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de Sales PC, McCarthy MM, Dickson VV, Sullivan-Bolyai S, Melkus GD, Chyun D. The Importance of Social Support in the Management of Hypertension in Brazil. J Cardiovasc Nurs 2025; 40:198-207. [PMID: 38888420 DOI: 10.1097/jcn.0000000000001108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
BACKGROUND The prevalence of hypertension (HTN) is high in Brazil, and control rates are low. Little is known about the factors that contribute to HTN control from a family-based perspective. OBJECTIVES Guided by the Family Management Style Framework, specific aims were to (1) describe the prevalence of adequate blood pressure (BP) control in individuals cared for the Family Health Strategy, (2) identify facilitators and barriers to HTN management, and (3) identify individual contextual sociocultural influences (sociocultural context and social and Family Health Strategy support), definition of the situation, and management behaviors that help or interfere with individual functioning (BP control in the individual with HTN). METHODS This descriptive, cross-sectional study included 213 individuals with HTN randomly selected from 3 Family Health Strategy units from July 2016 until July 2017. RESULTS Most of the individuals were female (n = 139, 65.3%), retired (n = 129, 60.5%), and White (n = 129, 60.2%) and had less than a high school education (n = 123, 57.6%). Family income (n = 166, 77.8%) was less than 5500 reals (US $1117/month). Mean (SD) systolic BP was 137.1 (±24.1) mm Hg, and mean (SD) diastolic BP was 83.8 (±18.6) mm Hg, with 47.9% (n = 102) having uncontrolled BP. In the multivariate logistic model, only high levels of perceived social support were significantly associated (odds ratio, 3.29; 95% confidence interval, 1.44-7.5; P = .005) with controlled BP. CONCLUSIONS Social support is strongly associated with BP control. Optimizing support may play an important role in BP control and preventing HTN-related complications.
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Teasdale E, Mercille G, Roncarolo F, Riva M, Sylvestre MP, Blanchet R, Potvin L. Association between food security status and dietary patterns in a cohort of first-time food-aid users. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2025; 116:59-69. [PMID: 39436533 PMCID: PMC11870709 DOI: 10.17269/s41997-024-00932-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 08/02/2024] [Indexed: 10/23/2024]
Abstract
OBJECTIVE To examine the associations between food security status and dietary patterns among first-time food-aid users. METHODS From September 2018 to January 2020, a sample of 1001 newly registered food-aid users from 106 community-based food donation organizations were recruited across urban, rural, and peri-urban areas in four administrative regions of the province of Quebec, Canada. The Household Food Security Survey Module (HFSSM) and the Short Diet Questionnaire (SDQ) were used to assess food security status and food intake, respectively. A posteriori dietary patterns were identified through principal component analysis. Regression analyses were performed on 987 participants with complete data to quantify the association between food security status and dietary patterns. RESULTS Three main dietary patterns were identified: prudent (intake of fruits and fruit juice, plant-based beverages and legumes, green salad, carrots, other vegetables, whole grains, and fish), western (intake of poultry, red meat, potatoes and fried potatoes, rice, and pasta and refined grains), and snack foods (intake of salty snacks, cheese, butter and margarine, sweets, condiments, sweet beverages, and processed meat). Food insecurity was negatively associated with the prudent dietary pattern and positively associated with the snack food dietary pattern. CONCLUSION This study highlights the complexity of dietary patterns in a vulnerable population of first-time food-aid users, especially among those who are severely food insecure.
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Affiliation(s)
- Emma Teasdale
- Department of Nutrition, Université de Montréal, Montreal, QC, Canada
- Centre de Recherche en Santé Publique (CReSP), Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada
| | - Geneviève Mercille
- Department of Nutrition, Université de Montréal, Montreal, QC, Canada
- Centre de Recherche en Santé Publique (CReSP), Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada
| | - Federico Roncarolo
- Centre de Recherche en Santé Publique (CReSP), Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada.
- Chaire Approches Communautaires et Inégalités de Santé, Université de Montréal, Montreal, QC, Canada.
- École de Santé Publique, Université de Montréal, Montreal, QC, Canada.
