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Orbolato R, Fernandes RA, Turi-Lynch BC, Araujo MYC, Ferro IDS, Gobbo LA, Zanuto EAC, Codogno JS. Impact of cycling and walking on adiposity and healthcare costs among adults: longitudinal study. CAD SAUDE PUBLICA 2024; 40:e00102623. [PMID: 38422248 PMCID: PMC10896485 DOI: 10.1590/0102-311xen102623] [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: 06/02/2023] [Revised: 10/23/2023] [Accepted: 12/01/2023] [Indexed: 03/02/2024] Open
Abstract
Leisure-time physical activity seems relevant to prevent the development of chronic diseases and obesity. However, not much is known about the economic burden of these healthy behaviors, mainly in longitudinal designs. This study aimed to analyze the impact of walking and cycling on leisure-time on adiposity and healthcare costs among adults. This longitudinal study was conducted at a medium-size Brazilian city and included 198 participants with no missing data attended in the Brazilian Unified National Health System. Cycling and walking were assessed by a questionnaire with a face-to-face interview at four time-points (baseline, 6-month, 12-month, and 18-month). Healthcare costs were assessed using medical records. Adiposity markers included waist circumference and body fatness. Over the follow-up period, participants who were more engaged in cycling presented lower body fatness (p-value = 0.028) and healthcare costs (p-value = 0.038). However, in the multivariate model, the impact of cycling on costs was not significant (p-value = 0.507) due to the impact of number of chronic diseases (p-value = 0.001). Cycling on leisure-time is inversely related to adiposity in adults, whereas its role on preventing chronic diseases seems the main pathway linking it to cost mitigation.
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Affiliation(s)
- Rafael Orbolato
- Universidade Estadual Paulista Júlio de Mesquita Filho, Presidente Prudente, Brasil
| | | | - Bruna Camilo Turi-Lynch
- Universidade Estadual Paulista Júlio de Mesquita Filho, Presidente Prudente, Brasil
- Lander University, Greenwood, U. S. A
| | | | | | - Luis Alberto Gobbo
- Universidade Estadual Paulista Júlio de Mesquita Filho, Presidente Prudente, Brasil
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Martins RBM, Torres JL, Moreira BDS, Lima-Costa MF, Ygnatios NTM. [Sociodemographic characteristics associated with underweight and overweight in adults aged 50 years and over (ELSI-Brasil): differences between sexes]. CAD SAUDE PUBLICA 2024; 40:e00037023. [PMID: 38324866 PMCID: PMC10841375 DOI: 10.1590/0102-311xpt037023] [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: 02/26/2023] [Revised: 09/01/2023] [Accepted: 09/18/2023] [Indexed: 02/09/2024] Open
Abstract
The objective were to describe the prevalence of underweight and overweight, assessed by body mass index (BMI), stratified by sex and age group, and to analyze the sociodemographic characteristics associated with BMI in older women and men. This is a cross-sectional analysis of 8,974 participants aged ≥ 50 years from the baseline of the Brazilian Longitudinal Study of Aging (ELSI-Brasil, 2015-2016). BMI was classified as underweight, eutrophy, and overweight according to the participant's age. A multinomial logistic regression model was used, considering the sociodemographic characteristics of women and men. The results showed a higher prevalence of overweight in women compared to men (64.1% vs. 57.3%). In both sexes, the prevalence of underweight was higher in the longest-lived individuals, while overweight was lower. In women, the chance of underweight was higher than the chance of eutrophy in those who were single/widowed/divorced (OR = 1.95; 95%CI: 1.42-2.66) and in those living in rural areas (OR = 1.58; 95%CI: 1.01-2.49), while the chance of being overweight was lower than the chance of being eutrophy in those living in rural areas (OR = 0.78; 95%CI: 0.62-0.97) and in all geographic macro-regions related to the South Region. For men, the chance of being overweight was lower than the chance of being eutrophy among single/widowed/divorced individuals (OR = 0.58; 95%CI: 0.48-0.69). The richest had a lower chance of being underweight (OR = 0.59; 95%CI: 0.38-0.90), as well as a higher chance of being overweight (OR = 1.52; 95%CI: 1.20-1.92). In conclusion, the sociodemographic characteristics associated with BMI differed between the sexes.
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Affiliation(s)
| | - Juliana Lustosa Torres
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Fundação Oswaldo Cruz/Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
- Departamento de Medicina Preventiva e Social, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Bruno de Souza Moreira
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Fundação Oswaldo Cruz/Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Maria Fernanda Lima-Costa
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Fundação Oswaldo Cruz/Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
- Departamento de Medicina Preventiva e Social, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
- Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brasil
| | - Nair Tavares Milhem Ygnatios
- Centro Universitário Santa Rita, Conselheiro Lafaiete, Brasil
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Fundação Oswaldo Cruz/Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
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Oliveira PMBD, Lima MDO, Marinho PDM, Silveira JACD, Menezes RCED, Longo-Silva G. Association between sleep duration and latency, nocturnal awakenings, and body mass index among infants. Rev Paul Pediatr 2023; 42:e2023058. [PMID: 38126602 PMCID: PMC10742347 DOI: 10.1590/1984-0462/2024/42/2023058] [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] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 09/03/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE To investigate the association between sleep duration, nocturnal awakenings, and sleep latency with body mass index (BMI) at six and 12 months of age. METHODS 179 children from a birth cohort were enrolled. At six and 12 months of age, anthropometric data were obtained using standardized techniques and infants' mothers answered the Brief Infant Sleep Questionnaire for sleep data. The association of BMI with the independent variables (sleep duration, latency, and nocturnal awakenings) was assessed by linear regression models. Analyses were adjusted for potential confounders and a p-value<0.05 was adopted to define statistical significance. RESULTS For each additional hour of sleep duration, BMI was reduced by 0.15 kg/m² (95% confidence interval [CI] -0.28; -0.01; p=0.03) and each additional minute of sleep latency increased BMI by 0.01 kg/m² (95%CI -0.00; 0.03; p=0.02). These associations were independent of gestational age, child sex, birth weight, duration of exclusive breastfeeding, smoking during pregnancy, and mother's BMI, education, and marital status. Nocturnal awakenings showed no association with the outcome. CONCLUSIONS Our findings suggest that sleep duration and sleep latency time are associated with BMI in the first year of life. Insights into the influence of sleep early in life on weight status may be helpful to complement future nutritional recommendations and prevent and treat obesity.
