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Fruits and vegetables (FV) are important components of a healthy diet. They usually have low energy density and are sources of many vitamins, minerals and other bioactive components that bring health benefits( 1 – 3 ). According to WHO, low consumption of FV is one of the top ten risk factors for global mortality. Their adequate intake reduces the risk of non-communicable chronic diseases and also prevents and corrects multiple micronutrient deficiencies, especially in low- and middle-income countries( 1 , 2 , 4 ). Despite existing strategies and campaigns such as the ‘global strategy of food, physical activity and health’ and ‘5 a day’ which aim to increase the consumption of FV( 5 , 6 ), FV intake is still low among individuals of all ages in comparison with the current recommendation (400 g/d)( 6 – 8 ). Furthermore, several studies have found that this scenario of low consumption is especially common among children and adolescents from low-, middle- and high-income countries( 9 – 11 ). For instance, the literature shows that many Brazilian adolescents do not eat enough FV( 12 – 14 ). There is growing evidence that major behavioural and biological risk factors arise early in life and continue to have a negative impact over the subsequent years( 1 ). In addition, studies assessing eating habits suggest there are critical aspects during adolescence that have an impact on chronic diseases, such as the development of risk factors during this period and their potential stability throughout life( 1 , 15 – 17 ). The latter could be measured through tracking analyses, which assess the stability of a certain outcome variable over a period of time. These analyses involve the maintenance of a relative position within a distribution of values over time( 18 – 20 ). Also, the study of the dynamics of consumption towards a less or more healthy direction may be important in predicting the development of a disease. In high-income countries, there are several studies reporting longitudinal trends of consumption of FV( 15 , 21 – 28 ). However, we could not find studies assessing this item among low- and middle-income countries, where this information has become relevant for the nutrition transition phase that is taking place in those settings( 1 ). Therefore, the purpose of the present study was to examine the stability and changes in FV intake of urban Brazilians adolescents over a 3-year period. A greater knowledge of these issues will be useful for the development of actions to promote healthful eating habits during this life stage.

O objetivo do estudo foi identificar os fatores associados ao excesso de peso em crianças brasileiras menores de cinco anos. Foram utilizados dados da Pesquisa Nacional de Demografia e Saúde (PNDS) de 2006, um estudo transversal de base domiciliar. O diagnóstico do excesso de peso baseou-se no índice peso-para-altura superior a 2 escores z acima da mediana do padrão antropométrico da Organização Mundial de Saúde - 2006. A população estudada constituiu-se de 4.388 crianças. A prevalência de excesso de peso nas crianças foi descrita segundo variáveis socioeconômicas, demográficas, antropométricas e comportamentais. Foram realizadas análises bruta e ajustada através da Regressão de Poisson e todas foram estratificadas pelo sexo da criança. A prevalência de excesso de peso foi de 6,6%. Após análise ajustada, o índice de massa corporal materno e o peso ao nascer foram associados ao excesso de peso. Além disso, o excesso de peso mostrou-se associado ao tempo de amamentação exclusiva, nos meninos e ao nível socioeconômico e situação conjugal, nas meninas. Enfatiza-se a necessidade da implementação de políticas públicas que atuem, o mais precocemente possível, nos principais determinantes do excesso de peso. The scope of the study was to identify factors associated with excess weight in Brazilian children less than five years of age. Data from a cross-sectional home-based study entitled the National Demographic and Health Survey (NDHS) of 2006 were used. The diagnosis of excess weight was performed using the weight-for-height greater than 2 z scores above the median anthropometric standard recommended by the World Health Organization in 2006. The population under study consisted of 4,388 children. The prevalence of excess weight in children was described according to socio-economic, demographic, anthropometric, and behavioral variables. Crude and adjusted analyses were carried out to assess statistical significance stratified by gender using Poisson regression. The prevalence of excess weight was 6.6%. After adjusting for potential confounding factors, maternal body mass index and birth weight were associated with excess weight. Furthermore, being overweight was associated with exclusive breastfeeding for boys and with the socio-economic level and marital status of the mother for girls. The need to implement public policies that act on the major determinants of excess weight since childhood is emphasized.

Objetivo: Investigar o efeito de fatores demográficos, socioeconômicos, educacionais e familiares sobre o conhecimento acerca do HIV/AIDS em adolescentes com 11 anos de idade. Métodos: Foram estudados 3.949 adolescentes de Pelotas/RS. O conhecimento acerca do HIV/AIDS foi avaliado por meio de um questionário autoaplicado e mensurado através de cinco perguntas sobre relação heterossexual, relação homossexual, compartilhamento de seringas, beijo na boca e abraçar alguém com AIDS. As análises foram ajustadas com base em um modelo hierárquico, usando regressão de Poisson com ajuste robusto da variância. Resultados: Os percentuais de respostas erradas para as questões examinadas foram: 17,2% para transmissão em relações heterossexuais; 44,1% para relações homossexuais; 34,9% para compartilhar seringas; 25,6% para beijo na boca e 16,2% para abraçar pessoa com AIDS. Na análise ajustada, menor grau de conhecimento foi demonstrado pelos meninos, por adolescentes de menor nível econômico, cujas mães possuíam menor escolaridade, para os adolescentes que não haviam conversado sobre sexo com a mãe e entre os que não tiveram aula sobre educação sexual na escola. O grau de conhecimento não esteve associado com o tipo de escola, cor da pele, tampouco com a conversação com o pai sobre sexo. Conclusão: Fornecer informações aos adolescentes é fundamental para melhorar o conhecimento sobre o risco de transmissão de HIV e de outras infecções sexualmente transmissíveis, principalmente entre jovens do sexo masculino e de menor nível socioeconômico. As políticas públicas devem considerar o rol que a mãe e a escola desempenham no conhecimento sobre este tema por parte dos adolescentes. Objective: To investigate the effect of demographic, socioeconomic, educational and family variables on HIV/AIDS knowledge among adolescents aged 11 years. Methods: 3,949 adolescents born in Pelotas (Brazil). HIV/AIDS knowledge was assessed through a self-administered questionnaire and measured through five questions about HIV transmission: heterosexual intercourse, homosexual intercourse, needle sharing, open-mouth kissing and hugging someone with AIDS. All the analyses were adjusted based on a hierarchical model, using Poisson regression with robust adjustment of variance. Results: Prevalence of wrong answers to the examined questions were 17.2% for heterosexual transmission, 44.1% for homosexual intercourse, 34.9% for needle sharing, 25.6% for kiss on the mouth and 16.2% for hugging someone with AIDS. In adjusted analysis, lower knowledge levels were more prevalent among boys, adolescents with lower socioeconomic status and with less maternal education level, among those who had not talked about sex with mother and without sexual education lessons at school. Knowledge was not associated with school type (public or private), skin color or talk about sex with father. Conclusion: Providing information to adolescents is essential to improve knowledge about HIV and other sexually transmitted infections, especially among young males, with lower socioeconomic status and with lower maternal education level. Public policies aimed to reducing HIV infection should consider maternal and school relevance to improve knowledge on adolescents.

PurposeTo evaluate the associations between family socioeconomic trajectories from 0 to 11 years of age and risk factors for noncommunicable disease at 15 years.MethodsIndividuals born in the city of Pelotas, Brazil, in 1993 are part of a birth cohort study. Socioeconomic position, collected at birth and at 11 years of age, was our main exposure. Risk factors for chronic disease were collected at 15 years. Body mass index was transformed into Z score using the World Health Organization standard. Transport and leisure-time physical activity, smoking, and alcohol consumption were assessed by self-report. Blood pressure was measured using a digital sphygmomanometer.ResultsOf 5,249 cohort members, 85.7% were located at the 15-year follow-up visit. Rich adolescents were more likely to be overweight, be obese, and not use active modes of transport to school. Poor adolescents were more likely to smoke. In relation to socioeconomic trajectories, the odds of obesity were 46% higher among those who were “always rich” compared with those who were “always poor”; the odds of use of an inactive mode of transportation were 326% greater among the “always rich” than the “always poor,” whereas the reverse was observed for smoking (odds of 200%). The “always rich” had one-half the odds of walking or cycling to school compared with those who became wealthy in the studied period.ConclusionsAdolescent socioeconomic position is a stronger determinant of risk factors for noncommunicable diseases than socioeconomic trajectories. However, trajectories do matter, particularly in terms of use of active transportation to school.

