Search

Background and Aims: Multimorbidity is a common health condition, and the relationship between different patterns of multimorbidity and food consumption through dietary patterns needs to be determined. This study aimed to investigate the association between dietary patterns and multimorbidity patterns in women., Methods: This population-based cross-sectional study included 1128 women (aged 20-69 years) living in southern Brazil. We identified multimorbidity patterns using principal component analysis, and the main exposure of the study was three dietary patterns, as derived in a previous study: healthy, risk, and Brazilian patterns. Using Poisson regression with robust variance, the scores of multimorbidity patterns (high/low) were evaluated using different adjustment models., Results: Three patterns of multimorbidity were derived: cardiometabolic (dyslipidemia, circulatory disorders, hypertension, diabetes), endocrine-articular (thyroid diseases, osteoporosis/osteopenia, rheumatic diseases), and psychosomatic (chronic pain, common mental disorders, acid-related digestive disorders). In the relationship between the dietary patterns and multimorbidity patterns, after adjustment, it was observed that a greater adherence to the Brazilian dietary pattern was associated with a lower probability of a high score for the cardiometabolic pattern (PR = 0.68; 95% CI: 0.51-0.89) and psychosomatic pattern (PR = 0.63; 95% CI: 0.47-0.84). Greater adherence to the healthy dietary pattern was associated with a higher probability of a high score for the cardiometabolic pattern (PR = 1.69; 95% CI: 1.27-2.25) and endocrine-articular pattern (PR = 2.05; 95% CI: 1.39-3.02). The risk dietary pattern did not demonstrate an association after adjustment was implemented., Conclusions: This study provides the first evidence of an association between dietary patterns and multimorbidity patterns. Greater adherence to the Brazilian dietary pattern was a protective factor for a high score for the cardiometabolic and psychosomatic pattern in women. Dietary orientation should be considered in guidelines related to multimorbidity, constituting part of the prevention and management strategies for this condition., Competing Interests: Declaration of competing interest No potential conflict of interest was reported by the authors., (Copyright © 2022 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

Objective: This study aimed to investigate the association between dietary patterns and prevalence of multimorbidity in women., Methods: This population-based cross-sectional study was conducted in 2015 and included 1,128 women aged 20 to 69 years living in the urban area of São Leopoldo municipality, southern Brazil. Multimorbidity was defined as the presence of two or more chronic conditions, among the 26 identified. Poisson regression with robust variance was used to investigate the association between the three dietary patterns (healthy, risk, and Brazilian), using different models adjusted for sociodemographic, behavioral, and nutritional status variables., Results: The results showed differences in the prevalence of adherence to different dietary patterns and multimorbidity across age groups, with a prevalence of multimorbidity and a healthy dietary pattern showing a direct linear trend with age, whereas the risk dietary pattern showed an inverse linear trend with age. The prevalence of the Brazilian dietary pattern remained constant despite differences in age. After adjustment, we found that women with greater adherence to the Brazilian dietary pattern showed a 40% reduction in the prevalence of multimorbidity compared with those with less adherence (prevalence ratio, 0.60; 95% confidence interval, 0.40-0.86)., Conclusion: The results revealed that the prevalence of multimorbidity was significantly lower in women with greater adherence to the Brazilian dietary pattern and highlight the importance of dietary interventions in early adulthood as a way to prevent multimorbidity in women., Competing Interests: Financial disclosure/conflicts of interest: M.T.A.O. received research productivity grants from the Brazilian Council for Scientific and Technological Development (CNPq; process nos. 307257/2013-4 and 307175/2017-0). J.S.D-d-.C. received research productivity grants from CNPq (process no. 310595/2018-0)., (Copyright © 2022 by The North American Menopause Society.)

The objective was to verify the association between body dissatisfaction (BD) - constituted by the desire to lose weight - with family and personal aspects related to the shape of the body and weight control practices in female adolescents. A cross-sectional, observational epidemiological study with adolescents aged 12-19 years, enrolled in classes of the 8th and 9th years of public schools belonging to the urban area of the city of Caxias do Sul/Rio Grande do Sul, Brazil, was conducted. A self-applicable questionnaire was used. BD was assessed using a silhouette scale. Multivariate regression was performed using Poisson regression with robust variation, hierarchically using a pre-established conceptual model, using the prevalence ratio (PR) adjusted with 95 % CI as a measure of effect. A significance level of 5 % (P ≤ 0·05) was considered. Among the 685 female students, 77·2 % had BD. The father's incentive to diet sometimes (PR 1·19; 95 % CI 1·07, 1·32; P ≤ 0·001) and always (PR 1·15; 95 % CI 1·03, 1·28; P ≤ 0·001), trying to lose weight (PR 1·63; 95 % CI 1·33, 1·99; P ≤ 0·001), dieting five times or more (PR 1·22; 95 % CI 1·09, 1·36; P ≤ 0·001) and skipping meals less than once a week (PR 1·16; 95 % CI 1·04, 1·29; P = 0·026) increased the chances of having BD. In conclusion, among the investigated parents' behaviours, only the father's incentive to go on a diet was associated with BD. Adolescent weight control practices increased the chances of having BD. Thus, it facilitates the identification of this condition at an early stage, enabling adequate treatment and prevention of health complications.

