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Cabral MC, Coelho GMO, Oliveira N, Canella DS, Brasil RLO, Campos TAM, Faerstein E, Bezerra FF. Association of body image perception and (dis)satisfaction with adiposity in adults: The Pró-Saúde study. PLoS One 2024; 19:e0304987. [PMID: 38857269 PMCID: PMC11164337 DOI: 10.1371/journal.pone.0304987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 05/21/2024] [Indexed: 06/12/2024] Open
Abstract
INTRODUCTION Body image distortion and/or dissatisfaction may occur primarily due to body fat accumulation and/or distribution. The aim of this study was to evaluate the frequency of body image perception and (dis)satisfaction categories in adult men and women according to the adiposity classification. METHODS This is a cross-sectional study (n = 514; 33-79 years; 265 women) that is part of a prospective cohort (Pró-Saúde study). Adiposity measurements were determined by two methods: anthropometry, used to calculate the body mass index (BMI) and dual-energy X-ray absorptiometry (DXA), to estimate body fat percentage. Participants were grouped as "no excess adiposity" and "excess adiposity", considering BMI and body fat percentage (>30% for men, >40% for women). Perception and (dis)satisfaction with body image were evaluated using the Kakeshita scale, composed by 15 silhouettes, developed for the Brazilian population. Degree of distortion (perceived BMI - real BMI) and dissatisfaction (perceived BMI - desired BMI) were calculated. RESULTS A high proportion of men (58.6%; 74.3%), and especially of women (82.6%; 86.8%), presented body size overestimation and dissatisfaction due to excess weight, respectively. A relevant fraction of the women (32.6%) and men (30.8%) who were dissatisfied due to excess weight did not present excess adiposity, especially if classified by DXA. Variability in degree of distortion was hardly explained by anthropometric and DXA variables in women (<5%) and men (∼22%). Both anthropometric and DXA measurements accounted for ∼30% and ∼50% of the variability in degree of dissatisfaction among women and men, respectively. CONCLUSION Our results suggest a high frequency of body image distortion in Brazilian adult individuals, as well as dissatisfaction with excess weight, especially among women with excess adiposity. The findings indicate that anthropometric measurements explain much of the variability in degree of body image dissatisfaction in men, with no apparent advantage of the use of more refined DXA measurements.
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Affiliation(s)
- Magno C. Cabral
- PostGraduate Program of Food, Nutrition and Health, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | | | - Natalia Oliveira
- PostGraduate Program of Food, Nutrition and Health, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Daniela S. Canella
- Institute of Nutrition, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Raiane L. O. Brasil
- PostGraduate Program of Food, Nutrition and Health, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Tatiana A. M. Campos
- PostGraduate Program of Food, Nutrition and Health, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Eduardo Faerstein
- Institute of Social Medicine, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Flávia F. Bezerra
- Institute of Nutrition, Rio de Janeiro State University, Rio de Janeiro, Brazil
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Souza LNS, Confortin SC, Aristizábal LYG, Chagas DCD, Vieira AC, Simões VMF, Alves MTSSDBE. [Do depressive symptoms, anxiety and stressful symptoms during pregnancy affect gestational weight gain?]. CIENCIA & SAUDE COLETIVA 2023; 28:2087-2097. [PMID: 37436321 DOI: 10.1590/1413-81232023287.10532022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 01/06/2023] [Indexed: 07/13/2023] Open
Abstract
The scope of this article is to estimate the effects of symptoms of mental disorders during pregnancy (depressive symptoms, anxiety and stress) on gestational weight gain (kg). It is a longitudinal study, carried out with data from the BRISA Birth Cohort, which was launched in 2010 in São Luís, Maranhão. Gestational weight gain was classified according to the Institute of Medicine. The independent variable was a construct (latent variable) referred to as symptoms of mental disorders, made up of the depressive symptoms, anxiety and stressful symptoms variables (all on an ongoing basis). Structural equation modeling was used to investigate the association between mental health and weight gain. Regarding the association between symptoms of mental disorders and weight gain during pregnancy, no total effect was found (PC=0.043; p=0.377). Regarding indirect effects, no effect was found either through risk behaviors (PC=0.03; p=0.368) or through physical activity (PC=0.00; p=0.974). Finally, the data did not show a direct effect of symptoms of mental disorders during pregnancy such as gestational weight gain (PC=0.050; p=0.404). Gestational weight gain had no direct, indirect or total effect on symptoms of mental disorders in pregnant women.
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Affiliation(s)
- Larissa Nogueira Silva Souza
- Faculdade de Medicina, Universidade Federal do Maranhão (UFMA). Av. dos Portugueses 1966, Vila Bacanga. 65080-805 São Luís MA Brasil.
| | | | | | | | - Ana Cleide Vieira
- Programa de Pós- Graduação em Saúde da Família, UFMA. São Luís MA Brasil
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Araújo LF, Faerstein E. Family instability in childhood affects language and memory in adulthood: results from the Pró-Saúde Study, Brazil. CIENCIA & SAUDE COLETIVA 2023; 28:811. [PMID: 36888865 DOI: 10.1590/1413-81232023283.13782022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 09/13/2022] [Indexed: 03/08/2023] Open
Abstract
The study aims to investigate associations between adverse childhood psychosocial exposures and declarative memory, language, and executive function in adults with secondary schooling or more and without dementia. In 361 participants from the Pró-Saúde Study, we estimated associations between maternal educational attainment, principal source of the family´s income, food insecurity, and childhood family structure and performance in learning, word recall, and semantic and phonemic verbal fluency tests using multiple linear regression models. Individuals whose mother was the family breadwinner (mean difference: -1.97, 95%CI: -3.27; -0.72) and head-of-household (mean difference: -1.62, 95%CI: -2.89; -0.35) or who lived with a non-parental caregiver or in institutions in childhood (mean difference: -2.19, 95%CI: -4.29; -0.09) showed a reduction in the mean number of words in language and memory in adulthood. The results provide further evidence of the effect of adverse exposures in childhood. Without effective interventions, such exposures are likely to have far-reaching impacts on cognition.
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Affiliation(s)
- Larissa Fortunato Araújo
- Departamento de Saúde Comunitária, Escola de Medicina, Universidade Federal do Ceará. R. Papi Júnior - de 511/512 a 1949/1950, Rodolfo Teófilo. 60430-235 Fortaleza CE Brasil.
| | - Eduardo Faerstein
- Instituto de Medicina Social, Universidade Estadual do Rio de Janeiro. Rio de Janeiro RJ Brasil
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Stumpf FMDM, de Oliveira ASD, Faerstein E, Curioni CC. Cross-sectional associations between body mass index, waist circumference, and multimorbidity: Pró-Saúde study. PeerJ 2023; 11:e14744. [PMID: 36778147 PMCID: PMC9910183 DOI: 10.7717/peerj.14744] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 12/23/2022] [Indexed: 02/08/2023] Open
Abstract
Background This study aimed (1) To investigate the association between the Body Mass Index (BMI) and waist circumference (WC) with multimorbidity (MM), and (2) To identify patterns of MM and investigate the relationship between BMI and WC with specific combinations of MM (patterns of MM). Methods A cross-sectional study was conducted with 2,698 participants of the fourth phase of the Brazilian Longitudinal Study of Adult Health (Pró-Saúde Study). MM was defined by the presence of two or more morbidities. MM patterns were identified by exploratory factor analysis based on tetrachoric correlations. Logistic regression models were used to assess associations (odds ratios (OR) with the respective confidence intervals (CI)). Results Of the total number of participants, 39.5% were overweight and 30.0% were obese; 89.0% (n = 1,468) of women and 77.0% (n = 952) of men were abdominally obese. Indeed, 60.7% (n = 1,635) was identified with MM. For the category four or more morbidities, OR values of 5.98 (95% CI 4.84-7.13) and 7.48 (95% CI 6.14-8.18) were found for each point of increase in BMI, and 6.74 (95% CI 5.48-7.99) and 8.48 (95% CI 7.64-9.29) for each additional centimeter in the WC, for female and male, respectively. Five patterns of MM were identified: respiratory, osteoarticular, cardiometabolic, gastric, and thyroid diseases (56.4% of the total variance). Positive associations were found between BMI and patterns of cardiometabolic, osteoarticular, thyroid and gastric diseases (higher OR of 1.09 [95% CI 1.04-1.14]) and less pronounced between WC and patterns of cardiometabolic and osteoarticular (higher OR of 1.04 [95% CI 1.03-1.04]). Conclusions The results showed that an increase of both BMI and WC was associated with a higher number of morbidities and with patterns of cardiometabolic and osteoarticular diseases.
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Affiliation(s)
| | | | - Eduardo Faerstein
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Cintia Chaves Curioni
- Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
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Scharf A, Bezerra FF, Zembrzuski VM, Fonseca ACPDA, Gusmão L, Faerstein E. Investigation of associations of European, African, Amerindian genomic ancestries and MC4R, FTO, FAIM2, BDNF loci with obesity-related traits in Rio de Janeiro, Brazil. AN ACAD BRAS CIENC 2023; 95:e20220052. [PMID: 36921152 DOI: 10.1590/0001-3765202320220052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 08/02/2022] [Indexed: 03/12/2023] Open
Abstract
A complex web of causation is involved in adiposity, including environmental, social and genetic factors. We aimed to investigate associations between genetic factors such as ancestry and single nucleotide polymorphisms, and obesity-related traits in a sampled Brazilian population. A sample of 501 unrelated adults participating in 2013 at the longitudinal Pró-Saúde Study (EPS) in Rio de Janeiro, Brazil was selected. We analysed 46 AIM-InDels (insertion/deletion) as genetic ancestry markers and four single nucleotide polymorphisms located in the genes MC4R (rs17782313), FTO (rs9939609), FAIM2 (rs7138803) and BDNF (rs4074134), previously described as associated with obesity. The selected obesity-related markers were anthropometric parameters such as body mass index, waist circumference and waist-to-hip ratio, and body composition measurements namely body fat percentage, android fat mass and gynoid fat mass. The sample showed greater European ancestry (57.20%), followed by African (28.80%) and lastly Amerindian (14%). Our results suggest that the rs4074134 (BDNF) CC genotype was directly associated with gynoid fat mass, whereas body fat percentage, android fat mass and the anthropometric parameters seem not to be associated with neither ancestry nor the four polymorphisms in this population sample, most likely due to a stronger role of social, behavioural and environmental determinants.