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Monteiro MC, Assayag G, Botler R, Bergamin A, Conceição FL, Silva de Morais N, Seixas RPD, Berbara TMBL, Schtscherbyna A, Corcino CM, Saraiva DA, Vaisman M, Teixeira PFS. Thyroid Volume in Pregnancy is Associated with Parity, Gestational Age, and Body Mass Index in an Iodine-sufficient Area. Rev Bras Ginecol Obstet 2023; 45:e557-e561. [PMID: 37944921 PMCID: PMC10635786 DOI: 10.1055/s-0043-1776028] [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: 12/06/2022] [Accepted: 08/01/2023] [Indexed: 11/12/2023] Open
Abstract
OBJECTIVE We compared thyroid volume (TV) and presence of nodular goiter (NG) in pregnant vs. non-pregnant women in an iodine-sufficient area. We also evaluated the relationship between gestational age, parity, and TV in the pregnant women group, and determined the 2.5th and 97.5th percentiles of normal TV in pregnancy. METHODS This cross-sectional study included 299 healthy women (216 pregnant) without previous thyroid diseases. Thyroid ultrasounds were performed and compared between pregnant and non-pregnant women. The range of normal distribution of TV (2.5th and 97.5th percentiles) in pregnancy was determined after excluding individuals with positive thyroid antibodies, NG, and/or abnormal serum thyrotropin (TSH) or free thyroxine (FT4). RESULTS Thyroid volume was larger among pregnant compared to non-pregnant women (8.6 vs 6.1 cm3; p < 0.001) and was positively correlated with gestational age (rs = 0.221; p = 0.001), body mass index (BMI, rs 0.165; p = 0.002), and FT4 levels (rs 0.118 p = 0.021). Nodular goiter frequency did not differ between the two groups. There was a negative correlation between TV and TSH (rs -0.13; p = 0.014). Thyroid volume was lower among primiparous compared to multiparous patients (7.8 vs 8.9; p < 0.001) and was positively correlated with parity (rs 0.161; p = 0.016). The 2.5th and 97.5th percentiles of TV were 4.23 and 16.47 cm3, respectively. CONCLUSION Thyroid volume was higher in pregnant compared to non-pregnant women and was positively related to parity, BMI, and gestational age in a normal iodine status population. Pregnancy did not interfere with the development of NG.
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Affiliation(s)
- Mariana Couto Monteiro
- Endocrinology Postgraduate Program, Medical School, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Gabriela Assayag
- Endocrinology Postgraduate Program, Medical School, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Ricardo Botler
- Endocrinology Postgraduate Program, Medical School, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Anice Bergamin
- Endocrinology Postgraduate Program, Medical School, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Flávia Lúcia Conceição
- Endocrinology Postgraduate Program, Medical School, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Nathalie Silva de Morais
- Endocrinology Postgraduate Program, Medical School, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | | | - Annie Schtscherbyna
- Endocrinology Postgraduate Program, Medical School, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Carolina Martins Corcino
- Endocrinology Postgraduate Program, Medical School, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Débora Ayres Saraiva
- Endocrinology Postgraduate Program, Medical School, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Mário Vaisman
- Endocrinology Postgraduate Program, Medical School, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Botelho VH, Barros AJD, de Oliveira RG, Martins RC, Gonçalves H, Menezes AMB, Blumenberg C. Agreement between measured weight, height and BMI and Web-based self-reported data in participants of the 1993 Pelotas Birth Cohort, Brazil: a cross-sectional validation study. Epidemiol Serv Saude 2023; 32:e2022590. [PMID: 37531484 PMCID: PMC10379011 DOI: 10.1590/s2237-96222023000200013] [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: 10/25/2022] [Accepted: 03/21/2023] [Indexed: 08/04/2023] Open
Abstract
OBJECTIVE to evaluate the agreement between measured height, weight, and body mass index (BMI) during the 22-year follow-up of the 1993 Pelotas Birth Cohort, state of Rio Grande do Sul, Brazil, and self-reported data during the online follow-up of the coortesnaweb. METHODS this was a cross-sectional validation study; agreement was assessed by means of Lin's concordance correlation coefficient for continuous measures and weighted Kappa for nutritional status; Spearman's rank correlation coefficient was used to estimate the correlation between measurements. RESULTS a total of 783 participants were included; it could be seen high correlation and high agreement between the measured height (r = 0.966; ρ = 0.966), weight (r = 0.934; ρ = 0.928), and BMI (r = 0.903; ρ = 0.910) and Web-based self-reported data; there was no correlation between mean difference and the time interval between measurements. CONCLUSION using the Internet to collect self-reported anthropometric measurements is as valid as the traditional method.
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Affiliation(s)
- Vivian Hernandez Botelho
- Universidade Federal de Pelotas, Programa de Pós-Graduação em Epidemiologia, Pelotas, RS, Brazil
| | - Aluísio J. D. Barros
- Universidade Federal de Pelotas, Programa de Pós-Graduação em Epidemiologia, Pelotas, RS, Brazil
| | | | - Rafaela Costa Martins
- Universidade Federal de Pelotas, Programa de Pós-Graduação em Epidemiologia, Pelotas, RS, Brazil
| | - Helen Gonçalves
- Universidade Federal de Pelotas, Programa de Pós-Graduação em Epidemiologia, Pelotas, RS, Brazil
| | - Ana M. B. Menezes
- Universidade Federal de Pelotas, Programa de Pós-Graduação em Epidemiologia, Pelotas, RS, Brazil
| | - Cauane Blumenberg
- Universidade Federal de Pelotas, Programa de Pós-Graduação em Epidemiologia, Pelotas, RS, Brazil
- Causale Consultoria, Pelotas, RS, Brazil
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Escaldelai FMD, Silva Filho LVRFD, Neri LDCL, Bergamaschi DP. Quality of anthropometric data measured in children and adolescents with cystic fibrosis: a scoping review. Rev Paul Pediatr 2023; 41:e2021333. [PMID: 36888749 PMCID: PMC9984155 DOI: 10.1590/1984-0462/2023/41/2021333] [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] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 05/06/2022] [Indexed: 03/08/2023]
Abstract
OBJECTIVE This study aimed to identify methodological aspects involved in determining anthropometric measurements among studies assessing the nutritional status of individuals with cystic fibrosis (CF). METHODS A search of the literature was performed on MEDLINE via Pubmed, Embase, and Web of Science databases. The population comprised children and adolescents with CF. Observational studies and clinical trials using anthropometric and body composition measures and indices determined by dual-energy X-ray absorptiometry (DXA) and bioelectrical impedance assessment (BIA) were included. Use of a standardized procedure for data collection was defined when details on the instruments and their calibration were given, the measuring procedures were described, and when it was clear measures had been determined by a trained team, or the use of an anthropometric reference manual was cited. Data extracted were expressed as absolute and relative frequencies. RESULTS A total of 32 articles were included, and a total of 233 measures or indices were observed. The most frequently used measures were body mass index (kg/m2; 35%), weight (kg; 33%), and height (cm; 33%). Among the 28 studies that used anthropometric measures, 21 (75%) provided a complete or partial description of the measurement instruments used, 3 (11%) reported information on equipment calibration, 10 (36%) indicated the measurement procedures employed by assessors, and 2 (7%) stated a trained team had carried out the measurements. CONCLUSIONS The poor description of measuring procedures precluded a meaningful evaluation of data quality. Scientific debate on this theme can help raise awareness of the need to ensure quality in collecting and fully presenting data.
