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The objectives of this study were to assess the nutritional status of rural workers from a municipality in Southeastern Brazil and estimate the association of sociodemographic, labor, lifestyle, and dietary pattern factors with obesity and abdominal obesity of men and women of this rural area. This is a cross-sectional, epidemiological study of 740 farmers (51.5%, n = 381 males; 48.5%, n = 359 females). The sociodemographic, labor, lifestyle and dietary patterns determinants were assessed. Food intake data were obtained by applying three 24-hour recalls and dietary patterns were determined by Principal Component Analysis with Varimax orthogonal rotation. Poisson regression with robust variance stratified by sex was applied. The general prevalence of overweight status was 31.5% (95% CI 28.2-34.8%), 19.7% of obesity (95% CI 16.8-22.6%) and 31.5% of abdominal obesity (95% CI 28.2-34.8%), with higher rates in women (P < 0.001). Men of higher socioeconomic class had a 2.3 times higher prevalence of obesity (95% CI 1.08-4.90). In addition, the shorter travel time to purchase food increased the prevalence of abdominal obesity in males. For women, the older the age group, the greater the general and central obesity. A lower adherence to traditional dietary patterns (approximately PR [prevalence ratio] 1.6 for general obesity and PR 1.3 for abdominal obesity) and a greater number of places to buy food were associated with higher rates of obesity in women. Finally, women farmers with a higher workload had a 20% lower prevalence of central obesity (PR 0.80; 95% CI 0.65-0.97). Such findings demonstrate that obesity must be an issue in the health care of remote and rural populations. There is a need to promote healthier environments that respect traditional food culture through multiple approaches that consider the heterogeneity of rural areas and the differences between sexes.

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We estimated the caloric contribution of minimally processed foods, processed culinary ingredients, processed foods and ultra-processed foods in Brazilian farmers' diets and their association with the nutritional profile of the diet. It is an epidemiological study of cross-sectional, analytical and quantitative design with 740 farmers adults of Southeastern Brazil. Food intake data were obtained by applying three 24-hour recalls and were classified according to the degree and purpose of processing. The largest caloric contribution came from the group of minimally processed foods (64.7%), followed by ultra-processed foods (17.7%), processed culinary ingredients (12.4%), and processed foods (5.2%). Individuals in the fourth quartile of caloric contribution from minimally processed foods showed lower energy consumption (ß -0.16, P<0.001) and greater consumption of all 15 micronutrients analyzed. In contrast to what was identified for this food group, the higher caloric contribution from ultra-processed foods was associated with a greater caloric content of the diet (ß 0.17, P<0.001) and lower consumption of all 23 analyzed nutrients. Therefore, the caloric contribution from the consumption of ultra-processed foods in the rural area is still lower than the national average. However, measures aimed at delaying isocaloric exchanges for the group of ultra-processed foods must be carried out, maintaining the local food culture, since this group had worse nutritional levels. In addition, incentives to the greater consumption of minimally processed foods should be carried out, due to their nutritional quality.

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We sought (i) to evaluate the associations of cardiorespiratory fitness (CRF), muscular fitness (MF) and Southern European Atlantic Diet (SEADiet) with atherogenic index of plasma (AIP) and (ii) to investigate de combined association of MF, CRF and SEADiet on AIP in adolescents. A cross-sectional school-based study was conducted on 493 adolescents (285 girls and 208 boys) aged 15-18 years, from the Portuguese Azorean Archipelago. CRF was measured by shuttle run test and MF by curl up and push up tests. Adherence to SEADiet was assessed with a semi-quantitative food frequency questionnaire (FFQ). The AIP was estimated as log (TG/HDL-C). Measures of pubertal stage and socioeconomic status were assessed. Linear regression showed a significant inverse association between MF (standardized ß = -0.165; p < 0.001), CRF (standardized ß = -0.081; p < 0.030) and SEADiet (standardized ß = -0.081; p < 0.045) with AIP, after adjustments for age, sex, pubertal stage and parental education. Furthermore, participants classified with an optimal as well as those with low adherence to a SEADiet but with LowMF/LowCRF had on average the highest AIP (F(7.482) = 3.270; p = 0.002). Moreover, optimal SEADiet with HighMF/HighCRF group showed the lowest AIP when compared with those with low adherence to a SEADiet with HighMF/HighCRF group (p = 0.03). AIP is inversely associated with MF, CRF and SEADiet. The low MF combined with a low CRF levels seems to overcome the potential healthy effect of having an optimal adherence to the SEADiet on AIP. However, an optimal adherence to SEADiet seems to improve the AIP in those adolescents with high fitness levels.

