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Barbosa F, Devoz PP, Cavalcante MRN, Gallimberti M, Cruz JC, Domingo JL, Simões EJ, Lotufo P, Liu S, Bensenor I. Urinary levels of 30 metal/metalloids in the Brazilian southeast population: Findings from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Environ Res 2023; 225:115624. [PMID: 36878270 DOI: 10.1016/j.envres.2023.115624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/14/2023] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
The assessment of risks associated with environmental exposure to metals/metalloids requires well-established reference values for each population since it varies considerably according to distinct local/regional characteristics. However, very few studies establish baseline values for these elements (essential and toxic) in large population groups, especially in Latin American countries. This study was aimed at establishing urinary reference levels of 30 metals/metalloids: aluminum (Al), antimony (Sb), arsenic (As), barium (Ba), beryllium (Be), cadmium (Cd), cerium (Ce), cesium (Cs), chromium (Cr), cobalt (Co), copper (Cu), lanthanum (La), lead (Pb), lithium (Li), strontium (Sr), manganese (Mn), mercury (Hg), molybdenum (Mo), nickel (Ni), platinum (Pt), rubidium (Rb), selenium (Se), silver (Ag), tin (Sn), tellurium (Te), thallium (Tl), thorium (Th), tungsten (W), uranium (U) and zinc (Zn) in a Brazilian southeast adult population. This pilot study is a cross-sectional analysis conducted with the first wave of the ELSA-Brasil cohort (baseline examination). A total of 996 adults (45.5% men, N = 453, mean age: 50.5, and 54.5% women, N = 543, mean age: 50.6) were included in the study. Sample analyses were performed by Inductively Coupled Plasma Mass Spectrometry (ICP-MS). Percentiles (2.5, 10, 25, 50, 75, 95 (CI95%), and 97.5) of each element (μg/g of creatinine) in the study are presented according to sex. Moreover, differences in the mean metal/metalloid urinary levels according to age, education, smoking, and alcohol intake are also presented. Finally, median found values were compared to established values of large human biomonitoring surveys previously conducted in North America and France. This is the first comprehensive and systematic human biomonitoring study that established population reference ranges for 30 (essential and/or toxic elements) in a Brazilian population group.
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Affiliation(s)
- Fernando Barbosa
- Laboratório de Toxicologia Analítica e de Sistemas (ASTOx). Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
| | - Paula Picoli Devoz
- Laboratório de Toxicologia Analítica e de Sistemas (ASTOx). Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | | | - Matheus Gallimberti
- Laboratório de Toxicologia Analítica e de Sistemas (ASTOx). Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Jonas Carneiro Cruz
- Laboratório de Toxicologia Analítica e de Sistemas (ASTOx). Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - José Luis Domingo
- Universitat Rovira i Virgili, School of Medicine, Reus, Catalonia, Spain
| | - Eduardo J Simões
- University of Missouri School of Medicine and Institute for Data Science and informatics, Columbia, MO, USA
| | - Paulo Lotufo
- Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, University of São Paulo, São Paulo, SP, Brazil
| | - Simin Liu
- Departments of Epidemiology, Medicine, and Surgery, and Center for Global Cardiometabolic Health, Brown University, Providence, RI, USA.
| | - Isabela Bensenor
- Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, University of São Paulo, São Paulo, SP, Brazil.
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Ribeiro MCM, Sañudo A, Simões EJ, Ramos LR. Relationship between physical activity and functional capacity change in aged cohort in São Paulo, Brazil. Rev Bras Enferm 2021; 75:e20200837. [PMID: 34787237 PMCID: PMC9885500 DOI: 10.1590/0034-7167-2020-0837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 08/22/2021] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVES to evaluate the relationship between leisure-time physical activity and functional capacity change among aged people. METHODS we analyzed data of an aged cohort looking for determinants of functional capacity at follow-up. Baseline data were collected between 2007 and 2008 - average follow-up of 3,5 years. A full multivariate linear regression model was built to evaluate functional capacity at the end of the follow-up, controlling for functional capacity at baseline, sociodemographic, health and behavioral characteristics and amount of leisure-time physical activity in the period. RESULTS final model showed functional capacity independently correlated with age (p<0.001), body mass (p=0.013) and the number of activities of daily living compromised at baseline (p<0.001). Functional capacity improved with increased physical activity but loss statistical significance after adjustments (p=0.384). CONCLUSIONS functional capacity decreases with increased age, increased loss of functional capacity at baseline and increased body mass. Albeit a non-significant association, leisure-time physical activity appears as an important modifiable factor.
