Anthropometry and physical activity level in the prediction of metabolic syndrome in children.

OBJECTIVE: To evaluate the effectiveness of anthropometric measures and physical activity level in the prediction of metabolic syndrome (MetS) in children. DESIGN: Cross-sectional study with children from public and private schools. Children underwent an anthropometric assessment, blood pressure measurement and biochemical evaluation of serum for determination of TAG, HDL-cholesterol and glucose. Physical activity level was calculated and number of steps per day obtained using a pedometer for seven consecutive days. SETTING: Viçosa, south-eastern Brazil. SUBJECTS: Boys and girls (n 187), mean age 9·90 (SD 0·7) years. RESULTS: Conicity index, sum of four skinfolds, physical activity level and number of steps per day were accurate in predicting MetS in boys. Anthropometric indicators were accurate in predicting MetS for girls, specifically BMI, waist circumference measured at the narrowest point and at the level of the umbilicus, four skinfold thickness measures evaluated separately, the sum of subscapular and triceps skinfold thickness, the sum of four skinfolds and body fat percentage. CONCLUSIONS: The sum of four skinfolds was the most accurate method in predicting MetS in both genders.

Waist circumference percentile curves as a screening tool to predict cardiovascular risk factors and metabolic syndrome risk in Brazilian children.

The goals of this study were to develop reference values for waist circumference (WC) in Brazilian children between 6-10 years old and to evaluate the WC performance in predicting cardiovascular risk factors and metabolic syndrome (MetS) in children. This is a population-based epidemiological cross-sectional study, in which 1,397 children participated, with a 6-10 years old probability sampling and from public and private schools in the city of Uberaba, Minas Gerais State, Brazil. WC was measured at the waist narrowest point (WC1) and at the umbilicus level (WC2). Blood samples and blood pressure were collected to determine the MetS diagnosis. There was a significant effect of age (p = 0.001), anatomical point (WC1 vs. WC2, p = 0.001) and sex-anatomical point interaction (p = 0.016) for WC. Smoothed sex- and age-specific 5th, 10th, 25th, 50th, 75th, 90th and 95th percentile curves of WC1 and WC2 were designed by the LMS method. WC was accurate to predict MetS, for all ages [area under the ROC curve (AUC) > 0.79 and p < 0.05], regardless of sex. This study presented percentile curves for WC at two anatomical points in a representative sample of Brazilian children. Furthermore, WC was shown to be a strong predictor of cardiovascular risk factors and MetS in children.

Waist circumference percentile curves as a screening tool to predict cardiovascular risk factors and metabolic syndrome risk in Brazilian children / Curvas de percentis do perímetro de cintura como ferramenta de rastreamento para predizer fatores de risco cardiovasculares e risco de síndrome metabólica em crianças brasileiras / Curvas de percentil de circunferencia de cintura como herramienta de detección para predecir factores de riesgo cardiovascular y síndrome metabólico en niños brasileños

The goals of this study were to develop reference values for waist circumference (WC) in Brazilian children between 6-10 years old and to evaluate the WC performance in predicting cardiovascular risk factors and metabolic syndrome (MetS) in children. This is a population-based epidemiological cross-sectional study, in which 1,397 children participated, with a 6-10 years old probability sampling and from public and private schools in the city of Uberaba, Minas Gerais State, Brazil. WC was measured at the waist narrowest point (WC1) and at the umbilicus level (WC2). Blood samples and blood pressure were collected to determine the MetS diagnosis. There was a significant effect of age (p = 0.001), anatomical point (WC1 vs. WC2, p = 0.001) and sex-anatomical point interaction (p = 0.016) for WC. Smoothed sex- and age-specific 5th, 10th, 25th, 50th, 75th, 90th and 95th percentile curves of WC1 and WC2 were designed by the LMS method. WC was accurate to predict MetS, for all ages [area under the ROC curve (AUC) > 0.79 and p < 0.05], regardless of sex. This study presented percentile curves for WC at two anatomical points in a representative sample of Brazilian children. Furthermore, WC was shown to be a strong predictor of cardiovascular risk factors and MetS in children.

O estudo teve como objetivos desenvolver valores de referência para perímetro de cintura (PC) em crianças brasileiras entre 6 e 10 anos de idade e avaliar o desempenho da PC na predição de fatores de risco cardiovasculares e de síndrome metabólica (SM) em crianças. O estudo epidemiológico transversal de base populacional incluiu 1.397 crianças entre 6 e 10 anos de idade, através de amostragem probabilística em escolas públicas e privadas em Uberaba, Minas Gerais, Brasil. A PC era medida no ponto mais estreito da cintura (PC1) e ao nível do umbigo (PC2). Foram coletadas amostras de sangue e medidas de pressão arterial para determinar o diagnóstico de SM. Os seguintes fatores mostram associação significativa com PC: idade (p = 0,001), ponto anatômico (PC1 vs. PC2, p = 0,001) e interação sexo/ponto anatômico (p = 0,016). O método LMS foi utilizado para desenhar as curvas suavizadas específicas para sexo e idade, dos percentis 5, 10, 25, 50, 75, 90 e 95. A PC mostrou-se acurada para a predição de SM, para todas as idades [área sob a curva ROC (AUC) > 0,79 e p < 0,05], independente de sexo. Conclusão: o estudo apresentou curvas de percentis de PC em dois pontos anatómicos em uma amostra representativa de crianças brasileiras. Além disso, a PC mostrou ser forte preditor de fatores de risco cardiovasculares e SM em crianças.

