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Estudo transversal de base populacional na Cidade de Pelotas, Sul do Brasil, entre 1999 e 2000, para descrever a distribuição de adiposidade abdominal na população de acordo com os níveis de interven��ão e identificar fatores de risco. O estudo incluiu uma amostra de 1.935 adultos (20-69 anos) residentes na zona urbana do município. Obesidade abdominal foi classificada como nível I para circunferência da cintura (CCnI) de 80-88cm em mulheres e de 94-102cm em homens; e nível II (CCnII) > 88cm para mulheres e > 102cm para homens. Apresentavam obesidade abdominal 62% das mulheres e 37% dos homens. Os valores de CCnI foram 23% e 19% e de CCnII 39% e 19%, para mulheres e homens, respectivamente. Após ajuste para fatores de confusão, o aumento da idade e estar casado ou vivendo em união, em homens e mulheres, mantiveram-se fortemente associadas com CCnII. Escolaridade manteve-se como fator de risco apenas para homens e renda familiar apenas para mulheres, nas quais, o efeito da renda manteve-se inversamente associado com a obesidade abdominal. A utilização da medida da CC deveria ser incorporada às ações de promoção à saúde, principalmente, no acompanhamento e monitoramento da população.

A evolução da mortalidade perinatal foi estudada em Pelotas, Rio Grande do Sul, através de dois estudos de coorte realizados em 1982 e 1993. Todos os nascimentos hospitalares e os óbitos foram monitorizados com visitas diárias aos hospitais. A causa da morte foi determinada através de informações do prontuário, entrevista com o pediatra e de necrópsias. O coeficiente de mortalidade perinatal sofreu uma redução de 31% na década. O sub-registro que era de 42,1% em 1982, foi de apenas 6,8% em 1993. Dentre as causas de mortalidade perinatal, houve uma redução em 1993 de 58% para óbitos fetais antepartum, 47% para imaturidade e 62% para outras causas. Os coeficientes para asfixia sofreram um aumento de 4,5/1.000 para 8,3/1.000. As meninas apresentaram um coeficiente de mortalidade perinatal menor do que os meninos. Os coeficientes de mortalidade perinatal conforme peso ao nascer e renda familiar sofreram importantes reduções, sendo que a mais notável foi para crianças de baixo peso e de famílias de renda alta, com uma queda de 68%. Assim como em 1982, os recém-nascidos pré-termo tiveram coeficientes três vezes mais elevados do que crianças pequenas para a idade gestacional. Apesar da queda dos índices de mortalidade na década, as diferenças entre os grupos sociais mantiveram-se grandes.

Estudou-se a tendência temporal da mortalidade infantil através de dois estudos de coorte realizados em Pelotas, Rio Grande do Sul, em 1982 e 1993. Ambas coortes incluíram todos os nascimentos hospitalares e óbitos verificados através de visitas regulares aos hospitais, cartórios e cemitérios. As informações sobre a causa de morte foram obtidas através de entrevistas com pediatras, revisão do prontuário, necrópsias e entrevista com os pais das crianças. O coeficiente de mortalidade infantil caiu de 36,4 por mil nascidos vivos para 21,1 na década. As principais causas de mortalidade infantil em 1993 foram as perinatais, malformações congênitas, diarréia e infecções respiratórias. Crianças com baixo peso ao nascer apresentaram mortalidade 12 vezes maior do que crianças com peso adequado, e crianças pré-termo, duas vezes mais do que crianças com retardo de crescimento intra-uterino. Crianças de famílias com renda baixa (um salário mínimo) apresentaram mortalidade sete vezes superior àquelas com renda alta (10 salários mínimos). A mortalidade de crianças de baixo peso ao nascer e alta renda familiar decresceu em 67%, contra apenas 36% para as de baixa renda. Conclui-se que, mesmo com uma queda expressiva da mortalidade infantil na década, persistem importantes desigualdades sociais.

