[Aggregation of cardiovascular risk factors: alcohol, smoking, excess weight, and short sleep duration in adolescents in the ERICA study]

The Interactions between Smoking and Sleep

Smoking a cigarette before bed or first thing in the morning is a common habit. In this review, the relationship between smoking and sleep is investigated based on the existing literature. Out of 6504 unique items that were identified via a PubMed search related to smoking and sleep, 151 were included in this review. Tobacco smoking disrupts sleep architecture by reducing slow wave and rapid eye movement (REM) sleep and undermining sleep quality. Furthermore, smoking affects sleep-related co-morbidities, such as obstructive sleep apnea-hypopnea syndrome (OSAHS), insomnia, parasomnias, arousals, bruxism, and restless legs, as well as non-sleep-related conditions such as cardiovascular, metabolic, respiratory, neurologic, psychiatric, inflammatory, gynecologic and pediatric issues, while poor sleep quality also seems to worsen the chances of successful smoking cessation. In conclusion, the existing literature suggests that there is a wicked relation between smoking and sleep.

Social vulnerability and cardiovascular risk factors in adolescents

BACKGROUND

Social vulnerability can influence in the development of cardiovascular risk factors in adolescents (CRF). For this reason, the objective of our study was to evaluate the presence of CRF in adolescents, according to social vulnerability.

METHODS

This is a cross-sectional study with 517 adolescents of both sexes, from 10 to 19 years of age, classified into 2 groups by social vulnerability, according to socioeconomic characteristics collected by means of questionnaires, where adolescents who did not have access to drinking water, sewage network, and adequate per capita income were classified as vulnerable. Anthropometric, biochemical, and blood pressure data were evaluated. Level of physical activity was assessed by an adapted questionnaire, and food intake was assessed by a 3-day food record. Independent T, Mann-Whitney, and χ2 tests were used, according to the scale of measurement of the variables, on the statistical program SPSS, version 25, at a significance level of 5%.

RESULTS

Adolescents had median age of 14 (11 to 15) years; 58.4% were female; 32.4% were overweight, and 52.4% were physically inactive in leisure. Mean consumption of ultra-processed food was observed to account for 45.0% of calorie intake. Adolescents classified as vulnerable had lower weight, body mass index, waist circumference, hip circumference, and neck circumference when compared to non-vulnerable adolescents. Both groups had cholesterol concentrations above the normal level. Non-vulnerable adolescents had higher triglyceride concentrations, higher alcohol consumption, and lower fiber intake compared to vulnerable adolescents.

CONCLUSIONS

Adolescents with social vulnerability are less likely to have cardiovascular risk factors.

Abusive Consumption of Alcoholic Beverages and Associated Factors in Brazilian University Students

The university is considered an environment that favors the initiation and use of substances, especially those that are legal, such as alcohol. This consumption can be differentiated in university students, which makes it necessary to better understand this behavior. Taking into account these aspects, we analyzed the abusive consumption of alcoholic beverages in university students and its association with socioeconomic and behavioral factors. We conducted a cross-sectional study with regularly enrolled students. We assessed the abusive consumption of alcoholic beverages using the binge drinking pattern. We collected socioeconomic and behavioral data using a questionnaire. The association between the variables was verified using logistic regression. Abusive consumption of alcoholic beverages was high, with a high weekly frequency. The association with sociodemographic and behavioral factors can increase the health risk. Education campaigns within institutions with students in the classroom and with all those who can influence these students are important. As there are few studies that consider other health risk factors that have not been analyzed yet, such as those treated in our study, with the abusive consumption of alcoholic beverages, this study seeks to contribute to the knowledge of the relationships between these variables and in the elaboration of actions aimed at improving the lifestyle and health of university students.

Cardiovascular health in nursing and medical students

OBJECTIVE

To verify whether nursing and medical students take measures regarding their cardiovascular health and the associated risk factors.

METHOD

Cross-sectional study, online data collection with 413 students in February and March 2021, using specific and validated instruments. Kruskal-Wallis, chi-square and logistic regression were adopted for statistical analyses.

RESULTS

73.3% self-reported that they were healthy. We identified a higher risk for developing cardiovascular diseases in sedentary students (OR = 38.6, p < 0.001), with irregular adherence to physical activity (OR = 16.2, p < 0.001) and with a higher level of perceived stress (OR = 1.12, p < 0.001).

CONCLUSION

Students who take action to promote cardiovascular health showed lower risk compared to those who did not. If students do not value their own health during the education process, this may interfere with their professional performance after graduation.

Diet quality and associated factors in Brazilian undergraduates during the COVID-19 pandemic

Background

Diet quality is associated with psychobiological, psychological, biological, and physiological factors of individuals, and in the context of prolonged stress, such as the COVID-19 pandemic, it can lead to a worsening of the quality of food for undergraduates. This study aimed to analyze diet quality and associated factors in Brazilian undergraduates.