| | - Mylène Riva
- Canada Research Chair in Housing, Community and Health and Department of Geography, McGill University, Montreal, QC, Canada
| | - Marie-Pierre Sylvestre
- École de Santé Publique, Université de Montréal, Montreal, QC, Canada
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Université de Montréal (CR-CHUM), Montreal, QC, Canada
| | - Rosanne Blanchet
- Centre de Recherche en Santé Publique (CReSP), Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada
- École de Santé Publique, Université de Montréal, Montreal, QC, Canada
| | - Louise Potvin
- Centre de Recherche en Santé Publique (CReSP), Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada
- Chaire Approches Communautaires et Inégalités de Santé, Université de Montréal, Montreal, QC, Canada
- École de Santé Publique, Université de Montréal, Montreal, QC, Canada
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Godevithana J, Wijesinghe CJ, Wijesinghe MSD. Prevalence and determinants of healthy and balanced diet among office workers in a sedentary working environment: evidence from Southern Sri Lanka. BMC Public Health 2024; 24:3453. [PMID: 39696073 DOI: 10.1186/s12889-024-20935-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2024] [Accepted: 12/03/2024] [Indexed: 12/20/2024] Open
Abstract
BACKGROUND An unhealthy diet is a key risk factor for non-communicable diseases (NCD), which account for a significant number of premature deaths and disability-adjusted life years worldwide. Office workers are reported to have unhealthy and unbalanced diets, while being sedentary due to the nature of their work, placing them at a greater risk of NCD. This study aimed to determine dietary intake and associated factors among sedentary office workers in Southern Sri Lanka. METHODS A cross-sectional study was conducted among 518 sedentary workers in 20 offices in the Galle district. Socio-demographic, health and work-related factors and dietary practices were assessed using a self-administered questionnaire. Twenty-four-hour dietary recall was used to assess dietary intake, which was converted into the number of servings from each food group. Healthy dietary intake was defined as 'adherence to the numbers of servings recommended in Food Based Dietary Guidelines for Sri Lankans for more than three food groups including cereal and cereal-based foods, fruits, and vegetables, with the consumption of one or no unhealthy food per day'. RESULTS Only 4.6% (n = 24) of the participants consumed a healthy diet, while a considerable proportion had the recommended intake of cereal-based foods, vegetables and fish, meat and pulses (65.3%, 65.8% and 50.8%, respectively). Intake of fruits, dairy products, nuts and seeds was low among the participants. Meal skipping and group eating were significantly associated with an overall unhealthy diet. Stratified analysis showed sex as an effect modifier for the association between group eating and unhealthy diet. In multivariate analysis, none of the factors showed a significant association with healthy dietary intake. CONCLUSIONS The dietary intake of sedentary office workers was not up to the recommendations. Meal skipping and group eating were associated with unhealthy dietary intake. This study recommends introducing interventions to improve the intake of fruits, dairy products, nuts, and seeds for sedentary office workers.
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Affiliation(s)
- Janaka Godevithana
- Department of Community Medicine, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka.
- Centre for Public Health Nutrition Education & Research, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka.
| | - Champa Jayalakshmie Wijesinghe
- Centre for Public Health Nutrition Education & Research, Department of Community Medicine, University of Ruhuna, Galle, Sri Lanka
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de Azevedo LB, Martins HX, Luft VC, da Fonseca MDJM, Enriquez-Martinez OG, Molina MDCB. Factors Associated with the Practice of Low-Carb and Low-Fat Diets among Participants of the Longitudinal Study of Adult Health (ELSA-Brasil). Nutrients 2024; 16:2680. [PMID: 39203817 PMCID: PMC11357444 DOI: 10.3390/nu16162680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Revised: 08/06/2024] [Accepted: 08/08/2024] [Indexed: 09/03/2024] Open
Abstract
In the field of nutrition, both low-carbohydrate (LCD) and low-fat (LFD) diets were initially intended for specific subgroups but are now being embraced by the broader population for various purposes, including aesthetics and overall health. This study aims to assess sociodemographic, health, and lifestyle factors influencing diet choices among public servants in the ELSA-Brasil cohort. Diets were classified as LCD or LFD based on the Brazilian Diabetes Society (<45%) and WHO guidelines (<30%) respectively. A total of 11,294 participants were evaluated (45.3% men; 54.7% women) with a mean age of 52 ± 0.08 years. Having overweight, altered waist circumference, and a history of smoking confers higher chances of adopting an LCD compared to the usual diet, while being over 52 years, non-White race/skin color, in a lower income stratum, and having diagnosis of hypertension and/or diagnosis of diabetes mellitus decrease these chances. Regarding LFDs, belonging to the non-White race/skin color, being over 52 years old, being divorced, and practicing low physical activity decrease the chances of following such a diet compared to the usual diet. In conclusion, factors like age, socioeconomic status, health, and physical activity levels can be the key to understanding why individuals choose restrictive diets beyond clinical advice.
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Affiliation(s)
- Leticia Batista de Azevedo
- Postgraduate Program in Nutrition and Health, Federal University of Espírito Santo, Vitória 29043-213, Brazil; (L.B.d.A.); (H.X.M.)
| | - Haysla Xavier Martins
- Postgraduate Program in Nutrition and Health, Federal University of Espírito Santo, Vitória 29043-213, Brazil; (L.B.d.A.); (H.X.M.)
| | - Vivian Cristine Luft
- Postgraduate Program in Epidemiology, Faculdade de Medicina, Federal University of Rio Grande do Sul, Porto Alegre 90035-003, Brazil
| | | | - Oscar Geovanny Enriquez-Martinez
- Postgraduate Program in Nutrition and Health, Federal University of Espírito Santo, Vitória 29043-213, Brazil; (L.B.d.A.); (H.X.M.)