PurposeWe explored predictors of nutritional status change from 11 to 15 years of age by analyzing prospective data.MethodsWe collected data at 11 and 15 years of age from individuals born in 1993 in Pelotas, Brazil. We assessed nutritional status using body mass index (BMI) for age in z-score according to the World Health Organization 2007 standards. Independent variables collected at 11 years of age were socioeconomic position, adolescent's perception of own weight, body dissatisfaction, and weight loss dieting.ResultsOf the 4,032 adolescents whose nutritional status could be evaluated in the two follow-ups, 93% maintained their nutritional status classification from 11 to 15 years. A total of 102 (2.8%) became obese and 181 (4.5%) ceased to be obese in the 4-year period. The prevalence of obesity decreased from 11 to 15 years of age in both boys and girls. Low-income girls were more likely to become obese from 11 to 15 years of age compared with high-income ones. Among boys, those with high income were more likely to cease being obese compared those with low income. Those who perceived themselves to be obese, who wished to have a smaller silhouette, and who were on diets to lose weight were more likely to become obese or to achieve a normal BMI category at 15 years of age.ConclusionsBMI tracks strongly in early adolescence. This finding suggests that interventions to more effectively change nutritional status should be implemented in childhood and should consider emotional aspects as well as social and biological ones.

Purpose To evaluate the prospective association between leisure-time physical activity practice at 11 years of age and incidence of school failure from 11 to 15 years of age. Methods The sample comprised >4,300 adolescents followed up from birth to 15 years of age participating in a birth cohort study in Pelotas, Brazil. The incidence of school failure from age 11 to 15 years was calculated by first excluding from the analyses all subjects who experienced a school failure before 11 years of age, and then categorizing as "positive" all those who reported repeating a grade at school from 11 to 15 years of age. Leisure-time physical activity was measured using a validated questionnaire. Results The incidence of school failure was 47.9% among boys and 38.2% among girls. Adolescents in the top quartile of leisure-time physical activity practice at 11 years of age had a higher likelihood of school failure (OR: 1.36; 95% CI: 1.06, 1.75) compared with the least active adolescents. In adjusted analyses stratified by sex, boys in the top quartile of leisure-time physical activity practice at 11 years of age were also more likely to have failed at school from age 11 to 15 years (OR: 1.60; 95% CI: 1.09, 2.33). Conclusions Adolescents allocating >1,000 min/wk to leisure-time physical activity were more likely to experience a school failure from 11 to 15 years of age. Although this finding does not advocate against physical activity promotion, it indicates that excess time allocated to physical activity may jeopardize school performance among adolescents.

OBJETIVO: Descrever a frequência de consumo de diferentes tipos de carnes conforme variáveis sociodemográficas e nutricionais, e analisar o consumo, em adolescentes do Sul do Brasil, de dieta rica em gordura conforme os tipos de carne consumidos. MÉTODOS: Estudo transversal realizado com adolescentes pertencentes à coorte de nascimentos de 1993, em Pelotas (RS). A frequência de consumo de carnes vermelhas, brancas, vísceras e embutidos foi avaliada por um Questionário de Frequência de Consumo Alimentar, adaptado para este estudo. A ingestão de dieta rica em gordura foi avaliada a partir do instrumento proposto por Block. As variáveis independentes foram sexo, cor da pele, nível socioeconômico, escolaridade materna e estado nutricional. Nas análises estatísticas, foram utilizados testes Qui-quadrado de heterogeneidade e de tendência linear. RESULTADOS: Foram avaliados 4.325 adolescentes com idade média de 14,7, DP=0,3 anos, dos quais 51,2% eram do sexo feminino. A frequência de consumo diário de carnes vermelhas foi maior do que a de carnes brancas (43,0% e 9,7%, respectivamente). O consumo de embutidos por mais do que quatro vezes por semana foi referido por 48,5% dos indivíduos, e 81,4% relataram consumir vísceras raramente ou nunca. Adolescentes de maior nível socioeconômico e filhos de mães com maior escolaridade apresentaram maior consumo de carnes vermelhas e embutidos, enquanto aqueles em situação oposta apresentaram maior consumo de carnes brancas. Adolescentes que consomem carnes com maior frequência também consomem dieta rica em gordura. CONCLUSÃO: As carnes consumidas com maior frequência pelos adolescentes foram as vermelhas e os embutidos. No entanto, adolescentes de maior nível socioeconômico consomem carnes vermelhas com maior frequência, enquanto adolescentes menos favorecidos economicamente consomem mais carnes brancas. OBJECTIVE: The present study investigated the consumption frequency of various meats according to sociodemographic and nutritional variables and analyzed the consumption of high-fat diets according to type of meat by southern Brazilian adolescents. METHODS: This cross-sectional study included the 1993 birth cohort from Pelotas (RS). The consumption frequency of red, white and organ meats and sausage were investigated by a food frequency questionnaire adapted for this study. Dietary fat content was determined as proposed by Block. The independent variables were gender, skin color, socioeconomic level, maternal education level and nutritional status. The statistical analyses included the Chi-square linear tendency test and the Chi-square test of homogeneity. RESULTS: A total of 4,325 adolescents with a mean age of 14.7 years, SD=0.3 years, were assessed, of which 51.2% were females. Red meat was consumed more frequently daily than white meat (43.0% and 9.7%, respectively). Sausage consumption frequency greater than 4 times per week was reported by 48.5% of the sample, and 81.4% reported to consume organ meats rarely or never. Adolescents of higher socioeconomic levels and of mothers with higher education levels consumed more red meats and sausages, while those in the opposite situation consumed more white meats. Adolescents who consumed meats more frequently also consumed a high-fat diet. CONCLUSION: Red meats and sausages were the meats most frequently consumed by the study adolescents. However, adolescents of higher socioeconomic levels consumed red meats more often, while those of lower socioeconomic levels consumed white meats more often.

O objetivo deste artigo foi descrever os padrões de trabalho urbano em jovens de 14-15 anos do Sul do Brasil. O trabalho infantil foi caracterizado como qualquer atividade que resultasse em retribuição na forma de bens, serviços ou dinheiro. As análises foram estratificadas por sexo e nível econômico. Dos 4325 adolescentes entrevistados, a proporção de trabalho no último ano foi de 22,2%, sendo 27,7% para o sexo masculino e 17,0% para o sexo feminino. Essa proporção também foi maior para as classes D/E (30,0%) do que para as classes A/B (14,3%). A maioria dos adolescentes trabalhava fora de casa, aproximadamente metade começou a trabalhar antes dos 14 anos e cerca de 80,0% referiram trabalhar por interesse próprio. Apenas 1,0% tinha contrato ou carteira de trabalho, 30,0% trabalhavam mais de seis horas por dia, e a renda média foi menor do que R$ 150/mês. Os serviços domésticos predominaram entre os mais pobres. Existe a necessidade de maior monitoramento do trabalho infantil e de intervenções que busquem o cumprimento da legislação vigente.The scope of this article was to describe the urban work patterns among 14 to 15-year-old youths from Southern Brazil. Child labor was characterized as any activity that resulted in retribution in the form of goods, services or money. The analyses were stratified by sex and economic level. Of the 4325 adolescents interviewed, the proportion of labor in the last year was 22.2%, namely 27.7% for the male sex, and 17% for the female sex. This proportion was also higher among the poorer strata of the population (30.0%) than the more affluent (14.3%). The majority of adolescents worked away from home and approximately half of them began working before 14 years of age, and around 80.0% reported that they worked by choice. Only 1.0% had a labor contract or work booklet, 30.0% worked more than six hours per day, and the average income was less than US$85/month. Domestic work predominated among the poorest teenagers. There is a need for greater surveillance of child labor and of interventions seeking to enforce prevailing legislation.

