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The practice of leisure time physical activity brings several health benefits, such as the prevention of noncommunicable diseases. Investigating the temporal trend of physical activity practice in older adults by sociodemographic characteristics and geographical regions could be important to plan public health policies and effective interventions. This is a time series study that analyzes the temporal trend of leisure time physical activity among Brazilian older adults with data from 2009 to 2020. For this, we used a sample of 186,097 older adults (≥ 60 years old) obtained from the Risk and Protective Factors Surveillance System for Chronic Noncomunicable Diseases Through Telephone Interview (Vigitel) (2009-2020). Information on leisure time physical activity and sociodemographic and health characteristics were collected. Prais-Winsten regression was used to identify significant trends in the annual variation of the leisure time physical activity indicators. Practice of ≥ 150 minutes/week of moderate intensity leisure time physical activity varied from 23.3% to 27.5% (0.41p.p./year) (2009-2020), with a higher increase during 2015-2020 (0.59p.p./year). The increase in the most recent period occurred among men, aged from 60 to 69 years, with lower educational level, residing in the Northeast Region, and without self-reported chronic diseases. These results may contribute to the evaluation of Brazilian health policies targeting the leisure time physical activity practice in older adults.

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This cross-sectional study aimed to evaluate the health characteristics and behaviors associated with depression in a large probabilistic sample of Brazilian reproductive-aged women. A total of 11,698 non-pregnant women aged 18-49 years old from the 26 Brazilian capitals and Federal District were interviewed by landline between 2020 and 2021. Logistic regression models were used to estimate the Odds Ratio (OR) of health characteristics and behaviors (smoking, alcohol abuse, physical activity, regular intake of fruits and vegetables, overweight, obesity and poor self-rated health) according to the presence of depression and drug treatment for depression. Medical diagnosis of depression, and other health characteristics and behaviors were self-reported. Analyses were adjusted by age, race/skin color, education, and marital status. Prevalence of self-reported depression was 13.3% and drug treatment for depression was reported by 5.3% of the total studied population. The presence of self-reported depression was associated with smoking (adjusted OR - aOR 2.15; CI95%:1.44-3.20), regular intake of fruits and vegetables (aOR 0.75; CI95%:0.59-0.95), overweight (aOR 1.38; CI95%:1.10-1.71), obesity (aOR 1.34; CI95%:1.04-1.71) and poor self-rated health (aOR 4.34; CI95%:3.04-6.21). Drug treatment for depression was associated with smoking (aOR 2.29; CI95%:1.33-3.95), overweight (aOR 1.65; CI95%:1.18-2.30) and poor self-rated health (aOR 4.20; CI95%:2.59-6.83). Self-reported depression and drug treatment for depression were associated with unfavorable health characteristics and behaviors among reproductive-aged women in Brazil.

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INTRODUCTION: Individuals can accumulate multiple risk factors for noncommunicable diseases, increasing the chance of adverse health outcomes. We aimed to analyze the temporal trend in the coexistence of risk behaviors for noncommunicable diseases and their association with sociodemographic characteristics among adults in Brazil from 2009 through 2019. METHODS: This cross-sectional study and time-series analysis was based on data collected by the Surveillance System for Risk Factors and Protection for Chronic Diseases by Telephone Survey (Vigitel) from 2009 through 2019 (N = 567,336). We used item response theory to identify the coexistence of risk behaviors (infrequent consumption of fruits and vegetables, regular consumption of sugar-sweetened beverages, smoking, abusive alcohol consumption, insufficient leisure-time physical activity). We used Poisson regression models to assess the temporal trend in the prevalence of the coexistence of noncommunicable disease-related risk behaviors and associated sociodemographic characteristics. RESULTS: Risk behaviors that most contributed to the occurrence of coexistence were smoking, consumption of sugar-sweetened beverages, and alcohol abuse. Coexistence was more frequent among men and was inversely associated with age and education level. During the study period, we found a significant decrease in coexistence (adjusted prevalence ratio decreased from 0.99 in 2012 to 0.94 in 2019; P = .001), especially before 2015 (adjusted prevalence ratio = 0.94; P = .001). CONCLUSION: We found a reduction in the frequency of the coexistence of noncommunicable disease-related risk behaviors and their association with sociodemographic characteristics. It is necessary to implement effective actions to reduce risk behaviors, especially behaviors that lead to a greater coexistence of those behaviors.