Objective: Assess serum 25-hydroxyvitamin D (25OHD) concentration and associated factors among users of a referral outpatient unit for vascular diseases in Southern Brazil., Design: Cross-sectional study conducted for almost one year, from March 2016 to January 2017. The serum vitamin D level was determined biochemically and classified as: sufficient (>50 nmol/L), insufficient (30-50 nmol/L) and deficient (<30 nmol/L). Associations were tested through multiple linear regression., Setting: At a reference outpatient clinic specialized in vascular diseases located in a southern Brazilian medium-sized city (latitude 29°S)., Subjects: Consecutive sample of 133 individuals of both sexes, aged at least 40 years., Results: The mean serum 25OHD concentration was 54.9 ± 25.9 nmol/L (57.7 ± 27.9 nmol/L for men; 52.2 ± 24.2 nmol/L for women, p = 0.267). A total of 12.8% of the participants had vitamin D deficiency and 32.3% had insufficiency. Regarding the total sample, variables associated to the serum 25OHD concentration were: age (β = -0.55; CI95% -0.95; -0.17), sun exposure (β = 1.22; CI95% 0.32; 2.10) and vitamin D intake (β = 7.29; CI95% 2.10; 12.48). Among men, a significant association was observed for age (β = -0.82; CI95% -1.47; -0.17, p = 0.015) and borderline for sun exposure (β = 1.22; CI95% 0.32; 2.10, p = 0.053). Among women, only vitamin D intake was significantly associated with serum concentration of this vitamin (β = 8.74; CI95% 1.32; 16.17, p = 0.022)., Conclusion: Although the mean 25OHD concentration was greater than 50 nmol/L, about 45% of this consecutive sample presented poor vitamin D nutritional status. Unadjusted for seasonality, factors associated with serum 25OHD concentration were age and sun exposure among men and vitamin D intake among women., Competing Interests: Declaration of competing interest None., (Copyright © 2021 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

The aim of this study was to describe sedentary behavior (SB) across leisure, occupation, and transport domains and determine factors associated with excessive sedentary behavior (ESB). Cross-sectional survey with a representative sample of 1,126 women aged 20-69 years living in São Leopoldo/RS. SB, demographic, socioeconomic, behavioral and health factors data were collected using a questionnaire administered by interviewers. The cut-off point for ESB was defined as the median. Associations were tested using Poisson regression with robust error variance. The medians and interquartile intervals (min/day) for leisure, occupation, and transport SB were 163.9(86.6-2710.5), 51.4(0-257.1), and 17.1(5.7-37.3), respectively. The likelihood of leisure SB increased with education level, was higher among women who were not employed, lived in household without children, and smokers. In other domains, there was an inverse association between age, being white, economic class, education level, and income and ESB. Direct association between living in a household with a car and excessive transport SB and women who were not employed were 30% less likely to engage in ESB in this domain. The predominant domain in Total SB was leisure. Associations differed across domains, indicating that domain-specific interventions should be implemented in addressing excessive SB.

Objective: To investigate the association between low serum vitamin D levels and peripheral arterial disease (PAD)., Methods: A cross-sectional study with a consecutive sample of 133 individuals from Caxias do Sul, Brasil. We considered PAD patients those with an ankle-brachial index (ABI) ≤ 0.90 or with arterial revascularization. Vitamin D serum level was categorized as sufficient (≥30 ng/mL), insufficient (>20 to 29 ng/mL), and deficient (<20 ng/mL). Prevalence ratios (RP) were calculated through Poisson regression., Results: The prevalence of PAD was 50.7% (95% CI 42-59). After adjustment for potential PAD risk factors, RP were 1.08 (95% CI 0.66-1.76) for insufficient serum level and 1.57 (95% CI 0.96-2.57) for deficient vitamin D serum level; (p for trend = 0.020)., Conclusion: Vitamin D serum levels showed an inverse and significant dose-response relationship with PAD.

