Social environment perception and associations with overweight in the city of Porto Alegre, Brazil

Abstract

The prevalence of overweight in Brazilian adults has grown in recent years. There is evidence indicating that environmental factors, especially social characteristics, may be involved in the aetiology of overweight, but few studies have investigated this association adequately. The main objective of this study was to identify residents’ perception of their social environment (social cohesion, security and violence) and assess its relationship with overweight in a central area of Porto Alegre, Brazil. The associations between socioeconomic characteristics and social environment perception were also explored. This cross-sectional study conducted in 2018–19 had 400 participants aged from 20 to 70 years living in low- and high-income areas of the city of Porto Alegre. Participants’ perception of social cohesion, security and violence were evaluated using a validated questionnaire. Participants’ body mass index (BMI) was measured, and those with a BMI ≥25 kg/m2 were considered to be overweight. Unadjusted and adjusted prevalence ratios (PRs) and 95% confidence intervals (95% CIs) were estimated through Poisson regression analysis; level of significance was 5%. The prevalence of overweight in the sample was 68.8% (95% CI 64.0–73.2). Individuals with a more positive social cohesion perception had a higher prevalence of overweight (PR 1.06; 95% CI: 1.00–1.12; p=0.02) than those with a less positive perception. Brown individuals also had a higher prevalence of overweight (PR: 1.08; 95% CI: 1.02–1.15; p=0.03) than those of other skin colour/race. No association was found between overweight and perception of security or violence. Therefore, social cohesion may be an important factor in overweight and the findings highlight the importance of considering social factors, and their perceptions, when planning actions for the prevention and control of overweight in a population.

Direct and indirect associations of experience of racial discrimination, dietary patterns and obesity in adults from southern Brazil

“…The analysis is part of a larger epidemiological study titled ‘Social and Environmental Determinants of Food and Nutrition: An Ecosocial Approach’. This comprehensive study was devised to assess how ecosocial epidemiology can serve as a basis for exploring the social and environmental factors influencing food and nutrition, as well as their associated disparities, within an adult population residing in the central area of a major city in southern Brazil ( 22 , 23 ) . The sample size was initially determined to investigate the relationship between income and obesity.…”

“…The following parameters were adopted for sample size calculation: 95 % confidence level, 80 % statistical power, 1·35 relative risk, unexposed ratio: exposed 1:2, overweight prevalence among the unexposed 43 % and exposed 58 %. A sample of 419 individuals was estimated ( 22 ) . For this specific study, Kline’s recommendation stipulated a minimum of 200 cases for conducting structural equation modeling analysis ( 24 ) .…”

Association between social cohesion and food insecurity among adults in southern Brazil

“…The sample size was calculated considering the objectives of the main study-"Study of the social and environmental determinants of food and nutrition: An ecosocial approach" (20). Thus, the calculations of the sampling powers of each exposure variable were performed a posteriori.…”

“…BFP, Bolsa Família Program; and CPB, Continuing Payment Bene t. Multivariate analysis was performed using Poisson regression with robust variance. *Signi cance at p ≤ 0.05.Variables associated with the outcome and with exposure at a signi cance level lower than 20% (p<0 20). …”

Association between the community food environment and dietary patterns in residents of areas of different socio-economic levels of a southern capital city in Brazil

“…The sample size (n = 400) was calculated for the main objective of the broader study (Social and environmental determinants of food and nutrition: an ecosocial approach) (31) . For the present study, this sample size had the power to identify dietary patterns according to the criteria proposed by Hair et al (32) (five individuals per food item included in the principal component analysis and had 80% statistical power to detect effect https://doi.org/10.1017/S0007114522001969 Published online by Cambridge University Press Accepted manuscript sizes of approximately 0.12 in the prevalence ratios (PRs) for the association between food environment levels (exposure) and high consumption of dietary patterns (outcomes).…”