Avaliação de programa de prevenção de obesidade em adolescentes de escolas públicas

OBJETIVO: Avaliar os efeitos de um programa de prevenção de obesidade sobre práticas alimentares de adolescentes de escolas públicas. MÉTODOS: Intervenção com 331 estudantes de 11 a 17 anos de 5º e 6º anos de duas escolas públicas estaduais de Niterói, RJ, em 2005. As escolas foram classificadas em escola de intervenção (EI) e escola de controle (EC) para comparação. Práticas alimentares foram abordadas em questionários auto-respondidos antes e após o período de intervenção: consumo de fast food, consumo de refrigerantes, substituição de refeições por lanches, consumo de frutas, verduras e legumes e tipo de alimentação consumida nos intervalos das aulas. Testes qui-quadrado e McNemar foram aplicados para comparar proporções, considerando valor de p < 0,05. RESULTADOS: Na linha de base participaram 185 estudantes da EI (82,2% dos elegíveis) e 146 estudantes da EC (70,5% dos elegíveis). Na fase pós-intervenção houve perda de 10,3% dos adolescentes da EI e 27,4% da EC. Não se observaram mudanças significativas nas práticas alimentares na EC. Na EI aumentou a proporção de estudantes que relataram não consumir lanches vendidos por ambulantes (de 36,7% para 50,6%; p = 0,02) e dos jovens que relataram não substituir almoço (de 44,5% para 65,2%; p < 0,01) e jantar (de 38,4% para 54,3%; p < 0,01) por lanches. A principal mudança favorável foi a redução na freqüência de consumo de lanches fast food na EI comparada à EC (72,7% vs 54,4%; p = 0,001). CONCLUSÕES: Mudanças favoráveis nas práticas alimentares dos adolescentes foram encontradas e estimulam a implantação de programas dessa natureza; contudo, intervenções de maior duração precisam ser implementadas e avaliadas quanto a sua efetividade

Dietary patterns of adults living in Ouagadougou and their association with overweight

<p>Abstract</p> <p>Background</p> <p>Urbanization in developing countries comes along with changes in food habits and living conditions and with an increase in overweight and associated health risks. The objective of the study was to describe dietary patterns of adults in Ouagadougou and to study their relationship with anthropometric status of the subjects.</p> <p>Methods</p> <p>A qualitative food frequency questionnaire was administered to 1,072 adults living in two contrasted districts of Ouagadougou. Dietary patterns were defined by principal component analysis and described by multivariate analysis. Logistic regression was used to study their association with overweight.</p> <p>Results</p> <p>The diet was mainly made of cereals, vegetables and fats from vegetable sources. The two first components of the principal component analysis were interpreted respectively as a "snacking" score and as a "modern foods" score. Both scores were positively and independently associated with the economic level of households and with food expenditures (p ≤ 0.001 for both). The "snacking" score was higher for younger people (p = 0.004), for people having a formal occupation (p = 0.006), for those never married (p = 0.005), whereas the "modern foods" score was associated with ethnic group (p = 0.032) and district of residence (p < 0.001). Thirty-six percent of women and 14.5% of men were overweight (Body Mass Index > 25 kg/m²). A higher "modern foods" score was associated with a higher prevalence of overweight when confounding factors were accounted for (OR = 1.19 [95% CI 1.03-1.36]) but there was no relationship between overweight and the "snacking" score.</p> <p>Conclusions</p> <p>Modernisation of types of foods consumed was associated with the living conditions and the environment and with an increased risk of overweight. This should be accounted for to promote better nutrition and prevent non communicable diseases.</p

The burden of physical activity on type 2 diabetes public healthcare expenditures among adults: a retrospective study

<p>Abstract</p> <p>Background</p> <p>Determinants of public healthcare expenditures in type 2 diabetics are not well investigated in developing nations and, therefore, it is not clear if higher physical activity decreases healthcare costs. The purpose of this study was to analyze the relationship between physical activity and the expenditures in public healthcare on type 2 diabetes mellitus treatment.</p> <p>Methods</p> <p>Cross-sectional study carried out in Brazil. A total of 121 type 2 diabetics attended to in two Basic Healthcare Units were evaluated. Public healthcare expenditures in the last year were estimated using a specific standard table. Also evaluated were: socio-demographic variables; chronological age; exogenous insulin use; smoking habits; fasting glucose test; diabetic neuropathy and anthropometric measures. Habitual physical activity was assessed by questionnaire.</p> <p>Results</p> <p>Age (r = 0.20; p = 0.023), body mass index (r = 0.33; p = 0.001) and waist-to-hip ratio (r = 0.20; p = 0.025) were positively related to expenditures on medication for the treatment of diseases other than diabetes. Insulin use was associated with increased expenditures. Higher physical activity was associated with lower expenditure, provided medication for treatment of diseases other than diabetes (OR = 0.19; p = 0.007) and medical consultations (OR = 0.26; p = 0.029).</p> <p>Conclusions</p> <p>Type 2 diabetics with higher enrollment in physical activity presented consistently lower healthcare expenditures for the public healthcare system.</p