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Affiliation(s)
- Allan Scharf
- State University of Rio de Janeiro (UERJ), DNA Diagnostic Laboratory, São Francisco Xavier Street, 524, 20550-900 Rio de Janeiro, RJ, Brazil
| | - Flávia F Bezerra
- State University of Rio de Janeiro (UERJ), Institute of Nutrition, São Francisco Xavier Street, 524, 20550-900 Rio de Janeiro, RJ, Brazil
| | - Verônica M Zembrzuski
- Oswaldo Cruz Foundation (FIOCRUZ), Human Genetics Laboratory, Oswaldo Cruz Institute, Brasil Avenue, 4365, 21040-360 Rio de Janeiro, RJ, Brazil
| | - Ana Carolina P DA Fonseca
- Oswaldo Cruz Foundation (FIOCRUZ), Human Genetics Laboratory, Oswaldo Cruz Institute, Brasil Avenue, 4365, 21040-360 Rio de Janeiro, RJ, Brazil.,Oswaldo Cruz Foundation (FIOCRUZ), Laboratory of Immunopharmacology, Oswaldo Cruz Institute, Brasil Avenue, 4365, 21040-360 Rio de Janeiro, RJ, Brazil
| | - Leonor Gusmão
- State University of Rio de Janeiro (UERJ), DNA Diagnostic Laboratory, São Francisco Xavier Street, 524, 20550-900 Rio de Janeiro, RJ, Brazil
| | - Eduardo Faerstein
- State University of Rio de Janeiro (UERJ), Institute of Social Medicine, São Francisco Xavier Street, 524, 20550-900 Rio de Janeiro, RJ, Brazil
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Vettore MV, Abreu MHNG, da Rocha Mendes S, Faerstein E. Do changes in income and social networks influence self-rated oral health trajectories among civil servants in Brazil? Evidence from the longitudinal Pró-Saúde study. BMC Oral Health 2022; 22:153. [PMID: 35488334 PMCID: PMC9052516 DOI: 10.1186/s12903-022-02191-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Social factors are important determinants of health. However, evidence from longitudinal studies on the possible role of changes in socioeconomic circumstances on adult's oral health is scarce. This study aimed to test whether changes in income and changes in social networks of family members and friends were associated with trajectories of self-rated oral health (SROH) among adults over a 13-year period. METHODS A prospective cohort study (Pro-Saude Study) was conducted involving non-faculty civil servants at university campi in Rio de Janeiro, Brazil. Individual data was collected through self-completed questionnaires in four waves (1999, 2001, 2007 and 2012). SROH trajectories between 2001 and 2012 were "Good-stable SROH", "Changed SROH", "Poor-stable SROH". Per capita family income and social networks of family members and friends data obtained in 1999 and 2012 were grouped into "High stable", "Increase", "Decrease", "Low stable". Ordinal logistic regression using complete data of 2118 participants was used to estimate odds ratio (OR) and 95% CIs of changes in income and changes in social networks with SROH trajectories, adjusted for age, sex, skin colour and marital status. RESULTS Participants in the low income-stable and small social networks-stable groups showed 2.44 (95% CI 1.68-3.55) and 1.98 (95% CI 1.38-2.85) higher odds for worst trajectory of SRHO than those in the respective high-stable groups. Those in the decrease income group and decrease social networks group were 78% (95% CI 1.25-2.54) and 58% (95% CI 1.07-2.34) more likely to worst trajectory of SRHO than those in the high income-stable and high social networks-stable groups. CONCLUSIONS Adults reporting low income and low social networks of family members and friends over 13 years and those with income and social networks decrease during the study period were at higher risk of having worsened their self-rated oral health.
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Affiliation(s)
- Mario Vianna Vettore
- Department of Health and Nursing Sciences, University of Agder (UiA), Campus Kristiansand, Universitetsveien 25, 4630, Kristiansand, Norway.
| | | | - Suellen da Rocha Mendes
- Department of Social and Preventive Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Eduardo Faerstein
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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7
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Tooth loss over 13 years of follow-up: can regular dental visits reduce racial and socioeconomic inequalities? J Dent 2022; 122:104110. [DOI: 10.1016/j.jdent.2022.104110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/16/2022] [Accepted: 03/24/2022] [Indexed: 11/22/2022] Open
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8
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Bezerra FF, Normando P, Fonseca ACP, Zembrzuski V, Campos-Junior M, Cabello-Acero PH, Faerstein E. Genetic, sociodemographic and lifestyle factors associated with serum 25-hydroxyvitamin D concentrations in Brazilian adults: the Pró-Saúde Study. CAD SAUDE PUBLICA 2022; 38:e00287820. [DOI: 10.1590/0102-311x00287820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 05/21/2021] [Indexed: 11/22/2022] Open
Abstract
This study aims to investigate factors associated with serum 25-hydroxyvitamin D [25(OH)D] concentration in Brazilian adults considering sociodemographic and lifestyle factors, as well as vitamin D-related single nucleotide polymorphisms (SNPs). This is a cross-sectional study (n = 491; 34-79y; 251 women), nested within a prospective cohort (Pró-Saúde Study). Associations between serum 25(OH)D and sociodemographic characteristics, diet, use of supplement, physical activity, season of blood collection, body fat, skin type, sun exposure index, and SNPs CYP2R1-rs10741657 and GC-rs2282679 were explored by multiple linear regression. The prevalence of serum 25(OH)D < 50nmol/L was 55%. Serum 25(OH)D was lower among women (β = -4.38; 95%CI: -8.02; -0.74), those with higher visceral fat (β = -4.02; 95%CI: -5.92; -2.12), and those with AC and CC genotypes for GC-rs2282679 (β = -6.84; 95%CI: -10.09; -3.59; β = -10.63; 95%CI: -17.52; -3.74, respectively). Factors directly associated with serum 25(OH)D included summer (β = 20.14; 95%CI: 14.38; 25.90), intermediate skin type (β = 6.16; 95%CI: 2.52; 9.80), higher sun exposure (β = 0.49; 95%CI: 0.22; 0.75), vitamin D intake (β = 0.48; 95%CI: 0.03; 0.93), and physical activity (β = 4.65; 95%CI: 1.54; 7.76). Besides physical activity, diet, and sun exposure, non-modifiable factors, such as GC genotypes must be considered when evaluating vitamin D insufficiency in mixed-race populations. Moreover, high visceral fat in association with poorer vitamin D status deserve attention given that both conditions are unfavorably related with chronic and acute health outcomes.
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Vitamin D is directly associated with favorable glycemic, lipid, and inflammatory profiles in individuals with at least one component of metabolic syndrome irrespective of total adiposity: Pró-Saúde Study, Brazil. Nutr Res 2021; 96:1-8. [PMID: 34890855 DOI: 10.1016/j.nutres.2021.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 10/15/2021] [Accepted: 10/19/2021] [Indexed: 02/06/2023]
Abstract
Vitamin D insufficiency has been suggested as a risk factor for several metabolic disorders. The objective of the study was to investigate the association between serum 25 hydroxyvitamin D [25(OH)D] and metabolic health markers of Brazilian individuals with normal-weight, overweight or obesity. We hypothesized that serum 25(OH)D would be inversely associated with glycemic, lipid and inflammatory markers indicative of metabolic abnormality. Data of 511 individuals (33-79 years), recruited from a longitudinal investigation (Pró-Saúde Study), were analyzed cross-sectionally. Anthropometric, biochemical, body composition, socio-demographic and lifestyle data were collected. Based on body mass index (BMI; normal weight, overweight, obesity) and metabolic health (metabolically healthy (MH) and metabolically unhealthy (MU)) categories, the participants were classified into 6 phenotypes. Individuals having zero components of the metabolic syndrome were considered as "MH". MH obesity was frequent in 2.0% of the participants and 56.0% exhibited vitamin D insufficiency (<20 ng/mL). In the subgroups of the same BMI category, there were no significant differences in 25(OH)D concentrations between individuals classified as MH and MU. After adjustments (including %body fat and BMI), an inverse association was observed between 25(OH)D and visceral adipose tissue (B = -6.46, 95% confidence interval, CI: -12.87, -0.04), leptin (B = -0.09, 95% confidence interval, CI: -0.14, -0.03), insulin (B = -0.21, 95%CI: -0.34, -0.07), HOMA-IR (B = -0.06, 95%CI: -0.10, -0.02), triglycerides (B = -2.44, 95%CI: -3.66, -1.22), and TNF-α (B = -0.12, 95%CI: -0.24, -0.005) only in MU individuals. Our results indicate that the association of 25(OH)D concentrations with a favorable biochemical profile (glycemic, lipidic and inflammatory) seems to depend on the individual's overall metabolic health, suggesting more benefits from higher serum vitamin D in MU individuals, regardless of their adiposity.
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Pereira-Manfro WF, Lima GRD, Nogueira Neto JF, Portugal MRC, Milagres LG, Bezerra FF, Faerstein E, Koury JC. Association between visceral/subcutaneous adipose tissue ratio and plasma inflammatory markers and score for cardiovascular risk prediction in a Brazilian cohort: Pró-Saúde Study. Braz J Med Biol Res 2021; 54:e11521. [PMID: 34730680 PMCID: PMC8555454 DOI: 10.1590/1414-431x2021e11521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 09/06/2021] [Indexed: 12/13/2022] Open
Abstract
Visceral adipose tissue (VAT) is associated with various metabolic disorders, and adipokines, secreted by adipose tissue, are involved in their pathogenesis. This study investigated associations between VAT/subcutaneous adipose tissue (SAT) ratio, inflammatory markers, and cardiovascular (CV) risk-score in adults. Plasma levels of adipokines, plasma lipid profile, blood pressure, and body composition (using dual-emission x-ray absorptiometry) were determined. CV risk-score based on the American College of Cardiology and the American Heart Association (ACC/AHA) score was calculated in a sample of 309 Brazilian civil servants aged <60 years. Participants' VAT/SAT ratio were categorized into quartiles. Among males, plasma leptin (2.8 ng/mL) and C reactive protein (CRP) (0.2 mg/dL) (P<0.05) levels were higher at P75 and P50 than P5, and the highest calculated CV risk-score was observed at P75 (7.1%). Among females, higher plasma adiponectin levels were observed at P25 (54.3 ng/mL) compared with P75 (36 ng/mL) (P<0.05). Higher plasma CRP levels were observed at P75 (0.4 mg/dL) compared with P5 (0.1 mg/dL) (P<0.05). Higher CV risk-score was observed at P75 (2.0%) compared with P5 (0.7%). In both sexes, VAT and VAT/SAT ratio were directly associated with plasma leptin, CRP, and CV risk-score, and inversely associated with adiponectin; SAT was directly associated with plasma leptin and CRP (P<0.01); interleukin (IL)-10 and CRP were directly associated with adiponectin and leptin, respectively (P<0.05). Among men only, IL-10 (inversely) and CRP (directly) were associated with CV risk-score (P=0.02). Our results strengthened the relevance of the VAT/SAT ratio in cardiovascular risk.
