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Andretti B, Cardoso LO, Honório OS, de Castro Junior PCP, Tavares LF, da Costa Gaspar da Silva I, Mendes LL. Ecological study of the association between socioeconomic inequality and food deserts and swamps around schools in Rio de Janeiro, Brazil. BMC Public Health 2023; 23:120. [PMID: 36650487 PMCID: PMC9847189 DOI: 10.1186/s12889-023-14990-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 01/05/2023] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Previous research suggests that unhealthy community food environments around schools contribute to unhealthy eating habits and negative health outcomes among the youth. However, little is known about how socioeconomic inequalities in those community food environments are associated with food deserts and food swamps across schools' neighborhoods. METHODS An ecological study was carried out in all 3,159 public and private schools in Rio de Janeiro, Brazil. Three measures of socioeconomic inequality were evaluated: per capita income, segregation index and deprivation index. The community school food environment was analyzed by metrics of food swamps and food deserts. RESULTS Food deserts and food swamps were simultaneously more prevalent in neighborhoods of the lowest income, high deprivation, and high segregation. Spatial socioeconomic disparities at the neighborhoods of schools were associated with food deserts and food swamps in Rio de Janeiro. CONCLUSIONS Our results point to a spatial socioeconomic inequality of establishments that sell food around schools in a Brazilian metropolis, indicating that the areas of greatest deprivation of food services are also the areas with the worst socioeconomic characteristics.
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Affiliation(s)
- Bernardo Andretti
- Brazilian School of Public and Business Administration, Getulio Vargas Foundation, 30 R. Jornalista Orlando Dantas, Rio de Janeiro, CEP, 22231-010, Brazil.
| | - Letícia Oliveira Cardoso
- grid.418068.30000 0001 0723 0931 Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Olivia Souza Honório
- grid.411213.40000 0004 0488 4317 Nutrition School, Federal University of Ouro Preto, Ouro Preto, Brazil
| | | | - Letícia Ferreira Tavares
- grid.8536.80000 0001 2294 473XInstitute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Isabela da Costa Gaspar da Silva
- grid.418068.30000 0001 0723 0931 Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Larissa Loures Mendes
- grid.8430.f0000 0001 2181 4888Nutrition Department, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais Brazil
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Silva NCD, Cardoso LO, Muniz CK, Prestes IV, Pena GDG. Failure to achieve proteic goals in non-critical patients increases risk for death: Old discussion, ongoing problem. Nutrition 2020; 77:110894. [PMID: 32736297 DOI: 10.1016/j.nut.2020.110894] [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: 01/29/2020] [Revised: 05/30/2020] [Accepted: 05/30/2020] [Indexed: 12/07/2022]
Abstract
OBJECTIVES Providing adequate nutritional support for hospitalized patients continues to be a challenge. The aim of this study was to evaluate the association of energy and protein provision with in-hospital mortality in non-critically ill patients. METHODS A retrospective study (2014-2016) was performed with all patients >18 y of age who were admitted to medical and surgical clinic wards and given exclusive enteral therapy. The mean of energy and protein was estimated per day and per kilogram of body mass from the enteral prescription data, over the entire period of hospitalization. A prescription mean was considered hypocaloric or hypoproteic at <20 kcal · kg · d-1 or <0.8 g · kg · d-1, respectively. RESULTS Of the 240 patients, 58.3% were >60 y of age and 60% were men. The frequencies of in-hospital mortality (19.2%) and malnutrition (78.8%) were high. The means of protein (0.75 g· kg· d-1) and energy (17.60 kcal · kg · d-1) were below the general recommendations and 37.8% did not reach a mean of 20 kcal · kg · d-1 during the entire hospitalization period. Hypocaloric (hazard ratio [HR], 5.78; 95% confidence interval [CI], 1.59-21.04) and hypoproteic nutrition (HR, 3.69; 95% CI, 1.25-10.93) were predictors of all-cause in-hospital mortality in adjusted multivariate models. However, when we adjusted the hypoprotein nutrition by energy (non-protein calories to nitrogen ratio), hypoprotein nutrition seems to maintain the increased risk for death (HR, 3.15; 95% CI, 1.04-9.53). CONCLUSIONS Hypoproteic nutrition appears to be more significant than hypocaloric nutrition in predicting all-cause in-hospital mortality. Protocols should be implemented to ensure that target caloric and protein levels are reached as quickly as possible to optimize patient survival.