By March 3, 2022, the COVID-19 pandemic has caused more than 399 million infections and claimed the lives of more than five million people worldwide. To reduce infection rates, a series of prevention measures indicated by the World Health Organization (WHO) were adopted by countries, including the use of masks. This study aims to describe mask use in Brazil via data analysis from the EPICOVID19-BR, a population-based study conducted in 133 cities in the country in four phases between March and August 2020. The proportion of individuals who reported wearing a mask when they left their homes was 97.9% (95%CI: 97.8-98.0). The interviewer did not see interviewees' mask in 50% (95%CI: 49.9-51.1) of the cases at the time of the interview. However, between phase one and four of the survey, we observed a 4.4% decrease in the proportion of interviewees who failed to wear masks at the time of the interview. Mask non-visualization was more prominent in women, participants aged 10-19 and 20-29 years of indigenous, black, and brown skin color, and those with elementary and high school education and in the Central-West Region. The use of cloth masks showed a 91.4% predominance (95%CI: 91.2-1.5) with a 4.9% increase between phases 1 and 4. The results of the study bring important information to reinforce COVID-19 control policies in Brazil. The high percentage of people who failed to wear masks at the time of the interview suggests that it is still important to reinforce prevention and self-care, rather than relating mask wear to a mandatory measure.

We aimed to assess the proportion of the population in 133 Brazilian municipalities who - from March to August 2020 - had a health problem but failed to seek care or failed to attend to a health service for routine appointment or examination. We conducted a household survey from August 24-27 in 133 Brazilian cities by asking the subjects if, since the beginning of the COVID-19 pandemic in March 2020, they had suffered from a health problem but did not seek care or failed to attend to a routine or screening examination. Poisson regression was used for the analyses. We interviewed 33,250 subjects and 11.8% (95%CI: 11.4-12.1) reported that, since March 2020, they failed to seek care despite being ill, 17.3% (95%CI: 16.9-17.7) failed to attend to a routine or screening examination and 23.9% (95%CI: 23.4-24.4) reported one or both outcomes. Health service closure and fear of the COVID-19 infection were the main reasons for not seeking care. Women and the poorest were more likely to not look for a health service, despite having a health problem or a scheduled routine appointment. On the other hand, those subjects who self-identified as white were less likely to not look for a health service. The COVID-19 pandemic is more critical for the indigenous people and the poorest, and these people are also more likely to not seek care for other health conditions during the pandemic.

The objective of this study was to investigate the association between adverse childhood experiences (ACEs) and the use of alcohol, tobacco and illicit drugs among adolescents from a Brazilian cohort. The occurrence of five ACEs, the use of alcohol and tobacco and trying illicit drugs were investigated in the 1993 Pelotas birth cohort at the age of 15 (n = 4,230). A score was created for the ACEs and their association with the use of substances was evaluated. Around 25% of adolescents consumed alcohol, 6% smoked and 2.1% reported having used drugs at least once in their lives. The ACEs were associated with the use of alcohol, tobacco and illicit drugs. A dose-response relation between the number of ACEs and the substance use was found, particularly with regard to illicit drugs. The occurrence of ACEs was positively associated with the use of alcohol, tobacco and illicit drugs among adolescents and the risk may be different for men and women. These results point to the fact that strategies for preventing the use of substances should include interventions both among adolescents and within the family environment.

The study's objective was to evaluate the association between neonatal ventilatory support and the subsequent occurrence of respiratory diseases in children up to six years of age. This was a population-based birth cohort study. The main exposure was ventilatory support at birth, defined as the use of nasal continuous positive airway pressure (NCPAP) and/or mechanical ventilation (MV) for more than three hours from the time of hospitalization at birth until the first 28 days of life. Outcomes were: chest wheezing in the twelve months prior to the follow-up interview, medical diagnosis of asthma any time in the child´s life, and occurrence of pneumonia up to six years of age. Crude and adjusted analyses for potential confounding variables were performed using Poisson regression. 3,624 children were analyzed. NCPAP plus MV or MV alone was associated with higher frequency of medical diagnosis of asthma, even after adjusting for maternal and child characteristics (PR = 2.24; 95%CI: 1.27-3.99). The results highlight medium-term respiratory complications associated with neonatal ventilatory support.