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Affiliation(s)
| | - Adriana Sañudo
- Universidade Federal de São Paulo. São Paulo, São Paulo, Brazil
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Hidalgo KD, Mielke GI, Parra DC, Lobelo F, Simões EJ, Gomes GO, Florindo AA, Bracco M, Moura L, Brownson RC, Pratt M, Ramos LR, Hallal PC. Health promoting practices and personal lifestyle behaviors of Brazilian health professionals. BMC Public Health 2016; 16:1114. [PMID: 27776496 PMCID: PMC5078940 DOI: 10.1186/s12889-016-3778-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 10/15/2016] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND This study was conducted to examine the lifestyle behaviors and health promoting practices of physicians, nurses, and community health workers in Brazil. METHODS A random sample of primary health care units in Brazil was selected, and a pretested questionnaire was administered via phone interviews, in 2011, to 182 physicians, 347 nurses, and 269 community health workers, totaling 798 health professionals. The total initial sample included 1600 eligible health professionals. Variables measured included physical activity, alcohol intake, hours of sleep, diet, and perceived self-efficacy to provide preventive counseling on related lifestyle behaviors. RESULTS More than 25 % of physicians, nurses, and community health workers reported eating 0-2 portions of fruits and vegetables per day. In terms of cervical and breast cancer, nurses reported to be 'very prepared' to advise patients on these topics more frequently than physicians. The prevalence of smoking ranged from 4.9 % among nurses to 7.4 % among community health workers. The proportion of physical inactivity ranged from 40.3 % among nurses to 52.1 % among community health workers. CONCLUSION A reasonably high proportion of physicians, nurses, and community health workers report not engaging in healthy lifestyle behaviors that impact chronic diseases, thus, they may be less likely to encourage such behaviors in their patients.
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Affiliation(s)
- Karen D. Hidalgo
- JFK Johnson Rehabilitation Institute, JFK Medical Center, Edison, NJ USA
| | - Grégore I. Mielke
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Diana C. Parra
- Program in Physical Therapy, School of Medicine, Washington University in St. Louis, St. Louis, MO USA
| | - Felipe Lobelo
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - Eduardo J. Simões
- School of Medicine, Department of Health Management and Informatics, University of Missouri, Columbia, MO USA
| | - Grace O. Gomes
- Gerontology Department, Federal University of Sao Carlos, São Carlos, SP Brazil
| | - Alex A. Florindo
- School of Arts, Sciences and Humanities, University of Sao Paulo, Sao Paulo, Brazil
| | - Mário Bracco
- Center of Studies and Research Dr. João Amorim, CEJAM, São Paulo, SP Brazil
| | | | - Ross C. Brownson
- Prevention Research Center in St. Louis, Washington University in St. Louis, Brown School, St. Louis, MO USA
- School of Medicine, Division of Public Health Sciences and Alvin J. Siteman Cancer Center, Washington University in St. Louis, St. Louis, MO USA
| | - Michael Pratt
- Department of Family Medicine and Public Health, University of California, San Diego, CA USA
| | - Luiz R. Ramos
- Department of Preventive Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - Pedro C. Hallal
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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Hoehner CM, Ribeiro IC, Parra DC, Reis RS, Azevedo MR, Hino AA, Soares J, Hallal PC, Simões EJ, Brownson RC. Physical activity interventions in Latin America: expanding and classifying the evidence. Am J Prev Med 2013; 44:e31-40. [PMID: 23415133 PMCID: PMC4217143 DOI: 10.1016/j.amepre.2012.10.026] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2012] [Revised: 08/22/2012] [Accepted: 10/22/2012] [Indexed: 12/04/2022]
Abstract
CONTEXT Systematic reviews of public health interventions are useful for identifying effective strategies for informing policy and practice. The goals of this review were to (1) update a previous systematic review of physical activity interventions in Latin America which found that only school-based physical education had sufficient evidence to recommend widespread adoption; (2) assess the reporting of external validity elements; and (3) develop and apply an evidence typology for classifying interventions. EVIDENCE ACQUISITION In 2010-2011, community-level, physical activity intervention studies from Latin America were identified, categorized, and screened based on the peer-reviewed literature or Brazilian theses published between 2006 and 2010. Articles meeting inclusion criteria were evaluated using U.S. Community Guide methods. External validity reporting was assessed among a subset of articles reviewed to date. An evidence rating typology was developed and applied to classify interventions along a continuum based on evidence about their effectiveness in the U.S. context, reach, adoption, implementation, institutionalization, and benefits and costs. EVIDENCE SYNTHESIS Thirteen articles published between 2006 and 2010 met inclusion criteria and were abstracted systematically, yet when combined with evidence from articles from the previous systematic review, no additional interventions could be recommended for practice. Moreover, the reporting of external validity elements was low among a subset of 19 studies published to date (median=21% of elements reported). By applying the expanded evidence rating typology, one intervention was classified as evidence-based, seven as promising, and one as emerging. CONCLUSIONS Several physical activity interventions have been identified as promising for future research and implementation in Latin America. Enhanced reporting of external validity elements will inform the translation of research into practice.
