Tabagismo associado a outros fatores comportamentais de risco de doenças e agravos crônicos não transmissíveis

The association between ultra-processed food consumption and health-related quality of life differs across lifestyle and socioeconomic strata

BACKGROUND

In this prospective study, we aimed to examine the association between ultra-processed foods and health-related quality of life (HRQoL) and to evaluate the effect of lifestyle and socioeconomic factors on this association.

METHODS

This study included 1766 adults (aged 18 to 78, 54.3% women), who took part in the Tehran Lipid and Glucose study. The Short-Form 12-Item Health Survey version 2 was used to determine HRQoL, which includes the physical component summary (PCS) and mental component summary (MCS) scores. Ultra-processed food consumption was assessed using a validated semi-quantitative food frequency questionnaire. Lifestyle (physical activity and smoking status) and socioeconomic factors (education level and employment status) were also determined. General linear models (GLM) were applied to estimate the mean (95% confidence interval) for MCS and PCS scores across the ultra-processed foods tertiles. Additionally, the effect of lifestyle and socioeconomic factors on the relationship between ultra-processed foods and HRQoL was examined using GLM.

RESULTS

The median consumption of ultra-processed foods was 11.9% (IQR: 8.2 to 16.8) of total energy intake. There was a significant inverse association between ultra-processed foods consumption and PCS, but not MCS, after adjustment for confounding factors. Significant interactions were observed between ultra-processed food consumption, sex, and occupation on PCS score (all P values < 0.001). The interaction test tended to be significant for smoking status, education levels, and physical activity levels. As ultra-processed food consumption increased, the PCS score significantly decreased in women (P = 0.043), low physical active subjects (P = 0.014), smokers (P = 0.015), and lower-educated individuals (P = 0.022). Non-employed individuals with higher ultra-processed food intake showed a decline in their PCS and MCS scores. While there was no significant difference in MCS score among different strata of lifestyle and socioeconomic status across tertiles of ultra-processed foods.

CONCLUSIONS

Higher intake of ultra-processed foods was associated with poorer physical health, particularly among women, those with unhealthy lifestyles, and low socioeconomic conditions.

Co-occurrence of Smoking and Unhealthy Diet in the Brazilian Adult Population

BACKGROUND

Smoking and an inadequate diet are behavioral risk factors that contribute to the majority of deaths and disabilities caused by noncommunicable diseases.

OBJECTIVES

To estimate the prevalence of the co-occurrence of smoking and inadequate diet and identify associated factors in adults.

METHODS

A cross-sectional population-based study was conducted with a sample of 28,950 Brazilian adults (18 to 59 years old). Data were obtained from Sistema de Vigilância por Inquérito Telefônico (Vigitel [Brazilian Health Surveillance Telephone Survey]) in 2014. Independent associations were investigated using Poisson hierarchical regression analysis with 5% significance level.

RESULTS

The prevalence of the co-occurrence of smoking and unhealthy eating was 8.6% (95% CI: 7.9-9.3) and was higher among individuals residing in the southern region of the country than in those living in the central western region (PR = 1.50; 95% CI: 1.18-1.89), those with no private health insurance (PR = 1.14; 95% CI: 1.03-1.25), those who drank alcohol abusively (binge drinkers) (PR = 3.22; 95% CI: 2.70-3.85) and those who self-rated their health as fair (PR = 1.65; 95% CI: 1.36-1.99) or poor/very poor (PR = 1.70; 95% CI: 1.18-2.44). The prevalence of both factors was lower among individuals residing in the northeastern region of the country, women, individuals with brown skin color, those with a spouse, the more educated ones and those with overweight or obesity.

CONCLUSION

The more vulnerable segments to the co-occurrence of the risk factors studied were men residing in the southern region of the country, individuals with a lower socioeconomic status and those who reported binge drinking. Interventions addressing multiple behavioral risk factors adapted to specific contexts could have a greater impact on the Brazilian population.

