1
|
de Menezes MC, Duran AC, Langellier B, Pérez-Ferrer C, Barnoya J, Mayén AL. Socioeconomic Position, Pre-Obesity and Obesity in Latin American Cities: A Systematic Review. INTERNATIONAL JOURNAL OF SOCIAL DETERMINANTS OF HEALTH AND HEALTH SERVICES 2024; 54:224-232. [PMID: 38489831 DOI: 10.1177/27551938241238677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Abstract
Currently the socioeconomic gradient of obesity it is not well understood in the urban population in Latin American. This study reviewed the literature assessing associations between pre-obesity, obesity, and socioeconomic position (SEP) in adults living in urban areas in Latin American countries. PubMed and SciELO databases were used. Data extraction was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We extracted data on the association between SEP (e.g., education, income), pre-obesity (body mass index [BMI] ≥ 25 and < 30 kg/m2) and obesity (BMI ≥ 30 kg/m2). Relative differences between low and high SEP groups were assessed and defined a priori as significant at p < 0.05. Thirty-one studies met our inclusion criteria and most were conducted in Brazil and Mexico (22 and 3 studies, respectively). One study presented nonsignificant associations. Forty-seven percent of associations between education or income and pre-obesity were negative. Regarding obesity, 80 percent were negative and 20 percent positive. Most negative associations were found in women while in men they varied depending on the indicator used. Pre-obesity and obesity by SEP did not follow the same pattern, revealing a reversal of the obesity social gradient by SEP, especially for women in Latin America, highlighting the need for articulated policies that target structural and agentic interventions.
Collapse
Affiliation(s)
- Mariana Carvalho de Menezes
- Department of Social and Clinical Nutrition, Federal University of Ouro Preto, Campus Morro do Cruzeiro, Escola de Nutrição - Ouro Preto, Rua Dois, Brazil, CEP 35.400-000
| | - Ana C Duran
- Center for Food Studies, University of Campinas, Av. Albert Einstein, 291, Campinas, Sao Paulo, Brazil
| | - Brent Langellier
- Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Carolina Pérez-Ferrer
- National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, 62100 Cuernavaca, Mexico
| | - Joaquin Barnoya
- Unit of Cardiovascular Surgery, UNICAR, 9A Avenida 8, 01011 Guatemala, GT, Guatemala
| | - Ana-Lucia Mayén
- Department of Chronic Diseases, Institute of Nutrition of Central America and Panama, Guatemala city, Guatemala
| |
Collapse
|
2
|
Lima da Silva JM, Oliveira JS, Casagrande Borges D, Honório OS, Mendes LL, Canuto R. Social inequities in food deserts and food swamps in a northeastern Brazilian capital. J Biosoc Sci 2024; 56:493-503. [PMID: 38415307 DOI: 10.1017/s0021932024000087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
This study identified food deserts and swamps, investigating their associations with socioeconomic and demographic conditions. This ecological study was conducted using data from urban census tracts in the city of Recife, which were considered the unit of analysis. Information on food retail was obtained from government sources in 2019. Census tracts below the 25th percentile in the density of healthy food retail (i.e., those that predominantly sell natural or minimally processed foods, mixed businesses, and super- and hypermarkets) were classified as food deserts. Census tracts above the 25th percentile in the density of unhealthy food retail (i.e., those selling primarily ultra-processed foods) were considered food swamps. The socioeconomic and demographic conditions of the census tracts were evaluated using variables from the 2010 census (per capita income, average income, race, literacy of the head of household, and the availability of essential services) and the Health Vulnerability Index. Census tracts considered food deserts (28.5%) were more vulnerable, characterized by lower income and access to essential services, more illiterate residents and more minorities (Black/Indigenous/mixed race). Food swamps (73.47%) were more prevalent in less vulnerable neighbourhoods characterized by higher percentages of literate residents and Whites, greater purchasing power, and better basic sanitation. The characteristics of Recife's food deserts and swamps demonstrate social inequalities in the food environment. Public facilities could play a vital role in promoting healthy eating within food deserts. Additionally, future implementation of taxes on ultra-processed foods and the provision of tax subsidies to natural or minimally processed food sellers might contribute to fostering healthier dietary choices.