Los objetivos de este estudio fueron desarrollar valores de referencia para la circunferencia de cintura (WC por sus siglas en inglés), en niños brasileños entre 6-10 años de edad, y evaluar los resultados de WC para predecir factores de riesgo cardiovasculares y síndrome metabólico (MetS) en niños. Se trata de un estudio epidemiológico transversal, basado en población, en el que participaron 1.397 niños, de 6 a 10 años de edad con muestreo probabilístico, procedentes de escuelas públicas y privadas en la ciudad de Uberaba, Minas Gerais, Brasil. WC fue medido en el punto de cintura más estrecho (WC1) y al nivel del ombligo (WC2). Las muestras de sangre y presión arterial se recogieron para determinar el diagnóstico de MetS. Había un significativo efecto de la edad (p = 0.001), punto anatómico (WC1 vs. WC2, p = 0.001) y punto de interacción sexo-anatómico (p = 0.016) para el WC. Sexo uniforme y edad específica 5º, 10º, 25º, 50º, 75º, 90º y 95º curvas de percentil de WC1 y WC2 fueron diseñados mediante el método LMS. WC fue exacto para predecir MetS en todas las edades [área bajo la curva ROC (AUC) > 0.79 y p < 0.05], independientemente del sexo. Conclusión: este estudio presentó un percentil de curvas para WC en dos puntos anatómicos en una muestra representativa de niños brasileños. Asimismo, la WC se mostró como un fuerte predictor de factores de riesgo cardiovasculares y MetS en niños.

Prevalence and factors associated with metabolic syndrome in 6-10-year-old children

Abstract Aims: to identify the prevalence of metabolic syndrome (MetS) and associated risk factors in children. Methods: a total of 1,480 Brazilian children aged 6-10 years old (52.2% girls) participated in this population-based, epidemiological cross-sectional study. The inclusion criteria were children born between the years 2001 and 2006, of both sexes, who did not use remedy, were not on a calorie restriction diet, and who respected the 12-hour fast for blood collection. Anthropometric measurements, blood pressure, blood collection, and completion of the Previous Day Food Questionnaire and interview using a Physical Activity List were held at school. Parents were asked to complete a questionnaire on socioeconomic status and lifestyle habits of their child. Chi-square test compared proportions and factors associated with MetS were identified using Poisson Regression. Results: Girls had significantly higher MetS prevalence compared with boys (12.6% vs. 8.5%, p=0.046). After multivariable analysis, body fat percentage (p=0.001), fat mass (p<0.001), lean body mass (p< 0.001) and sedentary behavior (p= 0.050) were positively associated with MetS. Conclusions: Modifiable factors such as body fat percentage, fat mass, lean body mass and sedentary behavior were associated with MetS in children. Thus, interventions targeted for weight management, and adopting healthy habits such as reducing time in front of TV/computer/video game need to be part of the lifestyle of children.(AU)

Comparison of functional autonomy with associated sociodemographic factors, lifestyle, chronic diseases (CD) and neuropsychiatric factors in elderly patients with or without the metabolic syndrome (MS).

The objective of this study was to compare autonomy and its associated factors in the elderly with and without MS. This study was a cross-sectional evaluation comprised of 402 subjects aged 60 years or older, of both sexes, consulting at the Family Health program, in Viçosa/MG. Autonomy was classified according to the Group of Latin American Development to Maturity (GDLAM) protocol and MS according to classification of the International Diabetes Federation. The independent variables were sociodemographic gender, age, marital status, education, those related to lifestyle including levels of physical activity and sedentary behavior, neuropsychological aspects included depressive symptoms, level of cognition and the presence of CD. A multiple linear regression model was used to estimate associations of variables with autonomy in the elderly with or without the MS. In the elderly group without MS, autonomy was associated with increasing age, sedentary behavior and depressive symptoms. In the group of elderly patients with MS, in addition to these factors, autonomy was also associated with being illiterate, not being physically active and presenting chronic illness. It was concluded that the presence of MS worsened the functional autonomy of elderly persons.

Different waist circumference measurements and prediction of cardiovascular risk factors and metabolic syndrome in children.

OBJECTIVE: To compare the effectiveness of three waist circumference (WC) measurement sites to predict cardiovascular risk factors and metabolic syndrome (MS) in Brazilian children. METHODS: 187 children (mean age = 9.9 ± 0.7 years) were evaluated for weight, height, WC at three different sites: midpoint between the lower rib and iliac crest (WC1), umbilicus (WC2), and narrowest waist (WC3). Skinfolds (triceps and subscapular) and blood pressure were also measured. Analyses for triglycerides, HDL-C and glucose were carried out in 141 children. RESULTS: For boys, the most accurate predictor of overweight and obesity (from body mass index, BMI) and low HDL-C levels was WC3, and for high percentage of body fat (from skinfolds) was WC1. For girls, WC2 was the most accurate predictor of MS, and hypertriglyceridemia, and for overweight and obesity, high body fat percentage, and low HDL-C levels, WC3 was the best predictor. WC1 was the most accurate in the prediction of high blood pressure. CONCLUSIONS: Each WC measurement site was accurate in predicting cardiovascular risk factors and MS. However, our results indicate that WC3 was the best predictor of cardiovascular risk factors and MS in boys and girls.