Nutrition status of elderly smokers and former smokers of São Paulo City, Brazil

OBJECTIVES

The concomitance of smoking and poor dietary habits represents a worsened prognosis of health and quality of life for elderly. The aim of this study was to characterize the nutritional status of elderly who were smokers and former smokers and residents of São Paulo city.

METHODS

A cross-sectional study was conducted in 2010 with a representative sample of 1,345 individuals aged 60 years and over, who were part of the elderly cohort monitored at the SABE Study. Sociodemographic, health, and nutritional aspects of the elderly were described, according to their tobacco use in life.

RESULTS

The proportion of smokers and former smokers was 12.9 and 54.7%, 11.0 and 25.2%, and 11.8 and 37.2% for male, female, and total population, respectively. For both genders, increasing age decreased the proportion of smokers. The proportion of proper fruit intake was smaller for female smokers. Poorer nutritional status was observed in smokers, who had fewer meals per day and greater frequency of underweight compared with elderly nonsmokers.

CONCLUSION

Considering the impact of inappropriate eating habits and smoking on health, elderly smokers deserve special attention on their nutritional status.

As atitudes e o conhecimento sobre práticas de vida saudáveis de uma amostra da população de Juiz de Fora

O novo pentáculo do bem-estar refere-se a cinco características do estilo de vida que auxiliam a promoção da saúde individual: níveis de stress, características nutricionais, atividades físicas habituais, comportamento preventivo e qualidade dos relacionamentos humanos. Ao percebermos a dificuldade na alteração do estilo de vida dos pacientes e, também, em atuar na prevenção de doenças ou no seu tratamento, buscamos identificar os obstáculos na mudança para um estilo de vida saudável, além de avaliar hábitos de vida e conhecimento sobre práticas saudáveis. Assim, elaboramos um estudo transversal, descritivo e quantitativo realizado na cidade de Juiz de Fora - MG, coletando-se dados a partir do questionário validado, novo pentáculo do bem-estar, com amostra de 462 indivíduos. A maioria dos entrevistados têm noções dos hábitos saudáveis, com 55,2% da amostra baseando-se em orientações médicas; 93,7% acreditam nos benefícios da mudança de estilo de vida; 92,2% supõe que hábitos saudáveis atuais repercutem no futuro e 53,6% realizam algum tipo de atividade física. De modo geral, a amostra mantém hábitos nutricionais satisfatórios, 61,9% relataram ingesta diária de 05 porções de vegetais e 53,7% evitavam alimentos gordurosos e/ou doces. As dificuldades encontradas relacionam-se principalmente aos fatores culturais, vinculadas às crenças. Quanto as possibilidades/efetividades de mudanças; a falta de tempo foi a segunda maior dificuldade encontrada. Ao fim, concluiu-se que o perfil que melhor cuida da própria saúde compreende aqueles com nível de escolaridade mais elevado, menores de 34 anos e que recebem quatro ou mais salários mínimos por mês, independente do sexo.

Smoking among female sex workers: prevalence and associated variables

Objective:

To assess the prevalence of smoking and associated variables in female sex workers (FSWs)

Methods:

This was a quantitative cross-sectional study involving FSWs in the city of Botucatu, Brazil, who completed a sociodemographic questionnaire, including data regarding smoking status, motivational stage of change, and degree of nicotine dependence, as well as the Perceived Stress Scale and the Hospital Anxiety and Depression Scale

Results:

We included 83 FSWs. The mean age was 26.8 years. Among the participants, 58 (69.8%) had at least a high school education, only 26 (31.3%) resided in the city of Botucatu, 59 (71.1%) were smokers, 5 (6.0%) were former smokers, 74 (89.2%) regularly consumed alcohol, and 43 (51.8%) used illicit drugs. The majority of the women were classified as having an intermediate stress level, and 51 (61.4%) were classified as having possible or probable anxiety, whereas depression was found to be improbable in 57 (68.7%). The level of nicotine dependence was high among the smokers, the majority of whom showed no intention to quit smoking. Smoking was associated with illicit drug use (p = 0.0271) and with alcohol consumption (p = 0.0001), although not with the levels of stress, anxiety, or depression; nor was the age at smoking initiation associated with the length of time as an FSW (p = 0.4651)

Conclusions:

The prevalence of smoking among the FSWs evaluated here was much higher than the 8.3% reported for the overall female population of Brazil. Our findings show that FSWs are exposed to various risk factors inherent to their profession. Therefore, harm reduction is an important strategy to be adopted.

