BackgroundBrazil is among the 10 countries with the highest prevalence of overweight in the world. The aim was to analyse the changes in the dispersion of body mass index (BMI) in the Brazilian population from the 1970s to 2013 in specific population groups.MethodsData were extracted from five national household surveys between 1974–1975 and 2013, including adults aged 20 to 64. We calculated SD, median, fifth and 95th percentiles of BMI for each sociodemographic category (sex, age, schooling) and survey year in order to explore whether changes in mean BMI are followed by changes in dispersion.ResultsDuring the period the mean BMI ranged from 22.7 kg/m2 to 26.6 kg/m2, with a much higher variation in the 95th percentile (+6.1 kg/m2) when compared with the fifth percentile (+1.8 kg/m2). The within-group differences increased over time. The SD increased in all categories analysed and was higher among women, lower schooling groups and the oldest group. An increase of 1.0 kg/m2 in the BMI mean was associated with an increase of 0.32 kg/m2 in the SD, 0.45 kg/m2 in the fifth percentile and 1.50 kg/m2 in the 95th percentile of BMI.ConclusionsPopulation changes occurred in BMI are more complex than the simple increase of its average. Concomitant to the increase in BMI, there was an increase in the within-group differences, showing that growing inequalities are not driven solely by sociodemographic factors.

OBJECTIVE To test if the neighborhood socioeconomic status is associated with systolic blood pressure and hypertension in older adults.METHODS A cross-sectional population-based study with a sample of 1,705 older adults from Florianópolis, SC, Southern Brazil. The contextual variable used was the average years of schooling of the head of the household in census tracts. Participants were considered hypertensive when the systolic blood pressure was ≥ 140 mmHg, diastolic ≥ 90 mmHg, or both. Additionally, the use of antihypertensive medication was also considered. Data were analyzed by using multilevel models of logistic and linear regression.RESULTS The average age of the sample was 70.7 years and the average of systolic and diastolic blood pressure was 133.5 mmHg (SD = 20.5 mmHg) and 81.9 mmHg (SD = 12.5 mmHg), respectively. The systolic blood pressure was 4.46 mmHg (95%CI 1.00–7.92) higher and the chance of hypertension was 1.80 (95%CI 1.26–2.57) among those who lived in census tracts with lower level of schooling. When the use of antihypertensive medication was combined with blood pressure levels, none association was found between the outcome and the level of schooling of the census tract.CONCLUSIONS Analytical models more robust (such as multilevel analysis) in Brazil are still little used, with a small number of articles published. Neighborhood socioeconomic status is associated with systolic blood pressure and the chance of hypertension, regardless of individual characteristics.

OBJECTIVE To test whether there is an association between socioeconomic status in childhood and measures of body mass index, waist circumference and the presence of overall and abdominal obesity in adult life.METHODS A cross-sectional analysis of a population-based cohort study, including a sample of adults (22–63 years old) living in Florianópolis, Southern Brazil. The socioeconomic status in childhood was analyzed through the education level of the participant’s parents. Height, weight and waist circumference were measured by previously trained interviewers. Linear and logistic regressions with adjustment for confounding factors and stratification of data according to gender were used.RESULTS Of the 1,222 adults evaluated, 20.4% (95%CI 18.1–22.8) presented overall obesity and 24.8% (95%CI 22.4–27.4), abdominal obesity. The body mass index and waist circumference averages among women were, respectively, 1.2 kg/m2 (95%CI -2.3– -0.04) and 2.8 cm (95%CI -5.3– -0.2) lower among those with higher socioeconomic status in childhood. Among men, waist circumference was 3.9 cm (95%CI 1.0–6.8) higher in individuals with higher socioeconomic status in childhood. Regarding obesity, women of higher socioeconomic status in childhood had lower odds of abdominal obesity (OR = 0.56, 95%CI 0.34–0.90), and no such association was observed among men.CONCLUSIONS The socioeconomic status in childhood influences body mass index, waist circumference and obesity in adults, with a difference in the direction of association according to gender. The higher socioeconomic status among men and the lower socioeconomic status among women were associated with higher adiposity indicators.

Abstract. Introduction: According to the literature, education and income are determinants factors of diet quality and consequently of micronutrient intake. However, this association is still little known among adults who live in middle-income countries. Objective: To estimate energy and micronutrients intake by men and women living in a capital city in southern Brazil, according to education and income levels, and to identify prevalence of inadequate micronutrient intake according also to education and income levels. Method: This is a second wave cross-sectional analysis of a population-based longitudinal study, the EpiFloripa Adultos, including 1,222 individuals of 22–63 years. Data on food consumption were obtained through applying two 24-hour dietary recalls, and the prevalence of inadequate micronutrient intake, following the recommendations of the Institute of Medicine and from the National Research Council. Results: A tendency of increased intake with an increase in income (calcium, vitamins C, E) and education levels (calcium, vitamins A, C, D) was observed for most of the micronutrients analyzed (p<0.05 in all cases); still, a prevalence of inadequacy according to Estimated Average Requirement (EAR) between 85.5–100% in intake of vitamins A, D and E were found for the whole sample. Iron inadequate intake was associated with education level and among women less than 50 years of age (p=0.018). Conclusion: The results showed an influence of the education and income levels on micronutrient intake, point to the need of daily food consumption, of minimally processed and in natura foods (as fruits, vegetables, whole grains, milk and its derivatives) as a means to reduce the encountered inadequacies.