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Andrades CDSD, Poletti VV, Closs VE, Gustavo ADS, Oliveira MDS, Donadio MVF, Feoli AMP. Prevalence of dyslipidemia, atherogenic and cardiovascular risk in overweight and obese adolescents. Rev Paul Pediatr 2023; 41:e2021312. [PMID: 36921163 PMCID: PMC10014021 DOI: 10.1590/1984-0462/2023/41/2021312] [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] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 09/14/2022] [Indexed: 03/18/2023]
Abstract
OBJECTIVE To analyze the lipid profile and cardiovascular risk of overweight and obese adolescents and correlate the findings with anthropometric measurements. METHODS This is a cross-sectional study on overweight and obese adolescents of both sexes (aged 14 to 18 years old). The collected variables were sex, weight, height, age, total cholesterol, triglycerides, High-density lipoprotein (HDL) and low-density lipoprotein (LDL). The Atherogenic Index of Plasma and Castelli Risk Indices I and II were calculated. These indices were classified into cutoff points to stratify cardiovascular risk. The anthropometric profile was evaluated by Z score according to Body Mass Index for age. Significance level was considered as p≤0.05. RESULTS A total of 146 adolescents participated in the study; the mean age was 16.4±1.1 years and most of them were girls (74.7%) and obese (52.7%). The prevalent dyslipidemias were high triglycerides (47.9%), LDL (26.7%), total cholesterol (37.7%), and low HDL (46.6%). Most adolescents presented increased atherogenic risk according to the Atherogenic Index of Plasma (55.5%); 15.1% presented high cardiovascular risk according to Castelli Risk Index I; and 13.7%, according to Castelli Risk Index II. Boys presented higher values of anthropometric measurements and Castelli Risk Indices I and II in relation to girls - who, conversely, presented higher values of HDL. There was a positive correlation of the Z score with Atherogenic Index of Plasma and a negative correlation with HDL. CONCLUSIONS The adolescents of the study presented high prevalence of cardiovascular and atherogenic risk according to the evaluated indices. In addition, the increased cardiovascular risk was correlated with higher Body Mass Index.
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Fortini I, Felsenfeld BD. Headaches and obesity. Arq Neuropsiquiatr 2022; 80:204-213. [PMID: 35976296 PMCID: PMC9491411 DOI: 10.1590/0004-282x-anp-2022-s106] [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] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 04/29/2022] [Indexed: 06/15/2023]
Abstract
Obesity and headache disorders are two very common conditions in the general population that have been increasing in incidence over the last decades. Recent studies have shown a significant relationship between obesity and headaches, particularly migraine, with an important role in whether the disease is chronic. On the other hand, no such association was found with tension-type headaches. Studies showing an overlapping of hunger-control pathways and those involved in the pathophysiology of migraine may justify the close association between obesity and migraine. Moreover, a secondary headache for which obesity is a strong risk factor is idiopathic Intracranial Hypertension (pseudotumor cerebri), with several studies showing the impact of weight reduction/bariatric surgery in the treatment of the disease. In conclusion, since obesity is a modifiable risk factor, it is important for physicians treating patients with headaches, and particularly migraine, to be aware of the association between these two disorders.
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Affiliation(s)
- Ida Fortini
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, São Paulo SP, Brazil
| | - Bernardo Dror Felsenfeld
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, São Paulo SP, Brazil
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de Alencar AKN, Wang H, de Oliveira GMM, Sun X, Zapata-Sudo G, Groban L. Crossroads between Estrogen Loss, Obesity, and Heart Failure with Preserved Ejection Fraction. Arq Bras Cardiol 2021; 117:1191-1201. [PMID: 34644788 PMCID: PMC8757160 DOI: 10.36660/abc.20200855] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 12/16/2020] [Accepted: 01/27/2021] [Indexed: 11/24/2022] Open
Abstract
The prevalence of obesity and heart failure with preserved ejection fraction (HFpEF) increases significantly in postmenopausal women. Although obesity is a risk factor for left ventricular diastolic dysfunction (LVDD), the mechanisms that link the cessation of ovarian hormone production, and particularly estrogens, to the development of obesity, LVDD, and HFpEF in aging females are unclear. Clinical, and epidemiologic studies show that postmenopausal women with abdominal obesity (defined by waist circumference) are at greater risk for developing HFpEF than men or women without abdominal obesity. The study presents a review of clinical data that support a mechanistic link between estrogen loss plus obesity and left ventricular remodeling with LVDD. It also seeks to discuss potential cell and molecular mechanisms for estrogen-mediated protection against adverse adipocyte cell types, tissue depots, function, and metabolism that may contribute to LVDD and HFpEF.
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Affiliation(s)
| | - Hao Wang
- Wake Forest School of MedicineDepartments of AnesthesiologyWinston-SalemNorth CarolinaEstados Unidos da AméricaWake Forest School of Medicine - Departments of Anesthesiology, Winston-Salem, North Carolina - Estados Unidos da América
- Wake Forest School of MedicineWinston-SalemNorth CarolinaEstados Unidos da AméricaWake Forest School of Medicine - Internal Medicine-Section of Molecular Medicine, Winston-Salem, North Carolina - Estados Unidos da América
| | - Gláucia Maria Moraes de Oliveira
- Universidade Federal do Rio de JaneiroDepartamento de Clínica MédicaFaculdade de MedicinaRio de JaneiroRJBrasilUniversidade Federal do Rio de Janeiro - Departamento de Clínica Médica, Faculdade de Medicina, Rio de Janeiro, RJ - Brasil
| | - Xuming Sun
- Wake Forest School of MedicineDepartments of AnesthesiologyWinston-SalemNorth CarolinaEstados Unidos da AméricaWake Forest School of Medicine - Departments of Anesthesiology, Winston-Salem, North Carolina - Estados Unidos da América
| | - Gisele Zapata-Sudo
- Universidade Federal do Rio de JaneiroInstituto de Ciências BiomédicasRio de JaneiroRJBrasilUniversidade Federal do Rio de Janeiro - Instituto de Ciências Biomédicas, Rio de Janeiro, RJ - Brasil
- Universidade Federal do Rio de JaneiroInstituto de Cardiologia Edson SaadFaculdade de MedicinaRio de JaneiroRJBrasilUniversidade Federal do Rio de Janeiro - Instituto de Cardiologia Edson Saad, Faculdade de Medicina, Rio de Janeiro, RJ - Brasil
| | - Leanne Groban
- Wake Forest School of MedicineDepartments of AnesthesiologyWinston-SalemNorth CarolinaEstados Unidos da AméricaWake Forest School of Medicine - Departments of Anesthesiology, Winston-Salem, North Carolina - Estados Unidos da América
- Wake Forest School of MedicineWinston-SalemNorth CarolinaEstados Unidos da AméricaWake Forest School of Medicine - Internal Medicine-Section of Molecular Medicine, Winston-Salem, North Carolina - Estados Unidos da América
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de Almeida RT, Matos SMA, Aquino EML. Individual and Combined Performance of Indicators of Overall and Central Obesity to Estimate Coronary Risk in ELSA-Brasil Participants. Arq Bras Cardiol 2021; 117:701-712. [PMID: 34346941 PMCID: PMC8528349 DOI: 10.36660/abc.20200360] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 09/08/2020] [Accepted: 11/04/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Anthropometric indicators have been used in clinical practice and epidemiological studies for screening of health risk factors. OBJECTIVES To evaluate the individual discriminatory power of body adiposity index (BAI), body mass index (BMI), waist circumference (WC) and waist-hip-ratio (WHR) to identify individuals at risk for coronary heart disease and to evaluate whether combinations of anthropometric indicators of overall obesity with indicators of central obesity improve predictive ability in adults. METHODS A total of 15,092 participants (54.4% women) aged 35-74years were assessed at baseline of the ELSA-Brasil study. Individuals at risk for coronary heart disease were identified using the Framingham risk score and divided into very-high risk (VHR 20%) and high risk (HR10%). Measures of diagnostic accuracy and area under the ROC curves (AUC) were analyzed. Associations were tested using Poisson regression analysis with robust variance, according to age and sex. Statistical significance was set at 5%. RESULTS WHR showed the highest discriminatory power for VHR20% in all groups, with higher predictive ability in women (AUC: 0.802; 95%CI: 0.748-0.856 vs 0.657; 95%CI: 0.630-0.683 in the age range of 35-59 years, and AUC: 0.668; 95%CI: 0.621-0.715 vs 0.611; 95%CI: 0.587-0.635 in the age range of 60-74 years). BAI + WHR and BMI + WHR had the highest predictive power in men and women, respectively. Combinations of indicators of overall obesity with indicators of central obesity were more strongly associated with VHR20% and HR10% in all subgroups. CONCLUSION Combined indicators had greater predictive ability than indicators taken individually. BAI+ WHR and BMI + WHR were the best estimators of coronary risk in men and women, respectively, and WHR had the best individual performance.
