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Kodaira K, Abe FC, Galvão TF, Silva MT. Time-trend in excess weight in Brazilian adults: A systematic review and meta-analysis. PLoS One 2021; 16:e0257755. [PMID: 34582470 PMCID: PMC8478247 DOI: 10.1371/journal.pone.0257755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 09/10/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND This review aimed to estimate the time-trend prevalence of excess weight, overweight and obesity in the Brazilian adult population, from the 1970s-2020, through systematic review and meta-analysis (Protocol: CRD42018091002). METHODS A search for articles was conducted in the databases MEDLINE, EMBASE, Scopus, and LILACS up to June 2021. Studies that assessed excess weight, overweight and obesity in the adult population were eligible. Two authors selected studies, collected data and assessed the methodological quality of the studies. The primary outcomes were the prevalence of excess weight, overweight, and obesity by sex and period of years. Pooled prevalence and 95% confidence intervals (CIs) were calculated in the meta-analysis of the random effects model. Heterogeneity (I2) was investigated by meta-regression and publication bias was investigated by Egger's test. RESULTS A total of 7,938 references were identified in the search strategies, of which eighty-nine studies and nine national surveys, conducted from 1974-2020, were included in the meta-analysis. The pooled prevalence of excess weight in Brazilian adults increased from 33.5% (95% CI: 25.0; 42.6%) in 1974-1990 to 52.5% (95% CI: 47.6; 57.3%) in 2011-2020. The pooled prevalence of overweight in Brazilian adults was 24.6% (95% CI: 18.8; 31.0%) from 1974-1990 and 40.5% (95% CI: 37.0; 43.9%) from 2011-2020. The pooled prevalence of obesity in Brazilian adults increased by 15.0% from 1974-1990 to 2011-2020. The increases were observed for both men and women in almost all periods. The prevalence of excess weight and obesity remained higher among women in all periods. CONCLUSIONS A continuous increase in the prevalence of excess weight, overweight and obesity were observed over the years. The prevalence of excess weight affected half of Brazilian adults in the period from 2011-2020 and both sexes.
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Affiliation(s)
- Katia Kodaira
- Program of Pharmaceutical Sciences, University of Sorocaba, Sorocaba, São Paulo, Brazil
| | - Flavia Casale Abe
- Program of Pharmaceutical Sciences, University of Sorocaba, Sorocaba, São Paulo, Brazil
| | - Tais Freire Galvão
- Faculty of Pharmaceutical Science, Cidade Universitária Zeferino Vaz, State University of Campinas, Campinas, São Paulo, Brazil
| | - Marcus Tolentino Silva
- Program of Pharmaceutical Sciences, University of Sorocaba, Sorocaba, São Paulo, Brazil
- * E-mail:
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Mayne DJ, Morgan GG, Jalaludin BB, Bauman AE. Area-Level Walkability and the Geographic Distribution of High Body Mass in Sydney, Australia: A Spatial Analysis Using the 45 and Up Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16040664. [PMID: 30813499 PMCID: PMC6406292 DOI: 10.3390/ijerph16040664] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 02/07/2019] [Accepted: 02/19/2019] [Indexed: 12/12/2022]
Abstract
Improving the walkability of built environments to promote healthy lifestyles and reduce high body mass is increasingly considered in regional development plans. Walkability indexes have the potential to inform, benchmark and monitor these plans if they are associated with variation in body mass outcomes at spatial scales used for health and urban planning. We assessed relationships between area-level walkability and prevalence and geographic variation in overweight and obesity using an Australian population-based cohort comprising 92,157 Sydney respondents to the 45 and Up Study baseline survey between January 2006 and April 2009. Individual-level data on overweight and obesity were aggregated to 2006 Australian postal areas and analysed as a function of area-level Sydney Walkability Index quartiles using conditional auto regression spatial models adjusted for demographic, social, economic, health and socioeconomic factors. Both overweight and obesity were highly clustered with higher-than-expected prevalence concentrated in the urban sprawl region of western Sydney, and lower-than-expected prevalence in central and eastern Sydney. In fully adjusted spatial models, prevalence of overweight and obesity was 6% and 11% lower in medium-high versus low, and 10% and 15% lower in high versus low walkability postcodes, respectively. Postal area walkability explained approximately 20% and 9% of the excess spatial variation in overweight and obesity that remained after accounting for other individual- and area-level factors. These findings provide support for the potential of area-level walkability indexes to inform, benchmark and monitor regional plans aimed at targeted approaches to reducing population-levels of high body mass through environmental interventions. Future research should consider potential confounding due to neighbourhood self-selection on area-level walkability relations.
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Affiliation(s)
- Darren J Mayne
- The University of Sydney, School of Public Health, Sydney, NSW 2006, Australia.
- Illawarra Shoalhaven Local Health District, Public Health Unit, Warrawong, NSW 2502, Australia.
- University of Wollongong, School of Medicine, Wollongong, NSW 2522, Australia.
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW 2522, Australia.
| | - Geoffrey G Morgan
- The University of Sydney, School of Public Health, Sydney, NSW 2006, Australia.
- The University of Sydney, University Centre for Rural Health, Rural Clinical School-Northern Rivers, Sydney, NSW 2006, Australia.
| | - Bin B Jalaludin
- Ingham Institute, University of New South Wales, Sydney, NSW 2052, Australia.
- Epidemiology, Healthy People and Places Unit, Population Health, South Western Sydney Local Health District, Liverpool, NSW 1871, Australia.
| | - Adrian E Bauman
- The University of Sydney, School of Public Health, Sydney, NSW 2006, Australia.
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Canella DS, Novaes HMD, Levy RB. [The influence of excess weight and obesity on health spending in Brazilian households]. CAD SAUDE PUBLICA 2016; 31:2331-41. [PMID: 26840813 DOI: 10.1590/0102-311x00184214] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 05/11/2015] [Indexed: 11/22/2022] Open
Abstract
The objective of this study was to evaluate the influence of excess weight and obesity on health spending in Brazilian households. Data from the Household Budget Survey 2008-2009 were used to estimate monetary health spending, corresponding to out-of-pocket spending, including purchase of medicines and payment for healthcare services, and to evaluate the nutritional status of the 55,970 household residents. Monthly spending on health and its components were analyzed according to the number of excess weight and obese individuals in households (none, one, two, or three or more individuals). The presence and increasing number of excess weight and obese individuals has resulted in greater spending on health, especially on medicines and health insurance. The results were maintained after adjusting for income, region, area, and presence of elderly and number of residents in the household. Excess weight and obesity had a direct impact on out-of-pocket health spending by Brazilian families.
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Henry M, GalAn N, Teasdale K, Prado R, Amar H, Rays MS, Roberts L, Siqueira P, de Wildt G, Virmond M, Das PK. Factors Contributing to the Delay in Diagnosis and Continued Transmission of Leprosy in Brazil--An Explorative, Quantitative, Questionnaire Based Study. PLoS Negl Trop Dis 2016; 10:e0004542. [PMID: 26977811 PMCID: PMC4792453 DOI: 10.1371/journal.pntd.0004542] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 02/23/2016] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Leprosy is a leading cause of preventable disability worldwide. Delay in diagnosis of patients augments the transmission of infection, and allows progression of disease and more severe disability. Delays in diagnosis greater than ten years have been reported in Brazil. To reduce this delay, it is important to identify factors that hinder patients from presenting to doctors, and those that delay doctors from diagnosing patients once they have presented. This study aimed to explore factors associated with the delayed diagnosis of leprosy in Brazil. METHODOLOGY/ PRINCIPAL FINDINGS This is an exploratory study using a self-constructed questionnaire delivered to patients attending three leprosy referral clinics across three states in Brazil. Data were analysed to determine associations between variables and the time taken for participants to present to the health-service, and between variables and the time taken for doctors to diagnose participants once they had presented. Participants who suspected they had leprosy but feared community isolation were 10 times more likely to wait longer before consulting a doctor for their symptoms (OR 10.37, 95% CI 2.18-49.45, p = 0.003). Participants who thought their symptoms were not serious had a threefold greater chance of waiting longer before consulting than those who did (OR 3.114, 95% CI 1.235-7.856, p = 0.016). Forty-two point six per cent of participants reported initially receiving a diagnosis besides leprosy. These had a three times greater chance of receiving a later diagnosis of leprosy compared to those not misdiagnosed or not given a diagnosis (OR 2.867, 95% CI 1.288-6.384, p = 0.010). CONCLUSIONS/ SIGNIFICANCE This study implies a need for patient education regarding leprosy symptoms and the reduction of stigma to encourage patients to present. The high rate of misdiagnosis reported suggests a need to increase clinician suspicion of leprosy. Further education regarding disease symptoms in medical school curriculums may be advisable.
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Affiliation(s)
- Mary Henry
- Population Science and Humanities, University of Birmingham, Birmingham, United Kingdom
| | - Noêmi GalAn
- Instituto Lauro de Souza Lima, Bauru, São Paulo, Brazil
| | - Katherine Teasdale
- Population Science and Humanities, University of Birmingham, Birmingham, United Kingdom
| | - Renata Prado
- Instituto Lauro de Souza Lima, Bauru, São Paulo, Brazil
| | - Harpreet Amar
- Population Science and Humanities, University of Birmingham, Birmingham, United Kingdom
| | - Marina S. Rays
- Faculdade de Medicina de Marilia (FAMEMA), Marilia, São Paulo, Brazil
| | - Lesley Roberts
- Population Science and Humanities, University of Birmingham, Birmingham, United Kingdom
| | - Pedro Siqueira
- Centro Referencia em Tuberculose e Hanseniase, Sinop, Mato Grosso, Brazil
| | - Gilles de Wildt
- Population Science and Humanities, University of Birmingham, Birmingham, United Kingdom
| | | | - Pranab K. Das
- Department of Clinical Immunology, School of Infection and Immunity, University of Birmingham, Birmingham, United Kingdom
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Siddiqui ST, Kandala NB, Stranges S. Urbanisation and geographic variation of overweight and obesity in India: a cross-sectional analysis of the Indian Demographic Health Survey 2005-2006. Int J Public Health 2015. [PMID: 26198774 DOI: 10.1007/s00038-015-0720-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES We examined the nationwide geographic variation of overweight and obesity in India, as well as a range of potential correlates of excess body fat. METHODS We conducted cross-sectional analyses of the 2005-2006 Indian Demographic Health Survey (IDHS), based on 161,050 individuals (age range 18-54 years). Multivariate logistic regression models were used to determine odds ratios (OR) of overweight and obesity compared to normal weight with associated correlates. RESULTS The overall prevalence was 12.4% for overweight, 3.2% for obesity, and 26.5% for underweight. After multivariate adjustment, obesity was nearly thrice more likely in urban areas than in rural (OR 2.73, 95% CI 2.53-2.94). Women were 2.71 times more likely to be obese than men (95% CI 2.50-2.95). Better socioeconomic status was significantly associated with overweight and obesity. Overweight (OR 1.38, 95% CI 1.31-1.47) and obesity (OR 1.46, 95% CI 1.32-1.61) were most likely to occur in India's Southern zone, when controlled for confounding factors. CONCLUSIONS High-risk estimates for overweight/obesity in urban settings, along with socioeconomic prowess in India and the resulting nutritional transition make a compelling case for public health policy on healthy lifestyles to avert the growing burden of non-communicable diseases associated with overweight/obesity.