Methods

Data were collected from 4,799 undergraduate students from all Brazilian regions, from August 2020 to February 2021. The online questionnaire contained socioeconomic variables, the ESQUADA scale to assess diet quality, self-referred changes in weight, the Brazilian food insecurity scale (EBIA), sleep assessment and the perceived stress scale. Unconditional multiple logistic regression analysis was performed to study variables associated with poor and very poor diet quality.

Results

Most of participants presented a good diet quality (51.7%), while 9.8% had a poor or very poor diet quality and only 1.1% had an excellent diet quality. 58.2% of undergraduates reported to have an increase in weight during the pandemic and 74.3% of the students presented elevated stress during the pandemic. Logistic regressions showed students who gained weight during the pandemic presented the highest AOR = 1.56 (95% CI = 1.12-2.20) for poor or very poor diet quality. The elevated perceived stress was also associated with a higher AOR = 2.85 (95% CI = 1.71-4.74) for poor or very poor diet quality.

Conclusion

Most of the studied undergraduates presented a good diet quality. Nevertheless, poor/very poor diet quality was associated with higher perceived stress and weight gain. Our study indicated that policies should beaimed at the socioeconomically most vulnerable undergraduates, those in a situation of food and nutritional insecurity, high perceived stress, and who gained weight during the pandemic.

A saúde mental dos adolescentes brasileiros

Objetivo: descrever as prevalências dos indicadores de saúde mental entre os escolares brasileiros. Método: estudo transversal com dados da Pesquisa Nacional de Saúde do Escolar (PeNSE) de 2019. Estimou-se as prevalências e intervalos de confiança de 95% (IC95%) dos indicadores de saúde mental dos adolescentes brasileiros de 13 a 17 anos, segundo idade, sexo, dependência administrativa da escola e Unidade da Federação. Resultados: dos 125.123 escolares de 13 a 17 anos investigados, 4,0% (IC95% 3,7-4,3) mencionaram que não tinham amigos próximos; 50,6% (IC95% 49,8-51,4) sentiram-se preocupados com as coisas comuns do dia a dia; 31,4% sentiram-se tristes na maioria das vezes ou sempre; 30,0% (IC95% 29,4 - 30,6) achavam que ninguém se preocupava com eles; 40,9% (IC95% 40,2 - 41,5) ficaram irritados, nervosos ou mal-humorados; 21,4% (IC95% 20,9 - 22,0) sentiam que a vida não vale a pena ser vivida; e 17,7% (IC95% 17,2 - 18,2) apresentou autoavaliação em saúde mental negativa. A maioria desses indicadores foram mais frequentes em escolares de 16 e 17 anos, no sexo feminino e em escolas públicas. Conclusão: evidenciou-se o aumento do sofrimento mental entre os adolescentes brasileiros pelos indicadores de saúde mental da PeNSE edição 2019. Os resultados revelaram relações de desigualdades estruturais de gênero e classe social. É necessário maior investimento em políticas públicas a fim de diminuir as consequências do sofrimento mental entre os adolescentes brasileiros.

Temporal trend of simultaneous risk factors for chronic non-communicable diseases: National School Health Survey 2009, 2012, 2015

OBJECTIVE

To analyze the temporal trend of simultaneous occurrence of behavioral risk factors for chronic non-communicable diseases in Brazilian school adolescents.

METHODS

Ecological time-series study that analyzed data from the three editions of the National Survey of School Health with students in the 9th year of public and private schools. Cluster analysis was performed to identify the simultaneity of the following factors: irregular consumption of fresh or minimally processed foods, regular consumption of processed and ultra-processed foods, insufficient level of physical activity during leisure time, consumption of alcoholic beverages, use of cigarettes and illicit drugs. The cluster trend was tested using simple linear regression.

RESULTS

The sample was composed of 173,310 school adolescents. Sixty-four possible combinations were evaluated, resulting in the formation of six clusters. The grouping formed by all factors showed the highest ratios observed/expected prevalence in the last two years of the series. The highest ratios were observed for combinations in which alcohol and cigarettes were present. These substances integrated five of the six clusters. One of the groups (insufficient level of physical activity during leisure time + consumption of alcoholic beverages + use of cigarettes and illicit drugs) had an upward trend throughout the series.

CONCLUSION

The trend analysis showed four out of six clusters remaining stable throughout the series, which shows that the factors are persistently present among school adolescents.

