Consumo de bebidas com adição de açúcar e composição corporal de jovens das coortes RPS

Sugar-sweetened beverages (SSB) may be related to body composition. Few studies have found the relationship between SSB consumption and muscle mass index (BMI) and bone mineral density (BMD). Thus, the objectives of this thesis are to verify the association between SSB and BMD consumption in young people from the RPS birth cohorts and to analyze the association between SSB and IMM consumption in adolescents from São Luís, Maranhão. The design of the studies includes cross-sectional analyzes. In the DMO manuscript, young people aged 18 to 23 years old belonging to three Brazilian birth cohorts from the cities of Ribeirão Preto, Pelotas and São Luís were evaluated. In the IMM manuscript, adolescents 18 and 19 years old belonging to a cohort of birth of São Luís. The frequency, quantity and daily energy contribution of SSB (soft drinks, industrialized juices and chocolate) categorized in tertiles were the exhibitions of interest. The outcome variables were the bone mineral density (BMD) of the body and lumbar spine (in g/cm2 ) in the first manuscript and the muscle mass index (IMM) (in kg/m2 ) in the second manuscript. Unadjusted and adjusted models for confounding variables were analyzed by linear regression. Standardized coefficient (standardized β) was used to evaluate the effect size. In the first manuscript, the highest tertile of the frequency of consumption of SSB (2.1 to 16.7 times/day) was associated with a reduction in BMD of the lumbar spine (β = -0.009; 95% CI: -0.017; -0.001; β standardized = -0.030). The association remained after adjusting for confounding variables (β = -0.008; 95% CI: -0.016; -0.001; standardized β = -0.030). In the second manuscript it was found that the highest tertile of frequency of daily consumption of SSB (1.1 to 10.1 times / day) was associated with a reduction in IMM for males (β = -0.31; 95% CI: -0.60; -0.01; standardized β = -0.070) and female (β = -0.24; 95% CI: -0.45; -0.02; standardized β = -0.068). These associations did not remain after adjustment for the sugars contained in SSB in males (β = -0.16; 95% CI: -0.52; 0.20; standardized β = -0.060) and females (β = 0, 01; 95% CI: -0.24; 0.24; standardized β = -0.051). The highest tertile of SSB energy contribution (representing 3.0 to 28.4% in relation to total calories) was associated with a reduction in IMM in male adolescents (β = -0.34; 95% CI: -0.64; -0.04; standardized β = -0.080). This association was not maintained after adjustment for sugars contained in SSB (β = -0.19; 95% CI: -0.51; 0.12; standardized β = -0.076). In some young people, the consumption of SSB was a risk factor for the decrease in BMI and BMD in the lumbar spine. These results are important because the population evaluated was young and it was not expected to reduce muscle and bone mass at this stage of life.As bebidas com adição de açúcar (BAA) podem estar relacionadas à composição corporal. Poucos estudos verificaram as relações do consumo de BAA com o índice de massa muscular (IMM) e a densidade mineral óssea (DMO). Dessa forma, os objetivos dessa tese são verificar associação entre consumo de BAA e DMO em jovens das coortes de nascimento RPS e analisar associação entre consumo de BAA e IMM em adolescentes de São Luís, Maranhão. O delineamento dos estudos comtempla análises transversais. No manuscrito sobre DMO foram avaliados jovens de 18 a 23 anos de idade pertencentes a três coortes brasileiras de nascimento das cidades de Ribeirão Preto, Pelotas e São Luís. No manuscrito sobre IMM foram avaliados adolescentes de 18 e 19 anos de idade pertencentes a coorte de nascimento de São Luís. A frequência, quantidade e contribuição energética diárias das BAA (refrigerantes, sucos industrializados e achocolatados) categorizadas em tercis foram as exposições de interesse. As variáveis desfechos foram a densidade mineral óssea (DMO) de corpo e coluna lombar (em g/cm2 ) no primeiro manuscrito e o índice de massa muscular (IMM) (em kg/m2 ) no segundo manuscrito. Modelos não ajustado e ajustados para variáveis confundidoras foram analisados por regressão linear. Utilizou-se coeficiente padronizado (β padronizado) para avaliar o tamanho do efeito. No primeiro manuscrito o maior tercil da frequência de consumo de BAA (2,1 a 16,7 vezes/dia) foi associado à redução da DMO de coluna lombar (β = -0,009; IC 95%: -0,017; -0,001; β padronizado = -0.030). A associação manteve-se após ajuste para variáveis confundidoras (β = -0,008; IC 95%: -0.016; -0.001; β padronizado = -0.030). No segundo manuscrito verificou-se que o maior tercil de frequência de consumo diária de BAA (1,1 a 10,1 vezes/dia) foi associado à redução do IMM para os sexos masculino (β = -0,31; IC95%: -0,60; -0,01; β padronizado = -0,070) e feminino (β = -0,24; IC95%: -0,45; -0,02; β padronizado = -0,068). Essas associações não se mantiveram após o ajuste para os açúcares contidos nas BAA no sexo masculino (β = -0,16; IC95%: -0,52; 0,20; β padronizado = -0,060) e feminino (β = 0,01; IC95%: -0,24; 0,24; β padronizado = -0,051). O maior tercil de contribuição energética de BAA (representando 3,0 a 28,4% em relação às calorias totais) foi associado à redução do IMM nos adolescentes do sexo masculino (β = -0,34; IC95%: -0,64; - 0,04; β padronizado = -0,080). Essa associação não se manteve após ajuste para açúcares contidos nas BAA (β = -0,19; IC95%: -0,51; 0,12; β padronizado = -0,076). Em alguns jovens, o consumo de BAA foi fator de risco para a diminuição do IMM e da DMO de coluna lombar. Esses resultados são importantes pois a população avaliada era jovem e não se esperava ocorrer redução da massa muscular e óssea nessa fase da vida