Interrelationships between nursing workers' state of nutrition, socio demographic factors, work and health habits

The interrelationships between professional nursing workers' state of nutrition, variables relating to their socio demographic relationships, their professional work, and health behavior, were examined based on a correspondence analysis technique. This is a sectional study carried out involving 917 nursing professionals in a public hospital in Rio de Janeiro. The results show the formation of four groups, three of them grouped under BMI (body mass index) categories. The obese individuals group included poor health, current socio economic conditions, unfavorable past conditions, and former night shift workers. The low/adequate group showed the most favorable conditions, while the group of overweight individuals also included smoking, alcohol consumption, and current night shift work (up to five nights per two-week period). Specifically, among the interrelationships between the states of nutrition levels, we highlight those relating to current and previously evaluated socio economic conditions, and underscore the life-long importance of social indicators.

Overweight in men and women among urban area residents: individual factors and socioeconomic context

The present study aimed to evaluate factors associated with overweight among adults living in urban areas, with the income of the census tract as a context variable. The survey assessed individuals from two health districts of Belo Horizonte, Minas Gerais State, Brazil. Excess weight was determined by body mass index > 25kg/m2. Multilevel logistic regression was used. The sample comprised 2,935 individuals aged 20 to 60 years. The prevalence of overweight was 52.3% (95%CI: 49.9-54.8), similar between men and women. Higher schooling proved to be protective against overweight in women and a risk for men. Living in census tracts with higher income was associated with excess weight only in males. Report of the consumption of diet soft drinks was positively associated with overweight in both sexes. The occurrence of this event seems to be influenced by different factors or to interrelate differently in men and women.

[Cardiovascular risk factors on the Framingham Risk Score among hypertensive patients attended by family health teams]

The Framingham Risk Score (FRS) is used to stratify cardiovascular risk. This study sought to identify the prevalence of risk factors used in the FRS and the use of drugs that reduce cardiovascular risk among hypertensive patients attended by the Family Health Strategy (FHS). It is cross-sectional study, which evaluated a random sample of hypertensive patients in the FHS in northern Minas Gerais. Data were collected through interviews and from medical records. 505 hypertensive patients were evaluated in 9 municipalities of the region, with a predominance of women; 325 (64.4%), mean age of 66.4 years. In 90% of hypertensive patients there was at least one associated risk factor. The grouping of three or more factors occurred in 79 (15.7%) patients. Dyslipidemia was found in 188 (37.2%), diabetes in 101 (20%) and smoking in 36 (7.1%). The use of anti-hypertensive drugs was observed in 481 (95.2%) patients. The use of other cardioprotective drugs was higher among patients with 3 or more risk factors: 45.6% used antiplatelet and 27.8% used lipid-lowering drugs. The prevalence of risk factors from the FRS in the population studied was quite high and the use of cardioprotective drugs was seen to be restricted. Strategies to increase the use of FRS may improve the management of hypertension in the FHS.

[Patterns of alcohol consumption and associated factors among adult users of primary health care services of Rio de Janeiro, Brazil]

This study sought to verify the patterns of alcohol consumption and associated factors among adult users of a primary health care service in the city of Rio de Janeiro, Brazil. A household survey with a sample of 301 individuals who responded to a collection instrument containing the Alcohol Use Disorders Identification Test and social, demographic and health variables was conducted. Logistic regression was used to assess the association between the pattern of problematic alcohol consumption and the independent variables. Patterns of problematic alcohol consumption were identified among males, black, unmarried, smokers, with no religious affiliation, and persons without chronic disease attended at the health unit. Health services should therefore be prepared to identify the early stages of problematic alcohol abuse in order to prevent social and health consequences in the population, especially those attended in primary health care, for which the promotion of health and prevention of disease are priority health concerns.

