The Health Effects of Antenatal Multiple Micronutrient Supplementation in Nepalese Children.

Objectives: In low- and middle-income countries, prenatal multiple micronutrient supplementation has been shown in meta-analyses to increase birthweight and reduce the proportion of babies born small-for-gestational-age, but the longer term effects are unclear. We examined phenotypic and health differences between children born to mothers in a randomized controlled trial of prenatal multiple micronutrient (UNIMAPP) supplementation compared to iron and folate. Methods: The study was conducted in Dhanusha district, Nepal. We measured anthropometry, body composition using bioelectrical impedance (with population-specific isotope calibration), blood pressure, kidney dimensions by ultrasound, and spirometry. Health outcomes were recorded in questionnaires. Personal estimates of air pollution exposure (particles of less than 4 micrometers in size) were produced by microenvironment sampling. Results: We saw 841 children (80% of total), at a mean age of 8.5 years. The unadjusted mean (95%CI) difference (intervention minus control) in weight-for-age was 0.05 z-scores (-0.09,0.19), in height-for-age 0.02 z-scores (-0.10,0.15) and in BMI-for-age 0.04 z-scores (-0.09,0.18). Similar results were obtained from multi-variable regression analysis. No difference was found in body composition, kidney size, blood pressure or lung function. In addition there were no differences in health outcomes between allocation groups. Conclusions: Differences that were previously seen in phenotype and blood pressure at birth and at two years in children born to mothers who received antenatal UNIMMAP supplements were not apparent at 8.5 years of age. While not ruling out physiological differences and health benefits in adulthood, our findings do not suggest sustained effects of antenatal micronutrient supplementation.

Epidemiology of recreational football in Brazil: prevalence and association with risk factors for chronic diseases and self-rated health in adults / Epidemiologia do futebol recreacional no Brasil: prevalência e associação com fatores de risco para doenças crônicas e relato de saúde em adultos

The aim of this study was to describe the social and health characteristics of adults who practice football for recreation in adult living in Brazil. This was a cross-sectional study using data from the VIGITEL Surveillance System. In 2006, 54,369 interviews were carried out with adults. Individuals were classified in three groups: inactive in leisure-time; recreational football participants: one/ two times per week or three or more times per week. We ran descriptive analysis and binary logistic models. Recreation footballers in Brazil are mostly young men of low schooling levels. The southeastern region had the greatest proportion of practitioners in Brazil. Most footballers practiced once or two times per week (75.9%), for 60 minutes or more per day (87.7%), and used public locations (94.2%). Football players had less obesity and poor self-rated health compared with inactive. Football practice seems to provide health and wellbeing benefits, independent of the weekly frequency.

O objetivo deste estudo foi descrever características sociais e de saúde de adultos praticantes de futebol no Brasil. Este foi um estudo transversal que usou dados do Sistema VIGITEL. Em 2006 foram realizadas 54.369 entrevistas. Os indivíduos foram classificados em três grupos: inativos no lazer; praticantes de futebol recreacional: uma/duas vezes por semana ou três ou mais vezes por semana. Foi realizada análise descritiva e modelos de regressão logística. Os praticantes de futebol eram predominantemente jovens e com baixos níveis de escolaridade. A região sudeste teve a maior proporção de praticantes. A maioria praticava uma ou duas vezes por semana (75,9%), por 60 minutos ou mais por dia (87,7%) e usava espaços públicos (94,2%). Os praticantes de futebol tiveram baixa prevalência de obesidade e relato de saúde ruim comparados com os inativos. A prática de futebol contribui para a saúde e bem-estar, independente da frequência semanal de prática.

Objectively measured physical activity and body composition indices in Brazilian adolescents / Atividade física mensurada objetivamente e índices de composição corporal em adolescentes Brasileiros

The aim of the study was to explore the association between objectively measured physical activity and body composition indices in 13-year old adolescents living in country undergoing rapid nutritional transition. A population-based cross-sectional study nested within the 1993 Pelotas (Brazil) Birth Cohort was undertaken. A total of 457 boys and girls (80.5% of the target sample, 52.1% boys) participated in the study. Physical activity was measured by the Actigraph accelerometer for 5 consecutive days and expressed as total physical activity (i.e. average intensity, counts per minute) and time (min per day) spent at moderate and vigorous intensity activity. The outcomes investigated were sum of triceps and subscapular skinfolds, waist circumference, waist-to-hip ratio and waist-to-thigh ratio. After adjustment for sex, socioeconomic status, age, Tanner stage of sexual maturation, diet pattern, height, and birth weight, time (min/day) spent at vigorous intensity activity was inversely associated with waist circumference and sum of skinfolds. A one minute/day increase in vigorous intensity physical activity was associated, on average, with a reduction of 0.15cm in waist circumference (p=0.007) and 0.20mm in sum of skinfold thicknesses (p=0.02). These associations were stronger in boys than in girls. Total activity and time spent in moderate intensity physical activities were not associated with any of the outcomes in the adjusted analyses. Vigorous physical activity appears to have the strongest association with body composition. Preventive efforts aimed to decrease the obesity in adolescents may be more successful if they focus on vigorous intensity, instead of moderate intensity physical activities.

