The objective of this research was to describe health conditions and health services utilization among Brazilian seniors. The study was based on 28,943 adults > 60 years (99.9%) from an overall National Household Survey (PNAD 1998). The results show that prevalence rates for at least one chronic disease (69.0%), hypertension (43.9%), arthritis (37.5%), and inability to feed oneself/bathe/use the toilet (2.0%) are very similar to those observed in other populations. Physician visits and hospitalization patterns are within the variation reported by different countries. The low prevalence rates of older adults who had interrupted activities because of a health problem (13.9%) or had been bedridden (9.5%) in the previous 2 weeks or hospitalized in the previous year (13.6%) show that the vast majority are not subject to these events. Considering that 50% of this population live on less than or equal to one Brazilian monthly minimum wage, expenditures on medications consume approximately one-fourth (23%) of total income for half of the elderly population.
Objective: To evaluate the association of ultra-processed food (UPF) consumption with gains in weight and waist circumference, and incident overweight/obesity, in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) cohort. Design: We applied FFQ at baseline and categorized energy intake by degree of processing using the NOVA classification. Height, weight and waist circumference were measured at baseline and after a mean 3·8-year follow-up. We assessed associations, through Poisson regression with robust variance, of UPF consumption with large weight gain (1·68 kg/year) and large waist gain (2·42 cm/year), both being defined as ≥90th percentile in the cohort, and with incident overweight/obesity. Setting: Brazil. Participants: Civil servants of Brazilian public academic institutions in six cities (n 11 827), aged 35-74 years at baseline (2008)(2009)(2010). Results: UPF provided a mean 24·6 (SD 9·6) % of ingested energy. After adjustment for smoking, physical activity, adiposity and other factors, fourth (>30·8 %) v. first (<17·8 %) quartile of UPF consumption was associated (relative risk (95 % CI)) with 27 and 33 % greater risk of large weight and waist gains (1·27 (1·07, 1·50) and 1·33 (1·12, 1·58)), respectively. Similarly, those in the fourth consumption quartile presented 20 % greater risk (1·20 (1·03, 1·40)) of incident overweight/obesity and 2 % greater risk (1·02; (0·85, 1·21)) of incident obesity. Approximately 15 % of cases of large weight and waist gains and of incident overweight/obesity could be attributed to consumption of >17·8 % of energy as UPF. Conclusions: Greater UPF consumption predicts large gains in overall and central adiposity and may contribute to the inexorable rise in obesity seen worldwide.
Keywords
Ultra-processed food Obesity Weight gain Food handlingThe world has witnessed a progressive, major increase in the burden of obesity over recent decades. Since 1980, the prevalence has doubled in more than seventy out of 195 countries (1) and obesity has become a major problem not only in high-income but also in low-and middleincome countries (2) .
A adolescência é marcada por transformações e exposição a diversas situações e riscos para a saúde. O estudo atual estima a prevalência dos principais fatores de risco e proteção à saúde dos adolescentes entrevistados em 2009 na Pesquisa Nacional de Saúde do Escolar (PeNSE). A PeNSE, parceria do Instituto Brasileiro de Geografia e Estatística (IBGE) com o Ministério da Saúde, usou questionário autoaplicável em palmtop coletando informação de 60.973 estudantes em 1.453 escolas públicas privadas nas 27 capitais. RESULTADOS: consumo de alimentos em cinco dias ou mais na semana: 62,6% comem feijão, apenas 31,5% consomem frutas, 58,3% comem guloseimas e 37% tomam refrigerantes; 43,1% dos alunos são suficientemente ativos fisicamente e 79,5% gastam mais de duas horas diárias em frente à TV. Em relação a tabaco e drogas: 6,3% são fumantes atuais, 71,4% dos alunos disseram já ter experimentado alguma bebida alcoólica. O consumo atual de bebida alcoólica foi de 27% e as drogas ilícitas foram usadas alguma vez na vida em 8,7%. Esses dados geram evidências para orientar a implementação de políticas públicas e realizar ações para minimizar a exposição de fatores de risco dos adolescentes brasileiros.