Nutritional status and epidemiological profile of elderly people.

We intended to identify and evaluate the association between the socio-demographic and epidemiological characteristics of elderly people with their nutritional characteristics. This is a transversal study PMTI (from the Portuguese name of "Programa Municipal da Terceira Idade"), conducted at Viçosa, MG, Brazil. We analyzed 93 records of elderly people registered since 2006 and who underwent nutritional care. After having analyzed the questionnaire, we performed the descriptive and association analyses in the Epi Info (version 6.04) and Minitab softwares. Of the 93 analyzed records, most elderly people were women (80.4%), with an average of 72 years of age, of which 13.0% were long-lived people. The mean body mass index (BMI) was 27.4 kg/m(2), and 50.5% were overweight. We have found 26.8% elderly patients with hypertension, and 31.6% took antihypertensives. Elderly patients who were overweight are 4.54 times more likely to have arterial hypertension (odds ratio (OR)=4.54; 95% confidence interval (CI)=1.2-2.45). Only 7.5% smoked, 30.1% were alcoholics and 60.2% made physical activities. Inadequacies were found regarding the servings of fruits, dairy products, vegetables and sugars consumed. However, the servings of cereals, leguminous, meat and fat consumed were appropriate. This study showed that the nutritional diagnosis and the epidemiological and socio-demographic studies are critical tools to understand this population group, in addition to being important to the planning of health actions.

Association between triglycerides and HDL-cholesterol ratio and cardiovascular risk factors among elderly persons receiving care under the family health strategy of Viçosa, Minas Gerais / Associação entre razão Triglicerídeos e HDL-colesterol e fatores de risco cardiovascular em idosos atendidos na estratégia saúde da família de Viçosa, MG

Abstract Objective: To evaluate the association between triglycerides and HDL-cholesterol (TG/HDL-c) ratio and cardiovascular risk factors among the elderly. Method: A cross-sectional epidemiological study with a random sample of elderly persons (n=349) of both genders, who received care under the Family Health Strategy in the municipality of Viçosa, in the state of Minas Gerais, was performed. Cardiovascular risk was calculated by the relationship between the TG and the HDL-c levels, with values greater than 3.5 considered a risk. Social and economic variables, lifestyle, noncommunicable chronic diseases, serum glucose levels, waist circumference (WC) and body mass index were evaluated. Multiple linear regression was used to evaluate the association between the TG/HDL-c ratio and other variables. Variables associated with the dependent variable with a level of significance lower than 0.20 in univariate regression analysis were included in the final model (stepwise-forward), applying a significance level of p<0.05. Results: The highest TG/HDL-c ratio values were associated with the presence of hypertension, having been or currently be a smoker, having elevated serum glucose and an increased waist circumference. Conclusion: The findings reflect the importance of studies on cardiovascular risk in the elderly, as health professionals should be familiar with the parameters that classify at risk individuals. The TG/HDL-c ratio is a reliable classification method that is easy to apply and correlates closely with adverse health effects. AU

Resumo Objetivo: Avaliar a associação entre razão Triglicerídeos e HDL-colesterol (TG/HDL-c) e fatores de risco cardiovascular em idosos. Método: Estudo epidemiológico transversal, com amostra probabilística de idosos (n=349), de ambos os sexos, atendidos na Estratégia Saúde da Família do município de Viçosa, MG. O risco cardiovascular foi calculado pela relação entre os níveis de TG sobre os níveis de HDL-c, sendo considerado em risco um valor maior que 3,5. Foram investigadas variáveis sociais e econômicas de estilo de vida, doenças crônicas não transmissíveis, níveis séricos de glicose, circunferência da cintura (CC) e índice de massa corporal. Para avaliar a associação entre a razão TG/HDL-c e as demais variáveis, foi utilizada regressão linear múltipla. As variáveis que se associaram à variável dependente com nível de significância menor que 0,20, na análise de regressão univariada, foram incluídas no modelo final (Stepwise-forward), adotando-se nível de significância p<0,05. Resultados: Os maiores valores da razão TG/HDL-c associaram-se com a presença da hipertensão arterial, ter sido ou ser fumante, apresentar elevados níveis séricos de glicose e possuir maior CC. Conclusão: Os achados refletem a importância de estudos sobre risco cardiovascular em idosos, devendo os profissionais da área da saúde ter familiaridade com os parâmetros que classificam os indivíduos com risco cardiovascular, sendo a razão TG/HDL-c um método confiável, com fácil aplicabilidade e boa correlação com efeitos adversos à saúde. AU

Waist circumference percentile in children from municipalities of developed and developing countries

Abstract Aims: to design reference percentile curves of waist circumference (WC) in children aged 6-10 from municipalities of developed (Portugal) and developing (Brazil) countries and to compare these results with other international references. Methods: this cross-sectional study enrolled a 6-10-year-old probability sampling. Univariate analysis of covariance adjusted by height was carried out to test the main effects of age, sex, countries, and interactions. WC percentile curves were performed with the LMS Chart Maker. Results: The sample comprised 6,475 children. Portuguese children presented a curvilinear increase in WC curves and Brazilian WC curves have shown a linear increase with age both for boys and girls. Overweight and obesity prevalence was 15.9 % and 4.7 % for Portuguese children and 12.9 % 4.5% for Brazilian children, respectively. There was a main effect (p<0.0001) for age and countries, and an interaction effect for sex*age (p=0.001) and countries*age (p<0.0001). Portuguese boys and girls have shown higher values for the 50th, 75th, and 95th percentiles than Brazilian boys and girls. Conclusions: WC reference percentile curves were drawn for 6-10-year-old Portuguese and Brazilian children. Portuguese children have higher WC values than Brazilian children and other children from developed countries.

