RESUMO
OBJECTIVE: The aim of this study was to examine the influence of the socioeconomic status (SES) and age on the prevalence of overweight and obesity among 5 to 10-year-old children from Brazil. METHODS: The sample consisted of 80 782 (41 063 boys) students aged 5 to 10-year-old. Height and weight were measured and body mass index (BMI) was calculated. SES was self-reported by parents when registering for school in the same year as the assessment. RESULTS: An increasing trend in the prevalence of obesity, for boys and girls, and overweight, for girls, as they got older was observed. The prevalence of obesity was greater among medium SES boys, 18.1% (95% CI: 17.7, 18.6), and girls, 18.1% (95% CI: 17.7, 18.6), compared with low SES. For each year boys and girls get older their odds of being underweight, overweight and obese increase. Medium and high SES boys were 23% (95% CI: 1.14, 1.32) and 25% (95%CI: 1.03, 1.52) more likely to be obese than low SES boys. Girls with high SES were 20% (OR = 1.20; 95% CI: 1.10, 1.31) more likely of being obese than girls with low SES. Furthermore, age and being in the medium SES for both sexes and in the high SES for boys was positively related to the BMI z-score. CONCLUSION: Both age and SES were factors associated with obesity among Brazilian children. For public health policies to be effective, it is necessary to understand why higher SES children and older children have higher risk and prevalence of obesity and overweight.
Assuntos
Sobrepeso/epidemiologia , Fatores Etários , Peso Corporal , Brasil/epidemiologia , Criança , Saúde da Criança , Pré-Escolar , Feminino , Humanos , Masculino , Sobrepeso/economia , Obesidade Infantil/economia , Obesidade Infantil/epidemiologia , Prevalência , Fatores Sexuais , Classe Social , Magreza/epidemiologiaRESUMO
The aims were to examine changes in the prevalence of overweight and obesity among students from 2001 to 2011, and to verify if these changes differ according to age group, area of residence, and family income. We analyzed two cross-sectional surveys conducted in 2001 and 2011 with brazilian adolescents. Sociodemographic and anthropometric characteristics were self-reported using a questionnaire. Multinomial logistic regression was used to analyze changes in overweight and obesity between the two surveys. The nutritional status was the outcome of the present study and the surveys (2001 and 2011) were the exposure. The odds of being overweight and obese were higher among boys and girls in urban areas in the 2011 survey compared to the 2001. Boys and girls with higher income were also more likely to present overweight and obesity in the second survey compared to the first. An increase of overweight and obesity was observed over a decade. We suggest that future interventions consider the area of residence and the family income to strengthen the effectiveness of actions developed to prevent and control these indicators among adolescents.
Assuntos
Estado Nutricional , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Adolescente , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Renda , Masculino , Obesidade/economia , Sobrepeso/economia , Prevalência , Fatores Socioeconômicos , Estudantes/estatística & dados numéricos , Inquéritos e Questionários , Adulto JovemRESUMO
Abstract The aims were to examine changes in the prevalence of overweight and obesity among students from 2001 to 2011, and to verify if these changes differ according to age group, area of residence, and family income. We analyzed two cross-sectional surveys conducted in 2001 and 2011 with brazilian adolescents. Sociodemographic and anthropometric characteristics were self-reported using a questionnaire. Multinomial logistic regression was used to analyze changes in overweight and obesity between the two surveys. The nutritional status was the outcome of the present study and the surveys (2001 and 2011) were the exposure. The odds of being overweight and obese were higher among boys and girls in urban areas in the 2011 survey compared to the 2001. Boys and girls with higher income were also more likely to present overweight and obesity in the second survey compared to the first. An increase of overweight and obesity was observed over a decade. We suggest that future interventions consider the area of residence and the family income to strengthen the effectiveness of actions developed to prevent and control these indicators among adolescents.