Collapse
Affiliation(s)
| | | | | | | | | | - Raquel Canuto
- Program in Nutrition, Universidade Federal de Pernambuco, Brazil
- Program in Food, Nutrition and Health, Universidade Federal do Rio Grande do Sul, Brazil
| |
Collapse
|
3
|
da Silva AG, Souza JB, Gomes CS, da Silva TPR, Gomide Nogueira de Sá ACM, Malta DC. Multiple behavioral risk factors for non-communicable diseases among the adolescent population in Brazil: the analysis derived from the Brazilian national survey of school health 2019. BMC Pediatr 2024; 24:122. [PMID: 38360574 PMCID: PMC10868108 DOI: 10.1186/s12887-024-04601-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 01/29/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Health risk behaviors often emerge or intensify during adolescence and tend to co-occur, exposing individuals to an even greater risk for the development of non-communicable diseases (NCDs). The likelihood of exhibiting multiple health risk factors also increases throughout life and is associated with sociodemographic characteristics contributing to their escalation and severity. In this context, the objective of this study was to analyze the association between sociodemographic characteristics and multiple behavioral risk factors for non-communicable diseases among the adolescent population in Brazil. METHODS This cross-sectional study utilized data from the Brazilian National Survey of School Health 2019. The sample comprised 121,580 adolescents aged 13 to 17. The analyzed variables included irregular intake of fruits and vegetables, regular consumption of soft drinks and treats, insufficient physical activity, sedentary lifestyle, cigarette smoking, and alcohol consumption. To analyze MBRFs, a classification ranging from zero to five was created, and associations were estimated using Odds Ratio (OR) with the respective 95% confidence interval (CI). The Backward method was employed for the multivariate regression model, utilizing ordinal logistic regression. RESULTS Adolescents without behavioral risk factors for NCDs constituted only 3.9% (95% CI 3.7-4.1). The most prevalent categories were two and three MBRFs, accounting for 28.3% (95% CI: 27.7-28.8) and 27.0% (95% CI: 26.5-27.5), respectively. Adolescents aged 16 and 17 (ORadj: 1.39; 95% CI: 1.32-1.48), residing in the Brazilian Southeast (ORadj: 1.66; 95% CI: 1.52-1.81), and those reporting poor or very poor self-rated health (ORadj: 2.05; 95% CI: 1.87-2.25) were more likely to exhibit multiple behavioral risk factors. Conversely, male adolescents (adjusted OR: 0.65; 95% CI: 0.62-0.69), those of mixed race (adjusted OR: 0.92; 95% CI: 0.87-0.97), and residents of rural areas (adjusted OR: 0.76; 95% CI: 0.70-0.84) were less likely to manifest MBRFs for NCDs. CONCLUSION The majority of adolescents displayed MBRFs for NCDs, positively associated with age, region, and perceived health status. This underscores the necessity for healthcare promotional interventions throughout the life cycle, as these behaviors may persist into adulthood.
Collapse
Affiliation(s)
- Alanna Gomes da Silva
- Graduate Program in Nursing, Department of Maternal-Infant and Public Health Nursing, Federal University of Minas Gerais (UFMG), Avenida Professor Alfredo Balena, 190, Bairro Santa Efigênia, Belo Horizonte, 30130-100, Minas Gerais, Brazil.
| | - Juliana Bottoni Souza
- Faculty of Medicine, Graduate Program in Public Health, Federal University of Minas Gerais (UFMG), Belo Horizonte (MG), Brazil
| | - Crizian Saar Gomes
- Faculty of Medicine, Graduate Program in Public Health, Federal University of Minas Gerais (UFMG), Belo Horizonte (MG), Brazil
| | - Thales Philipe Rodrigues da Silva
- Federal University of São Paulo, Paulista School of Nursing, Rua Napoleão de Barros,754, Bairro Vila Clementino, São Paulo, 04023-062, Brazil
| | | | - Deborah Carvalho Malta
- School of Nursing, Graduate Program of the School of Nursing, Department of Maternal-Infant and Public Health Nursing, Federal University of Minas Gerais, Belo Horizonte (MG), Brazil.
