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de Oliveira BR, Magalhães EIDS, Bragança MLBM, Coelho CCNDS, Lima NP, Bettiol H, Barbieri MA, Cardoso VC, dos Santos AM, Horta BL, da Silva AAM. Performance of Body Fat Percentage, Fat Mass Index and Body Mass Index for Detecting Cardiometabolic Outcomes in Brazilian Adults. Nutrients 2023; 15:2974. [PMID: 37447300 PMCID: PMC10346298 DOI: 10.3390/nu15132974] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/21/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
Obesity is a recognized risk factor for the development of cardiometabolic outcomes. Therefore, it is essential to evaluate anthropometric and body composition indicators used for its diagnosis. This study aimed to assess the diagnostic performance of body fat percentage (BF%), fat mass index (FMI) and body mass index (BMI) for detecting cardiometabolic outcomes in adults. A cross-sectional study was conducted involving adults at 30 years of age from Pelotas, RS (n = 3517) and at 37-39 years from Ribeirão Preto, SP (n = 1696). Receiver operating characteristic (ROC) curves were used to determine the cut-off points for predicting cardiometabolic risk factors, including altered blood pressure, blood glucose, triglycerides, total cholesterol, low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDDL-c), C-reactive protein and glycated hemoglobin. The cut-off points of BF% ranged from 25.2 to 27.8 in men and from 37.4 to 39.7 in women at 30 years, and from 26.1 to 27.8 in men and from 38.5 to 42.2 in women at 37-39 years. For FMI (kg/m2), the cut-off points ranged from 6.3 to 7.5 in men and from 9.5 to 10.8 in women at 30 years, and from 7.3 to 7.8 in men and from 10.2 to 12.2 in women at 37-39 years. The BMI cut-off points (kg/m2) ranged from 26.3 to 27.3 in men and from 25.4 to 27.2 in women at 30 years, and from 28.3 to 29.0 in men and from 27.2 to 29.6 in women at 37-39 years. The areas under the curve were similar for the three indicators, ranging from 0.523 to 0.746. BMI showed a performance similar to that of the body fat-based indicators in identifying cardiometabolic outcomes. The cut-off points of the three indicators showed acceptable discriminatory power in subjects with cardiometabolic risk factors.
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Affiliation(s)
- Bianca Rodrigues de Oliveira
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (E.I.d.S.M.); (M.L.B.M.B.); (C.C.N.d.S.C.); (A.M.d.S.); (A.A.M.d.S.)
| | - Elma Izze da Silva Magalhães
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (E.I.d.S.M.); (M.L.B.M.B.); (C.C.N.d.S.C.); (A.M.d.S.); (A.A.M.d.S.)
| | - Maylla Luanna Barbosa Martins Bragança
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (E.I.d.S.M.); (M.L.B.M.B.); (C.C.N.d.S.C.); (A.M.d.S.); (A.A.M.d.S.)
| | - Carla Cristine Nascimento da Silva Coelho
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (E.I.d.S.M.); (M.L.B.M.B.); (C.C.N.d.S.C.); (A.M.d.S.); (A.A.M.d.S.)
| | - Natália Peixoto Lima
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Pelotas 96020-220, RS, Brazil; (N.P.L.); (B.L.H.)
| | - Heloisa Bettiol
- Postgraduate Programme in Child and Adolescent Health, University of São Paulo, Ribeirão Preto 14048-900, SP, Brazil; (H.B.); (M.A.B.); (V.C.C.)
| | - Marco Antônio Barbieri
- Postgraduate Programme in Child and Adolescent Health, University of São Paulo, Ribeirão Preto 14048-900, SP, Brazil; (H.B.); (M.A.B.); (V.C.C.)
| | - Viviane Cunha Cardoso
- Postgraduate Programme in Child and Adolescent Health, University of São Paulo, Ribeirão Preto 14048-900, SP, Brazil; (H.B.); (M.A.B.); (V.C.C.)
| | - Alcione Miranda dos Santos
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (E.I.d.S.M.); (M.L.B.M.B.); (C.C.N.d.S.C.); (A.M.d.S.); (A.A.M.d.S.)
| | - Bernardo Lessa Horta
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Pelotas 96020-220, RS, Brazil; (N.P.L.); (B.L.H.)
| | - Antônio Augusto Moura da Silva
- Postgraduate Programme in Collective Health, Federal University of Maranhão, São Luís 65020-070, MA, Brazil; (E.I.d.S.M.); (M.L.B.M.B.); (C.C.N.d.S.C.); (A.M.d.S.); (A.A.M.d.S.)