Body fat assessment by bioelectrical impedance and its correlation with different anatomical sites used in the measurement of waist circumference in children.

OBJECTIVE: To compare the different anatomical sites used in the measurement of waist circumference, as well as the effectiveness of these landmarks to predict the percentage of body fat by tetrapolar bioelectrical impedance analysis. METHODS: We evaluated 205 children from 6 to 9 years of age of both sexes. Data on weight, height and waist circumference were collected at three different sites: at the lower abdominal curvature, above the navel and at the midpoint between the last rib and the iliac crest. Nutritional status was assessed through the body mass index (BMI)/age as recommended by the World Health Organization. RESULTS: The sample was considered homogeneous in terms of sex, and the mean age was 7.2+/-1.2 years. Regarding nutritional status, 6.3% of the children had low weight, 75.1% were eutrophic, 7.3% were overweight, and 11.2% were obese. Among males, there was no statistical difference between the different sites of measurement; in females, the measurement above the navel was statistically higher. In the correlation analysis, the midpoint measurement showed the best correlation with percentage of body fat, with values of 0.50 in boys and 0.62 in girls. CONCLUSION: Waist circumference measured at the midpoint between the last rib and the iliac crest presented the best correlation with percentage of body fat.

Identificação e perfil de sensibilidade de bactérias em garrotes de uso hospitalar / Identification and sensitivity profile of bacteria on tourniquets used in hospitals

Este estudo teve como principais objetivos constatar a presença de bactérias em garrotes hospitalares e identificar o perfil de sensibilidade delas aos antimicrobianos mais conhecidos e utilizados. O cenário da pesquisa foi três hospitais do município de Ubá-MG e posteriormente, o Laboratório de Microbiologia da Faculdade Presidente Antônio Carlos. Foi coletado um garrote em cada setor hospitalar, somando um total de 15 garrotes. Em análise macroscópica, observou a presença de sangue em 26,66%. De todos os garrotes analisados, houve crescimento bacteriano apenas do gênero Staphylococcus, predominando a espécie Staphylococcus aureus em 57,14% sobre a de Staphylococcus Coagulase Negativo 43,86%. Sendo assim, os garrotes podem servir como veiculo de disseminação para contaminação hospitalar, principalmente na forma de transmissão de microrganismos multirresistentes.

The aim of this study was to investigate the presence of bacteria on rubber tourniquets in hospitals and determine their sensitivity profile to the best-known, routinely used antimicrobials. The material was collected from three hospitals in the city of Ubá (MG, Brazil) and analyzed at the Microbiology Laboratory of President Antônio Carlos Faculty in Ubá. We collected one tourniquet from each hospital unit, giving a total of 15. Macroscopic inspection showed the presence of blood on 4 specimens (26,66%). Every tourniquet gave rise to bacterial growth of only one genus, Staphylococcus. The species S. aureus (57,14%) predominated over coagulase-negative staphylococci (43,86%). Consequently, the tourniquets may serve as a vehicle for the spreading of infection in the hospital, especially the transmission of multidrug-resistant microorganisms.

Nível de atividade física como preditor de fatores de risco cardiovasculares em crianças / Physical activity level as a predictor of cardiovascular risk factors in children / El nivel de actividad física como un predictor de riesgo cardiovascular en niños

O presente estudo avaliou a eficácia do nível de atividade física (NAF), envolvimento em atividade física de moderada a vigorosa intensidade (AFMV) e número de passos/dia para predição dos fatores de risco cardiovasculares (FRCV) em crianças. Foram mensuradas medidas antropométricas, composição corporal, pressão arterial, glicemia, HDL-c e triacilglicerídeos. NAF e envolvimento em AFMV foram obtidos pelo registro de atividade física e número de passos por pedômetro. Participaram 187 crianças com 9,90 ± 0,7 anos de idade. NAF apresentou área sob a curva ROC significativa para predição da obesidade, alto % de gordura corporal e pressão arterial alterada (PAA) nas meninas. NAF foi acurado em predizer obesidade e síndrome metabólica (SM) e AFMV foi acurada em predizer SM e PAA nos meninos. Meninos que atingiram a recomendação de 13000 passos/dia foram protegidos da SM e baixo HDL-c. Atender as recomendações de envolvimento em AFMV e número de passos protegem crianças dos FRCV.

This study evaluated the effectiveness of the physical activity level (PAL), engagement in physical activity of moderate to vigorous intensity (MVPA) and number of steps/day as prediction of cardiovascular risk factors (CVRF) in children. We measured anthropometric parameters, body composition, blood pressure, blood glucose, HDL-c and triglycerides. The PAL and engagement in MVPA were obtained using a questionnaire and computing number steps/days with a pedometer. Participants were 187 children, with a mean age of 9.90 (± 0.7) years. The PAL showed a significant area under the ROC curve as a predictir of obesity, high body fat %, and high blood pressure (HBP) in girls. The PAL accurately predicted obesity and metabolic syndrome (MS), and MVPA accurately predicted MS and HBP in boys. Boys who achieved the recommended 13.000 steps/day were protected from MS and low HDL-c. Achieving the recommendations of engagement in MVPA and number of steps were protection against CVRFfactors in children.