| |
Collapse
|
4
|
Almeida IJD, Garcez A, Backes V, Cunha CMDL, Schuch I, Canuto R. Association between the community food environment and dietary patterns in residents of areas of different socio-economic levels of a southern capital city in Brazil. Br J Nutr 2022; 129:1-9. [PMID: 35811411 DOI: 10.1017/s0007114522001969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This study aimed to verify the association between the community food environment and dietary patterns in a population of different socio-economic levels. This cross-sectional study was conducted with a sample of 400 adults and elderly aged between 20 and 70 years residing in the central area of Porto Alegre, Rio Grande do Sul. Four dietary patterns were explored: healthy, traditional Brazilian, refined carbohydrates and sugars, and fast food. The community food environment included the identification of all food stores by areas where individuals lived and auditing based on the Nutrition Environment Measures Survey in Stores (NEMS-S) score. Poisson regression was used to estimate the prevalence ratios (PR) and their respective 95 % CI. After the adjustment for individual sociodemographic characteristics, residents of the area with the best community food environment (highest NEMS-S score) had 12 % and 18 % lower probabilities of high consumption (upper tertile) of the traditional (PR = 0·88; 95 % CI (0·78, 0·98)) and refined carbohydrate and sugar (PR = 0·82; 95 % CI (0·73, 0·92)) dietary patterns, respectively, compared with those living in the area with the worst community food environment (lowest NEMS-S score). Healthy and fast-food dietary patterns showed no association with the community food environment. In conclusion, the community food environment is a factor associated with the consumption of certain dietary patterns, independent of individual sociodemographic characteristics. Thus, aspects of the community food environment become important in food and nutrition actions and policies aimed at health promotion.
Collapse
Affiliation(s)
- Isadora Jardim de Almeida
- Postgraduate Program in Nutrition Sciences, Federal University of Health Science of Porto Alegre, UFCSPA, Porto Alegre, RS, Brazil
| | - Anderson Garcez
- Postgraduate Program in Nutrition Sciences, Federal University of Health Science of Porto Alegre, UFCSPA, Porto Alegre, RS, Brazil
- Postgraduate Program in Collective Health, University of Vale do Rio dos Sinos, UNISINOS, São Leopoldo, RS, Brazil
| | - Vanessa Backes
- Department of Nutrition, University of Vale do Rio dos Sinos, UNISINOS, São Leopoldo, RS, Brazil
| | - Caroline Marques de Lima Cunha
- Postgraduate Program in Collective Health, University of Vale do Rio dos Sinos, UNISINOS, São Leopoldo, RS, Brazil
- Postgraduate Program in Food, Nutrition and Health, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, RS, Brazil
| | - Ilaine Schuch
- Postgraduate Program in Food, Nutrition and Health, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, RS, Brazil
| | - Raquel Canuto
- Postgraduate Program in Food, Nutrition and Health, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, RS, Brazil
| |
Collapse
|
5
|
Golfin F, Murillo C, Jensen ML, Frongillo EA. Adaptation and Validation of the Nutrition Environment Measures Survey in Stores (NEMS-S) in Costa Rica. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2022. [DOI: 10.1080/19320248.2022.2088262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Francesca Golfin
- School of Nutrition, University of Costa Rica, San José, Costa Rica
| | - Carla Murillo
- School of Nutrition, University of Costa Rica, San José, Costa Rica
| | - Melissa L. Jensen
- School of Nutrition, University of Costa Rica, San José, Costa Rica
- UConn Rudd Center for Food Policy and Health, Hartford, Connecticut, USA
| | - Edward A. Frongillo
- Arnold School of Public Health, University of South Carolina Columbia, South Carolina, USA
| |
Collapse
|
6
|
Augusto NA, Loch MR, Dias DF, Silva AMR. [Incidence of increase and decrease in Body Mass Index in middle-aged men and women: four-year follow-up]. CIENCIA & SAUDE COLETIVA 2022; 27:1455-1468. [PMID: 35475826 DOI: 10.1590/1413-81232022274.03612021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 04/19/2021] [Indexed: 11/21/2022] Open
Abstract
The scope of this study was to analyze the incidence of increase and decrease in Body Mass Index (BMI) among middle-aged men and women according to sociodemographic characteristics and classification of nutritional status. It involved a population-based cohort of 689 adults aged 40 to 64 years followed up for four years. The proportion of reduction and increase in BMI (≥1 kg/m²) was verified according to sociodemographic variables and classification of nutritional status in the baseline by means of crude and adjusted Poisson regression. There was a higher incidence of reduced BMI among men in the 55-64 age group (RR: 1.78; 95%CI: 1.06-3.00), in those without a partner (RR: 1.85; 95%CI: 1.09-3.14), in those classified as overweight (RR: 2.06; 95%CI: 1.13-3.74) and in those classified as obese (RR: 2.33; 95%CI: 1.24-4.35), and among women in the 55-64 age group (RR: 1.43; 95%CI: 1.02-2.00) and in those classified as obese (RR: 2.10; 95%CI%: 1.30-3.38). The incidence of increased BMI was lower in the 55 to 64 age group among men (RR: 0.62; 95%CI: 0.41-0.95) and women (RR: 0.68; 95%CI: 0.49-0.95). These data are important for understanding the factors related to the variation of BMI and the elaboration of public policies aimed at the health care of middle-aged adults.