Submitted by Simone Maisonave (simonemaisonave@hotmail.com) on 2020-06-11T15:58:36Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Prevalencia_de_retencao_escolar_e_fatores_associados_em_adolescentes.pdf: 153519 bytes, checksum: 7bccb49850e04323ea7dd6c2375353e9 (MD5) Approved for entry into archive by Aline Batista (alinehb.ufpel@gmail.com) on 2020-06-12T12:56:00Z (GMT) No. of bitstreams: 2 Prevalencia_de_retencao_escolar_e_fatores_associados_em_adolescentes.pdf: 153519 bytes, checksum: 7bccb49850e04323ea7dd6c2375353e9 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Made available in DSpace on 2020-06-12T12:56:00Z (GMT). No. of bitstreams: 2 Prevalencia_de_retencao_escolar_e_fatores_associados_em_adolescentes.pdf: 153519 bytes, checksum: 7bccb49850e04323ea7dd6c2375353e9 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2012 Objetivo. Avaliar a ocorrência de retenção escolar até os 11 anos de idade e os fatores associados à retenção. Métodos. Estudo prospectivo, incluindo 4 452 adolescentes da coorte de nascidos em Pelotas, Estado do Rio Grande do Sul, Brasil, em 1993. A amostra representa 87,5% da coorte original. A retenção escolar foi definida como a repetição de pelo menos uma série escolar até a data da entrevista. As variáveis independentes analisadas foram: sexo, cor da pele, peso ao nascer, índice de bens, idade e escolaridade materna, tipo de escola (privada, estadual ou municipal), idade de ingresso na escola e trabalho. Resultados. A frequência de retenção escolar foi de 36,3%, sendo de 42,8% entre os meninos e 30,0% entre as meninas. Na análise ajustada, quanto menor a escolaridade da mãe, o índice de bens e o peso ao nascer, maior foi o risco de retenção escolar em ambos os sexos. Adolescentes cuja cor da pele era parda/preta, aqueles que frequentavam escolas públicas e aqueles que ingressaram na escola com 7 anos ou mais apresentaram maior risco de retenção escolar. Apenas entre os meninos, o trabalho infantil esteve associado com a ocorrência de retenção. Conclusões. O baixo nível socioeconômico e a baixa escolaridade materna foram os fatores mais fortemente associados com a retenção escolar. Estratégias para a redução desse evento devem levar em consideração características demográficas e socioeconômicas.

Analisou-se a validade do peso e altura autorreferidos para determinação do estado nutricional, e as implicações do seu uso em análises de associação com desfechos em saúde. Baseando-se em um estudo transversal de base populacional realizado em Pelotas, Rio Grande do Sul, Brasil, em 2007 (n = 2.986), sorteou-se uma subamostra de 276 indivíduos com idade > 20 anos. Em média, o peso autorreferido foi similar ao medido; a altura medida foi superestimada nos homens (1,4cm) e nas mulheres (2,5cm); o índice de massa corporal (IMC) real foi subestimado em quase 1kg/m². Mesmo com diferenças médias pequenas, a variabilidade dos dados foi grande. Sexo, idade e escolaridade influenciaram nos resultados. O uso de medidas autorreferidas gerou subestimativas de sobrepeso e obesidade, assim como erros imprevisíveis em análises de associação com desfechos em saúde (subestimativa, superestimativa e inversão nas medidas reais de efeito). Equações de correção reduziram a média das diferenças com os valores medidos, mas não reduziram a variabilidade das diferenças e nem solucionaram erros de classificação ou vieses nas associações.

BACKGROUND: A novel approach is explored for improving causal inference in observational studies by comparing cohorts from high-income with low- or middle-income countries (LMIC) where confounding structures differ. This is applied to assessing causal effects of breastfeeding on child blood pressure (BP) body mass index (BMI) and intelligence quotient (IQ). METHODS: Standardized approaches for assessing the confounding structure of breastfeeding by socio-economic position were applied to the British Avon Longitudinal Study of Parents and Children (ALSPAC) (N approximately 5000) and Brazilian Pelotas 1993 cohorts (N approximately 1000). This was used to improve causal inference regarding associations of breastfeeding with child BP BMI and IQ. Analyses were extended to include results from a meta-analysis of five LMICs (N approximately 10 000) and compared with a randomized trial of breastfeeding promotion. Findings Although higher socio-economic position was strongly associated with breastfeeding in ALSPAC there was little such patterning in Pelotas. In ALSPAC breastfeeding was associated with lower BP lower BMI and higher IQ adjusted for confounders but in the directions expected if due to socioeconomic patterning. In contrast in Pelotas breastfeeding was not strongly associated with BP or BMI but was associated with higher IQ. Differences in associations observed between ALSPAC and the LMIC meta-analysis were in line with those observed between ALSPAC and Pelotas but with robust evidence of heterogeneity detected between ALSPAC and the LMIC meta-analysis associations. Trial data supported the conclusions inferred by the cross-cohort comparisons which provided evidence for causal effects on IQ but not for BP or BMI. CONCLUSION: While reported associations of breastfeeding with child BP and BMI are likely to reflect residual confounding breastfeeding may have causal effects on IQ. Comparing associations between populations with differing confounding structures can be used to improve causal inference in observational studies.

The interplay of factors that affect post-partum loss or retention of weight gained during pregnancy is not fully understood. The objective of this paper is to describe patterns of weight change in the six sites of the World Health Organization (WHO) Multicentre Growth Reference Study (MGRS) and explore variables that explain variation in weight change within and between sites. Mothers of 1743 breastfed children enrolled in the MGRS had weights measured at days 7, 14, 28 and 42 post-partum, monthly from 2 to 12 months and bimonthly thereafter until 24 months post-partum. Height, maternal age, parity and employment status were recorded and breastfeeding was monitored throughout the follow-up. Weight change patterns varied significantly among sites. Ghanaian and Omani mothers lost little or gained weight post-partum. In Brazil, India, Norway and USA, mothers on average lost weight during the first year followed by stabilization in the second year. Lactation intensity and duration explained little of the variation in weight change patterns. In most sites, obese mothers tended to lose less weight than normal-weight mothers. In Brazil and Oman, primiparous mothers lost about 1 kg more than multiparous mothers in the first 6 months. In India and Ghana, multiparous mothers lost about 0.6 kg more than primiparas in the second 6 months. Culturally defined mother-care practices probably play a role in weight change patterns among lactating women. This hypothesis should stimulate investigation into gestational weight gain and post-partum losses in different ethnocultural contexts.

Background Although there is longstanding evidence of the short-term benefits of promoting rapid growth for young children in low-income settings, more recent studies suggest that early weight gain can also increase the risk of chronic diseases in adults. This paper attempts to separate the effects of early life weight and length/height gains on blood pressure, body mass index (BMI), sum of skin folds and subscapular/triceps skin fold ratio at 14–15 years of age. Methods The sample comprised 833 members of a prospective population-based birth cohort from Brazil. Conditional size (weight or height) analyses were used to express the difference between observed size at a given age and expected size based on a regression, including all previous measures of the same anthropometric index. A positive conditional weight or height indicates growing faster than expected given prior size. Results Conditional weights at all age ranges were positively associated with most outcomes; each z-score of conditional weight at 4 years was associated with an increase of 6.1 mm in the sum of skin folds (95% CI 4.5 to 7.6) in adolescence after adjustment for conditional length/height. Associations of the outcomes with conditional length/height were mostly negative or non-significant—each z-score was associated with a reduction of 2.4 mm (95% CI −3.8 to −1.1) in the sum of skin folds after adjustment for conditional weight. No associations were found with the skin fold ratio. Conclusion The promotion of rapid length/height gain without excessive weight gain seems to be beneficial for long-term outcomes, but this requires confirmation from other studies.