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Affiliation(s)
- W F Pereira-Manfro
- Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - G R de Lima
- Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - J F Nogueira Neto
- Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - M R C Portugal
- Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.,Departamento de Nutrição, Centro Universitário de Volta Redonda - UniFOA, Volta Redonda, RJ, Brasil
| | - L G Milagres
- Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - F F Bezerra
- Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - E Faerstein
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - J C Koury
- Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
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Rocha TFD, Curioni C, Verly Junior E, Bezerra F, Faerstein E. Food consumption patterns, overweight and cardiovascular risk: a cross-sectional analysis of the Pró-Saúde Study, Brazil, 2013. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2021; 30:e2021033. [PMID: 34854467 DOI: 10.1590/s1679-49742021000400020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 08/11/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To identify food consumption patterns and association between overweight and risk of cardiovascular disease. METHODS This was a cross-sectional study with staff of the Universidade do Estado do Rio de Janeiro, Brazil, who took part in the Pró-Saúde Study. Food consumption was investigated using a food frequency questionnaire. Association between dietary patterns (exposure) and overweight and cardiovascular risk (outcomes) was estimated using linear regression. RESULTS Among the 520 staff assessed, four dietary patterns were found: 'ultra-processed', 'healthy', 'meat' and 'traditional'. After adjustment, the 'meat' pattern was inversely associated with waist circumference (ß=-1.52 - 95%CI -2.66;-0.39), body mass index (ß=-0.56 - 95%CI -1.01;-0.11), and the Framingham Risk Score (ß=-0.36 - 95%CI -0.64;-0.09). CONCLUSION In view of excess weight, risk of cardiovascular disease and inverse association between the 'meat' food consumption pattern and BMI, it is important to conduct further investigations, with non-working groups, with the aim of gaining greater understanding of the health-disease process related to food consumption.
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Affiliation(s)
- Thalita Fialho da Rocha
- Universidade do Estado do Rio de Janeiro, Programa de Pós-Graduação em Alimentação, Nutrição e Saúde, Rio de Janeiro, RJ, Brasil
| | - Cíntia Curioni
- Universidade do Estado do Rio de Janeiro, Departamento de Nutrição Social, Rio de Janeiro, RJ, Brasil
| | - Eliseu Verly Junior
- Universidade do Estado do Rio de Janeiro, Departamento de Epidemiologia, Rio de Janeiro, RJ, Brasil
| | - Flávia Bezerra
- Universidade do Estado do Rio de Janeiro, Departamento de Nutrição Básica e Experimental, Rio de Janeiro, RJ, Brasil
| | - Eduardo Faerstein
- Universidade do Estado do Rio de Janeiro, Departamento de Epidemiologia, Rio de Janeiro, RJ, Brasil
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Passos VMDA, Raymundo CE, Bezerra FF, Faerstein E. Diabetes and hypertension are associated with lowered cognitive performance among middle-aged Brazilian adults: cross-sectional analyses nested in the longitudinal Pró-Saúde study. SAO PAULO MED J 2021; 139:46-52. [PMID: 33656123 PMCID: PMC9632506 DOI: 10.1590/1516-3180.2020.0269.r1.30102020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 10/30/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Cardiovascular risk factors are frequently associated with lowered cognitive performance among elderly people, but rarely among middle-aged adults. OBJECTIVES To investigate associations between cardiovascular risk factors (age, physical inactivity, smoking, alcohol use, hypertension and diabetes) and lower cognitive performance among middle-aged (45-64 years) Brazilian adults. DESIGN AND SETTING Cross-sectional study nested within the Pró-Saúde cohort. From 2,876 baseline study participants (1999), we randomly selected 488 participants and gave them validated and standardized cognitive tests (2012). METHODS We used multiple linear and logistic regression analyses to detect associations of cardiovascular risk factors with crude scores in cognitive tests on memory (word test) and executive function (verbal fluency tests), and with overall cognitive performance scores, respectively. RESULTS All cognitive test scores presented statistically significant inverse associations with age and direct associations with education. There was no association between lower cognitive performance and smoking or alcohol use. In both 1999 and 2012, after adjusting for sex, age and schooling, being physically active was inversely associated with lower performance regarding late memory. For individuals with diabetes in 1999, there was an association with lower performance regarding executive function, while there was a borderline association for those reporting it only in 2012. Having a diagnosis of hypertension since 1999 was associated with lower performance regarding both memory and executive functions, while reporting hypertension in 2012 was associated with lower performance regarding executive function. CONCLUSIONS Aging, low schooling and cardiovascular risk factors may represent life course disadvantages associated with cognitive decline even among middle-aged Brazilian adults.
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Affiliation(s)
- Valéria Maria de Azeredo Passos
- MD, PhD. Associate Professor, Postgraduate Program on Health Science, Faculdade de Ciências Médicas de Minas Gerais (FCMMG), Belo Horizonte (MG), Brazil.
| | - Carlos Eduardo Raymundo
- IT, MSc. Doctoral Student, Instituto de Estudos em Saúde Coletiva (IESC), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro (RJ), Brazil.
| | - Flávia Fioruci Bezerra
- RD, DSc. Associate Professor, Institute of Nutrition, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro (RJ), Brazil.
| | - Eduardo Faerstein
- MD, PhD. Associate Professor, Institute of Social Medicine, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro (RJ), Brazil.
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Normando P, Bezerra FF, Santana BA, Calado RT, Santos-Rebouças CB, Epel ES, Faerstein E. Association between socioeconomic markers and adult telomere length differs according to sex: Pro-Saúde study. ACTA ACUST UNITED AC 2020; 53:e10223. [PMID: 33053112 PMCID: PMC7552895 DOI: 10.1590/1414-431x202010223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 08/09/2020] [Indexed: 11/24/2022]
Abstract
Understanding the social determinants of telomere length is critical to evaluate the risk of early biological aging. We investigated sex differences on the association between socioeconomic status (SES) and demographic markers and leukocyte telomere length (LTL) in Brazilian adults. This cross-sectional study was conducted in a subsample (women=228; men=200) nested within the Pro-Saúde study, a prospective cohort study of university civil servants in Rio de Janeiro, Brazil (2012-2013). Adjusted multivariate models were used to test the relationship between SES markers (marital status, educational attainment, father's educational attainment, race/skin color, household income, and childhood experience of food deprivation) and LTL. After adjusting for age and potential health-related confounders, lower educational attainment was associated with shorter LTL among men (β=-0.05, 95% confidence interval (CI)=95%CI: -0.10, 0.00, P=0.03). In women, LTL was inversely associated with unmarried status (β=-0.05, 95%CI: -0.09, 0.00, P=0.03), lower father's educational attainment (β=-0.05, 95%CI: -0.13, 0.00, P=0.04), and childhood experience of food deprivation (β=-0.07, 95%CI: -0.13, 0.00, P=0.04). Our findings suggested that the association between SES markers and LTL differs according to sex. SES markers able to induce lifelong stress, reflected in LTL, appeared to be more related to individual factors in men, whereas in women they were family-related.
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Affiliation(s)
- P Normando
- Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - F F Bezerra
- Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - B A Santana
- Departamento de Imagens Médicas, Hematologia e Oncologia Clínica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - R T Calado
- Departamento de Imagens Médicas, Hematologia e Oncologia Clínica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - C B Santos-Rebouças
- Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - E S Epel
- University of California San Francisco, San Francisco, CA, USA
| | - E Faerstein
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
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Portugal MRC, Canella DS, Curioni CC, Bezerra FF, Faerstein E, Neves MF, Koury JC. Bioelectrical impedance analysis–derived phase angle is related to risk scores of a first cardiovascular event in adults. Nutrition 2020; 78:110865. [DOI: 10.1016/j.nut.2020.110865] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 03/11/2020] [Accepted: 04/29/2020] [Indexed: 01/25/2023]
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Romeiro ACT, Curioni CC, Bezerra FF, Faerstein E. Sociodemographic determinants of food consumption pattern: Pró-Saúde Study. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2020; 23:e200090. [PMID: 32725090 DOI: 10.1590/1980-549720200090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 07/25/2019] [Indexed: 02/07/2023] Open
Abstract
AIMS To identify dietary patterns (DP) and to investigate their association with sociodemographic aspects. METHODOLOGY A cross-sectional data analysis of a sub-sample from Phase 4 of the Pró-Saúde Longitudinal Study (2012-2013), constituting a total of 520 participants. DP were obtained by principal component analysis from a food frequency questionnaire. Association between DP and sociodemographic aspects was analyzed by adjusted logistic regression. RESULTS Four DP were identified: processed and ultraprocessed products; fresh food; meats and alcoholic beverages; and traditional Brazilian foods. There was a greater adherence chance to "processed and ultraprocessed products" pattern among adults ≥ 55 years and lower chance among men. The probability of adherence to "fresh food" pattern was directly associated to men, subjects with a high educational level and inversely associated to adults aged ≥ 60 years. There was a lower chance of "meats and alcoholic beverages" pattern among men and increased chance of adherence to "traditional Brazilian foods" pattern among whites, subjects with ≥ 60 years and low schooling. CONCLUSION Sociodemographic factors were important determinants of DP, especially gender, schooling and age. Presence of a DP composed of processed and ultraprocessed products indicates the need for awareness strategies and supply limitation in this population, since it affects their health.
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Affiliation(s)
- Ariane Cristina Thoaldo Romeiro
- Programa de Pós-Graduação em Alimentação, Nutrição e Saúde, Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Cintia Chaves Curioni
- Programa de Pós-Graduação em Alimentação, Nutrição e Saúde, Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Flávia Fiorucci Bezerra
- Programa de Pós-Graduação em Alimentação, Nutrição e Saúde, Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Eduardo Faerstein
- Programa de Pós-Graduação em Saúde Coletiva, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Normando P, Santos-Rebouças C, Leung C, Epel E, da Fonseca AC, Zembrzuski V, Faerstein E, Bezerra FF. Variants in gene encoding for vitamin D binding protein were associated with leukocyte telomere length: The Pró-Saúde Study. Nutrition 2020; 71:110618. [DOI: 10.1016/j.nut.2019.110618] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 09/23/2019] [Accepted: 10/13/2019] [Indexed: 12/27/2022]
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Neighborhood food environment and consumption of fruit and leafy vegetables: Pro-Saude Study, Brazil. Public Health 2020; 182:7-12. [PMID: 32112980 DOI: 10.1016/j.puhe.2020.01.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 11/21/2019] [Accepted: 01/09/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To explore the relationship between availability of different types of retail food stores and consumption of fruit and leafy vegetables. STUDY DESIGN This study is a cross-sectional study. METHODS Data were derived from 2032 adults living in the city of Rio de Janeiro, Brazil, participating in the longitudinal Pro-Saude Study. Exposure to street markets, fruit and vegetable stores, groceries and markets, unhealthy food outlets, restaurants, and supermarkets within 1600 m buffers was obtained by georeferencing residential addresses. Consumption of fruit and leafy vegetables was assessed via two single questions, categorized as 'yes' (≥4 days/week) and 'no' (<3 days/week). Multiple logistic regression models were used to assess relationships of interest adjusted for surrounding average monthly income, sex, age, education, and family income per capita. RESULTS Except for supermarkets, the presence of a greater number of retail food stores - irrespective of the type - was associated with higher odds of consumption of fruit and leafy vegetables than with areas with a lower number (e.g. odds ratio = 1.47; 95% confidence interval = 1.13-1.91). CONCLUSIONS The greater availability of several types of retail food stores close to participants' residences was associated with higher consumption of fruit and leafy vegetables in Rio de Janeiro.
