Adjusted* relative risks of cesarean delivery, preterm birth, small for gestational age (SGA) and large for gestational age (LGA) birth for women below and above the Institute of Medicine (IOM/NRC 2009) guidelines for 3^rd trimester weekly gestational weight gain.

<p>Brazilian Study of Gestational Diabetes (EBDG) (n = 2,244). *adjusted through Poisson regression with a robust error variance for education, age, skin color, parity, hypertensive disorders, diabetes, height, smoking, alcohol consumption and 2^nd trimester weight gain. Wt G: weight gain.</p

Adjusted* relative risks of cesarean delivery, preterm birth, small for gestational age (SGA) and large for gestational age (LGA) birth for women below and above the Institute of Medicine (IOM/NRC 2009) guidelines for 2^nd trimester weekly gestational weight gain. Brazilian Study of Gestational Diabetes (EBDG) (n = 2,244).

<p>*adjusted through Poisson regression with a robust error variance for education, age, skin color, parity, hypertensive disorders, diabetes, height, smoking, alcohol consumption and 3^rd trimester weight gain. Wt G: weight gain.</p

Association of small for gestational age and large for gestational age birth with weekly gestational weight gain in 2^nd and 3^rd trimesters and with total weight gain (according to Institute of Medicine, 2009 categories).

†<p>Differences from 2,244 due to lack of data on specific outcome (small and large for gestational age).</p>‡<p>Significant relative risk.</p>*<p>Small-for-gestational-age: Model 2 (2^nd trimester) = Model 1+ pre-pregnancy BMI, hypertensive disorders, height, smoking and 3^rd trimester weight gain. Age, skin color, parity and diabetes were removed due to lack of statistical significance. Model 2 (3^rd trimester) = Model 1+ pre-pregnancy BMI, hypertensive disorders, height, smoking and 2^nd trimester weight gain. Age, skin color, parity and diabetes were removed due to lack of statistical significance. Model 2 (total weight gain) = Model 1+ pre-pregnancy BMI, hypertensive disorders, smoking and diabetes. Age, skin color, parity and height were removed due to lack of statistical significance.</p>**<p>Large-for-gestational-age: Model 2(2^nd trimester) = Model 1+ pre-pregnancy BMI, 3^rd trimester weight gain, diabetes, smoking and height. Age, skin color, parity and education were removed due to lack of statistical significance. Model 2 (3^rd trimester) = Model 1+ pre-pregnancy BMI, height, 2^nd trimester weight gain, smoking and diabetes. Age, parity and education were removed due to lack of statistical significance. Model 2 (total weight gain) = Model 1+ pre-pregnancy BMI, smoking, diabetes and height. Age, parity, and education were removed due to lack of statistical significance.</p><p>Reference category =  Adequate weight gain.</p><p>Brazilian Study of Gestational Diabetes (EBDG).</p

Association of cesarean section and preterm birth with weekly gestational weight gain in the 2^nd and 3^rd trimesters and total weight gain (according to Institute of Medicine, 2009, categories). Brazilian Study of Gestational Diabetes (EBDG).

†<p>Differences from 2,244 due to lack of data on the specific outcomes.</p>‡<p>Significant relative risk.</p>*<p>Cesarean section: Model 2 (2^nd trimester) = Model 1+ pre-pregnancy BMI, age, education, parity, hypertensive disorders, height and birth weight. Skin color and 3^rd trimester weekly weight gain were removed from the model 2 due to lack of statistical significance. Model 2 (3^rd trimester) = Model 1+ pre-pregnancy BMI, age, education, parity, hypertensive disorders, diabetes, height, birth weight, alcohol consumption, gestational age at delivery and 2^nd trimester gestational weight gain. Skin color and smoking were removed from the model 2 due to lack of statistical significance. Model 2 (total weight gain) = Model 1+ pre-pregnancy BMI, age, education, parity, hypertensive disorders height and birth weight. Skin color, alcohol consumption, diabetes, smoking and gestational age at delivery were removed from the model 2 due to lack of statistical significance.</p>**<p>Preterm birth: Model 2 (2^nd trimester) = Model 1+ pre-pregnancy BMI, education, hypertensive disorders, diabetes, 3^rd trimester gestational weight gain and birth weight. Age, height and parity were removed from the model 2 due to lack of statistical significance. Model 2 (3^rd trimester) = Model 1+ pre-pregnancy BMI, education, diabetes, birth weight and 2^ndtrimester gestational weight gain. Hypertensive disorders was removed due to lack of statistical significance.</p><p>Model 2 (total weight gain) = Model 1+ pre-pregnancy BMI, diabetes, hypertensive disorders, birth weight. Education was removed due to lack of statistical significance.</p><p>RR = risk relative; Reference category = Adequate weight gain.</p

2^nd and 3^rd trimester weight gain^† according to maternal characteristics. Brazilian Study of Gestational Diabetes (EBDG) (n = 2,244).

