Validade de peso e estatura informados e índice de massa corporal: estudo pró-saúde

OBJECTIVE: Evaluate the validity of self-reported weight and height and the body mass index (BMI). METHODS: A study was made of 3,713 employees of a public university in Rio de Janeiro, in which they were participants in Phase 1 of a longitudinal study. Information was obtained through a self-administered questionnaire, and measurements were carried out after its application. Student's paired t-test, Bland & Altman's graphs and the intraclass correlation coefficient (ICC) were utilized to evaluate the differences between the measured and the reported parameters. The sensitivity and specificity of the various BMI categories were estimated. RESULTS: There was high agreement between the measured and reported weights (ICC=0.977) and heights (ICC=0.943). The BMI sensitivity, in its various categories, was around 80%, and the specificity was close to 92%. There was a slight and uniform tendency toward self-reported weight underestimation and self-reported height overestimation in both sexes. CONCLUSIONS: Self-reported and measured weight and height information had good agreement and validity. In similar populations, when few resources are available, it is possible to use self-reported data instead of actual measurements.OBJETIVO: Avaliar a validade do peso e da estatura informados e do índice de massa corporal (IMC). MÉTODOS: Foram estudados 3.713 funcionários públicos de uma universidade no Rio de Janeiro, participantes da Fase 1 de um estudo longitudinal. As informações foram obtidas por meio de questionário auto-preenchível; as aferições foram realizadas após a aplicação. Para avaliar as diferenças entre os parâmetros aferidos e informados, utilizou-se o teste t pareado de Student, gráficos de Bland & Altman e o coeficiente de correlação intraclasse (CCIC). Estimou-se a sensibilidade e a especificidade das várias categorias do IMC. RESULTADOS: Houve alta concordância entre a aferição e a informação do peso (CCIC=0,977) e da estatura (CCIC=0,943). A sensibilidade do IMC, em suas várias categorias, variou em torno de 80%, e a especificidade foi próxima de 92%. Houve tendência leve e uniforme à subestimação do peso informado e à superestimação da estatura informada em ambos os sexos. CONCLUSÕES: As informações relatadas e aferidas de peso e estatura apresentaram boa concordância e validade; em populações similares, que disponham de recursos escassos, é possível utilizar dados informados ao invés de valores aferidos

Optimizing strategies to identify high risk of developing type 2 diabetes

Introduction: The success of diabetes prevention based on early treatment depends on high-quality screening. This study compared the diagnostic properties of currently recommended screening strategies against alternative score-based rules to identify those at high risk of developing diabetes. Methods: The study used data from ELSA-Brasil, a contemporary cohort followed up for a mean (standard deviation) of 7.4 (0.54) years, to develop risk functions with logistic regression to predict incident diabetes based on socioeconomic, lifestyle, clinical, and laboratory variables. We compared the predictive capacity of these functions against traditional pre-diabetes cutoffs of fasting plasma glucose (FPG), 2-h plasma glucose (2hPG), and glycated hemoglobin (HbA1c) alone or combined with recommended screening questionnaires. Results: Presenting FPG > 100 mg/dl predicted 76.6% of future cases of diabetes in the cohort at the cost of labeling 40.6% of the sample as high risk. If FPG testing was performed only in those with a positive American Diabetes Association (ADA) questionnaire, labeling was reduced to 12.2%, but only 33% of future cases were identified. Scores using continuously expressed clinical and laboratory variables produced a better balance between detecting more cases and labeling fewer false positives. They consistently outperformed strategies based on categorical cutoffs. For example, a score composed of both clinical and laboratory data, calibrated to detect a risk of future diabetes ≥20%, predicted 54% of future diabetes cases, labeled only 15.3% as high risk, and, compared to the FPG ≥ 100 mg/dl strategy, nearly doubled the probability of future diabetes among screen positives. Discussion: Currently recommended screening strategies are inferior to alternatives based on continuous clinical and laboratory variables

