Intradialytic Resistance Training Improves Functional Capacity and Lean Mass Gain in Individuals on Hemodialysis: A Randomized Pilot Trial.

OBJECTIVE: To compare the effects of high vs moderate loads of intradialytic resistance training (RT) on body composition, sarcopenia prevalence, functional capacity, inflammatory markers, and quality of life (QoL) in individuals on hemodialysis. DESIGN: A pilot randomized clinical trial. SETTING: Two hemodialysis centers. PARTICIPANTS: Individuals on hemodialysis (N=80; 51% men, aged 30-75y) in treatment for at least 3 months, adequately dialyzed (Kt/V≥1.2, where K is dialyzer clearance in mL/min, t is time, and V is volume of water) with vascular access via arteriovenous fistula. INTERVENTIONS: The 12 weeks of intradialytic RT was performed 3 times per week. The training groups were: high-load intradialytic group (HLG, 8-10 repetitions), moderate-load intradialytic group (MLG, 16-18 repetitions), and control group (CG, stretching exercise). The total training volume was equalized among training groups. MAIN OUTCOME MEASURES: Lean leg mass was assessed by a dual-energy x-ray absorptiometry; functional capacity was assessed by Short Physical Performance Battery and Timed Up and Go test; and QoL was assessed by Kidney Disease QoL Instrument, inflammatory markers, and sarcopenia. RESULTS: After the training period, the HLG increased lean leg mass compared with the CG. The HLG also displayed improvements in the pain and physical function domains. The skeletal muscle index and functional capacity increased in both RT protocols. The prevalence of sarcopenia was reduced 14.3% and 25% in the MLG and HLG, respectively, while there was an increase of 10% in the CG. No differences were observed in cytokines after intervention. CONCLUSIONS: High-load intradialytic RT was associated with gains in lean leg mass and QoL while functional capacity, appendicular muscle mass, and sarcopenia status were improved regardless of the RT load.

Sedentary lifestyle and its associated factors among adolescents from public and private schools of a Brazilian state capital.

BACKGROUND: Adolescence is a transition stage between childhood and adulthood and is an important phase for the acquisition of future lifestyles, including the practice of physical activity (PA). The prevalence of sedentary lifestyle in adolescents is often high, creating the need for studies addressing the practice of PA and its associated factors for a better understanding of the phenomenon and possible interventions that would encourage positive changes. METHODS: Cross-sectional study of a representative sample of students aged 14-18 years enrolled in both public and private schools of a large Brazilian city to determine the level of physical activity (PA) and its associated factors. Sedentary lifestyle was measured by applying the International Physical Activity Questionnaire. The independent variables were gender, age, race, tobacco use and alcohol consumption in the past 30 days, socioeconomic status, body mass index, waist circumference and blood pressure. The crude prevalence ratio was used as a measure of association and was estimated from a Poisson regression. RESULTS: The sample consisted of 862 adolescents with a mean age of 15.4 ± 1.1 years. Females were predominant (52.8%), and the age between 14 and 15 years was the most frequent (52.2%). The majority of the group reported themselves as Caucasians (51.2%), belonging to socioeconomic class C (52.5%) and were attending to public schools (69.1%). The prevalence of sedentary lifestyle was 66.8% (95% confidence interval [CI]: 63.5-69.9), where values of 65.4% and 69.9% were observed among students from public and private schools, respectively (p = 0.196). Sedentary lifestyle was more frequent in females (78.0% vs 54.3%; p < 0.001). The factor directly associated with sedentary lifestyle was female gender both in public and private schools and the only independent variable related to sedentarism was also female gender. CONCLUSION: The prevalence of sedentary lifestyle was extremely high in the population of adolescents studied both in public and private schools. Female sex was directly associated with sedentary lifestyle.

Low handgrip strength is related to elevated echogenicity in patients with chronic kidney disease: A pilot, cross-sectional and exploratory study.