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Abstract: We sought (i) to evaluate the associations of cardiorespiratory fitness (CRF), muscular fitness (MF) and Southern European Atlantic Diet (SEADiet) with atherogenic index of plasma (AIP) and (ii) to investigate de combined association of MF, CRF and SEADiet on AIP in adolescents. A cross-sectional school-based study was conducted on 493 adolescents (285 girls and 208 boys) aged 15-18 years, from the Portuguese Azorean Archipelago. CRF was measured by shuttle run test and MF by curl up and push up tests. Adherence to SEADiet was assessed with a semi-quantitative food frequency questionnaire (FFQ). The AIP was estimated as log (TG/HDL-C). Measures of pubertal stage and socioeconomic status were assessed. Linear regression showed a significant inverse association between MF (standardized β = -0.165; p < 0.001), CRF (standardized β = -0.081; p < 0.030) and SEADiet (standardized β = -0.081; p < 0.045) with AIP, after adjustments for age, sex, pubertal stage and parental education. Furthermore, participants classified with an optimal as well as those with low adherence to a SEADiet but with LowMF/LowCRF had on average the highest AIP (F(7.482) = 3.270; p = 0.002). Moreover, optimal SEADiet with HighMF/HighCRF group showed the lowest AIP when compared with those with low adherence to a SEADiet with HighMF/HighCRF group (p = 0.03). AIP is inversely associated with MF, CRF and SEADiet. The low MF combined with a low CRF levels seems to overcome the potential healthy effect of having an optimal adherence to the SEADiet on AIP. However, an optimal adherence to SEADiet seems to improve the AIP in those adolescents with high fitness levels.

Resumo: O estudo teve como objetivos: (i) avaliar as associações entre a aptidão cardiorrespiratória (ACR), aptidão muscular (AM) e Dieta Atlântica do Sul da Europa (SEADiet) e o índice aterogênico do plasma (IAP) e (ii) investigar a associação combinada entre AM, ACR e SEADiet e IAP em adolescentes. Foi realizado um estudo transversal de base escolar em uma amostra de 493 adolescentes (285 do sexo feminino), entre 15 e 18 anos de idade, nos Arquipélago dos Açores, Portugal. A ACR foi medida pelo teste aeróbico de corrida de vai-e-vem e a AM pelos testes de abdominal modificado e de flexão. A adesão ao SEADiet foi avaliada através de um questionário semi-quantitativo de frequência alimentar. O IAP foi calculado como log(TG/HDL-C). Foram avaliadas as medidas de estágio de puberdade e de nível socioeconômico. A regressão linear revelou uma associação inversa significativa entre AM (β padronizado = -0,165; p < 0,001), ACR (β padronizado = -0,081; p < 0,030) e SEADiet (β padronizado = -0,081; p < 0,045) e IAP, depois de ajustar para idade, sexo, estágio de puberdade e escolaridade dos pais. Além disso, os participantes classificados como adesão excelente ou baixa ao padrão alimentar SEADiet mas com BaixaAM/BaixaACR, tiveram, em média, os maiores níveis de IAP (F(7,482) = 3,270; p = 0,002). O grupo com adesão excelente ao SEADiet e AltaAM/AltaACR mostrou IAP mais baixo, comparado com o grupo com baixa adesão ao padrão alimentar SEADiet e AltaAM/AltaACR (p = 0,03). O IAP está associado inversamente com AM, ACR e SEADiet. Os níveis baixos de AM e ACR parecem contrabalançar o efeito saudável potencial da adesão excelente ao padrão alimentar SEADiet sobre o IAP. Entretanto, a adesão excelente ao SEADiet parece melhorar o IAP nos adolescentes com níveis altos de aptidão física.