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Affiliation(s)
- Rogério Tosta de Almeida
- Universidade Estadual de Feira de SantanaDepartamento de SaúdeFeira de SantanaBABrasilUniversidade Estadual de Feira de Santana - Departamento de Saúde, Feira de Santana, BA – Brasil
- Universidade Federal da BahiaInstituto de Saúde ColetivaSalvadorBABrasilUniversidade Federal da Bahia - Instituto de Saúde Coletiva, Salvador, BA – Brasil
| | - Sheila Maria Alvim Matos
- Universidade Federal da BahiaInstituto de Saúde ColetivaSalvadorBABrasilUniversidade Federal da Bahia - Instituto de Saúde Coletiva, Salvador, BA – Brasil
| | - Estela M. L. Aquino
- Universidade Federal da BahiaInstituto de Saúde ColetivaSalvadorBABrasilUniversidade Federal da Bahia - Instituto de Saúde Coletiva, Salvador, BA – Brasil
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Favarato D. Obesity, Body Fat Content and Cardiovascular Outcome: Beyond Body Mass Index. Arq Bras Cardiol 2021; 116:887-888. [PMID: 34008808 PMCID: PMC8121476 DOI: 10.36660/abc.20210074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Desiderio Favarato
- Universidade de São PauloFaculdade de MedicinaHospital das ClinicasSão PauloSPBrasilInstituto do Coração do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP – Brasil.
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Tozo TA, Pereira BO, Menezes Junior FJD, Montenegro CM, Moreira CMM, Leite N. Hypertensive Measures In Schoolchildren: Risk Of Central Obesity And Protective Effect Of Moderate-To-Vigorous Physical Activity. Arq Bras Cardiol 2020; 115:42-49. [PMID: 32785497 PMCID: PMC8384320 DOI: 10.36660/abc.20180391] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 12/03/2018] [Revised: 06/18/2019] [Accepted: 07/17/2019] [Indexed: 12/21/2022] Open
Abstract
Background The proportion of arterial hypertension (AH) has increased in children and adolescents and is associated with several comorbidities. Objective To verify the association of arterial hypertension with central and general obesity as well as according to the level of physical activity in schoolchildren. Methods 336 children and adolescents aged 11 to 17 participated in the study. Height, body weight, waist circumference (WC) and blood pressure (BP) were measured. The body mass index z-score (BMI-z) was calculated. The level of physical activity was assessed by the short form of the International Physical Activity Questionnaire (IPAQ) according to the practice of moderate-to-vigorous physical activities (AF-mv). Students with systolic (SBP) and/or diastolic blood pressure (DBP) higher than the 95thpercentile according to sex, age and height or ≥120/80 were considered hypertensive. Statistical tests of t-Student, Chi-square, Mann-Whitney and binary logistic regression model were used, considering the significance level of p<0.05. Results It was found that 40.5% of the students had AH, 35.11% were overweight (12.5% obese), 13.39% had high WC and 40.2% were considered insufficiently active in AF-mv. The chances of AH were related to high WC (OR = 6.11; 95% CI: 2.59¬-14.42) and overweight (OR = 2.91; 95% CI: 1.76-4.79). In addition, adolescents who practiced AF-mv had a lower risk of high DBP (OR = 0.33; 95% CI: 0.15-0.72). Conclusion Central obesity was the best predictor of AH in children and adolescents, as well as general obesity and males. The practice of AF-mv demonstrated a protective effect on high DBP in schoolchildren. (Arq Bras Cardiol. 2020; 115(1):42-49).
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Affiliation(s)
| | | | | | | | | | - Neiva Leite
- Universidade Federal do Paraná, Curitiba, PR, Brasil
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Zilberstein B, Santo MA, Carvalho MH. CRITICAL ANALYSIS OF SURGICAL TREATMENT TECHNIQUES OF MORBID OBESITY. Arq Bras Cir Dig 2019; 32:e1450. [PMID: 31644670 PMCID: PMC6812144 DOI: 10.1590/0102-672020190001e1450] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 01/16/2019] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Obesity is a disease of high prevalence in Brazil and in the world, and bariatric surgery, with its different techniques, is an alternative treatment. OBJECTIVE To compare techniques: adjustable gastric band (AGB), sleeve gastrectomy), Roux-en-Y gastric bypass (RYGB) and biliopancreatic diversion (BPD) analyzing leaks, bleeding, death, weight loss, resolution of type 2 diabetes, systemic arterial hypertension, dyslipidemia and obstructive sleep apnea. METHODS Were selected studies in the PubMed database from 2003 to 2014 using the descriptors: obesity surgery; bariatric surgery; biliopancreatic diversion; sleeve gastrectomy; Roux-en-Y gastric bypass and adjustable gastric banding. Two hundred and forty-four articles were found with the search strategy of which there were selected 116 studies through the inclusion criteria. RESULTS Excess weight loss (EWL) after five years in AGB was 48.35%; 52.7% in SG; 71.04% in RYGB and 77.90% in BPD. The postoperative mortality was 0.05% in the AGB; 0.16% on SG; 0.60% in RYGB and 2.52% in BPD. The occurrence of leak was 0.68% for GBA; 1.93% for SG; 2.18% for RYGB and 5.23% for BPD. The incidence of bleeding was 0.44% in AGB; 1.29% in SG; 0.81% in RYGB and 2.09% in BPD. The rate of DM2 resolved was 46.80% in AGB, 79.38% in SG, 79.86% in RYGB and 90.78% in BPD. The rate of dyslipidemia, apnea and hypertension resolved showed no statistical differences between the techniques. CONCLUSION The AGB has the lowest morbidity and mortality and it is the worst in EWL and resolution of type 2 diabetes. The SG has low morbidity and mortality, good resolution of comorbidities and EWL lower than in RYGB and BPD. The RYGB has higher morbidity and mortality than AGB, good resolution of comorbidities and EWL similar to BPD. The BPD is the worst in mortality and bleeding and better in EWL and resolution of comorbidities.