There are discrepancies in the literature regarding time trends in the occurrence of asthma in adults. This study compared asthma prevalence in two cross-sectional studies with a ten-year interval in Pelotas, Rio Grande do Sul State, Brazil. The first, in 2000, included 1,968 individuals, and the second, in 2010, 2,466 adults (20-69 years). Prevalence of wheezing and shortness of breath in the prior 12 months remained the same after ten years (6% and 6.1%, respectively). In both studies, asthma was more frequent among females and people with low family income. Physician-diagnosed asthma increased by 35.6%, and lifetime incidence of asthma, by 32.2%. There was no percentage change in current asthma symptoms or current asthma. Local socioeconomic improvement between the two studies was consistent with the increase in medical diagnosis, but did not reflect better management of asthma symptoms, underlining the need for investment regarding other determinants of the disease.

The aim of this study was to evaluate the association between size at birth and mental health problems at 11 years of age in the 1993 Pelotas (Brazil) Birth Cohort Study. Newborns were weighed and measured, and anthropometric indices were calculated. At 11 years of age, mental health problems were assessed using the Strengths and Difficulties Questionnaire (SDQ). Prevalence of mental health problems was 32% (95%CI: 31-33). After adjusting for potential confounders, newborns with weight and body mass index (BMI) for age z-scores < -2 SD were at 27% (95%CI: 7-49) and 29% (95%CI: 10-51) greater risk, respectively, of developing mental health problems at age 11 years than those born with normal scores. Newborns with BMI and head circumference for age z-scores > +2 SD were at 34% (95%CI: 6-71) and 19% (95%CI: 1-40) greater risk, respectively, of developing mental health problems than those with normal scores. The results suggest that early factors that are reflected as size measurements at birth can cause mental health problems later in life.

The aim of the present study was to introduce Focused Principal Component Analysis (FPCA) as a novel exploratory method for providing insight into dietary patterns that emerge based on a given characteristic of the sample. To demonstrate the use of FPCA, we used a database of 1,968 adults. Food intake was obtained using a food frequency questionnaire covering 26 food items. The focus variables used for analysis were age, income, and schooling. All analyses were carried out using R software. The graphs generated show evidence of socioeconomic inequities in dietary patterns. Intake of whole-wheat foods, fruit, and vegetables was positively correlated with income and schooling, whereas for refined cereals, animal fats (lard), and white bread this correlation was negative. Age was inversely associated with intake of fast-food and processed foods and directly associated with a pattern that included fruit, green salads, and other vegetables. In an easy and direct fashion, FPCA allowed us to visualize dietary patterns based on a given focus variable.

The study aims to describe and compare two methods of energy intake assessment and one measure of energy expenditure applied in adolescents from a birth cohort. In a sub-sample of the 1993 Pelotas (Brazil) birth cohort, followed up in 2006-7, information on intake was obtained through a food-frequency questionnaire (FFQ) and three 24-hour-recalls (24hR), while energy expenditure was assessed using an accelerometer. Bland & Altman plots were used in the analyses in order to compare the methods. The mean difference between FFQ and 24hR was 592 ± 929cal/day. Compared to energy expenditure, intake was overestimated when measured by FFQ (357 ± 968cal/day) and underestimated by 24hR (-278 ± 714cal/day). In spite of the great differences between energy intake obtained using the two methods, lower differences were observed when these methods were compared to expenditure.

The aim of this prospective analysis was to describe the cumulative incidence of hospital admissions in the first year of life and between 1 and 11 years of age and to explore associated factors. Hospital admissions were collected through regular monitoring in the first year of life, and through maternal report on admissions between 1 and 11 years. Analyses were stratified by sex and adjusted for confounding factors. 18.1% of children were hospitalized in the first year of life, and 30.7% between ages 1 and 11 years. Among boys, hospital admission in the first year was associated with low family income, paternal smoking during pregnancy, preterm delivery, and low birthweight. Among girls, in addition to the variables described for boys, black/mixed skin color was also a risk factor for hospital admission. For admissions between 1 and 11 years of age, low family income and gestational age > 37 weeks were found to be significant risk factors.