Objectives: To assess the association between neighbourhood environmental variables and excessive transport-related and leisure-time sedentary behaviour (ETSB and ELSB, respectively) amongst adult women in Southern Brazil., Methods: A cross-sectional survey was conducted using a representative sample of 1079 women 20 to 69 years of age who lived in 44 neighbourhoods. Each neighbourhood was determined by drawing a 400-m buffer around the median point of the participants' homes. Neighbourhoods were assessed by audit and by using government data. Sedentary behaviour (SB) and the remaining individual variables were assessed via questionnaire that was administered as an interview. Multilevel logistic regression analysis was conducted., Results: In the adjusted analysis, women who lived in neighbourhoods with a higher percentage of terrain slope and fewer public recreation areas per resident had significantly (p ≤ 0.05) increased odds of exhibiting ETSB and ELSB, with 50% and 40% increases, respectively., Conclusions: The results show that some aspects of the neighbourhood environment such as terrain slope and total public recreation areas per resident are related to specific SBs, indicating that improvements in neighbourhoods can reduce SB in women.

Introduction: Dietary patterns may be more predictive of disease risk than individual nutrients or foods., Objective: To identify dietary patterns and associated factors among adult women., Method: Population-based cross-sectional study with 1,128 women, aged 20 to 69 years, living in São Leopoldo, Rio Grande do Sul. Food intake was assessed with a frequency questionnaire. The principal component analysis identified dietary patterns. We estimated crude and adjusted prevalence ratios using Poisson regression with robust variance., Results: Threedietary patterns - responsible for 25.8% of the total variance - were identified: healthy (fruits, vegetables, and whole foods); risk (ultra-processed foods); and Brazilian (rice and beans). The healthy pattern showed the largest percentage of explained variation (11.62%). The probability of adherence to the healthy pattern increased linearly with age and schooling and was higher among ex-smokers [prevalence ratio (PR)=1.22; confidence interval of 95% (95%CI) 1.04 - 1.42]. Younger women and those with better schooling had more chances of adhering to the risk pattern. The probability of adherence to the Brazilian pattern increased as schooling decreased and was higher among non-white women (PR = 1.29; 95%CI 1.04- 1.59)., Conclusions: While adherence to healthy and risk patterns behaved differently according to women's age, it was similar regarding schooling. Socioeconomic conditions defined adherence to the Brazilian pattern.

Background: Musculoskeletal pain is one of the most common occupational problems in the industrial society and its prevalence is potentially associated with mental disorders., Objective: To estimate the prevalence of work-related musculoskeletal pain and its association with occurrence of common mental disorders among employees of a poultry processing company in Southern Brazil., Methods: Cross-sectional study conducted in 2010 with 1,103 employees aged 18 to 52 years old. Musculoskeletal pain was investigated based on a human figure adapted from the Standardized Nordic Questionnaire. We considered reported work-related pain in any part of the body in the past 12 months. Occurrence of common mental disorders was assessed- by the Self-Reporting Questionnaire (SRQ-20). Crude and adjusted prevalence ratios (PR) and corresponding 95% confidence interval (95%CI) were obtained by Poisson regression with robust variance., Results: The prevalence of work-related musculoskeletal pain was 40.3% (95%CI 37.4-43.2) for the total sample, 46.8% (95%CI 43.2-50.5) for women and 27.8% (95%CI 23.2-32.3) for men. The prevalence of musculoskeletal pain was twice higher for the participants with common mental disorders compared to those without this condition (PR=2.27; 95%CI 1.99-2.58). This effect remained significant after adjustment for sociodemographic, behavioral, health-related and occupational variables., Conclusion: The results of the present study point to the relevance of preventive measures to promote the mental and physical health of workers in order to reduce or minimize the occurrence of pain.

The aim of this study was to explore the association between sleep-related problems with the occurrence of minor psychiatric disorders in shift workers of southern Brazil. A cross-sectional study with 1202 workers (785 females) aged 18-50 years was carried out. Minor psychiatric disorders were assessed using the Self-Reporting Questionnaire (SRQ-20), and four sleep problems were collected and analyzed: sleep deprivation (≤ 5h), difficulty falling asleep, waking up during sleep, and sleep medication use. Results show that the overall prevalence of minor psychiatric disorders was 26.8%, but it was more prevalent among females than males (30.2% vs. 20.4%). Nightshift work was significantly associated with the occurrence of sleep-related problems. After adjusting for confounding factors, the number of sleep-related problems showed a positive linear trend with psychiatric disorders in both sexes. Having two or more sleep-related problems was associated with increased probability of psychiatric disorders approximately three-fold among males and two-fold among females, when compared with those without sleep problems. In conclusion, this study demonstrated that sleep-related problems have a strong and independent association with psychiatric disorders among shift workers. Furthermore, the prevalence of both conditions was higher among females than males; however, the strength of these associations was higher in males., (Copyright © 2017 Elsevier B.V. All rights reserved.)