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Affiliation(s)
- Bruno Zilberstein
- Department of Gastroenterology, School of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Marco Aurélio Santo
- Department of Gastroenterology, School of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Marnay Helbo Carvalho
- Department of Gastroenterology, School of Medicine, University of São Paulo, São Paulo, SP, Brazil
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de Andrade GN, Matoso LF, Miranda JWB, de Lima TF, Gazzinelli A, Vieira EW. Anthropometric indicators associated with high blood pressure in children living in urban and rural areas. Rev Lat Am Enfermagem 2019; 27:e3150. [PMID: 31038641 PMCID: PMC6528627 DOI: 10.1590/1518-8345.2760-3150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 02/07/2019] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE to evaluate anthropometric and demographic indicators associated with high blood pressure in children aged 6 to 10 years in urban and rural areas of Minas Gerais. METHOD this is a cross-sectional study with 335 children. Anthropometric, demographic and blood pressure data were collected. The statistics analyzes were performed using the chi-square, t-student, Mann-Whitney and logistic regression tests, and the odds ratio was the association measure. RESULTS the prevalence of high blood pressure was significantly higher among rural children. In the urban area, the chance of high blood pressure was higher in children who had a high body mass index (2.97 [1.13-7.67]) and in the rural area, in those who had increased waist circumference (35.4 [3.0-406.2]) and the age range of 9-10 years (4.29 [1.46-12.6]). CONCLUSION elevated body mass index and waist circumference were important anthropometric indicators for high blood pressure, as well as age in children living in rural area. The evaluation of body mass index and waist circumference, in addition to nutritional assessments, represents an important action for the screening of high blood pressure in children from different territorial contexts.
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Affiliation(s)
- Gisele Nepomuceno de Andrade
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Belo
Horizonte, MG, Brasil
- Bolsista do Conselho Nacional de Desenvolvimento Científico e
Tecnológico (CNPq), Brasil
| | - Leonardo Ferreira Matoso
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Belo
Horizonte, MG, Brasil
- Bolsista da Coordenação de Aperfeiçoamento de Pessoal de Nível
Superior (CAPES), Brasil
| | | | | | - Andréa Gazzinelli
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Belo
Horizonte, MG, Brasil
| | - Ed Wilson Vieira
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Belo
Horizonte, MG, Brasil
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Anastácio LR, Ferreira LG, Ribeiro HS, Diniz KGD, Lima AS, Correia MITD, Vilela EG. SARCOPENIA, OBESITY AND SARCOPENIC OBESITY IN LIVER TRANSPLANTATION: A BODY COMPOSITION PROSPECTIVE STUDY. Arq Bras Cir Dig 2019; 32:e1434. [PMID: 31038559 PMCID: PMC6488274 DOI: 10.1590/0102-672020190001e1434] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 01/17/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Sarcopenia is prevalent before liver transplantation, and it is considered to be a risk factor for morbidity/mortality. After liver transplantation, some authors suggest that sarcopenia remains, and as patients gain weight as fat, they reach sarcopenic obesity status. AIM Prospectively to assess changes in body composition, prevalence and associated factors with respect to sarcopenia, obesity and sarcopenic obesity after transplantation. METHODS Patients were evaluated at two different times for body composition, 4.0±3.2y and 7.6±3.1y after transplantation. Body composition data were obtained using bioelectrical impedance. The fat-free mass index and fat mass index were calculated, and the patients were classified into the following categories: sarcopenic; obesity; sarcopenic obesity. RESULTS A total of 100 patients were evaluated (52.6±13.3years; 57.0% male). The fat-free mass index decreased (17.9±2.5 to 17.5±3.5 kg/m2), fat mass index increased (8.5±3.5 to 9.0±4.0; p<0.05), prevalence of sarcopenia (19.0 to 22.0%), obesity (32.0 to 37.0%) and sarcopenic obesity (0 to 2.0%) also increased, although not significantly. The female gender was associated with sarcopenia. CONCLUSION The fat increased over the years after surgery and the lean mass decreased, although not significantly. Sarcopenia and obesity were present after transplantation; however, sarcopenic obesity was not a reality observed in these patients.
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Affiliation(s)
| | - Lívia Garcia Ferreira
- Nutrition and Health Post-Graduation Program, Universidade Federal de Lavras, Lavras, MG
| | - Helem Sena Ribeiro
- Instituto de Ensino e Pesquisa, Santa Casa de Belo Horizonte, Belo Horizonte,MG
| | - Kiara Gonçalves Dias Diniz
- Adult Health Post-Graduation Program, Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG
| | - Agnaldo Soares Lima
- Surgery Post-Graduation Program, Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG Brazil
| | | | - Eduardo Garcia Vilela
- Surgery Post-Graduation Program, Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG Brazil
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Takesian M, Santo MA, Gadducci AV, Santarém GCDF, Greve J, Silva PR, Cleva RD. TRUNK BODY MASS INDEX: A NEW REFERENCE FOR THE ASSESSMENT OF BODY MASS DISTRIBUTION. Arq Bras Cir Dig 2018; 31:e1362. [PMID: 29947696 PMCID: PMC6050002 DOI: 10.1590/0102-672020180001e1362] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 02/16/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Body mass index (BMI) has some limitations for nutritional diagnosis since it does not represent an accurate measure of body fat and it is unable to identify predominant fat distribution. AIM To develop a BMI based on the ratio of trunk mass and height. METHODS Fifty-seven patients in preoperative evaluation to bariatric surgery were evaluated. The preoperative anthropometric evaluation assessed weight, height and BMI. The body composition was evaluated by bioimpedance, obtaining the trunk fat free mass and fat mass, and trunk height. Trunk BMI (tBMI) was calculated by the sum of the measurements of the trunk fat free mass (tFFM) and trunk fat mass (tFM) in kg, divided by the trunk height squared (m2)). The calculation of the trunk fat BMI (tfBMI) was calculated by tFM, in kg, divided by the trunk height squared (m2)). For the correction and adjustment of the tBMI and tfBMI, it was calculated the relation between trunk extension and height, multiplying by the obtained indexes. RESULTS The mean data was: weight 125.3±19.5 kg, height 1.63±0.1 m, BMI was 47±5 kg/m2) and trunk height was 0.52±0,1 m, tFFM was 29.05±4,8 kg, tFM was 27.2±3.7 kg, trunk mass index was 66.6±10.3 kg/m², and trunk fat was 32.3±5.8 kg/m². In 93% of the patients there was an increase in obesity class using the tBMI. In patients with grade III obesity the tBMI reclassified to super obesity in 72% of patients and to super-super obesity in 24% of the patients. CONCLUSION The trunk BMI is simple and allows a new reference for the evaluation of the body mass distribution, and therefore a new reclassification of the obesity class, evidencing the severity of obesity in a more objectively way.
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Affiliation(s)
| | | | | | | | - Julia Greve
- Department of Orthopedics and Traumatology, Medical School of University of São Paulo São Paulo, SP, Brazil
| | - Paulo Roberto Silva
- Department of Orthopedics and Traumatology, Medical School of University of São Paulo São Paulo, SP, Brazil
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Café ACC, Lopes CADO, Novais RLR, Bila WC, da Silva DK, Romano MCC, Lamounier JA. INTAKE OF SUGAR-SWEETENED BEVERAGES, MILK AND ITS ASSOCIATION WITH BODY MASS INDEX IN ADOLESCENCE: A SYSTEMATIC REVIEW. Rev Paul Pediatr 2018; 36:91-99. [PMID: 29513855 PMCID: PMC5849383 DOI: 10.1590/1984-0462/;2018;36;1;00010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 04/04/2017] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To systematize literature references addressing the association of sugar-sweetened beverage (SSB) and milk intake with body mass index (BMI) in adolescents. DATA SOURCE A search was carried out in PubMed (US National Library of Medicine National Institutes of Health) and BVS (Virtual Library in Health). The descriptors used were: adolescents, young adult, beverages, drinking, obesity, overweight, BMI, and nutritional status. The following filters were applied: age ranging from 10 to 19 years, studies published in Portuguese or English language between 2011-2015. DATA SYNTHESIS Thirty studies were selected (22 cross-sectional studies, 4 cohort studies, 1 randomized clinical trial, 1 case-control study, and 1 quasi-experimental study). There was association between the intake of these beverages and increase in BMI in 55% of all 20 studies that dealt with sugary drinks. When it came to soft drinks, 100% of studies reported association with increase in BMI. As to milk intake, only one article showed association with increased BMI. Three articles reported milk as a protection factor against increase in BMI; three studies found no association between this intake and BMI. Nineteen studies had representative samples and 20 surveys reported random samples. Among papers using questionnaires, 84% had been validated. CONCLUSIONS There is no consensus in the literature about the association between SSB or milk intake and BMI in adolescents.