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Affiliation(s)
- Saad T Siddiqui
- Statistics and Epidemiology Team, Warwick Medical School, University of Warwick, Coventry, UK,
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Buitrago-Lopez A, van den Hooven EH, Rueda-Clausen CF, Serrano N, Ruiz AJ, Pereira MA, Mueller NT. Socioeconomic status is positively associated with measures of adiposity and insulin resistance, but inversely associated with dyslipidaemia in Colombian children. J Epidemiol Community Health 2015; 69:580-7. [PMID: 25691273 DOI: 10.1136/jech-2014-204992] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 01/13/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND Low socioeconomic status (SES) has been associated with higher risk of cardiometabolic diseases in developed societies, but investigation of SES and cardiometabolic risk in children in less economically developed populations is sparse. We aimed to examine associations among SES and cardiometabolic risk factors in Colombian children. METHODS We used data from a population-based study of 1282 children aged 6-10 years from Bucaramanga, Colombia. SES was classified according to household wealth, living conditions and access to public utilities. Anthropometric and biochemical parameters were measured at a clinic visit. Cardiometabolic risk factors were analysed continuously using linear regression and as binary outcomes-according to established paediatric cut points-using logistic regression to calculate OR and 95% CIs. RESULTS Mean age of the children was 8.4 (SD 1.4) and 51.1% of the sample were boys. Odds of overweight/obesity, abdominal obesity and insulin resistance were greater among higher SES. Compared with the lowest SES stratum, children in the highest SES had higher odds of overweight/obesity (OR=3.25, 95% CI 1.89 to 5.57), abdominal obesity (OR=2.74, 95% CI 1.41 to 5.31) and insulin resistance (OR=2.60, 95% CI 1.81 to 3.71). In contrast, children in the highest SES had lower odds of hypertriglyceridaemia (triglycerides ≥90th centile; OR=0.28, 95% CI 0.14 to 0.54) and low (≤10th centile) high-density lipoprotein (HDL) cholesterol (OR=0.35, 95% CI 0.15 to 0.78). CONCLUSIONS In Colombian children, SES is directly associated with obesity and insulin resistance, but inversely associated with dyslipidaemia (hypertriglyceridaemia and low HDL cholesterol). Our findings highlight the need to analyse cardiometabolic risk factors separately in children and to carefully consider a population's level of economic development when studying their social determinants of cardiometabolic disease.
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Affiliation(s)
- Adriana Buitrago-Lopez
- Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Edith H van den Hooven
- Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Christian F Rueda-Clausen
- Department of Medicine, University of Alberta, Li Ka Shing Centre for Heath Research Innovation, University of Alberta, Edmonton, Alberta, Canada
| | - Norma Serrano
- Division of Research, Fundacion Cardiovascular de Colombia, Floridablanca, Santander, Colombia
| | - Alvaro J Ruiz
- Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogota DC, Colombia
| | - Mark A Pereira
- Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Noel T Mueller
- Department of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, New York, New York, USA Institute of Human Nutrition and Department of Medicine, College of Physicians and Surgeons, Columbia University Medical Center, New York, New York, USA
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Veiga LHS, Neta G, Aschebrook-Kilfoy B, Ron E, Devesa SS. Thyroid cancer incidence patterns in Sao Paulo, Brazil, and the U.S. SEER program, 1997-2008. Thyroid 2013; 23:748-57. [PMID: 23410185 PMCID: PMC3675840 DOI: 10.1089/thy.2012.0532] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Thyroid cancer incidence has risen steadily over the last few decades in most of the developed world, but information on incidence trends in developing countries is limited. Sao Paulo, Brazil, has one of the highest rates of thyroid cancer worldwide, higher than in the United States. We examined thyroid cancer incidence patterns using data from the Sao Paulo Cancer Registry (SPCR) in Brazil and the National Cancer Institute's Surveillance Epidemiology End Results (SEER) program in the United States. METHODS Data on thyroid cancer cases diagnosed during 1997-2008 were obtained from SPCR (n=15,892) and SEER (n=42,717). Age-adjusted and age-specific rates were calculated by sex and histology and temporal patterns were compared between the two populations. RESULTS Overall incidence rates increased over time in both populations and were higher in Sao Paulo than in the United States among females (SPCR/SEER incidence rate ratio [IRR]=1.65) and males (IRR=1.23). Papillary was the most common histology in both populations, followed by follicular and medullary carcinomas. Incidence rates by histology were consistently higher in Sao Paulo than in the United States, with the greatest differences for follicular (IRR=2.44) and medullary (IRR=3.29) carcinomas among females. The overall female/male IRR was higher in Sao Paulo (IRR=4.17) than in SEER (IRR=3.10) and did not change over time. Papillary rates rose over time more rapidly in Sao Paulo (annual percentage change=10.3% among females and 9.6% among males) than in the United States (6.9% and 5.7%, respectively). Regardless of sex, rates rose faster among younger people (<50 years) in Sao Paulo, but among older people (≥50 years) in the United States. The papillary to follicular carcinoma ratio rose from <3 to >8 among both Sao Paulo males and females, in contrast to increases from 9 to 12 and from 6 to 7 among U.S.males and females, respectively. CONCLUSIONS Increased diagnostic activity may be contributing to the notable rise in incidence, mainly for papillary type, in both populations, but it is not likely to be the only reason. Differences in iodine nutrition status between Sao Paulo and the U.S. SEER population might have affected the observed incidence patterns.
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Affiliation(s)
- Lene H S Veiga
- Institute of Radiation Protection and Dosimetry, Brazilian Nuclear Energy Commission, Rio de Janeiro, Brazil.
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Piperata BA, Ivanova SA, Da-gloria P, Veiga G, Polsky A, Spence JE, Murrieta RSS. Nutrition in transition: dietary patterns of rural Amazonian women during a period of economic change. Am J Hum Biol 2011; 23:458-69. [PMID: 21538648 DOI: 10.1002/ajhb.21147] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2010] [Revised: 12/02/2010] [Accepted: 12/15/2010] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES The goal of this study was to understand the relationship between economic change (wage labor, retirement, and the Bolsa Família program) and dietary patterns in the rural Amazon and to determine the extent to which these changes followed the pattern of the nutrition transition. METHODS The study was longitudinal. The weighed-inventory method and economic interviews were used to collect data on dietary intake and household economics in a sample of 30 and 52 women in 2002 and 2009, respectively. Twenty of the women participated in both years and make-up the longitudinal sub-sample. Comparative statistics were used to identify changes in dietary patterns over time and multiple linear regressions were used to explore the relationship between economics, subsistence strategies, and diet. RESULTS There was a significant decline in kcal (P < 0.01) and carbohydrate (P < 0.01) but no change in protein intake over time in both the larger and smaller, longitudinal subsample. The percent of energy, carbohydrate, protein, and fat purchased increased in the larger and longitudinal samples (P ≤ 0.02) and there was an increase in refined carbohydrate and processed, fatty-meat consumption over time. The abandonment of manioc gardens was associated with increased dependence on purchased food (P = 0.03) while receipt of the Bolsa Família was associated with increased protein intake and adequacy (P = 0.02). CONCLUSIONS The dietary changes observed are only in partial agreement with predictions of the nutrition transition literature. The relationship between the economic and diet changes was shaped by the local context which should be considered when implementing CCT programs, like the Bolsa Família.
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Affiliation(s)
- Barbara A Piperata
- Department of Anthropology, The Ohio State University, Columbus, 43210, USA.
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García-Alcala H, Cuevas-Ramos D, Genestier-Tamborero C, Hirales-Tamez O, Almeda-Valdés P, Mehta R, Aguilar-Salinas CA. Significant increment in the prevalence of overweight and obesity documented between 1994 and 2008 in Mexican college students. Diabetes Metab Syndr Obes 2010; 3:79-85. [PMID: 21437078 PMCID: PMC3047981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
We describe the changes in the prevalence of overweight and obesity in 4606 students that applied to a Mexican University during 1994 to 2008. The mean (± standard deviation [SD]) age was 17.7 ± 1.2 years-old. Progressive and significant increments of bodyweight (female [F] = 2.6, P = 0.03), body mass index (BMI) (F = 4.4, P = 0.001), and waist circumference (F = 30.08, P < 0.0001) in women, and bodyweight (male [M] = 8.9, P < 0.001), BMI (M = 10.4, P < 0.001), and waist circumference (M = 13.01, P < 0.001) in men were observed. A significant increment (P < 0.05) in the prevalence of overweight since 1994 (n = 87, 12.1%) throughout 1997 (n = 102, 14.1%), 1998 (n = 133, 18.4%), 1999 (n = 1993, 26.8%), and 2008 (n = 206, 19.9%) was documented. Similarly, the prevalence of obesity had a significant increment in all students evaluated (P < 0.0001) since 1994 (n = 29, 13.2%) through 1997 (n = 11, 5.0%), 1998 (n = 45, 20.5%), 1999 (n = 53, 24.1%), and 2008 (n = 82, 37.3%). The increment was significant in both women (P = 0.02) and men (P < 0.001). In summary, we report a significant increment in the prevalence of overweight and obesity in Mexican students living in an urban setting over a time period of 14 years.