Resumo Os objetivos do estudo foram examinar as mudanças na prevalência de sobrepeso e obesidade entre os estudantes de 2001 a 2011 e verificar se essas alterações diferem de acordo com a faixa etária, a área de residência e a renda familiar. Analisamos dois levantamentos transversais realizados em 2001 e 2011 com adolescentes brasileiros. As características sociodemográficas e antropométricas foram autorrelatadas por meio de um questionário. Regressão logística multinomial foi utilizada para analisar as mudanças no sobrepeso e obesidade entre os dois inquéritos. O estado nutricional foi considerado o desfecho do presente estudo e os inquéritos (2001 e 2011) foram as exposições. As razões de chance de sobrepeso e obesidade foram maiores entre os meninos e meninas em áreas urbanas no inquérito de 2011 em comparação com 2001. Meninos e meninas com maior renda também apresentaram maior chance de sobrepeso e obesidade no segundo inquérito. Sugerimos que futuras intervenções considerem a área de residência e a renda familiar para fortalecer a eficácia das ações desenvolvidas para prevenir e controlar esses indicadores entre os adolescentes.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Estado Nutricional , Sobrepeso/epidemiologia , Obesidade/epidemiologia , Fatores Socioeconômicos , Estudantes/estatística & dados numéricos , Brasil/epidemiologia , Prevalência , Estudos Transversais , Inquéritos e Questionários , Sobrepeso/economia , Renda , Obesidade/economiaRESUMO
OBJECTIVES: To estimate the burden of disease attributable to obesity and overweight conditions using disability-adjusted life-years (DALYs) in Colombia. METHODS: The burden of disease was estimated following an adapted methodology published by the World Health Organization. A selection of diseases was performed in which overweight and obesity are risk factors. DALYs were calculated by obtaining the proportion of cases and deaths of every disease that can be attributable to obesity and overweight conditions. The economic impact of obesity was calculated by multiplying the cost of care per patient for each comorbidity by the number of cases attributable exclusively to obesity. RESULTS: A total of 997 371 DALYs were estimated, 45% of which corresponded to men; 81% of DALYs corresponded to years lived with disability. Conditions with greater attributable DALYs are, in order, hypertension (31.6% of the total DALYs), type 2 diabetes mellitus (28.0%), cardiac ischemic disease (14.6%), and lower back pain (11.2%). An estimation of 20.5 DALYs per 1000 inhabitants was made. The economic impact of care for comorbidities associated with obesity could amount to $2158 million. CONCLUSIONS: Obesity and overweight conditions are related to higher mortality and disability than previously estimated; effective interventions aimed at prevention and treatment will have a high impact on quality of life.
Assuntos
Efeitos Psicossociais da Doença , Obesidade/complicações , Sobrepeso/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Colômbia/epidemiologia , Diabetes Mellitus Tipo 2/economia , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/etiologia , Feminino , Humanos , Hipertensão/economia , Hipertensão/epidemiologia , Hipertensão/etiologia , Dor Lombar/economia , Dor Lombar/epidemiologia , Dor Lombar/etiologia , Masculino , Pessoa de Meia-Idade , Isquemia Miocárdica/economia , Isquemia Miocárdica/epidemiologia , Isquemia Miocárdica/etiologia , Obesidade/economia , Obesidade/epidemiologia , Sobrepeso/economia , Sobrepeso/epidemiologia , Anos de Vida Ajustados por Qualidade de Vida , Fatores de RiscoRESUMO
OBJECTIVE: To evaluate the health-related quality of life (HRQoL) of adolescents diagnosed with different chronic conditions and to identify demographic, socioeconomic, and health-status outcomes associated with the impairment in HRQoL. STUDY DESIGN: Cross-sectional study. METHODS: We evaluated 276 adolescents (50.7% male) aged 14 ± 2 years that were assisted by healthcare public service and diagnosed with cancer (CA), type 1 diabetes mellitus (DM1), overweight (OW), asthma (AS), and no chronic health condition-control group (CG). Adolescents and parent-proxy completed age-appropriate self-report and/or parent-proxy report on generic HRQoL measures using PedsQL™. RESULTS: Adolescents with CA had lower overall HRQoL as well as poorer scores in all dimensions than either healthy participants or other chronic disease sufferers. HRQoL scores reported by parent-proxy were similar to those reported by adolescents across all chronic diseases. CG members reported better scores in all dimensions. Maternal education, family income, and marital status of parents were correlated with HRQoL scores in all dimensions. The risk of having an affected HRQoL score was higher in adolescents with CA than in adolescents with other chronic diseases. CONCLUSIONS: The likelihood of cancer affecting HRQoL was higher when compared to other chronic diseases, and the OW group had a worse overall score compared to CG. Adolescents with CA, AS, and OW reported worse school dimensions when compared to healthy adolescents. The education of adolescents and their parent-proxy, body weight, and family income influence the dimensions of HRQoL in adolescents with chronic diseases.