Uso de substâncias psicoativas e perfil nutricional de usuários do CAPS AD III, Palmas/TO

O objetivo desse trabalho foi estudar uso de substâncias psicoativas, estado nutricional e hábitos alimentares de indivíduos atendidos no Centro de Atenção Psicossocial para Álcool e Outras Drogas (CAPS AD III) de Palmas, Tocantins. Trata-se de estudo realizado com 50 usuários do Sistema Único de Saúde que procuraram tratamento no CAPS AD III de Palmas-TO, os quais participaram das atividades do Programa de Educação pelo Trabalho para a Saúde – PET/Saúde. Os entrevistados responderam questionários sobre dados socioeconômicos, uso de substâncias psicoativas e hábitos alimentares. Verificou-se que a substância psicoativa que mais se apresentou como sugestiva ao abuso foi o tabaco (58%) e a que mais se destacou como sugestiva de dependência foi cocaína/crack (34%). Quanto ao estado nutricional 70% de todos os entrevistados relataram terem perdido peso após iniciar o uso de substâncias psicoativas. Com relação aos hábitos alimentares, grande parte relatou realizar nenhuma refeição durante o uso (50%). Conclui-se que medidas de acompanhamento e orientação alimentar e nutricional, fazem-se necessárias para minimizar impactos que o uso de substâncias psicoativas causa nestes indivíduos

Uso de substâncias psicoativas e perfil nutricional de usuários do CAPS AD III, Palmas/TO