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Affiliation(s)
- H García-Alcala
- Universidad Popular Autónoma del Estado de Puebla, Puebla, Mexico
| | - D Cuevas-Ramos
- Department of Endocrinology, Instituto Nacional de Ciencias Medicas y Nutricion “Salvador Zubiran” (INC MNSZ), Mexico City, Mexico
| | | | - O Hirales-Tamez
- Universidad Popular Autónoma del Estado de Puebla, Puebla, Mexico
| | - P Almeda-Valdés
- Department of Endocrinology, Instituto Nacional de Ciencias Medicas y Nutricion “Salvador Zubiran” (INC MNSZ), Mexico City, Mexico
| | - R Mehta
- Department of Endocrinology, Instituto Nacional de Ciencias Medicas y Nutricion “Salvador Zubiran” (INC MNSZ), Mexico City, Mexico
| | - CA Aguilar-Salinas
- Department of Endocrinology, Instituto Nacional de Ciencias Medicas y Nutricion “Salvador Zubiran” (INC MNSZ), Mexico City, Mexico
- Correspondence: Carlos A Aguilar-Salinas, Instituto Nacional de Ciencias Medicas y Nutricion “Salvador Zubiran” Vasco de Quiroga 15, Seccion XVI, Tlalpan 14000, Mexico City, Mexico, Tel +52 55 55133891, Fax +52 55 55133891, Email
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Ribeiro RC, Coutinho M, Bramorski MA, Giuliano IC, Pavan J. Association of the Waist-to-Height Ratio with Cardiovascular Risk Factors in Children and Adolescents: The Three Cities Heart Study. Int J Prev Med 2010; 1:39-49. [PMID: 21677765 PMCID: PMC3075487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2009] [Accepted: 12/12/2009] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES To determine the best anthropometric index in relation to cardiovascular disease risk factors among children and adolescents. METHODS This cross-sectional school-based study was conducted among a random sample of 3179 students, aged 6 to 18 years, in three large cities in Brazil. RESULTS The prevalence of overweight and obesity was 10% and 5%, respectively. In relation to the students in the lower quartile (Q1) of the distribution of subscapular skinfold, the students in the upper quartile (Q4) presented a 2.0 times higher risk (odds ratio) of having elevated total cholesterol levels. Overweight and obese students had a 3.3 times higher risk of having elevated systolic blood pressure, and a 1.9 times higher risk of elevated diastolic blood pressure than other students. The less active students presented a 1.58 times higher risk of having waist-to-height ratio (WHtR) above the upper tertile (Q3). WHtR mean values was 0.46 (SE 0.00) presented the largest area under the curve (AUC) [0.613 (CI995%:0.578-0.647)] for high total cholesterol levels, [0.546 (CI995%: 0.515-0.578)] for low HDL-C levels, and [0.614 (CI95%: 0.577-0.651)] for high LDL-C levels, while body mass index presented the largest AUC [0.669 (CI95%: 0.64-0.699)] for increased diastolic blood pressure followed by the waist circumference for increased systolic blood pressure [0.761 (CI95%: 0.735-0.787)]. CONCLUSIONS WHtR is considered as a simple and accurate anthropometric parameter that identifies youth with cardiovascular risk factors. In this study, WHtR above 0.44 was indicative of risk factors in children and adolescents. These findings can be applied in future preventive strategies against CVDs, and screening programs.
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Affiliation(s)
- Robespierre C. Ribeiro
- Department of Pediatrics, School of Medicine, Federal University of Minas Gerais, Minas Gerais, Brazil,Correspondence to: Robespierre Costa Ribeiro, MD, MSc PhD Al. Guilherme Henrique Daniel 94, 30.220-200 Belo Horizonte, MG, Brazil. E-mail:
| | - Mário Coutinho
- Department of Cardiology, School of Medicine, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Marco A Bramorski
- Department of Cardiology, School of Medicine, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Isabela C. Giuliano
- Department of Cardiology, School of Medicine, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Júlia Pavan
- Department of Statistics, University of São Paulo, São Paulo, Brazil
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Silva H, Padez C. Body size and obesity patterns in Caboclo populations from Pará, Amazonia, Brazil. Ann Hum Biol 2009; 37:217-29. [DOI: 10.3109/03014460903397734] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Measurements of adiposity and high blood pressure among children and adolescents living in Belo Horizonte. Cardiol Young 2009; 19:436-40. [PMID: 19586575 DOI: 10.1017/s1047951109990606] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To verify an association, if it exists, between obesity and blood pressure raised beyond the 90th percentile in children and adolescents, and to determine the measure of adiposity that best correlates with blood pressure in these subjects. DESIGN Cross-sectional study. SETTING A school-based study in Belo Horizonte, Brazil. PARTICIPANTS We selected randomly 1,403 students, aged from 6 to 18 years, from 545,046 students attending 521 public and private schools. Those selected completed the study. MAIN MEASURES OF OUTCOME: We recorded the weight, height, skin fold in the triceps, subscapular, and suprailiac areas, waist and hip circumference, body-mass index, and resting systolic and diastolic blood pressures using a mercury sphygmomanometer. RESULTS In univariate analyses, body mass index greater or lesser than 85th percentile, measurements of skin thickness in the subscapular and suprailiac areas, and the sum of all measurements of skinfold thickness, were associated with both systolic and diastolic measurements of blood pressure. After multivariate analyses that adjusted for all measurements of adiposity except itself, and age, race, and socioeconomic state, we found that the increased body mass index was associated with a 3.6-fold increased frequency of elevated systolic measurements of blood pressure, with 95% confidence intervals from 2.2 to 5.8, and a 2.7-fold increased frequency of elevated measurements of diastolic blood pressure, with 95% confidence intervals from 1.9 to 4.0. CONCLUSIONS Body-mass index serves as a better predictor of elevated blood pressure among children than do local measurements of adiposity.
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Abstract
AbstractObjectiveTo investigate the correlation between the consumption of refined carbohydrates and fats and the prevalence of obesity in the state capitals of Brazil.DesignAn ecological evaluation of obesity and dietary risk factors was carried out in twenty-six state capitals of Brazil.SettingAnalysis was based on the age-standardized prevalence of obesity (BMI ≥ 30·0 kg/m2) among adults aged 20–59 years. Both intake and obesity prevalence were obtained from the last National Family Household Budget Survey (HBS). The survey was conducted from July 2002 to June 2003, based on a probabilistic national sample of 48 470 households. In each household, during seven consecutive days, all monetary and non-monetary expenses for food and beverages for family consumption were transformed into energy. The relative contribution of foods and food groups was expressed as the proportion (%) of total energy. Fruits and vegetables were also measured by the quantity bought in grams.ResultsPrevalence of obesity varied from 5·1 % to 13·6 % among women and from 5·2 % to 17·6 % among men. For women, there were statistically significant correlations between obesity and intake of sugar and soft drinks (rS = 0·60; P = 0·001), ready-to-eat meals (rS = 0·39; P = 0·05) and potatoes (rS = 0·40; P = 0·04). For men there were no such associations.ConclusionsIncreasing intake of refined carbohydrates, mainly soft drinks, may play a role in the prevalence of obesity among women in Brazil. Effecting changes in family purchase patterns may be a strategy to reduce obesity.
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Abstract
La obesidad tiene una etiología multifactorial en la que los factores de mayor fuerza se relacionan con los estilos de vida. El incremento tan abrupto de la obesidad y su gran extensión obedecen principalmente a cambios importantes en la alimentación de la población, al patrón de actividad física y a otros factores de índole sociocultural, todo lo cual se ha manifestado en un proceso de transición nutricional. Las tendencias de aumento y de las diferencias sociales en la obesidad, hacen que las minorías y aquellos estratos de la población con menor nivel educativo y socioeconómico puedan ser los más afectados. En los pobres la obesidad se asocia, entre otros, a episodios de desnutrición en la edad temprana, incluso durante la vida intrauterina, a factores alimentarios, socioculturales y de género. La relación entre la obesidad y la condición socioeconómica es muy variable y compleja, ya que la asociación es diferente en contextos socioeconómicos distintos y puede quedar disimulada por varios factores (ejercicio físico, dieta, factores psicológicos, herencia, factores socioculturales) que influyen en la asociación. Tanto el nivel socioeconómico podría condicionar la presencia de obesidad, como la obesidad podría tener consecuencias sociales en el individuo (si la movilidad social es el factor más relevante, es la obesidad la que condicionaría la posición social del individuo). Los argumentos tratados son suficientes para justificar la importancia del problema en Latinoamérica. De esta manera, debe representar un desafío, principalmente para investigadores y aquellos que toman decisiones, traducible en priorizar la obesidad en condiciones de pobreza.
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Eyken EBBDV, Moraes CL. Prevalência de fatores de risco para doenças cardiovasculares entre homens de uma população urbana do Sudeste do Brasil. CAD SAUDE PUBLICA 2009; 25:111-23. [DOI: 10.1590/s0102-311x2009000100012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2007] [Accepted: 05/30/2008] [Indexed: 11/22/2022] Open
Abstract
O monitoramento dos fatores de risco para as doenças cardiovasculares vem sendo indicado em todo o mundo. Nesse sentido, o objetivo do estudo foi estimar a prevalência de tabagismo, sobrepeso/obesidade, atividade física insuficiente, hipertensão arterial e pressão arterial limítrofe entre homens adscritos à Estratégia Saúde da Família em área urbana de Juiz de Fora, Minas Gerais, Região Sudeste do Brasil. Foi realizado um inquérito domiciliar com 217 homens, entre 20 e 49 anos, selecionados por meio de amostragem sistemática baseada em listagem de moradores desta faixa etária. O sobrepeso/obesidade foi o fator de risco de maior freqüência (43,3%; IC95%: 36,6-50,2). Os sedentários e irregularmente ativos fisicamente totalizaram 28% (IC95%: 22,2-34,6). O consumo de cigarros era hábito de 25,3% (IC95%: 19,7-31,7) da população. Foram classificados como hipertensos 24% (IC95%: 18,4-30,2) dos entrevistados e 19,4% (IC95%: 14,3-25,2) com pressão arterial limítrofe. A simultaneidade de dois ou mais fatores de risco foi encontrada em 45,2% da população. A magnitude das prevalências sugere que é preciso intensificar as estratégias de promoção de saúde voltadas para a população masculina.