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Oliveira VP, Dias MDS, Lima NP, Horta BL. Birth conditions nutritional status in childhood associated with cardiometabolic risk factors at 30 years of age: a cohort study. CAD SAUDE PUBLICA 2023; 39:e00215522. [PMID: 37377296 PMCID: PMC10494699 DOI: 10.1590/0102-311xen215522] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 02/17/2023] [Accepted: 03/15/2023] [Indexed: 06/29/2023] Open
Abstract
This study aimed to assess the association of birth conditions, nutritional status, and childhood growth with cardiometabolic risk factors at 30 years of age. We also evaluated whether body mass index (BMI) at 30 years mediated the association of weight gain in childhood with cardiometabolic risk factors. This is a prospective cohort study that included all live births in 1982 in hospitals in the city of Pelotas, Rio Grande do Sul State, Brazil, whose families lived in the urban area. Mothers were interviewed at birth, and participants were followed at different ages. For our analyses, we used data on weight and height collected at birth, 2 and 4 years and cardiovascular risk factors at 30 years. Multiple linear regressions were performed to obtain adjusted coefficients and G-formula for mediation analysis. Relative weight gain in childhood, despite the age, was positively related to mean arterial pressure, whereas relative weight gain in late childhood was positively associated with carotid intima-media thickness, pulse wave velocity, triglycerides, non-HDL cholesterol, plasma glucose, and C-reactive protein. BMI in adulthood captured the total effect of relative weight gain in the period between 2 and 4 years on carotid intima-media thickness, triglycerides, non-HDL cholesterol, and C-reactive protein. Our findings reinforce the evidence that rapid relative weight gain after 2 years of age may have long-term consequences on the risk of metabolic and cardiovascular disorders.
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Affiliation(s)
- Vânia Pereira Oliveira
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brasil
| | - Mariane da Silva Dias
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brasil
- Universidade Federal do Rio Grande, Rio Grande, Brasil
| | - Natália Peixoto Lima
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brasil
| | - Bernardo Lessa Horta
- Departamento de Medicina Social, Universidade Federal de Pelotas, Pelotas, Brasil
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Poveda NE, Adair LS, Martorell R, Patel SA, Ramirez-Zea M, Bhargava SK, Bechayda SA, Carba DB, Kroker-Lobos MF, Horta BL, Lima NP, Mazariegos M, Menezes AMB, Norris SA, Nyati LH, Richter LM, Sachdev H, Wehrmeister FC, Stein AD. Growth patterns in childhood and adolescence and adult body composition: a pooled analysis of birth cohort studies from five low and middle-income countries (COHORTS collaboration). BMJ Open 2023; 13:e068427. [PMID: 36921951 PMCID: PMC10030655 DOI: 10.1136/bmjopen-2022-068427] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
Abstract
OBJECTIVE We examined associations among serial measures of linear growth and relative weight with adult body composition. DESIGN Secondary data analysis of prospective birth cohort studies. SETTINGS Six birth cohorts from Brazil, Guatemala, India, the Philippines and South Africa. PARTICIPANTS 4173 individuals followed from birth to ages 22-46 years with complete and valid weight and height at birth, infancy, childhood and adolescence, and body composition in adult life. EXPOSURES Birth weight and conditional size (standardised residuals of height representing linear growth and of relative weight representing weight increments independent of linear size) in infancy, childhood and adolescence. PRIMARY OUTCOME MEASURES Body mass index, fat mass index (FMI), fat-free mass index (FFMI), fat mass/fat-free mass ratio (FM/FFM), and waist circumference in young and mid-adulthood. RESULTS In pooled analyses, a higher birth weight and relative weight gains in infancy, childhood and adolescence were positively associated with all adult outcomes. Relative weight gains in childhood and adolescence were the strongest predictors of adult body composition (β (95% CI) among men: FMI (childhood: 0.41 (0.26 to 0.55); adolescence: 0.39 (0.27 to 0.50)), FFMI (childhood: 0.50 (0.34 to 0.66); adolescence: 0.43 (0.32 to 0.55)), FM/FFM (childhood: 0.31 (0.16 to 0.47); adolescence: 0.31 (0.19 to 0.43))). Among women, similar patterns were observed, but, effect sizes in adolescence were slightly stronger than in childhood. Conditional height in infancy was positively associated with FMI (men: 0.08 (0.03 to 0.14); women: 0.11 (0.07 to 0.16)). Conditional height in childhood was positively but weakly associated with women's adiposity. Site-specific and sex-stratified analyses showed consistency in the direction of estimates, although there were differences in their magnitude. CONCLUSIONS Prenatal and postnatal relative weight gains were positive predictors of larger body size and increased adiposity in adulthood. A faster linear growth in infancy was a significant but weak predictor of higher adult adiposity.