Resumen: Nuestro objetivo (i) fue evaluar las asociaciones de las condiciones cardiorrespiratorias (CRF), musculares (MF) y de la Dieta Atlántica del Sur de Europa (SEADiet), con el índice aterogénico de plasma (AIP), así como (ii) investigar la asociación combinada de MF, CRF y SEADiet en el AIP en adolescentes. Se trata de un estudio transversal, basado escolares, que se dirigió a 493 adolescentes (285 niñas), con edades comprendidas entre los 15 a 18 años, procedentes del archipiélago portugués de las Azores. Las CRF se midieron mediante una prueba de sprint y las MF mediante pruebas con flexiones y abdominales. La adherencia a la SEADiet se evaluó con un cuestionario semicuantitativo sobre la frecuencia de las comidas. El AIP se calculó como log (TG/HDL-C). Se evaluaron las medidas de la fase puberal y el estatus socioeconómico. La regresión lineal mostró una asociación significativa inversa entre MF (β estandarizado = -0,165; p < 0,001), CRF (β estandarizado = -0,081; p < 0,030) y SEADiet (β estandarizado = -0,081; p < 0,045) con el AIP, tras los ajustes por edad, sexo, fase puberal y educación parental. Asimismo, los participantes clasificados con una adherencia muy buena, así como los que tuvieron una baja adherencia a la SEADiet, pero con BajasMF/BajasCRF contaron con el promedio más alto en el AIP (F(7.482) = 3.270; p = 0,002). Además, el grupo con una muy buena SEADiet con AltasMF/AltasCRF mostró el más bajo AIP, cuando se compara con el grupo que tenía una baja adherencia a la SEADiet con AltasMF/AltasCRF (p = 0.03). El AIP está inversamente asociado con MF, CRF y SEADiet. La baja MF, combinada con los niveles bajos de CRF, parece superar el efecto potencial saludable de contar con una muy buena adherencia a la SEADiet en el AIP. No obstante, una muy buena adherencia a la SEADiet parece mejorar el AIP en aquellos adolescentes con altos niveles de condición física.

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OBJECTIVES: To examine the association between cardiorespiratory fitness and cardiovascular indices 2 years later, and to determine whether changes in cardiorespiratory fitness are associated with cardiovascular indices at a 2-year follow-up in adolescents. STUDY DESIGN: The sample comprised 734 adolescents (349 girls) aged 12-18 years followed for 3 years from the LabMed Physical Activity Study. Cardiorespiratory fitness was assessed by the 20-meter shuttle run test. Height, weight, waist circumference, and resting blood pressure (BP) were measured according to standard procedures. RESULTS: Regression analyses showed a significant inverse association between cardiorespiratory fitness at baseline and systolic BP (B = -0.126; P = .047) and rate pressure product (B = -29.94; P = .016), at follow-up after adjustments for age, sex, height, pubertal stage, socioeconomic status, and waist circumference. Significant differences were found between cardiorespiratory fitness groups (fit vs unfit) at baseline and systolic BP and rate pressure product at follow-up (P < .05 for all). Analysis of covariance showed a significant association between cardiorespiratory fitness changes and systolic BP (P = .024) and rate pressure product (P = .014), after adjustment for age, sex, height, pubertal status, socioeconomic status, and waist circumference. CONCLUSIONS: Changes in cardiorespiratory fitness during adolescence were associated with cardiovascular indices over a 2-year period. Adolescents with persistently low levels of cardiorespiratory fitness exhibited the highest levels of systolic BP and rate pressure product.

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ABSTRACT BACKGROUND AND OBJECTIVES: Fear of movement and re/injury (kinesiophobia) is factor associated to chronic pain and incapacity. Since elderly population is highly affected by chronic health problems followed by pain, especially musculoskeletal problems, it is important to understand the impact of pain-related fear on elderly females' health. This study aimed at determining the incidence of kinesiophobia in elderly females assisted in a geriatrics and gerontology ambulatory, as well as at investigating possible correlations with physical performance and other health and socio-demographic variables. METHODS: This is a crossover exploratory study with nonprobabilistic convenience sample of 30 elderly females, carried out with interviews, physical tests and medical charts review. Patients were evaluated for the presence of kinesiophobia, physical performance and other variables related to chronic musculoskeletal pain, in addition to socio-demographic information. RESULTS: There has been kinesiophobia in 80% of the sample. There has been significant moderate correlation between physical performance and kinesiophobia (r=541; p=0.002). No other correlations were found. CONCLUSION: Data have shown high incidence of kinesiophobia among evaluated elderly females, in addition to physical performance impairment associated to it.

