Low diet quality in older adults:a population-based study in southern Brazil

Resumo O objetivo deste estudo foi identificar os fatores associados à baixa qualidade da dieta de idosos da cidade de Pelotas, RS. As informações de consumo alimentar foram coletadas através de um questionário de frequência alimentar resumido e a qualidade da dieta foi avaliada através do Índice de Qualidade da Dieta de Idosos (IQD-I), desenvolvido pelos autores. Foram atribuídos pontos a cada alimento avaliado, conforme sua frequência de consumo. As maiores frequências de consumo receberam maior pontuação quando alimentos saudáveis e menor quando não saudáveis. A pontuação total foi dividida em tercis, classificados em: baixa, intermediária e boa qualidade. A associação entre a qualidade da dieta e as variáveis independentes foi investigada através de regressão logística multinomial. Os fatores associados à dieta de baixa qualidade foram: sexo masculino, idade inferior a 80 anos, baixa escolaridade, dificuldade financeira para compra de alimentos, baixo peso, problemas na boca ou nos dentes e realizar menos de quatro refeições por dia. Importantes barreiras para o consumo de uma dieta de boa qualidade foram identificadas neste estudo, ficando evidente a importância de se considerar esses aspectos na promoção da alimentação saudável em idosos

Internalizing and externalizing behavior problems and substance use in adolescence

Este estudo investigou a relação entre problemas de comportamento externalizantes (PCE), internalizantes (PCI) e desses concomitantemente (PCEI) no início da adolescência (11 anos) e o consumo de substâncias (bebidas alcoólicas, tabaco e drogas ilícitas) aos 15 anos, utilizando dados da coorte de nascimentos de Pelotas, Rio Grande do Sul, Brasil, de 1993. Os problemas de comportamento foram avaliados pelo Strengths and Difficulties Questionnaire (SDQ) aplicado às mães quando os filhos tinham 15 anos. O consumo de substâncias foi avaliado por meio de questionário sigiloso autoaplicado ao adolescente. A associação entre problemas de comportamento e uso de substâncias foi analisada por meio de regressão de Poisson com ajuste robusto da variância. Após ajuste para fatores de confusão, os adolescentes com PCE tiveram maior risco para consumo abusivo de álcool (RR = 1,74; IC95%: 1,21; 2,50) e para experimentação (RR = 1,78; IC95%: 1,42; 2,23) e uso de tabaco nos últimos 30 dias (RR = 2,38; IC95%: 1,64; 3,45). Os adolescentes com PCI tiveram maior risco de experimentar tabaco (RR = 1,54; IC95%: 1,22; 1,93) e de utilizá-lo nos últimos 30 dias (RR = 1,92; IC95%: 1,31; 2,83). Os adolescentes com PCEI apresentaram maior risco para experimentação (RR = 2,24; IC95%: 1,57; 3,21) e consumo de tabaco nos últimos 30 dias (RR = 3,01; IC95%: 1,63; 5,56), e menor risco de experimentação de álcool aos 15 anos (RR = 0,72; IC95%: 0,55; 0,94). Ações de saúde pública que atuem na redução dos problemas de comportamento no início da adolescência poderão diminuir o consumo de tabaco e de bebidas alcoólicas aos 15 anos

Breastfeeding and behavior disorders among children and adolescents: a systematic review

OBJECTIVE: This systematic review study aimed to assess the evidence available for the association between breastfeeding and behavior disorders in childhood and adolescence. METHODS: The search was carried out in the PubMed, Lilacs, and PsycINFO databases up to December 2016. Inclusion criteria were as follows: prospective, retrospective and cross-sectional studies assessing the association between breastfeeding and behavior disorders in childhood or adolescence, using psychometric tests, carried out in humans and published in Portuguese, English, or Spanish. The search was performed in several stages by two independent researchers using pre-established criteria. RESULTS: Eighteen studies met the inclusion criteria. Breastfeeding for a period equal to or higher than three or four months seemed to be inversely associated with total behavior and conduct disorders in childhood; however, the association remains unclear for other behavior disorders. Only four studies assessed behavior disorders in adolescence, and when an association was found, it was likely to be positive. The duration of breastfeeding seemed to be more important than the exclusive or non-exclusive pattern of breastfeeding. CONCLUSIONS: Breastfed children for at least three to four months had fewer total behavior and conduct disorders in childhood. Further studies are needed to better understand this association, particularly in adolescence and involving other behavioral profiles