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Affiliation(s)
- Nayara Cristina da Silva
- Graduate Program in Health Sciences, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | | | - Cinara Knychala Muniz
- Food and Nutrition Service of Hospital of the Federal University of Uberlandia, Brazil
| | | | - Geórgia das Graças Pena
- Graduate Program in Health Sciences, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil.
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Chor D, Cardoso LO, Nobre AA, Griep RH, Fonseca MDJM, Giatti L, Bensenor I, del Carmen Bisi Molina M, Aquino EML, Diez-Roux A, de Pina Castiglione D, Santos SM. Association between perceived neighbourhood characteristics, physical activity and diet quality: results of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). BMC Public Health 2016; 16:751. [PMID: 27506819 PMCID: PMC4977638 DOI: 10.1186/s12889-016-3447-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 08/05/2016] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The study explores associations between perceived neighbourhood characteristics, physical activity and diet quality, which in Latin America and Brazil have been scarcely studied and with inconsistent results. METHODS We conducted a cross-sectional analysis of 14,749 individuals who participated in the Brazilian Longitudinal Study of Adult Health (Estudo Longitudinal de Saúde do Adulto, ELSA-Brasil) baseline. The study included current and retired civil servants, aged between 35 and 74 years, from universities and research institutes in six Brazilian states. The International Physical Activity Questionnaire (IPAQ) long form was used to characterize physical activity during leisure time and commuting; additional questions assessed how often fruit and vegetables were consumed, as a proxy for diet quality. Neighbourhood characteristics were evaluated by the "Walking Environment" and "Availability of Healthy Foods" scales originally used in the Multi-Ethnic Study of Atherosclerosis (MESA). Associations were examined using multinomial logistic regression. RESULTS Perceiving a more walkable neighbourhood was positively associated with engaging in leisure time physical activity and doing so for longer weekly. Compared with those who saw their neighbourhood as less walkable, those who perceived it as more walkable had 1.69 (95 % CI 1.57-1.83) and 1.39 (1.28-1.52) greater odds of engaging in leisure time physical activity for more than 150 min/week or up to 150 min/week (vs. none), respectively. Perceiving a more walkable neighbourhood was also positively associated with transport-related physical activity. The same pattern was observed for diet: compared with participants who perceived healthy foods as less available in their neighbourhood, those who saw them as more available had odds 1.48 greater (1.31-1.66) of eating fruits, and 1.47 greater (1.30-1.66) of eating vegetables, more than once per day. CONCLUSIONS Perceived walkability and neighbourhood availability of healthy food were independently associated with the practice of physical activity and diet quality, respectively, underlining the importance of neighbourhood-level public policies to changing and maintaining health-related habits.
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Affiliation(s)
- Dóra Chor
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, RJ Brazil
| | | | - Aline Araújo Nobre
- Programa de Computação Científica, Fundação Oswaldo Cruz, Rio de Janeiro, RJ Brazil
| | - Rosane Härter Griep
- Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, 21040–360 RJ Brazil
| | | | - Luana Giatti
- Escola de Nutrição, Universidade Federal de Ouro Preto, Ouro Preto, MG Brazil
| | - Isabela Bensenor
- Hospital Universitário, Universidade de São Paulo, São Paulo, SP Brazil
| | | | - Estela M. L. Aquino
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia Brazil
| | - Ana Diez-Roux
- School of Public Health, Drexel University, Philadelphia, PA USA
| | | | - Simone M. Santos
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, RJ Brazil
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Tavares LF, Castro IRRD, Cardoso LO, Levy RB, Claro RM, Oliveira AFD. Validade de indicadores de atividade física e comportamento sedentário da Pesquisa Nacional de Saúde do Escolar entre adolescentes do Rio de Janeiro, Brasil. CAD SAUDE PUBLICA 2014; 30:1861-74. [DOI: 10.1590/0102-311x00151913] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Accepted: 01/07/2014] [Indexed: 11/22/2022] Open
Abstract
Analisou-se a validade relativa dos indicadores de atividade física do questionário utilizado na Pesquisa Nacional de Saúde do Escolar (PeNSE) entre adolescentes da cidade do Rio de Janeiro, Brasil. Foram estudados 174 alunos. Avaliaram-se os seguintes indicadores referentes ao tempo semanal acumulado com a prática de atividade física: ATIVO-300MIN (acumulou 300 minutos ou mais); ATIVO-150MIN (acumulou 150 minutos ou mais); INATIVO (não praticou atividade física). Também foram estudados os indicadores de comportamento sedentário referentes ao tempo diário despendido assistindo TV, jogando videogame e usando computador. Foram comparados os resultados do questionário e dos três recordatórios de 24 horas. Os resultados de ATIVO-300MIN, ATIVO-150MIN e INATIVO gerados pela PeNSE apresentaram alta acurácia. Esses indicadores tiveram melhor desempenho que os de comportamento sedentário, tanto em relação às estimativas de frequência quanto em relação à sensibilidade, especificidade e índice de acurácia. Os indicadores de atividade física da PeNSE apresentaram validade relativa satisfatória.