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Affiliation(s)
| | - Claudia Leite Moraes
- Universidade Estácio de Sá, Brasil; Universidade do Estado do Rio de Janeiro, Brasil
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16
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Harvey, Glenny, Kirk, Summerbell. Effective professional practice: protocol for a systematic review of health professionals’ management of obesity. J Hum Nutr Diet 2008. [DOI: 10.1046/j.1365-277x.1998.00104.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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17
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Development and application of rapid assessment diet and physical activity indexes, which suggest high consumption of energy-dense foods and inadequate exercise among adolescents from 6 Latin American cities: a pilot study. Nutr Res 2008; 28:590-9. [DOI: 10.1016/j.nutres.2008.05.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2008] [Revised: 04/28/2008] [Accepted: 05/08/2008] [Indexed: 11/23/2022]
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18
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Montes de Oca M, Tálamo C, Perez-Padilla R, Jardim JRB, Muiño A, Lopez MV, Valdivia G, Pertuzé J, Moreno D, Halbert RJ, Menezes AMB. Chronic obstructive pulmonary disease and body mass index in five Latin America cities: the PLATINO study. Respir Med 2008; 102:642-50. [PMID: 18314321 DOI: 10.1016/j.rmed.2007.12.025] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2007] [Revised: 12/19/2007] [Accepted: 12/22/2007] [Indexed: 10/22/2022]
Abstract
BACKGROUND The body mass index (BMI) is a prognostic factor for chronic obstructive pulmonary disease (COPD). Despite its importance, little information is available regarding BMI alteration in COPD from a population-based study. We examined characteristics by BMI categories in the total and COPD populations in five Latin-American cities, and explored the factors influencing BMI in COPD. METHODS COPD was defined as a postbronchodilator forced expiratory volume in the first second/forced vital capacity (FEV(1)/FVC) <0.70. BMI was categorized as underweight (< 20 kg/m(2)), normal weight (20-24.9 kg/m(2)), overweight (25.0-29.9 kg/m(2)), and obese (> or = 30.0 kg/m(2)). RESULTS Interviews were completed in 5571 subjects from 6711 eligible individuals, and spirometry was performed in 5314 subjects. There were 759 subjects with COPD and 4555 without COPD. Compared with the non-COPD group, there was a higher proportion of COPD subjects in the underweight and normal weight categories, and a lower proportion in the obese category. Over one-half COPD subjects had BMI over 25 kg/m(2). No differences in BMI strata among countries were found in COPD subjects. Factors associated with lower BMI in males with COPD were aging, current smoking, and global initiative for chronic obstructive lung disease (GOLD) stages III-IV, whereas wheeze and residing in Santiago and Montevideo were associated with higher BMI. In females with COPD, current smoking, lower education, and GOLD stages II-IV were associated with lower BMI, while dyspnea and wheeze were associated with higher BMI. CONCLUSIONS BMI alterations are common in COPD with no significant differences among countries. Current smoking, age, GOLD stages, education level, residing in Santiago and Montevideo, dyspnea and wheeze were independently associated with BMI in COPD.
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Affiliation(s)
- Maria Montes de Oca
- Servicio de Neumonología, Hospital Universitario de Caracas, Facultad de Medicina, Universidad Central de Venezuela, Piso 8, Los Chaguaramos, 1030 Caracas, Venezuela.
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Martins Jr AN, Figueiredo MMD, Rocha OD, Fernandes MAF, Jeronimo SM, Dourado Jr ME. Frequency of stroke types at an emergency hospital in Natal, Brazil. ARQUIVOS DE NEURO-PSIQUIATRIA 2007; 65:1139-43. [DOI: 10.1590/s0004-282x2007000700009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2007] [Accepted: 09/01/2007] [Indexed: 11/22/2022]
Abstract
We performed a cross-sectional study of stroke type frequency at a local emergency hospital, in Natal, Brazil. The sample consisted of all patients who were admitted to an emergency hospital with a presumptive diagnosis of stroke. Of the 416 patients, 328 were studied, 88 were excluded for not meeting inclusion criteria, 74.7% (n= 245) had ischemic stroke 17.7% (n=58) had intracerebral hemorrhage, 7.6% (n=25) had subarachnoid hemorrhage; 173 were men (52.7%). Mean age was 64.1 years. The intrahospital mortality rate was 10.2%, 17.2% and 36% for ischemic stroke, intracerebral hemorrhage and subarachnoid hemorrhage, respectively. The most prevalent modifiable risk factor was hypertension for ischemic stroke (67.6%) and hemorrhage stroke (57.8%). Logistic regression analysis identified diabetes (OR=3.70; CI=1.76-7.77) as independent risk factor for ischemic stroke. The ischemic stroke was most common type of stroke. Hypertension and diabetes were important risk factors for stroke.
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Sousa RMRDP, Sobral DP, Paz SMRSD, Martins MDCDCE. Prevalência de sobrepeso e obesidade entre funcionários plantonistas de unidades de saúde de Teresina, Piauí. REV NUTR 2007. [DOI: 10.1590/s1415-52732007000500003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: O objetivo deste trabalho foi identificar a prevalência de sobrepeso e obesidade, bem como os fatores a eles associados, em funcionários de quatro Unidades de Saúde do Município de Teresina, Piauí. MÉTODOS: Estudo transversal com amostra estratificada proporcional de 207 funcionários plantonistas diurnos das Unidades Básicas de Saúde da Prefeitura Municipal de Teresina, que foram entrevistados e avaliados a partir de dados antropométricos. Para a classificação do estado nutricional foi utilizado o Índice de Massa Corporal e, para a classificação do risco cardiovascular de acordo com a distribuição da gordura corporal, foi utilizada a circunferência da cintura. RESULTADOS: A prevalência de excesso de peso foi de 53,72%, sendo as proporções de sobrepeso e obesidade de 35,75% e 17,70%, respectivamente. O sobrepeso esteve mais presente no sexo masculino (45,16%) e a obesidade no sexo feminino (19,31%). As variáveis que se mantiveram associadas significantemente com a obesidade foram: idade, função desempenhada pelo funcionário, obesidade dos pais, renda, fumo e circunferência da cintura. CONCLUSÃO: As elevadas proporções de excesso de peso entre os funcionários das Unidades de Saúde mostram a necessidade de ações de saúde destinadas à prevenção e ao controle, de modo a contribuir para a redução desses índices e para o controle das doenças crônicas.
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Tomé FS, Cardoso VC, Barbieri MA, Silva AAMD, Simões VMF, Garcia CA, Bettiol H. Are birth weight and maternal smoking during pregnancy associated with malnutrition and excess weight among school age children? ACTA ACUST UNITED AC 2007; 40:1221-30. [PMID: 17713645 DOI: 10.1590/s0100-879x2006005000163] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2006] [Accepted: 06/21/2007] [Indexed: 11/21/2022]
Abstract
In the late 1980's child malnutrition was still prevalent in Brazil, and child obesity was beginning to rise in the richest regions of the country. To assess the extent of the nutritional transition during the period and the influence of birth weight and maternal smoking on the nutritional condition of schoolchildren, we estimated the prevalence of excess weight and malnutrition in a cohort of Brazilian schoolchildren from 1987 to 1989. We calculated the body mass index (BMI) of 8- to 10-year-old schoolchildren born in Ribeirão Preto in 1978/79. We considered children with a BMI <5th percentile (P5) to be malnourished, children with P5 > or = BMI<P85 to be thin and normal, and children with BMI > or = P85 to be overweight. We evaluated the association of these nutritional disorders with birth factors (infant weight, sex, preterm delivery, number of pregnancies, maternal smoking during pregnancy, marital status, and schooling) and type of school using nominal logistic regression. A total of 2797 schoolchildren were evaluated. There was a significant prevalence of malnutrition (9.5%) and excess weight already tended to increase (15.7%), while 6.4% of the children were obese. Excess weight was more prevalent among children attending private schools (odds ratio, OR = 2.27) and firstborn children (OR = 1.69). Maternal smoking during pregnancy protected against malnutrition (OR = 0.56), while children with lower birth weight were at higher risk for malnutrition (OR = 4.23). We conclude that a nutritional transition was under way while malnutrition was still present, but excess weight and related factors were already emerging.
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Affiliation(s)
- F S Tomé
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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Goldani MZ, Haeffner LSB, Agranonik M, Barbieri MA, Bettiol H, Silva AAM. Do early life factors influence body mass index in adolescents? Braz J Med Biol Res 2007; 40:1231-6. [PMID: 17713665 DOI: 10.1590/s0100-879x2006005000131] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2006] [Accepted: 05/11/2007] [Indexed: 11/22/2022] Open
Abstract
The association between early life factors and body mass index (BMI) in adulthood has been demonstrated in developed countries. The aim of the present study was to assess the influence of early life factors (birth weight, gestational age, maternal smoking, and social class) on BMI in young adulthood with adjustment for adult socioeconomic position. A cohort study was carried out in 1978/79 with 6827 mother-child pairs from Ribeirão Preto city, located in the most developed economic area of the country. Biological, economic and social variables and newborn anthropometric measurements were obtained shortly after delivery. In 1996, 1189 males from this cohort, 34.3% of the original male population, were submitted to anthropometric measurements and were asked about their current schooling on the occasion of army recruitment. A multiple linear regression model was applied to determine variables associated with BMI. Mean BMI was 22.7 (95%CI = 22.5-23.0). After adjustment, BMI was 1.22 kg/m(2) higher among infants born with high birth weight ( > or = 4000 g), 1.21 kg/m(2) higher among individuals of low social class at birth and 0.69 kg/m(2) higher among individuals whose mothers smoked during pregnancy (P < 0.05). The association between social class at birth and BMI remained statistically significant (P < 0.05) even after adjustment for adult schooling. These findings suggest that early life social influences on BMI were more important and were not reversed by late socioeconomic position. Therefore, prevention of overweight and obesity should focus not only on changes in adult life styles but also on factors such as high birth weight.
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Affiliation(s)
- M Z Goldani
- Departamento de Pediatria e Puericultura, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil.
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Gigante DP, Dias-da-Costa JS, Olinto MTA, Menezes AMB, Silvia M. [Adult obesity in Pelotas, Rio Grande do Sul, Brazil, and the association with socioeconomic status]. CAD SAUDE PUBLICA 2007; 22:1873-9. [PMID: 16917584 DOI: 10.1590/s0102-311x2006000900018] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2005] [Accepted: 11/28/2005] [Indexed: 11/21/2022] Open
Abstract
The objectives of this study were to: (1) describe obesity prevalence in a Brazilian city; (2) test the association between obesity and socio-demographic variables; and (3) compare results with a survey in the same city in 1994. A cross-sectional population-based study was carried out in a random sample of 1,968 20-69-year-olds residing in the urban area of Pelotas, Rio Grande do Sul State. Obesity was defined as Body Mass Index (BMI) > 30 kg/m(2). Age and sex-adjusted obesity prevalence was 19.4%. Schooling was not associated with obesity in men. Obesity prevalence was higher in middle-income men. Women with more schooling had lower obesity rates. There was a non-statistically significant reduction in obesity rates compared to a similar study from 1994.