Ultra-processed foods, incident overweight and obesity, and longitudinal changes in weight and waist circumference : the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Objective: To evaluate the association of ultra-processed food (UPF) consumption with gains in weight and waist circumference, and incident overweight/obesity, in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort. Design: We applied FFQ at baseline and categorized energy intake by degree of processing using the NOVA classification. Height, weight and waist circumference were measured at baseline and after a mean 3·8-year follow-up. We assessed associations, through Poisson regression with robust variance, of UPF consumption with large weight gain (1·68 kg/year) and large waist gain (2·42 cm/year), both being defined as ≥90th percentile in the cohort, and with incident overweight/obesity. Setting: Brazil. Participants: Civil servants of Brazilian public academic institutions in six cities (n 11 827), aged 35–74 years at baseline (2008–2010). Results: UPF provided a mean 24·6 (SD 9·6) % of ingested energy. After adjustment for smoking, physical activity, adiposity and other factors, fourth (>30·8 %) v. first (17·8 % of energy as UPF. Conclusions: Greater UPF consumption predicts large gains in overall and central adiposity and may contribute to the inexorable rise in obesity seen worldwide

Cross-cultural adaptation of discrimination and vigilance scales in ELSA-Brasil

OBJECTIVE: To describe the process of cross-cultural adaptation for the use in Brazil of the everyday discrimination scale (EDS) and the heightened vigilance scale (HVS) applied in the Longitudinal Study of Adult Health (ELSA-Brasil). METHODS: Conceptual, item and semantic equivalence analyses were conducted by a group of four epidemiologists; evaluation of measurement equivalence (factorial analysis of configural, metric and scalar structures, according to sociodemographic characteristics) and reliability. A total of 11,987 participants responded to the discrimination scale, and a subsample of 260 people participated in the test-retest study. In the case of HVS, 8,916 people responded, while 149 individuals did so in the test-retest study. RESULTS: The scales presented conceptual, item and semantic equivalence pertinent in the Brazilian context, in addition to adequate correspondence of referential/denotative meaning of terms and also of the general/connotative of the items. The confirmatory factor analysis of EDS revealed a unidimensional structure, with residual correlations between two pairs of items, presenting configural and metric invariance among the four subgroups evaluated. Scalar invariance was identified according to sex and age group, but it was not observed for race/color and education. Heightened vigilance showed low loads and high residuals, with inadequate adjustment indicators. For the items of the discrimination scale the weighted kappa coefficient (Kp) ranged from 0.44 to 0.78, and the intraclass correlation coefficient (ICC) was 0.87. For HVS items, the Kp ranged from 0.47 to 0.59 and the ICC was 0.83. CONCLUSIONS: Although there are correlated items, it was concluded that the EDS is a promising scale to evaluate experiences of perceived discrimination in Brazilian daily life. However, the heightened vigilance scale did not present equivalence of measurement in the current format

Marcadores do vírus da hepatite B (HBV) em candidatos à doação de sangue no Estado do Maranhão

