consequências de um evento tão traumático podem levar um tempo considerável para se manifestar.

Sociodemographic and residential factors associated with multimorbity: results of Brumadinho Health Project / Fatores sociodemográficos e de área de residência associados à multimorbidade: resultados do Projeto Saúde Brumadinho

ABSTRACT Objective: To evaluate the prevalence of multimorbidity and sociodemographic and residential factors associated with this condition among adults living in Brumadinho, Minas Gerais. Methods: Cross-sectional study with baseline data from the Brumadinho Health Project, conducted in 2021 and comprising 2,777 individuals aged 18 years and over. The outcome variable was multimorbidity, defined by the existence of two or more of 20 chronic diseases. The exploratory variables were sex, age group, educational level, skin color and area of residence according to the dam failure. The association between exploratory variables and multimorbidity was assessed by logistic regression. Results: The prevalence of multimorbidity was 53.8% (95%CI 50.6-56.9). A greater chance of multimorbidity was found among women (adjusted OR=2.5; 95%CI 1.9-3.2), in participants aged between 40 and 59 (adjusted OR=2.8; 95%CI 1.8-4.3) or 60 years and older (adjusted OR=7.9; 95%CI 4.7-13.4) and in residents of the areas that were directly affected by the dam failure (adjusted OR=1.6; 95%CI 1.3-2.0). Conclusion: The burden of multimorbidity on the population of Brumadinho requires effective preventive measures and actions to the whole population, but mainly to the most vulnerable groups, that is, women, middle-aged and older individuals, and those directly affected by the dam failure, in addition to a timely provision of health care to reverse this situation.

RESUMO Objetivo: Avaliar a prevalência de multimorbidade e os fatores sociodemográficos e de área de residência associados a essa condição entre adultos residentes em Brumadinho, Minas Gerais. Métodos: Estudo transversal realizado a partir dos dados da linha de base do Projeto Saúde Brumadinho, que foi conduzida no ano de 2021 e incluiu 2.777 indivíduos com 18 anos ou mais. A variável desfecho foi a multimorbidade, definida pela existência de duas ou mais entre 20 doenças crônicas. As variáveis exploratórias foram sexo, faixa etária, escolaridade, cor da pele e área de residência. A associação entre as variáveis exploratórias e a multimorbidade foi avaliada pela regressão logística. Resultados: A prevalência de multimorbidade foi de 53,8% (IC95% 50,6-56,9). Maior chance de multimorbidade foi encontrada entre as mulheres (ORajustado=2,5; IC95% 1,9-3,2), nos participantes com idade entre 40 e 59 (ORajustado= 2,8; IC95% 1,8-4,3) ou com 60 anos ou mais (ORajustado= 7,9; IC95% 4,7-13,4) e nos residentes em áreas que foram diretamente atingidas pelo rompimento da barragem (ORajustado=1,6; IC95% 1,3-2,0). Conclusão: A elevada carga de multimorbidade sobre a população de Brumadinho requer medidas preventivas eficazes e ações no âmbito populacional, mas principalmente entre aqueles grupos mais vulneráveis, ou seja, mulheres, indivíduos de meia-idade e idosos bem como aqueles diretamente atingidos pelo rompimento da barragem, além de oferta oportuna de cuidados de saúde, de modo a reverter esse quadro apresentado.

Chronic respiratory diseases and respiratory symptoms after a mining dam rupture: Brumadinho Health Project / Doenças respiratórias crônicas e sintomas respiratórios após rompimento de barragem de mineração: Projeto Saúde Brumadinho

ABSTRACT: Objective: To identify factors associated with asthma and chronic obstructive pulmonary disease (COPD) and respiratory symptoms, in Brumadinho, state of Minas Gerais, Brazil, after a dam rupture. Methods: This is a cross-sectional study, including a representative sample of adults (aged 18 years and over) in the municipality. Associations were assessed between dependent variables (medical diagnosis of asthma and COPD; symptoms of wheezing, dry cough, and nose irritation) and exploratory variables (sex, age group, smoking habit, having worked at Vale S.A. company before the dam rupture, time and area of residence in relation to the dam rupture). Logistic regression models with odds ratio (OR) calculation and 95% confidence interval were used. Results: We identified a prevalence of 7.2% of asthma; 3.5% of COPD; 8.8% of wheezing; 23.6% of dry cough; and 31.8% of nose irritation. We observed a greater chance of asthma among women and residents in the affected and mining regions, while a greater chance of COPD was observed in smokers and in those with longer time of residence in the municipality. Among the symptoms, we verified a higher chance of nose irritation among women, while a higher chance of wheezing and dry cough were found among smokers (current and former). Residents of regions affected by the mud reported a greater chance of presenting all the analyzed symptoms. Conversely, level of education was negatively associated with wheezing and dry cough. Conclusion: We found respiratory changes and identified the groups most vulnerable to developing them, which could contribute to directing actions to reduce the population's respiratory problems.