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PURPOSE: To analyze the temporal trend of leisure screen time among adults in Brazil between 2016 and 2021. DESIGN: Time-series analysis of six cross-sectional surveys. SETTING: Data from the Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey (Vigitel) (2016/21). SUBJECTS: A probabilistic sample of 265 252 adults (≥18 years). MEASURES: Time watching television (TV), or using cell phone, computer, or tablet (CCT) during leisure time, and indicators of prolonged exposure for the total population and sociodemographic groups. ANALYSIS: Prais-Winsten regression models were used to identify trends in the studied period. RESULTS: Mean time watching TV remained stable (2.3 h to 2.2 h/day) as the frequency of adults watching TV ≥ 3 hours/day (25.7% to 25.1%) for 2016/21. There was an increase in mean time spent on CCT (1.7 h to 2.0 h/day; .08 h/day/year; P < .001) and in the frequency of adults spending ≥ 3 hours/day on CCT (19.9% to 25.5%; 1.33 pp/year; P < .001) for 2016/21. The increase in screen time was relevant in all sociodemographic groups. CONCLUSION: Leisure screen time has increased in Brazil, with greater intensity over time.

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OBJECTIVE: Randomized double-blind placebo-controlled trial was conducted with sixty pregnant women to evaluate the effect of antenatal omega-3 supplementation on maternal depressive symptoms from pregnancy to 6 months postpartum. METHODS: Participants with gestational age between 22 and 24 weeks were randomized in placebo (olive oil; n = 30) or omega-3 (fish oil; n = 30) groups and supplemented until childbirth. Fish oil capsules provided 1440 mg/day of docosahexaenoic acid. Depressive symptoms were evaluated during the gestational period: (G1) 22-24 weeks; (G2) 26-28 weeks; (G3) 30-32 weeks; (G4) 34-36 weeks; and postpartum: (P1) second week; (P2) first month; (P3) fourth month; and (P4) sixth month, using the Edinburgh Postnatal Depression Scale (EPDS). Intention-to-treat and per-protocol analyses were performed using Generalized Estimating Equations (GEE). RESULTS: Comparison between groups showed no differences in the EPDS score at any time during pregnancy or postpartum, in both intention-to-treat and per-protocol analysis (p > 0.05). Both groups presented a reduction in the EPDS score over time. According to intention-to-treat analysis, when comparing to the baseline, the placebo group showed a reduction in the EPDS score at P1 and P4, while the omega-3 group showed a reduction at all times from G4 to P4. In per-protocol analysis, the placebo group showed a reduction in the EPDS score at P3, while the omega-3 group showed a reduction at all times from G2 to P4. CONCLUSIONS: The supplementation with omega-3 did not promote significant differences between groups. However, an earlier reduction in the EPDS score was observed in the omega-3 group, which may indicate a benefit of antenatal omega-3 supplementation.

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The practice of leisure time physical activity brings several health benefits, such as the prevention of noncommunicable diseases. Investigating the temporal trend of physical activity practice in older adults by sociodemographic characteristics and geographical regions could be important to plan public health policies and effective interventions. This is a time series study that analyzes the temporal trend of leisure time physical activity among Brazilian older adults with data from 2009 to 2020. For this, we used a sample of 186,097 older adults (≥ 60 years old) obtained from the Risk and Protective Factors Surveillance System for Chronic Noncomunicable Diseases Through Telephone Interview (Vigitel) (2009-2020). Information on leisure time physical activity and sociodemographic and health characteristics were collected. Prais-Winsten regression was used to identify significant trends in the annual variation of the leisure time physical activity indicators. Practice of ≥ 150 minutes/week of moderate intensity leisure time physical activity varied from 23.3% to 27.5% (0.41p.p./year) (2009-2020), with a higher increase during 2015-2020 (0.59p.p./year). The increase in the most recent period occurred among men, aged from 60 to 69 years, with lower educational level, residing in the Northeast Region, and without self-reported chronic diseases. These results may contribute to the evaluation of Brazilian health policies targeting the leisure time physical activity practice in older adults.

A prática de atividade física no lazer traz diversos benefícios à saúde, como a prevenção de doenças não transmissíveis. Investigar a tendência temporal da prática de atividade física em idosos de acordo com características sociodemográficas e regiões geográficas pode ser importante para formular políticas públicas de saúde e intervenções efetivas. Este é um estudo de série temporal para analisar a tendência temporal de idosos brasileiros à prática de atividade física no lazer entre 2009 e 2020. Uma amostra de 186.097 idosos (≥ 60 anos) foi obtida do Sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (Vigitel) (2009-2020). Foram coletadas informações sobre prática de atividade física no lazer e características sociodemográficas e de saúde. A regressão de Prais-Winsten foi utilizada para identificar tendências significativas na variação anual dos indicadores de prática de atividade física no lazer. A prática de atividades físicas moderadas por ≥ 150 minutos/semana variou de 23,3% a 27,5% (0,41p.p./ano) (2009-2020) com maior aumento em 2015-2020 (0,59p.p./ano). O aumento mais recente ocorreu entre homens, indivíduos entre 60 e 69 anos de idade, aqueles com menor escolaridade, residentes na Região Nordeste e sem doença crônica autorreferida. Esses resultados podem contribuir para a avaliação das políticas de saúde brasileiras voltadas à prática de atividade física no lazer em idosos.