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.

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. Evidências mostram efeitos negativos de dietas sem orientação e de alta restrição calórica. O objetivo do estudo foi determinar o percentual de adolescentes que realizaram regime de emagrecimento e os fatores associados a este comportamento. Estudo transversal incluindo 4.452 nascidos em Pelotas, Rio Grande do Sul, Brasil, no ano de 1993. Os adolescentes que relataram ter feito algum tipo de regime com a finalidade de emagrecimento nos últimos 12 meses foram positivos ao desfecho. A freqüência de realização de regime foi de 8,6% (IC95%: 7,7;9,4), sendo maior entre as meninas. O índice de massa corporal (IMC) materno elevado associou-se à realização de regime entre meninas. O sentimento do adolescente e dos pais em relação ao peso do jovem, o excesso de peso e o consumo de refrigerantes diet/light mostraram-se associados ao desfecho. Encontrou-se associação positiva entre regime e nível econômico. Tais achados constituem-se um importante subsídio para formação de políticas a fim de melhorar a dieta de adolescentes, uma vez que expressa a grande preocupação com o peso, e assim, um porcentual significativo de indivíduos tendo comportamentos equivocados.

Objetivou-se descrever o estado nutricional dos adolescentes da 9ª série de escolas públicas e privadas das capitais brasileiras e sua associação com variáveis sociodemográficas. Por meio de questionário autopreenchido, foram registradas informações sobre sexo, raça/cor, idade, escola pública/privada, macrorregião do país, escolaridade materna e posse de bens familiares. Peso e altura foram aferidos segundo procedimentos padronizados. A altura para idade e o Índice de Massa Corporal para idade foram avaliados segundo critérios da Organização Mundial da Saúde. Obtiveram-se medidas antropométricas de 58.971 adolescentes, sendo que 2,9% apresentaram déficit estatural e 2,9% magreza. O excesso de peso foi de 23,0% e a obesidade de 7,3%, sendo mais altos no Sul e no Sudeste do país. Déficits de altura e peso, excesso de peso e obesidade foram mais prevalentes nos meninos. Os déficits foram superiores nas escolas públicas, e o excesso de peso e a obesidade nas privadas. Adolescentes cujas mães eram de menor escolaridade ou de famílias mais pobres apresentaram maior déficit de altura; o inverso ocorreu com o excesso de peso e a obesidade. Prevalências de déficits, excesso de peso e obesidade ressaltam a necessidade de intervenções nutricionais direcionadas para esta fase da vida. The aim of this study was to describe the nutritional status of adolescents in the 9th year of public and private schools of the Brazilian capitals and its association with socio-demographic variables. By means of a self-completed questionnaire, information related to sex, race, age, public/private school, macro-region of the country, maternal education and family possessions were recorded. Measures of weight and height were measured according to standardized procedures. Height for age and body mass index for age was evaluated according to the World Health Organization reference. Anthropometric measurements of 58,971 adolescents were obtained, of which 2.9% were stunted and 2.9% underweight. There was 23.0% of overweight and 7.3% of obesity, which were higher in the South and Southeast regions. Deficits in height and weight, overweight and obesity were more prevalent in boys. The deficits were higher at public schools while overweight and obesity at private ones. Adolescents whose mothers were less educated or from poorer families had greater deficits in height and the reverse occurred with overweight and obesity. The findings about the deficits, overweight and obesity highlight the need for nutritional interventions designed to reach this stage of life.

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.

Estimar a prevalência de constipação intestinal e fatores associados entre adultos de 20 anos ou mais. Estudo transversal de base populacional conduzido na zona urbana de Pelotas, Rio Grande do Sul, Brasil, 2007. Constipação intestinal foi definida de acordo com os critérios de Roma III. Inicialmente foi realizada a análise descritiva e, posteriormente, utilizou-se Regressão de Poisson, as análises bi e multivariáveis. A prevalência de constipação intestinal encontrada foi de 26,9% (IC95%: 25,1-28,8). As mulheres apresentaram 2,5 vezes mais constipação que os homens (36,8% vs. 13,9%). Entre os homens, na análise ajustada, mostraram-se como fatores de risco idade maior que 60 anos, cor da pele preta/parda e menor nível econômico. Entre as mulheres, idade teve relação inversa com o desfecho, apresentando efeito protetor entre as idosas. Constipação intestinal é relativamente comum na população estudada. Os fatores associados a essa doença foram os mesmos entre homens e mulheres, exceto o nível econômico, que não se mostrou associado entre as mulheres.

Objetivo. Comparar a autopercepção corporal e o estado nutricional objetivamente medido por meio de peso, altura e pregas cutâneas em adolescentes e avaliar os fatores associados à discordância entre essas duas medidas. Métodos. A amostra incluiu os membros da coorte de nascimentos de 1993 na Cidade de Pelotas, Estado do Rio Grande do Sul, Brasil, que foram visitados em seus domicílios em 2004 e 2005. O desfecho em estudo resultou da comparação entre o estado nutricional e a percepção que os adolescentes tinham de seu peso corporal, sendo dividido em três categorias: subestimação, concordância e superestimação. As variáveis explanatórias foram sexo, cor da pele, índice de bens, sedentarismo, dieta inadequada, discriminação, regime para emagrecimento e sentimento de bem-estar e opinião do adolescente sobre como os pais percebiam o corpo desse adolescente. Para as análises estatísticas, empregou-se regressão logística multinomial. Resultados. Foram entrevistados 4 452 indivíduos (87,5% da coorte original). A média de idade foi de 11 anos. De acordo com o estado nutricional, 7,1% foram classificados como magros, 69,8% como eutróficos, 11,6% com sobrepeso e 11,6% com obesidade. Com relação ao peso percebido, 19% dos jovens se achavam magros ou muito magros, 56% se sentiam normais quanto ao peso e 25% se consideravam gordos ou muito gordos. A concordância global entre a autopercepção corporal do adolescente e seu estado nutricional foi de 65% (kappa = 0,36). A subestimação foi de 24,9% entre meninos vs. 20,3% entre meninas. A superestimação foi de 15,8 % entre meninas vs. 8,5% entre meninos. Conclusão. Houve tendência de as meninas superestimarem o seu peso corporal e de os meninos subestimarem o mesmo. Detectou-se também forte associação entre a opinião que os adolescentes acreditam que os pais têm de si e a autopercepção de estado nutricional dos adolescentes. Objective. To compare weight self-perception and nutritional status based on objective measurements of weight, height, and skin folds in adolescents, and to evaluate factors associated with disagreement between these measures. Methods. The sample included the 1993 birth cohort from the city of Pelotas, Brazil, who were interviewed at home in 2004 and 2005. The study outcome resulted from the comparison between nutritional status and the weight self-perception of adolescents, and was divided into three categories: underestimation, agreement, and overestimation. The explanatory variables were sex, skin color, accumulated goods index, physical activity, eating habits, discrimination, dieting, feeling of well-being, and opinion of the adolescent concerning the perception of his/her parents regarding the adolescent’s weight. Multivariate logistic regression was used for statistical analysis. Results. A total of 4 452 interviews were conducted (87.5% of original cohort). Mean age was 11 years. The analysis of nutritional status revealed that 7.1% were underweight, 69.8% normal weight, 11.6% overweight, and 11.6% obese. The analysis of selfperceived weight revealed that 19% saw themselves as thin or very thin, 56% believed their weight was normal, and 25% saw themselves as fat or very fat. Global agreement between weight self-perception and nutritional status was 65% (kappa = 0.36). Weight underestimation occurred in 24.9% of boys vs. 20.3% of girls. Overestimation occurred in 15.8% of girls vs. 8.5% of boys. Conclusion. Girls tended to overestimate their weight, and boys, to underestimate it. There was a strong association between the opinion of adolescents concerning their parents’ view of the adolescent’s body and self-perceived weight.

