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.
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) .
Self-reported and measured weight and height information had good agreement and validity. In similar populations, when few resources are available, it is possible to use self-reported data instead of actual measurements.
This study evaluated the reproducibility and relative validity of the Food Frequency Questionnaire (FFQ) used in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Participants (n = 281) completed the FFQ and three food records on two occasions during a 12-month period. Energy and nutrient values from food records were disattenuated and log-transformed. Reproducibility and validity were assessed by the intra-class correlation coefficient (ICC). Agreement between the two methods was evaluated by classification in tertiles. In the evaluation of reproducibility, ICC estimated ranged from 0.55 to 0.83 for protein and vitamin E, respectively. On relative validity, ICC ranged from 0.20 to 0.72 for selenium and calcium, respectively. Exact and adjacent agreement between methods varied from 82.9% for vitamin E to 89% for lipids and calcium (mean 86%). Average disagreement was 13.6%. In conclusion, this FFQ showed satisfactory reliability for all nutrients and reasonable validity, especially for energy, macronutrients, calcium, potassium, and vitamins E and C.
OBJECTIVE: To analyze factors associated with self-reported sickness absenteeism among nursing workers.
METHODS:Cross-sectional study with 1,509 workers from three public hospitals in the city of Rio de Janeiro (Southeastern Brazil) in 2006. Absenteeism was classifi ed in three levels: no day, a few days (1-9 days) and many days (≥ 10 days), based on the answer to a question of the work ability index questionnaire. The logistic regression analysis considered a conceptual model based on distal (socioeconomic status), intermediate I (occupational characteristics), intermediate II (lifestyle characteristics), and proximal (diseases and health conditions) determinants.
RESULTS:The frequencies of sickness absenteeism were 20.3% and 16.6% for a few days and many days, respectively. Those who reported more than one job, musculoskeletal diseases and rated their health as poor or regular had higher odds of absenteeism. Compared to nurses, nursing assistants were less likely to mention a few days, and technicians were more likely to have many days of absence. Higher odds of mentioning many days of absence were observed among public servants, compared to contract workers (OR = 3.12; 95%CI 1.86;5.22), and among married (OR = 1.73; 95%CI 1.14;2.63) and separated, divorced and widowed individuals (OR = 2.06, 95%CI 1.27;3.35), compared to singles.
CONCLUSIONS:Different variables were associated with the two forms of absenteeism, which suggests its multiple and complex determination related to factors from different levels that cannot be exclusively explained by health problems.
Magnesium and copper phyllosilicates, SILMSH (M~Mg, Cu), were synthesized by a sol±gel process from the reaction of these metallic cations and mercaptotrialkoxysilane in aqueous basic solution at 298 K. The inorganic±organic hybrids formed were characterized by elemental analysis, giving 4.88 and 3.68 mmol g 21 of organic groups, with larger thermal stability for the magnesium compound and surface areas of 46.9¡1.8 and 107.0¡3.0 m 2 g 21 for magnesium and copper hybrids, respectively. X-Ray diffraction patterns gave basal peaks associated with an interlayer distance of 1300 pm for SILMgSH due to the presence of the organic radical chain in the structure. However, for the copper hybrid an interplanar distance of 695 pm was obtained. The terminal S±H groups on organic chains in the structure were con®rmed by infrared data, showing a stretching band at 2556 cm 21 for the magnesium hybrid, while this same band was absent in copper phyllosilicate. 29 Si NMR showed the presence of silicon species: R±Si*±(OSi) 3 , R±Si*±(OSi) 2 ±OH and R±Si*±(OSi)±(OH) 2 in the inorganic±organic backbone structure. The ®rst species demonstrated that better polymerization occurred in the SILMgSH hybrid. The amount of copper adsorbed on the magnesium phyllosilicate was 5.93 mmol g 21. The interaction of this cation in the SILMgSH matrix can be related to two processes: rearrangement of inorganic layers around copper cations and formation of interlayer complexes with S±H groups. The nanocomposite containing adsorbed copper has a similar structure to the SILCuSH hybrid, suggesting a new route for these copper compounds. A simple low-temperature procedure was employed to synthesize these reproducible SILMgSH/Cu and SILCuSH hybrids, which are 1 : 1 phyllosilicates.
Our results indicated that skill discretion and decision authority formed two distinct dimensions. Additionally, the item repetitive work should be removed, as well as one of the items work fast or work intense (demands). Future research is still required to confirm these findings.
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