This research involves a school-based cross sectional study to evaluate the association between food insecurity (FI) and inadequate food intake (IFI), among 782 children (mean age of 6.9±0.5) of the 1st year of primary school in the municipal schools of São Leopoldo in the state of Rio Grande do Sul. Data were gathered from mothers or guardians. FI was obtained through the Brazilian Food Insecurity Scale, and food consumption using the food frequency questionnaire. Foods were classified as healthy eating markers (HEM) and unhealthy (UEM) and received scores according to intake frequency. HEM: 0 - 1 day - zero; 2 to 3 days - 0.25; 4 to 5 days - 0.75; 6 to 7 days - 1, and the reverse for the UEM. The scores could range from 0 to 25 (HEMS) and 0 to 19 (UEMS). A standardized total score (TS) was obtained [HEMS * (19/44) + UEMS * (25/44)] and could range from 0 to 22. The scores were categorized into terciles and the 1st considered IFI. The FI was 45.1% and the average scores were 5.9 (HEMS), 15.9 (UEMS) and 11.6 (TS). No association was found between IA and IFI. High IA and low food scores require intersectoral approaches to ensure access to food in quantity and quality appropriate for this population.

Background: Diabetes has been shown to be associated with increased mortality and morbidity worldwide. This study explored whether diabetes significantly impacts on outcomes among elderly adults with cardiovascular disease (CVD) admitted to a specialist hospital in Southern Brazil., Design: A prospective cohort study of 411 patients admitted to hospital after a cardiac event between 2008 and 2010., Methods: The primary end point was death by all causes during the follow up period of 6 months from admission. All hospital death reports matched those reported by the Brazilian Public Health Death Records. Cumulative probability of survival by Kaplan-Meier plot and log rank tests compared hospital admissions with or without diabetes. Adjusted and unadjusted hazard ratios (HR) for overall mortality were calculated., Results and Conclusions: The mean ± SD age of the subjects was 69.8 years ± 14 and 50% were men. Overall study mortality was 8.7%. Half of the deaths occurred in patients &#8805;80 years (p=0.001). Diabetes was associated with 53% of the overall mortality (p&lt;0.01) and 79% of the CVD-related deaths (p&lt;0.03). The adjusted HR was 2.88 (95% CI 1.42-5.84) for diabetic patients aged &#8805;80 years. In conclusion, the results suggest that elderly patients of European origin with diabetes residing in Southern Brazil admitted to hospital for specialist CVD treatment have poorer survival and higher risk of further CVD events 6 months after hospital discharge compared with those without. We recommend that better strategies for managing CVD risk factors among elderly diabetic patients from similar patient cohorts in Brazil are necessary.

Background/objectives: Because studies have evidenced variations in nutrient intake, further investigation of the interaction between demographic characteristics and the seasons is necessary. We aimed to test the differences in food intake throughout the seasons and the interaction between the seasons and sex and age., Subjects/methods: This study included 273 individuals. Food intake was evaluated with 24-hour dietary recalls, and the reported food items were sorted into food groups. We performed the test on the differences in intake of food groups throughout the seasons with repeated measures and on the interaction effect by using the Generalized Estimate Equation., Results: Intake of fruits and natural fruit juices and sweetened beverages was lower, whereas that of grains and derivatives was higher in the winter. The intake of leafy vegetables and fish and seafood was lower in the autumn. The consumption of coffee and eggs was higher in the spring. Intake of chocolate powder and sugar, salt and lean poultry was higher in the winter. The variation in consumption of grains and derivatives, eggs, fatty poultry and processed meat over the seasons was more likely to be modified by sex. Age interacted with the seasons for leafy vegetables, beans and lentils, lean beef, lean poultry, low fat milk and light yogurt, vegetable oil and unsalted margarine, chocolate powder and sugar and processed meat., Conclusions: This study shows that food intake may change seasonally and that seasonal variation depends on sex and age, which might aggregate a specific co-variation component.

The relationship between shift work and the eatinghabits of workers was investigated in a slaughterhouse in southern Brazil. It involved a cross-sectional study with 1,206 workers of both sexes between 18 and 50 years of age. A standardized questionnaire was used to gather demographic, socioeconomic, work shift and eating habit information. The shift of work was categorized into daytime and nighttime, based on the starting and ending times of the shift. The eating habits of workers were evaluated as follows: number and type of meals eaten during the 24 hours of a normal day, the inappropriateness of the hoursof these meals and the dietaryrisk score. This was built on the risk score of the weekly consumption of 13 food items. After adjusting for potential confounders, non-Caucasian and younger male workers were more likely to manifest eating risk habits. Nighttimeshift workers consumed ahigher number of meals/day with greater inappropriateness of meal times than daytimeshift workers. The night shift can negatively influence the eating habits of workers of that shift.