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Affiliation(s)
- Natalia E Poveda
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Linda S Adair
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Reynaldo Martorell
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Shivani A Patel
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Manuel Ramirez-Zea
- INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala
| | - Santosh K Bhargava
- Department of Pediatrics, Safdarjang Hospital and Vardhman Mahavir Medical College, New Delhi, India
| | - Sonny A Bechayda
- Office of Population Studies Foundation, University of San Carlos - Talamban Campus, Cebu City, The Philippines
| | - Delia B Carba
- Office of Population Studies Foundation, University of San Carlos - Talamban Campus, Cebu City, The Philippines
| | - Maria F Kroker-Lobos
- INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala
| | - Bernardo Lessa Horta
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Natália Peixoto Lima
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Mónica Mazariegos
- INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala
| | | | - Shane A Norris
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Pediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Lukhanyo H Nyati
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Pediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Linda M Richter
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Harshpal Sachdev
- Senior Consultant Pediatrics and Clinical Epidemiology, Sitaram Bhartia Institute of Science and Research, New Delhi, India
| | - Fernando C Wehrmeister
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Aryeh D Stein
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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Magalhães EIDS, Lima NP, Menezes AMB, Gonçalves H, Wehrmeister FC, Assunção MCF, Horta BL. Maternal smoking during pregnancy and birthweight on the third generation: results from two birth cohort studies. Eur J Pediatr 2023; 182:2095-2104. [PMID: 36813908 DOI: 10.1007/s00431-023-04888-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 02/03/2023] [Accepted: 02/16/2023] [Indexed: 02/24/2023]
Abstract
UNLABELLED The purpose of this research is to investigate whether grandmother's smoking during pregnancy reduces the grandchildren's birthweight and whether maternal smoking during pregnancy modified this association. We also evaluated the effect of duration and intensity of smoking. This study included data from three generations from two birth cohorts carried out in Pelotas, a southern Brazilian city: women enrolled in the perinatal study in the 1982 and 1993 cohorts (G1); daughters (G2) of those G1 mothers who were followed to adulthood; and first children (G3) born from G2 women. Information on maternal smoking during pregnancy was obtained from women (G1) shortly after delivery of the two cohorts and from G2 in the follow-up in adulthood of the 1993 cohort. Mothers (G2) reported G3 birthweight during the follow-up visit at adulthood. Multiple linear regression was used to obtain effect measures adjusted for confounders. The study included 1602 grandmothers (G1), mothers (G2), and grandchildren (G3). Prevalence of maternal (G1) smoking during pregnancy was 43% and mean G3 birthweight was 3118.9 g (SD: 608.8). Grandmother's smoking in the pregnancy was not associated with grandchild's birthweight. However, offspring of both G1 and G2 smokers had lower mean birthweight than those whose mother and grandmother did not smoke (adjusted β: - 223.05; 95% CI: - 415.16, - 32.76). CONCLUSION No significant association was observed between grandmother's smoking in the pregnancy and grandchild's birthweight. But it seems that grandmother's smoking in pregnancy has an effect on grandchild's birthweight when the mother also smoked in the pregnancy. . WHAT IS KNOWN • Most studies on the association of maternal tobacco smoking in pregnancy with offspring birthweight have been restricted to two generations, and an inverse association is well known. WHAT IS NEW • Besides to investigate whether grandmother's smoking during pregnancy reduces the grandchildren's birthweight, we examined whether this association varied according to maternal smoking during pregnancy.
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Affiliation(s)
- Elma Izze da Silva Magalhães
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 3º piso, Centro, Pelotas, Rio Grande do Sul (RS), 96020-220, Brazil.
| | - Natália Peixoto Lima
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 3º piso, Centro, Pelotas, Rio Grande do Sul (RS), 96020-220, Brazil
| | - Ana Maria Baptista Menezes
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 3º piso, Centro, Pelotas, Rio Grande do Sul (RS), 96020-220, Brazil
| | - Helen Gonçalves
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 3º piso, Centro, Pelotas, Rio Grande do Sul (RS), 96020-220, Brazil
| | - Fernando C Wehrmeister
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 3º piso, Centro, Pelotas, Rio Grande do Sul (RS), 96020-220, Brazil
| | - Maria Cecília Formoso Assunção
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 3º piso, Centro, Pelotas, Rio Grande do Sul (RS), 96020-220, Brazil
| | - Bernardo Lessa Horta
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 3º piso, Centro, Pelotas, Rio Grande do Sul (RS), 96020-220, Brazil
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Orellana JDY, Murray J, Lima NP, Pinheiro RT, Horta BL. Robbery Victimization in Early Adulthood, and Depression and Anxiety at Age 30 Years: Results From the 1982 Pelotas (Brazil) Birth Cohort Study. Front Public Health 2022; 10:821881. [PMID: 35757622 PMCID: PMC9218107 DOI: 10.3389/fpubh.2022.821881] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 05/17/2022] [Indexed: 11/13/2022] Open
Abstract
Robbery is one of the most common urban crimes, but little is known about its relationship with mental disorders in young adults. This study aimed to assess the relationship between robbery victimization and Major Depressive Disorder (MDD), Generalized Anxiety Disorder (GAD) and comorbidity between MDD and GAD at 30 years of age. A birth cohort study has followed all children born in the city of Pelotas, southern Brazil, since 1982. At ages 23 and 30 years, participants were interviewed and asked about lifetime and recent experiences of robbery. Covariates were measured in interviews between birth and age 30 years. MDD and GAD were measured using the MINI-International Neuropsychiatric Interview. Adjusted prevalence ratio (aPR) and corresponding 95% confidence interval (CI) for associations between robbery and mental disorders were calculated using Poisson regression with robust standard error. Of 3,701 cohort members interviewed at age 30 years, 42% reported robbery victimization during their lifetime. Victimization across three periods (lifetime, past 10 years, past 12 months) was associated with increased occurrence of MDD, GAD, as well as the MDD and GAD comorbidity. The strongest associations were found to robbery occurring in the previous 12 months with the MDD and GAD comorbidity, both for burglary at home (aPR 2.52; 95% CI 1.52-4.22) or community family victimization (aPR 2.10; 95% CI 1.34-3.27). These findings highlight the importance of community violence for mental health in young adulthood, and the need for public policies to prevent violence as well as support services for victims to mitigate its adverse health consequences.