Reproducibilidad y validación relativa de un cuestionario de frecuencia de consumo de alimentos semicuantitativo en población adulta de Rosario, Argentina

Introduction: Dietary assessment of nutrients and food groups by food frequency questionnaire needs to be validated in each population. The objective of this cross-sectional study was to evaluate the reproducibility and relative validity of a semi-quantitative food frequency questionnaire among adults of Rosario, Argentina.Material and Methods: Two food frequency questionnaires and four 24-hour dietary recalls were applied in a sample of 88 adults. Reproducibility of food frequency questionnaire was estimated by correlation coefficients, and validity was assessed comparing the second food frequency questionnaire and the average of the 24-hour dietary recalls using cross-classification and Bland–Altman analyses.Results: Pearson and intraclass correlation coefficients showed higher correlation for food groups than for energy and nutrients. More than 65% of the subjects were classified into the same quintile or into the adjacent quintile by both food frequency questionnaires. Bland–Altman plots showed reasonably acceptable agreement between the second food frequency questionnaire and 24-hour dietary recalls, especially for the main Argentinian foods groups (meat, cereal, dairy products, vegetables and fruits).Conclusions: Overall, food frequency questionnaire showed acceptable reproducibility and relative validity for assessment main food groups and nutrient intakes for adult population in Rosario.Introducción: La evaluación del consumo de nutrientes y grupos de alimentos mediante cuestionarios de frecuencia de consumo requiere ser validada en cada población. El objetivo de este estudio transversal fue evaluar la reproductibilidad y la validez relativa de un cuestionario semicuantitativo de frecuencia de consumo en población adulta de Rosario, Argentina.Material y Métodos: Dos cuestionarios de frecuencia de consumo y cuatro recordatorios de 24 horas fueron aplicados en una muestra de 88 adultos. La reproductibilidad del cuestionario de frecuencia de consumo fue estimada mediante el coeficiente de correlación y la validez fue evaluada comparando el segundo cuestionario de frecuencia de consumo y el promedio de los recordatorios de 24 horas mediante clasificación cruzada y análisis de Bland–Altman.Resultados: Los coeficientes de Pearson e intraclase mostraron mayor correlación para los grupos de alimentos que para energía y nutrientes. Más del 65% de los individuos fue clasificado en el mismo quintil o en el adyacente por ambos cuestionarios de frecuencia de consumo. El gráfico de Bland–Altman mostró una razonable concordancia entre el segundo cuestionario de frecuencia de consumo y recordatorios de 24 horas, especialmente para los principales grupos de alimentos de la dieta Argentina (carne, cereales, lácteos, vegetales y frutas).Conclusiones: En general, el cuestionario de frecuencia de consumo presentó una reproductibilidad aceptable y validez relativa para evaluar los principales grupos de alimentos y la ingesta de nutrientes en la población adulta de Rosario

Mental disorders and suicide risk in emerging adulthood: the 1993 Pelotas birth cohort