Collapse
Affiliation(s)
- Nathalia Assis Augusto
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Estadual de Londrina (UEL). Rod. Celso Garcia Cid, PR-445, Km 380, Campus Universitário. 86057-970 Londrina PR Brasil.
| | - Mathias Roberto Loch
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Estadual de Londrina (UEL). Rod. Celso Garcia Cid, PR-445, Km 380, Campus Universitário. 86057-970 Londrina PR Brasil.
| | | | - Ana Maria Rigo Silva
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Estadual de Londrina (UEL). Rod. Celso Garcia Cid, PR-445, Km 380, Campus Universitário. 86057-970 Londrina PR Brasil.
| |
Collapse
|
7
|
Westbury S, Ghosh I, Jones HM, Mensah D, Samuel F, Irache A, Azhar N, Al-Khudairy L, Iqbal R, Oyebode O. The influence of the urban food environment on diet, nutrition and health outcomes in low-income and middle-income countries: a systematic review. BMJ Glob Health 2021; 6:bmjgh-2021-006358. [PMID: 34635553 PMCID: PMC8506857 DOI: 10.1136/bmjgh-2021-006358] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 09/17/2021] [Indexed: 12/12/2022] Open
Abstract
Introduction Diet and nutrition are leading causes of global morbidity and mortality. Our study aimed to identify and synthesise evidence on the association between food environment characteristics and diet, nutrition and health outcomes in low-income and middle-income countries (LMICs), relevant to urban settings, to support development and implementation of appropriate interventions. Methods We conducted a comprehensive search of 9 databases from 1 January 2000 to 16 September 2020 with no language restrictions. We included original peer-reviewed observational studies, intervention studies or natural experiments conducted in at least one urban LMIC setting and reporting a quantitative association between a characteristic of the food environment and a diet, nutrition or health outcome. Study selection was done independently in duplicate. Data extraction and quality appraisal using the National Heart Lung and Blood Institute checklists were completed based on published reports using a prepiloted form on Covidence. Data were synthesised narratively. Results 74 studies met eligibility criteria. Consistent evidence reported an association between availability characteristics in the neighbourhood food environment and dietary behaviour (14 studies, 10 rated as good quality), while the balance of evidence suggested an association with health or nutrition outcomes (17 of 24 relevant studies). We also found a balance of evidence that accessibility to food in the neighbourhood environment was associated with diet (10 of 11 studies) although evidence of an association with health outcomes was contradictory. Evidence on other neighbourhood food environment characteristics was sparse and mixed. Availability in the school food environment was also found to be associated with relevant outcomes. Studies investigating our other primary outcomes in observational studies of the school food environment were sparse, but most interventional studies were situated in schools. We found very little evidence on how workplace and home food environments are associated with relevant outcomes. This is a substantial evidence gap. Conclusion ‘Zoning’ or ‘healthy food cart’ interventions to alter food availability may be appropriate in urban LMIC. PROSPERO registration number CRD42020207475.
Collapse
Affiliation(s)
- Susannah Westbury
- School of Public Health and Preventative Medicine, Monash University, Clayton, Victoria, Australia
| | - Iman Ghosh
- Warwick Medical School, University of Warwick, Coventry, UK
| | | | - Daniel Mensah
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Folake Samuel
- Department of Human Nutrition and Dietetics, University of Ibadan, Ibadan, Oyo, Nigeria
| | - Ana Irache
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Nida Azhar
- Department of Community Health Sciences, The Aga Khan University, Karachi, Sindh, Pakistan
| | | | - Romaina Iqbal
- Department of Community Health Sciences, The Aga Khan University, Karachi, Sindh, Pakistan
| | | |
Collapse
|
8
|
Paulitsch RG, Dumith SC. Is food environment associated with body mass index, overweight and obesity? A study with adults and elderly subjects from southern Brazil. Prev Med Rep 2021; 21:101313. [PMID: 33604235 PMCID: PMC7876564 DOI: 10.1016/j.pmedr.2021.101313] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 12/17/2020] [Accepted: 12/20/2020] [Indexed: 11/20/2022] Open
Abstract
Proximity to food establishments had few associations with body mass index. Living near a street fair was associated with a higher body mass index. Living near a convenience store was associated with a higher body mass index. Living near a restaurant was associated with lower body mass index. Living near a fruit shop was associated with lower body mass index.