Análise de hábitos nocivos à saúde entre pacientes com lesões bucais

Objetivo Propõe-se identificar a prevalência dos hábitos tabagistas e etilistas entre pacientes diagnosticados com lesões bucais, assim como possíveis fatores associados. Material e método Estudo analítico, de caráter retrospectivo, entre pacientes assistidos por clínica odontológica universitária na área de Diagnóstico Bucal. Foram analisados os prontuários odontológicos e laudos histopatológicos dos pacientes que realizaram o procedimento de biópsia entre fevereiro de 2010 e julho de 2012. As variáveis dependentes – hábitos nocivos à saúde – foram construídas pelas informações referentes aos hábitos tabagistas e etilistas então atuais ou passados. Utilizou-se o software SPSS 19.0. Foram conduzidas análises descritivas e univariada pelo teste qui-quadrado de Pearson (p≤0,05). A normalidade da amostra foi investigada pelo teste Kolmogorov-Smirnov e Shapiro-Wilk (p<0,05). Resultado Dos 125 pacientes atendidos no período de avaliação, 110 foram incluídos. A presença de hábitos tabagistas e etilistas – então atuais ou passados – foi identificada em 42 (38,2%) e 21 (19,1%) pacientes, respectivamente. Na análise univariada, as variáveis estatisticamente significantes (p≤0,05) associadas ao hábito tabagista foram: sexo, faixa etária, tipo de biópsia e diagnóstico histopatológico. Quanto ao hábito etilista, as variáveis foram: sexo e tipo de biópsia. Conclusão Os hábitos tabagistas e etilistas estiveram ou permaneceram presentes na vida de uma parcela significativa dos indivíduos investigados, que desenvolveram lesões bucais. Nota-se, ainda, quão relevante é o sinergismo de ambos no desenvolvimento de tais lesões.

Clustering of risk factors for non communicable diseases in adults from Florianopolis, SC

OBJECTIVE

To investigate clustering patterns of health risk behaviors for non communicable diseases and its associated factors.

METHODS

a Random telephone survey with 1,996 adults from Florianopolis, SC, was conducted in 2005. Tobacco use, high alcoholic intake episodes, fruit consumption and physical inactivity were investigated. Clustering was examined by the ratio between observed and expected prevalence of each of the 16 possible combinations. These clustered risk factors comprised the main outcome and binomial and multinomial logistic regression was conducted to examine socio-demographic correlates.

RESULTS

43% of men and 36.6% of women clustered at least two health risk factors. Three (19.2%; CI 95% 16.7 - 21.7) and five (9.8%; CI 95% 8.0 - 11.6) specific combinations exceed the expected prevalence, respectively, in men and women. Women with low schooling level and older were more likely to cluster health risk behaviors.

CONCLUSION

although men showed higher prevalence of single health risk behavior and its combinations, women presented more specific combinations that clustered above the expected. Knowledge on the clustering pattern of these health risk behaviors may guide the design of more effective health promotion initiatives.

[Risk of chronic non-communicable diseases in the population attended in the nutritional education program in Goiânia in the state of Goiás, Brazil]

The scope of this work was to evaluate the risk factors for chronic non-communicable diseases (CNCDs) in subjects treated in the Nutrition Education Program of the School of Physical Education of the Federal University of Goiás. The number of individuals evaluated was 79, namely 65 adults and 14 adolescents. Socio-economic data, lifestyle and previous diseases were recorded by using anamnesis, the feeding habits (FH) were assessed by a food frequency questionnaire and the anthropometric indexes used were body mass index (BMI) and waist circumference (WC). The prevalence of overweight and obesity in the population was 42.9% (n = 27) and the average WC of adults was 82.67 ± 12.49, and 45.1% had increased or very increased risk of cardiovascular diseases. About 88.6% of the population reported the existence of CNCDs in the family. Most of the people (75%) exercised regularly. Those who smoked also drank alcohol frequently, and those that did not smoke were the ones that exercised more. The intake of fruit and vegetables is practiced by 36.7% and 63.3% of participants at least once a day, respectively. The conclusion reached is that the population studied had a high prevalence of exposure to at least one risk factor for CNCDs.