OBJECTIVES: Evaluate associations between triceps braqui muscle ultrasound measures (TB US) and handgrip strength (HGS), and the sensibility of TB US for low HGS in non-dialysis-dependent chronic kidney disease (nd-CKD) patients. PARTICIPANTS AND METHODS: This pilot, cross-sectional, and exploratory study evaluated TB cross-sectional images from A-mode US and processed by FIJI-Image J to obtain muscle thickness (MT), echogenicity (EI), cross-sectional area (CSA), pennation angle (PA), and fascicle length (Lf) associating them with absolute HGS by simple and, multiple linear regression. The HGS was normalized to body mass index (BMI) and separated into low HGS (HGS/BMI≤10p according to sex and age) and adequate HGS (HGS/BMI>10p) groups. The body composition was from multifrequency bioimpedance. ROC analysis verified the TB US diagnostic accuracy to low HGS. RESULTS: Were included 42 (21M/21F) adults with 65.5 (60-70) y median age, 47.22% in 3b CKD stage. The low HGS group (45.23%) showed a higher fat mass (FM), TB muscle medium head's PA, and EI than adequate HGS (p<0.05). In crude model, a pixels increase in EI was associated with a 0.452kgf HGS reduction (p=0.019); adjusted for sex, age, and FM, a one-unit increase in EI was associated with a 0.510kgf HGS reduction (p=0.011). The EI also showed moderate diagnostic accuracy (AUC=0.730; CI 95%=0.589; 0.919) to low HGS and a sensitivity of 86.9% (cutoff≥13.52 pixels). CONCLUSION: In nd-CKD patients, of all measurements from US, the EI was the most associated with HGS, and the only one sensitive to low HGS diagnosis.

Comparison between general obesity and abdominal adiposity to estimate cardiovascular disease prevalence in individuals with chronic kidney disease: results from NHANES 2005-2016.

Abdominal obesity, regardless of overall obesity, is associated with metabolic abnormalities and with direct impact on cardiovascular risk. The aim of this study was to compare body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) to estimate cardiovascular disease (CVD) prevalence in individuals with chronic kidney disease (CKD). The data analyzed is from 2005-2016 cycles of the NHANES. A total of 2,825 participants with CKD were included in this study, and most of them had a high BMI, 66.1%, to be exact (BMI ≥ 25.0 kg/m² if age <65 or >27.0 if age ≥ 65). The prevalence rates of high WC (≥102 cm for men or ≥88 cm for women) and high WHtR (WHtR>0.5) in the study population were 70.0% and 91.0%, respectively. The results of this study suggest that BMI is a good indicator of the risk of CVDs in individuals with CKD. In addition, the results show that WC and WHtR are associated with CVDs in non-overweight individuals of both sexes. These results indicate that the assessment of abdominal fat is essential even in non-overweight patients because the risk of CVDs cannot be identified in this subpopulation using only BMI.

FRAIL scale as a screening tool and a predictor of mortality in non-dialysis dependent patients.

BACKGROUND: This study aimed to compare the diagnostic yield of the FRAIL scale with respect to the physical frailty phenotype measure and their association with mortality in non-dialysis-dependent patients. METHODS: In this prospective cohort study, non-dialysis dependent patients with chronic kidney disease (CKD) stages 3b-5 seen in the nephrology outpatient clinics of two university hospitals were included. The presence of frailty was evaluated by physical frailty phenotype measure and the FRAIL scale. Patients were evaluated for six months, and mortality was recorded. The Kappa test was used to evaluate the diagnostic properties between the methods, and logistic regression to test the association between frailty and mortality. RESULTS: One hundred fifty-three patients were evaluated; average age was 65 (56-70) years, 50.9% were women, and the all-cause mortality rate was 2.6%. Forty-six patients were classified as living with frailty according to the physical frailty phenotype while 36 patients were rated frail by the FRAIL scale. In adults < 60 years of age, the FRAIL scale showed good accuracy (84.9%) and specificity (93.2%) but had low sensitivity (41.3%) and moderate agreement (Kappa = 0.41; p < 0.001) compared to the definition of the physical frailty phenotype. The adjusted logistic regression model showed that the patients with frailty assessed by the FRAIL scale had a greater chance of mortality than the non-frail patients (OR: 6.8; CI95%:1.477-31.513; p = 0.014). CONCLUSION: Physical frailty phenotype identifies more patients as having pre-frailty and frailty in non-dialysis dependent patients as compared to the FRAIL scale. However, the FRAIL scale is a simple bedside tool that can be useful for screening for frailty and whose results were associated with mortality.

Intuitive eating in general aspects of eating behaviors in individuals with obesity: Randomized clinical trial.