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Parajára MDC, Fogal Vegi AS, Machado ÍE, de Menezes MC, Verly-Jr E, Meireles AL. Disability and costs of IHD attributable to the consumption of trans-fatty acids in Brazil. Public Health Nutr 2024; 27:e132. [PMID: 38726481 PMCID: PMC11112431 DOI: 10.1017/s1368980024001101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 03/25/2024] [Accepted: 05/01/2024] [Indexed: 05/23/2024]
Abstract
OBJECTIVE To estimate the disability and costs of the Brazilian Unified Health System for IHD attributable to trans-fatty acid (TFA) consumption in 2019. DESIGN This ecological study used secondary data from the Global Burden of Disease (GBD) Study 2019 to estimate the years lived with disability from IHD attributable to TFA in Brazil in 2019. Data on direct costs (purchasing power parity: 1 Int$ = R$ 2·280) were obtained from the Hospital and Ambulatory Information Systems of the Brazilian Unified Health System. Moreover, the total costs in each state were divided by the resident population in 2019 and multiplied by 10 000 inhabitants. The relationship between the socio-demographic index, disease and economic burden was investigated. SETTING Brazil and its twenty-seven states. PARTICIPANTS Adults aged ≥ 25 years of both sexes. RESULTS IHD attributable to TFA consumption resulted in 11 165 years lived with disability (95 % uncertainty interval 932–18 462) in 2019 in Brazil. A total of Int$ 54 546 227 (95 % uncertainty interval 4 505 792–85 561 810) was spent in the Brazilian Unified Health System in 2019 due to IHD attributable to TFA, with the highest costs of hospitalisations, for males and individuals aged ≥ 50 years or over. The highest costs were observed in Sergipe (Int$ 6508/10 000; 95 % uncertainty interval 576–10 265), followed by the two states from the South. Overall, as the socio-demographic index increases, expenditures increase. CONCLUSIONS TFA consumption results in a high disease and economic IHD burden in Brazil, reinforcing the need for more effective health policies, such as industrial TFA elimination, following the international agenda.
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Affiliation(s)
- Magda do Carmo Parajára
- Programa de Pós-Graduação em Saúde e Nutrição, Escola de Nutrição, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Aline Siqueira Fogal Vegi
- Programa de Pós-Graduação em Saúde e Nutrição, Escola de Nutrição, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Ísis Eloah Machado
- Programa de Pós-Graduação em Saúde e Nutrição, Escola de Nutrição, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
- Departamento de Medicina de Família, Saúde Mental e Coletiva, Escola de Medicina, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Mariana Carvalho de Menezes
- Programa de Pós-Graduação em Saúde e Nutrição, Escola de Nutrição, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
- Departamento de Nutrição Clínica e Social, Escola de Nutrição, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Eliseu Verly-Jr
- Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Adriana Lúcia Meireles
- Programa de Pós-Graduação em Saúde e Nutrição, Escola de Nutrição, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
- Departamento de Nutrição Clínica e Social, Escola de Nutrição, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
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Guimarães JSF, Mesquita JA, Kimura TY, Oliveira ALM, Leite MF, Oliveira AG. Burden of liver disease in Brazil, 1996-2022: a retrospective descriptive study of the epidemiology and impact on public healthcare. LANCET REGIONAL HEALTH. AMERICAS 2024; 33:100731. [PMID: 38800645 PMCID: PMC11117060 DOI: 10.1016/j.lana.2024.100731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 03/15/2024] [Accepted: 03/20/2024] [Indexed: 05/29/2024]
Abstract
Background Liver disease is a major cause of mortality and morbidity worldwide and its epidemiology depends on the genetic background, exposure to risk factors, access to healthcare and other sociodemographic characteristics. Brazil is a large country with diverse multicultural and ethnic heritages and important socioeconomic inequalities. The burden of liver disease in Brazil, its regions and population is unknown. Methods We retrieved data from the Unified Health System regarding liver diseases and analyzed the mortality and morbidity from 1996 to 2022 by gender, race/ethnicity, age, region and overall. We calculated the age-specific risk of deaths by liver disease, age-standardization of the data, mean hospitalization and liver transplant-associated costs. Findings Malignant neoplasm of the liver and intrahepatic bile ducts, alcohol-associated liver disease, fibrosis, and cirrhosis of the liver, other diseases of the liver, hepatic failure, chronic viral hepatitis were identified as the major causes of death and morbidity in Brazil in the period analyzed. The epidemiology of these diseases was diverse, with variations according to geographic regions, gender and race/ethnicity. The major economic burden of liver disease is related to liver transplants, a common outcome of the progression of these diseases. Interpretation Liver disease in Brazil is a serious issue for the public health system due to the high number of deaths and increasing mortality rate. Our study contributes as a necessary prerequisite for the development of tailored public health policies aimed at mitigating the increasing burden of liver diseases in specific populations and regions. Funding CNPq, INCT, CAPES, FAPEMIG.
