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Malta DC, Bernal RTI, Vieira Neto E, Curci KA, Pasinato MTDM, Lisbôa RM, Cachapuz RF, Coelho KSC. Trends in risk and protective factors for non-communicable diseases in the population with health insurance in Brazil from 2008 to 2015. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2018; 21:e180020. [PMID: 30517471 DOI: 10.1590/1980-549720180020.supl.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 11/16/2017] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE To analyze trends in risk and protective factors for non-communicable diseases (NCD) and access to preventive tests in the population with health insurance in Brazilian state capitals between 2008 and 2015. METHODS This is a cross-sectional study that analyzed data collected from the Surveillance of Risk and Protective Factors for non-communicable diseases (NCD) Telephone Survey (Sistema Nacional de Vigilância de Doenças Crônicas por Inquérito Telefônico - Vigitel) on adults aged 18 years and older. We analyzed trends in NCD indicators among health insurance users in approximately 30 thousand interviews done between 2008 and 2015. We used the simple linear regression model to calculate the trends. RESULTS Health insurance users showed an increase in the prevalence of protective factors such as fruit and vegetable consumption, and physical activity in leisure time. Also, there was a decrease in risk factors such as smoking and soft drink consumption, increase in mammography coverage, and a drop in smoking prevalence. However, overweight, obesity, and diabetes increased. CONCLUSION There are differences according to gender, and, in general, women accumulate more protective factors and men, more risk factors.
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Affiliation(s)
- Deborah Carvalho Malta
- Departamento de Enfermagem Materno Infantil e Saúde Pública, Escola de Enfermagem, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil
| | - Regina Tomie Ivata Bernal
- Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Faculdade de Saúde Pública, Universidade de São Paulo - São Paulo (SP), Brasil
| | - Eduardo Vieira Neto
- Diretoria de Normas e Habilitação dos Produtos, Agência Nacional de Saúde Suplementar - Rio de Janeiro (RJ), Brasil
| | - Katia Audi Curci
- Diretoria de Normas e Habilitação dos Produtos, Agência Nacional de Saúde Suplementar - Rio de Janeiro (RJ), Brasil
| | | | - Raquel Medeiros Lisbôa
- Diretoria de Normas e Habilitação dos Produtos, Agência Nacional de Saúde Suplementar - Rio de Janeiro (RJ), Brasil
| | - Renata Fernandes Cachapuz
- Diretoria de Normas e Habilitação dos Produtos, Agência Nacional de Saúde Suplementar - Rio de Janeiro (RJ), Brasil
| | - Karla Santa Cruz Coelho
- Diretoria de Normas e Habilitação dos Produtos, Agência Nacional de Saúde Suplementar - Rio de Janeiro (RJ), Brasil
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Nascimento CMC, Zazzetta MS, Gomes GAO, Orlandi FS, Gramani-Say K, Vasilceac FA, Gratão ACM, Pavarini SCI, Cominetti MR. Higher levels of tumor necrosis factor β are associated with frailty in socially vulnerable community-dwelling older adults. BMC Geriatr 2018; 18:268. [PMID: 30400833 PMCID: PMC6219095 DOI: 10.1186/s12877-018-0961-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 10/23/2018] [Indexed: 12/22/2022] Open
Abstract
Background The complex physiology underpinning the frailty syndrome is responsible for the absence of robust biomarkers that can be used for screening, diagnostic and/or prognostic purposes and has made clinical implementation difficult. Considering socially vulnerable populations, who have poor health status and increased morbidity and mortality, this scenario is even more complex. However, to the best of our knowledge, there are no studies available to investigate frailty biomarkers in socially vulnerable populations. Thus, the aim of this cross-sectional study was to identify potential blood-based biomarkers of frailty in a socially vulnerable population. Methods A sample consisting of 347 community-dwelling older people living in a context of high social vulnerability was divided into non-frail (robust), pre-frail and frail groups, according to modified Fried frailty phenotype criteria. Blood samples were collected and analyzed for basic metabolic parameters and for inflammatory cytokines. Results Levels of Interleukin-1α (IL-1α) and Tumor Necrosis Factor α (TNF-α) were significantly higher in pre-frail subjects, compared to non-frail ones. Tumor Necrosis Factor β (TNF-β) levels