BACKGROUND AND AIMS: Dysfunctional eating behaviors may be associated with weight gain and have a negative impact on obesity. Intuitive eating is a strategy that helps with changing eating behaviors. This study aimed to analyze the effects of intuitive eating alone or combined with nutritional guidelines on eating behaviors, weight, and body mass index (BMI), in individuals with obesity. METHODS: This is a randomized clinical trial of 58 individuals (84.5% females and 84.5% candidates for bariatric surgery). The mean age was 40.5 years (SD = 9.1). The mean BMI was 48.3 kg/m2 (SD = 7.4). Individuals were randomized into three groups: 1) the control group (CG; n = 18), who received an individualized meal plan, 2) the intuitive eating group (IEG; n = 23), and 3) the intuitive eating and nutritional guidelines application group (IEGDG; n = 17). The study lasted for six months. Eating behaviors were assessed using the Binge Eating Scale and Three Factor Eating Questionnaire, the 21-item version. RESULTS: Compared with the CG, the IEG and IEGDG did not differ in binge eating, cognitive restriction, emotional eating, and uncontrolled eating. Likewise, there were no significant differences in weight and BMI. CONCLUSIONS: Intuitive eating alone or in combination with nutritional guidelines did not alter the general domains of eating behaviors, weight, and BMI in individuals with obesity. We suggest further studies involving other health professionals, as well as evaluating the effects of intuitive eating using scales, in addition to eating behaviors. CLINICAL TRIAL REGISTRATION: https://ensaiosclinicos.gov.br6, Identifier: RBR-7q9nj8.

Low hand grip strength is associated with worse functional capacity and higher inflammation in people receiving maintenance hemodialysis.

OBJECTIVES: To evaluate the associations of hand grip strength (HGS) with body composition, functional capacity, muscle quality, and inflammatory markers in people receiving maintenance hemodialysis. METHODS: This is a cross-sectional study in people receiving maintenance hemodialysis. HGS was measured by hydraulic dynamometer on the upper limb without fistula. Participants were stratified into low or adequate HGS, based on population-specific cutoff points. Body composition was assessed by dual-energy X-ray absorptiometry, and functional capacity by the Short Physical Performance Battery and timed up-and-go tests. In addition, serum creatinine, interleukin-6 (IL-6), IL-10, tumor necrosis factor-α, and ultra-sensitive C-reactive protein (us-CRP) were measured before the dialysis session. RESULTS: A total of 67 participants (41.8% women, 58.2% male; ages 54.1 ± 11.7 y) were included. Those with low HGS had worse functional capacity than those with adequate HGS (timed up-and-go test, 10.7 ± 1.0 versus 8.5 ± 0.8 sec, respectively; P < 0.001). IL-6 and us-CRP were higher in those with low HGS than their counterparts (IL-6: 2.7 ± 0.3 versus 1.9 pg/mL, P = 0.03; us-CRP: 14.8 ± 3.0 versus 4.7 ± 1.9 mg/L, P = 0.03). Multiple linear regression analysis showed that appendicular lean mass, us-CRP, age, sex, and seven-point subjective global assessment score were associated with HGS. CONCLUSIONS: Participants with low HGS showed higher inflammation and lower functional capacity. In addition to muscle mass, inflammation and nutritional status also affect HGS..

Turmeric supplementation with piperine is more effective than turmeric alone in attenuating oxidative stress and inflammation in hemodialysis patients: A randomized, double-blind clinical trial.