The objective of this work was to study the use of psychoactive substances, nutritional status and eating habits of individuals who were assisted in the Psychosocial Attention Center for Alcohol and other Drugs (PSAC AD/CAPS AD) in Palmas, Tocantins. This study was carried on with fifty (50) Unified Health System users seeking for treatment at PSAC AD/CAPS AD III, in Palmas, TO. They participated in the activities promoted by the Labor Education Program for Health – LEP HEALTH/ PET Health. The users answered questionnaires concerning socioeconomic data, use of psychoactive substances and eating habits. It was noted that the psychoactive substances presented as most subjected to use abuse was tobacco (58%) and the most subjected to addiction was cocaine/crack (34%). Regarding nutritional status, 70% of all participants reported having lost weight after starting the use of psychoactive substances. With regard to eating habits, most reported making no meals during the use (50%). It was concluded that food and nutritional orientation and follow up are necessary to minimize the impacts that the use of psychoactive substances in these individuals. El objetivo de este trabajo fue estudiar el consumo de sustancias psicoactivas, el estado nutricional y los hábitos alimenticios de las personas atendidas en el Centro de Atención Psicosocial de Alcohol y Otras Drogas (CAPS AD III) de Palmas, Tocantins. Se trata de un estudio realizado con 50 usuarios del Sistema Único de Salud que buscaron tratamiento en CAPS AD III Palmas - Tocantins, los cuales también participaron de las actividades del Programa de Educación para la Salud Laboral - PET / Salud. Los encuestados respondieron a cuestionarios sobre datos socioeconómicos, consumo de sustancias psicoactivas y hábitos alimenticios. Se verificó que la sustancia psicoativa que más se presenta como estimulante al abuso fue el tabaco (58%) y la que más se destacó como sugerente de dependencia fue la cocaína/crack (34%). En cuanto al estado nutricional, 70% de los encuestados relató haber perdido peso después de comenzar el uso de sustancias psicoactivas. Con respecto a los hábitos, la mayoría informó no alimentarse durante el uso (50%). Se concluye que las medidas de acompañamiento y la orientación nutricional son necesarias para minimizar los impactos que el uso de sustancias psicoactivas causa en estos individuos.O objetivo desse trabalho foi estudar uso de substâncias psicoativas, estado nutricional e hábitos alimentares de indivíduos atendidos no Centro de Atenção Psicossocial para Álcool e Outras Drogas (CAPS AD III) de Palmas, Tocantins. Trata-se de estudo realizado com 50 usuários do Sistema Único de Saúde que procuraram tratamento no CAPS AD III de Palmas-TO, os quais participaram das atividades do Programa de Educação pelo Trabalho para a Saúde – PET/Saúde. Os entrevistados responderam questionários sobre dados socioeconômicos, uso de substâncias psicoativas e hábitos alimentares. Verificou-se que a substância psicoativa que mais se apresentou como sugestiva ao abuso foi o tabaco (58%) e a que mais se destacou como sugestiva de dependência foi cocaína/crack (34%). Quanto ao estado nutricional 70% de todos os entrevistados relataram terem perdido peso após iniciar o uso de substâncias psicoativas. Com relação aos hábitos alimentares, grande parte relatou realizar nenhuma refeição durante o uso (50%). Conclui-se que medidas de acompanhamento e orientação alimentar e nutricional, fazem-se necessárias para minimizar impactos que o uso de substâncias psicoativas causa nestes indivíduos

Uso de substâncias psicoativas e perfil nutricional de usuários do CAPS AD III, Palmas/TO

The objective of this work was to study the use of psychoactive substances, nutritional status and eating habits of individuals who were assisted in the Psychosocial Attention Center for Alcohol and other Drugs (PSAC AD/CAPS AD) in Palmas, Tocantins. This study was carried on with fifty (50) Unified Health System users seeking for treatment at PSAC AD/CAPS AD III, in Palmas, TO. They participated in the activities promoted by the Labor Education Program for Health – LEP HEALTH/ PET Health. The users answered questionnaires concerning socioeconomic data, use of psychoactive substances and eating habits. It was noted that the psychoactive substances presented as most subjected to use abuse was tobacco (58%) and the most subjected to addiction was cocaine/crack (34%). Regarding nutritional status, 70% of all participants reported having lost weight after starting the use of psychoactive substances. With regard to eating habits, most reported making no meals during the use (50%). It was concluded that food and nutritional orientation and follow up are necessary to minimize the impacts that the use of psychoactive substances in these individuals. El objetivo de este trabajo fue estudiar el consumo de sustancias psicoactivas, el estado nutricional y los hábitos alimenticios de las personas atendidas en el Centro de Atención Psicosocial de Alcohol y Otras Drogas (CAPS AD III) de Palmas, Tocantins. Se trata de un estudio realizado con 50 usuarios del Sistema Único de Salud que buscaron tratamiento en CAPS AD III Palmas - Tocantins, los cuales también participaron de las actividades del Programa de Educación para la Salud Laboral - PET / Salud. Los encuestados respondieron a cuestionarios sobre datos socioeconómicos, consumo de sustancias psicoactivas y hábitos alimenticios. Se verificó que la sustancia psicoativa que más se presenta como estimulante al abuso fue el tabaco (58%) y la que más se destacó como sugerente de dependencia fue la cocaína/crack (34%). En cuanto al estado nutricional, 70% de los encuestados relató haber perdido peso después de comenzar el uso de sustancias psicoactivas. Con respecto a los hábitos, la mayoría informó no alimentarse durante el uso (50%). Se concluye que las medidas de acompañamiento y la orientación nutricional son necesarias para minimizar los impactos que el uso de sustancias psicoactivas causa en estos individuos.O objetivo desse trabalho foi estudar uso de substâncias psicoativas, estado nutricional e hábitos alimentares de indivíduos atendidos no Centro de Atenção Psicossocial para Álcool e Outras Drogas (CAPS AD III) de Palmas, Tocantins. Trata-se de estudo realizado com 50 usuários do Sistema Único de Saúde que procuraram tratamento no CAPS AD III de Palmas-TO, os quais participaram das atividades do Programa de Educação pelo Trabalho para a Saúde – PET/Saúde. Os entrevistados responderam questionários sobre dados socioeconômicos, uso de substâncias psicoativas e hábitos alimentares. Verificou-se que a substância psicoativa que mais se apresentou como sugestiva ao abuso foi o tabaco (58%) e a que mais se destacou como sugestiva de dependência foi cocaína/crack (34%). Quanto ao estado nutricional 70% de todos os entrevistados relataram terem perdido peso após iniciar o uso de substâncias psicoativas. Com relação aos hábitos alimentares, grande parte relatou realizar nenhuma refeição durante o uso (50%). Conclui-se que medidas de acompanhamento e orientação alimentar e nutricional, fazem-se necessárias para minimizar impactos que o uso de substâncias psicoativas causa nestes indivíduos