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Affiliation(s)
| | | | | | - Wendell Costa Bila
- Universidade Federal de São João del-Rei (UFSJ), Divinópolis, MG,
Brasil
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Araújo RGPDS, da Gama SGN, de Barros DC, Saunders C, Mattos IE. Validity of self-reported weight, height, and BMI in mothers of the research Birth in Brazil. Rev Saude Publica 2017; 51:115. [PMID: 29211205 PMCID: PMC5708269 DOI: 10.11606/s1518-8787.2017051006775] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 10/18/2016] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To evaluate the accuracy of information on pre-gestational weight, height, pre-gestational body mass index, and weight at the last prenatal appointment, according to maternal characteristics and sociodemographic and prenatal variables. METHODS The study was developed using data from the face-to-face questionnaire and prenatal card (gold standard) of the study "Birth in Brazil, 2011-2012". To evaluate the differences between the measured and self-reported anthropometric variables, we used the the Kruskal-Wallis test for the variables divided into quartiles. For the continuous variables, we used the Wilcoxon test, Bland-Altman plot, and average difference between the information measured and reported by the women. We estimated sensitivity and the intraclass correlation coefficient. RESULTS In the study, 17,093 women had the prenatal card. There was an underestimation of pre-gestational weight of 1.51 kg (SD = 3.44) and body mass index of 0.79 kg/m2 (SD = 1.72) and overestimation of height of 0.75 cm (SD = 3.03) and weight at the last appointment of 0.22 kg (SD = 2.09). The intraclass correlation coefficients (ICC) obtained for the anthropometric variables were: height (ICC = 0.89), pre-gestational weight (ICC = 0.96), pre-gestational body mass index (ICC = 0.92), and weight at the last appointment (ICC = 0.98). CONCLUSIONS The results suggest that the mentioned anthropometric variables were valid for the study population, and they may be used in studies of populations with similar characteristics.
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Affiliation(s)
- Roberta Gabriela Pimenta da Silva Araújo
- Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Departamento de Epidemiologia e Métodos Quantitativos em Saúde. Rio de Janeiro, RJ, Brasil
- Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Centro de Saúde Escola Germano Sinval Faria. Rio de Janeiro, RJ, Brasil
- Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Programa de Pós-Graduação em Epidemiologia em Saúde Pública. Rio de Janeiro, RJ, Brasil
| | - Silvana Granado Nogueira da Gama
- Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Departamento de Epidemiologia e Métodos Quantitativos em Saúde. Rio de Janeiro, RJ, Brasil
| | - Denise Cavalcante de Barros
- Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Centro de Saúde Escola Germano Sinval Faria. Rio de Janeiro, RJ, Brasil
| | - Cláudia Saunders
- Universidade Federal do Rio de Janeiro. Instituto de Nutrição Josué de Castro. Rio de Janeiro, RJ, Brasil
| | - Inês Echenique Mattos
- Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Departamento de Epidemiologia e Métodos Quantitativos em Saúde. Rio de Janeiro, RJ, Brasil
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Pucci F, Machado G, Solera E, Cenovicz F, Arruda C, Braga C, Nisihara R. Blood pressure levels and body mass index in Brazilian adults with Down syndrome. SAO PAULO MED J 2016; 134:330-4. [PMID: 27557142 PMCID: PMC10876337 DOI: 10.1590/1516-3180.2016.0057180316] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 03/18/2016] [Indexed: 12/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE Increased life expectancy among people with Down syndrome (DS) has introduced new environmental factors that may affect blood pressure (BP) and/or lead to obesity in this population. The aim here was to investigate BP levels and body mass index (BMI) in adults with DS, correlating these data with the patients' sex and age. DESIGN AND SETTING Analytical cross-sectional observational study conducted in special schools in Curitiba (PR), Brazil. METHODS 97 adult patients were included. BP was measured in accordance with the established guidelines. BMI was calculated by dividing the weight by the height squared (kg/m2). RESULTS Sex had no influence on BMI; nor did systolic BP (SBP) or diastolic BP (DBP). The age range was from 18 to 56 years. No correlation was observed between increasing age and greater BMI or BP. Eighty-six individuals (88.7%) presented normal BP, eleven (11.3%) prehypertension and none hypertension. Twenty patients (20.4%) presented BP lower than 90 × 60 mmHg. BMI ranged from 18 to 48 kg/m2 (mean of 28.8 ± 3.92 kg/m2): 21.9% had normal weight; 40.7% were overweight; and 25.3% had obesity class I, 9.9% class II and 2.2% class III. Higher BMI was associated with significantly greater SBP and DBP (P = 0.0175 and P = 0.0015). CONCLUSION Sex and age did not influence SBP, DBP or BMI in Brazilian adults with DS. Higher BMI was associated with greater BP (both systolic and diastolic).
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Affiliation(s)
- Felipe Pucci
- MD. Attending Physician, Department of Medicine, Universidade Positivo (UP), Curitiba, PR, Brazil.
| | - Guilherme Machado
- MD. Attending Physician, Department of Medicine, Universidade Positivo (UP), Curitiba, PR, Brazil.
| | - Edcarlo Solera
- MD. Attending Physician, Department of Medicine, Universidade Positivo (UP), Curitiba, PR, Brazil.
| | - Fernanda Cenovicz
- Undergraduate Student, Department of Medicine, Universidade Positivo (UP), Curitiba, PR, Brazil.
| | - Christian Arruda
- MD. Attending Physician, Department of Medicine, Universidade Positivo (UP), Curitiba, PR, Brazil.
| | - Chiu Braga
- PhD, Assistant Professor, Department of Medicine, Universidade Positivo (UP), Curitiba, PR, Brazil.
| | - Renato Nisihara
- PhD, Assistant Professor, Department of Medicine, Universidade Positivo (UP), Curitiba, PR, Brazil.