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Piperata BA. Nutritional status ofRibeirinhos in Brazil and the nutrition transition. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2007; 133:868-78. [PMID: 17405126 DOI: 10.1002/ajpa.20579] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Anthropometric and household data (size, composition, economic activity) were collected from a population of Ribeirinhos living in a rural setting in the eastern Amazon. Data are compared to international reference standards and to other Amazonian populations with the goals of increasing our understanding of the Amazon's largest ethnic group and identifying the relationship between changes in subsistence strategies and nutritional status. Data on height, weight, skinfolds, and circumferences were collected from 471 adults and subadults. The population showed a high degree of stunting with an average HAZ below -2.0 for all age groups over 3 years, and 60% of adult men and 70% of adult women were stunted. Wasting was rare. Average skinfold thicknesses and upper-arm muscle area were near or below average but within the normal range compared to the reference standard, indicating adequate energy and protein stores. Thirty-one percent of males and 29% of females were overweight/obese, and the highest average BMIs were found among men and women in their 40s. Adult males who participated in wage labor had higher weights, BMIs, and UMA values, and were more likely to be overweight and obese compared with those who did not work in wage-labor jobs. Children of fathers who worked in wage labor had higher BMI and UMA values, but there was no significant effect on the nutritional status of other adults in these same households. Signs of the nutrition transition were most noticeable among adult males involved in wage labor because of changes in their diet and activity patterns.
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Affiliation(s)
- Barbara A Piperata
- Department of Anthropology, The Ohio State University, Columbus, OH 43210, USA.
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Gomes MDB, Giannella Neto D, Mendonça ED, Tambascia MA, Fonseca RM, Réa RR, Macedo G, Modesto Filho J, Schmid H, Bittencourt AV, Cavalcanti S, Rassi N, Faria M, Pedrosa H, Dib SA. Prevalência de sobrepeso e obesidade em pacientes com diabetes mellitus do tipo 2 no Brasil: estudo multicêntrico nacional. ACTA ACUST UNITED AC 2006; 50:136-44. [PMID: 16628286 DOI: 10.1590/s0004-27302006000100019] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVO: Avaliar a prevalência de sobrepeso e obesidade em pacientes ambulatoriais com diabetes mellitus tipo 2 (DM2) em diferentes regiões do Brasil. PACIENTES E MÉTODOS: Avaliamos aleatoriamente 2.519 pacientes em 11 hospitais, 2 ambulatórios especializados e um posto de saúde em 10 cidades brasileiras. Consideramos sobrepeso um índice de massa corporal (IMC) > 25 e obesidade um IMC > 30 kg/m². O controle glicêmico (CG) foi avaliado pelo índice de CG [ICG= HbA1 e ou HbA1c do paciente/limite superior de normalidade do método x 100]. RESULTADOS: Os pacientes tinham idade de 58,8 ± 11,6 anos, tempo de diagnóstico clínico de DM de 9,0 ± 7,3 anos, IMC de 28,3 ± 5,2 kg/m², e 39% eram do sexo masculino. Do total da amostra, 265 pacientes (10,5%) não apresentavam avaliação do IMC. Os pacientes da região Nordeste apresentaram menor IMC em comparação com os das regiões Centro-Oeste, Sudeste e Sul, respectivamente (26,4 ± 4,7 vs. 27,9 ± 4,8 vs. 29,2 ± 5,1 vs. 29,4 ± 5,4 kg/m²; p< 0,001). Houve maior prevalência de obesidade na região Sudeste e Sul em comparação à região Nordeste (p< 0,001) e nos pacientes do sexo feminino, respectivamente (69 vs. 31%; p< 0,001). Os pacientes com peso normal apresentaram menor ICG. Aqueles em tratamento com associação de duas ou mais drogas orais e associação de insulina + droga oral apresentaram maior IMC do que aqueles em tratamento com dieta, hipoglicemiante oral e insulina; p< 0,001. O IMC não diferiu entre os pacientes assistidos ou não por especialistas. CONCLUSÕES: Da população estudada, 75% não estava na faixa de peso ideal, sendo que um terço tinha obesidade. Nossos dados indicam que o sobrepeso e a obesidade já atingem um percentual de pacientes com DM2 no Brasil semelhante ao relatado em estudos europeus, mas ainda menor do que o observado nos EUA. A prevalência de obesidade nos pacientes diabéticos foi três vezes maior do que a observada na população brasileira em geral de acordo com os dados do IBGE.
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Dalla Vecchia CF, Susin C, Rösing CK, Oppermann RV, Albandar JM. Overweight and obesity as risk indicators for periodontitis in adults. J Periodontol 2006; 76:1721-8. [PMID: 16253094 DOI: 10.1902/jop.2005.76.10.1721] [Citation(s) in RCA: 158] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Developed and developing countries are facing an obesity epidemic with various health consequences. Few studies have addressed the relationship between obesity and periodontal health. The present study assessed the association of overweight and obesity with periodontitis in Brazilian adults. METHODS A representative probability sample comprising 706 subjects aged 30 to 65 years from south Brazil was examined clinically and using a structured interview. Overweight and obesity were assessed by body mass index (BMI) using the World Health Organization (WHO) criteria. Individuals with > or =30% teeth with attachment loss > or =5 mm were classified as having periodontitis. Statistical analysis accounted for survey design, and separate analyses were performed for non-smokers. RESULTS In this population, 60% and 65% of males and females, respectively, were overweight or obese. Periodontitis was observed in 50.7% and 35.3% of males and females, respectively. The percentage of males with periodontitis was similar in the overweight/obese individuals compared to those with normal weight. In females, there was a positive correlation between the BMI index and the occurrence of periodontitis, with a significantly (P < 0.05) higher prevalence of periodontitis in obese than in normal weight females. The multivariable analysis showed that obese females were significantly more likely (odds ratio = 2.1) to have periodontitis than normal weight females. A separate analysis for non-smokers showed that obese females were approximately 3.4 times more likely to have periodontitis than the normal BMI group. There were no significant differences in the prevalence of periodontitis between BMI groups among smokers of both genders and in male non-smokers. CONCLUSIONS Obesity was significantly associated with periodontitis in adult, non-smoker women. Overweight was not significantly associated with periodontitis. Smoking may attenuate the association of periodontitis with obesity.
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Espinosa-Larrañaga F, Vejar-Jalaf M, Medina-Santillán R. The importance of low serum levels of high-density lipoprotein cholesterol (HDL-C) as a cardiovascular risk factor. Diab Vasc Dis Res 2005; 2 Suppl 1:S1-8. [PMID: 16342610 DOI: 10.3132/dvdr.2005.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
In order to discuss and establish a joint position on the treatment of low serum levels of high-density lipoprotein cholesterol (HDL-C), a group of experts involved in the care of people with dyslipidaemia and at risk of cardiovascular disease met in Miami, Florida, U.S., on 5th and 6th March 2005. The experts came from the Latin American countries Argentina, Brazil, Chile, Colombia, Ecuador, Guatemala, Mexico and Venezuela and had at least five years of experience in the care of patients with dyslipidaemia and low HDL-C. The main objective of the meeting was to discuss and propose a treatment for low serum HDL-C levels as a cardiovascular risk factor in patients and to create a group of useful recommendations in this regard, applicable to the daily clinical practice of physicians dealing with patients with dyslipidaemia and cardiovascular disease. This document describes the methodology developed to obtain these recommendations and presents the results of this academic meeting.
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Levy-Costa RB, Sichieri R, Pontes NDS, Monteiro CA. [Household food availability in Brazil: distribution and trends (1974-2003)]. Rev Saude Publica 2005; 39:530-40. [PMID: 16113900 DOI: 10.1590/s0034-89102005000400003] [Citation(s) in RCA: 235] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Data from household food budget surveys were examined in order to describe the regional and socio-economic distribution of household food availability in Brazil in 2002-2003 and trends from 1974 to 2003. METHODS The study uses data from the "Pesquisa de Orçamento Familiar 2002-2003" budget survey conducted by the Brazilian Institute for Geography and Statistics (Instituto Brasileiro de Geografia e Estatística) from July 2002 to June 2003, including a national sample of 48,470 households. In each household, during seven consecutive days, all monetary and non-monetary expenses with food and beverages for family consumption were registered. Crude weights of purchased foods were transformed into calories and nutrients with the use of food composition tables. RESULTS Adequate protein content and a high proportion of animal protein were found in all regions and income strata. These were the most important positive aspects identified in the household food availability in Brazil. On the other hand, all regions and socio-economic strata showed excess calories from sugar and little availability of fruits and vegetables. An excessive proportion of calories came from total and saturated fat in the more economically developed regions and in the urban milieu, as well as among higher-income families. Time-trends in metropolitan areas indicated a decline in the consumption of basic, traditional foods, such as rice and beans; notable increases (up to 400%) in the consumption of processed food items, such as cookies and soft drinks; maintenance of the excessive consumption of sugar; and a continuous increase in total fat and saturated fat content in the diet. CONCLUSIONS Patterns and trends regarding household food availability in Brazil are consistent with the increasing participation of chronic non-communicable diseases in morbidity and mortality and with the continuous increase in the prevalence of obesity.
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Affiliation(s)
- Renata Bertazzi Levy-Costa
- Núcleo de Investigação em Nutrição, Instituto de Saúde, Secretaria de Estado da Saúde de São Paulo, São Paulo, SP, Brasil
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Nubé M. Relationships between undernutrition prevalence among children and adult women at national and subnational level. Eur J Clin Nutr 2005; 59:1112-20. [PMID: 16015261 DOI: 10.1038/sj.ejcn.1602220] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES The objective of this study is to analyze the relationships between undernutrition prevalence rates among children and adults, both at the level of countries and at the level of smaller geographical subunits within countries (districts, provinces). Results are considered of relevance for evaluation and proper usage of anthropometric information in poverty and food security assessment. DESIGN Anthropometric information on both children and adults, as reported in the Demographic and Health Surveys, has been the primary source of data. In addition, data published by WHO, FAO, and data from some country specific reports have been used. The final analysis is based on data from 289 subnational geographical units divided over 56 countries in Africa, Asia and Latin America. Ordinary least squares has been used for regression analysis and F-tests for testing differences of variances. RESULTS At the level of countries, results reveal a strong positive relationship between undernutrition prevalence rates among children and adults. At the level of smaller geographical units, high levels of undernutrition in adult women are almost invariably associated with high levels of undernutrition in children. At the same time, however, low or intermediate levels of undernutrition among adult women are no guarantee that undernutrition levels among children are also low or moderate. CONCLUSION At the level of countries, information on undernutrition prevalence in children can be considered a proximate of the overall nutritional and food security conditions in a country. At the level of smaller geographical units, relationships are less straightforward, and are hypothesized to depend, at least partially, on the relative importance of food and nonfood factors in the causation of undernutrition.