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Tavares LF, Castro IRRD, Levy RB, Cardoso LO, Passos MDD, Brito FDSB. Validade relativa de indicadores de práticas alimentares da Pesquisa Nacional de Saúde do Escolar entre adolescentes do Rio de Janeiro, Brasil. CAD SAUDE PUBLICA 2014; 30:1029-41. [DOI: 10.1590/0102-311x00000413] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Accepted: 11/04/2013] [Indexed: 01/14/2023] Open
Abstract
Avaliou-se a validade relativa dos indicadores de práticas alimentares do questionário utilizado na Pesquisa Nacional de Saúde do Escolar (PeNSE) entre adolescentes da cidade do Rio de Janeiro, Brasil. Foram estudados 174 alunos. Foram avaliados os indicadores: a ingestão regular (≥ 5 vezes/semana) dos alimentos marcadores de alimentação saudável, marcadores de alimentação não saudável e as rotinas alimentares: realizar refeição com responsável (REFEIÇÃO), realizar o desjejum (DESJEJUM) e comer enquanto estuda ou assiste à TV. Foram comparados os resultados do questionário e dos três recordatórios de 24 horas. Para todos os marcadores de alimentação saudável, não houve diferença na proporção de ingestão regular de acordo com os dois métodos. As frequências geradas pelo questionário foram superiores para os indicadores salgadinhos de pacote e biscoitos salgados e mais baixas para embutidos e REFEIÇÃO. Os indicadores de consumo regular de marcadores de alimentação saudável e aquele referente a DESJEJUM foram os que apresentaram maior acurácia. Os indicadores de práticas alimentares utilizados pela PeNSE apresentaram validade satisfatória.
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Castro IRRD, Engstrom EM, Cardoso LO, Damião JDJ, Rito RVFV, Gomes MADSM. Time trend in breast-feeding in the city of Rio de Janeiro, Southeastern Brazil: 1996-2006. Rev Saude Publica 2009; 43:1021-9. [PMID: 20027497 DOI: 10.1590/s0034-89102009005000079] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2008] [Accepted: 05/11/2009] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze time trend in breast-feeding (BF) and exclusive breast-feeding (EBF). METHODS Data from a monitoring system, based on surveys conducted during the National Immunization Campaign in the city of Rio de Janeiro, Southeastern Brazil, in 1996, 1998, 2000, 2003 and 2006, were analyzed. Study population was comprised of 19,044 children younger than one year of age, who were present in vaccination stations. A probability cluster sample (vaccination stations), self-weighted and representative of the population of children younger than 12 months of age (<12), was studied for each year. A structured questionnaire with closed questions about the child's diet at the moment of the study and maternal sociodemographic characteristics was applied. The BF and EBF indicators proposed by the World Health Organization were adopted. RESULTS BF<12 increased from 61.3% to 73.4% between 1996 and 2006. Similar trend was observed in all age groups analyzed. EBF in children <4 and <6 months of age (EBF<6) increased from 18.8% to 42.4% and from 13.8% to 33.3%, respectively. Improvements in BF>6 and EBF<6 were found in all categories of all maternal sociodemographic variables. For EBF<6, the disadvantage observed in women with a lower level of education in 1996 and in women who worked in 1998 was not completely overcome by 2006. CONCLUSIONS BF and EBF increased in the period studied, independently from child age group and maternal socio-demographic characteristics. The differences found among women in distinct sociodemographic situations were not completely overcome.
