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Background: Few studies have addressed the influence of dietary patterns (DP) during adolescence on the amount of body fat in early adulthood., Objective: To analyze the associations between DP tracking and changes in the period between 15 and 18 years of age and the percentage of body fat (%BF) at age 18 years., Methods: We used data from 3,823 members of the 1993 Pelotas (Brazil) birth cohort. Body density was measured at age 18 years by air displacement plethysmograph (BOD POD) and the %BF was calculated applying the Siri equation. Based on the estimates from the FFQ, we identified DP at ages 15 ("Varied", "Traditional", "Dieting" and "Processed meats") and 18 years ("Varied", "Traditional", "Dieting" and "Fish, fast food and alcohol"). The DP tracking was defined as the individual's adherence to the same DP at both ages. Associations were tested using multiple linear regression models stratified by sex., Results: The mean %BF was 25.0% (95% CI: 24.7 to 25.4), significantly greater for girls than boys (p<0.001). The adherence to any DP at age 15 years was not associated with the %BF at age 18 years. However, individuals who adhered to a "Dieting" DP at age 18 years showed greater %BF (1.30 and 1.91 percentage points in boys and girls, respectively) in comparison with those who adhered to a "Varied" DP. Boys who presented tracking of a "Dieting" DP presented greater average %BF in comparison with others DP, as well as girls who changed from the "Traditional" or "Processed meats" DP to a "Dieting" DP., Conclusion: These results may support public health policies and strategies focused on improving dietary habits of adolescents and young adults and preventing accumulation of body fat, especially among the adolescents with restrictive dietary habits.

The scope of this article is to evaluate the relationship between stressor events that occurred last year in the family of children and adolescents that are indicative of mental health problems in a sample of students from two schools in a city in southern Brazil. It involved a cross-sectional study with 1,075 students enrolled in two public elementary schools. The Strengths and Difficulties Questionnaire was used to assess emotional and behavioral factors of the child and the Social Readjustment Rating Scale (SRRS) of Holmes and Rahe (1967) to assess stressor events. The chi-square and Poisson regression test with robust variance adjustment for expressing the results in the prevalence ratio (PR) and confidence intervals of 95% were used. The chances of presenting problems of hyperactivity were 1.42 (95% CI 1.10 to 1.83) times higher in the intermediate tercile and 1.37 (95% CI 1.06-1.78) in the higher tercile compared with the lower tercile. With respect to relationship problems the chances were of 1.49 (95% CI 1.15 to 1.93) times higher in the higher tercile when compared with the lower tercile. The results suggest that environmental factors may be strongly related to the etiology of mental disorders in childhood and adolescence.

Objectives: To measure the prevalence and risk factors associated with iron supplementation among pregnant women in the municipality of Rio Grande, Southern Brazil., Methods: All mothers living in this municipality who had children in 2007 were surveyed for demographic, socioeconomic and health care received during pregnancy and childbirth. The statistical analysis consisted of Poisson regression with robust adjustment of variance, and the measure of effect was prevalence ratio (PR)., Results: Among the 2,557 mothers interviewed (99% of total), 59% were supplemented with iron during pregnancy period. After adjusting for various confounding factors, a higher PR to iron supplementation was observed among teenagers, women with black skin color, primigravidae, who had six or more antenatal visits, who performed prenatal care in public sector and received vitamin during pregnancy., Conclusion: There is a clear need to increase the iron supplementation coverage of all pregnant women, especially among those currently considered with low gestational risk.

Prenatal care is a key indicator of the quality of health services. The current study aimed to evaluate the correlation between data from prenatal care cards and maternal recall in the city of Rio Grande, Rio Grande do Sul State, Brazil. The cross-sectional study included all mothers from 2010 who had received prenatal care. Interviews were conducted with a pre-coded questionnaire in the maternity hospital. Of the 2,288 mothers interviewed, 1,228 (53.7%) had the prenatal care card with them and thus comprised the group for comparison. The analysis used kappa correlation and confidence interval. The variables six or more prenatal visits, clinical breast and gynecological examination, two blood tests, VDRL, HIV serology, urine test, and tetanus vaccination showed statistically significant differences between annotated and maternal recall data (p ≤ 0.001). Adequacy of prenatal care based on the guidelines of the Program for Humanization of Prenatal Care (PHPN) was 23.9% according to information provided by the patients and 4.4% according to information recorded on the prenatal cards (p ≤ 0.001). The prenatal care card showed underreporting, which limited the quality assessment of prenatal care.