Prevalence and correlates of meeting physical activity, screen time and sleep duration guidelines among Brazilian adolescents: findings from ERICA

The prevalence of meeting movement guidelines is low in developed countries; however there is a lack of data among medium-income countries, including Brazil. We evaluated the prevalence and correlates of meeting physical activity, screen time, and sleep guidelines in Brazilian adolescents. Employing a cross-sectional design, Brazilian adolescents (aged 12-17) were surveyed about their physical activity levels, sleep, and screen time. The data was collected at schools through a self-administered questionnaire using a Personal Digital Assistant for entering the data. Poisson regression models were used to examine the associations between correlates (sex, age, socioeconomic status, region, skin colour and shift of school) and meeting movement guidelines. A total of 58,535 adolescents were included. Although only 8.7% of adolescents met all three movement guidelines, the prevalence of those who met physical activity, screen time and sleep duration guidelines was 46.4%, 42.5% and 40%, respectively. Moreover, male sex, age 14-15 years old, non-white skin colour, afternoon shift of school and living in the Northern and Northeastern regions were associated with a higher prevalence of meeting all movement guidelines. The prevalence of adolescents who met all three movement guidelines was low among Brazilian adolescents. Adolescents living in less developed regions show greater adherence to movement guidelines, suggesting a possible impact of the urbanization process on these behaviours. Novelty bullets: - The prevalence of Brazilian adolescents whom met all three movement behaviours guidelines was around 9%. - Among all adolescents, 40% met only one movement guideline.

Tendência temporal dos fatores de risco simultâneos para doenças crônicas não transmissíveis: Pesquisa Nacional de Saúde do Escolar 2009, 2012, 2015

RESUMO: Objetivo: Analisar a tendência temporal da ocorrência simultânea de fatores de risco comportamentais para doenças crônicas não transmissíveis em adolescentes escolares brasileiros. Métodos: Estudo ecológico de série temporal, que analisou os dados das três edições da Pesquisa Nacional de Saúde do Escolar dos alunos do 9º ano de escolas públicas e privadas. Realizou-se a análise de cluster para a identificação da simultaneidade dos seguintes fatores: consumo irregular de alimentos in natura ou minimamente processados, consumo regular de alimentos processados e ultraprocessados, nível insuficiente de atividade física no lazer, consumo de bebidas alcoólicas, uso de cigarro e de drogas ilícitas. A tendência dos clusters foi testada utilizando-se regressão linear simples. Resultados: A amostra constituiu-se de 173.310 escolares. Sessenta e quatro possíveis combinações foram avaliadas, havendo a formação de seis clusters. O agrupamento formado por todos os fatores apresentou as maiores razões entre prevalências observadas e esperadas para os dois últimos anos da série. As maiores razões foram verificadas para as combinações em que estavam presentes o álcool e o cigarro. Além disso, essas substâncias integraram cinco dos seis clusters. Um dos agrupamentos (nível insuficiente de atividade física no lazer + consumo de bebidas alcóolicas + uso de cigarro e drogas ilícitas) apresentou tendência crescente durante toda a série. Conclusão: A análise de tendência constatou que quatro de seis clusters mantiveram-se estáveis durante toda a série, demonstrando que os fatores continuam presentes de forma persistente entre os adolescentes escolares.

[Sleep duration, overweight and consumption of ultra-processed foods among adolescents]

The scope of this article is to analyze the relationship between insufficient sleep duration, overweight/obesity and the consumption of ultra-processed foods among adolescents aged 10 to 14 years. This is a cross-sectional study, with an evaluation of 1,384 adolescents from public schools in João Pessoa-PB, participating in the Longitudinal Study on Sedentary Behavior, Physical Activity, Diet and Adolescent Health (LONCAAFS). Sociodemographic variables, sleep duration, class shift, anthropometric nutritional status, sedentary behavior and food consumption were measured. Linear and logistic regression of the following were performed using Stata 13.0 Software: the prevalence of short sleep duration of 29.5% (<9h/night); a significant association between short sleep duration and excess weight only for adolescents <12 years old. With respect to the relationship between sleep duration and the consumption of ultra-processed foods, the longer the sleep duration, the lower the consumption of snacks by adolescents under 12 years old, with a positive association for ≥12 years old only with adjustment by the physical activity variable. There was no association with the "sugary drinks" and "cookies" groups for any of the age groups analyzed.

Prevalence of overweight and obesity in Brazilian children and adolescents: a systematic review

abstract It is important to know about overweight and obesity situation of Brazilian children and adolescents. The present study aims to update scientific production, through a systematic review, on the prevalence and factors associated with overweight and obesity in Brazilian children and adolescents. Nine databases were verified, and 1,316 references were examined from 2018 to 2019. The electronic search was conducted by three independent researchers. All review steps followed a strategy based on PRISMA. 40 studies were included in this systematic review. Most studies use the World Health Organization classification criteria. The prevalence of overweight in Brazilian children and adolescents varies from 8.8% to 22.2% (boys: 6.2% to 21%; girls: 6.9% to 27.6%). The prevalence of obesity varied from 3.8% to 24% (boys: 2.4% to 28.9%; girls: 1.6% to 19.4%). It was observed that the socioeconomic factors (sex, skin color, economic level, region, mother's educational level, living in a rented house and without access to the internet), hereditary/genetic (family history of dyslipidemia and overweight and rs9939609 genotype) and behavioral (physical activity, screen time, eating habits, perceived body weight, health vulnerability, presence of a result close to home, alcoholic beverages, cigarette consumption) were associated with the outcome. It is concluded that the prevalence of overweight and obesity among Brazilian children and adolescents are worrisome and most of the factors associated with the outcomes are subject to change from the adoption of a healthy lifestyle.