This cross-sectional school-based study in São Leopoldo, Rio Grande do Sul State, Brazil, evaluated the association between food insecurity and overweight in first grade students in the municipal elementary school system. A total of 2,369 students were invited to participate, of whom 847 were examined, and of these, 782 had data available on weight and height. Dietary data were obtained from a parent or guardian. Food insecurity was measured by the Brazilian Food Insecurity Scale (EBIA). Data on weight and height were provided by the Nutrition Service of the Municipal Department of Education. Prevalence rates for overweight and food insecurity were 38.1% and 45.1%, respectively. After controlling for potential confounders, children with food insecurity had 22% lower odds of overweight. Notwithstanding the inverse association between the exposure and outcome, this sample showed high rates of food insecurity and overweight, revealing a complex relationship and indicating that further research is needed to understand it. Robust public policies are critical for addressing these conditions.

Objective: To analyze if the demographic and socioeconomic variables, as well as percutaneous coronary intervention are associated with the use of medicines for secondary prevention of acute coronary syndrome., Methods: In this cohort study, we included 138 patients with acute coronary syndrome, aged 30 years or more and of both sexes. The data were collected at the time of hospital discharge, and after six and twelve months. The outcome of the study was the simultaneous use of medicines recommended for secondary prevention of acute coronary syndrome: platelet antiaggregant, beta-blockers, statins and angiotensin-converting-enzyme inhibitor or angiotensin receptor blocker. The independent variables were: sex, age, education in years of attending, monthly income in tertiles and percutaneous coronary intervention. We described the prevalence of use of each group of medicines with their 95% confidence intervals, as well as the simultaneous use of the four medicines, in all analyzed periods. In the crude analysis, we verified the outcome with the independent variables for each period through the Chi-square test. The adjusted analysis was carried out using Poisson Regression., Results: More than a third of patients (36.2%; 95%CI 28.2;44.3) had the four medicines prescribed at the same time, at the moment of discharge. We did not observe any differences in the prevalence of use in comparison with the two follow-up periods. The most prescribed class of medicines during discharge was platelet antiaggregant (91.3%). In the crude analysis, the demographic and socioeconomic variables were not associated to the outcome in any of the three periods., Conclusions: The prevalence of simultaneous use of medicines at discharge and in the follow-ups pointed to the under-utilization of this therapy in clinical practice. Intervention strategies are needed to improve the quality of care given to patients that extend beyond the hospital discharge, a critical point of transition in care.

OBJECTIVE To analyze if metabolic syndrome and its altered components are associated with demographic, socioeconomic and behavioral factors in fixed-shift workers. METHODS A cross-sectional study was conducted on a sample of 902 shift workers of both sexes in a poultry processing plant in Southern Brazil in 2010. The diagnosis of metabolic syndrome was determined according to the recommendations from Harmonizing the Metabolic Syndrome. Its frequency was evaluated according to the demographic (sex, skin color, age and marital status), socioeconomic (educational level, income and work shift), and behavioral characteristics (smoking, alcohol intake, leisure time physical activity, number of meals and sleep duration) of the sample. The multivariate analysis followed a theoretical framework for identifying metabolic syndrome in fixed-shift workers. RESULTS The prevalence of metabolic syndrome in the sample was 9.3% (95%CI 7.4;11.2). The most frequently altered component was waist circumference (PR 48.4%; 95%CI 45.5;51.2), followed by high-density lipoprotein. Work shift was not associated with metabolic syndrome and its altered components. After adjustment, the prevalence of metabolic syndrome was positively associated with women (PR 2.16; 95%CI 1.28;3.64), workers aged over 40 years (PR 3.90; 95%CI 1.78;8.93) and those who reported sleeping five hours or less per day (PR 1.70; 95%CI 1.09;2.24). On the other hand, metabolic syndrome was inversely associated with educational level and having more than three meals per day (PR 0.43; 95%CI 0.26;0.73). CONCLUSIONS Being female, older and deprived of sleep are probable risk factors for metabolic syndrome, whereas higher educational level and higher number of meals per day are protective factors for metabolic syndrome in fixed-shift workers.