To investigate the main dental caries life course determinants and predictors of dental caries at age 12.This study was nested in a population-based birth cohort started in 1993 in Pelotas, Brazil. A sample of 359 children was followed-up. Dental examinations and interviews were performed at 6 and at 12 years old. Dental caries (DMFT) at 12 years old was the outcome. Exploratory variables included socioeconomic and demographic variables at birth, children's nutritional and development characteristics, primary dental caries, oral health related behaviors and dental service use at age 6 and 12. Poisson regression was used in order to provide relative risk ratio estimates. Attributable risk or etiology fraction and population attributable risk for both main early life variables were calculated. Dental caries prediction (DMFTor= 1) at 12 years old was tested using logistic regression analyses.Children who presented height-for-age deficit at 12 months (RR 1.50 CI: 95%=1.03-2.18), children who showed a DMFT of 1-3 and 4-19 at 6 years (RR=2.01; CI: 95%=1.33-3.03, and RR=2.66; CI: 95%=1.81-2.53, respectively) and those children aged 12 in the highest tertile of proportion of teeth experiencing gingival bleeding (RR=1.58; CI: 95%=1.11-2.24) presented a higher level of dental caries at age 12. Attributable risk for dental caries at age 12 were 79.1% and 74.2% for deficit in height for age at 12 months and for primary dental caries at age 6 years respectively; population attributable risk for dental caries at age 12 were 3.1% for deficit in height for age at 12 months and 64.9% for primary dental caries at age 6. The level of accuracy in predicting dental caries at age 12 by using life course socioeconomic, behavioral and clinical data was modest.The results of this study support the hypothesis linking social, biological and behavioral exposures and dental caries at 12 years old. In addition, the findings reinforce the lack of accuracy of dental caries predictors therefore limiting the individuals high-risk approach as a public health strategy.

To evaluate the association between breastfeeding duration, introduction of solid or semi-solid foods before four months of age and overweight/obesity at 11 years.Prospective population-based birth cohort study, including 1 204 adolescents aged 11 years who were born in Pelotas (Brazil), in 1993, and were previously interviewed at birth, six and 12 months of age. Five explanatory variables were used: duration of any breastfeeding, duration of exclusive or predominant breastfeeding, ever breastfeeding, introduction of solid or semi-solid foods before four months of age, and feeding pattern at four months of age. Risk of overweight was defined as body mass index (BMI)or = 85(th) percentile, and obesity was defined as BMIor = 85(th) percentile plus triceps and subscapular skinfoldsor = 90(th) percentile, using the National Center for Health Statistics curves.The prevalence of risk of overweight and obesity at 11 years were 23.2% and 11.6%, respectively. The lowest prevalence of both outcomes was found among subjects who were breastfed for one to three months. However, tests for linear trend or heterogeneity did not result in a significant association between breastfeeding indicators and anthropometry at 11 years. Adjustment for sex, skin color, birth weight, maternal schooling, smoking during pregnancy and maternal pre-pregnancy BMI did not alter the findings.Our results do not support the hypothesis that breastfeeding has a long-term lasting effect on anthropometry in this population.

Background:We aimed to describe levels of physical activity (PA) in adolescents living in southern Brazil and to explore associations between PA levels and demographic, socioeconomic, health-related, and parental variables. A further aim was to test the validity and reliability of the questionnaire used.Methods:We conducted a population-based, cross-sectional study including 857 adolescents selected randomly. Insufficient PA was defined as Results:Reliability of the questionnaire was good, and its validity in comparison with a longer questionnaire was also satisfactory. In comparison with pedometer data, the questionnaire presented moderate agreement. The prevalence of insufficient PA in the whole sample was 69.8% (95% CI = 66.7–72.9). Boys were more active than girls. The prevalence of insufficient PA increased with age in girls but not in boys. Among boys, those from low socioeconomic levels were more likely to be sedentary. Among girls, paternal PA was directly associated with adolescent activity levels.Conclusions:Urgent strategies aimed at increasing levels of activity of adolescents are necessary in Brazil given the high prevalence of insufficient PA detected in this study. The variables associated with insufficient PA varied between boys and girls.

Background: All previous longitudinal community studies assessing the continuity of child behavioral/emotional problems were conducted in developed countries. Method: Six hundred and one children randomly selected from a Brazilian birth cohort were evaluated for behavioral/emotional problems through mother interview at 4 and 12 years with the same standard procedure – Child Behavior Checklist (CBCL). Results: CBCL Total Problem score presented a medium stability (r = .42) with externalizing problems showing higher stability and more homotypic continuity than internalizing problems. Of the children presenting deviant scores at the age of 4, only 31% remained deviant at the age of 12 (p

Disruption of circadian rhythms has been associated with obesity in children and adolescents, and with hypertension in adults, in industrialized populations.We examined cross-sectional associations between sleep duration or television viewing and obesity and blood pressure in Brazilian adolescents.The sample consisted of 4452 adolescents aged 10-12 years participating in a prospective birth cohort study in Pelotas, Brazil. Sleep duration and television viewing were determined through questionnaires. Obesity was assessed using international cut-offs for body mass index (BMI), and body fatness by skinfold thicknesses. Blood pressure was measured using a validated monitor.Short sleep duration was associated with increased BMI, skinfolds, systolic blood pressure, activity levels and television viewing. Each hour of sleep reduced BMI by 0.16 kg/m(2) (s.e. 0.04), and was associated with odds ratio for obesity of 0.86 (s.e. 0.04), both P0.001. Television viewing was associated with increased BMI and skinfolds, and increased blood pressure. The effects of sleep duration and television viewing on obesity were independent of one another. Their associations with blood pressure were mediated by body fatness.Both short sleep duration and increased television viewing were associated with greater body fatness, obesity and higher blood pressure, independently of physical activity level. These associations were independent of maternal BMI, identified in other studies as the strongest predictor of childhood obesity. Our study shows that behavioural factors associated with metabolic risk in industrialized populations exert similar deleterious effects in a population undergoing nutritional transition and suggest options for public health interventions.

Objectives: To assess the effect of birth weight, length and ponderal index at birth on body mass index (BMI) and skinfold thickness in early adolescence. Subjects/Methods: Population-based, prospective birth cohort study in Pelotas, Brazil. Out of 5249 cohort members, 87.5% were traced at 11 years of age. Birth weight, length and ponderal index (birth weight/birth length3 × 100)—treated as continuous variable and divided into fourths—were the exposure variables. BMI at 11 years, triceps and subscapular skinfolds were the outcomes. Confounders included sex, gestational age, parity, maternal schooling, family income, maternal smoking during pregnancy and maternal BMI. Results: All three exposure variables were significantly associated with BMI in early adolescence, but the strongest effect was observed for birth weight. Each unit (Z-score) increase in birth weight was associated with 0.46 kg m−2 increase in BMI at 11 years. The equivalent coefficients for ponderal index and birth length were 0.22 and 0.21 kg m−2, respectively. High birth weight, length and ponderal index were also associated with increased values for triceps and subscapular skinfolds at 11 years, and with increased prevalence of obesity. Conclusions: Of the three birth exposures studied, birth weight presented the strongest effect on anthropometry in early adolescence. Ponderal index, a proportionality indicator associated with infant mortality, hospitalizations and anthropometry in infancy, was also associated with anthropometry in early adolescence, but its predictive value for the latter is lower than that of birthweight alone. All three birth size indicators studied presented poor predictability of the later risk of obesity.

