ObjectiveTo examine the associations between objectively measured physical activity and sedentary time with pulse wave velocity (PWV) in Brazilian young adults.MethodsCross-sectional analysis with participants of the 1982 Pelotas (Brazil) Birth Cohort who were followed-up from birth to 30 years of age. Overall physical activity (PA) assessed as the average acceleration (mg), time spent in moderate-to-vigorous physical activity (MVPA – min/day) and sedentary time (min/day) were calculated from acceleration data. Carotid-femoral PWV (m/s) was assessed using a portable ultrasound. Systolic and diastolic blood pressure (SBP/DBP), waist circumference (WC) and body mass index (BMI) were analyzed as possible mediators. Multiple linear regression and g-computation formula were used in the analyses.ResultsComplete data were available for 1241 individuals. PWV was significantly lower in the two highest quartiles of overall PA (0.26 m/s) compared with the lowest quartile. Participants in the highest quartile of sedentary time had 0.39 m/s higher PWV (95%CI: 0.20; 0.57) than those in the lowest quartile. Individuals achieving ≥30 min/day in MVPA had lower PWV (β = −0.35; 95%CI: −0.56; −0.14). Mutually adjusted analyses between MVPA and sedentary time and PWV changed the coefficients, although results from sedentary time remained more consistent. WC captured 44% of the association between MVPA and PWV. DBP explained 46% of the association between acceleration and PWV.ConclusionsPhysical activity was inversely related to PWV in young adults, whereas sedentary time was positively associated.Such associations were only partially mediated by WC and DBP.
Early life stunting may have long-term effects on body composition, resulting in obesity-related comorbidities. We tested the hypothesis that individuals stunted in early childhood may be at higher cardiometabolic risk later in adulthood. 1753 men and 1781 women participating in the 1982 Pelotas (Brazil) birth cohort study had measurements of anthropometry, body composition, lipids, glucose, blood pressure, and other cardiometabolic traits at age 30 years. Early stunting was defined as height-for-age Z-score at age 2 years below -2 against the World Health Organization growth standards. Linear regression models were performed controlling for sex, maternal race/ethnicity, family income at birth, and birthweight. Analyses were stratified by sex when p-interaction<0.05. Stunted individuals were shorter (β = -0.71 s.d.; 95% CI: -0.78 to -0.64), had lower BMI (β = -0.14 s.d.; 95%CI: -0.25 to -0.03), fat mass (β = -0.28 s.d.; 95%CI: -0.38 to -0.17), SAFT (β = -0.16 s.d.; 95%CI: -0.26 to -0.06), systolic (β = -0.12 s.d.; 95%CI: -0.21 to -0.02) and diastolic blood pressure (β = -0.11 s.d.; 95%CI: -0.22 to -0.01), and higher VFT/SAFT ratio (β = 0.15 s.d.; 95%CI: 0.06 to 0.24), in comparison with non-stunted individuals. In addition, early stunting was associated with lower fat free mass in both men (β = -0.39 s.d.; 95%CI: -0.47 to -0.31) and women (β = -0.37 s.d.; 95%CI: -0.46 to -0.29) after adjustment for potential confounders. Our results suggest that early stunting has implications on attained height, body composition and blood pressure. The apparent tendency of stunted individuals to accumulate less fat-free mass and subcutaneous fat might predispose them towards increased metabolic risks in later life.
The objective of this study was to estimate the prevalence of aspirin use in primary and secondary prevention of cardiovascular disease. A population-based cross-sectional study was conducted in Pelotas, Rio Grande do Sul State, Brazil, from January to May 2010. The study had two outcomes: 1) aspirin use in primary prevention (individuals > 40 years of age with at least two risk factors: hypertension, diabetes mellitus, and/or hyperlipidemia) and 2) aspirin use in secondary prevention (history of stroke and/or angina/myocardial infarction). The outcomes were analyzed based on demographic, socioeconomic, and lifestyle variables. Prevalence of aspirin use was 24.8% for primary prevention and 34.3% for secondary prevention. In primary prevention, aspirin use was more common in non-whites and older individuals and among those with worse self-rated health. For secondary prevention, aspirin use was more frequent among older and higher-income individuals and former smokers. Prevalence of aspirin use was well below recommended levels for prevention of cardiovascular diseases.