†<p>as defined by Institute of Medicine 2009 recommendations (IOM/NRC 2009).</p>‡<p>P value refers to chi-square test for proportions.</p>*<p>Smoking habit: Never smoking, quitting smoking prior to pregnancy, continued to smoke during pregnancy.</p><p>BMI: Body mass index (kg/m²).</p

2^nd and 3^rd trimester gestational weekly weight gain according to pre-pregnancy body mass index category according Institute of Medicine/NRC 2009. Brazilian Study of Gestational Diabetes (EBDG) (n = 2,244).

<p>SD, standard deviation.</p><p>BMI, body mass index.</p>†<p>Wilcoxon signed rank sum test for difference between 2^nd and 3^rd trimester.</p

Fully-adjusted (Model 3) associations of frequency of coffee consumption per day with newly diagnosed diabetes and intermediate hyperglycemia, from ELSA-Brasil (2008–2012) (N = 12586).

<p>For IFG, IGT, HbA1c analyses, n = 11245 after exclusion of participants with newly diagnosed diabetes.</p

Adjusted^* Mean (SE) values for metabolic measures according to the relationship with frequency of coffee consumption per day.

<p>Values presented are Mean ± SE (Standard error). Fasting insulin, two-hour postload insulin, HOMA-IR, HOMA-β, & ISI (composite) are presented as Geometric means. To convert to conventional units: mmol*18.018 = mg/dl; pmol/l*.167 = μIU/ml.</p><p>† P-value for the test of any association between coffee consumption and the outcome of interest</p><p>* Model 1: adjusted for sex, age (years), ELSA-Brasil center.</p><p>Model 2: + race/color (white, pardo, black, asian/indigenous), education (high school or less, some university or more), education of mother (high school or less, some university or more), smoking status (current, former, never smoker), alcohol intake (user, former user, never user), leisure time physical activity level (engage in physical activity one time per week or less, engage in physical activity two or more times per week), hypertension, family history of diabetes, daily fruit consumption, daily vegetable consumption, dairy product intake (g/day), beef intake (g/day), white rice intake (g/day), soda intake (g/day), juice intake (g/day), tea intake (g/day), % kcal from fat.</p><p>Model 3: + body mass index, waist-hip ratio, C-reactive protein.</p><p>Model 4: + Magnesium. Further adjustment for insulin measures (fasting and 2-hour postload) for fasting glucose, two-hour postload glucose, and HbA1c analyses.</p><p>ELSA-Brasil, 2008–2012 (N = 12586).</p

Characterization of ELSA-Brasil participants (N = 12586) by frequency of coffee consumption per day, at baseline (2008–2010).

<p>Values are means and standard deviations for continuous variables and frequencies and percentages for categorical variables. Abbreviations: BMI, body mass index (kg/m²); WHR, waist-hip ratio.</p><p>^a “Other”: those reporting their race/skin color as “Asian” or “Indigenous.</p><p>^b Highest level of instruction completed was High school, or less.</p><p>^c Typically engage in leisure time physical activity 1 day/week or less.</p><p>Characterization of ELSA-Brasil participants (N = 12586) by frequency of coffee consumption per day, at baseline (2008–2010).</p

Timing and Type of Alcohol Consumption and the Metabolic Syndrome - ELSA-Brasil

<div><p>The prevalence of the metabolic syndrome is rising worldwide. Its association with alcohol intake, a major lifestyle factor, is unclear, particularly with respect to the influence of drinking with as opposed to outside of meals. We investigated the associations of different aspects of alcohol consumption with the metabolic syndrome and its components. In cross-sectional analyses of 14,375 active or retired civil servants (aged 35–74 years) participating in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), we fitted logistic regression models to investigate interactions between the quantity of alcohol, the timing of its consumption with respect to meals, and the predominant beverage type in the association of alcohol consumption with the metabolic syndrome. In analyses adjusted for age, sex, educational level, income, socioeconomic status, ethnicity, smoking, body mass index, and physical activity, light consumption of alcoholic beverages with meals was inversely associated with the metabolic syndrome (≤4 drinks/week: OR = 0.85, 95%CI 0.74–0.97; 4 to 7 drinks/week: OR = 0.75, 95%CI 0.61–0.92), compared to abstention/occasional drinking. On the other hand, greater consumption of alcohol consumed outside of meals was significantly associated with the metabolic syndrome (7 to 14 drinks/week: OR = 1.32, 95%CI 1.11–1.57; ≥14 drinks/week: OR = 1.60, 95%CI 1.29–1.98). Drinking predominantly wine, which occurred mostly with meals, was significantly related to a lower syndrome prevalence; drinking predominantly beer, most notably when outside of meals and in larger quantity, was frequently associated with a greater prevalence. In conclusion, the alcohol—metabolic syndrome association differs markedly depending on the relationship of intake to meals. Beverage preference—wine or beer—appears to underlie at least part of this difference. Notably, most alcohol was consumed in metabolically unfavorable type and timing. If further investigations extend these findings to clinically relevant endpoints, public policies should recommend that alcohol, when taken, should be preferably consumed with meals.</p></div