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Affiliation(s)
| | - Joseph Murray
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.,Human Development and Violence Research Centre, Federal University of Pelotas, Pelotas, Brazil
| | - Natália Peixoto Lima
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.,Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil
| | | | - Bernardo Lessa Horta
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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Fernandes MP, Lima NP, Barros FC, Gonçalves H, Menezes AMB, Wehrmeister FC, Hartwig FP, Horta BL. Association between cesarean section and human capital in adulthood: 1982 and 1993 Pelotas birth cohorts, Rio Grande do Sul State, Brazil. CAD SAUDE PUBLICA 2021; 37:e00235520. [PMID: 34586169 DOI: 10.1590/0102-311x00235520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 12/17/2020] [Indexed: 11/22/2022] Open
Abstract
This study aims to assess the association between mode of delivery and human capital among young adults enrolled in the 1982 and 1993 Pelotas birth cohorts, Rio Grande do Sul State, Brasil. In 1982 and 1993, the maternity hospitals of the municipality were daily visited, the births identified, and those live births, whose family lived in the urban area of Pelotas, were examined and their mothers interviewed. Information on mode of delivery, vaginal or cesarean, was provided by the mother in the perinatal study. Performance in intelligence tests achieved schooling and income were evaluated in the 30 years visit at the 1982 cohort. At the 1993 cohort, schooling and income were assessed at the 22 years visit, whereas IQ was evaluated at 18 years. Tobacco smoking in adulthood and type of school was used as negative outcomes to strength causal inference. Initially, cesarean section was positively associated with human capital at adulthood, with the exception of income in the 1993 cohort. After controlling for confounders, the magnitude of the associations was strongly reduced, and the regression coefficients were close to the null value. The negative outcome analysis showed that, after controlling for confounding variables, the mode of delivery was not associated with tobacco smoking and type of school. Suggesting that the variables included in the regression model to control for confounding, provided an adequate adjustment and it is unlikely that the results are due to residual confounding by socioeconomic status. On the other hand, considering the short- and long-term risks and the epidemic of cesarean sections, measures should be implemented to reduce its prevalence.
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Carvalho CAD, Magalhães EIDS, Bettiol H, Barbieri MA, Cardoso VC, Matijasevich A, Menezes AMB, Horta BL, Wehrmeister FC, Gonçalves H, Santos IS, Lima NP, França AKTDC, Silva AAMD. Excess weight and obesity prevalence in the RPS Brazilian Birth Cohort Consortium (Ribeirão Preto, Pelotas and São Luís). CAD SAUDE PUBLICA 2021; 37:e00237020. [PMID: 34008736 DOI: 10.1590/0102-311x00237020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 01/04/2021] [Indexed: 11/21/2022] Open
Abstract
Our objective was to estimate the prevalence of excess weight and obesity, according to sex and income in the RPS Brazilian Birth Cohort Consortium (Ribeirão Preto, Pelotas, and São Luís). Participants in the Ribeirão Preto (1978/1979 and 1994), Pelotas (1982, 1993 and 2004) and São Luís (1997/1998) birth cohorts were included in different follow-ups from 7 years old onwards. Excess weight (overweight and obesity) were assessed by body mass index. The highest prevalences were observed in Ribeirão Preto (excess weight: 27.7% at 9-11 and 47.1% at 22-23 years; obesity: 8.6% at 9-11 and 19.8% at 22-23 years) while the smallest was in São Luís (excess weight: 5.4 to 7-9 and 17.2% at 18-19 years; obesity: 1.8% at 7-9 and 3.6% at 18-19 years). The younger the cohort, the greater the prevalence of excess weight and obesity when comparing similar age groups. Increases in obesity prevalence were greater than in excess weight prevalence. Women had lower excess weight prevalence in older cohorts and higher obesity prevalence in younger cohorts. Higher excess weight and obesity prevalence were observed in higher income children and adolescents, and in poorer adults. Differences in the prevalence of excess weight and obesity evidenced that individuals from younger cohorts are more exposed to this morbidity, as well as those who were born in the most developed city, low-income adults as well as children and adolescents belonging to families of the highest income tertile. Therefore, the results of this study indicate the need to prioritize actions aimed at younger individuals.