The purpose of this article was to investigate the association of food environment variables with Body Mass Index (BMI), excess weight and obesity. This was a cross-sectional study determining the presence or absence of food establishments within a 100-m buffer zone from each sampled household. Individuals aged 18 years and older living in the urban area of Rio Grande, RS State, Brazil, in 2016, were considered eligible. A total of 1,139 individuals, with an average age of 46.5 years (SD 17.1), residing in the household for more than one year, were selected as a representative sample of the population. The mean BMI of study participants was 27.0 kg/m2 (SD 4.8), and the prevalence of excess weight and obesity was 61.6% (95%CI: 58.9; 64.3) and 23.7% (95%CI: 21.3; 26.1), respectively. Living near a convenience store was associated with a higher BMI and a higher likelihood of being above normal weight and obese. In contrast, living near a restaurant was associated with a lower BMI and a lower likelihood of being above normal weight and obese. In addition, participants who lived close to fruit shops had lower BMI and a lower likelihood of being above normal weight. Concluding few associations were found between food environment and the health-related outcomes. Proximity to food establishments does not seem to significantly affect BMI, excess weight and obesity in the studied population.
Collapse
Affiliation(s)
- Renata G. Paulitsch
- Graduate Program in Health Sciences, Federal University of Rio Grande, 102 Visconde de Paranaguá St., Room 418, 96203-900 Rio Grande, RS, Brazil
- Corresponding author at: 441 General Câmara St., Centro, Rio Grande, 96200-320, RS, Brazil.
| | - Samuel C. Dumith
- Graduate Program in Health Sciences, Federal University of Rio Grande, 102 Visconde de Paranaguá St., Room 418, 96203-900 Rio Grande, RS, Brazil
- Graduate Program in Public Health, Federal University of Rio Grande, 102 Visconde de Paranaguá St., Fourth Floor, 96203-900 Rio Grande, RS, Brazil
| |
Collapse
|
9
|
Mendes LL, Pessoa MC, Duarte CK. Comments on the Article: "Food Environment Research in Low- and Middle-Income Countries: A Systematic Scoping Review". Adv Nutr 2020; 11:1044-1045. [PMID: 32666112 PMCID: PMC7360444 DOI: 10.1093/advances/nmaa018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Larissa Loures Mendes
- From the Department of Nutrition, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Milene Cristina Pessoa
- From the Department of Nutrition, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Camila Kümmel Duarte
- From the Department of Nutrition, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil (CKD, e-mail: )
| |
Collapse
|
10
|
Affiliation(s)
- Christopher Turner
- From the Natural Resources Institute, University of Greenwich, Food and Markets Department, Chatham Maritime, United Kingdom
| | - Suneetha Kadiyala
- London School of Hygiene and Tropical Medicine, Faculty of Epidemiology and Population Health, London, United Kingdom
| |
Collapse
|
11
|
Carvalho BGCD, Andrade ACDS, Andrade RGD, Mendes LL, Velasquez-Melendez G, Xavier CC, Proietti FA, Caiaffa WT. Densidade de estabelecimentos que comercializam bebidas alcoólicas na área residencial está associada ao consumo de álcool em adolescentes? REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2020; 23:e200089. [DOI: 10.1590/1980-549720200089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 01/30/2020] [Indexed: 11/22/2022] Open
Abstract
RESUMO: Objetivos: Investigar a associação entre a densidade de estabelecimentos de venda de bebidas alcoólicas no entorno da residência dos adolescentes e a prevalência de consumo de álcool na vida e atual, ajustado por fatores individuais e familiares. Métodos: As informações provêm da pesquisa domiciliar por amostragem probabilística estratificada e por conglomerados em três estágios (setor censitário, domicílio, adulto e adolescente), realizada em Belo Horizonte, Brasil (Saúde em Beagá, 2008-9) e de fontes oficiais de estabelecimentos que comercializam bebidas alcoólicas, devidamente georreferenciados. O desfecho foi o autorrelato de consumo de álcool na vida e atual pelos adolescentes. A variável de exposição foi a densidade de estabelecimentos definida como número de locais de venda de bebida dentro do buffer de 200 metros da residência dos adolescentes. A associação foi estimada pela regressão de Poisson ajustada por fatores individuais e familiares. Resultados: Participaram 601 adolescentes de 14-17 anos; 53,3% eram homens e 71% tinham renda familiar até cinco salários mínimos. A prevalência de consumo de álcool na vida foi de 57,0% (intervalo de confiança de 95% - IC95% 51,5 - 62,6) e o atual de 11,9% (IC95% 8,7 - 15,0). Na análise multivariada, verificou-se associação significativa entre o consumo atual de bebidas alcoólicas e a densidade de lanchonetes (razão de prevalência - RP = 1,13; IC95% 1,03 - 1,24), bares (RP = 1,21; IC95% 1,05 - 1,38) e restaurantes (RP = 1,11; IC95% 1,02 - 1,21). Interações significativas entre densidade de estabelecimentos com sexo e idade foram encontradas. Conclusão: O consumo atual de álcool pode ser potencializado pela presença de alguns tipos de estabelecimentos localizados no buffer de 200 metros da residência dos adolescentes.