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Oliveira N, Coelho GMDO, Cabral MC, Bezerra FF, Faerstein E, Canella DS. Association of body image (dis)satisfaction and perception with food consumption according to the NOVA classification: Pró-Saúde Study. Appetite 2019; 144:104464. [PMID: 31539579 DOI: 10.1016/j.appet.2019.104464] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 09/15/2019] [Accepted: 09/17/2019] [Indexed: 10/26/2022]
Abstract
The literature on body image and food consumption has generally focused on isolated food items, while overlooking the growing role of ultra-processed foods in the overall diet. The objective of this study was to assess the association of body image (dis)satisfaction and perception with food consumption, according to the NOVA classification, which takes into account the extent and purpose of industrial food processing. A silhouette scale developed considering the Brazilian adults' Body Mass Index was used to assess body image (dis)satisfaction and perception. Food consumption was evaluated using a Food Frequency Questionnaire, and its items were categorized into three groups: unprocessed or minimally-processed foods and culinary preparations; processed foods; ultra-processed foods. The association was assessed using linear regression models. A total of 514 of Brazilian university employees were evaluated. Women dissatisfied due to excess weight consumed less unprocessed or minimally-processed foods and culinary preparations (-6.6, 95% CI: -10.7; -2.5) and more ultra-processed foods (3.7, 95% CI: 0.1; 7.2) compared to satisfied. Women that overestimated their body size consumed less unprocessed or minimally-processed food and culinary preparations (-4.2, 95% CI: -7.3; -1.1), compared to those who had not distorted body image. Food consumption appears to be more strongly associated with body image (dis)satisfaction than with perception. An association was established between body image dissatisfaction and unhealthy eating habits. This relation deserves public health attention since it may contribute to the development of chronic diseases and reduce the quality of life and body image assessment could be adopted by nutritionists and other health professionals in their practice.
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Affiliation(s)
- Natália Oliveira
- Graduate Program of Food, Nutrition and Health, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | | | - Magno Cerqueira Cabral
- Graduate Program of Food, Nutrition and Health, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | | | - Eduardo Faerstein
- Institute of Social Medicine, Rio de Janeiro State University, Rio de Janeiro, Brazil
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Berti TL, Rocha TFD, Curioni CC, Verly Junior E, Bezerra FF, Canella DS, Faerstein E. Food consumption according to degree of processing and sociodemographic characteristics: Estudo Pró-Saúde, Brazil. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2019; 22:e190046. [PMID: 31460625 DOI: 10.1590/1980-549720190046] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 07/13/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To investigate the food consumption according to the degree of processing and associations with sociodemographic characteristics. METHODS A cross-sectional study of the Estudo Pró-Saúde (Pro-Health Study), with 520 civil servants of university campuses, Rio de Janeiro, 2012-13. A food frequency questionnaire was used to classify food consumption: 1) in natura, minimally processed, food preparations based on these foods; 2) processed foods; 3) ultra-processed foods. The relative energy contribution of each group was determined, and a seemingly unrelated equations regression (SUR) regression model was used to estimate associations with sociodemographic characteristics. RESULTS The in natura food group (1) contributed with 59% of the energy consumption and was directly associated with age [45-49 years (β = 1.8 confidence interval of 95% - 95%CI -1.2; 4.8); 50-54 (β = 1.5 95%CI -1.5; 4.5); 55-59 (β = 2.9 95%CI -0.4; 6.3) and ≥ 60 (β = 4.6 95%CI 1.1; 8.2)], compared to age ≤ 44. In contrast, the group of ultra-processed foods contributed 27% and were inversely associated with age [45-49 (β = -1.7 95%CI -4.3; 0.9); 50-54 (β = -1.8 95%CI -4.3; 0.9); 55-59 (β = -4.9 95%CI -8.0; -2.0); ≥ 60 (β = -4.5 95%CI -7.6; -1.5)]. Gender, income and schooling were not associated with food consumption. CONCLUSION Younger adults had higher consumption of ultra-processed foods, indicating the need for interventions mainly in this age group. The absence of association with other sociodemographic characteristics may be due to the influence of contextual factors.
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Affiliation(s)
- Talita Lelis Berti
- Programa de Pós-Graduação em Saúde Coletiva do Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro - Rio de Janeiro (RJ), Brasil
| | - Thalita Fialho da Rocha
- Programa de Pós-Graduação em Alimentação, Nutrição e Saúde, Instituto de Nutrição, Universidade do Estado do Rio de Janeiro - Rio de Janeiro (RJ), Brasil
| | - Cíntia Chaves Curioni
- Departamento de Nutrição Social, Instituto de Nutrição, Universidade do Estado do Rio de Janeiro - Rio de Janeiro (RJ), Brasil
| | - Eliseu Verly Junior
- Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro - Rio de Janeiro (RJ), Brasil
| | - Flávia Fioruci Bezerra
- Departamento de Nutrição Básica e Experimental, Instituto de Nutrição, Universidade do Estado do Rio de Janeiro - Rio de Janeiro (RJ), Brasil
| | - Daniela Silva Canella
- Departamento de Nutrição Aplicada, Instituto de Nutrição, Universidade do Estado do Rio de Janeiro - Rio de Janeiro (RJ), Brasil
| | - Eduardo Faerstein
- Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro - Rio de Janeiro (RJ), Brasil
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Smoking status affects bioimpedance-derived phase angle in men but not in women: The Pró-Saúde Study, Brazil. Nutrition 2019; 61:70-76. [DOI: 10.1016/j.nut.2018.10.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 09/18/2018] [Accepted: 10/23/2018] [Indexed: 12/31/2022]
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Ribeiro SVO, Batista RFL, Ribeiro MRC, Pessoa KC, Simões VMF, Figueiredo FPD, Bettiol H. Violence and depressive symptoms during pregnancy in BRISA cohort: using structural equation modeling approach. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2019. [DOI: 10.1590/1806-93042019000100010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract Objectives: to analyze associations among violence against pregnant women, depressive symptoms during pregnancy and maternal depression symptoms. Methods: a sample of 1,139 mothers was conducted on a prenatal cohort study in the municipality of São Luís in Brazil. Psychological and physical violence against pregnant women were measured by the World Health Organization Violence Against Woman. Depressive symptoms during pregnancy were measured by the Escala de Depressão do Centro de Estudos Epidemiológicos (CES-D) (Depression Scale for Epidemiological Studies Center) and maternal depression symptoms were measured by the Edinburgh Postnatal Depression Scale (EPDS). The conceptual model of the structural equation modeling contained socioeconomic situation, social support, psychological and physical violence and depression during pregnancy as determinants of the maternal depression symptoms. Results: maternal depression symptoms were more frequently reported by pregnant women who suffered psychological violence (Standardized Coefficient, SC=0.256; p-value, p<0.001), physical violence (SC=0.221 p<0.001) and those who presented depressive symptoms during pregnancy SC=0.322, p<0.001). Depressive symptoms during pregnancy mediated the effects on physical and psychological violence on maternal depression. Conclusions: pregnant women who were submitted to psychological and physical violence and presented depressive symptoms during pregnancy frequently reported more of having maternal depression symptoms.
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da Silva AP, Feilbelmann TCM, Silva DC, Palhares HMC, Scatena LM, de Resende EAMR, de Fátima Borges M. Prevalence of overweight and obesity and associated factors in school children and adolescents in a medium-sized Brazilian city. Clinics (Sao Paulo) 2018; 73:e438. [PMID: 30517282 PMCID: PMC6238815 DOI: 10.6061/clinics/2018/e438] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 07/04/2018] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES The objective of this study was to describe the prevalence of overweight and obesity in school children and adolescents in a medium-sized Brazilian city. METHODS In total, 1,125 children and adolescents between the ages of 5.6 and 18 years from public and private schools participated in the study. The sample included 681 girls and 444 boys. Each subject's weight and height were obtained according to Brazilian guidelines (SISVAN). The triceps (TSF), subscapular (SSF), biceps, suprailiac, femoral and calf skinfolds were measured in triplicate. Body mass index (BMI) was classified as the BMI percentile (BMIP) according to the World Health Organization (WHO) 2007 criteria. The percentage body fat (%BF) was obtained using the equations by Slaughter et al., 1998. Categorical variables were analyzed using the chi-squared test. RESULTS Overall, 364 participants with excess weight were identified: 17.3% were overweight, and 15.0% were obese. Among the girls, 18.0% were overweight, and 12.5% were obese; among the boys, 15.3% were overweight, and 18.0% were obese. These prevalence rates were higher when the time spent watching TV or participating in media-related activities surpassed 5 hrs/day, when individuals belonged to a higher economic class and when the head of the family had a higher education level (≥12 years). CONCLUSION It is important to emphasize the need to increase our understanding of factors associated with overweight and obesity, and it is essential to implement measures and policies aimed at reversing this trend, such as stimulating healthy eating habits and physical activity and reducing time spent watching TV and participating in other media activities, including video games and social networking.
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Affiliation(s)
- Adriana Paula da Silva
- Divisao de Endocrinologia, Universidade Federal do Triangulo Mineiro, Uberaba, MG, BR
- *Corresponding author. E-mail: /
| | | | | | | | - Lúcia Marina Scatena
- Departamento de Medicina Social, Universidade Federal do Triangulo Mineiro, Uberaba, MG, BR
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Faerstein E, da Silveira IH, Boclin KDLS, Curioni CC, Castro IRRD, Junger WL. Associations of neighborhood socioeconomic, natural and built environmental characteristics with a 13-year trajectory of non-work physical activity among civil servants in Rio de Janeiro, Brazil: The Pro-Saude Study. Health Place 2018; 53:110-116. [PMID: 30098468 DOI: 10.1016/j.healthplace.2018.07.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 07/21/2018] [Accepted: 07/30/2018] [Indexed: 11/15/2022]
Abstract
Positive influences of natural and built environment characteristics on human physical activity have been observed mainly in high-income countries, but mixed results exist. We explored these relationships in Rio de Janeiro, Brazil, where exuberant nature coexists with high levels of social inequality and urban violence. Data originated from questionnaires self-administered by 1731 civil servants at university campuses who participated in 4 waves (1999, 2001, 2007, 2012) of a longitudinal study, and had their residential addresses geocoded. In multinomial regression models, adjusted for individual sociodemographic characteristics, mutually adjusted associations were estimated between 13-year trajectories of non-work physical activity and 8 contextual variables: distances from waterfronts, cycle paths, outdoor gym equipment, and squares; 2 indicators of exposure to greenness (a vegetation index - NDVI - derived from satellite images, and trees close to home); an indicator of walkability (street density), and neighborhood average income. Compared to participants living in the upper quartile of distance to waterfronts, those living in its lowest quartile had 2.6-fold higher odds (aOR: 2.62, 95% CI: 1.37-5.01) of reporting non-work PA in all 4 study waves. Similar results were observed in relation to distance to cycle paths; no independent associations were observed with other natural and built environment variables.