presented higher values in the frail compared to non-frail individuals. Interleukin-6 (IL-6) levels in pre-frail and frail subjects were significantly higher compared to the levels of non-frail subjects. Using an ordinal regression analysis, we observed that socially vulnerable older people at higher risk of developing frailty were subjects above 80 years old (OR: 2.5; 95% CI: 1.1–5.6) and who presented higher levels of TNF-β (≥0.81 pg/mL, OR: 2.53; 95% CI: 1.3–4.9). Conclusion As vulnerable populations continue to age, it is imperative to have a greater understanding of the frailty condition, identifying novel potential blood-based biomarkers. The results presented here could help to implement preventive healthcare strategies by evaluating frailty and at the same time measuring a set of inflammatory biomarkers, paying special attention to TNF-β plasmatic levels. Electronic supplementary material The online version of this article (10.1186/s12877-018-0961-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Carla M C Nascimento
- Department of Gerontology, Federal University of São Carlos, Rod. Washington Luis, Km 235, Monjolinho, São Carlos, SP, CEP 13565-905, Brazil
| | - Marisa S Zazzetta
- Department of Gerontology, Federal University of São Carlos, Rod. Washington Luis, Km 235, Monjolinho, São Carlos, SP, CEP 13565-905, Brazil
| | - Grace A O Gomes
- Department of Gerontology, Federal University of São Carlos, Rod. Washington Luis, Km 235, Monjolinho, São Carlos, SP, CEP 13565-905, Brazil
| | - Fabiana S Orlandi
- Department of Gerontology, Federal University of São Carlos, Rod. Washington Luis, Km 235, Monjolinho, São Carlos, SP, CEP 13565-905, Brazil
| | - Karina Gramani-Say
- Department of Gerontology, Federal University of São Carlos, Rod. Washington Luis, Km 235, Monjolinho, São Carlos, SP, CEP 13565-905, Brazil
| | - Fernando A Vasilceac
- Department of Gerontology, Federal University of São Carlos, Rod. Washington Luis, Km 235, Monjolinho, São Carlos, SP, CEP 13565-905, Brazil
| | - Aline C M Gratão
- Department of Gerontology, Federal University of São Carlos, Rod. Washington Luis, Km 235, Monjolinho, São Carlos, SP, CEP 13565-905, Brazil
| | - Sofia C I Pavarini
- Department of Gerontology, Federal University of São Carlos, Rod. Washington Luis, Km 235, Monjolinho, São Carlos, SP, CEP 13565-905, Brazil
| | - Marcia R Cominetti
- Department of Gerontology, Federal University of São Carlos, Rod. Washington Luis, Km 235, Monjolinho, São Carlos, SP, CEP 13565-905, Brazil.
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Malta DC, Silva MMAD, Moura LD, Morais OLD. The implantation of the Surveillance System for Non-communicable Diseases in Brazil, 2003 to 2015: successes and challenges. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2018; 20:661-675. [PMID: 29267751 DOI: 10.1590/1980-5497201700040009] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 04/05/2017] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE To describe the implantation of the Surveillance System for Noncommunicable Diseases (NCDs) in the Unified Health System (Sistema Único de Saúde) and the challenges in maintaining it. METHODS A literature review was carried out the information contained in federal government directives between 2003 and 2015 was consulted. RESULTS A comprehensive risk and protection factor surveillance system was implemented. It is capable of producing information and providing evidence to monitor changes in the health behavior of the population. Among the advances cited are the organization of epidemiological surveys, such as the Surveillance System for Risk Factors and Protection for NCD (Sistema de Vigilância de Fatores de Risco e Proteção para DCNT - Vigitel), the National School Health Survey (Pesquisa Nacional de Saúde do Escolar - PeNSE), and the National Health Survey (Pesquisa Nacional de Saude) from 2013, which enabled the most extensive health diagnosis of the Brazilian population. In 2011, the NCD National Plan 2011-2022 established targets for reducing risk factors and NCD mortality. CONCLUSION The information gathered from the NCD surveillance system can support the implementation of sectoral and intersectorial strategies, which will result in the implementation of the Brazilian Strategic Action Plan for the prevention and control of NCDs, as well as the monitoring and evaluation of their results periodically. Finally, it can be a very important tool to help Brazil achieve the goals proposed by the 2030 Agenda for Sustainable Development and the Global Plan to Tackling NCDs.