Assuntos
Peso Corporal/fisiologia , Doença Crônica/economia , Doença Crônica/psicologia , Adolescente , Estudos Transversais , Educação , Feminino , Indicadores Básicos de Saúde , Humanos , Renda , Masculino , Sobrepeso/economia , Sobrepeso/psicologia , Pais/educação , Pais/psicologia , Procurador/psicologia , Qualidade de Vida , Autorrelato/economiaRESUMO
ABSTRACT CONTEXT AND OBJECTIVE: One of the big challenges facing governments worldwide is the financing of healthcare systems. Thus, it is necessary to understand the factors and key components associated with healthcare expenditure. The aim here was to identify demographic, socioeconomic, lifestyle and clinical factors associated with direct healthcare expenditure within primary care, among adults attended through the Brazilian National Health System in the city of Bauru. DESIGN AND SETTING: Cross-sectional study conducted in five primary care units in Bauru (SP), Brazil. METHODS: Healthcare expenditure over the last 12 months was assessed through medical records of adults aged 50 years or more. Annual healthcare expenditure was assessed in terms of medication, laboratory tests, medical consultations and the total. Body mass index, waist circumference, hypertension, age, sex, physical activity and smoking were assessed through face-to-face interviews. RESULTS: The total healthcare expenditure for 963 participants of this survey was US$ 112,849.74 (46.9% consultations, 35.2% medication and 17.9% laboratory tests). Expenditure on medication was associated with overweight (odds ratio, OR = 1.80; 95% confidence interval, CI: 1.07-3.01), hypertension (OR = 3.04; 95% CI: 1.91-4.82) and moderate physical activity (OR = 0.56; 95% CI: 0.38-0.81). Expenditure on consultations was associated with hypertension (OR = 1.67; 95% CI: 1.12-2.47) and female sex (OR = 1.70; 95% CI: 1.14-2.55). CONCLUSIONS: Our results showed that overweight, lower levels of physical activity and hypertension were independent risk factors associated with higher healthcare expenditure within primary care.
RESUMO CONTEXTO E OBJETIVO: Um dos grandes desafios dos governos em todo o mundo é o financiamento de sistemas de saúde e, por isso, é necessário compreender fatores e componentes-chave associados a despesas em saúde. O objetivo foi identificar fatores demográficos, socioeconômicos, de estilo de vida e clínicos associados aos gastos diretos com saúde na atenção primária entre adultos do Sistema Único de Saúde da cidade de Bauru. TIPO DE ESTUDO E LOCAL: Estudo transversal realizado em cinco Unidades Básicas de Saúde em Bauru (SP), Brasil. MÉTODO: Gastos com saúde nos últimos 12 meses foram avaliados através de prontuários médicos de adultos de 50 anos ou mais. Gastos anuais com saúde foram avaliados com: medicamentos, exames laboratoriais, consultas médicas e total. Índice de massa corporal, circunferência da cintura, hipertensão, idade, sexo, atividade física e tabagismo foram avaliados por meio de entrevista face a face. RESULTADOS: O gasto total com serviços de saúde para os 963 participantes deste inquérito foi de US$ 112.849.74 (46,9% consultas, 35,2% medicamentos e 17,9% exames). Gastos com medicamentos foram associados com sobrepeso (odds ratio, OR = 1,80 [intervalo de confiança, IC 95%: 1,07-3,01]), hipertensão (OR = 3,04 [IC 95%: 1,91-4,82]) e atividade física moderada (OR = 0,56 [95% IC: 0,38-0,81]). Gastos com consultas foram associados com hipertensão (OR = 1,67 [IC 95%: 1,12-2,47]) e sexo feminino (OR = 1,70 [IC 95%: 1,14-2,55]). CONCLUSÃO: Nossos resultados mostraram que sobrepeso, menor nível de atividade física e hipertensão são fatores de risco independentes associados com maiores gastos com saúde na atenção primária.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Atenção Primária à Saúde/economia , Gastos em Saúde/estatística & dados numéricos , Assistência Ambulatorial/economia , Programas Nacionais de Saúde/economia , Fatores Socioeconômicos , Fatores de Tempo , Brasil , Exercício Físico , Modelos Logísticos , Fatores Sexuais , Antropometria , Prontuários Médicos , Estudos Transversais , Fatores de Risco , Fatores Etários , Estatísticas não Paramétricas , Sobrepeso/economia , Hipertensão/economia , Estilo de VidaRESUMO