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Affiliation(s)
- Eduardo Faerstein
- Institute of Social Medicine, State University of Rio de Janeiro, Brazil.
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Moura DCAD, Greco RM, Paschoalin HC, Portela LF, Arreguy-Sena C, Chaoubah A. Psychological demand and control of the work process of public university servants. CIENCIA & SAUDE COLETIVA 2018; 23:481-490. [PMID: 29412406 DOI: 10.1590/1413-81232018232.13892015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Accepted: 01/16/2016] [Indexed: 11/22/2022] Open
Abstract
This cross-sectional research aimed to analyze the psychological demand and work control self-reported by the Education Administrative Technicians of a public university. This is a complete sample selection consisting of 833 Education Administrative Technicians who self-completed a questionnaire with questions structured in 2013/2014. A descriptive bivariate analysis was performed with the calculation of psychosocial stress at work, using the Demand-Control Model quadrants categorized as: low-demand work (low-demand and high-control), reference group, passive work (low-demand and low-control), active work (high-demand and high-control), high-demand (high-demand and low-control) - group with the highest exposure. The study complies with all ethical and legal research requirements involving human beings. There was a predominance of the category of workers performing passive work (n = 319, 39.7%), low work demand (n = 274, 34.1%), high work demand (n = 116, 14.4%) and active work (n = 95, 11.8%). There were contributions from the investigation on the health of these workers insofar as they provided a diagnosis of the category. There is a recommendation for such data to support interventions to empower them and retailor jobs.
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Affiliation(s)
- Denise Cristina Alves de Moura
- Faculdade de Enfermagem, Universidade Federal de Juiz de Fora. Campus Universitário Centro de Ciências da Saúde/Faculdade de Enfermagem, Martelos. 36036-330 Juiz de Fora MG Brasil.
| | - Rosangela Maria Greco
- Faculdade de Enfermagem, Universidade Federal de Juiz de Fora. Campus Universitário Centro de Ciências da Saúde/Faculdade de Enfermagem, Martelos. 36036-330 Juiz de Fora MG Brasil.
| | - Heloisa Campos Paschoalin
- Faculdade de Enfermagem, Universidade Federal de Juiz de Fora. Campus Universitário Centro de Ciências da Saúde/Faculdade de Enfermagem, Martelos. 36036-330 Juiz de Fora MG Brasil.
| | | | - Cristina Arreguy-Sena
- Faculdade de Enfermagem, Universidade Federal de Juiz de Fora. Campus Universitário Centro de Ciências da Saúde/Faculdade de Enfermagem, Martelos. 36036-330 Juiz de Fora MG Brasil.
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Jantsch AG, Alves RFS, Faerstein E. Educational inequality in Rio de Janeiro and its impact on multimorbidity: evidence from the Pró-Saúde study. A cross-sectional analysis. SAO PAULO MED J 2018; 136:51-58. [PMID: 29513787 PMCID: PMC9924166 DOI: 10.1590/1516-3180.2017.0209100917] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Accepted: 09/10/2017] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Information about multimorbidity is scarce in developing countries. This study aimed to estimate the association of educational attainment with occurrences of multimorbidity in a population of public employees on university campuses in Rio de Janeiro. DESIGN AND SETTING We conducted cross-sectional analyses on baseline data (1999-2001) from 3,253 participants in the Pró-Saúde study, conducted in Brazil. METHODS The prevalence of multimorbidity, defined as a self-reported history of medical diagnoses of two or more chronic conditions, was estimated according to sex, age, smoking, obesity and educational level. The association between education and multimorbidity was estimated using odds ratios (OR) and the relative and slope indices of inequality, in order to quantify the degree of educational inequality among individuals with multimorbidity in this population. RESULTS Greater age, female sex, smoking and obesity had direct associations with multimorbidity; and tobacco exposure and obesity also showed direct relationships with poorer educational level. There was a monotonic inverse linear trend between educational level and the presence of multimorbidity among women, with twice the odds (OR 2.47; 95% confidence interval, CI: 1.42-4.40) between extremities of schooling categories. There was excess multimorbidity of 22% at the lowest extremity of schooling, thus showing that women with worse educational status were more affected by the outcome. No trend and no excess multimorbidity was seen among men. CONCLUSIONS Educational inequality is an important determinant for development of multimorbidity. Men and women experience its effect differently. Researchers need to consider that sex may be an effect modifier in multimorbidity studies.
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Affiliation(s)
- Adelson Guaraci Jantsch
- MD, MSc. Doctoral Student, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro (UERJ), and Coordinator, Residency Program in Family and Community Medicine, Secretaria Municipal de Saúde do Rio de Janeiro, Rio de Janeiro (RJ), Brazil.
| | - Ronaldo Fernandes Santos Alves
- MSc. Doctoral Student, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro (RJ), Brazil.
| | - Eduardo Faerstein
- MSc, PhD. Associate Professor, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro (RJ), Brazil.
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Oliveira DSD, Boccolini CS, Faerstein E, Verly E. Breastfeeding duration and associated factors between 1960 and 2000. J Pediatr (Rio J) 2017; 93:130-135. [PMID: 27453144 DOI: 10.1016/j.jped.2016.05.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 05/13/2016] [Accepted: 05/25/2016] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To describe a historical series on the median duration of breastfeeding in a population of mothers whose children were born from the 1960s onwards, identifying factors associated with the interruption of breastfeeding in each decade. METHODS Data were analyzed from the Pró-Saúde Study, a longitudinal epidemiological investigation started in 1999 among technical and administrative employees of a university in the state of Rio de Janeiro. Breastfeeding duration was collected in two study phases: Phase 1 (1999), and phase 4 (2011-2012). Of these, those who had at least one child and reported the duration of breastfeeding for the first child were selected (n=1539). To analyze the duration of breastfeeding, survival curves were constructed using the Kaplan-Meier method and the effect of covariates on the duration of breastfeeding was estimated by Cox regression model. RESULTS It was found that the median duration of breastfeeding was higher in the 1990s and 2000s and lower in the 1970s, compared to the 1960s. In addition, there was an association between higher income and maternal age with breastfeeding interruption, which was focused in the 1970s. CONCLUSION There was shorter duration of breastfeeding in the 1970s compared to the 1960s. Increased duration and prevalence of breastfeeding from the 1970s onwards coincided with the national trend and the promotion of this practice since 1980.
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Affiliation(s)
- Danielle Soares de Oliveira
- Universidade do Estado do Rio de Janeiro (UERJ), Instituto de Medicina Social (IMS), Rio de Janeiro, RJ, Brazil
| | | | - Eduardo Faerstein
- Universidade do Estado do Rio de Janeiro (UERJ), Instituto de Medicina Social (IMS), Rio de Janeiro, RJ, Brazil
| | - Eliseu Verly
- Universidade do Estado do Rio de Janeiro (UERJ), Instituto de Medicina Social (IMS), Rio de Janeiro, RJ, Brazil.
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Oliveira DSD, Boccolini CS, Faerstein E, Verly‐Jr E. Breastfeeding duration and associated factors between 1960 and 2000. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2017. [DOI: 10.1016/j.jpedp.2016.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Chain A, Crivelli M, Faerstein E, Bezerra FF. Association between fat mass and bone mineral density among Brazilian women differs by menopausal status: The Pró-Saúde Study. Nutrition 2017; 33:14-19. [PMID: 27908545 DOI: 10.1016/j.nut.2016.08.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 08/08/2016] [Accepted: 08/11/2016] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the association between bone mineral density (BMD) and fat mass (FM) in a multiethnic population of Brazilian women and to evaluate the influence of total body mass and lean mass on this association. METHODS This was a cross-sectional study nested within the Pro-Saúde Study, a prospective cohort of university civil servants in Rio de Janeiro. Participants were pre- (n = 100) and postmenopausal (n = 166) women. Total fat, lean mass, and BMD of total body, lumbar spine, and femoral neck were measured using dual energy x-ray absorptiometry. The association of BMD with FM was investigated after adjustment for total body mass (model 1) and lean mass (model 2) and potential confounding variables using multivariate linear regression models. RESULTS In model 1, FM was inversely associated with BMD for total body (B = -0.010; P < 0.01) and for femoral neck (B = -0.009 P < 0.05) in premenopausal women. No association between FM and BMD was observed in postmenopausal women. Model 2 yielded direct associations between FM and BMD (total and specific sites; B = 0.003-0.008; P < 0.01) in postmenopausal women only. CONCLUSIONS Independently of the adjustment used, the results of the present study suggest the absence of an inverse association between FM and BMD in postmenopausal women. Additionally, when adjusted for lean mass, a direct association between FM and bone mass can be observed, suggesting that for postmenopausal women being slightly obese does not confer excessive risk for bone loss and may even result in a bone density advantage.
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Affiliation(s)
- Amina Chain
- Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil; Instituto de Pesquisa e Capacitação Física do Exército, Rio de Janeiro, Brazil
| | - Marise Crivelli
- Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Eduardo Faerstein
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Flávia F Bezerra
- Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
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Faerstein E, Chor D, Werneck GL, Lopes CDS, Kaplan G. Race and perceived racism, education, and hypertension among Brazilian civil servants: the Pró-Saúde Study. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2016; 17 Suppl 2:81-7. [PMID: 25409639 DOI: 10.1590/1809-4503201400060007] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Accepted: 06/12/2013] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Brazil has the largest population of African descendants outside Africa. OBJECTIVE Mindful of the imprint of slavery on their contemporary social position, we investigated the relationship of perceived racism to hypertension. METHODS We analyzed data (1999 - 2001) from 3,056 civil servants (mean age 42 years; 56% females) at university campuses in Rio participating in the longitudinal Pró-Saúde Study. RESULTS Cases of prevalent hypertension had measured blood pressure equal to or greater than 140/90 mmHg or used antihypertensive medication. Self-administered questionnaires assessed participants' perceived history of lifetime discrimination (due to race, gender, socioeconomic position, and other attributes) at work and school, neighborhood, public places, and in contact with the police. Participants used 41 terms as responses to an open-ended question on racial self-identification; for these analyses, 48% were classified as afrodescendants. Racial discrimination in at least one setting was reported by 14% of afrodescendants. Compared to whites, the age- and gender-adjusted prevalence of hypertension was higher for afrodescendants with history of self-perceived racism (prevalence ratio--PR = 2.1; 95%CI 1.5-3.0) than for those with no such history (PR = 1.5; 95%CI 1.2-1.8). Comparing the former to whites, the adjusted association with hypertension was stronger for those with elementary education (PR = 3.0; 95%CI 1.3-6.7) than for those with a college degree (PR = 1.7; 95%CI 1.0-3.1). CONCLUSION Racism may increase the risk of hypertension of afrodescendants in Brazil, and socioeconomic disadvantage--also influenced by societal racism--may further potentiate this increased risk.