Descrever a frequência de consumo de diferentes tipos de carnes conforme variáveis sociodemográficas e nutricionais, e analisar o consumo, em adolescentes do Sul do Brasil, de dieta rica em gordura conforme os tipos de carne consumidos. MétodosEstudo transversal realizado com adolescentes pertencentes à coorte de nascimentos de 1993, em Pelotas (RS). A frequência de consumo de carnes vermelhas, brancas, vísceras e embutidos foi avaliada por um Questionário de Frequência de Consumo Alimentar, adaptado para este estudo. A ingestão de dieta rica em gordura foi avaliada a partir do instrumento proposto por Block. As variáveis independentes foram sexo, cor da pele, nível socioeconômico, escolaridade materna e estado nutricional. Nas análises estatísticas, foram utilizados testes Qui-quadrado de heterogeneidade e de tendência linear. ResultadosForam avaliados 4.325 adolescentes com idade média de 14,7, DP=0,3 anos, dos quais 51,2% eram do sexo feminino. A frequência de consumo diário de carnes vermelhas foi maior do que a de carnes brancas (43,0%
Objective: To evaluate the adequacy and accuracy of cut-off values currently recommended by the WHO for assessment of cardiovascular risk in southern Brazil. Design: Population-based study aimed at determining the predictive ability of waist circumference for cardiovascular risk based on the use of previous medical diagnosis for hypertension, diabetes mellitus and/or dyslipidaemia. Descriptive analysis was used for the adequacy of current cut-off values of waist circumference, receiver operating characteristic curves were constructed and the most accurate criteria according to the Youden index and points of optimal sensitivity and specificity were identified. Setting: Pelotas, southern Brazil. Subjects: Individuals (n 2112) aged $20 years living in the city were selected by multistage sampling, since these individuals did not report the presence of previous myocardial infarction, angina pectoris or stroke. Results: The cut-off values currently recommended by WHO were more appropriate in men than women, with overestimation of cardiovascular risk in women. The area under the receiver operating characteristic curve showed moderate predictive ability of waist circumference in men (0?74, 95 % CI 0?71, 0?76) and women (0?75, 95 % CI 0?73, 0?77). The method of optimal sensitivity and specificity showed better performance in assessing the accuracy, identifying the values of 95 cm in men and 87 cm in women as the best cut-off values of waist circumference to assess cardiovascular risk. Conclusions: The cut-off values currently recommended for waist circumference are not suitable for women. Longitudinal studies should be conducted to evaluate the consistency of the findings.
BackgroundPulse wave velocity (PWV) is an early marker of arterial stiffness. Low birthweight, infant feeding and childhood nutrition have been associated with cardiovascular disease in adulthood. In this study, we evaluated the association of PWV at 30 years of age with birth condition and childhood nutrition, among participants of the 1982 Pelotas birth cohort.MethodsIn 1982, the hospital births in Pelotas, southern Brazil, were identified just after delivery. Those liveborn infants whose family lived in the urban area of the city were examined and have been prospectively followed. At 30 years of age, we tried to follow the whole cohort and PWV was assessed in 1576 participants.ResultsRelative weight gain from 2 to 4 years was positively associated with PWV. Regarding nutritional status in childhood, PWV was higher among those whose weight-for-age z-score at 4 years was >1 standard deviation above the mean. On the other hand, height gain, birthweight and duration of breastfeeding were not associated with PWV.ConclusionRelative weight gain after 2 years of age is associated with increased PWV, while birthweight and growth in the first two years of life were not associated. These results suggest that the relative increase of weight later in childhood is associated with higher cardiovascular risk.
Background Elevated blood pressure and excess weight are established major risk factors for cardiovascular disease (CVD). Previous studies have suggested that hypertension is a greater cardiovascular hazard among obese compared with lean individuals, but the epidemiological evidence is conflicting. Methods and ResultsThe interaction between systolic blood pressure (SBP) and BMI on fatal or non-fatal coronary heart disease (CHD), ischaemic stroke and hemorrhagic stroke was examined using pooled data from the Asia Pacific Cohort Studies Collaboration. Participants of the study were 419 448 men and women aged >30 years at baseline. BMI was categorised into five groups (12.0e18.4, 18.5e22.9, 23.0e24.9, 25.0e29.9 and 30.0e60.0 kg/m 2 ). Cox proportional hazard models, stratified by sex and study, were used to estimate HRs adjusting for age and smoking status, and the interaction between SBP and BMI was assessed by likelihood ratio test. During 2 619 241 person-years of follow-up, there were 10 877 CVD events (59% in Asia, 34% women, 71% fatal). For all forms of CVD except haemorrhagic stroke, there was evidence of an antagonistic interaction between SBP and BMI such that the risks of subsequent CHD (p¼0.01), ischaemic stroke (p¼0.03) and CVD (p¼0.001) associated with increases in SBP were higher in normal-weight individuals compared with obese individuals. Conclusion Increased SBP is an important determinant of subsequent cardiovascular risk irrespective of body size and, in relative terms, lean individuals were shown to have a poorer prognosis for CHD and ischaemic stroke. Background Alcohol consumption, metabolic factors and oxidative stress have consistently been linked to cancer development. Gamma-glutamyltransferase (GGT) is a biomarker for adverse alcohol consumption and oxidative stress. It is highly related to metabolic factors such as hyperglycaemia, dislipidaemia and obesity. We therefore hypothesise that GGT is associated with cancer incidence at different sites. Methods First visit measurements in 94 628 adult women and 80 224 men screened for metabolic risk factors as part of the Vorarlberg Health Monitoring & Promotion Programme (VHM&PP). During a median follow-up of 13 years, a total of 5136 incident cancers were diagnosed in men and 4665 in women. Sexspecific Cox proportional hazards models, adjusted for age, bodymass index and smoking were performed to estimate HRs and 95% CI per quintiles of GGT. P2-310 GAMMA-GLUTAMYLTRANSFERASE AS
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