CONTEXT AND OBJECTIVE:: One of the big challenges facing governments worldwide is the financing of healthcare systems. Thus, it is necessary to understand the factors and key components associated with healthcare expenditure. The aim here was to identify demographic, socioeconomic, lifestyle and clinical factors associated with direct healthcare expenditure within primary care, among adults attended through the Brazilian National Health System in the city of Bauru. DESIGN AND SETTING:: Cross-sectional study conducted in five primary care units in Bauru (SP), Brazil. METHODS:: Healthcare expenditure over the last 12 months was assessed through medical records of adults aged 50 years or more. Annual healthcare expenditure was assessed in terms of medication, laboratory tests, medical consultations and the total. Body mass index, waist circumference, hypertension, age, sex, physical activity and smoking were assessed through face-to-face interviews. RESULTS:: The total healthcare expenditure for 963 participants of this survey was US$ 112,849.74 (46.9% consultations, 35.2% medication and 17.9% laboratory tests). Expenditure on medication was associated with overweight (odds ratio, OR = 1.80; 95% confidence interval, CI: 1.07-3.01), hypertension (OR = 3.04; 95% CI: 1.91-4.82) and moderate physical activity (OR = 0.56; 95% CI: 0.38-0.81). Expenditure on consultations was associated with hypertension (OR = 1.67; 95% CI: 1.12-2.47) and female sex (OR = 1.70; 95% CI: 1.14-2.55). CONCLUSIONS:: Our results showed that overweight, lower levels of physical activity and hypertension were independent risk factors associated with higher healthcare expenditure within primary care.
Assuntos
Assistência Ambulatorial/economia , Gastos em Saúde/estatística & dados numéricos , Programas Nacionais de Saúde/economia , Atenção Primária à Saúde/economia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Antropometria , Brasil , Estudos Transversais , Exercício Físico , Feminino , Humanos , Hipertensão/economia , Estilo de Vida , Modelos Logísticos , Masculino , Prontuários Médicos , Pessoa de Meia-Idade , Sobrepeso/economia , Fatores de Risco , Fatores Sexuais , Fatores Socioeconômicos , Estatísticas não Paramétricas , Fatores de TempoRESUMO
To analyse the changes in eating patterns in Argentina from 1961 to 2011, and to assess changes in overweight and obesity in their socioeconomic and political context, we performed a hierarchical cluster analysis. We used the information from Food Balance Sheets of the United Nations Food and Agriculture Organisation to identify dietary patterns of apparent consumption. Years were grouped into five patterns. The food group with the highest apparent consumption was cereals (30% of total kcal/person/day) although this decreased slightly. Meats were second and their contribution decreased by 12%. The following foods contribution increased during the period: Sugar and milk by 2% and vegetable oils by 6%. The changes observed in the number of kcal/person/day were in line with changes in real wage, and coincided with economic and political crises that Argentina experienced during that period. Changes in eating patterns allow us to interpret that they relate to the increase in overweight and obesity.
