Cardiovascular risk factors in a Brazilian rural population

Self-rated health status and associated factors in rural workers

BACKGROUND

Self-rated health status can be considered a good predictor of morbidity and mortality and has been used due to its easy assessment and applicability. The instrument is efficient for understanding sociodemographic, environmental and clinical conditions that may be related to the self-rated health status. Thus, this study aims to analyze the self-assessment of health status in rural workers and its association with socioeconomic characteristics, lifestyle, clinical condition and work characteristics.

METHODS

This is a cross-sectional study carried out with 787 male and female rural reporting agriculture as their main source of income in the municipality of Santa Maria de Jetibá. A simple and direct question was used "In general, compared to people your age, how do you rate your own state of health?" to see how rural workers rate their current health status. The independent variables analyzed were socioeconomic, clinical, health and work conditions. The magnitude of the associations was evaluated by means of hierarchical logistic regression.

RESULTS

It was found that 42.1% of rural workers self-rated their health status as regular or poor. Belonging to socioeconomic classes C (OR = 1.937; 95% CI = 1.009-3.720) or D/E (OR = 2.280; 95% CI = 1.178-4.415), being overweight (or having excess weight) (OR = 1.477; 95% CI = 1.086-2.008), multimorbidity (OR = 1.715; 95% CI = 1.201-2.447) and complex multimorbidity (OR = 1.738; 95% CI = 1.097-2.751) were risk factors for worse self-rated health.

CONCLUSION

It was concluded that chronic diseases, socioeconomic status and overweight are risk factors for negative self-rated health. The identification of these determinants through self-rated status can support the planning of actions aimed at improving the health of the rural population.

TRIAL REGISTRATION

This study was approved by the Research Ethics Committee of the Health Sciences Center of the Federal University of Espírito Santo (Protocol No. 2091172; CAAE No. 52839116.3.0000.5060). All research participants gave their informed consent.

Cardiovascular risk factors across different levels of urbanization in Brazilian Afro‐derived communities ( quilombos )

OBJECTIVES

The frequency of cardiovascular diseases has increased throughout the world. People of African descent have been disproportionately affected, particularly if they reside in urban settings. In this work, we evaluate risk factors associated with cardiovascular diseases (CVD) and other chronic diseases in rural and urban Afro-derived communities (quilombo) in Central Brazil. We also determine if there are associations between the frequency of CVD risk factors, sex, and proximity to urban environments.

METHODS

Through a cross-sectional study of participants (n = 347) within three Brazilian Afro-derived communities: Kalunga (a semi-isolated rural community; n = 214), Cocalinho (a non-isolated rural village; n = 70), and Pé do Morro (an urban community; n = 63), we collected data regarding chronic disease (i.e., CVD, diabetes, and hypertension) risk through questionnaires, anthropometrics, blood pressure, and blood samples using standard protocols. Differences between variables were tested by the Chi-square test of Pearson and Fisher's Exact Test, independent sample t-tests, analysis of variances, and Kruskal-Wallis tests (p ≤ .05).

RESULTS

The prevalence of hypertension, overweight, obesity, and other cardiovascular risk factors were higher in the non-isolated rural and urban communities than in the semi-isolated rural community. We found significant sex differences in the distribution of the CVD risk factors, with all occurring at a higher frequency among females.

CONCLUSIONS

Our findings indicate that Brazilian Afro-derived communities are currently going through an epidemiological transition. The urban lifestyle and its environmental factors are likely contributing to an escalation in cardio-metabolic disease risk. However, the magnitude of this transition differentially impacts the sexes, as females suffer a higher frequency of risk factors compared to males.

Cut Points of the Conicity Index and Associated Factors in Brazilian Rural Workers

(1) Background: Metabolic syndrome is associated with cardiovascular complications. Therefore, this study aims to establish cut points for the conicity index based on the components of metabolic syndrome and to associate it with characteristic sociodemographic, food consumption and occupational factors in Brazilian rural workers; (2) Methods: A cross-sectional study carried out with farmers. The receiver operating characteristic curve was calculated and the cut-off points for the conicity index were identified by the area under the curve, sensitivity and specificity. The variables included in the binary logistic regression analysis were selected by considering p < 0.20 in the bivariate test; (3) Results: The cut points were similar in females according to both criteria, resulting in a single cut-off of 1.269. In males, the cut points showed differences, resulting in 1.272 according to the NCEP-ATP III and 1.252 according to the IDF. We have shown that younger people, those who work more than 40 h a week and the lowest contribution of culinary ingredients are associated with increased odds of abdominal obesity, while the consumption of the products they sell or produce decreases these chances; (4) Conclusions: The conicity index showed high discriminatory power for the identification of abdominal obesity in rural workers. Therefore, there is a need to improve eating habits and promote healthier eating environments for individuals, respecting traditional food culture, mainly to contain the advance of MS in rural areas.