PURPOSE: Turmeric has renop rotective effects that can act to reduce oxidative stress and inflammation in hemodialysis (HD) patients. Piperine has been indicated as a bioavailability enhancer of turmeric and consequently of its biological effects. However, data on the efficacy of the turmeric/piperine combination in HD patients are limited. We aimed to verify whether turmeric supplementation in combination with piperine has a superior effect to turmeric alone in increasing antioxidant capacity and reducing oxidative stress and inflammation in HD patients. METHODS: This randomized, double-blind clinical trial was conducted in HD patients (age 20-75 years). Patients were supplemented with turmeric (3 g/day) or turmeric/piperine (3 g turmeric + 2 mg piperine/day) for 12 weeks. Malondialdehyde (MDA), antioxidant enzymes catalase (CAT), glutathione peroxidase (GPx), glutathione reductase (GR), high-sensitivity C-reactive protein (hs-CRP), and ferritin were evaluated at baseline and the end of the study. RESULTS: There was a reduction in the MDA and ferritin levels in the turmeric/piperine group and in the comparison between groups at the end of the study [MDA: -0.08(-0.14/0.01) nmol/mL versus -0.003(-0.10/0.26) nmol/mL, p = 0.003; ferritin: -193.80 ±â€¯157.29 mg/mL versus 51.99 ±â€¯293.25 mg/mL, p = 0.018]. In addition, GPx activity reduced in the turmeric group (p = 0.029). No changes were observed for CAT, GR, and hs-CRP. CONCLUSION: Turmeric plus piperine was superior to turmeric alone in decreasing MDA and ferritin levels. The use of a combination of turmeric and piperine as a dietary intervention may be beneficial for modulating the status oxidative and inflammation in HD patients. BRAZILIAN REGISTRY OF CLINICAL TRIALS NUMBER: RBR-2t5zpd; Registration Date: May 2, 2018.

Antioxidant and anti-inflammatory response to curcumin supplementation in hemodialysis patients: A randomized, double-blind, placebo-controlled clinical trial.

BACKGROUND AND OBJECTIVES: Hemodialysis (HD) patients are vulnerable to malnutrition and cardiovascular complications due to many factors, including oxidative stress and inflammation. Curcumin supplementation is associated with attenuation of proinflammatory cytokines and increased activity of antioxidant enzymes, but its effects in HD patients are unknown. This study aimed to evaluate the effect of curcumin supplementation on oxidative stress and inflammation in HD patients. METHODS: This randomized, double-blind, placebo-controlled trial enrolled 43 HD patients and divided them into two groups: supplemented with curcumin (1 g/day) or placebo (corn starch) for 12 weeks. Demographic information and blood samples were taken at the start and the end of the study to determine serum malondialdehyde (MDA) concentrations, antioxidant enzyme activity, and high-sensitivity C-reactive protein (hs-CRP). RESULTS: The curcumin group showed a significant increase in catalase activity [Δ = 1.13 ± 2.87 versus Δ = -1.08 ± 2.68; p = 0.048] and preserved glutathione peroxidase activity [Δ = -4.23 ± 11.50 versus Δ = -14.44 ± 13.96; p < 0.01] compared with the placebo group. However, no significant changes were found in MDA concentrations, glutathione reductase activity, and hs-CRP concentrations after the intervention. CONCLUSION: Curcumin supplementation for 12 weeks had potential effects on antioxidant response, but it was not enough to reduce oxidative stress markers and inflammation in HD patients. This trial was registered at EnsaiosClínicos.gov.br under registration number RBR-2t5zpd.

Transcultural adaptation of the Thirst Distress Scale (TDS) into Brazilian Portuguese and an analysis of the psychometric properties of the scale for patients on hemodialysis.

OBJECTIVE: To produce a transcultural adaptation of the Thirst Distress Scale (TDS) into Brazilian Portuguese and analyze the scale's psychometric properties for patients on hemodialysis (HD). METHODS: The original scale was translated, back translated, and discussed with psychometric assessment experts. The final version was tested with 126 patients on HD and retested with 70 individuals from the original patient population. Cronbach's alpha was used to measure the scale's internal consistency. Reliability of thirst intensity evaluated via the visual analogue scale (VAS) was tested with Kappa statistic and the Bland-Altman plot. Reproducibility was assessed based on the intraclass correlation coefficient (ICC). RESULTS: The wording of three items and the verb tenses of six had to be adjusted in the final version of the Brazilian Portuguese TDS. Comprehension of the scale by patients on HD was good, the scale's internal consistency was satisfactory (0.84; p<0.001), agreement with a visual analogue scale (VAS) was moderate (kappa=0.44; p<0.001), and reproducibility neared perfection (ICC=0.87; p<0.001). CONCLUSION: Our results showed that the Brazilian Portuguese version of the scale might be used reliably. The Brazilian Portuguese version of the TDS is a practical, affordable, accessible and well-accepted tool that has a lot to offer for the management of patients with HD.

Effect of Extra Virgin Olive Oil and Traditional Brazilian Diet on the Bone Health Parameters of Severely Obese Adults: A Randomized Controlled Trial.