En este estudio se evaluó la efectividad del nivel de actividad física (NAF), la participación en la actividad física de intensidad moderada a vigorosa (ATMV) y el número de pasos / día para la predicción de los factores de riesgo cardiovascular (FRCV) en niños. Medimos las medidas antropométricas, composición corporal, presión arterial, glucemia, colesterol HDL y triglicéridos. NAF y la participación en ATMV se obtuvieron los registros de la actividad física y los pasos podómetro por número. 187 niños participan 9,90 ± 0,7 años. NAF tuvo un área bajo la curva ROC significativa para la predicción de la obesidad, alto% de grasa corporal y la presión arterial enmendada (PAE) en las niñas. NAF fue precisa en la predicción de la obesidad y el síndrome metabólico (SM) y moderada a vigorosa fue precisa en la predicción de SM y PAE en los niños. Los niños que alcanzaron la cantidad recomendada de 13000 pasos /día fueron protegidos de la SM y bajo HDL-c. Alcanzar las recomendaciones de la participación en ATMV y el número de pasos proteger a los niños de los FRCV.

[Identification of the area of influence of the public basic health care delivery to the elderly population in Viçosa-MG]. / Identificação da área de influência do serviço de atenção básica do sistema público de saúde à população idosa, município de Viçosa-MG.

This study aimed to describe the demographic and epidemiological characteristics of the elderly population, identify the area of influence of basic care in relation to the area of residence of the elderly and the rate of service use, as well as to map the demand according to the geographic location of the Basic Care Unit. The sample comprised 6,964 male and female subjects aged 60 years or more, who sought any of the outpatient public health services between May 2003 and April 2004. From this total, 64.1% were women and 35.9% men. The results show that cardiovascular diseases account for the greater part of medical consultations in the health system, with a mean of 3,576 consultations per year per elderly. Geographic mapping showed the demand for medical consultations in determinate basic care units to be related with the medical specialty available at these units. These results allow identifying the neighborhoods with the highest concentrations of specific diseases, indicating the need for insertion/redistribution of professionals between the basic care units in order to improve the quality of life of the elderly.

Perfil de utilização dos serviços de saúde pelos idosos cadastrados no programa municipal da terceira idade, Viçosa - MG / Profile of health services use by seniors registered on a third-age municipal program, Viçosa, Minas Gerais, Brazil

Este estudo teve como objetivo descrever o perfil de utilização dos serviços de saúde pelos idosos cadastrados no Programa Municipal de Terceira Idade (PMTI), da cidade de Viçosa ? MG. Trata-se de estudo observacional, transversal, com amostragem não probabilística. A coleta de dados se deu por meio de entrevistas semiestruturadas. Paraverificação das variáveis utilizou-se teste de normalidade com nível de significância de p igual a 0,05. Os resultados demonstraram que 60,0% dos idosos realizavam atividade física mais de duas vezes na semana, 76,19% eram hipertensos, 15,24% diabéticos e 50,48% relataram possuir dislipidemia. O perfil de utilização dos serviços de saúde talvezpossa ser atribuído à situação socioeconômica do idoso e/ou da sua família, sendo estabelecidas relações estatísticas positivas de que quanto mais alta a renda, maior a utilização dos serviços privados. Tal fato deve ser considerado na oferta de condições para prevenção de agravos e promoção de envelhecimento saudável.

This study had as its aim to describe the profile of health service use by seniors registered on a Third-Age Municipal Program (TAMP), in Viçosa, Minas Gerais, Brazil. It is an observational and cross-sectional study, with non-probabilistic sampling. Data collection was performed by semi-structured interviews. In order to verify the variables, the normality test was used with a significance level of p=0.05. Results demonstrated that 60.0% of seniors did a physical activity more than twice a week, 76.19% were hypertensive, 15.24% were diabetic, and 50.48% had dyslipidemia. The profile of health services use may be attributed to the socioeconomic situation of the senior and/or their families. Positive statistic relations state that when the income is higher, the use of private services increases. Such fact should be taken into account when offering conditions to prevent losses and health aging promotion.

Análise do perfil sociossanitário de idosos: a importância do Programa de Saúde da Família / Analysis of the social and health profile of the elderly: the relevance of the Family Health Program

O objetivo do presente estudo foi analisar as características sociossanitárias dos idosos de Teixeiras-MG, tendo como referência a organização territorial, no contexto do Programa de Saúde da Família (PSF), visando a auxiliar a compreensão das demandas, necessidades e estruturação sociossanitária da população idosa. Foi realizado um estudo transversal, sendo aplicado um questionário especificamente criado para este estudo, que coletou informações sociossanitárias de 211 idosos residentes no município de Teixeiras. Quanto ao perfil sociossanitário, os resultados mostraram que a maioria dos idosos recebe apoio emocional familiar, possui vínculo conjugal, reside em moradia própria, é de baixa escolaridade e de baixa renda, pratica atividades físicas, é portadora de comorbidades, não fuma, não ingere bebidas alcoólicas, necessita de cuidados à saúde (consultas e medicamentos) e não possui plano de saúde privado. Nesse sentido, há que se pensar em como promover a saúde da população idosa, buscando-se prevenir os agravos à saúde, afastar as causas evitáveis de morbidades e mortalidade, proporcionando-lhe condições para um envelhecimento saudável e ativo.