OBJECTIVE: To assess the prevalence of some mental disorders and suicide risk, and the association between them in youths. METHODS: Data from the 1993 Pelotas Birth Cohort (Brazil) was used. The prevalence of mental disorders at 22 years [major depressive disorder (MDD), generalized anxiety disorder (GAD), social anxiety disorder (SAD), attention-deficit/ hyperactivity disorder (ADHD), bipolar disorders type 1 and 2 (BD1; BD2), post-traumatic stress disorder (PTSD), and antisocial personality disorder (APD)] and of suicide risk were assessed using the Mini International Neuropsychiatric Interview (n = 3,781). Comorbidity between disorders was also assessed. Association of each mental disorder and the number of disorders with suicide risk was assessed using Poisson regression. RESULTS: The prevalence of any mental disorder was 19.1% (95%CI 17.8–20.3), and GAD was the most prevalent (10.4%; 95%CI 9.5–11.4). The prevalence of current suicide risk was 8.8% (95%CI 5.9–9.7). All disorders (except APD) and the suicide risk were higher among women. Mental disorders were associated with a higher suicide risk, with the highest risks being observed for MDD (RR = 5.6; 95%CI 4.1–7.8) and PTSD (RR = 5.0; 95%CI 3.9–6.3). The higher the number of co-occurring mental disorders, the higher the risk of suicide. CONCLUSIONS: Our findings showed that about 20% of the youths had at least one mental disorder. However, this prevalence is underestimated since other relevant mental disorders were not assessed. Mental disorders were associated with higher suicide risk, especially the comorbidity between the

Breastfeeding and behavior disorders among children and adolescents:a systematic review

ABSTRACT OBJECTIVE This systematic review study aimed to assess the evidence available for the association between breastfeeding and behavior disorders in childhood and adolescence. METHODS The search was carried out in the PubMed, Lilacs, and PsycINFO databases up to December 2016. Inclusion criteria were as follows: prospective, retrospective and cross-sectional studies assessing the association between breastfeeding and behavior disorders in childhood or adolescence, using psychometric tests, carried out in humans and published in Portuguese, English, or Spanish. The search was performed in several stages by two independent researchers using pre-established criteria. RESULTS Eighteen studies met the inclusion criteria. Breastfeeding for a period equal to or higher than three or four months seemed to be inversely associated with total behavior and conduct disorders in childhood; however, the association remains unclear for other behavior disorders. Only four studies assessed behavior disorders in adolescence, and when an association was found, it was likely to be positive. The duration of breastfeeding seemed to be more important than the exclusive or non-exclusive pattern of breastfeeding. CONCLUSIONS Breastfed children for at least three to four months had fewer total behavior and conduct disorders in childhood. Further studies are needed to better understand this association, particularly in adolescence and involving other behavioral profiles

Adiposity, depression and anxiety: interrelationship and possible mediators

OBJECTIVES: To explore the association between adiposity, major depressive disorder and generalized anxiety disorder, and to assess the role of inflammation, diet quality and physical activity in this association. METHODS: We used data from 2,977 individuals from the 1993 Pelotas Cohort (Brazil) who attended the 18- and 22-year follow-ups. We assessed general obesity using body mass index, fat mass index, and abdominal obesity using waist circumference. Major Depressive Disorder and generalized anxiety disorder were assessed using the mini-international neuropsychiatric interview. C-reactive protein and interleukin-6 (IL-6) levels were used as a measure of inflammation; diet quality was estimated using the revised diet quality index, and physical activity was assessed by the International physical activity questionnaire (IPAQ, min/day). The association between adiposity and major depressive disorder and generalized anxiety disorder was assessed using logistic regression, and the natural indirect effect via the mediators was estimated using G-computation. RESULTS: General obesity assessed by body mass index (OR: 2.3; 95% CI:1.13; 4.85), fat mass index (OR: 2.6; 95%CI: 1.37; 4.83), and abdominal obesity (OR: 2.5; 95%CI: 1.18; 5.39) were associated with higher odds of major depressive disorder, whereas major depressive disorder was only associated with obesity assessed by body mass index (OR=1.9; 95% CI: 1.09; 3.46). Obesity and generalized anxiety disorder were not associated. C-reactive protein, diet quality and physical activity did not mediate the effect of obesity on major depressive disorder, and C-reactive protein mediated about 25% of the effect of major depressive disorder on adiposity. CONCLUSIONS: Depression, but not generalized anxiety disorder, is associated with adiposity in both directions, with a stronger evidence for the direction obesity-depression. Inflammation explains part of the effect of major depressive disorder on obesity but not the other way around. Further research should explore other mechanisms that could be involved in the association between obesity and depression