Collapse
|
12
|
Backes V, Bairros F, Cafruni CB, Cummins S, Shareck M, Mason K, Dias-da-Costa JS, Olinto MTA. Food environment, income and obesity: a multilevel analysis of a reality of women in Southern Brazil. CAD SAUDE PUBLICA 2019; 35:e00144618. [PMID: 31483048 DOI: 10.1590/0102-311x00144618] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 04/02/2019] [Indexed: 11/22/2022] Open
Abstract
The objective of this study was to explore relationships between the neighborhood food environment and obesity in urban women living in São Leopoldo, Rio Grande do Sul State, Brazil. A cross-sectional survey was carried out. This study was conducted with 1,096 women. Structured interviews were conducted using a standard pre-tested questionnaire. Obesity was defined as body mass index (BMI) ≥ 30kg/m2. Circular buffers of 400m in radius were created based on the centroid of the women's houses who participated, in the 45 census tracts inhabited by them. Neighborhood food establishments were identified through systematic survey of all streets in the study areas and geographical coordinates of shops were collected. Establishments were evaluated using the NEMS tool. The prevalence of obesity was 33% among the women participants. After adjusting for individual variables, supermarkets and healthy food establishments were positively associated with obesity, PR = 1.05 (95%CI: 1.01-1.10), PR = 1.02 (95%CI: 1.00-1.04), respectively, while mean buffer income was negatively associated, PR = 0.64 (95%CI: 0.49-0.83). Neighborhood food environment factors were associated with obesity even after controlled for individual variables, as socioeconomic variables, behavioral and food purchase.
Collapse
Affiliation(s)
- Vanessa Backes
- Universidade do Vale do Rio dos Sinos, São Leopoldo, Brasil.,Prefeitura Municipal de São Leopoldo, São Leopoldo, Brasil
| | | | | | - Steven Cummins
- London School of Hygiene & Tropical Medicine, London, U.K
| | | | - Kate Mason
- London School of Hygiene & Tropical Medicine, London, U.K
| | | | | |
Collapse
|
13
|
Silva FMOD, Novaes TG, Ribeiro AQ, Longo GZ, Pessoa MC. [Environmental factors associated with obesity in the adult population in a medium-sized Brazilian city]. CAD SAUDE PUBLICA 2019; 35:e00119618. [PMID: 31141028 DOI: 10.1590/0102-311x00119618] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 01/24/2019] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to estimate associations between environmental variables and obesity in the adult population in a medium-sized Brazilian city. This was a cross-sectional study with individual data from a population-based study and environmental data obtained by direct observation, later georeferenced by the addresses. The sample included 965 adults 20 to 59 years of age, and the study used anthropometric, socioeconomic, demographic, behavioral, and self-rated health data. The outcome variable was obesity, defined as body mass index (BMI) ≥ 30kg/m2. Retail food outlets were classified as: supermarkets and establishments with a predominance of healthy, unhealthy, and mixed foods. Settings for physical activity were categorized as public and private. Characterization of the social environment used the census tracts' per capita income in tertiles and the crime rate. Binary logistic regression analysis was performed according to the generalized estimating equations model. An inverse association was found between density of public and private locations for physical activity and obesity (OR = 0.95, 95%CI: 0.92-0.99; OR = 0.98, 95%CI: 0.97-0.99) in models adjusted by individual and environmental variables. In all the models, the highest per capita income tertile was inversely associated with obesity (p ≤ 0.05). The food environment and crime rates were not independently associated with obesity. These findings suggest that the census tract's income and its environment for physical activity can orient public policies to decrease obesity in this city.