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Affiliation(s)
- Eduardo Faerstein
- Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Dóra Chor
- Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | | | - George Kaplan
- Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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da Rocha TF, Hasselmann MH, Chaves Curioni C, Bezerra FF, Faerstein E. Alcohol consumption is associated with DXA measurement of adiposity: the Pró-Saúde Study, Brazil. Eur J Nutr 2016; 56:1983-1991. [DOI: 10.1007/s00394-016-1240-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 05/30/2016] [Indexed: 10/21/2022]
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Alves RFS, Faerstein E. Desigualdade educacional na ocorrência de obesidade abdominal por gênero e cor/raça: Estudo Pró-Saúde, 1999-2001 e 2011-2012. CAD SAUDE PUBLICA 2016; 32:e00077415. [DOI: 10.1590/0102-311x00077415] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 12/10/2015] [Indexed: 11/21/2022] Open
Abstract
Resumo Análise de dados seccionais do Estudo Pró-Saúde (1999-2001 e 2011-2012) revelou importante diferença de gênero e cor/raça na magnitude e variação temporal da desigualdade educacional na obesidade abdominal. Probabilidade de estar obeso foi gradativamente maior em mulheres (independentemente de cor/raça) e homens (pardos/pretos) menos escolarizados. Tais gradientes foram quantificados pelo índice relativo de desigualdade (IRD). Ao longo da década, observou-se redução da desigualdade em mulheres pardas/pretas (ΔIRD: 0,5; IC95%: 0,2-1,1), subjacente ao relativo aumento da prevalência de obesidade abdominal entre as mais escolarizadas. Houve estabilidade do IRD em mulheres brancas e homens pardos/pretos, indicando crescimento similar da prevalência de obesidade abdominal nos subgrupos educacionais. Associação da escolaridade com a ocorrência de obesidade abdominal sofreu interação múltipla de fatores sociodemográficos. Nossos resultados encorajam a estratificação conjunta por gênero e cor/raça no estudo das desigualdades socioeconômicas na ocorrência da obesidade abdominal.
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Alves RFS, Faerstein E. Educational inequality in the occurrence of abdominal obesity:Pró-Saúde Study. Rev Saude Publica 2015; 49:65. [PMID: 26465669 PMCID: PMC4587820 DOI: 10.1590/s0034-8910.2015049005786] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 01/31/2015] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE To estimate the degree of educational inequality in the occurrence of abdominal obesity in a population of non-faculty civil servants at university campi.METHODS In this cross-sectional study, we used data from 3,117 subjects of both genders aged 24 to 65-years old, regarding the baseline of Pró-Saúde Study, 1999-2001. Abdominal obesity was defined according to abdominal circumference thresholds of 88 cm for women and 102 cm for men. A multi-dimensional, self-administered questionnaire was used to evaluate education levels and demographic variables. Slope and relative indices of inequality, and Chi-squared test for linear trend were used in the data analysis. All analyses were stratified by genders, and the indices of inequality were standardized by age.RESULTS Abdominal obesity was the most prevalent among women (43.5%; 95%CI 41.2;45.9), as compared to men (24.3%; 95%CI 22.1;26.7), in all educational strata and age ranges. The association between education levels and abdominal obesity was an inverse one among women (p < 0.001); it was not statistically significant among men (p = 0.436). The educational inequality regarding abdominal obesity in the female population, in absolute terms (slope index of inequality), was 24.0% (95%CI 15.5;32.6). In relative terms (relative index of inequality), it was 2.8 (95%CI 1.9;4.1), after the age adjustment.CONCLUSIONS Gender inequality in the prevalence of abdominal obesity increases with older age and lower education. The slope and relative indices of inequality summarize the strictly monotonous trend between education levels and abdominal obesity, and it described educational inequality regarding abdominal obesity among women. Such indices provide relevant quantitative estimates for monitoring abdominal obesity and dealing with health inequalities.
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Affiliation(s)
- Ronaldo Fernandes Santos Alves
- Programa de Pós-Graduação em Saúde Coletiva. Instituto de Medicina Social. Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil
| | - Eduardo Faerstein
- Departamento de Epidemiologia. Instituto de Medicina Social. Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil
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Social inequalities in BMI trajectories: 8-year follow-up of the Pró-Saúde study in Rio de Janeiro, Brazil. Public Health Nutr 2015; 18:3183-91. [PMID: 25895645 PMCID: PMC4642226 DOI: 10.1017/s1368980015001032] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE In a cohort of government employees in Rio de Janeiro, Brazil, we investigated prospectively, sex-specific associations between education and BMI trajectories and their potential effect modification by race. DESIGN Of the 4030 participants in Phase 1 (1999), 3253 (81 %) participated in Phase 2 (2003) and 3058 (76 %) participated in Phase 3 (2006). Education was categorized as elementary, high school or college graduate. Study participants self-identified as White, Black or Pardo. BMI was calculated from measured weight and height. BMI trajectories were modelled using a generalized additive regression model with mixed effects (GAMM). SETTING The Pro-Saúde Study, a longitudinal investigation of social determinants of health. SUBJECTS Women (n 1441) and men (n 1127) who participated in the three phases of data collection and had complete information for all study variables. RESULTS Women and men with less than high school, or only a high school education, gained approximately 1 kg/m(2) more than college graduates (women: 1·06 kg/m(2) (P<0·001) and 1·06 kg/m(2) (P<0·001), respectively; men: 1·04 kg/m(2) (P=0·013) and 1·01 kg/m(2) (P=0·277), respectively). For women only, race was independently associated with weight gain. Women identifying as Pardo or Black gained 1·03 kg/m(2) (P=0·01) and 1·02 kg/m(2) (P=0·10), respectively, more than Whites. No effect modification by race was observed for either men or women. CONCLUSIONS While both lower education and darker race were associated with greater weight gain, gender similarities and differences were observed in these associations. The relationship between weight gain and different indicators of social status are therefore complex and require careful consideration when addressing the obesity epidemic.
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Oliveira AJ, Lopes CS, Rostila M, Werneck GL, Griep RH, Leon ACMPD, Faerstein E. Gender differences in social support and leisure-time physical activity. Rev Saude Publica 2015; 48:602-12. [PMID: 25210819 PMCID: PMC4181105 DOI: 10.1590/s0034-8910.2014048005183] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 07/04/2014] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To identify gender differences in social support dimensions’ effect on adults’ leisure-time physical activity maintenance, type, and time. METHODS Longitudinal study of 1,278 non-faculty public employees at a university in Rio de Janeiro, RJ, Southeastern Brazil. Physical activity was evaluated using a dichotomous question with a two-week reference period, and further questions concerning leisure-time physical activity type (individual or group) and time spent on the activity. Social support was measured with the Medical Outcomes Study Social Support Scale. For the analysis, logistic regression models were adjusted separately by gender. RESULTS A multinomial logistic regression showed an association between material support and individual activities among women (OR = 2.76; 95%CI 1.2;6.5). Affective support was associated with time spent on leisure-time physical activity only among men (OR = 1.80; 95%CI 1.1;3.2). CONCLUSIONS All dimensions of social support that were examined influenced either the type of, or the time spent on, leisure-time physical activity. In some social support dimensions, the associations detected varied by gender. Future studies should attempt to elucidate the mechanisms involved in these gender differences.
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Affiliation(s)
- Aldair J Oliveira
- Laboratório de Dimensões Sociais Aplicadas à Atividade Física e ao Esporte, Instituto de Educação, Universidade Federal Rural do Rio de Janeiro, Seropédica, RJ, Brasil
| | - Claudia S Lopes
- Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Mikael Rostila
- Centre for Health Equity Studies, Stockholm University, Stockholm, Sweden
| | - Guilherme Loureiro Werneck
- Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | | | | | - Eduardo Faerstein
- Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
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Feibelmann TCM, Silva APD, Resende DCS, Resende EAMRD, Scatena LM, Borges MDF. Puberty in a sample of Brazilian schoolgirls: timing and anthropometric characteristics. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2015; 59:105-11. [PMID: 25993671 DOI: 10.1590/2359-3997000000021] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 01/13/2015] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The objective of this study was to determine the age at which puberty begins, age of menarche and anthropometric data of the participants at different stages of puberty. SUBJECTS AND METHODS This is a cross-sectional study in which we evaluated 665 girls, a sample representing the female schoolchildren population in Uberaba. RESULTS We found that thelarche, pubarche, underarm hair and menarche were attained at the age of 9.8 ± 1.4, 10.2 ± 1.4, 10.5 ± 1.5 and 11.7 ± 1.3 years, respectively. The mean interval between thelarche and menarche (ITM) was 1.7 ± 1.3 years. The prevalence of overweight and obesity was 31.3% and 95% of the participants began at thelarche between the age of 7 and 12 years. CONCLUSION These values indicate a secular tendency to the decrease of the age of menarche and an earlier start of puberty. It is very important to understand these parameters to establish public policies aimed at plans to prevent these early events, especially regarding control of the prevalence of obesity.
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Affiliation(s)
- Taciana Carla Maia Feibelmann
- Department of Clinical Medicine, Department of Endocrinology and Metabolism, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brazil
| | - Adriana Paula da Silva
- Department of Clinical Medicine, Department of Endocrinology and Metabolism, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brazil
| | - Daniela Cristina Silva Resende
- Department of Clinical Medicine, Department of Endocrinology and Metabolism, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brazil
| | | | | | - Maria de Fátima Borges
- Department of Clinical Medicine, Department of Endocrinology and Metabolism, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brazil
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Alves MGDM, Braga VM, Faerstein E, Lopes CS, Junger W. The demand-control model for job strain: a commentary on different ways to operationalize the exposure variable. CAD SAUDE PUBLICA 2015; 31:208-12. [PMID: 25715304 DOI: 10.1590/0102-311x00080714] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2014] [Accepted: 08/29/2014] [Indexed: 01/19/2023] Open
Abstract
Demand-control has been the most widely used model to study job strain in various countries. However, researchers have used the model differently, thus hindering the comparison of results. Such heterogeneity appears in both the study instrument used and in the definition of the main exposure variable - high strain. This cross-sectional study aimed to assess differences between various ways of operationalizing job strain through association with prevalent hypertension in a cohort of workers (Pro-Health Study). No difference in the association between high job strain and hypertension was found according to the different ways of operationalizing exposure, even though prevalence varied widely, according to the adopted form, from 19.6% for quadrants to 42% for subtraction tertile. The authors recommend further studies to define the cutoff for exposure variables using combined subjective and objective data.