RESUMO JUSTIFICATIVA E OBJETIVOS: O medo de movimento e reincidência de lesão (cinesiofobia) é um fator associado à dor crônica e incapacidade. Visto que a população idosa é altamente atingida por problemas crônicos de saúde acompanhados por dor, especialmente musculoesqueléticos, faz-se relevante a compreensão dos impactos do medo relacionado à dor sobre a saúde das idosas. O objetivo deste estudo foi determinar a ocorrência de cinesiofobia em idosas atendidas em um ambulatório geriátrico e gerontológico, bem como investigar possíveis correlações com desempenho físico e outras variáveis de saúde e sócio-demográficas. MÉTODOS: Estudo transversal exploratório com amostra por conveniência não probabilística de 30 idosas, realizado por meio de entrevista, teste físico e revisão de prontuário. Foram avaliadas quanto à presença de cinesiofobia, ao desempenho físico e a outras variáveis relacionadas à saúde e à dor crônica musculoesquelética, além de informações sócio-demográficas. RESULTADOS: A amostra estudada revelou ocorrência de cinesiofobia de 80%. Houve correlação significativa moderada entre desempenho físico e cinesiofobia (r=541; p=0,002). Não foram encontradas demais correlações. CONCLUSÃO: Os dados revelam alta ocorrência de cinesiofobia nas idosas avaliadas e comprometimento do desempenho físico associado à mesma.

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OBJECTIVE: To examine the combined effects of physical activity and weight status on blood pressure (BP) in preschool-aged children. STUDY DESIGN: The sample included 733 preschool-aged children (49% female). Physical activity was objectively assessed on 7 consecutive days by accelerometry. Children were categorized as sufficiently active if they met the recommendation of at least 60 minutes daily of moderate-to-vigorous physical activity (MVPA). Body mass index was used to categorize children as nonoverweight or overweight/obese, according to the International Obesity Task Force benchmarks. BP was measured using an automated BP monitor and categorized as elevated or normal using BP percentile-based cut-points for age, sex, and height. RESULTS: The prevalence of elevated systolic BP (SBP) and diastolic BP was 7.7% and 3.0%, respectively. The prevalence of overweight/obese was 32%, and about 15% of children did not accomplish the recommended 60 minutes of daily MVPA. After controlling for age and sex, overweight/obese children who did not meet the daily MVPA recommendation were 3 times more likely (OR 3.8; CI 1.6-8.6) to have elevated SBP than nonoverweight children who met the daily MVPA recommendation. CONCLUSIONS: Overweight or obese preschool-aged children with insufficient levels of MVPA are at significantly greater risk for elevated SBP than their nonoverweight and sufficiently active counterparts.

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BACKGROUND: Latent tuberculosis infection (LTBI) is a reservoir for new TB cases. Isoniazid preventive therapy (IPT) reduces the risk of active TB by as much as 90%, but LTBI screening has limitations. Unlike tuberculin skin testing (TST), interferon-gamma release assays are not affected by BCG vaccination, and have been reported to be cost-effective in low-burden countries. The goal of this study was to perform a cost-effectiveness analysis from the health system perspective, comparing three strategies for LTBI diagnosis in TB contacts: tuberculin skin testing (TST), QuantiFERON®-TB Gold-in-Tube (QFT-GIT) and TST confirmed by QFT-GIT if positive (TST/QFT-GIT) in Brazil, a middle-income, high-burden country with universal BCG coverage. METHODOLOGY/PRINCIPAL FINDINGS: Costs for LTBI diagnosis and treatment of a hypothetical cohort of 1,000 adult immunocompetent close contacts were considered. The effectiveness measure employed was the number of averted TB cases in two years. Health system costs were US$ 105,096 for TST, US$ 121,054 for QFT-GIT and US$ 101,948 for TST/QFT-GIT; these strategies averted 6.56, 6.63 and 4.59 TB cases, respectively. The most cost-effective strategy was TST (US$ 16,021/averted case). The incremental cost-effectiveness ratio was US$ 227,977/averted TB case for QFT-GIT. TST/QFT-GIT was dominated. CONCLUSIONS: Unlike previous studies, TST was the most cost-effective strategy for averting new TB cases in the short term. QFT-GIT would be more cost-effective if its costs could be reduced to US$ 26.95, considering a TST specificity of 59% and US$ 18 considering a more realistic TST specificity of 80%. Nevertheless, with TST, 207.4 additional people per 1,000 will be prescribed IPT compared with QFT.