CORRELAÇÃO ENTRE O ÍNDICE DE MASSA CORPORAL E INDICADORES ANTROPOMÉTRICOS DE RISCO CARDIOVASCULAR EM MULHERES / CORRELATION BETWEEN BODY MASS INDEX AND CARDIOVASCULAR RISK ANTHROPOMETRIC INDICATORS IN WOMEN

Introdução: As doenças cardiovasculares (DCV) compreendem a principal causa de morbimortalidade no mundo. Mulheres adultas que apresentam fatores de risco podem desenvolver a doença cardiovascular precocemente. Estudos têm demonstrado a capacidade de alguns indicadores antropométricos na predição do risco cardiovascular. Objetivos: Verificar a correlação entre índice de massa corporal (IMC) e os indicadores antropométricos de risco cardiovascular. Métodos: Estudo transversal, realizado com 120 mulheres de 20 a 49 anos do município de São José de Ribamar (MA). Foram coletados dados socioeconômicos e demográficos, estilo de vida e antropométricos. Avaliou-se o IMC, circunferência da cintura (CC), razão cintura estatura (RCest), razão cintura quadril (RCQ) e índice de conicidade (IC). Utilizou-se o teste de correlação de Pearson entre IMC e indicadores antropométricos de risco cardiovascular. Resultados: Da amostra estudada, 60,0% das mulheres estavam com excesso de peso de acordo com o IMC, 70,8%, tinham risco para DCV por meio da CC, 60,8% pela RCest e 74,2% pelo IC. Quanto ao IMC e os indicadores antropométricos observou-se correlação significativa: CC (p< 0,001, r= 0,47), RCQ (p< 0,001, r= 0,62), RCEst (p< 0,001, r= 0,85) e IC (p< 0,001, r= 0,52). Conclusão: Todos os indicadores antropométricos avaliados se mostraram moderadamente correlacionados com o IMC, com exceção da RCest que teve forte correlação.Palavras-chave: Antropometria. Obesidade Abdominal. Doenças Cardiovasculares.AbstractIntroduction: Cardiovascular diseases (CVD) comprise the leading cause of morbidity and mortality worldwide. Adult women who have risk factors may develop CVD early. Studies have shown the capacity of some anthropometric indicators to predict cardiovascular risks. Objectives: To investigate the correlation between body mass index (BMI) and cardiovascular risk anthropometric indicators. Methods: Cross-sectional study conducted with 120 women aged between 20-49 years old from São José de Ribamar, Maranhão, Brazil. Socioeconomic, demographic, lifestyle and anthropometric data were collected. BMI, waist circumference (WC), waist height (WHtR), waist hip ratio (WHR) and conicity index (CI) were evaluated. Pearson correlation test between BMI and cardiovascular risk anthropometric indicators were used. Results: In the study sample, 60% of women were overweight according to BMI, while CVD risk was observed in 70.8% of women according to WC, 60.8% according to WHtR and 74.2% according to CI. Regarding BMI and anthropometric indicators, significant correlation was observed, as follows: WC (p <0.001, r = 0.47), WHR (p <0.001, r = 0.62), WHtR (p <0.001, r = 0.85) and CI (p <0.001, r = 0.52). Conclusion: All the evaluated anthropometric indicators have proven to be moderately correlated with BMI, except for WHtR, which had strong correlation.Keywords: Anthropometry. Abdominal Obesity. Cardiovascular Diseases