The aim of this study was to estimate the prevalence of sedentary behavior and investigate associated factors in adolescents 11 years of age from the 1993 birth cohort in Pelotas, Rio Grande do Sul State, Brazil. Sedentary behavior was investigated with a questionnaire, and was defined as spending more than two hours per day watching television, playing videogames, or using the computer. Of the 4,452 adolescents interviewed, 98% reported watching television, 44% playing videogames, and 22% using the computer. The average time spent on each of these electronic media was 197, 36, and 17 minutes per day, respectively. Prevalence of sedentary behavior was 79.7% (95%CI: 78.6; 80.9) and showed a positive association with socioeconomic level and nutritional status and a negative association with well-being. These 11-year-olds spent extensive time at TV viewing, videogames, and the computer. Special attention should be given to the most exposed groups of adolescents, including the more affluent, overweight, and those with limited schooling.

The aim of this study was to investigate medicine use and associated factors among adolescents. This was a prospective cohort study including 4,452 adolescents born in Pelotas, Rio Grande do Sul State, Brazil, in 1993. Information on medicine use in the 15 days prior to the interviews was collected from the mothers. Overall prevalence of medicine use was 30.9%, and 64.7% of the medicines had been prescribed by a physician. The most frequently used pharmacological groups were medicines for the nervous (35.9%) and respiratory systems (25.7%). Medicine use was directly associated with socioeconomic status, maternal schooling, complications during pregnancy or delivery, and neonatal problems resulting in the need for intensive care. Underweight and obese adolescents were more likely to use medicines as compared to those with normal body mass index. A direct association was observed between maternal use of hypnotic drugs and sedatives and adolescent medicine use. It is essential to implement educational policies aimed at promoting rational use of medicines by adolescents.

This study describes the food intake of adolescents participating in the 1993 birth cohort from Pelotas, Southern Brazil, according to socioeconomic position. We carried out a cross-sectional analysis of data collected in the 2004-2005 follow-up visit. Food intake in the previous year was evaluated using the Block questionnaire. Socioeconomic status was evaluated based on an assets index, divided into quintiles. Foods with the highest frequency of daily intake were white bread (83%), butter or margarine (74.6%), beans (66.4%) and milk (48.5%). Intake of butter or margarine, bread, and beans was more frequent among poorer adolescents, and the inverse was true for milk. Intake of fruits and vegetables was low in all socioeconomic strata, but particularly low among the poor. In early adolescence, all socioeconomic groups showed high consumption of foods rich in fat and low consumption of foods rich in fiber.

The aim of this study was to describe oral health follow-up studies nested in a birth cohort. A population-based birth cohort was launched in 1993 in Pelotas, Rio Grande do Sul State, Brazil. Two oral health follow-up studies were conducted at six (n = 359) and 12 (n = 339) years of age. A high response rate was observed at 12 years of age; 94.4% of the children examined at six years of age were restudied in 2005. The mean DMF-T index at age 12 was 1.2 (SD = 1.6) for the entire sample, ranging from 0.6 (SD = 1.1) for children that were caries-free at age six, 1.3 (SD = 1.5) for those with 1-3 carious teeth at six years, and 1.8 (SD = 1.8) for those with 4-19 carious teeth at six years (p < 0.01). The number of individuals with severe malocclusions at 12 years was proportional to the number of malocclusions at six years. Oral health problems in early adolescence were more prevalent in individuals with dental problems at six years of age.