La práctica de actividad física por ocio trae diversos beneficios a la salud, como la prevención de enfermedades no transmisibles. Investigar la tendencia temporal de la práctica de actividad física en adultos mayores según las características sociodemográficas y las regiones geográficas puede ser importante para formular políticas de salud pública e intervenciones efectivas. Este es un estudio de serie temporal para analizar la tendencia temporal de adultos mayores brasileños a la práctica de actividad física por ocio entre 2009 y 2020. Se obtuvo una muestra de 186,097 adultos mayores (≥ 60 años) del Vigilancia de Factores de Riesgo y Protección para Enfermedades Crónicas No Transmisibles por Entrevista Telefónica (Vigitel) (2009-2020). Se recopiló información sobre práctica de actividad física por ocio y las características sociodemográficas y de salud. Se utilizó la regresión de Prais-Winsten para identificar tendencias significativas en la variación anual de los indicadores de práctica de actividad física por ocio. La práctica de actividades físicas moderada por ≥ 150 minutos/semana varió de 23,3% a 27,5% (0,41p.p./año) (2009-2020) con el mayor aumento en 2015-2020 (0,59p.p./año). El aumento más reciente ocurrió entre hombres, las personas entre 60 y 69 años de edad, aquellos con menor educación, residentes en la Región Nordeste y sin enfermedad crónica autoinformada. Estos resultados pueden contribuir a la evaluación de las políticas de salud brasileñas dirigidas a la práctica de actividad física por ocio en adultos mayores.

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Abstract Objectives: to analyze the ultra-processed foods (UPF) consumption in pregnant women's diets associated with nutrient intake. Methods: a cross-sectional study using socioeconomic, anthropometric and food consumption data from low-risk pregnant women. Consumption of energy, macro and micronutrient were obtained through two 24-hour recalls (R24h). The UPF were identified using the NOVA classification, and the percentage of energy from this food was classified in quartiles and associated with nutrient intake. So, the ANCOVA test adjusted for age and per capita income were adopted. Results: a total of 60 pregnant women with a mean of age of 28.44 (CI95%=27.20-29.69) years old were evaluated. The average percentage of UPF in the diet was 20.68 (CI95%=17.88-23.47). Pregnant women in the highest quartile of UPF consumption had lower protein intake (13.48g vs. 18.84g; p=0.031) and lower zinc intake (4.52mg vs. 6.18mg; p=0.045) when compared to those in the lowest quartile. Conclusions: the results showed a negative relationship between the participation of UPF in pregnant women's diets and the intake of protein and zinc, important nutrients for the gestational period. Such findings reinforce the importance of promoting healthy eating habits during pregnancy to ensure an adequate supply of nutrients in this phase.

Resumo Objetivos: analisar o consumo de alimentos ultraprocessados (AUP) e sua associação com a ingestão de nutrientes entre gestantes de risco habitual. Métodos: estudo transversal com dados socioeconômicos, antropométricos e de consumo alimentar de gestantes de risco habitual. O consumo de energia, macro e micronutrientes foi obtido através de dois Recordatórios 24 horas (R24h). Os AUP foram identificados através da classificação NOVA, e o percentual de calorias proveniente destes alimentos foi classificado em quartis e associado à ingestão de nutrientes. Para tal, adotou-se o teste ANCOVA ajustado segundo a idade e a renda per capita. Resultados: foram avaliadas 60 gestantes com média de idade de 28,44 (IC95%=27,20-29,69) anos. O percentual médio de AUP na dieta foi de 20,68 (IC95%=17,88-23,47). Gestantes no maior quartil de consumo de AUP apresentaram menor ingestão de proteína (13,48g vs. 18,84g; p=0,031) e zinco (4,52mg vs. 6,18mg; p=0,045) quando comparadas ao menor quartil. Conclusão: os resultados evidenciaram uma relação desfavorável entre a participação de AUP na dieta e a ingestão de proteínas e zinco, nutrientes importantes para o período gestacional. Tais achados reforçam a importância da promoção de hábitos alimentares saudáveis durante a gestação para garantir o aporte adequado de nutrientes nessa fase.