O objetivo deste estudo foi descrever e comparar as pregas cutâneas triciptal (PCT) e subescapular (PCS) de acordo com características demográficas, sócio-econômicas, comportamentais e biológicas em adolescentes de Pelotas, Rio Grande do Sul, Brasil. Realizou-se um estudo transversal aninhado a uma coorte de nascimentos (N = 4.452; média de idade = 11 anos). Os desfechos foram apresentar prega cutânea maior ou igual ao percentil 90 da curva de referência do National Center for Health Statistics. A prevalência de PCT e PCS elevada foi, respectivamente, de 20,2% e 17,3% nos meninos e de 14,2% e 10,5% nas meninas. O fator mais fortemente associado com adiposidade nos meninos foi o nível econômico (p < 0,001) e entre as meninas foi o índice de massa corporal materno (p < 0,001). Baixo nível de atividade física (< 300 minutos/semana) esteve associado com PCS elevadas somente entre as meninas, enquanto que escolaridade se associou à PCT e PCS elevada somente entre os meninos. Dieta, cor da pele e comportamento sedentário não se associaram com nenhum dos desfechos. Concluiu-se que os principais preditores de adiposidade foram características maternas e sócio-econômicas. Recomendam-se investigações utilizando-se outras técnicas de composição corporal para confirmação dos achados deste estudo.

The aim of this study was to compare the evolution of nutritional deficits and overweight in one-year-old children from three birth cohorts started in 1982, 1993 and 2004 in Pelotas, Southern Brazil. Samples from the 1982 and 1993 cohorts and all children from 2004 were weighed and measured, and their mothers interviewed. Anthropometric deficits and overweight were assessed using both NCHS and WHO growth standards. A comparison of the existence of nutritional deficits showed that, after a decline between 1982 and 1993, its prevalence stabilized between 1993 and 2004. Across the whole period, a decrease in all deficits was observed. Obesity, on the other hand, increased. A deficit in the ratio of body length to age was found to be strongly associated with family income. The group with income below one minimum wage was the only to present a significant reduction of stunting during the study period. The most significant improvements in the reduction of nutritional deficits occurred in the first half of the study period, while social differentials remained. Fighting malnutrition is still necessary among the 40% of the population considered poor, and must be accompanied by efforts to combat overweight which is being observed in all social strata. O estudo teve como objetivo comparar a evolução dos déficits nutricionais e sobrepeso em crianças de um ano, com base em três coortes de nascimentos iniciadas em 1982, 1993 e 2004 em Pelotas, Rio Grande do Sul, Brasil. Amostras das coortes de 1982 e 1993 e todos as crianças da coorte de 2004 foram pesadas e medidas, e suas mães foram entrevistadas. Déficits antropométricos e sobrepeso foram analisados utilizando os padrões de crescimento definidos pelo NCHS e OMS. A comparação dos déficits nutricionais mostrou que, depois de declinar entre 1982 e 1993, a prevalência se estabilizou entre 1993 e 2004. Durante o período inteiro, foi observada uma diminuição em todos os déficits. Inversamente, houve um aumento na obesidade. Baixa estatura para a idade esteve fortemente associada com renda familiar. O grupo de renda familiar abaixo de um salário mínimo foi o único que mostrou uma redução significativa em baixa estatura para idade durante o período estudado. Houve melhorias importantes na redução dos déficits nutricionais na primeira metade do período de estudo, embora ainda persistam desigualdades sociais. Combater a desnutrição ainda é necessário nos 40% mais pobres da população, em paralelo com a luta contra o sobrepeso, que vem sendo observado em todas as classes sociais.

Various cut-off points for body mass index have been proposed to assess nutritional status in adolescents. The aim of this study was to compare two methods for evaluating overweight and obesity. In 2004-5, 4,452 adolescents from the 1993 Pelotas (Brazil) birth cohort study were evaluated, representing 87.5% of the original cohort. Overweight and obesity were evaluated using the methods proposed by the World Health Organization (WHO) and International Obesity Task Force (IOTF). Prevalence of overweight was similar when comparing the two methods (WHO: 23.2%; IOTF: 21.6%). Prevalence of obesity was higher according to the WHO criterion (total sample: 11.6%; boys: 15.1%; girls: 8.2%) as compared to IOTF (total sample: 5.0%; boys: 5.6%; girls: 4.4%). The kappa statistic was around 0.9 for determining overweight and 0.4 for obesity. The IOTF classification showed high specificity in comparison to the WHO criterion for determining overweight and obesity. However, sensitivity was high for overweight but low for obesity. Our data show that the IOTF classification underestimates the prevalence of obesity in early adolescence. Vários pontos de corte para o índice de massa corporal têm sido propostos para avaliação nutricional de adolescentes. O objetivo deste estudo foi comparar dois métodos de avaliação de sobrepeso e obesidade. Em 2004-2005, foram avaliados 4.452 adolescentes pertencentes à coorte de nascimentos de 1993 de Pelotas, Rio Grande do Sul, Brasil, representando 87,5% da coorte original. Sobrepeso e obesidade foram avaliados segundo os métodos da Organização Mundial da Saúde (OMS) e do International Obesity Task Force (IOTF). As prevalências de sobrepeso foram semelhantes entre os métodos: OMS: 23,2%; IOTF: 21,6%. A obesidade foi maior com o método da OMS (amostra total: 11,6%; meninos: 15,1%; meninas: 8,2%) do que com a classificação IOTF (amostra total: 5%; meninos: 5,6%; meninas: 4,4%). Para determinação de sobrepeso, o índice kappa foi ao redor de 0,90, enquanto na obesidade foi ao redor de 0,40. A classificação da IOTF mostrou alta especificidade em comparação à classificação da OMS para determinação de sobrepeso e obesidade. A sensibilidade foi alta para determinação de sobrepeso, mas baixa para determinação de obesidade. Os dados mostraram que a classificação IOTF subestima a prevalência de obesidade nessa faixa etária.

OBJETIVO: Descrever o nivel de atividade fisica de adolescentes nascidos em 1993 em Pelotas (Brasil) e avaliar o efeito de variaveis socioculturais sobre o nivel de atividade fisica. METODOS: Utilizamos uma combinacao de duas abordagens metodologicas, a epidemiologica e a etnografica. No estudo epidemiologico, 4 452 adolescentes nascidos em 1993 foram entrevistados. O nivel de atividade fisica foi avaliado atraves de questionario. Foram classificados como sedentarios os adolescentes com menos de 300 minutos por semana de atividade fisica. O estudo etnografico incluiu 69 adolescentes, selecionados aleatoriamente entre todos os participantes da coorte. Foram realizadas, em media, tres entrevistas aprofundadas (uma a cada 6 meses), separadamente com as maes e os adolescentes. RESULTADOS: A prevalencia de sedentarismo foi de 48,7% (IC95%: 46,5 a 50,8) nos meninos e 67,5% (IC95%: 65,6 a 69,5) nas meninas (P < 0,001). A variavel independente que apresentou a associacao mais forte com o nivel de atividade fisica foi o numero de vezes por semana que o adolescente encontrava amigos fora do ambiente escolar. O estudo etnografico mostrou que os meninos tem mais apoio social e familiar para a realizacao de atividades fisicas na adolescencia e que muitos pais atribuem o mau desempenho escolar ao tempo gasto na rua. CONCLUSOES: Este estudo sugere que a atividade fisica e muitas vezes considerada como concorrente dos valores familiares na adolescencia. E importante que essa nocao seja foco de estudos adicionais e que seja trabalhada junto as familias para que a atividade fisica possa ser adotada como um habito cultural.