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Boclin KDLS, Faerstein E, Leon ACMPD. Neighborhood contextual characteristics and leisure-time physical activity: Pró-Saúde Study. Rev Saude Publica 2015; 48:249-57. [PMID: 24897046 PMCID: PMC4206140 DOI: 10.1590/s0034-8910.2014048004935] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2013] [Accepted: 11/07/2013] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To estimate the association between neighborhood contextual variables and
leisure-time physical activity. METHODS Data were analyzed for 2,674 adults from Rio de Janeiro, RJ, Southeastern
Brazil, participating in the longitudinal study in 1999. Leisure-time
physical activity in the two preceding weeks was assessed dichotomously.
Sex, age, income, education and marital status were analyzed as individual
variables. Neighborhood contextual characteristics were the social
development index, the Theil index and the proportion of the area occupied
by parks, squares and gardens, categorized in quintiles. The unadjusted and
adjusted odds ratios and 95% confidence intervals were estimated using
multilevel logistic regression. RESULTS The prevalence of leisure-time physical activity was higher in residents in
neighborhoods with higher indices of social development (between 32.3% and
53.1%) and a greater proportion of parks, squares and gardens (between 35.8%
and 53.1%). Regarding the social development index, the adjusted odds ratios
for physical activity were 1.22 (95%CI 0.93;1.61), 1.44 (95%CI 1.09;1.89),
1.75 (95%CI 1.31;2.34) and 2.25 (95%CI 1.70;3.00) for residents in
neighborhoods in the second, third, fourth and fifth quintiles,
respectively, compared with residents in neighborhoods in the first
quintile. The odds ratios for the proportion of parks, squares and gardens
were 0.90 (95%CI 0.69;1.19), 1.41 (95%CI 1.04;1.90), 1.63 (95%CI 1.24;2.14)
and 1.05 (95%CI 0.80;1.38) for residents in neighborhoods in the second,
third, fourth and fifth quintiles. After adjusting for the other variables,
only the social development index continued to be associated with
leisure-time physical activity, with odds ratios of 1.41 (95%CI 1.02;1.95);
1.54 (95%CI 1.12;2.12); 1.65 (95%CI 1.14;2.39) and 2.13 (95%CI 1.40;3.25)
for residents in neighborhoods in the second, third, fourth and fifth
quintiles. CONCLUSIONS Leisure-time physical activity was more common in residents in neighborhoods
with higher social development indices. No association was observed between
access to leisure areas and income inequality.
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Affiliation(s)
- Karine de Lima Sírio Boclin
- Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Eduardo Faerstein
- Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
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Boclin KDLI, Faerstein E, Szklo M. Does life-course socioeconomic position influence racial inequalities in the occurrence of uterine leiomyoma? Evidence from the Pró-Saúde Study. CAD SAUDE PUBLICA 2014; 30:305-17. [PMID: 24627059 DOI: 10.1590/0102-311x00025413] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 08/22/2013] [Indexed: 11/22/2022] Open
Abstract
We aimed to investigate whether life-course socioeconomic position mediates the association between skin color/race and occurrence of uterine leiomyomas. We analyzed 1,475 female civil servants with baseline data (1999-2001) of the Pró-Saúde Study in Rio de Janeiro State, Brazil. Life-course socioeconomic position was determined by parental education (early life socioeconomic position), participant education (socioeconomic position in early adulthood) and their combination (cumulative socioeconomic position). Gynecological/breast exams and health insurance status were considered markers of access to health care. Hazard ratios (HR) and 95% confidence intervals (95%CI) were estimated using Cox proportional hazards models. Compared with white women, black and parda ("brown") women had higher risk of reporting uterine leiomyomas, respectively HR: 1.6, 95%CI: 1.2-2.1; HR: 1.4, 95%CI: 0.8-2.5. Estimates were virtually identical in models including different variables related to life-course socioeconomic position. This study corroborated previous evidence of higher uterine leiomyomas risk in women with darker skin color, and further suggest that life-course socioeconomic position adversity does not influence this association.
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Affiliation(s)
- Karine de Limas Irio Boclin
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Eduardo Faerstein
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Moyses Szklo
- Bloomberg School of Public Health, John Hopkins University, Baltimore, USA, Bloomberg School of Public Health, John Hopkins University, Baltimore, USA
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Lopes CS, Sampaio MMA, Werneck GL, Chor D, Faerstein E. Influence of psychosocial factors on smoking cessation: longitudinal evidence from the Pro-Saude Study. Rev Saude Publica 2014; 47:732-9. [PMID: 24346664 DOI: 10.1590/s0034-8910.2013047004524] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Accepted: 02/21/2013] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate the incidence of smoking cessation and its association with psychosocial factors. METHODS Data came from three consecutive waves of the Pro-Saude Study, a longitudinal study of non-faculty civil servants working at a university in Rio de Janeiro, Southeastern Brazil. Inclusion criteria were having participated in Phases 1 and 3 and being a smoker at baseline (Phase 1--1999). Those who had stopped smoking less than a year before the follow-up (Phase 3--2007) were excluded. The final study population consisted of 661 employees (78% of those eligible). Relative risks (RR) of smoking cessation were evaluated through Poisson regression with robust variance. RESULTS The cumulative incidence of smoking cessation in eight years of follow-up was 27.7%. Among the psychosocial factors evaluated in the multivariate analysis, only lack of experience of physical violence was associated with higher smoking cessation (RR = 1.67, 95%CI 1.09;2.55). CONCLUSIONS The incidence of smoking cessation was high, and the fact that associations were not found with most factors evaluated suggests that much of the effect found is due to the impact of public policies implemented in Brazil over the past decades. The association between no exposure to violence and higher incidence of smoking cessation draws attention to the importance of this factor in tobacco control policies.
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Affiliation(s)
- Claudia S Lopes
- Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de JaneiroRJ, Brasil
| | | | - Guilherme L Werneck
- Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de JaneiroRJ, Brasil
| | - Dóra Chor
- Departamento de Epidemiologia e Métodos Quantitativos em Saúde, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de JaneiroRJ, Brasil
| | - Eduardo Faerstein
- Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de JaneiroRJ, Brasil
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de Sousa TF, Fonseca SA, José HPM, Nahas MV. MONISA study: characteristics and methodological aspects. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2013; 15:904-7. [PMID: 23515784 DOI: 10.1590/s1415-790x2012000400020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2011] [Accepted: 09/12/2012] [Indexed: 11/22/2022] Open
Abstract
The objective is to present the characteristics and methodological procedures adopted in the MONISA Study (Surveillance of health and quality of life indicators of college students). This is a prospective, panel type study, with biannual surveys of representative samples of undergraduate students at a public university in the State of Bahia, Brazil. This study carried out five surveys, totaling 10 years of monitoring (2010-2018). The sample is stratified and proportional to the courses, study period (day and night) and year of attending university. Finally, college students are selected at each stratum, through the registration list in alphabetical order. To obtain the information is used a structured questionnaire with the following sections: socio-demographic indicators, indicators of lifestyle and health, eating habits and body weight control, physical activity and other leisure options, preventive behaviors, and indicators environment and learning conditions. The novel aspects of this study may help in clarifying possible trends related to the health of Brazilian college students and to subsidize policies and programs or projects to promote health and quality of life in local, organizational level.
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Affiliation(s)
- Thiago Ferreira de Sousa
- Grupo de Pesquisa em Atividade Física e Saúde, Universidade Estadual de Santa Cruz, Ilhéus, Bahia, Brazil.
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Otero UB, Chor D, Carvalho MS, Faerstein E, Lopes CDS, Werneck GL. Association between socioeconomic position in earlier and later life and age at natural menopause: Estudo Pró-Saúde, Brazil. ACTA ACUST UNITED AC 2012; 7:719-27. [PMID: 22040212 DOI: 10.2217/whe.11.53] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
This study was based on a prospective cohort of university staff in Rio de Janeiro, Brazil (the Estudo Pró-Saúde). In this article the association between socioeconomic position (SEP) earlier and later in life and age at menopause is investigated. The main indicators investigated were for earlier SEP: mother's and father's schooling; stature; leg and trunk length. For later SEP they were: schooling; home and/or car ownership. Median age at menopause was estimated and survival curves were generated by the Kaplan-Meier method, while the association between indicators of SEP and age at menopause was explored by means of Cox semiparametric models. Associations were found between earlier SEP - represented by trunk length - and earlier menopause and between later SEP - represented by the indicator 'present schooling' - and earlier menopause. The association between earlier and later SEP was confirmed. Adverse situations over the life course can impact age at menopause and related health outcomes.
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Affiliation(s)
- Ubirani Barros Otero
- Department of Epidemiology, National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
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Pavão ALB, Coeli CM, Lopes CDS, Faerstein E, Werneck GL, Chor D. Social determinants of the use of health services among a public university workers. Rev Saude Publica 2012; 46:98-103. [PMID: 22218759 DOI: 10.1590/s0034-89102012005000002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Accepted: 09/15/2011] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze the use of health services and socioeconomic status among a public university workers. METHODS A cross-sectional study with 759 workers at a Brazilian public university who reported health-related restrictions of their usual activities in the previous 14 days, was carried out. Data were supplied by the 2001 cohort of the "Pró-Saúde Study" in Rio de Janeiro, Southeastern Brazil. Health services use was assessed with a proxy for "seeking health care" and according to the type of service. The presence of additional variation in morbidity was verified by time restriction. Schooling, income and occupation markers were analyzed, and crude and adjusted proportion ratios of use and types of service were calculated. RESULTS The occupation level was the indicator of the greatest inequality in health services use. After adjustments for gender, age and the other socioeconomic status markers, the ratio of the proportion of health care use was 1.31 for manual workers (95%CI: 1.11;1.55) and 1.21 for non-manual workers (95%CI: 1.06;1.37) compared to the reference category of professionals. CONCLUSIONS A pattern of social inequality was identified in health services use. Even after an adjustment for health need, the pattern favored individuals with lower socioeconomic status, particularly for the occupation marker. Remaining differences in individual morbidities do not explain this finding. Rather, occupational factors may exert a greater influence on health services use in this population.