This study aim was to analyze the social and health characteristics of the elderly in Teixeiras-MG, having as reference the territorial organization, in the context of the Family Health Program (FHP) / Programa de Saúde da Família (PSF), with the purpose of helping to understand the social and health demands, needs and structure of the elderly population. A cross-sectional study was carried out, applying a questionnaire specifically created for the study, which collected social and health information of 211 elderly people living in the Teixeiras municipality. Regarding the social and health profile, the results show that most elderly receive family emotional support, are married, homeowners, have low education level and low income, have physical activities, have comorbidities, do not smoke, do not drink alcoholic beverages, need health care (consultations and medication) and do not have private health plans. Therefore, it must be thought how to promote the elderly population health, seeking to prevent health damage, remove possible morbidity and mortality causes, providing conditions for healthy and active ageing.

Avaliação de gordura corporal pela bioimpedância elétrica e sua correlação com diferentes pontos anatômicos de medida da circunferência da cintura em crianças / Body fat assessment by bioelectrical impedance and its correlation with different anatomical sites used in the measurement of waist circumference in children

OBJETIVO: Comparar os diferentes pontos anatômicos de medida da circunferência da cintura, bem como a eficácia desses locais em predizer o percentual de gordura corporal mensurado pela bioimpedância elétrica tetrapolar. MÉTODOS: Foram avaliadas 205 crianças de 6 a 9 anos de idade de ambos os sexos. Foram coletados dados de peso, estatura e circunferência da cintura em três locais diferentes: na menor curvatura abdominal, sobre a cicatriz umbilical e no ponto médio entre a última costela e crista ilíaca. A avaliação do estado nutricional foi realizada a partir do índice de massa corporal/idade recomendado pela Organização Mundial de Saúde. RESULTADOS: No presente estudo houve homogeneidade entre os sexos, e a idade média foi de 7,2±1,2 anos. Em relação ao estado nutricional, 6,3 por cento das crianças apresentaram baixo peso, 75,1 por cento eram eutróficas, 7,3 por cento apresentaram sobrepeso e 11,2 por cento obesidade. No sexo masculino não houve diferença estatística entre os diferentes locais de medida. No feminino, a medida sobre a cicatriz umbilical foi estatisticamente maior. Na análise de correlação, a circunferência medida no ponto médio foi a que obteve melhor correlação com o percentual de gordura corporal, com valores de 0,50 nos meninos e 0,62 nas meninas. CONCLUSÃO: A circunferência da cintura medida no ponto médio entre a crista ilíaca e ultima costela foi a que apresentou melhor correlação com o percentual de gordura corporal.

OBJECTIVE: To compare the different anatomical sites used in the measurement of waist circumference, as well as the effectiveness of these landmarks to predict the percentage of body fat by tetrapolar bioelectrical impedance analysis. METHODS: We evaluated 205 children from 6 to 9 years of age of both sexes. Data on weight, height and waist circumference were collected at three different sites: at the lower abdominal curvature, above the navel and at the midpoint between the last rib and the iliac crest. Nutritional status was assessed through the body mass index (BMI)/age as recommended by the World Health Organization. RESULTS: The sample was considered homogeneous in terms of sex, and the mean age was 7.2±1.2 years. Regarding nutritional status, 6.3 percent of the children had low weight, 75.1 percent were eutrophic, 7.3 percent were overweight, and 11.2 percent were obese. Among males, there was no statistical difference between the different sites of measurement; in females, the measurement above the navel was statistically higher. In the correlation analysis, the midpoint measurement showed the best correlation with percentage of body fat, with values of 0.50 in boys and 0.62 in girls. CONCLUSION: Waist circumference measured at the midpoint between the last rib and the iliac crest presented the best correlation with percentage of body fat.

Identificação da área de influência do serviço de atenção básica do sistema público de saúde à população idosa, município de Viçosa-MG / Identification of the area of influence of the public basic health care delivery to the elderly population in Viçosa-MG

O objetivo deste estudo foi descrever as características demográficas e epidemiológicas da população idosa e identificar a área de influência dos serviços de atenção básica do sistema público de saúde em relação ao bairro de residência do idoso, identificar a taxa de utilização dos serviços e mapear a procura por atendimento de acordo com a localização geográfica da Unidade Básica de Saúde (UBS). Compuseram a amostra 6.964 atendimentos de saúde, prestados a 2.391 indivíduos idosos, ambos os sexos, que compareceram a um dos serviços públicos de atenção básica à saúde do município, no período de maio de 2003 a abril de 2004. Do total da amostra, 64,1 por cento são do sexo feminino e 35,9 por cento, do masculino. Os resultados mostram que as doenças cardiovasculares são as responsáveis pelo maior contingente de atendimentos no sistema de saúde. O número médio de consultas foi de 3,6 ao ano por idoso. O mapeamento geográfico permitiu visualizar que a procura por atendimento em determinadas UBS está relacionado com a especialidade médica que a unidade oferece e não com o local de residência do idoso. Os resultados deste estudo permitem identificar os bairros com maiores concentrações de enfermidades, como doenças cardiovasculares, indicando a necessidade da inserção de outros profissionais nas UBS dos bairros.