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Affiliation(s)
- Christine M Hoehner
- Division of Public Health Sciences and Alvin J. Siteman Cancer Center, School of Medicine, Washington University in St. Louis, St. Louis, MO 63110, USA.
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Hoehner CM, Soares J, Parra Perez D, Ribeiro IC, Joshu CE, Pratt M, Legetic BD, Malta DC, Matsudo VR, Ramos LR, Simões EJ, Brownson RC. Physical activity interventions in Latin America: a systematic review. Am J Prev Med 2008; 34:224-233. [PMID: 18312811 DOI: 10.1016/j.amepre.2007.11.016] [Citation(s) in RCA: 112] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2007] [Revised: 09/18/2007] [Accepted: 11/07/2007] [Indexed: 11/15/2022]
Abstract
BACKGROUND Recommendations for physical activity in the Guide to Community Preventive Services (the Community Guide) have not been systematically examined or applied in developing countries such as those in Latin America. The aim of this systematic review was to assess the current evidence base concerning interventions to increase physical activity in Latin America using a modified Community Guide process and to develop evidence-based recommendations for physical activity interventions. METHODS In 2006, a literature review of both peer-reviewed and non-peer-reviewed literature in Portuguese, Spanish, and English was carried out to identify physical activity interventions conducted in community settings in Latin America. Intervention studies were identified by searching ten databases using 16 search terms related to physical activity, fitness, health promotion, and community interventions. All intervention studies related to physical activity were summarized into tables. Six reviewers independently classified the intervention studies by the categories used in the Community Guide and screened the studies for inclusion in a systematic abstraction process to assess the strength of the evidence. Five trained researchers conducted the abstractions. RESULTS The literature search identified 903 peer-reviewed articles and 142 Brazilian theses related to physical activity, of which 19 were selected for full abstraction. Only for school-based physical education classes was the strength of the evidence from Latin America sufficient to support a practice recommendation. CONCLUSIONS This systematic review highlights the need for rigorous evaluation of promising interventions to increase physical activity in Latin America. Implementation and maintenance of school physical education programs and policies should be strongly encouraged to promote the health of Latin American children.
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Affiliation(s)
- Christine M Hoehner
- Prevention Research Center, Saint Louis University School of Public Health, St. Louis, Missouri 63104, USA.
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Sampaio LR, Simões EJ, Assis AMO, Ramos LR. Validity and reliability of the sagittal abdominal diameter as a predictor of visceral abdominal fat. ACTA ACUST UNITED AC 2007; 51:980-6. [DOI: 10.1590/s0004-27302007000600013] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2006] [Accepted: 03/09/2007] [Indexed: 11/21/2022]
Abstract
OBJECTIVES: To evaluate the reliability of the sagittal abdominal diameter and its validity as a predictor of visceral abdominal fat, as well as to identify the most appropriate cut-off points to identify the area of visceral fat that is known to represent a risk factor for cardiovascular disease. DESIGN: Validation study. SUBJECTS: 92 healthy volunteers (57 women, 35 men), age: 20-83 y, body mass index: 19.3 to 35.9 kg/m². MEASUREMENTS: Sagittal abdominal diameter (SAD), weight, height, circumferences (waist, hip, and thigh), sub-scapular skinfold thickness, abdominal diameter index, and waist-hip ratio (WHR). METHOD OF CHOICE: Computed tomography (CT). STATISTIC: Receiver operating characteristic (ROC) curve. RESULTS: The reliability for SAD measurement was very high (Inter-class coefficient = 0.99). Visceral fat as measured by VAF through CT was highly correlated with SAD (women r = 0.80; men r = 0.64, p < 0.001), waist circumference (women r = 0.77; men r = 0.73, p < 0.001), and WHR (women r = 0.72; men r = 0.58, p < 0.001). The ROC curve indicated 19.3 cm and 20.5 cm as the threshold values for abdominal sagittal diameter in women and men (sensitivity 85% and 83%, specificity 77% and 82%, respectively). CONCLUSIONS: There was a high correlation between SAD and VAF. The cut-off values identified for SAD presented a sensitivity and specificity that were considered adequate.
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