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ABSTRACTObjective: This cross-sectional study aimed to evaluate the association of dietary fatty acids, cholesterol and omega-6/omega-3 ratio to depressive symptoms in a sample of low-risk pregnant women.Methods: Pregnant women (n = 60) within 20-40 years of age and with 22-24 gestational weeks were evaluated. Food intake was assessed by two 24-h recalls and depressive symptoms according to the Edinburgh Postnatal Depression Scale.Results: The prevalence of depressive symptoms was 18.3%. The Prevalence Ratio (PR) adjusted by per capita income, history of depression and pregnancy intention, showed a higher prevalence of depressive symptoms among pregnant women with excessive total fatty acid intake (PR: 5.80; CI95% 1.20-27.7) and omega-6/omega-3 ratio above 10:1 (PR: 3.63; CI95% 1.20-10.94).Discussion: Our results indicated a higher risk of depressive symptoms among pregnant women with total fatty acids intake and omega-6/omega-3 ratio above recommendation, but further studies are required to elucidate the mechanism of dietary fatty acids in the onset of maternal depression.

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Abstract Objectives: to present the main evidence, recommendations and challenges for maternal and child health in the context of COVID-19 pandemic. Methods: narrative review of national and international documents and reflections on the theme. Results: the coexistence ofpregnancy/puerperium and COVID-19 infection establishes many challenges. It is extremely important that the conduct should be individually adopted, covering all aspects of health in the mother-child binomial, estimating risks and benefits of each decision. Until now, it is recognized that natural childbirth should be encouraged and breastfeeding maintained, if adequate hygienic-sanitary care is ensured. Cesarean delivery and the isolation and separation of the mother-child contact without breastfeeding, will only be eligible when the clinical status of the mother or child is critical. The child must be included in all stages of health care, as this commonly asymptomatic group plays an important role in the family's transmissibility of the disease. Routine immunization should be provided, as well as clinical assistance when necessary, and families must be assisted in favor of their well-being. Conclusion: at the moment, it is not possible to measure the consequences of this new pandemic on maternal and child health, demanding attention to its evolution and new evidences about the implications in mother and child care.

Resumo Objetivos: apresentar as principais evidências, recomendações e desafios à saúde materno-infantil no contexto da pandemia de COVID-19. Métodos: revisão narrativa de documentos nacionais e internacionais e reflexões sobre a temática. Resultados: a coexistência da gestação/puerpério e infecção por COVID-19 impõe muitos desafios. A conduta adotada deve ser de caráter individual, abrangendo todos os aspectos de saúde do binômio mãe-filho, estimando os riscos e benefícios de cada decisão. Até o momento, reconhece-se que o parto natural deve ser incentivado e a amamentação mantida, desde que assegurados os cuidados higienicossanitários. O parto cirúrgico e o isolamento com separação do contato mãe-filho, sem amamentação, serão elegíveis para casos em que o quadro clínico da mãe ou da criança seja crítico. A criança deve ser incluída em todas as etapas do cuidado em saúde, pois esse grupo comumente assintomático desempenha papel importante na transmissibilidade familiar da doença. Deve-se propiciar a imunização de rotina, oportunizar a assistência clínica, quando necessária, e auxiliar as famílias em prol do bem-estar. Conclusão: o atual momento ainda não nos permite mensurar as consequências dessa nova pandemia no âmbito da saúde materno-infantil, demandando atenção à sua evolução e novas evidências acerca das implicações no cuidado ao binômio mãe-filho.

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OBJECTIVE: To evaluate the contribution of ultra-processed foods (UPF) in the schoolchildren diet and associated factors. METHODS: Cross-sectional study with children from public schools in Southeast of Brazil, aged eight to 12 years old. A questionnaire was applied to the students to investigate anthropometric data, eating and lifestyle habits and food consumption. The consumption of UPF was evaluated by two 24-hour dietary recalls (24HR) of non-consecutive days, and the NOVA method was adopted for food classification. The sample was estimated considering the percentage of total caloric value from UPF identified by a similar study (n=260). The association between variables was evaluated by Simple and Multiple Logistic Regression. RESULTS: The average energy consumption was 1992 kcal/day, 25.2% from UPF. Schoolchildren had a mean of 9.8±0.5 years of age, 53.4% were female and 32.6% were overweight. The most consumed UPF were industrialized pastas, sweet biscuits, sausages, chocolate powder and soft drinks. In the multivariate model, schoolchildren who have the habit of TV watching during meals and those with obesity presented 1.87 (95% confidence interval [95%CI] 1.03-3.39) and 2.05 (95%CI 1,01-4.20) times more chance of having higher consumption of ultra-processed foods, respectively. CONCLUSIONS: The contribution of UPF was expressive in the feeding of the students and it was positively associated with the excess of weight and with the habit of eating while watching television. These findings indicate the importance of nutritional interventions to promote healthy habits, thus preventing overweight during childhood.

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