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Affiliation(s)
- João Sérgio Fonseca Guimarães
- Department of Physiology and Biophysics, Institute of Biological Science, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Jordana Almeida Mesquita
- Department of Physiology and Biophysics, Institute of Biological Science, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
- School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Thais Yuki Kimura
- Department of Physiology and Biophysics, Institute of Biological Science, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
- School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Ana Luíza Matos Oliveira
- Economic Development Unit, Economic Commission for Latin America and the Caribbean (ECLAC), Mexico City, Mexico
| | - M. Fatima Leite
- Department of Physiology and Biophysics, Institute of Biological Science, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - André Gustavo Oliveira
- Department of Physiology and Biophysics, Institute of Biological Science, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
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de Sousa KG, de Carvalho Chaves S, de Souza Barbosa T, Gavião MBD. Nutritional status, feeding behavior, and oral conditions in preschool children exposed to secondhand smoke. Ecol Food Nutr 2024; 63:63-82. [PMID: 38308642 DOI: 10.1080/03670244.2024.2307431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2024]
Abstract
This study evaluated whether the nutritional status of preschoolers is influenced by secondhand smoke. Pairs of mothers-children (N = 201) were allocated in "children exposed to secondhand smoke (ESHS)" or "not exposed (N_ESHS)." Mothers answered, "The Parental Feeding Style Questionnaire (PFSQ)." The nutritional status and oral conditions were evaluated using WHO criteria. ESHS was 3.5 more likely to have a high BMI and their mothers had 10 kg more than N_ESHS. The probability of having dental caries was 2.28 and 3.68 times greater when the mother's BMI increases and when family/mothers were smokers, independently whether they smoke in the child's presence.
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Affiliation(s)
- Karina Guedes de Sousa
- Departamento de Ciências da Saúde e Odontologia Infantil, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas (FOP-UNICAMP), Piracicaba, SP, Brasil
- Department of Dentistry, UniFacex, Natal, Brasil
| | | | - Taís de Souza Barbosa
- Department of Social and Pediatric Dentistry, Institute of Science and Technology, Campus of São José dos Campos, São Paulo State University (UNESP), São José dos Campos, Brasil
| | - Maria Beatriz Duarte Gavião
- Departamento de Ciências da Saúde e Odontologia Infantil, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas (FOP-UNICAMP), Piracicaba, SP, Brasil
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Pradeilles R, Landais E, Pareja R, Eymard‐Duvernay S, Markey O, Holdsworth M, Rousham EK, M. Creed‐Kanashiro H. Exploring the magnitude and drivers of the double burden of malnutrition at maternal and dyad levels in peri-urban Peru: A cross-sectional study of low-income mothers, infants and young children. MATERNAL & CHILD NUTRITION 2023; 19:e13549. [PMID: 37485734 PMCID: PMC10483951 DOI: 10.1111/mcn.13549] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 07/25/2023]
Abstract
Multiple forms of malnutrition coexist in Peru, especially in peri-urban areas and poor households. We investigated the magnitude of, and the contribution of, dietary and socio-demographic factors to the double burden of malnutrition (DBM) at maternal (i.e., maternal overweight/obesity with anaemia) and dyad (i.e., maternal overweight/obesity with child anaemia) levels. A cross-sectional survey was conducted among low-income mother-child (6-23 months) dyads (n = 244) from peri-urban communities in Peru. Dietary clusters and the minimum dietary diversity score (MDD) were generated for mothers and infants, respectively. A composite indicator using the maternal dietary clusters and the MDD was created to relate to dyad level DBM. Two dietary clusters were found: (i) the 'high variety (i.e., animal-source foods, fruit and vegetables), high sugary foods/beverages' (cluster 1) and (ii) the 'high potato, low fruit and vegetables, low red meat' (cluster 2). DBM prevalence among mothers and dyads was 19.9% and 36.3%, respectively. Logistic regression analyses revealed that the only socio-demographic factor positively associated with maternal DBM was maternal age (aOR/5 years: 1.35 [1.07, 1.71]). Mothers belonging to diet cluster 1 were less likely to experience the DBM (aOR = 0.52 [0.26, 1.03]), although CIs straddled the null. Socio-demographic factors positively associated with dyad level DBM included maternal age (aOR/5 years: 1.41 [1.15, 1.73]), and having ≥ two children under 5 years (aOR = 2.44 [1.23, 4.84]). Diet was not associated with dyad-level DBM. Double-duty actions that tackle the DBM are needed given that one-third of dyads and a fifth of mothers had concurrent overweight/obesity and anaemia.