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Affiliation(s)
- Inês Rugani Ribeiro de Castro
- Instituto Annes Dias, Subsecretaria de Promoção, Atenção Básica e Vigilância em Saúde, Secretaria Municipal de Saúde e Defesa Civil do Rio de Janeiro, Av. Pasteur 44, Rio de Janeiro, RJ, Brazil.
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Castro IRRD, Engstrom EM, Cardoso LO, Damião JDJ, Rito RVFV, Gomes MADSM. Tendência temporal da amamentação na cidade do Rio de Janeiro: 1996-2006. Rev Saude Publica 2009. [DOI: 10.1590/s0034-89102009005000087] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Engstrom EM, Castro IRRD, Portela M, Cardoso LO, Monteiro CA. Efetividade da suplementação diária ou semanal com ferro na prevenção da anemia em lactentes. Rev Saude Publica 2008. [DOI: 10.1590/s0034-89102008000500002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Castro IRRD, Cardoso LO, Engstrom EM, Levy RB, Monteiro CA. Vigilância de fatores de risco para doenças não transmissíveis entre adolescentes: a experiência da cidade do Rio de Janeiro, Brasil. CAD SAUDE PUBLICA 2008; 24:2279-88. [DOI: 10.1590/s0102-311x2008001000009] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2007] [Accepted: 04/03/2008] [Indexed: 11/22/2022] Open
Abstract
Este trabalho apresenta métodos e resultados da implantação de sistema de vigilância de fatores de risco para doenças não transmissíveis entre adolescentes. Uma amostra (n = 1.699) probabilística de alunos de oitava série do ensino fundamental da rede pública municipal de ensino do Rio de Janeiro, Brasil, respondeu a questionário autopreenchido anônimo sobre consumo alimentar, atividade física, atividades sedentárias de lazer e consumo de cigarro. Estimativas de prevalência dos fatores de risco foram calculadas para o total da amostra e segundo sexo. Taxas de não resposta variaram de 0,2% a 13,4%. Foram observados: baixo consumo de frutas (45,8%) e hortaliças (20% e 16,5% para saladas e legumes cozidos), consumo freqüente de refrigerantes (36,7%), balas e doces (46,7%), grande quantidade de horas alocadas em frente à TV, computador ou videogame (71,7% alocam pelo menos 4h/dia nestas atividades), baixa freqüência de prática regular de atividade física (40%) e prevalência de 6,4% de fumantes. Meninas apresentaram menores índices de atividade física e maiores de consumo de cigarro. O sistema testado mostrou-se factível e indicou prevalências relevantes de fatores de risco para doenças não transmissíveis.
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Engstrom EM, Castro IRRD, Portela M, Cardoso LO, Monteiro CA. Effectiveness of daily and weekly iron supplementation in the prevention of anemia in infants. Rev Saude Publica 2008; 42:786-95. [PMID: 18709235 DOI: 10.1590/s0034-89102008005000043] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2007] [Accepted: 03/26/2008] [Indexed: 05/25/2023] Open
Abstract
OBJECTIVE To evaluate the effectiveness of universal prophylactic targeting with iron sulfate on daily or weekly basis in the prevention of anemia in infants. METHODS Randomized clinical field trial with children between ages six and 12 months seen at primary health care units in the municipality of Rio de Janeiro, Brazil, between 2004 and 2005. Three concurrent cohorts were compared: daily group (n=150; 12.5mg Fe/day); weekly group (n=147; 25mg Fe/week) and control group. The intervention consisted of universal supplementation with iron sulfate for 24 weeks, combined with educational adherence-promoting measures. OUTCOME mean serum hemoglobin concentration, distribution and prevalence of anemia (Hb<110.0 g/l) at age 12 months. Effectiveness was evaluated considering both intent to treat and adherence to protocol, using multiple regression analysis (linear and Poisson). RESULTS Groups were homogeneous in terms of descriptive variables. The intervention was implemented successfully, with high adhesion to protocol in both groups, and no statistical difference between them. After adjustment, only the daily regimen showed a protective effect. Adherence analysis demonstrated an evident dose-response effect on mean Hb and prevalence of anemia only for the daily regimen. No protective effect was detected for the weekly regimen. CONCLUSIONS Universal supplementation with iron sulfate from six to 12 months of age was effective in increasing serum Hb and decreasing risk of anemia only when administered on a daily basis.
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Affiliation(s)
- Elyne Montenegro Engstrom
- Escola Nacional de Saúde Pública Sérgio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil. ocruz.br
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