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Affiliation(s)
- M Nubé
- Centre for World Food Studies (SOW-VU), Vrije Universiteit, Amsterdam, Netherlands.
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Vasconcellos LDS, Sabino KR, Petroianu A. Relação entre ooforectomia e peso em modelo experimental. Rev Col Bras Cir 2005. [DOI: 10.1590/s0100-69912005000300006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJETIVO: Avaliar a influência da privação dos hormônios ovarianos no ganho ponderal, em modelo experimental. MÉTODO: Foram utilizadas 40 ratas fêmeas adultas, distribuídas aleatoriamente em três grupos: Grupo 1 (n=10) - controle, Grupo 2 (n=10) - submetido apenas à laparotomia, Grupo 3 (n=20) - submetido à ooforectomia total bilateral. Os animais foram pesados semanalmente durante 30 semanas e os resultados foram avaliados pelo teste t de Student, com significância para p < 0,05. RESULTADOS: As ratas ooforectomizadas apresentaram ganho ponderal maior do que as demais, sendo a diferença significativa a partir da 9ª semana e persistindo até o fim do experimento. CONCLUSÕES: No presente trabalho, a privação dos hormônios ovarianos foi um fator relacionado com o maior ganho ponderal, em ratas.
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Affiliation(s)
| | | | - Andy Petroianu
- Universidade Federal de Minas Gerais; Universidade de São Paulo; Universidade Federal de São Paulo; Conselho Nacional de Desenvolvimento Científico e Tecnológico
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Abstract
OBJECTIVE To update the social distribution of women's obesity in the developing world and, in particular, to identify the specific level of economic development at which, if any, women's obesity in the developing world starts to fuel inequities in health. DESIGN Multilevel logistic regression analyses applied to anthropometric and socioeconomic data collected by nationally representative cross-sectional surveys conducted from 1992 to 2000 in 37 developing countries within a wide range of world regions and stages of economic development (gross national product (GNP) from 190 to 4440 US dollars per capita). SUBJECTS : In total, 148 579 nonpregnant women aged 20-49 y. MEASUREMENTS Body mass index to assess obesity status; quartiles of years of education to assess woman's socioeconomic status (SES), and GNP per capita to assess country's stage of economic development. RESULTS Belonging to the lower SES group confers strong protection against obesity in low-income economies, but it is a systematic risk factor for the disease in upper-middle income developing economies. A multilevel logistic model-including an interaction term between the country's GNP and each woman's SES-indicates that obesity starts to fuel health inequities in the developing world when the GNP reaches a value of about 2500 US dollars per capita. CONCLUSIONS For most upper-middle income economies and part of the lower-middle income economies, obesity among adult women is already a relevant booster of health inequities and, in the absence of concerted national public actions to prevent obesity, economic growth will greatly expand the list of developing countries where this situation occurs.
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Affiliation(s)
- C A Monteiro
- Department of Nutrition and Center for Epidemiological Studies in Health and Nutrition, School of Public Health, University of Sao Paulo, Ave. Dr Arnaldo, São Paulo, SP, Brazil.
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da Veiga GV, da Cunha AS, Sichieri R. Trends in overweight among adolescents living in the poorest and richest regions of Brazil. Am J Public Health 2004; 94:1544-8. [PMID: 15333312 PMCID: PMC1448491 DOI: 10.2105/ajph.94.9.1544] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2004] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We assessed changes in body mass index (BMI) among Brazilian adolescents. METHODS In 1975, 1989, and 1997, we conducted household surveys of the weights and statures of a probabilistic sample of about 50,000 Brazilian adolescents aged 10 to 19 years. Weighted prevalences were calculated and an analysis was performed with the sample design taken into account. RESULTS Adolescents of rich (southeast) and poor (northeast) regions showed a substantial increase in BMI. In the southeast, the prevalence of overweight, defined by international age- and gender-specific BMI cutoffs, for both genders reached 17% in 1997, whereas in the northeast, the prevalence tripled, reaching 5% among boys and 12% among girls. Older girls living in urban areas in the southeast showed a decrease in prevalence from 16% to 13% in the latter 2 surveys. For all boys and for young girls, the BMI values for the 85th percentile in 1997 were much higher than the 95th percentile values in 1975. CONCLUSIONS BMI increased dramatically in Brazilian adolescents, mainly among boys; among older girls from the richest region, the prevalence of overweight is decreasing.
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Bloch KV, Salles GF, Muxfeldt ES, Da Rocha Nogueira A. Orlistat in hypertensive overweight/obese patients: results of a randomized clinical trial. J Hypertens 2004; 21:2159-65. [PMID: 14597860 DOI: 10.1097/00004872-200311000-00026] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess the effect of orlistat plus diet compared with diet alone in promoting weight loss and blood pressure reduction in hypertensive, overweight/obese patients. DESIGN A pragmatic randomized, controlled trial. SETTING Hypertension clinic of a university hospital. PATIENTS Hypertensive patients aged 18-75 years with a body mass index greater than 25 kg/m(2). INTERVENTIONS Orlistat 360 mg/day combined with a hypocaloric diet (treatment group), or a calorie-restricted diet alone (control group). MAIN OUTCOME MEASURES Primary outcomes were reductions in weight and blood pressure. Secondary outcomes were decreases in lipid and glucose concentrations. A subgroup analysis of the main outcomes among diabetic and non-diabetic patients was also performed. RESULTS A total of 204 patients were included in the intention-to-treat analysis. After 12 weeks the orlistat group lost, on average, 3.7 kg and the control group lost 2.0 kg in weight (P < 0.001). Systolic (SBP) and diastolic (DBP) blood pressures decreased by 15.3 and 11.4 mmHg, respectively, in the group given orlistat plus a hypocaloric diet and by 11.6 and 5.2 mmHg, respectively, in the control group given the calorie-restricted diet alone (P = 0.25 and P = 0.0004, respectively). Fasting glucose (0.82 and 0.17 mmol/l, P = 0.01) and total cholesterol (0.85 and 0.56 mmol/l, P = 0.05) were reduced to a greater extent with orlistat than with diet alone. The mean reduction in triglycerides with orlistat plus the hypocaloric diet was 0.75 mmol/l and that in the control group was 0.30 mmol/l (P = 0.28); the increases in high-density lipoprotein cholesterol were 0.05 and 0.00 mmol/l, respectively, in the two groups (P = 0.17). Treatment improved blood pressure and glucose control in the individuals with diabetes, but not in those without diabetes. CONCLUSION In both groups there was a reduction in weight, blood pressure and metabolic parameters. The orlistat group performed better in reducing weight, DBP, glucose and cholesterol. Results show that even a small reduction in weight helps to control blood pressure and glucose. The cost-benefit of the use of orlistat should be evaluated for hypertensive obese patients.
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Affiliation(s)
- Katia Vergetti Bloch
- Hypertension Program, Department of Preventive Medicine, Medical School, University Hospital Clementino Fraga Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
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Vasconcellos LS, Leite JM, Sabino KR, Petroianu A. Influência da ooforectomia na variação ponderal em ratas jovens e adultas. ACTA ACUST UNITED AC 2004; 48:299-304. [PMID: 15640886 DOI: 10.1590/s0004-27302004000200014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Para avaliar a influência do tempo de ooforectomia na variação ponderal, foram utilizadas 60 ratas, divididas em dois grupos (30 em cada grupo): Grupo A - jovens; e Grupo B - adultas. Os animais de cada grupo foram subdivididos em três subgrupos: Subgrupo 1 - controle (n= 6); Subgrupo 2 - laparotomia (n= 6); Subgrupo 3 (n= 18) - ooforectomia total bilateral. Os animais foram pesados semanalmente durante 13 semanas e os resultados foram avaliados pelo teste t de Student, com significância para p<0,05. As ratas ooforectomizadas tiveram ganho ponderal maior do que as demais, sendo a diferença significativa a partir da 11ª semana no Grupo A e 9ª semana no Grupo B, persistindo até o fim do experimento. No presente trabalho, a ooforectomia bilateral em ratas relacionou-se com maior ganho ponderal, independente da idade dos animais.
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Affiliation(s)
- Leonardo S Vasconcellos
- Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG
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Sibai AM, Hwalla N, Adra N, Rahal B. Prevalence and covariates of obesity in Lebanon: findings from the first epidemiological study. ACTA ACUST UNITED AC 2004; 11:1353-61. [PMID: 14627756 DOI: 10.1038/oby.2003.183] [Citation(s) in RCA: 119] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To estimate the prevalence of overweight and obesity and examine associated covariates in the Lebanese population. RESEARCH METHODS AND PROCEDURES A cross-sectional survey of a representative sample of 2104 individuals, 3 years of age and older. Anthropometric measurements and dietary assessments were conducted following standard methods and techniques. Overweight and obesity (classes I to III) were defined according to internationally standardized criteria for classification of BMI. RESULTS For children 3 to 19 years of age, prevalence rates of overweight and obesity were higher overall for boys than girls (22.5% vs. 16.1% and 7.5% vs. 3.2%, respectively). For adult men and women (age > or = 20 years), the prevalence of overweight was 57.7% and 49.4%, respectively. In contrast, obesity (BMI > or = 30 kg/m(2)) was higher overall among women (18.8%) than men (14.3%), a trend that became more evident with increasing obesity class. BMI, percentage of body fat, and waist circumference increased to middle age and declined thereafter. Whereas lack of exercise associated significantly with obesity among children, obesity in older adults was more prevalent among the least educated, nonsmokers, and those reporting a family history of obesity. DISCUSSION The results from this national population-based study in Lebanon show high prevalence rates of overweight and obesity comparable with those observed in developed countries such as the United States. While further studies are needed to examine the underlying social and cultural factors associated with lifestyle and nutritional habits, now is the time to institute multicomponent interventions promoting physical activity and weight control nationwide.