Assuntos
Dieta/efeitos adversos , Grão Comestível/efeitos adversos , Ingestão de Energia , Transição Epidemiológica , Carne/efeitos adversos , Obesidade/etiologia , Sobrepeso/etiologia , Argentina/epidemiologia , Análise por Conglomerados , Bases de Dados Factuais , Dieta/classificação , Dieta/etnologia , Dieta/tendências , Inquéritos sobre Dietas , Grão Comestível/economia , Ingestão de Energia/etnologia , Fast Foods/efeitos adversos , Fast Foods/economia , Manipulação de Alimentos , Humanos , Carne/economia , Obesidade/economia , Obesidade/epidemiologia , Obesidade/etnologia , Sobrepeso/economia , Sobrepeso/epidemiologia , Sobrepeso/etnologia , Política , Pobreza/tendências , Prevalência , Fatores de Risco , Salários e Benefícios/tendências , Fatores Socioeconômicos , Nações UnidasRESUMO
BACKGROUND: It is unclear what effects a conditional cash transfer (CCT) program would have on child anthropometry, language development, or school achievement in the context of the nutrition transition experienced by many low- and middle-income countries. OBJECTIVE: We estimated the association of participation in Peru's Juntos CCT with anthropometry, language development, and school achievement among children aged 7-8 y. METHODS: We used data from the Young Lives Study of a cohort born between 2001 and 2002. We estimated associations of the Juntos program with height-for-age z score (HAZ), body mass index-for-age z score (BAZ), stunting, and overweight at age 7-8 y separately for children participating in the program for ≥2 y (n = 169) and children participating for <2 y (n = 188). We then estimated associations with receptive vocabulary and grade achievement among children who had been assessed at age 4-6 y before enrollment in Juntos (n = 243). We identified control subjects using propensity score matching and conducted difference-in-differences comparisons. RESULTS: Juntos participation was associated with increases in HAZ among boys participating for ≥2 y [average effect of treatment among the treated (ATT): 0.43; 95% CI: 0.09, 0.77; P = 0.01] and for boys participating for <2 y (ATT: 0.52; 95% CI: 0.23, 0.80; P < 0.01). Among girls participating in the program for ≥2 y, BAZ declined (ATT: -0.60; 95% CI: -1.00, -0.21; P < 0.01) as did the prevalence of overweight (ATT: -22.0 percentage points; 95% CI: -42.5, -2.7 percentage points; P = 0.03). We observed no significant associations of Juntos participation with receptive vocabulary or grade attainment. CONCLUSIONS: CCT program participation in Peru was associated with better linear growth among boys and decreased BAZ among girls, highlighting that a large-scale poverty-alleviation intervention may influence anthropometric outcomes in the context of the nutrition transition.
Assuntos
Desenvolvimento Infantil , Fenômenos Fisiológicos da Nutrição Infantil , Dieta , Sobrepeso/prevenção & controle , Pobreza/prevenção & controle , Assistência Pública , Índice de Massa Corporal , Criança , Estudos de Coortes , Dieta/efeitos adversos , Dieta/economia , Escolaridade , Feminino , Seguimentos , Implementação de Plano de Saúde , Humanos , Desenvolvimento da Linguagem , Masculino , Sobrepeso/economia , Sobrepeso/epidemiologia , Sobrepeso/etiologia , Peru/epidemiologia , Prevalência , Fatores SexuaisRESUMO
OBJECTIVE: In a cohort of government employees in Rio de Janeiro, Brazil, we investigated prospectively, sex-specific associations between education and BMI trajectories and their potential effect modification by race. DESIGN: Of the 4030 participants in Phase 1 (1999), 3253 (81 %) participated in Phase 2 (2003) and 3058 (76 %) participated in Phase 3 (2006). Education was categorized as elementary, high school or college graduate. Study participants self-identified as White, Black or Pardo. BMI was calculated from measured weight and height. BMI trajectories were modelled using a generalized additive regression model with mixed effects (GAMM). SETTING: The Pro-Saúde Study, a longitudinal investigation of social determinants of health. SUBJECTS: Women (n 1441) and men (n 1127) who participated in the three phases of data collection and had complete information for all study variables. RESULTS: Women and men with less than high school, or only a high school education, gained approximately 1 kg/m(2) more than college graduates (women: 1·06 kg/m(2) (P<0·001) and 1·06 kg/m(2) (P<0·001), respectively; men: 1·04 kg/m(2) (P=0·013) and 1·01 kg/m(2) (P=0·277), respectively). For women only, race was independently associated with weight gain. Women identifying as Pardo or Black gained 1·03 kg/m(2) (P=0·01) and 1·02 kg/m(2) (P=0·10), respectively, more than Whites. No effect modification by race was observed for either men or women. CONCLUSIONS: While both lower education and darker race were associated with greater weight gain, gender similarities and differences were observed in these associations. The relationship between weight gain and different indicators of social status are therefore complex and require careful consideration when addressing the obesity epidemic.