This study aimed to describe the demographic and epidemiological characteristics of the elderly population, identify the area of influence of basic care in relation to the area of residence of the elderly and the rate of service use, as well as to map the demand according to the geographic location of the Basic Care Unit. The sample comprised 6,964 male and female subjects aged 60 years or more, who sought any of the outpatient public health services between May 2003 and April 2004. From this total, 64.1 percent were women and 35.9 percent men. The results show that cardiovascular diseases account for the greater part of medical consultations in the health system, with a mean of 3,576 consultations per year per elderly. Geographic mapping showed the demand for medical consultations in determinate basic care units to be related with the medical specialty available at these units. These results allow identifying the neighborhoods with the highest concentrations of specific diseases, indicating the need for insertion/redistribution of professionals between the basic care units in order to improve the quality of life of the elderly.

Promoção da saúde: a importância das frutas e hortaliças e seu papel no câncer / Promoción de la salud: la importancia de las frutas y hortalizas y su papel en cáncer / Health promotion: the relevance of fruits and vegetables and their role in cancer

Ao decorrer do tempo, o homem descobriu que as frutas e hortaliças possuem não só um grande valor nutritivo, mas também efeito medicinal, sendo estas propriedades caracterizadas para cada espécie. O objetivo desse trabalho foi destacar a promoção da saúde através do consumo de frutas e hortaliças e seu papel na prevenção do câncer. Entre os principais mecanismos de ação das frutas e vegetais na prevenção e tratamento de doenças, principalmente câncer, pode-se citar a atividade antioxidante. O hábito de consumir frutas e hortaliças, em geral, auxilia o metabolismo do corpo humano, fortalece as células e ajudam a prevenir certos tipos de câncer. O câncer é uma das doenças mais comuns nos dias atuais, sendo classificada como a segunda causa de morte por doença no Brasil. Fatores ambientais podem atuar, aumentando os efeitos danosos. Enquanto pesquisas sobre a dieta e câncer continuam, pesquisadores concordam que, para manter a saúde e possivelmente reduzir o risco de câncer dever-se-ia adotar uma dieta pobre em gordura, rica em hortaliças e frutas (cinco porções diárias), evitando o consumo de álcool e fumo e mantendo um peso corporal saudável. Apesar disso, ainda hoje é reduzido o número de programas de promoção da saúde relacionados ao consumo de alimentos e sua implicação na geração do câncer, bem como, de sua atuação em diferentes locais do corpo humano. Assim, sugere-se a ampliação destes programas, visando melhor adequação dos hábitos alimentares saudáveis, ressaltando os benefícios do consumo de frutas e hortaliças na prevenção do câncer. PALAVRAS-CHAVE: Câncer. Alimentação saudável. Alimentos protetores.

In time, human beings discovered that fruits and vegetables have not only a high nutritional value, but also medicinal effects, and each species has its own properties. The aim of this work was to point out how to promote health by consuming fruits and vegetables and their role in cancer prevention. Among the main action mechanisms of fruits and vegetables in disease prevention and treatment, mainly cancer, antioxidant activity should be mentioned. The habit of consuming fruits and vegetables generally aids human body metabolism, strengthens cells and helps preventing certain cancer types. Cancer is one of the most common diseases today, being classified as the second causes of death by disease in Brazil. Environmental factors can act so as to increase harmful effects. While researches about diet and cancer continue, researchers agree that to maintain health and possibly to reduce cancer risk, a diet should be adopted low in fat, rich in vegetables and fruits (five daily portions), and the consumption of alcohol and tobacco avoided, besides maintaining a healthy corporal weight. Nevertheless, the number of health promotion programs in relation to foods consumption and its relation with cancer, as well as their action in different parts of the human body is reduced. Considering this, we suggest increasing the number of these programs for promoting better healthy alimentary habits, emphasizing the benefits of fruits and vegetables consumption in cancer prevention.KEYWORDS: Cancer. Healthy diet. Protector foods.

En el recurrido del tiempo, los seres humanos descubrieron que las frutas y hortalizas tienen no solamente un alto valor alimenticio, pero también efectos medicinales, y cada especie tiene sus propias características. La meta de este trabajo fue precisar cómo promover la salud consumiendo frutas y hortalizas y su papel en la prevención del cáncer. Entre los mecanismos principales de la acción de las frutas y hortalizas en la prevención y el tratamiento de enfermedades, principalmente el cáncer, se debe mencionar la actividad antioxidante. El hábito de consumir frutas y hortalizas ayuda al metabolismo del cuerpo humano, consolida las células y ayuda a prevenir ciertos tipos del cáncer. El cáncer es una de las enfermedades más comunes hoy, siendo clasificado como la segunda causa de muerte por enfermedad en Brasil. Los factores ambientales pueden actuar para aumentar sus efectos dañosos. Mientras investigaciones sobre dieta y cáncer continúan, los investigadores acuerdan que para mantener la salud y posiblemente reducir el riesgo del cáncer, se debe adoptar una dieta baja en grasa, rica en hortalizas y frutas (cinco porciones diarias), y evitar el consumo del alcohol y del tabaco, además de mantener un peso corporal sano. Sin embargo, el número de los programas de promoción de la salud en lo referente al consumo de alimentos y a su relación con el cáncer, así bien como su acción en diversas partes del cuerpo humano, son todavía reducidos. En vista de esto, sugerimos el aumento del número de estos programas para promover hábitos mejores alimenticios sanos, acentuando las ventajas del consumo de frutas y hortalizas en la prevención del cáncer. PALABRAS LLAVE: Cáncer. Dieta sana. Alimentos protectores.