Introdução: A hepatite B é uma doença infecciosa, causada pelo vírus da hepatite B (VHB) com distribuição universal, sendo considerado um grave problema de saúde pública. Anualmente um milhão de óbitos no mundo são estimados devido a cirrose hepática ou ao carcinoma hepatocelular decorrentes da hepatite B. Objetivo: Determinar a prevalência dos casos positivos aos marcadores do VHB em candidatos à doação de sangue do Centro de Hematologia e Hemoterapia do Maranhão. Métodos: Estudo transversal retrospectivo com 184.186 candidatos à doação de sangue atendido entre 2002 e 2006, no Centro de Hematologia e Hemoterapia do Maranhão. Os dados foram coletados a partir dos registros, por meio de um formulário. Resultados: Encontrou-se 9.407 (5,1%) indivíduos positivos em pelo menos um dos marcadores do VHB. A maioria era do sexo masculino (73,9%), tinham ensino médio incompleto (40,1%), idade entre 25 e 34 anos (33,2%), e solteiros (50,9%). A prevalência de positividade entre 2002 a 2005 foi em torno de 5,5% e em 2006 foi de 4,27%. O anti-HBc foi o marcador mais frequente com prevalência de 4,58%. Conclusão: O teste anti-HBc foi o marcador mais identificado entre os testes de triagem. A baixa escolaridade representou um fator significativo entre os candidatos, pela associação com a falta de esclarecimentos sobre os riscos para a infecção pela hepatite B.Palavras-chaves: Hepatite B. Doador de sangue. Epidemiologia.AbstractIntroduction: The hepatitis B is an infectious disease caused by the Hepatitis B virus (VHB). This disease is spread worldwide and considered as a serious public health problem. It is estimated that one million people die every year due to hepatic cirrhosis or hepatocellular carcinoma caused by hepatitis B. Objective: To determine the positive cases of HBV serological markers in blood donor candidates in the Hematology Center and Hemotherapy of Maranhão. Methods: Retrospective cross-sectional study with 184,186 blood donor candidates from 2002 to 2006 in the Hematology Center and Hemotherapy of Maranhão. The data was collected from record sheets by using a form. Results: 9,407 (5.10%) individuals presented positive result in at least one of the HBV markers. Most individuals were male (73.9%), 40.1% had incomplete high school, 33.2% were between 25 to 34 years of age and 50.9% were single. The positivity prevalence between 2002 and 2005 was 5.5% and 4.27% in 2006. The anti-HBc was the most frequent marker with 4.58%. Conclusion: The anti-HBc marker was the most found marker among the screening tests. The low education level represented a significant factor among the candidates when associated to the lack of knowledge about the risk of HBV infection.Keywords: Hepatitis B. Blood Donner. Epidemiology

Working from home, work-time control and mental health: results from the brazilian longitudinal study of adult health (ELSA-Brasil)

This cross-sectional study investigated the association between work-time control (WTC), independently and in combination with hours worked (HW), and four mental health outcomes among 2,318 participants of the Longitudinal Study of Adult Health (ELSA-Brasil) who worked from home during the COVID-19 pandemic. WTC was assessed by the WTC Scale, and mental health outcomes included depression, anxiety, stress (measured by the Depression, Anxiety and Stress Scale, DASS-21), and self-rated mental health. Logistic regression models were used to determine odds ratios (ORs) and 95% confidence intervals (CIs). Among women, long HW were associated with stress (OR = 1.56; 95% CI = 1.11–2.20) and poor self-rated mental health (OR = 1.64; 95% CI = 1.13–2.38), whereas they were protective against anxiety among men (OR = 0.59; 95% CI = 0.37–0.93). In both sexes, weak WTC was associated with all mental health outcomes. Among women, the long HW/weak WTC combination was associated with all mental health outcomes, and short HW/weak WTC was associated with anxiety and stress. Among men, long HW/strong WTC was protective against depression and stress, while short HW/strong WTC and short HW/weak WTC was associated with all mental health outcomes. In both sexes, weak WTC, independently and in combination with HW, was associated with all mental health outcomes. WTC can improve working conditions, protect against mental distress, and fosterwork-life balance for those who work from home

Major electrocardiographic abnormalities according to the Minnesota coding system among Brazilian adults (from the ELSA-Brasil cohort study)

The electrocardiogram is a simple and useful clinical tool; nevertheless, few studies have evaluated the prevalence of electrocardiographic abnormalities in the Latin American population. This study aims to evaluate the major electrocardiographic abnormalities according to the Minnesota coding system in Brazilian adults, stratified by gender, age, race, and cardiovascular risk factors. Data from 14,424 adults (45.8% men, age 35 to 74 years) were obtained at baseline of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), according to standardized protocol. The electrocardiogram were obtained with the Burdick Atria 6100 machine, stored on Pyramis System, automatically coded according to the Minnesota coding system by the Glasgow University software and then manually revised. Major abnormalities were more prevalent in men than women (11.3% and 7.9%, p <0.001). These differences were consistent through the different age groups, race, and number of cardiovascular risk factors. Electrocardiographic major abnormalities were more prevalent in black participants for both men (black: 15.1%, mixed: 10.4%, white: 11.1%, p = 0.001) and women (black: 10%, mixed: 7.6%, white: 7.2%, p = 0.004). In conclusion, in this large sample of Brazilian adults, the prevalence of major electrocardiographic abnormalities was higher among men, the elderly, black, and among people with more cardiovascular risk factors