Collapse
|
14
|
Kim A, Choi M. Factors Influencing the Diagnosis and Treatment of Latent Tuberculosis among Contacts in Congregated Settings in Korea. J Korean Med Sci 2019; 34:e138. [PMID: 31074252 PMCID: PMC6509364 DOI: 10.3346/jkms.2019.34.e138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 04/30/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND This study aimed to compare the indicators (the rates of diagnosis, need for treatment, treatment initiation, and treatment completion) of management of latent tuberculosis infection (LTBI) in contacts and to identify the impact of active tuberculosis (TB) index case characteristics on the exposed population in congregated settings, such as schools, workplaces, and medical institutes. METHODS The data of 8,648 clusters in the TB epidemiological investigation database between 2013 and 2016 were extracted and analyzed to evaluate the indicators and perform multilevel logistic regression (MLR) analyses to identify the factors affecting each indicator. RESULTS The rates of total LTBI diagnosis, need for treatment, treatment initiation, and treatment completion were 15.2%, 10.2%, 69.4%, and 76.6%, respectively. After adjusting for other factors on MLR, the probability of diagnosis and need for treatment of latent TB in contacts was higher in most types of facilities than in schools. Conversely, treatment completion rates in these facilities were lower. Notably, the correctional institutions showed the highest odds ratio (OR) relative to school for LTBI diagnosis (OR, 6.37) and need for treatment (OR, 4.49) and the lowest OR for treatment completion (OR, 0.10). CONCLUSION This study provided evidence for the implementation of latent TB control policies in congregated settings.
Collapse
Affiliation(s)
- Ahreum Kim
- Regional Center for Respiratory Diseases, Pusan National University Hospital, Busan, Korea
| | - Minhyeok Choi
- Regional Center for Respiratory Diseases, Pusan National University Hospital, Busan, Korea.
| |
Collapse
|
15
|
Obesity and Urban Environments. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16030464. [PMID: 30764541 PMCID: PMC6388392 DOI: 10.3390/ijerph16030464] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 02/02/2019] [Indexed: 12/25/2022]
Abstract
Obesity is a major public health issue, affecting both developed and developing societies. Obesity increases the risk for heart disease, stroke, some cancers, and type II diabetes. While individual behaviours are important risk factors, impacts on obesity and overweight of the urban physical and social environment have figured large in the recent epidemiological literature, though evidence is incomplete and from a limited range of countries. Prominent among identified environmental influences are urban layout and sprawl, healthy food access, exercise access, and the neighbourhood social environment. This paper reviews the literature and highlights the special issue contributions within that literature.
Collapse
|
16
|
Corvalán C, Garmendia ML, Jones-Smith J, Lutter CK, Miranda JJ, Pedraza LS, Popkin BM, Ramirez-Zea M, Salvo D, Stein AD. Nutrition status of children in Latin America. Obes Rev 2017; 18 Suppl 2:7-18. [PMID: 28741907 PMCID: PMC5601284 DOI: 10.1111/obr.12571] [Citation(s) in RCA: 125] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 05/03/2017] [Indexed: 12/30/2022]
Abstract
The prevalence of overweight and obesity is rapidly increasing among Latin American children, posing challenges for current healthcare systems and increasing the risk for a wide range of diseases. To understand the factors contributing to childhood obesity in Latin America, this paper reviews the current nutrition status and physical activity situation, the disparities between and within countries and the potential challenges for ensuring adequate nutrition and physical activity. Across the region, children face a dual burden of undernutrition and excess weight. While efforts to address undernutrition have made marked improvements, childhood obesity is on the rise as a result of diets that favour energy-dense, nutrient-poor foods and the adoption of a sedentary lifestyle. Over the last decade, changes in socioeconomic conditions, urbanization, retail foods and public transportation have all contributed to childhood obesity in the region. Additional research and research capacity are needed to address this growing epidemic, particularly with respect to designing, implementing and evaluating the impact of evidence-based obesity prevention interventions.
Collapse
Affiliation(s)
- C Corvalán
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - M L Garmendia
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - J Jones-Smith
- Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA
| | | | - J J Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - L S Pedraza
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - B M Popkin
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - M Ramirez-Zea
- INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama, Guatemala
| | - D Salvo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico.,Michael and Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston, School of Public Health, Austin Campus, Austin, TX, USA
| | - A D Stein
- Hubert Department of Global Health of the Rollins School of Public Health, Emory University, Atlanta, GA, USA
| |
Collapse
|
17
|
Yang T, Yu L, Barnett R, Jiang S, Peng S, Fan Y, Li L. Contextual influences affecting patterns of overweight and obesity among university students: a 50 universities population-based study in China. Int J Health Geogr 2017; 16:18. [PMID: 28482842 PMCID: PMC5423012 DOI: 10.1186/s12942-017-0092-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 04/27/2017] [Indexed: 01/20/2023] Open
Abstract
Background Many studies have examined childhood and adolescent obesity, but few have examined young adults and the effect of their home and current living environments on prevalence rates. The present study explores contextual factors affecting overweight and obesity among university students in China and, in particular, focuses on how the SES–obesity relationship varies across different geographical contexts. Methods Participants were 11,673 students, who were identified through a multistage survey sampling process conducted in 50 universities. Individual data was obtained through a self-administered questionnaire, and contextual variables were retrieved from a national database. Multilevel logistic regression models were used to examine urban and regional variations in overweight and obesity. Results Overall the prevalence of overweight and obesity in the study sample was 9.5% (95% CI 7.7, 11.3%). After controlling for individual factors, both attributes of the home location (regional GDP <gross domestic product> per capita and rurality) and the current university location (city population) were found to be important, thus suggesting that the different origins of students affect current levels of obesity. At the individual level, while students with more financial resources were more likely to be obese, the extent of this relationship was highly dependent upon area income and city size. Conclusion The results of this study add important insights about the role of contextual factors affecting overweight and obesity among young adults and indicate a need to take into account both past as well as present environmental influences when considering the role of contextual factors in models of the nutrition transition.