The impact of essential and toxic elements on cardiometabolic risk factors in adults and older people

BACKGROUND AND AIM

Evidence suggests an association between essential and toxic elements and the worsening of cardiometabolic risk factors. This study aimed to investigate the concentrations of zinc, copper, selenium, arsenic, cadmium, and mercury and their relationship with cardiometabolic risk factors in adults and older people.

METHODS

This cross-sectional study was carried out with 112 adults with a mean age of 59 (sd 14) years old and a BMI of 29.30 (sd 5.11) Kg/m². The subject's weight and height were measured for body mass index (BMI) calculation, classified according to the cut-off points recommended by the World Health Organization (WHO). We evaluated sociodemographic, clinical, lifestyle, waist circumference - WC, visceral adiposity index - VAI, glycemic lipid profile, blood pressure, and high-sensitive C-reactive protein (hs-CRP). Cardiovascular risk was defined by The Global Risk Score (GRS) score. Plasma zinc, selenium, copper levels, urinary arsenic, cadmium, and mercury levels were measured using the inductively coupled plasma mass spectrometry technique (ICP-MS).

RESULTS

There was a negative association between urinary arsenic and VAI (β - 0.03, p < 0.01), triglycerides (β - 1.10, p < 0.01), and VLDL cholesterol (β - 0.14, p = 0.02). Plasma copper and copper/zinc ratio were positively associated with fasting glucose and hs-CRP (β 0.38, p < 0.01; β 36.02, p = 0.01, β 0.004, p < 0.01, β 0.68, p < 0.001, respectively). Urinary arsenic (β - 0.14, p = 0.04) and cadmium (β - 36.42, p = 0.04) were negatively associated with systolic blood pressure. Also, urinary cadmium was negatively associated with diastolic blood pressure (β - 21.55, p = 0.03), and urinary mercury showed an opposite behavior (β 1.45, p = 0.03).

CONCLUSION

Essential and toxic elements in urine and plasma could be potential biomarkers for cardiovascular risk factors. A healthy lifestyle should be adopted; in addition, government policies should be developed to guarantee sustainable production and a safe environment.

Cardiovascular risk behavior among industrial workers in the Northeast of Brazil: a cluster analysis

This research aimed to investigate the occurrence of clusters of cardiovascular risk behaviors and their association with social demographic and occupational characteristics in a population of industrial workers in the metropolitan area of Recife, Brazil. It was a transversal study with 727 workers of both genders. We identified cluster distribution from the variables: smoking, alcohol consumption, physical activity and waist circumference, by a combination of hierarchical and non-hierarchical analysis. We later tested the association with the social demographic and occupational variables with a multi-varied analysis. We have identified a protection cluster (sufficient physical activity, moderate alcohol consumption) and a risk cluster (high waist circumference, sedentarism, smoking, excessive alcohol consumption). The protection cluster was positively associated with night shift or variable shift work (RP: 1.66, IC95%: 1.26-2.17), and the risk cluster was associated with women (RP: 1.15, IC95%: 1.01-1.31). Cluster analysis allowed to identify that, for day shift workers and women, the shortest daytime outside the work environment can influence the adoption of cardiovascular risk behaviors.

Energy contribution of NOVA food groups and the nutritional profile of the Brazilian rural workers' diets

We estimated the caloric contribution of minimally processed foods, processed culinary ingredients, processed foods and ultra-processed foods in Brazilian farmers' diets and their association with the nutritional profile of the diet. It is an epidemiological study of cross-sectional, analytical and quantitative design with 740 farmers adults of Southeastern Brazil. Food intake data were obtained by applying three 24-hour recalls and were classified according to the degree and purpose of processing. The largest caloric contribution came from the group of minimally processed foods (64.7%), followed by ultra-processed foods (17.7%), processed culinary ingredients (12.4%), and processed foods (5.2%). Individuals in the fourth quartile of caloric contribution from minimally processed foods showed lower energy consumption (β -0.16, P<0.001) and greater consumption of all 15 micronutrients analyzed. In contrast to what was identified for this food group, the higher caloric contribution from ultra-processed foods was associated with a greater caloric content of the diet (β 0.17, P<0.001) and lower consumption of all 23 analyzed nutrients. Therefore, the caloric contribution from the consumption of ultra-processed foods in the rural area is still lower than the national average. However, measures aimed at delaying isocaloric exchanges for the group of ultra-processed foods must be carried out, maintaining the local food culture, since this group had worse nutritional levels. In addition, incentives to the greater consumption of minimally processed foods should be carried out, due to their nutritional quality.