Adesão ao tratamento farmacológico e não farmacológico e fatores associados na atenção primária da hipertensão arterial

Com o objetivo de determinar a adesão aos tratamentos farmacológico e não farmacológico da hipertensão arterial na atenção primária e identificar fatores associados, realizou-se estudo transversal com 385 hipertensos de 20 a 79 anos cadastrados em uma unidade de saúde da família de Londrina, Paraná. A adesão ao tratamento farmacológico foi de 59,0%. A atividade física regular foi relatada por 68 (17,7%) hipertensos, enquanto 266 (69,1%) referiram mudanças da alimentação. Na análise de regressão múltipla, associaram-se à adesão ao tratamento farmacológico: maior idade (50 a 79 anos), ter recebido ao menos uma consulta ao ano, não ingestão regular de bebidas alcoólicas e infarto prévio. Hipertensos do sexo masculino, com escolaridade igual ou superior à 4ª série, que receberam pelo menos uma consulta ao ano, com diabetes e sem relato de colesterol elevado mostraram-se mais aderentes à atividade física regular. A realização de dieta associou-se à escolaridade inferior à 4ª série e ao fato de ter recebido no mínimo uma consulta ao ano. Tais resultados demonstram níveis variados de adesão ao tratamento e evidenciam a importância de ações integrais na atenção ao hipertenso.

[Factors associated with smoking in the elderly: a health survey in São Paulo (ISA-SP)]

This article reports on smoking prevalence and associated factors in the elderly, based on a population-based cross-sectional study with multi-stage sampling including 1,954 individuals 60 years or older living in four areas of São Paulo State, Brazil. Overall smoking prevalence was 12.2%, and higher rates were associated with male gender, age 60-69 years, not belonging to an Evangelical church, lower income, low body weight, lack of leisure-time physical activity, depression/anxiety, and hypertension. There was a high prevalence of smokers among individuals with a history of stroke, cancer, and chronic obstructive pulmonary disease. The results point to the need for effective interventions in healthcare services to promote smoking cessation among the elderly, since many are unable to stop on their own, even when they have tobacco-related illnesses. Special attention should be paid to individuals that depend on the National Health System, since smoking prevalence is higher in underprivileged socioeconomic groups.

Excesso de peso em adultos do Estado de Pernambuco, Brasil: magnitude e fatores associados

Com o objetivo de avaliar a magnitude do excesso de peso e fatores associados em adultos do Estado de Pernambuco, Brasil, foi realizado estudo transversal, de base populacional, em 2006, envolvendo 1.580 adultos, na faixa etária de 25-59 anos. O excesso de peso foi determinado pelo índice de massa corporal > 25kg/m². O modelo conceitual considerou variáveis socioeconômicas/demográficas, reprodutivas e comportamentais. A prevalência de excesso de peso foi de 51,1% (IC95%: 48,6-53,6). A análise multivariada mostrou que o excesso de peso foi maior a partir de 40 anos (RP = 1,27; IC95%: 1,10-1,46), em mulheres (RP = 1,29; IC95%: 1,16-1,43), em ex-fumantes (RP = 1,42; IC95%: 1,20-1,69), em indivíduos com maior renda (RP = 1,49; IC95%: 1,30-1,71) e em mulheres com primeira gestação com idade < 18 anos (RP = 1,25; IC95%: 1,11-1,66). Não houve associação com o consumo de álcool, com a atividade física e com o consumo alimentar. A expressiva prevalência do excesso de peso corrobora os níveis epidêmicos que este problema tem assumido em todo o mundo e a associação com vários fatores e reforçam a multifatorialidade de sua etiologia.