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Affiliation(s)
- Abla Mehio Sibai
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Riad el Solh, Beirut 1107-2020, Lebanon
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Ramos de Marins VM, Almeida RMVR, Pereira RA, de Azevedo Barros MB. The relationship between parental nutritional status and overweight children/adolescents in Rio de Janeiro, Brazil. Public Health 2004; 118:43-9. [PMID: 14643626 DOI: 10.1016/s0033-3506(03)00145-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The association between overweight parents and overweight children/adolescents was investigated in Rio de Janeiro, Brazil between 1995 and 1996, controlling for the influence of socio-economic and demographic factors. METHODS Data were obtained from a two-stage, residence-based, random sample survey of children and adolescents aged 6-19 years and their parents. Body mass index (BMI) was used to classify nutritional status. Initially, a logistic regression model was built, using an indicator of parental weight (maternal BMI) as one of the independent variables and the child/adolescent's BMI as the dependent variable. Following that, the association between socio-economic and demographic variables and overweight children/adolescents was analysed in a univariate analysis. These variables were pre-selected for inclusion in the logistic model, provided that their levels of statistical significance were below P=0.25, and were added to the model individually according to the order of association strength in the univariate analysis. Finally, variables were retained in this model at a significance level of P=0.05. RESULTS This study found that 20.7% of girls and 26.9% of boys were overweight, with a larger prevalence among children aged less than 9 years. In addition to maternal BMI, the predictors of overweight children and adolescents were age, gender and the number of people in a house. CONCLUSIONS These results demonstrate the relationship between maternal nutritional status and overweight children and adolescents, suggesting that obesity-prevention programmes should be focused on the family.
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Affiliation(s)
- V M Ramos de Marins
- Nutrition College, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil.
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Moraes CMD, Portella RB, Pinheiro VS, Oliveira MM, Fuks AG, Cunha EF, Gomes MB. Prevalência de sobrepeso e obesidade em pacientes com diabetes tipo 1. ACTA ACUST UNITED AC 2003. [DOI: 10.1590/s0004-27302003000600009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Para avaliar a prevalência de sobrepeso e obesidade em diabéticos tipo 1 (DM1), estudamos 170 pacientes (89F/81M; 14 crianças, 51 adolescentes e 105 adultos, com 24,4±11,9 anos) e correlacionamos seus dados antropométricos com fatores demográficos e clínicos. A prevalência de obesidade, sobrepeso e/ou risco de sobrepeso foi de 21,2% (n= 36). Houve uma correlação de 0,97 entre o score z do IMC e o percentil do IMC (p= 0,00) no grupo de crianças e adolescentes. Houve diferença na PAS (p= 0,004) e na PAD (p= 0,0007) entre pacientes com IMC normal e alterado. Ocorreu uma tendência a um aumento progressivo da medida da cintura com os níveis de PA (p= 0,0000). O IMC foi dependente da idade (OR: 1,04, 95% IC = 1,01-1,07; p= 0,008) na análise multivariada. Na análise stepwise, a PAS foi dependente da cintura (r= 0,57; p= 0,00) e da idade (r= 0,63; p= 0,00) e a PAD, da cintura (r= 0,53; p= 0,00). A prevalência de sobrepeso e obesidade nos DM1 parece refletir a tendência mundial de aumento de peso e suas conseqüências clínicas, reforçando a necessidade do controle de peso nestes pacientes.
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Sichieri R, Silva CVC, Moura AS. Combined effect of short stature and socioeconomic status on body mass index and weight gain during reproductive age in Brazilian women. Braz J Med Biol Res 2003; 36:1319-25. [PMID: 14502363 DOI: 10.1590/s0100-879x2003001000007] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Short stature, a marker for undernutrition early in life, has been associated with obesity in Brazilian women, but not in men. We tested the hypothesis that weight gain during the reproductive years could explain this gender difference. A national two-stage household survey of mothers with one or more children under five years of age was conducted in Brazil in 1996. The subjects were women aged 20 to 45 years (N = 2297), with last delivery seven months or more prior to the interview. The regions of the country were divided into rural, North/Northeast (urban underdeveloped) and South/Southeast/Midwest (urban developed). The dependent variables were current body mass index (BMI) measured, BMI prior to childbearing (reported), and BMI change. Socioeconomic variables included mother's years of education and family purchasing power score. A secondary analysis was restricted to primiparous women. The prevalence of current overweight and overweight prior to childbearing (BMI > or = 25 kg/m2) was higher among shorter women (<1.50 m) compared to normal stature women only in the urban developed region (P < 0.05). After adjustment for socioeconomic variables, age, parity, BMI prior to childbearing, and age at first birth, current BMI was 2.39 units higher (P = 0.008) for short stature women living in the urban developed area compared with short stature women living in the urban underdeveloped area. For both multiparous and primiparous women, BMI gain compared to the value prior to childbearing was significantly higher among short stature women living in the urban developed region (P <= 0.04). These results provide clear evidence that short stature was associated with a higher BMI and with an increased risk of weight gain/retention with pregnancy in the developed areas of Brazil, but not in the underdeveloped ones.
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Affiliation(s)
- R Sichieri
- Instituto de Medicina Social, Universidade Estadual do Rio de Janeiro, Brasil
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McArthur LH, Holbert D, Peña M. Prevalence of overweight among adolescents from six Latin American cities: a multivariable analysis. Nutr Res 2003. [DOI: 10.1016/s0271-5317(03)00158-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Frutuoso MFP, Bismarck-Nasr EM, Gambardella AMD. Redução do dispêndio energético e excesso de peso corporal em adolescentes. REV NUTR 2003. [DOI: 10.1590/s1415-52732003000300003] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A contemporânea redução no dispêndio energético apresenta-se como fator determinante da atual epidemia de obesidade observada em centros urbanos. Em adolescentes esta modificação intensifica-se quando associada a atividades passivas de lazer, como assistir televisão, brincar com jogos eletrônicos e usar a Internet. Este trabalho procurou analisar a inatividade física e a influência da televisão na prática alimentar de adolescentes, aspectos preditivos ao excesso de peso. Participaram deste estudo 155 indivíduos com média de 11,5 ± 1,43 anos de idade. Os diagnósticos de sobrepeso e obesidade basearam-se no índice de massa corporal para adolescentes. Foram detectadas associações estatisticamente significativas entre apresentar sobrepeso e obesidade e praticar atividades passivas e consumir alimentos em frente à televisão para ambos os sexos. Estes achados mostraram que a inatividade física, associada ao aumento no consumo de alimentos energéticos enquanto assistem televisão ou em decorrência da influência de comerciais de produtos alimentícios por ela veiculados, representa um dos fatores determinantes para o desenvolvimento de peso corporal excessivo durante a adolescência.
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Barreto SM, Passos VMA, Lima-Costa MFF. Obesity and underweight among Brazilian elderly: the Bambuí Health and Aging Study. CAD SAUDE PUBLICA 2003. [DOI: 10.1590/s0102-311x2003000200027] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The coexistence of obesity (body mass index, BMI > or = 30kg/m²) and underweight (BMI <= 20kg/m²) and related factors were investigated among all residents aged 60+ years in Bambuí, Minas Gerais State, using multinomial logistic regression. 1,451 (85.5%) of the town's elderly participated. Mean BMI was 25.0 (SD = 4.9kg/m²) and was higher for women and decreased with age. Prevalence of obesity was 12.5% and was positively associated with female gender, family income, hypertension, and diabetes and inversely related to physical activity. Underweight affected 14.8% of participants, increased with age, and was higher among men and low-income families. It was negatively associated with hypertension and diabetes and directly associated with Trypanosoma cruzi infection and > or = 2 hospitalizations in the previous 12 months. Both obesity and underweight were associated with increased morbidity. The association of underweight with T. cruzi infection, increased hospitalization, and low family income may reflect illness-related weight loss and social deprivation of elderly in this community. Aging in poverty may lead to an increase in nutritional deficiencies and health-related problems among the elderly.
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Affiliation(s)
- Sandhi M. Barreto
- Fundação Oswaldo Cruz, Brasil; Universidade Federal de Minas Gerais, Brasil
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Stevens J, Jones DW, Arnett D. Associations of aging and birth cohort with body mass index in a biethnic cohort. OBESITY RESEARCH 2003; 11:426-33. [PMID: 12634441 DOI: 10.1038/oby.2003.58] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To examine associations of aging and birth cohort with body mass index (BMI) in a biethnic cohort. RESEARCH METHODS AND PROCEDURES This was a longitudinal closed cohort study of 14,500 white and African-American men and women, 45 to 64 years of age, followed for 9 years. Aging was defined as the length of the interval in years between baseline and following visits. Birth cohort was defined by the year in which participants were born. Mixed model analyses were used to examine associations of aging, birth cohort, and BMI in four ethnicity-gender groups. RESULTS We found that aging was associated with an increase in BMI in white and African-American men and women. The associations between aging and BMI were stronger in the younger birth cohorts. Except for white women, younger birth cohort was associated with a higher BMI. After adjusting for aging, birth cohort was associated with an increase in BMI of 0.1 kg/m(2) [95% confidence interval (95% CI): -0.1, 0.3] among white women. The corresponding values for African-American women, white men, and African-American men are 0.5 kg/m(2) (95% CI: 0.1, 0.9), 0.6 kg/m(2) (95% CI: 0.4, 0.8), and 0.6 kg/m(2) (95% CI: 0.2, 1.0), respectively. DISCUSSION Our analyses show that, in all except white women, people in this age range who were born later have a higher BMI at the same attained age. In all groups, people who are born later gained more weight as they aged. In general, subjects ages 45 to 64 years gained weight as they aged 9 years.