Collapse
Affiliation(s)
- Tingzhong Yang
- Department of Social Medicine/Center for Tobacco Control Research, Zhejiang University School of Medicine, Hangzhou, 310058, China.
| | - Lingwei Yu
- Department of Social Medicine/Center for Tobacco Control Research, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Ross Barnett
- Department of Geography, University of Canterbury, Private Bag 4800, Christchurch, New Zealand
| | - Shuhan Jiang
- Department of Social Medicine/Center for Tobacco Control Research, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Sihui Peng
- Department of Social Medicine/Center for Tobacco Control Research, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Yafeng Fan
- Department of Nursing, Hangzhou Normal University, Hangzhou, 310036, China
| | - Lu Li
- Institute of Family and Social Medicine, Zhejiang University School of Medicine, Hangzhou, 310058, China
| |
Collapse
|
18
|
Menezes MC, Costa BVL, Oliveira CDL, Lopes ACS. Local food environment and fruit and vegetable consumption: An ecological study. Prev Med Rep 2017; 5:13-20. [PMID: 27872803 PMCID: PMC5114690 DOI: 10.1016/j.pmedr.2016.10.015] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 08/31/2016] [Accepted: 10/27/2016] [Indexed: 12/27/2022] Open
Abstract
Ecological studies are essential for understanding the environment-diet relationship. The purpose of this study was to describe environmental conditions and their relationship with fruit and vegetable (FV) consumption among Brazilian public health service users in the city of Belo Horizonte. We evaluated food stores contained within 1600 m buffer zones at 18 Health Academy Programme sites, from 2013 to 2014. Variables at the community (density, proximity and type) and the consumer (sectional location of FV; availability, quality, variety, price and advertising of FV and ultra-processed foods) nutrition environment were measured by direct observation, while aggregate data from users (income and FV consumption) were obtained by interview. Data were analysed using the Kernel intensity estimator, average nearest neighbour value and Local Moran's Index for local spatial autocorrelation. We interviewed 3414 users and analysed 336 food stores. Major geographical variations in the FV consumption were identified. Average consumption was higher (site 2A: 410.5 ± 185.7 g vs. site 4B: 311.2 ± 159.9 g) in neighbourhoods with higher income and concentration of food stores, and better index of access to healthy foods. Sites with poor FV consumption had the most stores with poor access to healthy foods (index in the first tertile, ≤ 10). In conclusion, negative characteristics of the food environment, as seen in the present study, may contribute to low FV consumption, suggesting the need for the development and consolidation of public policies aimed at creating healthy environments through built environment interventions that increase access to and consumption of healthy foods like FV.
Collapse
Affiliation(s)
- Mariana Carvalho Menezes
- Department of Nutrition, Nursing School, Federal University of Minas Gerais, Avenida Alfredo Balena, 190, Room 316, Belo Horizonte, Minas Gerais 30130-100, Brazil
| | - Bruna Vieirade Lima Costa
- Department of Nutrition, Nursing School, Federal University of Minas Gerais, Avenida Alfredo Balena, 190, Room 316, Belo Horizonte, Minas Gerais 30130-100, Brazil
| | - Cláudia Di Lorenzo Oliveira
- Department of Medicine, Campus Midwest, Federal University of Sao Joao del-Rei, Rua Sebastião Goncalves Coelho, 400, Divinópolis, Minas Gerais 35501-296, Brazil
| | - Aline Cristine Souza Lopes
- Department of Nutrition, Nursing School, Federal University of Minas Gerais, Avenida Alfredo Balena, 190, Room 316, Belo Horizonte, Minas Gerais 30130-100, Brazil
| |
Collapse
|