RESUMO: Objetivo: Identificar fatores associados a asma, doença pulmonar obstrutiva crônica (DPOC) e sintomas respiratórios em Brumadinho (MG), após rompimento de barragem. Métodos: Estudo transversal com amostra representativa de adultos. Verificaram-se associações entre variáveis dependentes (diagnóstico médico de asma e DPOC e os sintomas chiado no peito, tosse seca e irritação nasal) e variáveis exploratórias (sexo, faixa etária, tabagismo, ter trabalhado na Vale S.A. antes do rompimento da barragem, tempo e área de residência em relação ao rompimento da barragem). Modelos de regressão logística com cálculo da odds ratio e intervalo de confiança de 95% foram empregados. Resultados: Identificou-se prevalência de asma de 7,2%, de DPOC de 3,5%, de chiado no peito de 8,8%, de tosse seca de 23,6% e de irritação nasal de 31,8%. Maior chance de asma foi observada no sexo feminino e nos residentes em área diretamente atingida pela lama e área de mineração, enquanto maior chance de DPOC foi vista nos fumantes e naqueles com maior tempo de residência no município. Entre os sintomas, maior chance de irritação nasal foi observada no sexo feminino, e de chiado no peito e tosse seca em fumantes (atuais e no passado). Residentes em área atingida pela lama relataram maior chance de apresentarem todos os sintomas analisados. Já a escolaridade apresentou associação negativa com chiado no peito e tosse seca. Conclusão: O estudo mostrou alterações respiratórias e identificou os grupos com maior vulnerabilidade para desenvolvê-las, podendo contribuir com o direcionamento de ações para a redução de problemas respiratórios da população.

Food consumption of Brumadinho Health Project participants / Consumo alimentar em participantes do Projeto Saúde Brumadinho

ABSTRACT: Objective: To analyze the food consumption patterns of residents of Brumadinho, Minas Gerais, Brazil, according to sociodemographic characteristics, neighborhood and area of residence. Methods: Cross-sectional study with baseline data from the Brumadinho Health Project, conducted with 2,805 adult individuals. The healthy food consumption markers analyzed were: fruits and vegetables (FV), beans and fish; the unhealthy markers were: sweets and soda/artificial juices, whole-fat milk and red meat with visible fat or chicken with skin. Prevalence values and 95% confidence intervals were calculated for the total sample and according to sociodemographic characteristics, presence of commercial establishments with varieties of FV in the neighborhood and area of residence affected by the dam failure. Results: Among the healthy food consumption markers, the most common was beans (81.6%), and among the unhealthy ones, whole-fat milk (68.8%) and red meat with visible fat/chicken with skin (61.1%). Women were more prone to higher consumption of FV, while men, of beans and fish; the prevalence of these markers was higher among individuals with higher education degrees and higher incomes. Unhealthy eating markers were more prevalent among men, younger people, individuals with lower educational level and lower incomes, and residents in an area directly affected by the dam failure or in a mining region. Conclusion: Less than half of the participants were considered to follow regular or recommended consumption of healthy eating markers, except for beans. Individual characteristics and area of residence were associated with individuals' food consumption patterns and should be taken into account in actions to promote adequate and healthy eating.

RESUMO: Objetivo: Analisar o consumo alimentar de residentes de Brumadinho, Minas Gerais, Brasil, segundo as características sociodemográficas da vizinhança e a área de residência. Métodos: Estudo transversal com dados da linha de base do Projeto Saúde Brumadinho, conduzido com 2.805 indivíduos adultos. Os marcadores de alimentação saudável analisados foram frutas e hortaliças (FH), feijão e peixe; os não saudáveis foram doces e refrigerante/suco artificial, leite com teor integral de gordura e carne vermelha com gordura visível/frango com pele. Prevalências e intervalos de confiança de 95% foram calculados para a amostra total, segundo características sociodemográficas; presença de estabelecimentos comerciais de FH na vizinhança e área de residência, segundo rompimento da barragem. Resultados: Entre os marcadores de alimentação saudável, o mais prevalente foi o feijão (81,6%) e, entre os não saudáveis, leite com teor integral de gordura (68,8%) e carne vermelha com gordura visível/frango com pele (61,1%). Mulheres apresentaram maior consumo de FH, e homens, de feijão e peixe, sendo maiores as prevalências desses marcadores entre os indivíduos com maior escolaridade e renda. Os marcadores de alimentação não saudável foram mais prevalentes entre os homens, os mais jovens, indivíduos com menor escolaridade e renda e residentes em área diretamente atingida pelo rompimento da barragem ou região de mineração. Conclusão: Menos da metade dos participantes apresentou consumo regular ou recomendado de marcadores de alimentação saudável, exceto o feijão. Características individuais e área de residência foram associadas ao consumo alimentar dos indivíduos, devendo ser consideradas nas ações de promoção da alimentação adequada e saudável.