We evaluate the influence of demographic, socioeconomic, and maternal variables on the nutritional status of adolescents aged 11 years. We conducted a prospective cohort study including 4,452 adolescents born in Pelotas, Southern Brazil, in 1993, accounting for 87.5% of the original cohort. Nutritional status was evaluated based on World Health Organization criteria. Subjects were classified according to nutritional status into thin, normal, overweight and obese. Independent variables analyzed included skin color, socioeconomic status, maternal schooling, and maternal body mass index (BMI). Analyses were stratified by sex, and multivariable regression was performed using the multinomial logistic approach. Overall, 7% of adolescents were classified as thin, 11.6% as overweight, and 11.6% as obese. Among boys, thinness was inversely associated with maternal schooling and maternal BMI. Among girls, thinness was directly associated with maternal BMI. Overweight and obesity were directly associated with socioeconomic status and maternal BMI, the former showing the strongest association with nutritional status among adolescents.

The aim of this study was to evaluate concurrent risk factors for high blood pressure in adolescents. This is a prospective cohort study including 4,452 adolescents born in Pelotas, Rio Grande do Sul State, Brazil, in 1993. Blood pressure was measured before and after the interview, and the mean value was used in the analyses. Mean systolic blood pressure was 101.9mmHg (SD = 12.3) and mean diastolic pressure was 63.4mmHg (SD = 9.9). Adolescents with black skin had higher blood pressure than those with white skin. Mean systolic pressure among subjects in the top quartile of body mass index (BMI) was 11.6mmHg higher than among those in the lowest quartile. Mean systolic pressure among postmenarcheal girls was 5.4mmHg higher than among premenarcheal girls. Similar trends were found for diastolic arterial pressure. Our findings suggest that blood pressure control must begin already in childhood and adolescence.

The aim of this study was to describe resting pulse rate and associated factors among adolescents. This was a cross-sectional analysis nested in a prospective cohort study, including 4,452 adolescents born in Pelotas, Rio Grande do Sul State, Brazil in 1993, representing 87.5% of the original cohort. Pulse rate was measured with an electronic device at the beginning and end of the interview, and the mean value was used in the analyses. Mean pulse rate was 78.4 bpm (SD = 11.0) in the total sample, 76.5 bpm (SD = 10.7) in boys, and 80.2 bpm (SD = 10.9; p < 0.001) in girls. Black adolescents showed lower mean pulse rates. There was a direct association between pulse rate and blood pressure. Physical activity was inversely associated with pulse rate in the crude analysis only. Elevated pulse rate is strongly associated with high blood pressure, and both variables are predictors of risk of chronic disease in adulthood.

The aim of this study was to assess early determinants of attention and hyperactivity problems in adolescents. In 1993, all hospital births in the city of Pelotas, Rio Grande do Sul State, Brazil, were monitored and mothers were interviewed (N = 5,249). At 11 years of age, 4,423 mothers answered the Strengths and Difficulties Questionnaire (SDQ) in order to evaluate attention and hyperactivity problems in the adolescents. Crude and adjusted prevalence ratios were calculated using Poisson regression. Prevalence of attention and hyperactivity problems was 19.9%. Factors associated with the outcome in the adjusted analysis were: male gender, low family income, smoking during pregnancy, minor psychiatric disorders in the mother, and history of child's behavioral/emotional problems at four years of age. Early life events impacted attention and hyperactivity problems in adolescence. Risk factors for attention and hyperactivity problems found in this study were similar to those reported in other cultures.

The aim of this study was to estimate the prevalence of experimental alcohol intake and associated factors in early adolescence. The overall sample consisted of 4,452 adolescents (mean age = 11.3 years; SD = 0.3) from the 1993 birth cohort in Pelotas, Rio Grande do Sul State, Brazil. Experimental use of alcohol was reported by 17.5% of the interviewees (95%CI: 16.3-18.6), and 5% reported having tried alcohol at nine years of age or younger. Prevalence of experimental alcohol use was higher among adolescents whose mothers had consumed alcohol during pregnancy, whose parents consumed alcohol, who worked outside the home themselves, and who had ever tried smoking. Family strife, parental alcohol intake, and adolescent smoking were strong predictors of experimental alcohol use in early adolescence. Special attention should be targeted to these groups in order to avoid heavy and premature alcohol use in early adolescence.