Population-based seroprevalence of SARS-CoV-2 and the herd immunity threshold in Maranhão

OBJECTIVE: To estimate the seroprevalence of SARS-CoV-2 in the state of Maranhão, Brazil. METHODS: A population-based household survey was performed, from July 27, 2020 to August 8, 2020. The estimates considered clustering, stratification and non-response. Qualitative detection of IgM and IgG antibodies was performed in a fully-automated Elecsys® Anti-SARS-CoV-2 electrochemiluminescence immunoassay on the Cobas® e601 analyzer (Roche Diagnostics). RESULTS: In total, 3,156 individuals were interviewed. Seroprevalence of total antibodies against SARS-CoV-2 was 40.4% (95%CI 35.6-45.3). Population adherence to non-pharmaceutical interventions was higher at the beginning of the pandemic than in the last month. SARS-CoV-2 infection rates were significantly lower among mask wearers and among those who maintained social and physical distancing in the last month compared to their counterparts. Among the infected, 26.0% were asymptomatic. The infection fatality rate (IFR) was 0.14%, higher for men and older adults. The IFR based on excess deaths was 0.28%. The ratio of estimated infections to reported cases was 22.2. CONCLUSIONS: To the best of our knowledge, the seroprevalence of SARS-CoV-2 estimated in this population-based survey is one of the highest reported. The local herd immunity threshold may have been reached or might be reached soon.OBJECTIVE: To estimate the seroprevalence of SARS-CoV-2 in the state of Maranhão, Brazil. METHODS: A population-based household survey was performed, from July 27, 2020 to August 8, 2020. The estimates considered clustering, stratification and non-response. Qualitative detection of IgM and IgG antibodies was performed in a fully-automated Elecsys® Anti-SARS-CoV-2 electrochemiluminescence immunoassay on the Cobas® e601 analyzer (Roche Diagnostics). RESULTS: In total, 3,156 individuals were interviewed. Seroprevalence of total antibodies against SARS-CoV-2 was 40.4% (95%CI 35.6-45.3). Population adherence to non-pharmaceutical interventions was higher at the beginning of the pandemic than in the last month. SARS-CoV-2 infection rates were significantly lower among mask wearers and among those who maintained social and physical distancing in the last month compared to their counterparts. Among the infected, 26.0% were asymptomatic. The infection fatality rate (IFR) was 0.14%, higher for men and older adults. The IFR based on excess deaths was 0.28%. The ratio of estimated infections to reported cases was 22.2. CONCLUSIONS: To the best of our knowledge, the seroprevalence of SARS-CoV-2 estimated in this population-based survey is one of the highest reported. The local herd immunity threshold may have been reached or might be reached soon

Association between socioeconomic factors and fruit and vegetable consumption in Brazilians aged &ge; 50 years: ELSI-Brazil data