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Affiliation(s)
| | | | - Heloisa Bettiol
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brasil
| | | | - Viviane Cunha Cardoso
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brasil
| | | | | | | | | | - Helen Gonçalves
- Faculdade de Medicina, Universidade Federal de Pelotas, Pelotas, Brasil
| | - Iná S Santos
- Faculdade de Medicina, Universidade Federal de Pelotas, Pelotas, Brasil
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Confortin SC, Ribeiro MRC, Barros AJD, Menezes AMB, Horta BL, Victora CG, Barros FC, Gonçalves H, Bettiol H, Santos ISD, Barbieri MA, Saraiva MDCP, Alves MTSSDBE, Silveira MFD, Domingues MR, Lima NP, Rocha PRH, Cavalli RC, Batista RFL, Cardoso VC, Simões VMF, Silva AAMD. RPS Brazilian Birth Cohorts Consortium (Ribeirão Preto, Pelotas and São Luís): history, objectives and methods. CAD SAUDE PUBLICA 2021; 37:e00093320. [PMID: 33950086 DOI: 10.1590/0102-311x00093320] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 08/20/2020] [Indexed: 01/11/2023] Open
Abstract
This paper describes the history, objectives and methods used by the nine Brazilian cohorts of the RPS Brazilian Birth Cohorts Consortium (Ribeirão Preto, Pelotas and São Luís) Common thematic axes are identified and the objectives, baseline periods, follow-up stages and representativity of the population studied are presented. The Consortium includes three birth cohorts from Ribeirão Preto, São Paulo State (1978/1979, 1994 and 2010), four from Pelotas, Rio Grande do Sul State (1982, 1993, 2004 and 2015), and two from São Luís, Maranhão State (1997 and 2010). The cohorts cover three regions of Brazil, from three distinct states, with marked socioeconomic, cultural and infrastructure differences. The cohorts were started at birth, except for the most recent one in each municipality, where mothers were recruited during pregnancy. The instruments for data collection have been refined in order to approach different exposures during the early phases of life and their long-term influence on the health-disease process. The investigators of the nine cohorts carried out perinatal studies and later studied human capital, mental health, nutrition and precursor signs of noncommunicable diseases. A total of 17,636 liveborns were recruited in Ribeirão Preto, 19,669 in Pelotas, and 7,659 in São Luís. In the studies starting during pregnancy, 1,400 pregnant women were interviewed in Ribeirão Preto, 3,199 in Pelotas, and 1,447 in São Luís. Different strategies were employed to reduce losses to follow-up. This research network allows the analysis of the incidence of diseases and the establishment of possible causal relations that might explain the health outcomes of these populations in order to contribute to the development of governmental actions and health policies more consistent with reality.
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da Silva Magalhães EI, Peixoto Lima N, Baptista Menezes AM, Gonçalves H, Wehrmeister FC, Formoso Assunção M, Lessa Horta B. Maternal smoking during pregnancy and offspring body composition in adulthood: Results from two birth cohort studies. BMJ Open 2019; 9:e023852. [PMID: 31196896 PMCID: PMC6575638 DOI: 10.1136/bmjopen-2018-023852] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE To evaluate the association of maternal smoking during pregnancy with offspring body composition in adulthood and explore the causality of this association. DESIGN Birth cohort. SETTING Population-based study in Pelotas, Brazil. PARTICIPANTS All newborn infants in the city's hospitals were enrolled in 1982 and 1993. At a mean age of 30.2 and 22.6 years, the 1982 and 1993 cohorts, respectively, followed the subjects and 7222 subjects were evaluated. PRIMARY OUTCOME MEASURES Body mass index (BMI), fat mass index, android to gynoid fat ratio, waist circumference, waist to height ratio, lean mass index and height. RESULTS Prevalence of maternal smoking during pregnancy was 35.1% and 32.6%, in 1982 and 1993 cohorts, respectively. Offspring of smoking mothers showed higher mean BMI (β: 0.84; 95% CI: 0.55 to 1.12 kg/m2), fat mass index (β: 0.44; 95% CI: 0.23 to 0.64 kg/m2), android to gynoid fat ratio (β: 0.016; 95% CI: 0.010 to 0.023), waist circumference (β: 1.74; 95% CI: 1.15 to 2.33 cm), waist to height ratio (β: 0.013; 95% CI: 0.010 to 0.017) and lean mass index (β: 0.33; 95% CI: 0.24 to 0.42 kg/m2), whereas height was lower (β: -0.95; -1.26 to -0.65). Weight gain in the first 2 years captured most of the association of maternal smoking with BMI (96.2%), waist circumference (86.1%) and fat mass index (71.7%). CONCLUSIONS Maternal smoking in pregnancy was associated with offspring body composition measures in adulthood.
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Affiliation(s)
| | - Natália Peixoto Lima
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | | | - Helen Gonçalves
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Fernando C Wehrmeister
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | | | - Bernardo Lessa Horta
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
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Lima NP, Bassani DG, Silva BGCD, Motta JVS, Magalhães EIS, Barros FC, Horta BL. Association of breastfeeding, maternal anthropometry and body composition in women at 30 years of age. CAD SAUDE PUBLICA 2019; 35:e00122018. [PMID: 30785489 DOI: 10.1590/0102-311x00122018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 09/10/2018] [Indexed: 11/22/2022] Open
Abstract
This study aimed at assessing the association of breastfeeding with maternal body mass index (BMI), waist circumference, fat mass index, fat free mass index, android/gynoid fat ratio and bone mineral density. In 1982, the maternity hospitals in Pelotas, Rio Grande do Sul State, Brazil, were daily visited and all live births were identified and examined. These subjects underwent follow-up for several times. At 30 years of age, the participants were interviewed and examined. Parous women provided information on parity and duration of breastfeeding. Multiple linear regression was used in the multivariate analysis, controlling for genomic ancestry, family income, schooling and smoking at 2004-2005. After controlling for confounding factors, breastfeeding was inversely associated with BMI and fat mass index, whereas breastfeeding per live birth was negatively associated with BMI, waist circumference and fat mass index. Women who had had a child in the last 5 years and had breastfed, showed lower BMI (β = -2.12, 95%CI: -4.2; -0.1), waist circumference (β = -4.46, 95%CI: -8.3; -0.6) and fat mass index (β = -1.79, 95%CI: -3.3; -0.3), whereas no association was observed among those whose last childbirth was > 5 years, but the p-value for the tests of interaction were > 0.05. Our findings suggest that breastfeeding is associated with lower BMI and other adiposity measures, mostly in the first years after delivery. Besides that, it has no negative impact on bone mineral density.