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Hampl JS, Heaton CLB, Taylor CA. Snacking patterns influence energy and nutrient intakes but not body mass index. J Hum Nutr Diet 2003; 16:3-11. [PMID: 12581404 DOI: 10.1046/j.1365-277x.2003.00417.x] [Citation(s) in RCA: 114] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To study dietary intake and body mass index (BMI) patterns among US adults, stratified by snacking patterns. DESIGN The 1994-1996 Continuing Survey of Food Intakes by Individuals (CSFII) provided the study sample. Snacking episodes were defined as a 'food and/or beverage break', and subjects were classified as morning, afternoon, evening, multiple or never snackers. SUBJECTS/SETTING Our study included data from 1756 men and 1511 women who provided two nonconsecutive, multiple-pass 24-h dietary recalls. STATISTICAL ANALYSES Mean values of each subject's two 24-h recalls were used for analyses, and data were analysed using the Statistical Package for the Social Sciences (SPSS) for Windows and SUDAAN. RESULTS Compared with women, men were more likely to be evening, multiple or never snackers. Male multiple snackers had significantly higher energy intakes than did afternoon and never snackers, whereas female multiple snackers had higher energy intakes than did morning, evening and never snackers. At the same time, male and female multiple snackers had more prudent energy-adjusted intakes of protein, cholesterol, calcium and sodium. Coffee, cola, milk, ice cream and fruits were among the most frequently consumed snacks by men and women. The BMI did not differ significantly across snacker categories. CONCLUSIONS These data indicate that snacking patterns have some effects on energy and nutrient intakes but not on BMI. Snack food choices remain a concern, especially beverages, including those that are sweetened. Vegetables and fruits as snacks should be encouraged.
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Affiliation(s)
- J S Hampl
- Department of Nutrition, Arizona State University, Mesa, AZ 85212, USA.
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Abstract
This paper is an attempt to discuss the problem of malnutrition within the framework of the global need for development and the challenges posed by the trends of neoliberalism and globalization. We argue that there is a two-way link between poverty and health in which nutrition plays an important role both as an active and as a mediating factor. Key concepts are exposed and expanded: (a) Development per se does not ensure better health; (b) unequal distribution of income has an independent effect on health indicators after adjusting for total income; (c) improving health can make an important contribution to reducing poverty; (d ) improving nutrition throughout the whole life course is an indispensable strategy for better health; (e) obesity has to be included amongst the most critical health problems, has different traits, and presents with different challenges in the developing world and in the industrialized countries.
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Affiliation(s)
- Manuel Peña
- Pan American Health Organization/World Health Organization, Cross Roads, P.O. Box 384, Kingston 5, Jamaica.
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Khongsdier R. Body mass index and morbidity in adult males of the War Khasi in Northeast India. Eur J Clin Nutr 2002; 56:484-9. [PMID: 12032646 DOI: 10.1038/sj.ejcn.1601281] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2001] [Revised: 05/31/2001] [Accepted: 06/06/2001] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Data on the relationship between obesity, or high body mass index (BMI), and morbidity in adult individuals are frequently reported, but little is known about the relationship between morbidity and low BMI especially in developing countries. The present study was therefore an attempt to evaluate the relationship between BMI and morbidity in adult individuals. DESIGN The analyses were derived from the data based on self-reported morbidity and anthropometric measurements taken on adult males. The results were presented according to age and income groups for individuals of reporting and non-reporting illness. SUBJECTS The total sample size was 575 adult males (18-59 y) of the War Khasi population. SETTING Rural area of the state of Meghalaya in Northeast India. RESULTS : The prevalence of chronic energy deficiency (CED) was found to be 35%, although the mean BMI (20.06+/-2.65 kg/m(2)) in individuals of non-reporting illness was higher than in those reported for many populations of Northeast India. The relationship between BMI and reported illness was not significant, although the morbidity curve tended to be U-shaped, and the prevalence of reported illness (32%) was highest in the individuals with BMI below 17.0 kg/m(2). Moreover, the suggested cut-off 18.5 of BMI for screening the prevalence of CED did not correspond with the rise in morbidity, but both BMI and morbidity were significantly associated with age and income of the household. CONCLUSION In view of the present analysis and other related literature, BMI is likely to be a better indicator of standards of living than a predictor of illness as the latter may also predispose individuals to the former. Thus, morbidity and low BMI may be considered parts of ill health, which are influenced by a number of biological and environmental factors especially age, economic conditions, undernutrition, safe water sanitation, community pathogens, prevention and control measures of locally endemic diseases and infections.
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Affiliation(s)
- R Khongsdier
- Department of Anthropology, North-Eastern Hill University, Shillong, India.
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de Marins VMR, Almeida RMVR, Pereira RA, Barros MBDA. Overweight and risk of overweight in schoolchildren in the city of Rio de Janeiro, Brazil: prevalence and characteristics. ANNALS OF TROPICAL PAEDIATRICS 2002; 22:137-44. [PMID: 12070949 DOI: 10.1179/027249302125000869] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The association of overweight and risk of overweight with socio-economic and demographic variables was investigated among schoolchildren in the city of Rio de Janeiro, Brazil between 1995 and 1996. Data were obtained by direct interview and physical examination of boys and girls aged between 6 and 11 years in a two-stage, random sample, population-based survey. Univariate analysis was performed on the association between socio-economic and demographic predictors of overweight/risk of overweight and the dependent variables, i.e. body mass index (BMI), triceps skinfold and subscapular skinfold. Based on this analysis, logistic regression models were developed. The prevalence of overweight and risk of overweight was 37.8% in girls and 36.4% in boys. For the BMI model, the variables retained were age and number of persons per household; for the triceps skinfold model, the variables were age, gender and area of residence; and age, gender and persons/household were the variables for the subscapular skinfold model. The results suggest that both BMI and skinfold indicators should be used to assess overweight/risk of overweight and that public health programmes for schoolchildren should be developed to combat the alarming increase in obesity.
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Sichieri R. Dietary patterns and their associations with obesity in the Brazilian city of Rio de Janeiro. OBESITY RESEARCH 2002; 10:42-8. [PMID: 11786600 DOI: 10.1038/oby.2002.6] [Citation(s) in RCA: 144] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To evaluate the dietary patterns of adults living in the city of Rio de Janeiro, Brazil and their associations with body mass index (BMI). RESEARCH METHODS AND PROCEDURES A survey was conducted in 1996 in a probabilistic sample of 2040 households. Weight and height were measured and food intake was based on an 80-item semi-quantitative food frequency questionnaire. Dietary patterns were identified through factor analysis. RESULTS More than one-third of the adult population (20 to 60 years old) was overweight (BMI = 25 to 29.9 kg/m(2)), and 12% were obese (BMI >or= 30 kg/m(2)). Three major dietary patterns were identified: mixed pattern when all food groups and items had about the same factor loading, except for rice and beans; one pattern that relies mainly on rice and beans, which was called a traditional diet; and a third pattern, termed a Western diet, where fat (butter and margarine) and added sugar (sodas) showed the highest positive loading and rice and beans were strong negative components. Among men, the Western diet also included deep-fried snacks and milk products with high positive values. The traditional diet was associated with lower risk of overweight/obesity in logistic models adjusted for dieting, age, leisure physical activity, and occupation (13% reduction in men and 14% reduction in women comparing the traditional and Western diets). DISCUSSION Factors contributing to the effects of the Brazilian traditional diet may include low-energy density, high-dietary fiber content, incorporation of low glycemic index foods such as beans, or a relatively low food variety.
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Affiliation(s)
- Rosely Sichieri
- Instituto de Medicina Social, State University of Rio de Janeiro, UERJ, Brazil.
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Bertoldi Nucci L, Bartholow Duncan B, Serrate Mengue S, Branchtein L, Schmidt MI, Fleck ET. Assessment of weight gain during pregnancy in general prenatal care services in Brazil. CAD SAUDE PUBLICA 2001; 17:1367-74. [PMID: 11784897 DOI: 10.1590/s0102-311x2001000600007] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Obesity is an emerging major health risk for women around the world. In this regard, little attention has been given to pregnancy, a moment of risk not only for major weight gain in these women, but also for macrosomia in their offspring. The objective of this study is to evaluate weight gain during pregnancy. Data pertains to a cohort of pregnant women attending general prenatal care clinics in six state capitals in Brazil, from 1991 to 1995. We studied women aged 20 years and over with singleton pregnancies and no diagnosis of diabetes outside pregnancy, enrolled at approximately 20 - 28 weeks of gestation. According to the Institute of Medicine criteria, 38% (95%CI: 36-40%) of the women studied gained less and 29% (95%CI: 28-31%) had more than the recommended total weight gain. These proportions vary according to pre-pregnancy nutritional status. Given the increasing epidemic of obesity, the high prevalence of overweight and obesity in Brazilian women prior to pregnancy, and the lack of achievement of recommended weight gain during pregnancy, more effective means of managing weight gain during pregnancy are necessary.
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Affiliation(s)
- L Bertoldi Nucci
- Departamento de Medicina Social, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, 90035-003, Brasil
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McArthur L, Holbert D, Pena M. Obesity knowledge of adolescents from six Latin American cities: a multivariable analysis. Nutr Res 2001. [DOI: 10.1016/s0271-5317(01)00349-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Florêncio TM, Ferreira HS, de França AP, Cavalcante JC, Sawaya AL. Obesity and undernutrition in a very-low-income population in the city of Maceió, northeastern Brazil. Br J Nutr 2001; 86:277-84. [PMID: 11502242 DOI: 10.1079/bjn2001396] [Citation(s) in RCA: 88] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Obesity is the nutritional disorder which has shown the greatest increase in prevalence, even in those countries in which deficiency diseases represent a severe public health problem. The goal of the present study was to analyse the anthropometric profile of a community living in the outskirts of Maceió, capital of Alagoas (northeastern Brazil), and to investigate the hypothesis of a coexistence of undernutrition and obesity in a very low-income population. The survey was conducted on 315 families (1247 individuals). Among the children (aged < or =10 years), the prevalence of wasting, stunting and wasting plus stunting was 3.8, 8.3 and 8.7 % respectively. Wasting (10.2 %) was the most prevalent form of undernutrition among adolescents; nonetheless, a higher frequency of stunting (11 %) and overweight-obesity (5.5 %) was seen specifically in girls, in agreement with trends found in other studies. Adults exhibited a high prevalence of overweight-obesity (25 %), but stunting was also present (22 %). Of the stunted individuals, 30 % were overweight-obese and 16.3 % were underweight. There were eighty-six families with at least one parent who was underweight (27 %) and 104 families with at least one parent who was overweight (33 %). Underweight and overweight-obesity were both present in ninety-six households (30 %). These results may indicate that better living conditions in urban areas in a population 'adapted' to chronic famine might increase the susceptibility to obesity. Considering the harm caused by the cumulative effect of these two conditions (undernutrition in childhood and obesity in adult life) there is a clear need for new studies to uncover the determinant factors so that preventive measures can be implemented.
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Affiliation(s)
- T M Florêncio
- Departamento de Nutrição, Universidade Federal de Alagoas, Rua Hélio Pradines, 225/301 Ponta Verde, 57.035-220 Maceió, Alagoas, Brazil.
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