The aim of this study was to verify the agreement between different approaches for estimating levels of physical activity in adolescents. One questionnaire was administered to parents and two were administered to the adolescents. This was a cross-sectional analysis of data collected in the 2004-2005 follow-up of the 1993 Pelotas (Brazil) birth cohort study. Parents or guardians answered the following question: "Compared to most children the same age, would you say that your child exercises more, less, or the same amount?" A similar question was addressed to adolescents, as was a detailed questionnaire on physical activity. Agreement between the questionnaires was measured by the weighted kappa statistic. A total of 4,254 adolescents and parents/guardians answered the questionnaires. Kappa values indicated low agreement for all comparisons (kappa < 0.33 for all analyses). Measurement of physical activity in adolescents is complex, and available instruments should be validated prior to their use.

Evidence has shown the negative effects of unsupervised diets and those with excessive calorie restriction. The aim of this study was to determine the proportion of adolescents engaging in weight loss dieting and associated factors. This was a cross-sectional study of 4,452 adolescents born in Pelotas, Rio Grande do Sul State, Brazil, in 1993. The outcome was defined as adolescents that reported having practiced some type of weight loss dieting in the previous 12 months. Prevalence of such dieting was 8.6% (95%CI: 7.7;9.4), and was higher in girls. Elevated maternal body mass index (BMI) was associated with dieting among girls. The adolescent's and parents' view of the adolescent's weight, excess weight, and consumption of diet or light soft drinks were associated with adolescent dieting. There was a positive association between dieting and socioeconomic status. The findings provide important backing for policies aimed at improving adolescents' diet, since they express a major concern over weight and thus a significant percentage of individuals with erroneous and unhealthy behaviors.

The aim of this study is to describe the methodology of the 2004-2005 follow-up visit of the 1993 Pelotas (Brazil) birth cohort. All children born in Pelotas in 1993 and whose mothers lived in the city at that time were eligible to be enrolled in a longitudinal study. Between July 2004 and March 2005, all cohort participants were sought for a follow-up visit. Several strategies were used to help trace cohort members, including a census of the city's schools and a census of all households in the municipality. The Mortality Information System was monitored in order to identify deaths among cohort members. Of the 5,249 cohort members, 4,452 were interviewed in 2004-5. When added to the 141 deaths, these represent 87.5% of the original cohort. In spite of the logistic and financial difficulties, it is possible to carry out prospective studies with long-term follow-up in the Brazilian context.

Studies on well-being and its possible determinants are rare in the international literature, and almost non-existent in Brazil, particularly among youth. The present study focused on the epidemiology of well-being among adolescents belonging to a birth cohort. Well-being was measured using face-to-face interviews, with a question whose answer was based on a graphic scale of faces. 4,452 adolescents were interviewed. Approximately half (49.4%) classified themselves as very happy (face 1); this proportion was higher among girls than boys. Poorer adolescents were more likely than their wealthier peers to identify with the happiest face (number 1), but were also more likely to report moderate to low levels of well-being (faces 3-7). Body mass index was inversely associated with well-being. Among girls, physical activity was directly associated with well-being.

Three birth cohorts are currently being followed in Pelotas, Southern Brazil, in order to assess changes in birth conditions, growth, development, morbidity, and infant mortality, as well as the influence of pre- and perinatal factors on the subsequent morbidity of participants in their adult lives. We provide a description of the methodology used for the cohort studies that began in 1982, 1993, and 2004 in Pelotas, and a description of the economic conditions of the families involved. For the three cohorts, similar strategies were used to recruit babies born to mothers living in the municipality's urban area. These included daily visits to maternity hospitals where births were identified, mothers interviewed, and newborns examined. Over this time frame, there has been a significant reduction in the number of births due to declining fertility rates amongst the target population. Salaries (measured as a multiple of the minimum wage) were stable across cohorts, but quality of life indicators--such as the availability of piped water, flushing toilets and refrigerators--showed clear improvements. Mothers' levels of education improved markedly. Important changes in the demographic profile of risk factors and health outcomes are being recorded by the Pelotas cohorts.