Purpose: To determine the prevalence and risk factors associated with failure of voluntary screening for cervical cancer during the gestational period in Rio Grande, Rio Grande do Sul State, Southern Brazil., Methods: Previously trained interviewers applied a standardized questionnaire in the maternity to all mothers from this municipality who had delivered from January 1st to December 31st 2010 to obtain information about the demographic characteristics of the pregnant women, family socioeconomic status, and prenatal care received. The χ² test was used to compare proportions and Poisson regression with robust adjustment of variance was used in the multivariate analysis., Results: Among the 2,288 respondents, 33% were not submitted to the Pap smear during pregnancy. Two thirds of these women stated that they were not aware of the need to perform it, 18% were not screened out of fear or shame, and the rest for other reasons. After adjustment, the highest prevalence ratios (PR) for noncompliance with the Pap smear occurred among young women (PR=1.5; 95%CI 1.25 - 1.80), with lower educational level (PR=1.5; 95%CI 1.12 - 2.12), who were living without a partner (PR=1.4; 95%CI 1.24 - 1.62), smokers (PR=1.2; 95%CI 1.07 - 1.39), who did not plan the current pregnancy (PR=1.3; 95%CI 1,21 - 1.61), who had attended less than six medical visits during the prenatal period (PR=1.4; 95%CI 1.32 - 1.69) and among users of oral contraceptives (PR=1.2; 95%CI 1.04 - 1.38)., Conclusions: The higher the risk for uterine cervical cancer, the less likely a pregnant woman is to undergo a Pap smear. This definitely contributed to the increased morbidity and mortality from this disease in this setting.

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.

This study evaluated the validity and reliability of the visual assessment of tooth color using a commercial shade guide. Ninety-two individuals were randomly selected from subjects enrolled in a randomized controlled trial comparing two formulations of carbamide peroxide. Initially, each individual had the color of his or her six maxillary anterior teeth (n=552) determined by one examiner using a digital spectrophotometer (Vita Easyshade). Then, a visual assessment was made by two calibrated examiners using a shade guide (Vitapan Classical). Reliability was evaluated either by kappa coefficient when all the colors were grouped into two categories (dark and light) or by weighted kappa when all 16 colors of the shade guide were considered. The digital spectrophotometer (Vita Easyshade) was used as the gold standard to calculate sensitivity and specificity of the visual assessment. The reliability of the visual assessment using two color categories was "substantial" (k=0.69). When all colors of the shade guide were considered, the reliability was "mild" (kw=0.33). Sensitivity and specificity of the visual assessment with respect to the gold standard was 86.9% and 81.9%, respectively. Despite its subjectivity, visual assessment of tooth color using the Vitapan Classical shade guide is a valid method, with good reliability for differentiating between dark and light colors.

The objective of this study was to describe and compare the tricipital (TSF) and subscapular skinfold (SSF) thickness according to demographic, socioeconomic, behavioral, and biological characteristics in adolescents from Pelotas, Rio Grande do Sul State, Brazil. A cross-sectional study nested in a birth cohort (n = 4,452; mean age = 11 years) was conducted. The outcomes were defined as skinfold thickness >or= 90th percentile of the National Center for Health Statistics reference curve. The prevalence rates for elevated TSF and SSF were 20.2% and 17.3%, respectively, in boys and 14.2% and 10.5% in girls. The strongest factor associated with adiposity in boys was socioeconomic status (p < 0.001), whereas among girls it was maternal body mass index (p < 0.001). Low physical activity (< 300 minutes/week) was associated with elevated SSF only among girls, while schooling was associated with increased TSF and SSF only among boys. Diet, skin color, and sedentary behavior were not associated with any of the outcomes. We concluded that the main predictors of adiposity were maternal and socioeconomic characteristics. We recommend that further studies on this issue apply other methods to estimate body composition in order to confirm our results.

Objective: To describe the evolution of the epidemiological research on physical activity in Brazil., Methods: A systematic review of the literature was carried out in electronic databases (Medline/PubMed, Lilacs, Ovid, Science Direct, BioMed Central and High Wire), non-indexed Brazilian journals, query by specific authors, and contact with other researchers. The inclusion criteria were: the sample should be representative of a defined population; sample size equal to or greater than 500 individuals; data collection in Brazil; measurement of physical activity; and report of data on this variable., Results: A total of 42 studies were reviewed. The first study was published in 1990, and there has been a clear growth in the number of publications since 2000. Great regional disparities were seen and most studies were carried out in the Southeast and South regions. Almost all studies (93%) used questionnaires but operational definitions of sedentary lifestyle and questionnaires used varied markedly across studies preventing result comparisons., Conclusions: Although the literature on physical activity in Brazil has quantitatively increased, methodological limitations make it difficult to compare study results. Therefore, standardization of instruments and definitions is essential for the improvement of scientific knowledge in the area.