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Affiliation(s)
- Deborah Carvalho Malta
- Departamento de Enfermagem Materno Infantil e Saúde Pública, Escola de Enfermagem, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil
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Marinho F, de Azeredo Passos VM, Carvalho Malta D, Barboza França E, Abreu DMX, Araújo VEM, Bustamante-Teixeira MT, Camargos PAM, da Cunha CC, Duncan BB, Felisbino-Mendes MS, Guerra MR, Guimaraes MDC, Lotufo PA, Marcenes W, Oliveira PPV, de Moares Pedroso M, Ribeiro AL, Schmidt MI, Teixeira RA, Vasconcelos AMN, Barreto ML, Bensenor IM, Brant LCC, Claro RM, Costa Pereira A, Cousin E, Curado MP, dos Santos KPB, Faro A, Ferri CP, Furtado JM, Gall J, Glenn SD, Goulart AC, Ishitani LH, Kieling C, Ladeira RM, Machado IE, Martins SCO, Martins-Melo FR, Melo APS, Miller-Petrie MK, Mooney MD, Nunes BP, Palone MRT, Pereira CC, Rasella D, Ray SE, Roever L, de Freitas Saldanha R, Santos IS, Schneider IJC, Santos Silva DA, Silveira DGA, Soares Filho AM, Moraes Sousa TC, Szwarcwald CL, Traebert J, Velasquez-Melendez G, Wang YP, Lozano R, Murray CJL, Naghavi M. Burden of disease in Brazil, 1990-2016: a systematic subnational analysis for the Global Burden of Disease Study 2016. Lancet 2018; 392:760-775. [PMID: 30037735 PMCID: PMC6123514 DOI: 10.1016/s0140-6736(18)31221-2] [Citation(s) in RCA: 225] [Impact Index Per Article: 37.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 05/09/2018] [Accepted: 05/21/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Political, economic, and epidemiological changes in Brazil have affected health and the health system. We used the Global Burden of Disease Study 2016 (GBD 2016) results to understand changing health patterns and inform policy responses. METHODS We analysed GBD 2016 estimates for life expectancy at birth (LE), healthy life expectancy (HALE), all-cause and cause-specific mortality, years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life-years (DALYs), and risk factors for Brazil, its 26 states, and the Federal District from 1990 to 2016, and compared these with national estimates for ten comparator countries. FINDINGS Nationally, LE increased from 68·4 years (95% uncertainty interval [UI] 68·0-68·9) in 1990 to 75·2 years (74·7-75·7) in 2016, and HALE increased from 59·8 years (57·1-62·1) to 65·5 years (62·5-68·0). All-cause age-standardised mortality rates decreased by 34·0% (33·4-34·5), while all-cause age-standardised DALY rates decreased by 30·2% (27·7-32·8); the magnitude of declines varied among states. In 2016, ischaemic heart disease was the leading cause of age-standardised YLLs, followed by interpersonal violence. Low back and neck pain, sense organ diseases, and skin diseases were the main causes of YLDs in 1990 and 2016. Leading risk factors contributing to DALYs in 2016 were alcohol and drug use, high blood pressure, and high body-mass index. INTERPRETATION Health improved from 1990 to 2016, but improvements and disease burden varied between states. An epidemiological transition towards non-communicable diseases and related risks occurred nationally, but later in some states, while interpersonal violence grew as a health concern. Policy makers can use these results to address health disparities. FUNDING Bill & Melinda Gates Foundation and the Brazilian Ministry of Health.