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Askari G, Heidari-Beni M, Mansourian M, Esmaeil-Motlagh M, Kelishadi R. Interaction of lipoprotein lipase polymorphisms with body mass index and birth weight to modulate lipid profiles in children and adolescents: the CASPIAN-III Study. SAO PAULO MED J 2016; 134:121-9. [PMID: 26786614 PMCID: PMC10496545 DOI: 10.1590/1516-3180.2015.00792608] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 04/25/2015] [Accepted: 08/26/2015] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE Interactions between body mass index (BMI), birth weight and risk parameters may contribute to diseases rather than the individual effects of each factor. However this hypothesis needs to be confirmed. This study aimed to determine to what extent variants of lipoprotein lipase (LPL) might interact with birth weight or body weight in determining the lipid profile concentrations in children and adolescents. DESIGN AND SETTING Substudy of the third survey of a national surveillance system (CASPIAN-III Study) in Iran. METHODS Whole blood samples (kept frozen at -70 °C) were randomly selected from 750 students aged 10-18 years. Real-time polymerase chain reaction (PCR) and high-resolution melt analysis were performed to assess S447X (rs328), HindIII (rs320) and D9N (rs1801177) polymorphisms. RESULTS The AG/GG genotype in D9N polymorphism was associated with higher LDL-C (low-density lipoprotein cholesterol) and lower HDL-C (high-density lipoprotein cholesterol) concentration. Significant interactions were found for D9N polymorphism and birth weight in association with plasma HDL-C concentration, and also for D9N polymorphism and BMI in association with plasma triglyceride (TG) and HDL-C levels. HindIII polymorphism had significant association with birth weight for HDL-C concentration, and with BMI for TG and HDL-C levels. Significant interactions were found for S447X polymorphism and BMI in association with plasma TG and HDL-C concentrations. CONCLUSION We found significant interactive effects from LPL polymorphisms and birth weight on HDL-C concentration, and also effects from LPL polymorphisms and BMI on TG and HDL-C concentrations.
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Affiliation(s)
- Gholamreza Askari
- PhD. Assistant Professor, Discipline of Nutrition, Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Motahar Heidari-Beni
- Doctoral Student, Discipline of Nutrition, Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Marjan Mansourian
- PhD. Assistant Professor, Discipline of Biostatistics, Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Mohammad Esmaeil-Motlagh
- MD. Professor of Pediatrics, Department of Pediatrics, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Roya Kelishadi
- MD. Professor of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
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Harter DL, Busnello FM, Dibi RP, Stein AT, Kato SK, Vanin CMDM. Association between low bone mass and calcium and caffeine intake among perimenopausal women in Southern Brazil: cross-sectional study. SAO PAULO MED J 2013; 131:315-22. [PMID: 24310800 PMCID: PMC10876326 DOI: 10.1590/1516-3180.2013.1315428] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Accepted: 01/07/2013] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE Osteoporosis is a skeletal abnormality characterized by reduction and alteration of bone microarchitecture that results in increased fragility and greater predisposition to fractures. Age and low bone mass are the main non-modifiable risk factors for osteoporotic fractures. The modifiable factors include sedentary lifestyle, inadequate calcium intake, excessive alcohol and/or caffeine consumption, smoking and low body weight. The aim here was to evaluate the association between low bone mass and calcium and caffeine intake among perimenopausal women in Southern Brazil. DESIGN AND SETTING Cross-sectional study conducted in Porto Alegre and Canoas, Rio Grande do Sul, Brazil. METHODS Women (n = 155) of mean age 53.6 ± 9.5 years were evaluated through a cross-sectional study in Southern Brazil. Food frequency questionnaires, bone mass evaluation using calcaneal ultrasound and anthropometric assessment were used. RESULTS The prevalence of overweight was 67.7%. In the bone mass screening, 30.3% had low bone mass and 4.5% had osteoporosis. The median calcium intake was 574.94 mg/day and the caffeine intake was 108.11 mg/day. No association was found between bone mass and anthropometric parameters, calcium intake or caffeine intake. It was found that 38.4% of the women had low bone mass. CONCLUSIONS No association was found between calcium and caffeine intake and bone mass. High prevalence of low bone mass was observed.
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Affiliation(s)
- Daniele Lazzarotto Harter
- BSc. Nutritionist, Department of Nutrition, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Fernanda Michielin Busnello
- PhD. Adjunct Professor, Department of Nutrition, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Raquel Papandreus Dibi
- MSc. Preceptor of Medical Residency Program in Gynecology, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
| | - Airton Tetelbom Stein
- PhD. Titular Professor, Department of Public Health, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Sérgio Kakuta Kato
- MSc. Assistant Professor, Department of Public Health, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA).
| | - Carla Maria De Martini Vanin
- Department of Statistics, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil.
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Abstract
CONTEXT AND OBJECTIVE Excessive gestational weight gain is related to many complications (both maternal and fetal), such as macrosomia. The most common complications in macrosomic fetuses include: increased risk of intrauterine death, need for intensive care, fractures, neonatal hyperbilirubinemia, paralysis of the brachial plexus and obesity in childhood and adulthood. The aim of this study was to evaluate the association between gestational and fetal weight gain and the incidence of macrosomia in two maternity hospitals. DESIGN AND SETTING Cohort study in two public maternity hospitals in Goiânia, Brazil. METHODS This was a cohort study on 200 healthy pregnant women with normal body mass index, divided into two groups: one with normal weight gain and the other with excessive weight gain during pregnancy. RESULTS The cohorts were similar regarding maternal age, per capita income, schooling level and reproductive behavior. The fetal weight was greater in the cohort with excessive maternal weight gain (3,388.83 g ± 514.44 g) than in the cohort with normal weight (3,175.86 g ± 413.70 g) (P < 0.01). The general incidence of macrosomia was 6.5%: 13.0% (13 cases) in the cohort with excessive maternal weight gain and 0.0% (0 cases) in the cohort with adequate weight gain. CONCLUSION Excessive maternal weight gain was associated with increased fetal birth weight and incidence of macrosomia.
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Nascimento VG, da Silva JPC, Bertoli CJ, Abreu LC, Valenti VE, Leone C. Prevalence of overweight preschool children in public day care centers: a cross-sectional study. SAO PAULO MED J 2012; 130:225-9. [PMID: 22965362 PMCID: PMC10619951 DOI: 10.1590/s1516-31802012000400004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2011] [Revised: 06/16/2011] [Accepted: 11/25/2011] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE Brazil is undergoing a period of epidemiological transition associated with demographic and nutritional changes. The prevalence of obesity is also increasing in children and is causing numerous health problems that are becoming public health issues. The aim here was to evaluate the prevalence of overweight among children of two and three years of age. DESIGN AND SETTING Cross-sectional study in municipal day care centers in Taubaté, state of São Paulo, Brazil. METHODS Weight and height measurements were made on 447 preschool children forming a probabilistic randomized sample. Their body mass index (BMI) was calculated. Their nutritional status was classified using the World Health Organization reference cutoff points (2006). Their mean weight, height and BMI were compared according to their age and sex. RESULTS The mean values for the final sample (n = 447) were as follows: mean age: 38.6 months (± 3.5) and Z scores for: weight/height (W/H): 0.50 (± 1.22); height/age: -0.03 (± 1.07); weight/age (W/A): 0.51 (± 1.23); and BMI: 0.51(± 1.23). The prevalence of overweight children (BMI > 1 z) was 28.86%, while the prevalence of underweight children (BMI < -2 z) was 0.89%. There were no differences in mean BMI among the two and three-year age groups (P = 0.66). CONCLUSION A high prevalence of overweight was observed in the sample of two and three-year-old children, with practically no malnutrition, thus showing that a significant nutritional transition may already be occurring, even in medium-sized cities of developing countries.