Objectives: The purpose of this study was to evaluate the association between job characteristics and musculoskeletal pain among shift workers employed at a 24-hour poultry processing plant in Southern Brazil., Methods: This was a cross-sectional study of 1,103 production line workers aged 18-52 years. The job characteristics of interest were shift (day/night), shift duration, and plant sector ambient temperature. Musculoskeletal pain was defined as self-reported occupational-related pain in the upper or lower extremities and trunk, occurring often or always, during the last 12 months., Results: The mean (SD) participant age was 30.8 (8.5) years, and 65.7% of participants were women. The prevalence of musculoskeletal pain was greater among female participants than male participants. After adjustment for job characteristics and potential confounders, the prevalence ratios (PR) of lower extremity musculoskeletal pain among female workers employed in extreme-temperature conditions those working the night shift, and those who had been working longer on the same shift were 1.75 (95% CI 1.12, 2.71), 1.69 (95% CI 1.05, 2.70), and 1.64 (95% CI 1.03, 2.62), respectively. In male workers, only extreme-temperature conditions showed a significant association with lower extremity musculoskeletal pain (PR=2.17; 95% CI 1.12, 4.22) after adjustment analysis., Conclusions: These findings suggest a need for implementation of measures to mitigate the damage caused by nighttime work and by working under extreme temperature conditions, especially among female shift workers, such as changing positions frequently during work and implementation of rest breaks and a workplace exercise program, so as to improve worker quality of life.

Objective: The objective of our study was to explore the association between sleep deprivation and obesity among shift workers., Design: A cross-sectional study was conducted. Obesity was defined as BMI ≥30 kg/m2. Time of sleep was categorized as: >5 h of continuous sleep/d; ≤5 h of continuous sleep/d with some additional rest (sleep deprivation level I); and ≤5 h of continuous sleep/d without any additional rest (sleep deprivation level II). Sociodemographic, parental and behavioural variables were evaluated by means of a standardized pre-tested questionnaire. Potential confounding factors were controlled for in the multivariable model., Setting: A poultry-processing plant in southern Brazil., Subjects: Nine hundred and five shift workers (63 % female)., Results: Obesity was more prevalent in the participants who were female, aged 40 years and older, who had less schooling and reported excess weight in both parents. Sleep deprivation levels I and II were associated with increased income, number of meals consumed throughout the day and nightshift work. All of the workers who exhibited a degree of sleep deprivation worked the night shift. After controlling for potential confounding factors, the prevalence ratios of obesity were 1·4 (95 % CI 0·8, 2·2) and 4·4 (95 % CI 2·4, 8·0) in the workers with sleep deprivation levels I and II, respectively, compared with the reference group., Conclusions: These results show a strong association between sleep deprivation and obesity in shift workers and that sleep deprivation may be a direct consequence of working at night.

This study tested the relative validity and estimated calibration factors of a food-frequency questionnaire (FFQ) with 120 food items in 128 adults. We applied one FFQ and three 24h recalls. Validity was tested by the Bland-Altman method, intraclass correlation coefficient (ICC), classification in quartile categorization, and weighted kappa. Calibration factors were estimated by linear regression, with 24h recall of food intake as the dependent variable and the FFQ values as the independent variable. FFQ underestimated the nutrient intake when compared to 24h recall. The energy-adjusted and de-attenuated ICC ranged from 0.19 (zinc) to 0.82 (calcium). 37% of subjects were classified in the same quartile, with mean kappa of 0.28 (zinc: 0.08; calcium: 0.49). The highest calibration factors were 0.48 (calcium), 0.47 (potassium), and 0.44 (carbohydrates), and the lowest was 0.10 (retinol). FFQ showed satisfactory relative validity and calibrated energy and nutrient intake values similar to 24h recall.

Background: Physical inactivity is one of the most important modifiable risk factors that is raising the global burden of chronic diseases., Methods: This is a cross-sectional, population-based study of 790 women aged 20 years or older living in the urban area of a municipality in Southern Brazil. The level of physical activity was measured using the International Physical Activity Questionnaire, short form. Inactivity was defined as fewer than 150 min/wk-1 spent in moderate or vigorous physical activities. Prevalence ratios were calculated by robust Poisson regression., Results: The prevalence of physical inactivity was 48.7% (95% CI, 43.3%-54.1%). After adjusting for confounders, we found a linear trend for increasing prevalence of physical inactivity with increasing body mass index (P = .008). Women who were married or in a domestic partnership were 29% less physically active than single women (P = .044). A borderline association was detected between the presence of minor psychiatric disorders (MPD) and physical inactivity (P = .058)., Conclusions: There was a high prevalence of inactivity. Obese women, those married or in domestic partnerships and those with MPD were more likely to lead an inactive lifestyle. These results suggest that strategies are required for breaking down barriers to physical activity in this demographic group.