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Este trabalho tem como objetivo investigar a percepção das mães a respeito do cuidado paterno em famílias em situação de risco psicossocial, comparando famílias que mantêm seus filhos na creche e famílias cujas crianças aguardam por vaga. Foram realizadas entrevistas com 30 famílias, gravadas em audiocassete e transcritas, as quais continham dados de identificação e questões abertas referentes à família e ao cuidado. Nas entrevistas, as questões abertas foram analisadas segundo o método de análise de conteúdo temático. Para as perguntas fechadas pontuou-se a freqüência de ocorrência de respostas, com o objetivo de caracterizar os elementos específicos da participação do pai. As mães descreveram as atividades que seus companheiros realizavam com os filhos (sair, brincar, conversar e cantar), mas nem todas consideram-nas como atividades de cuidado. Constatou-se que o pai aproveita diferentemente da mãe o tempo que passa com as crianças(AU)

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Este trabalho tem como objetivo investigar a percepção das mães a respeito do cuidado paterno em famílias em situação de risco psicossocial, comparando famílias que mantêm seus filhos na creche e famílias cujas crianças aguardam por vaga. Foram realizadas entrevistas com 30 famílias, gravadas em audiocassete e transcritas, as quais continham dados de identificação e questões abertas referentes à família e ao cuidado. Nas entrevistas, as questões abertas foram analisadas segundo o método de análise de conteúdo temático. Para as perguntas fechadas pontuou-se a freqüência de ocorrência de respostas, com o objetivo de caracterizar os elementos específicos da participação do pai. As mães descreveram as atividades que seus companheiros realizavam com os filhos (sair, brincar, conversar e cantar), mas nem todas consideram-nas como atividades de cuidado. Constatou-se que o pai aproveita diferentemente da mãe o tempo que passa com as crianças.

The aim of this study is to investigate some mothers perception regarding paternal care in families who live in psychosocial risk situations. A comparison among families whose children attend day nursery institutions and families whose children are on wait lists is carried out. Interviews, including identification data and open questions about the families and their care, were applied to 30 families and, then, taped and transcribed. The open questions were analyzed according to the content analysis method. Considering the closed questions, the frequency of answers occurred was analyzed in order to characterize the specific elements of the fathers participation. Mothers described the activities their partners use to share with the children, such as going out, playing, talking and singing, however, not all of them were considered as care activities. It was observed that fathers spend their time with the children differently from mothers.

Este trabajo posee como objetivo investigar la percepción de las madres respecto al cuidado paterno en familias en situación de riesgo psicosocial, comparando familias que mantienen sus hijos en la guardería y familias cuyos niños aguardan una vacante. Se realizaron entrevistas a 30 familias, grabadas en cinta casete y transcritas, las cuales contenían datos de identificación y cuestiones de respuesta libre referentes a la familia y al cuidado. En las entrevistas, las cuestiones de respuesta libre fueron analizadas según el método de análisis de contenido temático. Para las preguntas cerradas tipo"test" se puntuó la frecuencia de ocurrencia de respuestas, con el objetivo de caracterizar los elementos específicos de la participación del padre. Las madres describieron las actividades que sus compañeros realizaban con los hijos (salir, jugar, charlar y cantar), pero ni todas las consideran como actividades de cuidado. Se constató que el padre aprovecha diferentemente de la madre el tiempo que pasa con los niños.

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