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Affiliation(s)
- Rebecca Pradeilles
- Centre for Global Health and Human Development School of Sport, Exercise and Health SciencesLoughborough UniversityLoughboroughUK
- UMR MoISA (Montpellier Interdisciplinary Centre on Sustainable Agri‐Food Systems)Univ Montpellier, CIRAD, CIHEAM‐IAMM, INRAE, Institut Agro, IRDMontpellierFrance
| | - Edwige Landais
- UMR MoISA (Montpellier Interdisciplinary Centre on Sustainable Agri‐Food Systems)Univ Montpellier, CIRAD, CIHEAM‐IAMM, INRAE, Institut Agro, IRDMontpellierFrance
| | | | - Sabrina Eymard‐Duvernay
- UMR MoISA (Montpellier Interdisciplinary Centre on Sustainable Agri‐Food Systems)Univ Montpellier, CIRAD, CIHEAM‐IAMM, INRAE, Institut Agro, IRDMontpellierFrance
| | - Oonagh Markey
- Centre for Global Health and Human Development School of Sport, Exercise and Health SciencesLoughborough UniversityLoughboroughUK
| | - Michelle Holdsworth
- UMR MoISA (Montpellier Interdisciplinary Centre on Sustainable Agri‐Food Systems)Univ Montpellier, CIRAD, CIHEAM‐IAMM, INRAE, Institut Agro, IRDMontpellierFrance
| | - Emily K. Rousham
- Centre for Global Health and Human Development School of Sport, Exercise and Health SciencesLoughborough UniversityLoughboroughUK
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Pereira CC, Pedroso CF, Batista SRR, Guimarães RA. Prevalence and factors associated with multimorbidity in adults in Brazil, according to sex: a population-based cross-sectional survey. Front Public Health 2023; 11:1193428. [PMID: 37342274 PMCID: PMC10278573 DOI: 10.3389/fpubh.2023.1193428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 05/12/2023] [Indexed: 06/22/2023] Open
Abstract
Introduction Multimorbidity, defined as the coexistence of two or more chronic diseases in the same individual, represents a significant health challenge. However, there is limited evidence on its prevalence and associated factors in developing countries, such as Brazil, especially stratified by sex. Thus, this study aims to estimate the prevalence and analyze the factors associated with multimorbidity in Brazilian adults according to sex. Methods Cross-sectional population-based household survey carried out with Brazilian adults aged 18 years or older. The sampling strategy consisted of a three-stage conglomerate plan. The three stages were performed through simple random sampling. Data were collected through individual interviews. Multimorbidity was classified based on a list of 14 self-reported chronic diseases/conditions. Poisson regression analysis was performed to estimate the magnitude of the association between sociodemographic and lifestyle factors with the prevalence of multimorbidity stratified by sex. Results A total of 88,531 individuals were included. In absolute terms, the prevalence of multimorbidity was 29.4%. The frequency in men and women was 22.7 and 35.4%, respectively. Overall, multimorbidity was more prevalent among women, the older people, residents of the South and Southeast regions, urban area residents, former smokers, current smokers, physically inactive, overweight, and obese adults. Individuals with complete high school/incomplete higher education had a lower prevalence of multimorbidity than those with higher educational level. The associations between education and multimorbidity differed between sexes. In men, multimorbidity was inversely associated with the strata of complete middle school/incomplete high school and complete high school/incomplete higher education, while in women, the association between these variables was not observed. Physical inactivity was positively associated with a higher prevalence of multimorbidity only in men. An inverse association was verified between the recommended fruit and vegetable consumption and multimorbidity for the total sample and both sexes. Conclusion One in four adults had multimorbidity. Prevalence increased with increasing age, among women, and was associated with some lifestyles. Multimorbidity was significantly associated with educational level and physical inactivity only in men. The results suggest the need to adopt integrated strategies to reduce the magnitude of multimorbidity, specific by gender, including actions for health promotion, disease prevention, health surveillance and comprehensive health care in Brazil.