The measurement of usual food intake (FI) is necessary to accurately establish the relationship between diet and disease. In most studies data are collected at one particular time of the year, which may influence the interpretation of the results. The purpose of this study was to investigate the effect of seasonality on FI in a sample of adults from Niterói, RJ, Brazil. A total of 102 healthy subjects (69 women) aged between 20 and 69 years were interviewed to obtain six 24-hour dietary recalls, three in summer and three in winter. In both seasons, the intake of energy (EI) and 23 nutrients was determined and the percent of subjects who met the recommendations for the nutrients were computed. The data of FI were deattenuated considering the within-person variability and adjusted for energy. The intake of energy and some nutrients were significantly different between men and women. EI did not differ between seasons, for both sexes, but the intake of macro and micronutrients was different. The results of this study suggest that the seasonality in the measurement of FI should be considered in order to improve the methods and instruments used in population dietary surveys.

The authors examined the associations of shiftwork with overweight and abdominal obesity through a cross-sectional study of 1206 employees 18 to 50 yrs of age who were working on a production line in a poultry processing plant. Night-shift workers (n = 800) were considered exposed, whereas day shiftworkers (n = 406) were considered nonexposed. Overweight was defined as a body mass index ≥ 25 kg/m(2) and abdominal obesity as a waist circumference ≥ 88 cm in women and ≥ 102 cm in men. The mean age of the workers was 30.5 yrs (standard deviation = 8.7 yrs), and 65.2% were women. Nightshift workers compared to dayshift workers showed higher prevalences of overweight (42.2% vs. 34.3%; p= .020) and abdominal obesity (24.9% vs. 19.5%; p = .037). After adjusting for sociodemographics, parental overweight status, behavioral characteristics, and sleep characteristics, including hours of sleep, the prevalence ratios for overweight and abdominal obesity were 1.27 (95% confidence interval [ CI]: 1.00-1.61) and 1.45 (95% CI: 1.10-1.92), respectively, for the nightshift workers compared to the dayshift workers. A consistent finding in our study was the independent contribution of night shiftwork to overweight and abdominal obesity among Brazilian workers. Further studies are needed to understand the biological mechanisms involved and the complex behavioral and social adaptations experienced by night-shift workers.

Our objective was to estimate the prevalence and test the association between psychological well-being and overweight in children. We conducted a cross-sectional study using anthropometrical measures and interviews with 1048 6-10-year-old school children from a Brazilian town. Overweight was assessed by the body mass index and included obesity. Psychological data of children and their parents were collected using a face scale. Poisson regression models were used to test the associations and to obtain unadjusted and adjusted prevalence ratios (PR). The prevalence of overweight was of 15.3% (95% CI: 13.2-17.6) and of only obesity was 3.8% (2.8-5.2). After controlling for age, sex, school type and parental overweight, the prevalence of overweight was 52% and 44% higher in children who reported a psychological dissatisfaction in themselves and in their mothers when compared with those with positive self perception (PR = 1.52 95% CI = 1.02-2.28; P = 0.038) and (PR = 1.44 95% CI = 1.00-2.09; P = 0.049), respectively. The study suggests that actions aiming weight control of children should take into account psychological aspects of children and their families., (© 2010 Blackwell Publishing Ltd.)

The objective of this study was to investigate the association between psychosocial factors and self-reported overweight. A cross-sectional study was carried out with 1,100 adults in a Brazilian city. Structured interviews were conducted using a standard pre-tested questionnaire. Overweight was self-reported by participants and defined as body mass index (BMI) > 25kg/m². Psychosocial factors were quality of life (WHO-8: EUROHIS) and social support (Medical Outcomes Study). Crude and adjusted prevalence ratios (PR) were obtained by modified Poisson regression. After controlling for socio-demographic and behavioral variables, prevalence of overweight among individuals reporting low quality of life and low social support was 19% (PR = 1.19; 95%CI: 1.03-1.38) and 12% (PR = 1.12; 95%CI: 0.96-1.31), respectively, and was higher in those reporting high/moderate quality of life and high/moderate social support, respectively. The findings suggest that psychosocial factors can play a role in self-assessment of overweight.