In 1982 a birth cohort study was initiated in Pelotas a Southern Brazilian city with a current population of 323 000 inhabitants. It started as a perinatal survey and later became one of the largest and longest running birth cohorts in the developing world. With the success of this initial study our group decided to propose a second birth cohort to be launched 10 years later. Due to delayed funding the new cohort could only start in 1993. Funding for the new cohort was obtained from the European Economic Commission in a collaboration that included the London School of Hygiene and Tropical Medicine and the Escuela Andaluza de Salud Publica from Granada. In the late 80s and early 90s the hypothesis that intrauterine infant and child growth could affect long-term health outcomes gained widespread attention. The beneficial effects of breastfeeding were also becoming more evident. To better describe growth and feeding patterns we opted to examine infants on several occasions at the ages of 1 3 6 and 12 months differently from our 1982 cohort when the first home visit took place at the age of 9-15 months. (excerpt)

Summary. Objectives: To explore the association between gender and leisure-time physical activity in a population-based sample of adults living in Brazil. To study a variety of variables possibly associated with physical activity levels. Methods: A multistage sampling of households was undertaken in Pelotas, a medium-sized Southern Brazilian city. Leisure-time physical activity was measured using the long version of the International Physical Activity Questionnaire. Data on potential predictors of leisure-time physical activity behavior were collected using a standardized questionnaire. 1 344 men and 1 756 women were interviewed. Several definitions of moderate and vigorous-intensity physical activity were used. Results: Regardless of the guideline used, males were more active than women. Socioeconomic level was positively associated with leisure-time physical activity in both genders. A positive dose-response between age and inactivity was found in men, but not among women. Conclusions: Because men and women have different levels of physical activity, and the variables associated with activity levels are not consistent across the genders, interventions promoting physical activity should take these differences into account.

Previous studies have suggested that birth size may influence blood pressure in later life. Most of these reported inverse associations only became evident after weight or body mass index at some later age was included in the regression model. In a prospective birth cohort study in Brazil, the effect of birth size on blood pressure at age 11 years was explored. Of the 5,249 cohort members, 4,452 were interviewed. Mean systolic and diastolic blood pressures were 101.9 mmHg (standard deviation, 12.3) and 63.4 mmHg (standard deviation, 9.9), respectively. Birth weight was positively associated with blood pressure in the crude analysis, but this effect was no longer significant after adjustment for confounders. When current body mass index-a possible mediating variable-was added to the model, the association between birth weight and blood pressure tended to become negative, though not quite significant. Birth length showed a positive effect on later blood pressure regardless of the adjustments made. Head circumference, gestational age, and ponderal index were not associated with blood pressure. Children born small for gestational age had lower blood pressure values. The postulated inverse association between birth weight and later blood pressure was not confirmed in this cohort. Instead, a positive effect of birth length was detected.

Purpose To evaluate the prevalence of tobacco use, and factors associated with it, in early adolescent (aged 10–12 years) participants of the 1993 Pelotas (Brazil) Birth Cohort Study. Methods Children born in 1993 in Pelotas, Brazil were included in a prospective health study. In 2004–2005, all cohort members were sought. Adolescents and mothers were interviewed. A confidential questionnaire was applied to adolescents, including a section on smoking. Smoking experience was defined as having tried at least one cigarette in life. Results Follow-up rate was 87.5%; 4452 adolescents were interviewed. Mean age was 11.3 years. Only 58 adolescents did not answer the question on smoking experience. Out of the 4394 respondents, 162 (3.7%; 95% confidence interval [CI] 3.1–4.2) had tried smoking. Of these, approximately half smoked the first cigarette before 10 years of age. Seventy-three cohort members reported smoking daily. In multivariable analysis, variables positively associated with smoking experience were: male gender, maternal smoking during pregnancy, living without the biological father, poor relationship with the mother, being beaten by the parents, family conflict, maternal smoking in 2004–2005, bad influences on the adolescent, participation in fights, history of attempting to run away from home, and experience with alcoholic beverages. The association was negative for socioeconomic level. Conclusion Family-related variables and habits of the adolescent were strongly associated with smoking in early adolescence. Because experimentation with tobacco in adolescence is related to a marked increase in the risk of tobacco addiction in adulthood, early interventions are warranted.

The prevalence of overweight and its association with demographic, socioeconomic, behavioral, and biological variables were evaluated. The sample included 810 adolescents (10-19 years of age) living in the urban area of Pelotas, a southern Brazilian city. Overweight was defined as a body mass index >= the 85th percentile, according to sex and age, and compared to the First National Health and Nutrition Examination Survey, following the WHO recommendation for adolescents. A clustering sampling strategy was used, and both the crude and adjusted analyses (Poisson Regression) took this strategy into account. The prevalence of overweight was 19.3% (95%CI: 16.6-22.0) and there was no difference between the sexes. The following groups presented a greater probability of being overweight: those classified in the wealthiest socioeconomic groups, those who had dieted to lose weight within the previous 3 months, those who watch 4 or more hours of television per day, and those who have less than 3 regular meals per day. After stratification by gender, high socioeconomic level was associated with greatest risk of overweight among boys. Dieting to lose weight during the previous 3 months, 4 or more hours of television viewing per day, and less than 3 formal meals per day were risk factors for overweight among girls.

To study the prevalence and current predictors of low body mass index (BMI) in a population undergoing a rapid nutritional transition. Population-based cross-sectional study. Individuals living in the urban area of Pelotas, a medium-sized southern Brazilian city, were interviewed at home. A multiple-stage sampling strategy was used. Out of 3372 eligible subjects, 3047 were interviewed. The study was restricted to adults (≥20 y). Low BMI was defined as

Background Physical inactivity is one of the leading causes of morbidity and mortality worldwide. Walking, an inexpensive and accessible activity, is protective against unhealthy outcomes. Little data on walking practices are available outside developed countries. This study estimated the prevalence and correlates of compliance with physical activity recommendations through leisure-time and all-domain (combined leisure time, commuting, and work-related) walking in individuals aged ≥20 years in a southern Brazilian city. Methods Data from two population-based surveys carried out in 2002 and 2003 in Pelotas, Rio Grande do Sul, were compared and analyzed in 2004. Multistage sampling procedures were undertaken in both surveys. Compliance with physical activity recommendations was defined as ≥150 minutes/week of walking during the previous week, although other cut-off points were estimated. The International Physical Activity Questionnaire was used in both studies. Results Samples comprised 3182 (2002 study) and 3100 (2003 study) individuals. Nonresponse rates were 5.6% and 3.5%, respectively. Both prevalence and correlates of leisure-time and all-domains walking were markedly different. Compliance with physical activity guidelines (≥150 minutes/week) through walking was 40.6% (all domains) and 15.0% (leisure time). Poor and uneducated participants had a lower likelihood of walking than higher-income and more educated people, particularly in leisure time. Walkers were also more likely to practice other vigorous and moderate-intensity activities. Conclusions Although the results derive from a single Brazilian city, they are likely to be relevant to similar environments/locales in middle-income countries, where the obesity epidemic is rapidly increasing. Due to the low levels of walking detected, particularly during leisure time, healthcare professionals are encouraged to recommend walking to their patients.

Analisou-se a validade do Índice de Massa Corporal (IMC), calculado por intermédio do peso e altura auto-referidos, para predizer o estado nutricional de adultos. Valendo-se de um estudo transversal de base populacional que inclui 3.934 indivíduos maiores de vinte anos em Pelotas, Rio Grande do Sul, Brasil, foi sorteada uma subamostra de 140 indivíduos para mensuração de peso e altura. A concordância e a validade do peso referido mostrou-se melhor do que a altura referida. Comparando-se os IMC medido e referido calculou-se o erro médio e identificaram-se os fatores associados a esse erro. O IMC "referido" é subestimado por mulheres, independentemente de seu estado nutricional; entre os homens, esse dado mostrou-se confiável. Em mulheres, idade e renda familiar mostraram-se associadas à subestimativa de IMC após análise multivariada. A utilização do IMC "referido" para predizer o estado nutricional de adultos pode resultar em subestimativa da prevalência de obesidade e superestimativa do sobrepeso em mulheres. O IMC "corrigido" calculado pela equação de regressão linear minimiza esse tipo de viés e torna os dados válidos. Outra opção é usar o peso informado com a altura medida para o cálculo do IMC.