Consumo alimentar e estado nutricional de crianças atendidas em serviços públicos de saúde do município de Viçosa, Minas Gerais / Food consumption and nutritional profile of children seen in public health services of Viçosa, Minas Gerais, Brazil

OBJETIVO: Avaliar o consumo alimentar e o estado nutricional de 174 crianças, entre 12 e 35 meses de idade, atendidas na rede pública de saúde de Viçosa, Minas Gerais, Brasil. MÉTODOS: O consumo alimentar foi investigado por meio de dois inquéritos dietéticos (recordatório 24 horas e questionário de freqüência de consumo alimentar). O estado nutricional foi avaliado pelos índices antropométricos peso/idade, peso/estatura e estatura/idade, e associado ao consumo alimentar. Utilizou-se o Teste "t" Student para comparar médias, Teste chi2 para verificar associação entre variáveis e Odds Ratio para avaliar fatores de risco envolvidos na ocorrência de déficits nutricionais (p<0,05). RESULTADOS: A quantidade média de energia consumida excedeu a recomendação para ambos os sexos (p<0,0001). A ingestão habitual de energia e nutrientes foi estatisticamente significante e maior entre os meninos (p<0,0001), exceto para vitamina C. Prevalências de inadequação foram observadas para as vitaminas C e A (96,6 por cento e 36,8 por cento) e os minerais ferro e zinco (13,2 por cento e 99,4 por cento). Com relação ao estado nutricional, as prevalências de desnutrição encontradas foram 13,2 por cento para o índice peso/idade, 13,8 por cento para peso/estatura e 4,0 por cento para estatura/idade. Encontrou-se associação positiva entre déficit nutricional e consumo alimentar inadequado. CONCLUSÃO: Estes resultados demonstram que o consumo alimentar inadequado tem contribuído para os déficits nutricionais do grupo pré-escolar. Recomenda-se a realização continuada de estudos de consumo alimentar nessa população, para conhecer sua prática alimentar.

Desenvolvimento de um inquérito para avaliação da ingestão alimentar de grupos populacionais / Development of a questionnaire to assess food intake of population groups

OBJETIVOS: Este trabalho procurou desenvolver um instrumento para obtenção de dados relativos ao consumo alimentar, de caráter qualitativo e quantitativo, para avaliar a ingestão dietética em estudos populacionais. MÉTODOS: Inicialmente foram coletados dados sobre a ingestão alimentar de uma amostra representativa de moradores da cidade de Viçosa (n=119). Para conhecer os alimentos mais consumidos e seus porcionamentos, foram utilizados os métodos recordatório de 24h e pesagem direta. A entrevista ocorreu no horário do almoço ou jantar, com pesagem de todos os alimentos constantes na refeição e de porções referidas como consumidas nas últimas 24h, usou-se também álbum fotográfico como auxiliar na estimativa do peso da porção. RESULTADOS: A partir dos 60 alimentos mais consumidos e dos porcionamentos identificados, foi desenvolvido um inquérito baseado no método Freqüência de Consumo Alimentar semi-quantitativo, com 65 itens e um álbum fotográfico de alimentos. Realizou-se um estudo piloto para avaliação desta metodologia em uma sub-amostra (n=34). Para comparação entre os dois métodos, avaliaram-se o valor energético e os macronutrientes, utilizando o coeficiente de Pearson e o teste "t" de Student, tendo-se obtido: r=0,53 para energia, r=0,43 para proteína, r=0,58 para lipídeos e r=0,21 para carboidratos. Não foi detectada diferença significante entre os dois métodos para proteína e lipídeos, pelo teste "t" (alfa=0,05). CONCLUSÃO: O inquérito desenvolvido mostrou-se um instrumento promissor para inquéritos populacionais, no entanto, são necessários maiores estudos para averiguar as limitações e os possíveis desdobramentos do inquérito para atingir toda a população.

OBJECTIVE: This study sought to develop an instrument to obtain and assess data on the qualitative and quantitative food intake of population groups. METHODS: Initially, data on food intake of a representative sample of inhabitants of Viçosa (n=119) were collected. The 24-hour recall and direct weight were used to determine the most consumed foods and their portions. Interview was done at lunch or dinner where all foods and portions mentioned in the previous 24 hours were weighed; a food picture album was used to aid in determining the weight of the portion. RESULTS: From the 60 most frequently consumed foods and the identified portions, a questionnaire based on the semi-quantitative Food Intake Frequency method, with 65 items and a food picture album were developed. A pilot study was done to assess this methodology in a subsample (n=34). To compare the two methods, the energy value and macronutrients were assessed, using the Pearson coefficient and the Student's "t" test and the values obtained were r=0.53 for energy, r=0.43 for proteins, r=0.58 for lipids and r=0.21 for carbohydrates. A significant difference was not detected by the Student's "t" test for proteins and lipids between the two methods (alpha=0.05). CONCLUSION: The questionnaire was proven to be a promising method for population surveys, yet more studies are necessary to determine its limitations and possibly expand the questionnaire in order to cover the entire population.