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Affiliation(s)
| | | | - Sandro Rogério Rodrigues Batista
- Department of Internal Medicine, School of Medicine, Federal University of Goiás, Goiânia, Brazil
- Federal District Health Department, Brasília, Brazil
| | - Rafael Alves Guimarães
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Brazil
- Faculty of Nursing, Federal University of Goiás, Goiânia, Brazil
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Cooper PJ, Figueiredo CA, Rodriguez A, dos Santos LM, Ribeiro‐Silva RC, Carneiro VL, Costa G, Magalhães T, dos Santos de Jesus T, Rios R, da Silva HBF, Costa R, Chico ME, Vaca M, Alcantara‐Neves N, Rodrigues LC, Cruz AA, Barreto ML. Understanding and controlling asthma in Latin America: A review of recent research informed by the SCAALA programme. Clin Transl Allergy 2023; 13:e12232. [PMID: 36973960 PMCID: PMC10041090 DOI: 10.1002/clt2.12232] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 02/01/2023] [Accepted: 02/15/2023] [Indexed: 03/29/2023] Open
Abstract
Asthma is an important health concern in Latin America (LA) where it is associated with variable prevalence and disease burden between countries. High prevalence and morbidity have been observed in some regions, particularly marginalized urban populations. Research over the past 10 years from LA has shown that childhood disease is primarily non-atopic. The attenuation of atopy may be explained by enhanced immune regulation induced by intense exposures to environmental factors such as childhood infections and poor environmental conditions of the urban poor. Non-atopic symptoms are associated with environmental and lifestyle factors including poor living conditions, respiratory infections, psychosocial stress, obesity, and a diet of highly processed foods. Ancestry (particularly African) and genetic factors increase asthma risk, and some of these factors may be specific to LA settings. Asthma in LA tends to be poorly controlled and depends on access to health care and medications. There is a need to improve management and access to medication through primary health care. Future research should consider the heterogeneity of asthma to identify relevant endotypes and underlying causes. The outcome of such research will need to focus on implementable strategies relevant to populations living in resource-poor settings where the disease burden is greatest.
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Affiliation(s)
- Philip J. Cooper
- Escuela de MedicinaUniversidad Internacional del EcuadorQuitoEcuador
- Institute of Infection and ImmunitySt George's University of LondonLondonUK
| | | | | | | | | | | | - Gustavo Costa
- Center for Data Knowledge and Integration for Health (CIDACS)Fundação Oswaldo CruzBahiaSalvadorBrazil
- Universidade Salvador (UNIFACS)SalvadorBahiaBrazil
| | - Thiago Magalhães
- Instituto de Saúde ColetivaUniversidade Federal da BahiaSalvadorBrazil
| | | | - Raimon Rios
- Instituto de Ciências da SaúdeUniversidade Federal da BahiaSalvadorBrazil
| | | | - Ryan Costa
- Instituto de Ciências da SaúdeUniversidade Federal da BahiaSalvadorBrazil
| | - Martha E. Chico
- Fundacion Ecuatoriana para la Investigacion en Salud (FEPIS)EsmeraldasEcuador
| | - Maritza Vaca
- Instituto de Saúde ColetivaUniversidade Federal da BahiaSalvadorBrazil
- Fundacion Ecuatoriana para la Investigacion en Salud (FEPIS)EsmeraldasEcuador
| | | | - Laura C Rodrigues
- Faculty of Epidemiology and Population HealthLondon School of Hygiene and Tropical MedicineLondonUK
| | - Alvaro A. Cruz
- Universidade Federal da Bahia and Fundação ProARSalvadorBrazil
| | - Mauricio L. Barreto
- Center for Data Knowledge and Integration for Health (CIDACS)Fundação Oswaldo CruzBahiaSalvadorBrazil
- Instituto de Saúde ColetivaUniversidade Federal da BahiaSalvadorBrazil
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11
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da Luz Moreira A, de Campos Lobato LF, de Lima Moreira JP, Luiz RR, Elia C, Fiocchi C, de Souza HSP. Geosocial Features and Loss of Biodiversity Underlie Variable Rates of Inflammatory Bowel Disease in a Large Developing Country: A Population-Based Study. Inflamm Bowel Dis 2022; 28:1696-1708. [PMID: 35089325 DOI: 10.1093/ibd/izab346] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND The epidemiology of inflammatory bowel disease (IBD) in developing countries may uncover etiopathogenic factors. We investigated IBD prevalence in Brazil by investigating its geographic, spatial, and temporal distribution, and attempted to identify factors associated with its recent increase. METHODS A drug prescription database was queried longitudinally to identify patients and verify population distribution and density, race, urbanicity, sanitation, and Human Development Index. Prevalence was calculated using the number of IBD patients and the population estimated during the same decade. Data were matched to indices using linear regression analyses. RESULTS We identified 162 894 IBD patients, 59% with ulcerative colitis (UC) and 41% with Crohn's disease (CD). The overall prevalence of IBD was 80 per 100 000, with 46 per 100 000 for UC and 36 per 100 000 for CD. Estimated rates adjusted to total population showed that IBD more than triplicated from 2008 to 2017. The distribution of IBD demonstrated a South-to-North gradient that generally followed population apportionment. However, marked regional differences and disease clusters were identified that did not fit with conventionally accepted IBD epidemiological associations, revealing that the rise of IBD was variable. In some areas, loss of biodiversity was associated with high IBD prevalence. CONCLUSIONS When distribution is considered in the context of IBD prevalence, marked regional differences become evident. Despite a background of Westernization, hotspots of IBD are recognized that are not explained by population density, urbanicity, sanitation, or other indices but apparently are explained by biodiversity loss. Thus, the rise of IBD in developing countries is not uniform, but rather is one that varies depending on yet unexplored factors like geoecological conditions.