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Survey on the Adherence to the 2009 NASPGHAN-ESPGHAN Gastroesophageal Reflux Guidelines by Brazilian Paediatricians. J Pediatr Gastroenterol Nutr 2018; 67:e1-e5. [PMID: 29394212 DOI: 10.1097/mpg.0000000000001902] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE The aim of the study was to evaluate the management of gastroesophageal reflux in children among Brazilian pediatricians and adherence to the 2009 North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN), and European Society of Gastroenterology, Hepatology, and Nutrition (ESPGHAN) Guideline in Brazil. METHODS An observational cross-sectional study was conducted, applying a standard questionnaire with 12 questions about gastroesophageal reflux (GER) and gastroesophageal reflux disease (GERD) management in infants, children, and adolescents to the pediatricians during the 37th Brazilian Pediatrics Congress in October, 2015. Adherence to the 2009 NASPGHAN-ESPGHAN Guideline was verified through analyses of interviewees' answers. Pediatricians' demographic and professional characteristics were screened. RESULTS A total of 390 Brazilian pediatricians answered the questionnaire. None showed complete adherence to Guideline recommendations. GERD diagnosis by history alone was reported by 67%, irrespective of the child's age. The mean score for diagnostic adherence to the guidelines was 0.94 ± 0.86 (range 0-4). Working in public health services (P = 0.026) was the only variable retained as a significant predictor of poor adherence for GER/GERD diagnosis after multivariate logistic regression analysis. No significant statistical differences were found between Brazilian regions on total score (P = 0.774). Proton pump inhibitors were prescribed by 28.4% of the pediatricians independent of child's age, and 59% use proton pump inhibitors to treat babies with unexplained crying and/or distressed behavior. CONCLUSIONS 2009 NASPGHAN-ESPGHAN Guideline recommendations had poor adherence by Brazilian pediatricians. Studies evaluating the reasons for the poor adherence to NASPGHAN/ESPGHAN guidelines are urgently needed.
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Lima-Costa MF, de Andrade FB, Souza PRBD, Neri AL, Duarte YADO, Castro-Costa E, de Oliveira C. The Brazilian Longitudinal Study of Aging (ELSI-Brazil): Objectives and Design. Am J Epidemiol 2018; 187:1345-1353. [PMID: 29394304 PMCID: PMC6031009 DOI: 10.1093/aje/kwx387] [Citation(s) in RCA: 163] [Impact Index Per Article: 27.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 12/21/2017] [Indexed: 12/17/2022] Open
Abstract
Brazil is experiencing among the world’s fastest demographic aging worldwide. This demographic transition is occurring in a context of few resources and great social inequalities. The Brazilian Longitudinal Study of Aging (ELSI-Brazil) is a nationally representative study of 9,412 people aged 50 years or older, residing in 70 municipalities across the 5 Brazilian regions. ELSI-Brazil allows investigations of the aging process, its health, psychosocial and economic determinants, and societal consequences. The baseline examination (2015–2016) included detailed household and individual interviews and physical measurements (blood pressure, anthropometry, grip strength, and timed walk and balance tests). Blood tests and sample storage were performed in a subsample of study participants. Subsequent waves are planned for every 3 years. The study adopts a conceptual framework common to other large-scale longitudinal studies of aging in the world, such as the Health and Retirement Study, allowing cross-national comparisons. The goal of ELSI-Brazil is not only to build an understanding of aging in a large, Western, middle-income country in a rapid demographic transition but also to provide scientific data to support and study policy changes that may affect older adults. We describe the methodology of the study and some descriptive results of the baseline survey.
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Affiliation(s)
| | | | | | | | | | - Erico Castro-Costa
- Instituto de Pesquisas René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brazil
| | - Cesar de Oliveira
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
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Nazif-Muñoz JI, Nandi A, Ruiz-Casares M. Protecting only white children: the impact of child restraint legislation in Brazil. J Public Health (Oxf) 2018; 41:287-295. [PMID: 29931193 DOI: 10.1093/pubmed/fdy105] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 05/26/2018] [Indexed: 01/26/2023] Open
Abstract
Abstract
Background
In 2010, Brazil introduced child restraint legislation (CRL). We assessed the effectiveness of CRL in reducing child (aged 0–8 years) injuries and fatalities by race. We performed an evaluation study with an interrupted time–series design.
Methods
We measured the effect of CRL on two outcomes—number of child deaths and number of child injured in traffic collisions per child population, stratified by race, from 2008 to 2014. We controlled for time, unemployment rate and oil consumption (barrels/day in thousands).