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Affiliation(s)
- Natália Peixoto Lima
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brasil
| | - Diego G Bassani
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Canada.,Department of Paediatrics, University of Toronto, Toronto, Canada
| | - Bruna G C da Silva
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brasil
| | - Janaína V S Motta
- Programa de Pós-graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, Brasil
| | - Elma Izze S Magalhães
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brasil
| | - Fernando C Barros
- Programa de Pós-graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, Brasil
| | - Bernardo L Horta
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brasil
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Magalhães EIDS, Sousa BAD, Lima NP, Horta BL. Maternal smoking during pregnancy and offspring body mass index and overweight: a systematic review and meta-analysis. CAD SAUDE PUBLICA 2019; 35:e00176118. [DOI: 10.1590/0102-311x00176118] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 08/02/2019] [Indexed: 08/30/2023] Open
Abstract
Abstract: The present study aimed to conduct a systematic review and meta-analysis to evaluate the evidence on the association of maternal smoking during pregnancy with offspring body composition in childhood, adolescence and adulthood. MEDLINE, Web of Science and LILACS databases were searched. Reference lists were also screened. We included original studies, conducted in humans, that assessed the association of maternal smoking during pregnancy with offspring body mass index (BMI) and overweight in childhood, adolescence and adulthood, published through May 1st, 2018. A meta-analysis was used to estimate pooled effect sizes. The systematic review included 64 studies, of which 37 evaluated the association of maternal smoking during pregnancy with overweight, 13 with BMI, and 14 evaluated both outcomes. Of these 64 studies, 95 measures of effect were extracted and included in the meta-analysis. We verified that the quality of evidence across studies regarding maternal smoking in pregnancy and overweight and BMI of offspring to be moderate and low, respectively. Most studies (44 studies) were classified as moderate risk bias. Heterogeneity among studies included was high and, in the random-effects pooled analysis, maternal smoking during pregnancy increased the odds of offspring overweight (OR: 1.43, 95%CI: 1.35; 1.52) and mean difference of BMI (β: 0.31, 95%CI: 0.23; 0.39). In conclusion, offspring of mothers who smoked during pregnancy have higher odds of overweight and mean difference of BMI, and these associations persisted into adulthood.
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Gigante DP, de França G, De Lucia Rolfe E, Lima NP, Dos Santos Motta JV, Gonçalves H, Horta BL, Barros FC, Ong KK. Adolescent parenthood associated with adverse socio-economic outcomes at age 30 years in women and men of the Pelotas, Brazil: 1982 Birth Cohort Study. BJOG 2018; 126:360-367. [PMID: 30099837 DOI: 10.1111/1471-0528.15428] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate the potential long-term effects of adolescent parenthood on completed education and income. DESIGN Population-based birth cohort study. SETTING All live births in 1982, whose mothers lived in the urban area of Pelotas, southern Brazil. SAMPLE A total of 3701 participants: 1914 women and 1787 men at age 30 years. METHODS Questionnaires were completed by the mothers in the early phases of this study, and by the cohort members in adolescence and adulthood. Linear regression models and G-computation were used in the analyses. MAIN OUTCOME MEASURES Educational attainment and income at age 30 years. RESULTS In women, adolescent parenthood was associated with lower attained education compared with women without adolescent maternity: by -2.8 years [95% confidence interval (CI) -3.2 to -2.3] if their first birth was at age 16-19, and by -4.4 years (-5.5 to -3.3) at age 11-15. These effects were greater among women who had three or more children. Women with adolescent parenthood also had 49 or 33% lower income at age 30 if their first child was born when aged 16-19 or 11-15, respectively. In men, the adverse effect of adolescent parenthood on education appeared to be mediated by a higher number of children and there was no effect of adolescent paternity on income at age 30 years. CONCLUSION These findings suggest lasting socio-economic disadvantages of adolescent parenthood, with larger effects being apparent in women than in men. TWEETABLE ABSTRACT Adolescent parenthood has an adverse effect on educational attainment later in life, and on household income among women.