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Affiliation(s)
- Andre da Luz Moreira
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil
- Inflammatory Bowel Disease Center, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA
| | | | | | - Ronir Raggio Luiz
- Institute of Collective Health Studies, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Celeste Elia
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil
| | - Claudio Fiocchi
- Department of Immunity & Inflammation, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Heitor Siffert Pereira de Souza
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil
- Department of Clinical Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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12
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Sturmer J, Franken DL, Ternus DL, Henn RL, Soares Dias-da-Costa J, Anselmo Olinto MT, Vieira Paniz VM. Dietary patterns and prevalence of multimorbidity in women in southern Brazil. Menopause 2022; 29:1047-1054. [PMID: 35969884 DOI: 10.1097/gme.0000000000002023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to investigate the association between dietary patterns and prevalence of multimorbidity in women. METHODS This population-based cross-sectional study was conducted in 2015 and included 1,128 women aged 20 to 69 years living in the urban area of São Leopoldo municipality, southern Brazil. Multimorbidity was defined as the presence of two or more chronic conditions, among the 26 identified. Poisson regression with robust variance was used to investigate the association between the three dietary patterns (healthy, risk, and Brazilian), using different models adjusted for sociodemographic, behavioral, and nutritional status variables. RESULTS The results showed differences in the prevalence of adherence to different dietary patterns and multimorbidity across age groups, with a prevalence of multimorbidity and a healthy dietary pattern showing a direct linear trend with age, whereas the risk dietary pattern showed an inverse linear trend with age. The prevalence of the Brazilian dietary pattern remained constant despite differences in age. After adjustment, we found that women with greater adherence to the Brazilian dietary pattern showed a 40% reduction in the prevalence of multimorbidity compared with those with less adherence (prevalence ratio, 0.60; 95% confidence interval, 0.40-0.86). CONCLUSION The results revealed that the prevalence of multimorbidity was significantly lower in women with greater adherence to the Brazilian dietary pattern and highlight the importance of dietary interventions in early adulthood as a way to prevent multimorbidity in women.
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Affiliation(s)
- Jaqueline Sturmer
- From the Post-graduate Programme in Collective Health, University of Vale do Rio dos Sinos, São Leopoldo, RS, Brazil
| | - Débora Luiza Franken
- From the Post-graduate Programme in Collective Health, University of Vale do Rio dos Sinos, São Leopoldo, RS, Brazil
| | - Daiane Luisa Ternus
- From the Post-graduate Programme in Collective Health, University of Vale do Rio dos Sinos, São Leopoldo, RS, Brazil
| | - Ruth Liane Henn
- From the Post-graduate Programme in Collective Health, University of Vale do Rio dos Sinos, São Leopoldo, RS, Brazil
| | | | | | - Vera Maria Vieira Paniz
- From the Post-graduate Programme in Collective Health, University of Vale do Rio dos Sinos, São Leopoldo, RS, Brazil
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13
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Wang Y, Armijos RX, Weigel MM. Dietary Inflammatory Index and Cardiometabolic Risk in Ecuadorian School-Age Children. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2022:1-10. [PMID: 35980812 DOI: 10.1080/27697061.2022.2113177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 08/07/2022] [Accepted: 08/10/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Cardiometabolic diseases and metabolic syndrome (MetS) are becoming increasingly prevalent in low- and middle-income countries (LMICs). Cardiometabolic diseases and MetS are closely associated with low-grade systemic inflammation, which may be modified by diet. Previous studies have focused on the association of dietary inflammation with MetS and cardiometabolic risk in adult populations, but few studies have examined this issue in children, especially in LMICs. METHODS We conducted a cross-sectional study to explore the association of dietary inflammation with cardiometabolic risk components and MetS in urban Ecuadorian children aged 6-12 years old (n = 276). A semi-quantitative food frequency questionnaire (FFQ) was used to collect data on child dietary intake. Dietary inflammation was evaluated using an energy-adjusted Dietary Inflammatory Index (DII), divided into quartiles. Data were also collected on cardiometabolic risk indicators including blood lipids, blood pressure (BP), blood glucose, body mass index, and waist circumference. Data were analyzed using multivariable linear and logistic regression. RESULTS Child DII scores ranged from -4.87 (most anti-inflammatory) to 4.75 (most pro-inflammatory). We transformed the continuous scores into quartiles (Q): Q1 was the most anti-inflammatory (-4.87 to -3.35), Q2 was anti-inflammatory (-3.34 to -1.45), Q3 was pro-inflammatory (-1.44 to 1.08), and Q4 was the most pro-inflammatory (1.09 to 4.75). In the covariate-adjusted model, DII scores were positively associated with total blood cholesterol (p = 0.027), triglycerides (p = 0.034), and diastolic BP (p = 0.013). In addition, for every one-unit increase in DII score, MetS increased by 1.20 in the covariate-adjusted model (95% CI = 1.01,1.43). CONCLUSIONS The findings suggest that more pro-inflammatory diets may contribute to poorer cardiometabolic health in school-age children. This is important because even small increases in child blood pressure, blood cholesterol, and glucose levels over time can damage health and lead to earlier progression to conditions such as hypertension and atherosclerosis.