Results
The CRL was associated with a 3% reduction in the rate of child injuries among whites (incidence rate ratio (IRR): 0.97; 95% CI: 0.96–0.99), but no reduction in child injuries among non-whites (IRR: 0.99; 95% CI: 0.99–1.00). In the first month after the implementation of Brazil’s CRL we observed a 39% reduction in all child fatalities (IRR: 0.61; 95% CI: 0.44–0.84), including a 52% reduction among whites (IRR: 0.48; 95% CI: 0.33–0.68), but no reduction in non-white fatalities (IRR: 0.87; 95% CI: 0.55–1.37).
Conclusions
Our results support the hypothesis that socially advantaged populations were more likely to consistently adopt and employ restraint devices following the reform. Countries should also consider complementary policies that facilitate an equitable distribution of safety devices that reach vulnerable populations.
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Affiliation(s)
- José Ignacio Nazif-Muñoz
- Institute for Health and Social Policy and Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Arijit Nandi
- Institute for Health and Social Policy and Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
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Malta DC, Felisbino-Mendes MS, Machado ÍE, Passos VMDA, Abreu DMXD, Ishitani LH, Velásquez-Meléndez G, Carneiro M, Mooney M, Naghavi M. Risk factors related to the global burden of disease in Brazil and its Federated Units, 2015. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2018; 20Suppl 01:217-232. [PMID: 28658385 DOI: 10.1590/1980-5497201700050018] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 02/20/2017] [Indexed: 08/30/2024] Open
Abstract
Objective: To analyze the global burden of disease related to disability adjusted life years (DALYs) attributed to selected risk factors in Brazil and its 27 Federated Units. Methods: Databases from the Global Burden of Disease study in Brazil and its Federated Units were used, estimating the summary exposure value (SEV) for selected environmental, behavioral, and metabolic risk factors (RFs), and their combinations. The DALYs were used as the main metric. The ranking of major RFs between 1990 and 2015 was compiled, comparing data by sex and states. Results: The analyzed RFs account for 38.8% of the loss of DALYs in the country. Dietary risks was the main cause of DALYs in 2015. In men, dietary risks contributed to 12.2% of DALYs and in women, to 11.1%. Other RFs were high systolic blood pressure, high body mass index, smoking, high fasting plasma glucose and, among men, alcohol and drug use. The main RFs were metabolic and behavioral. In most states, dietary risks was the main RF, followed by high blood pressure. Conclusion: Dietary risks leads the RF ranking for Brazil and its Federated Units. Men are more exposed to behavioral risk factors, and women are more exposed to metabolic ones.
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Affiliation(s)
- Deborah Carvalho Malta
- Departamento de Enfermagem Materno-Infantil e Saúde Pública, Escola de Enfermagem, Universidade Federal de Minas Gerais -A Belo Horizonte (MG), Brasil
| | - Mariana Santos Felisbino-Mendes
- Departamento de Enfermagem Materno-Infantil e Saúde Pública, Escola de Enfermagem, Universidade Federal de Minas Gerais -A Belo Horizonte (MG), Brasil
| | - Ísis Eloah Machado
- Departamento de Enfermagem Materno-Infantil e Saúde Pública, Escola de Enfermagem, Universidade Federal de Minas Gerais -A Belo Horizonte (MG), Brasil
| | | | | | - Lenice Harumi Ishitani
- Secretaria Municipal de Saúde de Belo Horizonte, Prefeitura de Belo Horizonte - Belo Horizonte (MG), Brasil
| | - Gustavo Velásquez-Meléndez
- Departamento de Enfermagem Materno-Infantil e Saúde Pública, Escola de Enfermagem, Universidade Federal de Minas Gerais -A Belo Horizonte (MG), Brasil
| | - Mariangela Carneiro
- Faculdade de Medicina, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil
| | - Meghan Mooney
- Institute for Health Metrics and Evaluation - Seattle (WA), Estados Unidos
| | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation - Seattle (WA), Estados Unidos
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da Silva SG, Evenson KR, da Silva ICM, Mendes MA, Domingues MR, da Silveira MF, Wehrmeister FC, Ekelund U, Hallal PC. Correlates of accelerometer-assessed physical activity in pregnancy-The 2015 Pelotas (Brazil) Birth Cohort Study. Scand J Med Sci Sports 2018. [PMID: 29542188 PMCID: PMC6055654 DOI: 10.1111/sms.13083] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Objective methods to measure physical activity (PA) have become available and widely used given the high degree of precision to evaluate PA. However, few studies have used accelerometers to measure PA during pregnancy, especially in low‐ and middle‐income countries. We assessed overall PA, moderate, vigorous, and moderate‐to‐vigorous physical activity (MVPA) objectively measured among pregnant women and their correlates in a population‐based study. PA was assessed for seven consecutive days using a raw triaxial wrist‐worn accelerometer in women interviewed around 16 and 24 weeks of gestation in the 2015 Pelotas (Brazil) Birth Cohort Study. The average acceleration, which expresses overall PA, was presented in milli‐g (1 mg = 0.001 g), and average time (min/day) spent in MVPA (>100 mg) was also analyzed in 5‐ and 10‐min bouts. Analyses were performed using linear regression. In total, 2317 women were included in the analyses. Overall PA was 27.6 mg. Pregnant women spent on average 14 min/day in MVPA and 0.4 min in vigorous PA. Time spent in MVPA and total PA were inversely associated with years in school and income, and were lower among women receiving advice to not exercise. MVPA was also inversely associated with age, lower among women living with a partner, and higher among non‐white women. The study indicated low levels of PA among pregnant women. The identified correlates may provide a framework to better understand factors influencing PA during pregnancy and thus inform future interventions.