The influence of socioeconomic circumstances on senior citizens' health is still controversial. We used data from the 1998 Brazilian National Household Survey (PNAD 1998) to examine this influence. A representative sample of the Brazilian population aged > or = 65 years (n = 19,068) were included in the study. The characteristics of those in the lower quintile of per capita household income were compared with those with higher income (< 0.67 vs > or = 0.67 the Brazilian minimum wage). The lower income group presented worse health conditions (self-rated health, inability to perform routine activities due to a health problem, bedridden conditions, and a report of any disease), and worse physical functioning (level of difficulty in performing selected physical activities), and less frequent use of medical and dental services. These results do not confirm observations, in some developed countries, of a lack of association between socioeconomic status and health among the elderly. On the contrary, according to our results, in Brazil even small differences in income are sufficiently sensitive to identify older adults with worse health conditions and limited access to health services.
Results indicate the existence of associations between greater energy contribution from ultra-processed foods and higher BMI and WC, which are independent of total energy intake. These findings corroborate public policies designed to reduce the intake of this type of food.
BackgroundThe MacArthur Scale of Subjective Social Status intend to measure the subjective social status using a numbered stepladder image. This study investigated the reliability of the MacArthur scale in a subsample of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).MethodThree scales were employed using different references: 1) the overall socioeconomic position; 2) the socioeconomic situation of the participant’s closer community; 3) the workplace as a whole. A total of 245 of the ELSA participants from six states were involved. They were interviewed twice by the same person within an interval of seven to fourteen days. The reliability of the scale was assessed with weighted Kappa statistics and intraclass correlation coefficient (ICC), with their respective 95% confidence interval (CI).ResultsKappa values were 0.62(0.58 to 0.64) for the society ladder; 0.58(0.56 to 0.61) for the community-related ladder; and 0.67(0.66 to 0.72) for the work-related ladder. The ICC ranged from 0.75 for the work ladder to 0.64 for the community ladder. These values differed slightly according to the participants’ age, sex and education category.ConclusionThe three ladders showed good stability in the test-retest, except the community ladder that showed moderate stability. Because the social structure in Brazil is rapidly changing, future qualitative and longitudinal studies are needed to confirm and understand the construct underlying the MacArthur Scale in the country.
ABSTRACT:Objective: This study describes the sexual behavior among students who participated in the National Adolescent School-based Health Survey (PeNSE) 2012 and investigates whether social inequalities, the use of psychoactive substances and the dissemination of information on sexual and reproductive health in school are associated with differences in behavior. Methodology: The response variable was the sexual behavior described in three categories (never had sexual intercourse, had protected sexual intercourse, had unprotected sexual intercourse). The explanatory variables were grouped into socio-demographic characteristics, substance use and information on sexual and reproductive health in school. Variables associated with the conduct and unprotected sex were identified through multinomial logistic regression, using "never had sexual intercourse" as a reference. Results: Over nearly a quarter of the adolescents have had sexual intercourse in life, being more frequent among boys. About 25% did not use a condom in the last intercourse. Low maternal education and work increased the chance of risky sexual behavior. Any chance of protected and unprotected sex increased with the number of psychoactive substances used. Among those who don't receive guidance on the prevention of pregnancy in school, the chance to have sexual intercourse increased, with the largest magnitude for unprotected sex (OR = 1.41 and OR = 1.87 ). Conclusion: The information on preventing pregnancy and STD/ AIDS need to be disseminated before the 9 th grade. Social inequalities negatively affect risky sexual behavior. Substance use is strongly associated with unprotected sex. Information on the prevention of pregnancy and STD/AIDS need to be disseminated early.
The objective of this study was to determine the prevalence of (and social-demographic factors associated with) the use of dental services. It was based on a sample of 28,943 adults > 60 years of age from the Brazilian National Household Sample Survey. Socio-demographic characteristics of seniors who had visited a dentist in the last year were compared with those of seniors who had visited a dentist more than one year previously and those who had never been to the dentist. The study showed independent associations between intervals > 1 year in visits to the dentist and such variables as age, residence, years of schooling, and per capita household income. All these variables, in addition to male gender and residence in the rural area, showed independent associations with absence of dental visits during the individual's lifetime. The results indicate a low rate of use of dental services among elderly Brazilians and that regional and socioeconomic differences are important determinants of dental services' use by Brazilian seniors.
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