This is a population-based cross-sectional study to evaluate the frequency of consumption of dairy products by adults and the elderly in Pelotas in the state of Rio Grande do Sul, in accordance with demographic, social and economic characteristics. Frequency of dairy product consumption was obtained by means of a questionnaire containing short, straightforward questions. Information about the type of milk (cow's milk, soy, other) and the fat contained in the milk consumed (full-cream, semi-skimmed and skimmed) was also investigated. Heterogeneity, linear trend and chi-square tests were used for the statistical analysis. The prevalence of regular dairy product consumption was 45.9%, and was 1.7 times higher among the elderly compared with 20 to 29-year-olds. Dairy product consumption frequency was higher among women, Caucasians and those with tertiary education. The economic level was significantly and inversely associated with the outcome. Nearly 98% of the sample drink cow's milk and 75.5% drink full-fat milk. About 26% of the adults do not drink milk and of these less than 20% consume dairy products daily. Dairy product consumption, especially low-fat products, should be encouraged among adults. Special attention should be given to younger individuals, males, and groups with less education and income.

The scope of the study was to identify factors associated with excess weight in Brazilian children less than five years of age. Data from a cross-sectional home-based study entitled the National Demographic and Health Survey (NDHS) of 2006 were used. The diagnosis of excess weight was performed using the weight-for-height greater than 2 z scores above the median anthropometric standard recommended by the World Health Organization in 2006. The population under study consisted of 4,388 children. The prevalence of excess weight in children was described according to socio-economic, demographic, anthropometric, and behavioral variables. Crude and adjusted analyses were carried out to assess statistical significance stratified by gender using Poisson regression. The prevalence of excess weight was 6.6%. After adjusting for potential confounding factors, maternal body mass index and birth weight were associated with excess weight. Furthermore, being overweight was associated with exclusive breastfeeding for boys and with the socio-economic level and marital status of the mother for girls. The need to implement public policies that act on the major determinants of excess weight since childhood is emphasized.

O propósito deste estudo foi avaliar a insatisfação corporal em adolescentes e explorar diferenças conforme sexo, nível econômico e índice de massa corporal. Foram estudados 4.325 indivíduos de 14 a 15 anos da cidade de Pelotas, Brasil. A insatisfação corporal foi avaliada comparando a imagem desejada com a imagem percebida, de acordo com escala de silhuetas de Tiggemann e Wilson-Barret. O estado nutricional foi categorizado conforme proposto pela Organização Mundial da Saúde, enquanto o nível socioeconômico foi avaliado segundo classificação da Associação Brasileira de Empresas de Pesquisas. Verificou-se que 27,6% dos adolescentes estavam acima do peso. A insatisfação corporal, avaliada pela escala de silhuetas, atingiu 51,0% dos meninos e 65,6% das meninas. O nível econômico e o estado nutricional estiveram associados com o desfecho. A maioria dos adolescentes com excesso de peso desejava ter uma silhueta menor do que a percebida. O nível econômico modificou o efeito do estado nutricional sobre a insatisfação corporal. Adolescentes das classes econômicas mais altas fora do peso ideal mostraram maior insatisfação corporal do que os mais pobres e, independente do nível econômico, as meninas estão mais insatisfeitas com o excesso de peso e os meninos com a magreza. The scope of this study was to evaluate body dissatisfaction among adolescents, and to explore differences according to sex, socioeconomic status and body mass index. 4325 individuals aged 14-15 years old from Pelotas, Brazil, were studied. Body dissatisfaction was evaluated comparing the desired image with the perceived image, according to the Tiggemann & Wilson-Barret silhouette scale. The nutritional status was categorized in accordance with World Health Organization criteria, whereas socioeconomic status was evaluated using classifications of the Brazilian Association of Research Institutes. It was found that 27.6% of teens were overweight. Body dissatisfaction, appraised by the silhouette scale, affected 51% of boys and 65.6% of girls. The economic and nutritional status was associated with the outcome. Most overweight adolescents wished to have a slimmer silhouette than the perceived one. The economic level modified the effect of nutritional status on body dissatisfaction. Adolescents from the wealthier economic classes who were not in the ideal weight range manifested greater body dissatisfaction than the less affluent individuals and, irrespective of economic status, girls are more dissatisfied with excess body weight and boys with slimness.

O objetivo deste artigo foi descrever os padrões de trabalho urbano em jovens de 14-15 anos do Sul do Brasil. O trabalho infantil foi caracterizado como qualquer atividade que resultasse em retribuição na forma de bens, serviços ou dinheiro. As análises foram estratificadas por sexo e nível econômico. Dos 4325 adolescentes entrevistados, a proporção de trabalho no último ano foi de 22,2%, sendo 27,7% para o sexo masculino e 17,0% para o sexo feminino. Essa proporção também foi maior para as classes D/E (30,0%) do que para as classes A/B (14,3%). A maioria dos adolescentes trabalhava fora de casa, aproximadamente metade começou a trabalhar antes dos 14 anos e cerca de 80,0% referiram trabalhar por interesse próprio. Apenas 1,0% tinha contrato ou carteira de trabalho, 30,0% trabalhavam mais de seis horas por dia, e a renda média foi menor do que R$ 150/mês. Os serviços domésticos predominaram entre os mais pobres. Existe a necessidade de maior monitoramento do trabalho infantil e de intervenções que busquem o cumprimento da legislação vigente. The scope of this article was to describe the urban work patterns among 14 to 15-year-old youths from Southern Brazil. Child labor was characterized as any activity that resulted in retribution in the form of goods, services or money. The analyses were stratified by sex and economic level. Of the 4325 adolescents interviewed, the proportion of labor in the last year was 22.2%, namely 27.7% for the male sex, and 17% for the female sex. This proportion was also higher among the poorer strata of the population (30.0%) than the more affluent (14.3%). The majority of adolescents worked away from home and approximately half of them began working before 14 years of age, and around 80.0% reported that they worked by choice. Only 1.0% had a labor contract or work booklet, 30.0% worked more than six hours per day, and the average income was less than US$85/month. Domestic work predominated among the poorest teenagers. There is a need for greater surveillance of child labor and of interventions seeking to enforce prevailing legislation.

Background Large epidemiological studies in DNA biobanks have increasingly used less invasive methods for obtaining DNA samples, such as saliva collection. Although lower amounts of DNA are obtained as compared with blood collection, this method has been widely used because of its more simple logistics and increased response rate. The present study aimed to verify whether a storage time of 8 months decreases the quality of DNA from collected samples. Methods Saliva samples were collected with an OrageneTM DNA Self-Collection Kit from 4,110 subjects aged 14–15 years. The samples were processed in two aliquots with an 8-month interval between them. Quantitative and qualitative evaluations were carried out in 20% of the samples by spectrophotometry and genotyping. Descriptive analyses and paired t-tests were performed. Results The mean volume of saliva collected was 2.2 mL per subject, yielding on average 184.8 μg DNA per kit. Most samples showed a Ratio of OD differences (RAT) between 1.6 and 1.8 in the qualitative evaluation. The evaluation of DNA quality by TaqMan®, High Resolution Melting (HRM), and restriction fragment length polymorphism-PCR (RFLP-PCR) showed a rate of success of up to 98% of the samples. The sample store time did not reduce either the quantity or quality of DNA extracted with the Oragene kit. Conclusion The study results showed that a storage period of 8 months at room temperature did not reduce the quality of the DNA obtained. In addition, the use of the Oragene kit during fieldwork in large population-based studies allows for DNA of high quantity and high quality.