Dietary interventions can stabilize and/or reverse bone mass loss. However, there are no reports on its effects on bone mineral density (BMD) in severely obese people, despite the vulnerability of this group to bone loss. We examine the effect of extra virgin olive oil supplementation and the traditional Brazilian diet (DieTBra) on BMD and levels of calcium, vitamin D, and parathyroid hormone (PTH) in severely obese adults. A randomized controlled trial followed-up with severely obese adults (n = 111, with mean body mass index 43.6 kg/m2 ± 4.5 kg/m2) for 12 weeks. Study participants received either olive oil (52 mL/day), DieTBra, or olive oil + DieTBra (52 mL/day + DieTBra). BMD was assessed by total spine and hip dual-energy X-ray absorptiometry. After interventions, BMD means for total spine (p = 0.016) and total hip (p = 0.029) were higher in the DieTBra group than in the olive oil + DieTBra group. Final mean calcium levels were higher in the olive oil group compared to the olive oil + DieTBra group (p = 0.026). Findings suggest that DieTBra and extra virgin olive oil have positive effects on bone health in severely obese adults. The major study was registered at ClinicalTrials.gov (NCT02463435).

[Hypertension and its association to anthropometric indexes in adults from a small city ln Brazil]. / Hipertensão arterial e sua associação com índices antropométricos em adultos de uma cidade de pequeno porte do interior do Brasil.

OBJECTIVE: Estimate the prevalence of Arterial Hypertension (AH) and its association with Body Mass Index (BMI) and Abdominal Circumference (AC) in the adult population from the city of Firminópolis, in the state of Goiás, Brazil. METHODS: Descriptive, observational, cross sectional population-based study substantiated by a home survey of a simple random sample (> or = 18 years old). The study evaluated 1168 individuals. Standardized questionnaires. Measurements performed were Blood Pressure (BP) (hypertension: BP > or = 140 x 90 mmHg), weight, height and AC. Microsoft Office Access and Epi-info, 3.3.2 version were used for data storage and analysis, respectively. RESULTS: There was a predominance of females (63.2%), mean age was 43.2 +/-14.9 years old. Prevalence of hypertension was 32.7%, with tendency to be higher among the male population (35.8%) when compared to the female (30.9%) (p=0.084). Association between AH and BMI was positive (p < 0.001), as well as between AC and age. Prevalence of overweight was 33.7% and obesity, 16.0%. Overweight was higher among the male population and obesity among the female population. Prevalence of increased as well as greatly increased AC in 51.9% of the studied population, with 28.6% among males and 65.5% among females. CONCLUSION: A high prevalence of hypertension and a large number of individuals with BMI and AC above the ideal values were found.

[Surveillance of risk factors for chronic diseases through telephone interviews: experience in Goiânia, Goiás State, Brazil]. / Monitoramento por entrevistas telefônicas de fatores de risco para doenças crônicas: experiência de Goiânia, Goiás, Brazil.

This study describes results from a surveillance system for risk factors for chronic non-communicable diseases in 2005 in the city of Goiânia, Goiás State, Brazil. A probabilistic sample (n = 2,002) of the adult population living in households with landline telephones was studied by phone interviews. Factors investigated were: food consumption, physical activity, smoking, alcohol intake, self-reported weight and height, and self-reported medical diagnosis of chronic non-communicable diseases. Prevalence and c(2) values were calculated. The data showed: low consumption (< 5 days/week) of fruits and vegetables (47.1%), high rate of physical inactivity at work (86.6%), in commuting (92.6%), and during leisure time (61.9%), high alcohol consumption (36.5%), and high rates of obesity (10.6%), hypertension (22.4%), dyslipidemia (18.4%), and diabetes (4.4%). Most of the factors were inversely related to schooling and directly related to age (p < 0.05). High prevalence of risk factors for chronic non-communicable diseases was reported. The advantages of this system were: low operational cost and the ability to monitor trends in chronic non-communicable diseases at the local level.