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Affiliation(s)
- Viviane Gabriela Nascimento
- PhD. Postdoctoral Researcher in the Department of Maternal and Child Health, Faculdade de Saúde Pública (FSP), Universidade de São Paulo (USP), São Paulo, Brazil.
| | - Janaína Paula Costa da Silva
- MSc. Nutritionist and Doctoral Student of Public Health, Faculdade de Saúde Pública (FSP), Universidade de São Paulo (USP), São Paulo, Brazil.
| | - Ciro João Bertoli
- PhD. Professor in the Department of Medicine, Universidade de Taubaté (Unitau), Taubaté, São Paulo, Brazil.
| | - Luiz Carlos Abreu
- MD, PhD. Postdoctoral Fellow in the Department of Maternal and Child Health, Faculdade de Saúde Pública (FSP), Universidade de São Paulo (USP), and Head of the Scientific Writing Laboratory, Department of Morphology and Physiology, Faculdade de Medicina do ABC (FMABC), Santo André, São Paulo, Brazil.
| | - Vitor Engrácia Valenti
- PhD. Student in the Department of Pathology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil.
| | - Claudio Leone
- MD, PhD. Full Professor and Head of the Department of Maternal and Child Health, Faculdade de Saúde Pública (FSP), Universidade de São Paulo (USP), São Paulo, Brazil.
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Matos LN, Giorelli GDV, Dias CB. Correlation of anthropometric indicators for identifying insulin sensitivity and resistance. SAO PAULO MED J 2011; 129:30-5. [PMID: 21437506 PMCID: PMC10865904 DOI: 10.1590/s1516-31802011000100006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2010] [Revised: 06/07/2010] [Accepted: 11/29/2010] [Indexed: 11/21/2022] Open
Abstract
CONTEXT AND OBJECTIVES Early detection of reduced insulin sensitivity (IS) and insulin resistance (IR) is desirable. The aim here was to evaluate correlations of anthropometric indicators for identifying IR or IS and determine the cutoff points of the most effective indicators. DESIGN AND SETTING Cross-sectional study in the city of São Paulo. METHODS Sixty-one individuals with normal fasting plasma glucose (NFPG) and 43 overweight women were analyzed. Body mass index (BMI), waist circumference (WC), waist-to-hip ratio, waist-to-height ratio (WHtR), conicity index and the HOMA-IS and HOMA-IR indices were determined. The correlations between the anthropometric indices and IS and IR were determined. ROC analysis was used to determine the areas under the curve (AUC) and cutoff points. RESULTS Among the NFPG individuals, BMI (r = -0.50; P = 0.002) and WHtR (r = -0.45; P = 0.007) showed correlations with HOMA-IS (homeostasis model assessment of insulin sensitivity). The ROC curve demonstrated statistical significance for BMI (AUC = 0.769; P = 0.005), WHtR (AUC = 0.764; P = 0.01) and WC (AUC = 0.702; P = 0.04), and the best cutoff points were 33.3 kg/m², 0.67 and 100 cm, respectively. Among the overweight women, the best correlation with HOMA-IR was demonstrated by WHtR (r = 0.37; P = 0.01), and the best cutoff point was 0.70 (AUC = 0.61; P = 0.25). CONCLUSION The most promising indicators for showing IS among the NFPG individuals were BMI, WHtR and WC. Among the overweight women, WHtR demonstrated greater correlation with IR.
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Affiliation(s)
- Lívia Nascimento Matos
- Department of Internal Medicine, Institute for Medical Treatment, Hospital do Servidor Público Estadual de São Paulo "Francisco Morato de Oliveira", São Paulo, Brazil.
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Narciso-Schiavon JL, Schiavon LDL, Carvalho-Filho RJD, Hayashida DY, Wang JHJ, Souza TS, Emori CT, Ferraz MLG, Silva AEB. Clinical characteristics associated with hepatic steatosis on ultrasonography in patients with elevated alanine aminotransferase. SAO PAULO MED J 2010; 128:342-7. [PMID: 21308157 PMCID: PMC10948078 DOI: 10.1590/s1516-31802010000600006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2010] [Revised: 09/16/2010] [Accepted: 09/24/2010] [Indexed: 01/21/2023] Open
Abstract
CONTEXT AND OBJECTIVE The main causes of hepatic steatosis (HS) are alcoholic liver disease and nonalcoholic fatty liver disease (NAFLD). Although liver biopsy is the gold standard for NAFLD diagnosis, the finding of abnormal aminotransferases in abstinent individuals, without known liver disease, suggests the diagnosis of NAFLD in 80-90% of the cases. Identification of clinical factors associated with HS on abdominal ultrasound may enable diagnoses of fatty liver non-invasively and cost-effectively. The aim here was to identify clinical variables associated with HS in individuals with elevated alanine aminotransferase (ALT) levels. DESIGN AND SETTING Cross-sectional study in a single tertiary care center. METHODS Individuals with elevated ALT, serologically negative for hepatitis B and C, were evaluated by reviewing medical files. Patients who did not undergo abdominal ultrasonography were excluded. RESULTS Among 94 individuals included, 40% presented HS on ultrasonography. Compared with individuals without HS, those with fatty liver were older (P = 0.043), with higher body mass index (BMI) (P = 0.003), diabetes prevalence (P = 0.024), fasting glucose levels (P = 0.001) and triglycerides (P = 0.003). Multivariate analysis showed that BMI (odds ratio, OR = 1.186; 95% confidence interval, CI: 1.049-1.341; P = 0.006) and diabetes mellitus (OR = 12.721; 95% CI: 1.380-117.247; P = 0.025) were independently associated with HS. CONCLUSIONS Simple clinical findings such as history of diabetes and high BMI may predict the presence of HS on ultrasonography in individuals with elevated ALT and negative serological tests for hepatitis.
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Velásquez-Meléndez G, Gazzinelli A, Côrrea-Oliveira R, Pimenta AM, Kac G. Prevalence of metabolic syndrome in a rural area of Brazil. SAO PAULO MED J 2007; 125:155-62. [PMID: 17923940 PMCID: PMC11020586 DOI: 10.1590/s1516-31802007000300006] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [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] [Received: 05/08/2006] [Revised: 05/08/2006] [Accepted: 05/23/2007] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE Metabolic syndrome (MS) is recognized worldwide as an important public health concern. However, little information is available for rural populations in Brazil. The aim was to determine the prevalence and risk factors associated with MS in a rural village in Brazil in 2004. DESIGN AND SETTING Cross-sectional population-based study, in Virgem das Graças, a rural community in the Jequitinhonha Valley, State of Minas Gerais. METHODS MS was the dependent variable, defined as any three of these risk factors: arterial hypertension, high glucose or triglyceride concentrations, low high-density lipoprotein cholesterol and abdominal obesity. MS prevalence, according to selected socioeconomic and demographic variables (age, skin color, marital status, schooling and smoking habits), was determined in 251 subjects aged 20-88 years. Multivariate logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals. RESULTS MS prevalence was 21.6% (7.7% for men and 33.6% for women); the age-adjusted prevalence was 19.0%. The highest prevalences were observed for women > 60 years of age (52.9%) and women with body mass index (BMI) >or= 25 kg/m(2) (64%). Age, sex and BMI were associated risk factors for MS, while skin color was only significantly associated with MS for women. The models were adjusted for age, smoking habits, marital status, skin color and schooling. CONCLUSIONS BMI and age were independently associated factors for MS in this rural community. These findings provide important evidence on the prevalence of MS as a public health problem, particularly for women and overweight individuals.
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Affiliation(s)
- Gustavo Velásquez-Meléndez
- Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
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