OBJECTIVE: Daily fruit and vegetable consumption is a critical factor in health, especially aging. This study aimed to evaluate the association between socioeconomic factors and daily fruit and vegetable consumption in men and women aged &ge; 50 years. METHODS: This cross-sectional study used 2015-2016 data from the Brazilian longitudinal study of aging (ELSI-Brazil), which included 8665 individuals aged &ge; 50 years. Daily fruit and vegetable consumption was the dependent variable, and income, education, sex, age, and race were the independent variables. Associations between fruit and vegetable consumption and the independent variables were determined using Poisson regression. RESULTS: Individuals who had completed higher education (OR 2.40; 95% CI 2.07-2.78), whose income was &gt; 3 times the minimum wage (OR 2.42; 95% CI 2.18-2.68), and those aged &gt; 80 years (OR 1.44; 95% CI 1.27-1.63) were more likely to consume fruits and vegetables. However, men (OR 0.63; 95% CI 0.58-0.67), Blacks (OR 0.74; 95% CI 0.65-0.84), and people of mixed race (OR 0.68; 95% CI 0.63-0.73), were less likely to consume fruits and vegetables. CONCLUSIONS: The results show inequality in fruit and vegetable consumption among people aged &ge; 50 years, which was lower among men, people of Black or mixed race, people with low income and education, and those with younger age. Interventions are needed to promote fruit and vegetable consumption, and thus healthy aging, among these groups.</p

Núcleo de apoio à saúde da família - NASF:: Práticas de um acadêmico de nutrição

The objective of this study was to report a nutrition internship experience in the Centers of Support for Family Health (NASF) in two Health Units Palmas-TO family. It was realized in two months and the main activities developed nutritional guidelines to the various population groups such as hypertensive, diabetic, pregnant women, the elderly, teenagers, students and their parents. The main method used was the food and nutrition education through active and playful methodologies aiming the empowerment of the subjects. It was possible to build knowledge for users of primary health care system and the trainee who analyzed the nutritionist possibilities of action in NASF, acquiring new knowledge. The importance of professional in the public health care network has been evident throughout the probationary period. It concludes that the collective activities of planning, intersectoral and continuing education provides a great environment to promote healthO objetivo desse trabalho foi relatar uma experiência de estágio de nutrição nos Núcleos de Apoio à Saúde da Família (NASF) em duas Unidades de Saúde da Família de Palmas-TO. Trata-se de estudo realizado em dois meses, tendo como principais atividades desenvolvidas as orientações nutricionais aos diversos grupos populacionais como hipertensos, diabéticos, gestantes, idosos, adolescentes, escolares e seus pais. O principal método utilizado foi a educação alimentar e nutricional por meio de metodologias ativas e lúdicas objetivando o empoderamento dos sujeitos. Foi possível construir saberes para os usuários do sistema de atenção básica e para o estagiário que analisou as possibilidades de atuação do nutricionista no NASF, adquirindo novos conhecimentos. A importância do profissional na rede de assistência pública à saúde foi evidenciada durante todo o período de estágio. Conclui-se que as atividades coletivas de planejamento, intersetorialidade e educação permanente proporcionam um ótimo ambiente de promoção à saúde.El objetivo de este estudio fue reportar una experiencia nutrición de prácticas en los Centros de Apoyo a la Salud de la Familia (NASF) en dos Unidades de Salud de la família de Palmas-TO. Es estudio en dos meses, las principales actividades desarrolladas directrices nutricionales a los diversos grupos de población, tales como, las mujeres diabéticos hipertensos embarazadas, ancianos, adolescentes, estudiantes y sus padres. El principal método utilizado fue la educación alimentaria y nutricional a través de metodologías activas y lúdicas dirigidas a la potenciación de los sujetos. Fue posible construir el conocimiento a los usuarios del sistema de atención primaria de salud y el aprendiz quien analizó las posibilidades del nutricionista de la acción en NASF, la adquisición de nuevos conocimientos. La importancia de los profesionales en la red de atención de la salud pública ha sido evidente a lo largo del período de prueba. Llega a la conclusión de que las actividades colectivas de la planificación, la educación intersectorial y continua proporcionan un gran ambiente para promover la salu

Support center for family health: nutrition course academic practices

The objective of this study was to report a nutrition internship experience in the Centers of Support for Family Health (NASF) in two Health Units Palmas-TO family. It was realized in two months and the main activities developed nutritional guidelines to the various population groups such as hypertensive, diabetic, pregnant women, the elderly, teenagers, students and their parents. The main method used was the food and nutrition education through active and playful methodologies aiming the empowerment of the subjects. It was possible to build knowledge for users of primary health care system and the trainee who analyzed the nutritionist possibilities of action in NASF, acquiring new knowledge. The importance of professional in the public health care network has been evident throughout the probationary period. It concludes that the collective activities of planning, intersectoral and continuing education provides a great environment to promote healt