Estado nutricional de crianças de 5 a 9 anos por regional de saúde do estado de Goiás / Nutritional status of children aged 5 to 9 years by regional health of the state of Goiás

Nos últimos anos a população brasileira apresenta um aumento expressivo de indivíduos com excesso de peso e redução na prevalência de desnutrição. O Sistema de Vigilância Alimentar e Nutricional (SISVAN) permite o monitoramento de dados antropométricos e marcadores de consumo alimentar dos usuários da Atenção Primária do Sistema Único de Saúde de todas as fases da vida. Objetivo: Estimar a prevalência de magreza, excesso de peso e déficit de estatura de escolares de 5 a 9 anos no estado de Goiás e regionais de saúde (RS). Métodos: Trata-se de estudo ecológico descritivo, realizado a partir de dados secundários registrados no SISVAN nos últimos 5 anos. A avaliação antropométrica foi realizada a partir dos indicadores estatura por idade e índice de massa corporal por idade. Resultados: Observou-se baixa prevalência de magreza (5,7%) e déficit de estatura (6,1%) e alta prevalência de excesso de peso (34,8%) entre as crianças avaliadas, sendo maior na RS Entorno Norte, nos dois primeiros parâmetros, e na RS Rio Vermelho, no último parâmetro. Com relação à evolução das prevalências nos últimos cinco anos, observou-se aumento do excesso de peso. Conclusão: Destacou-se o crescente aumento no excesso de peso em escolares de 5 a 9 anos, indicando a importância do monitoramento dos dados de estado nutricional, bem como a atenção para o desenvolvimento de ações voltadas para a reversão do cenário encontrado

In recent years, the Brazilian population has shown a significant increase in overweight individuals and a reduction in the prevalence of malnutrition. The Food and Nutrition Surveillance System (SISVAN) allows the monitoring of anthropometric data and food consumption markers of users of Primary Care of the Unified Health System of all stages of life. Objective: To estimate the prevalence of thinness, excess weight and short stature in schoolchildren aged 5 to 9 years in the state of Goiás and regional health centers (RS). Methods: This is an descriptive ecological study, based on secondary data recorded in SISVAN in the last 5 years. Anthropometric assessment was performed using height-for-age and body mass index-for-age indicators. Results: There was a low prevalence of thinness (5.7%) and short stature (6.1%) and a high prevalence of overweight (34.8%) among the children evaluated, being higher in RS Entorno Norte in the first two parameters and in the RS Rio Vermelho in the last parameter. Regarding the evolution of prevalence in the last five years, an increase in excess weight was observed. Conclusion: The growing increase in overweight in schoolchildren aged 5 to 9 years was highlighted, indicating the importance of monitoring nutritional status data, as well as attention to the development of actions aimed at reversing the scenario found

The relationship between body mass index and lifestyle in a Brazilian adult population: a cross-sectional survey.

This study focused on adult obesity prevalence in Goiânia, Goiás State, Brazil, and the association between socio-demographic variables, lifestyle, physical activity, eating habits, and food consumption frequency and body mass index (BMI). A cross-sectional study was conducted in 2001 with a sample of 1,252 individuals from 20 to 64 years of age. The association between socio-demographic variables, lifestyle, food consumption, and physical activity and BMI was evaluated by hierarchical multiple linear regression analysis. Obesity prevalence was 10.7% in men and 13.9% in women. In males, age, income, and meat consumption showed a positive association with BMI, while physical activity during leisure time and commuting and the habit of eating > 4 meals per day were inversely associated with BMI. In women, positively associated factors were age, no smoking, and no meat consumption; in contrast, consumption of grains was inversely associated with BMI. High obesity prevalence was observed; active lifestyle coupled with ingestion of more grains and less meat appeared to protect against increased BMI.

Overweight and associated factors in adolescents from a brazilian capital. / Excesso de peso e fatores associados em adolescentes de uma capital brasileira.

OBJECTIVE:: To evaluate the prevalence of overweight in adolescents and its associated factors. METHODS:: A cross-sectional study in public and private schools in Goiania, Brazil. Socioeconomic status, family history of obesity, lifestyle, blood pressure and Body Mass Index were studied in a sample of 1,169 Brazilian youth aged 12 - 18 years, who attended public and private schools. Data were obtained from a questionnaire and anthropometric measurements previously tested in a pilot study. Poisson regression was used to estimate the prevalence of overweight, prevalence ratios and associations with the other factors. RESULTS:: The prevalence of overweight was 21.2%, with a significant difference between boys and girls (26.3 and 16.8% respectively). Regression analysis showed that maternal obesity was associated with a higher prevalence of overweight in boys (PR = 1.86; p = 0.004), and boys aged 15 - 18 years had a lower prevalence of overweight than boys aged 12 - 14 years (PR = 0.70; p = 0.021). Among the girls, the presence of obese parents was associated with higher prevalence of overweight (PR = 2.42; p < 0.001), and the girls from a C class socioeconomic position were negatively associated with overweight (PR = 0.67; p = 0.035). CONCLUSIONS:: Overweight in adolescence is associated with gender, obesity family history, and socioeconomic position. These data should be considered when planning intervention programs.