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Affiliation(s)
- D P Gigante
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.,Medical Research Council Epidemiology Unit, School of Clinical Medicine, Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Gva de França
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.,Medical Research Council Epidemiology Unit, School of Clinical Medicine, Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - E De Lucia Rolfe
- Medical Research Council Epidemiology Unit, School of Clinical Medicine, Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - N P Lima
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - J V Dos Santos Motta
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.,Post-graduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil
| | - H Gonçalves
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - B L Horta
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - F C Barros
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.,Post-graduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil
| | - K K Ong
- Medical Research Council Epidemiology Unit, School of Clinical Medicine, Institute of Metabolic Science, University of Cambridge, Cambridge, UK
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Farías-Antúnez S, Lima NP, Bierhals IO, Gomes AP, Vieira LS, Tomasi E. Disability relating to basic and instrumental activities of daily living: a zopulation-based study with elderly in Pelotas, Rio Grande do Sul, Brazil, 2014. Epidemiol Serv Saude 2018; 27:e2017290. [PMID: 29898166 DOI: 10.5123/s1679-49742018000200005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 01/02/2018] [Indexed: 11/02/2022] Open
Abstract
OBJECTIVE to estimate the prevalence of disability related to basic and instrumental activities of daily living and its association with socioeconomic, demographic, behavioral and health characteristics in the elderly. METHODS population-based cross-sectional study in Pelotas, Brazil, in 2014; Katz and Lawton scales were used to assess the outcomes using Poisson regression. RESULTS the study included 1.451 elderly individuals; the prevalence of disability for basic and instrumental activities was 36.1% and 34.0%, respectively, and 18.1% in both; higher prevalence of functional disability were observed individuals ≥80 years (PR=3.01; 95%CI 2.17;4.18), not working (PR=2.02; 95%CI 1.13;3.60) and those with multiple morbidities (PR=3.28; 95%CI 1.38;7.79); and lower in individuals with ≥12 years of schooling (PR=0.40; 95%CI 0.24;0.66), and that were physically active (PR=0.42; 95%CI 0.21;0.82). CONCLUSION functional disability was associated to individuals older than 80, with less schooling years and affected by multiple morbidities.
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Affiliation(s)
- Simone Farías-Antúnez
- Universidade Federal de Pelotas, Faculdade de Medicina, Programa de Pós-Graduação em Epidemiologia, Pelotas, RS, Brasil
| | - Natália Peixoto Lima
- Universidade Federal de Pelotas, Faculdade de Medicina, Programa de Pós-Graduação em Epidemiologia, Pelotas, RS, Brasil
| | - Isabel Oliveira Bierhals
- Universidade Federal de Pelotas, Faculdade de Medicina, Programa de Pós-Graduação em Epidemiologia, Pelotas, RS, Brasil
| | - Ana Paula Gomes
- Universidade Federal de Pelotas, Faculdade de Medicina, Programa de Pós-Graduação em Epidemiologia, Pelotas, RS, Brasil
| | - Luna Strieder Vieira
- Universidade Federal de Pelotas, Faculdade de Medicina, Programa de Pós-Graduação em Epidemiologia, Pelotas, RS, Brasil
| | - Elaine Tomasi
- Universidade Federal de Pelotas, Faculdade de Medicina, Programa de Pós-Graduação em Epidemiologia, Pelotas, RS, Brasil
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Murray J, Lima NP, Ruivo ACO, Ramírez Varela A, Bortolotto CC, Magalhães EIDS, Leite FMC, Xavier MO, Pingault JB, Fazel S, Mielke GI, Anselmi L, Wehrmeister FC, Gonçalves H, Menezes AMB. Lifelong robbery victimisation and mental disorders at age 18 years: Brazilian population-based study. Soc Psychiatry Psychiatr Epidemiol 2018; 53:487-496. [PMID: 29453749 PMCID: PMC5908817 DOI: 10.1007/s00127-018-1488-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 01/21/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE Urban violence is a major problem in Brazil and may contribute to mental disorders among victims. The aim of this study was to assess the association between robbery victimisation and mental health disorders in late adolescence. METHODS At age 18 years, 4106 participants in the 1993 Pelotas Birth Cohort Study were assessed. A questionnaire about history of robbery victimisation was administered, the Self-Report Questionnaire was used to screen for common mental disorders, and the Mini International Neuropsychiatric Interview was used to assess major depressive disorder and generalised anxiety disorder. Cross-sectional prevalence ratios between lifetime robbery victimisation and mental disorders were estimated using Poisson regression with robust standard errors, adjusting for socioeconomic variables measured at birth and violence in the home and maltreatment measured at age 15. RESULTS There was a dose-response relationship between frequency of lifetime robberies and risk of mental disorders. Adolescents who had been robbed three or more times had twice the risk (PR 2.04; 95% CI 1.64-2.56) for common mental disorders, over four times the risk for depression (PR 4.59; 95% CI 2.60-8.12), and twice the risk for anxiety (PR 1.93; 95% CI 1.06-3.50), compared with non-victims, adjusting for covariates. Experiencing frequent robberies had greater impact on common mental disorders than experiencing an armed robbery. Population attributable fractions with regard to robbery were 9% for common mental disorders, 13% for depression, and 8% for anxiety. CONCLUSIONS Robberies are associated with common mental disorders in late adolescence, independently of violence between family members. Reducing urban violence could significantly help in preventing common mental illnesses.