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Affiliation(s)
- Yankun Wang
- Department of Environmental & Occupational Health, Indiana University-Bloomington School of Public Health, Bloomington, Indiana, USA
- Global Environmental Health Research Lab, Indiana University-Bloomington School of Public Health, Bloomington, Indiana, USA
| | - Rodrigo X Armijos
- Department of Environmental & Occupational Health, Indiana University-Bloomington School of Public Health, Bloomington, Indiana, USA
- Global Environmental Health Research Lab, Indiana University-Bloomington School of Public Health, Bloomington, Indiana, USA
| | - Mary-Margaret Weigel
- Department of Environmental & Occupational Health, Indiana University-Bloomington School of Public Health, Bloomington, Indiana, USA
- Global Environmental Health Research Lab, Indiana University-Bloomington School of Public Health, Bloomington, Indiana, USA
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14
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Moliterno P, Donangelo CM, Borgarello L, Pécora M, Olascoaga A, Noboa O, Boggia J. Association of Dietary Patterns with Cardiovascular and Kidney Phenotypes in an Uruguayan Population Cohort. Nutrients 2021; 13:nu13072213. [PMID: 34199124 PMCID: PMC8308311 DOI: 10.3390/nu13072213] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 05/22/2021] [Accepted: 05/24/2021] [Indexed: 01/21/2023] Open
Abstract
The impact of habitual diet on chronic diseases has not been extensively characterized in South America. We aimed to identify major dietary patterns (DP) in an adult cohort in Uruguay (Genotype Phenotype and Environment of Hypertension Study—GEFA-HT-UY) and to assess associations with metabolic, anthropometric characteristics, and cardiovascular and kidney phenotypes. In a cross-sectional study (n = 294), DP were derived by the principal component analysis. Blood and urine parameters, anthropometrics, blood pressure, pulse wave velocity, and glomerular filtration rate were measured. Multivariable adjusted linear models and adjusted binary logistic regression were used. Three DP were identified (Meat, Prudent, Cereal and Mate) explaining 22.6% of total variance in food intake. The traditional Meat DP, characterized by red and barbecued meat, processed meat, bread, and soft drinks, was associated with worse blood lipid profile. Prudent DP, characterized by vegetables, fish, and nuts, and lower loads for bread and crackers, was associated with reduced risk of vitamin D deficiency. Cereal and Mate DP, was characterized by higher loads of cereals, bread, and crackers, and mate infusion, with higher odds of excessive body weight. No direct associations of dietary patterns with hypertension, arterial stiffness, chronic kidney disease, and nephrolithiasis were found in the studied population, nor by age categories or sex.
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Affiliation(s)
- Paula Moliterno
- Departmento de Nutrición Clínica, Escuela de Nutrición, Universidad de la República, Montevideo CP 11600, Uruguay;
| | | | - Luciana Borgarello
- Laboratorio de Patología Clínica, Universidad de la República, Montevideo CP 11600, Uruguay; (L.B.); (A.O.)
| | - Matías Pécora
- Departmento de Fisiopatología, Universidad de la República, Montevideo CP 11600, Uruguay;
| | - Alicia Olascoaga
- Laboratorio de Patología Clínica, Universidad de la República, Montevideo CP 11600, Uruguay; (L.B.); (A.O.)
| | - Oscar Noboa
- Centro de Nefrología, Universidad de la República, Montevideo CP 11600, Uruguay;
| | - José Boggia
- Centro de Nefrología, Universidad de la República, Montevideo CP 11600, Uruguay;
- Correspondence:
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