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Affiliation(s)
- S G da Silva
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.,Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina - Chapel Hill, Chapel Hill, NC, USA
| | - K R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina - Chapel Hill, Chapel Hill, NC, USA
| | - I C M da Silva
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - M A Mendes
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - M R Domingues
- Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, Brazil
| | - M F da Silveira
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - F C Wehrmeister
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - U Ekelund
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - P C Hallal
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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Lifestyle Patterns and Weight Status in Spanish Adults: The ANIBES Study. Nutrients 2017; 9:nu9060606. [PMID: 28613259 PMCID: PMC5490585 DOI: 10.3390/nu9060606] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 06/08/2017] [Accepted: 06/08/2017] [Indexed: 02/07/2023] Open
Abstract
Limited knowledge is available on lifestyle patterns in Spanish adults. We investigated dietary patterns and possible meaningful clustering of physical activity, sedentary behavior, sleep time, and smoking in Spanish adults aged 18–64 years and their association with obesity. Analysis was based on a subsample (n = 1617) of the cross-sectional ANIBES study in Spain. We performed exploratory factor analysis and subsequent cluster analysis of dietary patterns, physical activity, sedentary behaviors, sleep time, and smoking. Logistic regression analysis was used to explore the association between the cluster solutions and obesity. Factor analysis identified four dietary patterns, “Traditional DP”, “Mediterranean DP”, “Snack DP” and “Dairy-sweet DP”. Dietary patterns, physical activity behaviors, sedentary behaviors, sleep time, and smoking in Spanish adults aggregated into three different clusters of lifestyle patterns: “Mixed diet-physically active-low sedentary lifestyle pattern”, “Not poor diet-low physical activity-low sedentary lifestyle pattern” and “Poor diet-low physical activity-sedentary lifestyle pattern”. A higher proportion of people aged 18–30 years was classified into the “Poor diet-low physical activity-sedentary lifestyle pattern”. The prevalence odds ratio for obesity in men in the “Mixed diet-physically active-low sedentary lifestyle pattern” was significantly lower compared to those in the “Poor diet-low physical activity-sedentary lifestyle pattern”. Those behavior patterns are helpful to identify specific issues in population subgroups and inform intervention strategies. The findings in this study underline the importance of designing and implementing interventions that address multiple health risk practices, considering lifestyle patterns and associated determinants.
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Landmann-Szwarcwald C, Macinko J. A panorama of health inequalities in Brazil. Int J Equity Health 2016; 15:174. [PMID: 27852273 PMCID: PMC5112735 DOI: 10.1186/s12939-016-0462-1] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 10/12/2016] [Indexed: 11/10/2022] Open
Affiliation(s)
- Celia Landmann-Szwarcwald
- Laboratório de Informações em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - James Macinko
- Departments of Health Policy and Management and Community Health Sciences, UCLA Fielding School of Public Health, 650 Charles E. Young Dr. South, Room 31-235B, Center for Health Sciences, Los Angeles, CA, 90095-1772, USA.
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