OBJECTIVE Evaluate the prevalence and the factors associated with the occurrence of falls among older adults.METHODS A cross-sectional study with a representative sample of 1,451 elderly residents in the urban area of Pelotas, RS, in 2014. A descriptive analysis of the data was performed and the prevalence of falls in the last year was presented. The analysis of demographic, socioeconomic, behavioral and health factors associated with the outcome was performed using Poisson regression with adjustment for robust variance according to the hierarchical model. The variables were adjusted to each other within each level and for the higher level. Those with p ≤ 0.20 were maintained in the model for confounding control and those with p < 0.05 were considered to be associated with the outcome.RESULTS The prevalence of falls among older adults in the last year was 28.1% (95%CI 25.9–30.5), and most occurred in the person’s own residence. Among the older adults who fell, 51.5% (95%CI 46.6–56.4) had a single fall and 12.1% (95%CI 8.9–15.3) had a fracture as a consequence, usually in the lower limbs. The prevalence of falls was higher in women, adults of advanced age, with lower income and schooling level, with functional incapacity for instrumental activities, and patients with diseases such as diabetes, heart disease, and arthritis.CONCLUSIONS The occurrence of falls reached almost a third of the older adults, and the prevalence was higher in specific segments of the population in question. About 12% of the older adults who fell fractured some bone. The factors associated with the occurrence of falls identified in this study may guide measures aimed at prevention in the older adult population.

Background Brazil has made substantial improvements in the duration of breastfeeding. We use data from four population-based cohorts to examine how trends and inequalities in breastfeeding indicators changed over time in a Brazilian city. Methods Data from four birth cohorts, each including all births in a calendar year (1982, 1993, 2004 and 2015) in the city of Pelotas were used. Information on breastfeeding was collected when children were aged between 3 and 20 months. The prevalences of continued breastfeeding at 1 year of age and of exclusive breastfeeding at 3 months were calculated according to family income, maternal skin colour and sex. Results Prevalence of breastfeeding at 12 months increased from 16% to 41% in the 33-year period. The prevalence of exclusive breastfeeding at 3 months increased from 7% in 1993 to 45% in 2015. Increases in exclusive breastfeeding at 3 months were seen in all socioeconomic groups, but the 2015 rates remain highest (57.2%) among the women in the richest quintile, and lowest among those in the poorest quintile (34.6%). Black mothers were more likely to breastfeed at 12 months than Whites in the four cohorts. In the earlier cohorts, breastfeeding at 12 months was more common among the poor, but by 2015 these differences had disappeared. Conclusions There were important positive changes in breastfeeding practices during this period, but less than half of the children in 2015 were receiving the full benefits of breast milk. Improved breastfeeding practices are being adopted by high-income women to a greater extent than by poor women.

RESUMO: Objetivo: Avaliar a tendência de mortalidade materna no Brasil e nas cinco regiões brasileiras, de 2001 a 2012, e descrever suas principais causas. Métodos: Trata-se de uma série temporal, a partir de dados obtidos no Sistema de Informação sobre Mortalidade e no Sistema de Informação sobre Nascidos Vivos. A razão de mortalidade materna e as causas de morte materna foram descritas conforme as categorias da 10ª revisão da Classificação Internacional de Doenças, nos anos de 2001, 2006 e 2011. Para estimar a tendência temporal foi utilizada a regressão linear. Resultados: A razão de mortalidade materna mais elevada no Brasil foi no ano de 2009 (77,31 por 100 mil nascidos vivos). Foi observada tendência significativa de diminuição da razão de mortalidade materna para as regiões Nordeste e Sul e de aumento na região Centro-Oeste. Houve incremento nas mortes por outras afecções obstétricas e uma queda nas mortes por edema, proteinúria e transtornos hipertensivos. Conclusão: Embora tenham sido observadas tendências de diminuição da razão de mortalidade materna para o Nordeste e o Sul, as elevadas taxas observadas para o Brasil evidenciam a necessidade de melhoria à assistência pré-natal, ao parto e ao puerpério.

functional disability was associated to individuals older than 80, with less schooling years and affected by multiple morbidities.

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This study assessed the association of breastfeeding with body composition at 30 years, among subjects who have been prospectively followed since birth in a southern Brazilian city. We also evaluated whether breastfeeding moderated the association between the rs9939609 variant in the FTO gene and adiposity. At 30 years, total and predominant breastfeeding were positively associated with lean mass index and inversely with visceral fat thickness. Among subjects breastfed for <1 month, all outcomes showed monotonically increasing values with additional copies of the A allele in the FTO genotype (rs9939609). Associations among subjects breastfed for one month or longer tended to be in the same direction but showed lower magnitude and were less consistent; for all outcomes. Interactions had p values ≤ 0.05 for body mass index, fat mass index and waist circumference. Even among young adults, breastfeeding moderates the association between the FTO variant rs9939609 and body composition.

ResumoEste trabalho analisou a prevalência de excesso de peso e obesidade na adolescência e idade adulta em indivíduos pertencentes a coorte de nascimentos de 1982, da

Background Pre-pregnancy nutritional status and weight gain during pregnancy have short- and long-term consequences for the health of women and children. This study was aimed at evaluating maternal height,- and overweight or obesity at the beginning of the pregnancy and gestational weight gain, according to socioeconomic status and maternal skin colour of mothers in Pelotas, a southern Brazilian city, in 1982, 1993, 2004 and 2015. Methods In 1982, 1993, 2004 and 2015, the maternity hospitals in Pelotas were visited daily, all deliveries were identified and mothers who lived in the urban area of the city were interviewed. Maternal weight at the beginning of the pregnancy was self-reported by the mother or obtained from the antenatal card. Maternal height was collected from the maternity records or measured by the research team. Overweight or obesity was defined by a body mass index ≥25 kg/m2. Gestational weight gain was evaluated according to the Institute of Medicine guidelines. Results In the four cohorts, we evaluated 19 931 women. From 1982 to 2015, the prevalence of overweight or obesity at the beginning of the pregnancy increased from 22.1% to 47.0% and height increased by an average of 5.2 cm, whereas gestational weight gain did not change. Socioeconomic status was positively associated with maternal height, and the difference between the poorest and the wealthiest decreased. Overweight or obesity was lower among those mothers in the extreme categories of family income. Conclusions Over the 33-year span, mothers were taller at the beginning of the pregnancy, but the prevalence of overweight or obesity more than doubled.