The objective of this study was to investigate the effect of seasonality on nutrient intake in healthy adults from the southernmost metropolitan area of Brazil. The dietary intake (24-hour dietary recall on six different days) in a sample of 162 adults (114 women), aged 20 to 69, was obtained during the year 2007. The nutrient intake was averaged for each season and adjusted for energy intake using the residual method. The effect of season on energy, macro and micro-nutrient intake was investigated based on the Generalized Estimate Equations (GEE) model. There were statistically significant differences between seasons for carbohydrate and total fat intake after controlling for gender, age, education, and interactions. In summer carbohydrate intake was higher than other seasons while the total fat intake was lower. These findings highlight the importance of considering seasonal variations not only for evaluating dietary intake but also nutrition and public health policy recommendations, particularly in adult populations living in temperate regions.

With the purpose of generating a list of foods for a food-frequency questionnaire, data from 24h dietary recalls on a typical day from a probabilistic sample of 1,724 adults of Niterói, Rio de Janeiro, Brazil, were analyzed. The frequency of food intake, the total intake of energy and macronutrients and the relative contribution of each food item to total energy and macronutrient intake were calculated. The most frequently reported food items (> 50% of adults) were rice, coffee, beans, refined canesugar, and bread. Whole milk was consumed more frequently then skimmed milk or semi-skimmed milk. Beef was consumed by more adults than chicken, pork or fish. Approximately 90% of energy and macronutrients intake was explained by 65 food items. The list of food items generated in the present analysis is similar to those found in other samples of adults from urban areas in Brazil. It may be possible to generate a core list of common foods with addition of regional foods to be used nationally in urban areas of the country.

This study assessed the validity of a food frequency questionnaire (FFQ-Porto Alegre), covering 135 food items, in comparison with the average of two consecutive 24-hour dietary recall questionnaires for adolescents, adults, and elderly who were randomly selected from a population-based survey. The Pearson correlation coefficients and cross-classification by quartiles of intake were used. The nutrients were log transformed and energy adjusted. The mean of adjusted de-attenuated correlation coefficient for adolescents was 0.44 and ranged from 0.18 (zinc) to 0.69 (folate) and for adult and elderly participants they were, respectively, 0.42, ranging from 0.16 (iron) to 0.73 (energy) and 0.52, ranging from 0.25 (vitamin E) to 0.84 (energy). The average classification percentage into the same or adjacent quartile for the two methods was 74.6% for adolescents, 74.9% for adults, and 81.2% for the elderly population. The FFQ showed fair relative validity for adolescents and adults, and may be used to study the dietary determinants of obesity and non-transmissible diseases in epidemiological surveys.

The reproducibility and validity of a Food Frequency Questionnaire (FFQ) was evaluated in 83 adults living in a State capital in southern Brazil. The reproducibility and validity were tested with intra-class correlation coefficients (ICC). Mean nutrient intakes from three 24-hour dietary recalls (24hDR) were compared to mean intakes from each FFQ (FFQ1 and FFQ2), adjusted for energy intake and within-person variation. Nutrients were categorized into quartiles and assessed using weighted kappa statistics. Mean ICC for the test-retest FFQ ranged from 0.44 (95%CI: -0.19-0.76) to 0.83 (95%CI: 0.72-0.90) for energy-adjusted carbohydrate and vitamin C intakes, respectively. Mean ICC, energy-adjusted and corrected for within-person variability, ranged from 0.23 (95%CI: -0.22-0.61) to 0.86 (95%CI: 0.21-1.16) for vitamin A and lipids for the FFQ1, and 0.50 (95%CI: -0.16-0.91) to 0.95 (95%CI: 0.79-1.05) for vitamin A and energy for the FFQ2. For the FFQ1, calcium showed the lowest weighted kappa value (0.10; 95%CI: 0.00-0.26), while vitamin C (0.38; 95%CI: 0.23-0.53) and total energy (0.38; 95%CI: 0.24-0.52) had the highest weighted kappa for the FFQ2. The FFQ showed good reproducibility and reasonable relative validity.

This study focused on the association between dietary patterns and obesity. A cross-sectional population-based study was performed in 1,026 adult women from Southern Brazil. Waist circumference (WC), height, and weight were measured according to a standardized protocol, and body mass index (BMI) was calculated. Obesity was defined as BMI > 30kg/m(2) and WC > 88cm. Principal components analysis was used to identify dietary patterns. Multivariate analysis used a Poisson regression model to estimate prevalence ratios and respective confidence intervals. After controlling for possible confounders, low consumption of "vegetables" protected against increased BMI (PR = 0.64; 95%CI: 0.47-0.86; p = 0.004), while low consumption of "nuts/oilseeds" protected against increased WC (PR = 0.93; 95%CI: 0.89-0.98; p = 0.008). Low consumption of "fruits" was a risk factor for high BMI (PR = 2.18; 95%CI: 1.35-3.53; p = 0.001). The study indicates the complexity of the association between dietary patterns and obesity. New studies are needed to further clarify the subject.