[Validity of self-reported weight and height: the Goiânia study, Brazil]. / Validade do peso e da altura auto-referidos: o estudo de Goiânia.

OBJECTIVE: To assess the validity of self-reported weight and height at the time of diagnosing obesity, and to identify the sociodemographic and individual characteristics that might be a source of information bias. METHODS: This was a cross-sectional population-based study carried out in the city of Goiânia in 2001. Interviews were conducted with 1,023 individuals aged 20-64 years, in their homes, to collect sociodemographic and self-reported weight and height information. On the same occasion, weight and height measurements were made on these individuals. The mean differences and correlation coefficients between self-reported and measured data were calculated according to age, body mass index (BMI), schooling, income and height. RESULTS: Both the men and women overestimated their heights (p<0.05), by 0.9 cm and 2.2 cm, respectively. There was no difference between self-reported and measured weights, either for the men (-0.44 kg; p=0.06) or for the women (-0.03 kg; p>0.05). The behavior of overestimating height was influenced by age, schooling, height and body mass index. Although this index obtained from the self-reported data was underestimated (p<0.05), by 0.27 kg/m(2) and 0.67 kg/m(2) for men and women respectively, the measured and self-reported data presented a high degree of agreement. Both the sensitivity and specificity of the self-reported body mass index were high, in relation to identifying the measured index. CONCLUSIONS: In epidemiological studies for monitoring the prevalence of excess weight in populations, self-reported weights and heights constitute reliable data, which gives validity to the methodology utilized.

Is energy intake underreported in hemodialysis patients?

INTRODUCTION: Underreporting of energy intake is not much studied in hemodialysis population. OBJECTIVE: To evaluate the underreporting of energy intake and associated factors in hemodialysis patients. METHODS: A cross-sectional study, with 344 patients stable adults, of ten hemodialysis centers in Goiânia-GO. Energy intake was assessed by six 24-hour dietary recalls and basal metabolic rate (BMR) was estimated using the Harris Benedict equation. It was considered as underreporting when the ratio between the average energy intake and basal metabolic rate was lower than1.27. For analysis of factors associated with underreporting, the Poisson regression with robust variance estimation was applied. RESULTS: The prevalence of underreporting was 65.7%, being more significant in individuals who are overweight and in the non dialysis days. The result of the multivariate analysis identified four factors independently associated with the underreporting: being a female (PR = 1.27, CI = 1.10 to 1.46), body mass index ≥ 25 kg/m2 (PR = 1.29, CI = 1.12 to 1.48), three meals or lower/day (PR = 1.31, CI = 1.14 to 1.51) and hemodialysis length lower than 5 years (PR = 1.19CI = 1.01 to 1.40). CONCLUSION: The population showed a high prevalence of underreporting of energy intake. Being a female, presenting overweight, lower number of meals/day and lower length time on hemodialysis were factors associated with underreporting.

Dental pain and associated factors in 2 to 4-year-old children in Goiânia.

OBJECTIVE: To investigate the prevalence of dental pain and associated factors in 2-4-year-old children in Goiânia (GO). METHODS: Cross-sectional study using home interviews with parents or guardians and anthropometric measures. The sample consisted of 385 children from 2 to 4 years old. The variables analyzed were: dental pain sometime in their lives, and demographic, socioeconomic and health-related factors (health condition, diet, nutritional status and behavior). Bivariate analysis and logistic regression were performed, based on a hierarchical model for risk assessment, considering the sample weights. RESULTS: Dental pain prevalence was 9.9% (95%CI 7.4 - 13.1). After adjustment for other variables, children whose mothers had low education level and those who regularly consumed artificial powder juice containing sugar were more likely to have dental pain (OR = 3.03 and 2.15, respectively). CONCLUSION: It was concluded that one in ten children had dental pain, and the prevalence was associated with low education level of the mother and the regular consumption of artificial powder juice.