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Affiliation(s)
- Ana Luiza Braz Pavão
- Programa de Pós-Graduação em Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
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Social support and leisure-time physical activity: longitudinal evidence from the Brazilian Pró-Saúde cohort study. Int J Behav Nutr Phys Act 2011; 8:77. [PMID: 21791105 PMCID: PMC3199735 DOI: 10.1186/1479-5868-8-77] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2011] [Accepted: 07/26/2011] [Indexed: 11/10/2022] Open
Abstract
Background Although social support has been observed to exert a beneficial influence on leisure-time physical activity (LTPA), multidimensional approaches examining social support and prospective evidence of its importance are scarce. The purpose of this study was to investigate how four dimensions of social support affect LTPA engagement, maintenance, type, and time spent by adults during a two-year follow-up. Methods This paper reports on a longitudinal study of 3,253 non-faculty public employees at a university in Rio de Janeiro (the Pró-Saúde study). LTPA was evaluated using a dichotomous question with a two-week reference period, and further questions concerning LTPA type (individual or group) and time spent on the activity. Social support was measured by the Medical Outcomes Study Social Support Scale (MOS-SSS). To assess the association between social support and LTPA, two different statistical models were used: binary and multinomial logistic regression models for dichotomous and polytomous outcomes, respectively. Models were adjusted separately for those who began LTPA in the middle of the follow up (engagement group) and for those who had maintained LTPA since the beginning of the follow up (maintenance group). Results After adjusting for confounders, statistically significant associations (p < 0.05) between dimensions of social support and group LTPA were found in the engagement group. Also, the emotional/information dimension was associated with time spent on LTPA (OR = 2.01; 95% CI 1.2-3.9). In the maintenance group, material support was associated with group LTPA (OR = 1.80; 95% CI; 1.1-3.1) and the positive social interaction dimension was associated with time spent on LTPA (OR = 1.65; 95% CI; 1.1-2.7). Conclusions All dimensions of social support influenced LTPA type or the time spent on the activity. However, our findings suggest that social support is more important in engagement than in maintenance. This finding is important, because it suggests that maintenance of LTPA must be associated with other factors beyond the individual's level of social support, such as a suitable environment and social/health policies directed towards the practice of LTPA.
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César CC, Carvalho MS. Stratified sampling design and loss to follow-up in survival models: evaluation of efficiency and bias. BMC Med Res Methodol 2011; 11:99. [PMID: 21703013 PMCID: PMC3144452 DOI: 10.1186/1471-2288-11-99] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2010] [Accepted: 06/26/2011] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Longitudinal studies often employ complex sample designs to optimize sample size, over-representing population groups of interest. The effect of sample design on parameter estimates is quite often ignored, particularly when fitting survival models. Another major problem in long-term cohort studies is the potential bias due to loss to follow-up. METHODS In this paper we simulated a dataset with approximately 50,000 individuals as the target population and 15,000 participants to be followed up for 40 years, both based on real cohort studies of cardiovascular diseases. Two sample strategies--simple random (our golden standard) and Stratified by professional group, with non-proportional allocation--and two loss to follow-up scenarios--non-informative censoring and losses related to the professional group--were analyzed. RESULTS Two modeling approaches were evaluated: weighted and non-weighted fit. Our results indicate that under the correctly specified model, ignoring the sample weights does not affect the results. However, the model ignoring the interaction of sample strata with the variable of interest and the crude estimates were highly biased. CONCLUSIONS In epidemiological studies misspecification should always be considered, as different sources of variability, related to the individuals and not captured by the covariates, are always present. Therefore, allowance must be made for the possibility of unknown confounders and interactions with the main variable of interest in our data. It is strongly recommended always to correct by sample weights.
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Affiliation(s)
- Cibele C César
- Department of Statistics, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Marilia S Carvalho
- National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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Otero UB, Chor D, Carvalho MS, Faerstein E, Lopes CDS, Werneck GL. Lack of association between age at menarche and age at menopause: Pró-Saúde Study, Rio de Janeiro, Brazil. Maturitas 2010; 67:245-50. [DOI: 10.1016/j.maturitas.2010.07.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2010] [Revised: 07/03/2010] [Accepted: 07/07/2010] [Indexed: 01/07/2023]
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Aguiar OBD, Fonseca MDJMD, Valente JG. Confiabilidade (teste-reteste) da escala sueca do Questionário Demanda-Controle entre Trabalhadores de Restaurantes Industriais do Estado do Rio de Janeiro. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2010. [DOI: 10.1590/s1415-790x2010000200004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Este estudo tem o objetivo de verificar a confiabilidade teste-reteste da versão em Português da escala sueca "Demand-Control-Support Questionnaire (DCSQ)" em uma população de trabalhadores com baixa escolaridade. MÉTODO: O questionário foi aplicado em dois momentos para 52 trabalhadores de três restaurantes industriais de uma empresa concessionária do Rio de Janeiro, com intervalos de 7 a 15 dias. Como indicadores de estabilidade foram utilizados o Coeficiente de Correlação Intraclasse (CCIC), a estatística Kappa Ponderado e o gráfico de Bland & Altman. Para avaliação da consistência interna utilizou-se o Coeficiente Alpha de Cronbach. RESULTADOS: O CCIC para as dimensões: demanda psicológica, controle do trabalho e apoio social no trabalho foi de 0,70, 0,68 e 0,80, respectivamente. O Alpha de Cronbach apresentou, no reteste, os seguintes resultados: 0,75, 0,50 e 0,82, para as dimensões anteriormente citadas, na mesma sequência. CONCLUSÕES: Ainda que o resultado da escala controle do trabalho tenha sido considerado baixo para o Alpha de Cronbach, os outros indicadores de confiabilidade apontam para uma boa estabilidade do instrumento, possibilitando sua utilização em estudos de associação entre estresse no trabalho e desfechos relacionados à saúde.
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Alves MGDM, Chor D, Faerstein E, Werneck GL, Lopes CS. Job strain and hypertension in women: Estudo Pro-Saúde (Pro-Health Study). Rev Saude Publica 2010; 43:893-6. [PMID: 19851634 DOI: 10.1590/s0034-89102009000500019] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2008] [Accepted: 04/17/2009] [Indexed: 11/22/2022] Open
Abstract
This study aimed to analyze the association between job strain and hypertension in the female population. A cross-sectional study was performed with 1,819 women who participated in the Estudo Pró-Saúde (Pro-Health Study), in the city of Rio de Janeiro, Southeastern Brazil, between 1999 and 2001. The Brazilian version of the short version of the Job Stress Scale (demand-control model) was used. Overall prevalence of measured hypertension (> or =140/90 mmHg and/or antihypertensive drug use) was 24%. Compared to participants with jobs classified as low strain, adjusted prevalence ratios for hypertension in women who performed passive and active high-strain jobs were, respectively, 0.93 (95% CI: 0.72;1.20), 1.06 (95% CI: 0.86;1.32) and 1.14 (95% CI: 0.88;1.47). Longitudinal analyses should be performed to clarify the role of these work environment psychosocial characteristics as a determinant of hypertension.
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Affiliation(s)
- Márcia Guimarães de Mello Alves
- Departamento de Planejamento em Saúde, Instituto de Saúde da Comunidade, Universidade Federal Fluminense, Niterói, RJ, Brasil.
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Robaina JR, Lopes CS, Rotenberg L, Faerstein E, Fischer FM, Moreno CRDC, Werneck GL, Chor D. Eventos de vida produtores de estresse e queixas de insônia entre auxiliares de enfermagem de um hospital universitário no Rio de Janeiro: estudo Pró-Saúde. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2009. [DOI: 10.1590/s1415-790x2009000300018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJETIVO: Avaliar a associação entre eventos de vida produtores de estresse (EVPE) e queixas de insônia (QI). MÉTODOS: Foram analisados dados seccionais de 695 auxiliares de enfermagem de um hospital universitário, participantes do Estudo Pró-Saúde - coorte de funcionários de uma universidade no Rio de Janeiro. As informações foram obtidas através de um questionário multidimensional e autopreenchido, que avaliou a ocorrência de EVPE nos últimos 12 meses, variáveis socioeconômicas e demográficas e QI. As QI foram analisadas como desfecho politômico (frequente, ocasional, e ausente). Odds ratios brutos e ajustados foram calculados através de regressão logística multinomial. RESULTADOS: A prevalência total de QI foi de 45,8% (16,7% frequentes e 29,1% ocasionais). Após ajuste por sexo, idade, estado civil, renda familiar per capita e regime de trabalho, os EVPE associados com QI frequentes foram: "rompimento de relação amorosa" (OR = 3,32; IC95% 1,90 - 5,78), "ter tido problemas graves de saúde" (OR = 2,82; IC95% 1,73 - 4,58); "dificuldades financeiras graves" (OR = 2,38; IC95% 1,46 - 3,88), e "mudança forçada de moradia" (OR = 1,97; IC95% 1,02 - 3,79). Com relação às QI ocasionais, houve associação apenas com rompimento de relação amorosa (OR = 2,30; IC95% 1,42 - 3,74) e dificuldades financeiras graves (OR = 1,87; IC95% 1,27 - 2,75). CONCLUSÕES: Dada a responsabilidade com vidas humanas que os auxiliares de enfermagem assumem durante seu horário de trabalho, nossos achados podem contribuir para ações mais efetivas, por parte dos serviços de saúde ao trabalhador, para lidar com o estresse nessa categoria.
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Hasselmann MH, Faerstein E, Werneck GL, Chor D, Lopes CS. Associação entre circunferência abdominal e hipertensão arterial em mulheres: Estudo Pró-Saúde. CAD SAUDE PUBLICA 2008; 24:1187-91. [DOI: 10.1590/s0102-311x2008000500029] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2007] [Accepted: 01/22/2008] [Indexed: 11/22/2022] Open
Abstract
O objetivo deste estudo foi estimar a prevalência de hipertensão arterial segundo estratos de circunferência abdominal (CA) e índice de massa corporal (IMC, em kg/m²) em uma população de funcionárias públicas de universidade localizada no Rio de Janeiro, Brasil. Foram analisados dados seccionais de 1.743 mulheres não grávidas de 24 a 69 anos participantes, em 2001, do Estudo Pró-Saúde. Mulheres com baixo peso ou apresentando IMC > 35kg/m² foram excluídas. Mulheres que apresentavam pressão sangüínea sistólica > 140mmHg ou diastólica > 90mmHg ou faziam uso de medicação anti-hipertensiva foram consideradas hipertensas. A análise foi conduzida segundo dois estratos de CA (normal: < 88cm; elevado: > 88cm) e três de IMC (eutrofia: 18,5-24,9kg/m²; sobrepeso: 25,0-29,9kg/m²; e obesidade I: 30,0-34,9kg/m²). Entre mulheres eutróficas, participantes com valores elevados de CA apresentaram o dobro da prevalência de hipertensão arterial do que aquelas com CA < 88cm (18% vs. 8%; p < 0,05). Adicionalmente à mensuração do IMC, a aferição da CA na rotina dos serviços de saúde pode contribuir para a identificação precoce ou suspeição de hipertensão arterial.
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Faerstein E. Relações entre Ensino e Pesquisa em Epidemiologia (com comentários sobre a estratégia do mestrado em consórcio da UFPel). REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2008. [DOI: 10.1590/s1415-790x2008000500015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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