Resumo Objetivo Analisar a associação da presença de acompanhante no pré-natal e parto com a qualidade da assistência recebida por usuárias do Sistema Único de Saúde (SUS). Métodos Estudo transversal com puérperas que realizaram pré-natal e parto pelo SUS em Santa Catarina, Brasil, em 2019, entrevistadas em até 48 horas após o parto. Estimaram-se as razões de prevalências mediante regressão de Poisson. Resultados Entrevistaram-se 3.580 puérperas. No pré-natal, a presença de acompanhante associou-se positivamente ao recebimento de orientações pelos profissionais da saúde (RP=1,27 - IC95% 1,08;1,50) e à construção do plano de parto (RP=1,51 - IC95% 1,15;1,97). No parto, a presença de acompanhante associou-se ao maior recebimento de analgesia (RP=2,89 - IC95% 1,40;5,97), manobra não farmacológica para alívio da dor (RP=1,96 - IC95% 1,44;2,65), escolha da posição para o parto (RP=1,63 - IC95% 1,24;2,16) e menor probabilidade de ser amarrada (RP=0,47 - IC95% 0,35;0,63). Conclusão A presença de acompanhante no pré-natal e parto mostrou-se associada à melhor qualidade da assistência.

The aim of this study was to estimate the association between contextual income and cognitive decline in the elderly in Florianópolis, a medium-sized city in southern Brazil. A nested cross-sectional study was performed in a cohort of elderly ≥ 60 years (n = 1,197), interviewed in the second wave (2013/2014) of the EpiFloripa cohort. Cognitive decline was assessed with the Mini Mental State Examination (MMSE) and contextual income was measured as the mean monthly income of the heads of households. Individual adjustment variables were sex, age, skin color, per capita household income, years of schooling, and time living in the neighborhood. The data were analyzed using multilevel logistic regression. The odds of cognitive decline were twice as high (OR = 1.99; 95%CI: 1.03; 3.87) in elderly living in census tracts with the lowest income quintile compared to those in the highest quintile, independently of individual characteristics. In conclusion, the socioeconomic environment is related to cognitive decline and should be considered in public policies with a focus on health of the elderly.

Our objective was to investigate the relationship between dietary vitamin D intake and serum concentration of vitamin D (25(OH)D) on changes in body weight, waist circumference (WC), and body mass index (BMI), and to determine if this relationship changes between obese and non-obese individuals at baseline and those who have or do not have 25(OH)D deficiency. This was a prospective study with a sample of 572 individuals aged 25–65 years, who were participants in the cohort study EpiFloripa Adults. Changes in weight (in kg), BMI, and WC between 2012 and 2014 were evaluated as outcomes. The main exposure was the dietary intake of vitamin D (2012), and the 25(OH)D serum concentration was secondary. When the analyses were stratified by the presence of obesity in the baseline, among obese individuals it was observed that those in the extreme categories of vitamin D intake had an average gain of 3.0 kg in weight, 0.9 kg/m2 in BMI, and 1.7–2.7 cm in WC. When 25(OH)D serum concentration were incorporated into the analyses, it was observed that non-obese subjects not having 25(OH)D deficiency had a mean reduction of 2.3 cm in WC. In conclusion, the increases in body weight, BMI, and WC were higher over time in obese patients with deficient 25(OH)D serum concentration, regardless of dietary vitamin D intake.

Objective: To evaluate the prevalence of breastfeeding (BF) and the association between occurrence/duration of BF and overweight/obesity in schoolchildren aged 7-14 years. Methods: This is a cross-sectional study, conducted in 2012-2013, on schoolchildren aged 7-14 years from Florianópolis, Santa Catarina, Southern Brazil. Weight and height were measured according to procedures of the World Health Organization. Breastfeeding and sociodemographic data were obtained from a questionnaire responded by parents/guardians. BF was categorized as a dichotomous variable (yes/no) and according to duration (months). Nutritional status was evaluated according to the Z score of the body mass index per age for sex and it was categorized into two groups: normal weight (<Z score+1) and overweight/obesity (≥Z score+1). The adjusted analysis was performed by logistic regression in two age strata (age groups of 7-10 and 11-14 years). Results: 6.6% of schoolchildren had never breastfed; 16.8% had been breastfed for ≤3 months; 16.7%, for 4-6 months; and 59.9%, for ≥7 months. No statistically significant differences were found in the occurrence and duration of BF between the age groups. The prevalence of overweight/obesity was 34.2%. For age groups (7-10 and 11-14 years), the prevalence of overweight/obesity was 36.7% and 29.8%, respectively. Chance of overweight/obesity for the age group of 7-10 years was lower among schoolchildren who were breastfed (OR=0.54; 95%CI 0.33-0.88), when compared with those who never breastfed. When categorized, the chance of overweight/obesity in the age group of 7-10 years was lower for duration of BF ≤3 months (OR=0.41; 95%CI 0.20-0.83), and 4-6 months (OR=0.48; 95%CI 0.28-0.82) when compared with children who never breastfed. Conclusions: BF for at least six months was associated with a lower chance of overweight/obesity for schoolchildren aged 7-10 years. No association was found for schoolchildren aged 11-14 years.