We studied time trends in infant mortality and associated factors between three cohort studies carried out in Pelotas, Rio Grande do Sul State, Brazil, in 1982, 1993, and 2004. All hospital births and deaths were determined by means of regular visits to hospitals, registrar's offices, and cemeteries. This data was used to calculate neonatal, post-neonatal, and infant mortality rates per thousand live births. Rates were also calculated according to cause of death, sex, birth weight, gestational age, and family income. The infant mortality rate fell from 36.4 per 1,000 live births in 1982 to 21.1 in 1993 and 19.4 in 2004. Major causes of infant mortality in 2004 were perinatal causes and respiratory infections. Mortality among low birth weight children from poor families fell 16% between 1993 and 2004; however, this rate increased by more than 100% among high-income families due to the increase in the number of preterm deliveries in this group. The stabilization of infant mortality in the last decade is likely to be due to excess medical interventions relating to pregnancies and delivery care.

Trends in perinatal mortality were studied in the city of Pelotas, Southern Brazil, using three population-based cohort studies carried out in 1982, 1993 and 2004. The objective of the present study was to analyze trends and differences in perinatal mortality during the 1982-2004 period. All hospital deliveries and perinatal deaths were monitored through daily visits to maternity wards. Cause of death was determined using information from hospital records and by interviewing physicians. Perinatal mortality fell by 43% in the two decades, with a greater reduction between 1982 and 1993. Intrapartum fetal deaths decreased by 72% and deaths from asphyxia fell from 4.5 per thousand in 1982 to 1.4 per thousand in 2004. In conclusion, reductions in perinatal mortality were also seen across all birth weight categories between 1982 and 1993, but the same was not true for the 1993 to 2004 period, when mortality increased in several categories above 2,000g.

In a prospective birth cohort study in Brazil, the prevalence and early risk factors for smoking in adolescence were investigated. All 1982 hospital-born children in Pelotas, Rio Grande do Sul, Brazil, were enrolled in a birth cohort study (N = 5,914; boys: 3,037; girls: 2,877). All male participants were searched in 2000 when enrolling in the national army, and 78.8% were traced. In 2001, a systematic sample of 473 girls was interviewed, representing a follow-up rate of 69.1%. Among males, 48.6% (95%CI: 46.6-50.7) had ever tried smoking and 15.8% (95%CI: 14.3-17.3) were daily smokers. Among females, 53.1% (95%CI: 48.6-57.6) had ever tried smoking and 15.4% (95%CI: 12.1-18.7) were daily smokers. Boys born to single mothers and those with fathers with low schooling were more likely to smoke in adolescence. Girls from low-income families, with mothers who smoked during pregnancy, and fathers with alcohol-related problems were more likely to smoke. Although the smoking prevalence was similar in boys and girls, risk factors for smoking were different between the sexes. Social environment appears to be the strongest predictor of tobacco use in adolescence.

During 1999 and 2000, a population-based cross-sectional study was conducted in Pelotas, southern Brazil, to describe the population distribution of abdominal adiposity according to "action level points" and to identify risk factors. The study included a sample of 1,935 adults (20-69 years) residing in urban areas. Abdominal obesity was classified as action level I for waist circumference (WCLI) 80-88 cm in women and 94-102 cm in men; and as action level II (WCLII) for > 88 cm in women and > 102 cm in men. Abdominal obesity was present in 62% of women and 37% of men. Some 23% and 19% of men and women were classified as WCLI, respectively; 39% of women and 19% of men were classified as WCLII. After adjustment for confounding variables, age and being married or in a stable relationship were strongly associated with WCLII. Schooling was a risk factor in men only, and family income in women. In women, income was inversely associated with abdominal obesity. Use of a simple measurement such as waist circumference, which allows identification of levels of intervention, should be incorporated into health promotion measures, especially to help community health workers monitor the population needs.