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Affiliation(s)
- Joseph Murray
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande Do Sul, Brazil.
| | - Natália Peixoto Lima
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande Do Sul, Brazil
| | | | - Andrea Ramírez Varela
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande Do Sul, Brazil
| | | | | | | | - Mariana Otero Xavier
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande Do Sul, Brazil
| | - Jean-Baptiste Pingault
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Gregore Iven Mielke
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande Do Sul, Brazil
| | - Luciana Anselmi
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande Do Sul, Brazil
| | | | - Helen Gonçalves
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande Do Sul, Brazil
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Motta JVDS, Lima NP, Olinto MTA, Gigante DP. Social mobility and smoking: a systematic review. Cien Saude Colet 2017; 20:1515-20. [PMID: 26017952 DOI: 10.1590/1413-81232015205.01642014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 06/24/2014] [Indexed: 11/22/2022] Open
Abstract
The purpose of this study is to review the literature on longitudinal studies that have evaluated the effect of social mobility on the occurrence of smoking in various populations. Articles were selected from the web databases PubMed and Web of Science using the words: follow up, cohort longitudinal prospective, social mobility, social change life, course socioeconomic, smoking, and tobacco. Of the six studies identified in this review, four used occupational classification to measure social mobility. All six were carried out on the continent of Europe. The results indicate higher proportions of tobacco users among those with lower socioeconomic level during the whole period of observation (for all variables analyzed); and that people who suffered downward mobility, that is to say people who were classified as having a higher socioeconomic level at the beginning of life, tended to mimic habits of the new group when they migrated to a lower social group.
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Silva BGCD, Lima NP, Silva SGD, Antúnez SF, Seerig LM, Restrepo-Méndez MC, Wehrmeister FC. Mortalidade materna no Brasil no período de 2001 a 2012: tendência temporal e diferenças regionais. Rev bras epidemiol 2016; 19:484-493. [DOI: 10.1590/1980-5497201600030002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 03/24/2016] [Indexed: 11/22/2022] Open
Abstract
RESUMO: Objetivo: Avaliar a tendência de mortalidade materna no Brasil e nas cinco regiões brasileiras, de 2001 a 2012, e descrever suas principais causas. Métodos: Trata-se de uma série temporal, a partir de dados obtidos no Sistema de Informação sobre Mortalidade e no Sistema de Informação sobre Nascidos Vivos. A razão de mortalidade materna e as causas de morte materna foram descritas conforme as categorias da 10ª revisão da Classificação Internacional de Doenças, nos anos de 2001, 2006 e 2011. Para estimar a tendência temporal foi utilizada a regressão linear. Resultados: A razão de mortalidade materna mais elevada no Brasil foi no ano de 2009 (77,31 por 100 mil nascidos vivos). Foi observada tendência significativa de diminuição da razão de mortalidade materna para as regiões Nordeste e Sul e de aumento na região Centro-Oeste. Houve incremento nas mortes por outras afecções obstétricas e uma queda nas mortes por edema, proteinúria e transtornos hipertensivos. Conclusão: Embora tenham sido observadas tendências de diminuição da razão de mortalidade materna para o Nordeste e o Sul, as elevadas taxas observadas para o Brasil evidenciam a necessidade de melhoria à assistência pré-natal, ao parto e ao puerpério.
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Lima NP, Horta BL, Motta JVDS, Valença MS, Oliveira V, Santos TVD, Gigante DP, Barros FC. [Evolution of overweight and obesity into adulthood, Pelotas, Rio Grande do Sul State, Brazil, 1982-2012]. CAD SAUDE PUBLICA 2016; 31:2017-25. [PMID: 26578025 DOI: 10.1590/0102-311x00173814] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 03/02/2015] [Indexed: 11/22/2022] Open
Abstract
This study assessed the prevalence of overweight and obesity in adolescence and adulthood among subjects enrolled in the 1982 Pelotas Birth Cohort, Rio Grande do Sul State, Brazil, according to social and demographic characteristics. In 1982, hospital births in Pelotas were identified and all live born infants (n = 5,914) were examined and have been followed since. The data were collected at 15, 18, 23, and 30 years of age. In women, prevalence of overweight increased from 23.6% at 15 years to 52.4% at 30 years of age, while obesity increased from 6.6% to 23.8%. In men, overweight increased from 22.9% to 62.9%, and obesity from 7.5% to 22.1%. Overweight and obesity increased more among individuals of both sexes with lower socioeconomic status, which can lead to more inequality in the occurrence of chronic diseases.
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Affiliation(s)
| | | | | | - Marina S Valença
- Faculdade de Nutrição, Universidade Federal de Pelotas, Pelotas, Brasil
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Abstract
The Sisters of Charity Health Care Systems, Inc., (SCHCS) developed methods to collect more than 290 data elements from its 15 hospitals to measure community benefit, illness prevention, patient satisfaction, severity of illness, appropriateness, traditional quality measures, outcome measures, maternal/child services, psychiatric services, efficiency, financial performance, and risk management. The data were compiled to produce a report card called the Hospital Quality Profile, which SCHCS hospitals now use for strategic quality planning, assessment, and monitoring. Collaboration between quality management, information systems, and financial department personnel is critical to the success of such a quality database.
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Affiliation(s)
- R N Alsever
- Sisters of Charity Health Care Systems, Inc., Colorado Springs
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