O objetivo deste estudo foi explorar a associação entre atividade física mensurada objetivamente e índices de composição corporal em adolescentes de 13 anos de idade residentes em um país sofrendo rápida transição nutricional. Um estudo transversal de base populacional aninhado a Coorte de Nascimentos de 1993 de Pelotas (Brasil) foi realizado. Um total de 457 meninos e meninas (80,5% da população alvo; 52,1% meninos) participaram do estudo. Atividade física foi mensurada pelo acelerômetro Actigraph por 5 dias consecutivos e expressa como atividade física total (intensidade média, counts por minuto) e tempo (min/dia) em atividades moderadas e vigorosas. Os desfechos investigados foram somatório de dobras triciptal e subescapular, circunferência da cintura, razão cintura-quadril e razão cintura-coxa. Após ajustes para sexo, nível econômico, idade, estágio de maturação sexual de Tanner, padrão de dieta, estatura e peso ao nascer, o tempo (min/dia) em atividades vigorosas foi inversamente associado à circunferência da cintura e somatório das dobras. O aumento de um minuto por dia no tempo em atividades vigorosas foi associado, em média, com uma redução de 0,15cm na circunferência da cintura (p=0,007) e 0,20mm no somatório das dobras (p=0,02). Estas associações foram mais fortes nos meninos comparado as meninas. Atividade física total e tempo em atividades moderadas não foram associados com nenhum dos desfechos na análise ajustada. Atividades vigorosas parecem ter a associação mais forte com composição corporal. Esforços preventivos que visem diminuir a obesidade em adolescentes podem ter mais sucesso se focarem em atividades vigorosas ao invés de atividades de intensidade moderada.

Body Composition of Bangladeshi Children: Comparison and Development of Leg-to-Leg Bioelectrical Impedance Equation.

The aim of this study was to investigate the validity of the Tanita TBF 300A leg-to-leg bioimpedance analyzer for estimating fat-free mass (FFM) in Bangladeshi children aged 4-10 years and to develop novel prediction equations for use in this population, using deuterium dilution as the reference method. Two hundred Bangladeshi children were enrolled. The isotope dilution technique with deuterium oxide was used for estimation of total body water (TBW). FFM estimated by Tanita was compared with results of deuterium oxide dilution technique. Novel prediction equations were created for estimating FFM, using linear regression models, fitting child’s height and impedance as predictors. There was a significant difference in FFM and percentage of body fat (BF%) between methods (p<0.01), Tanita underestimating TBW in boys (p=0.001) and underestimating BF% in girls (p<0.001). A basic linear regression model with height and impedance explained 83% of the variance in FFM estimated by deuterium oxide dilution technique. The best-fit equation to predict FFM from linear regression modelling was achieved by adding weight, sex, and age to the basic model, bringing the adjusted R2 to 89% (standard error=0.90, p<0.001). These data suggest Tanita analyzer may be a valid field-assessment technique in Bangladeshi children when using populationspecific prediction equations, such as the ones developed here.

Transiciones en contexto: hallazgos vinculados a migración rural-urbana y enfermedades no transmisibles en Perú / Transitions in context: findings related to rural-to-urban migration and chronic non-communicable diseases in Peru

El presente artículo busca describir, en contexto, los distintos procesos de cambio por el que transcurren, en la actualidad, nuestras sociedades y poblaciones a fin de comprender mejor la emergencia de las enfermedades crónicas no transmisibles en países de ingresos medios y bajos. Se describen aquellos factores relevantes para contextos específicos como el Perú, entre ellos migración interna, urbanización y los perfiles de adversidad en etapas tempranas de la vida, todos vinculados con enfermedades crónicas no transmisibles, incluyendo el sobrepeso y la obesidad. Se describe el modelo de “capacidad y carga”, el cual considera al riesgo de adquirir una enfermedad crónica no transmisible en la etapa adulta como una función de dos rasgos genéticos: capacidad metabólica y carga metabólica. Se presenta también la contribución de la migración rural-urbana a esta problemática en nuestro medio. Finalmente, se mencionan los retos pendientes en este tema para la salud pública del Perú.

In order to better understand the emergence of chronic non-communicable diseases in low- and middle-income countries this article seeks to present, in context, different transitional processes which societies and populations are currently undergoing. Relevant factors for specific contexts such as Peru are described, including internal migration, urbanization and profiles of adversity in early life, all of them linked to chronic non-communicable diseases, including obesity and overweight. The capacity-load model, which considers chronic disease risk in adulthood as a function of two generic traits, metabolic capacity and metabolic load, is described. The contribution of rural-to-urban migration to this problem is also presented. Finally, these topics are framed within pending challenges for public health in Peru.

Design and construction of an Electric Fish Finder

We provide notes on the design and construction of an Electric Fish Finder - a portable differential amplifier for detecting the electrostatic fields of gymnotiform knifefishes. The device can be adapted to locate electric fishes in any kind of aquatic environment. It is rugged, water resistant, and powered by alkaline batteries. This contribution is part of a series of technical papers designed to encourage students of neotropical ichthyology to explore the ecology, systematics, and electric signaling of gymnotiform fishes

Nós fornecemos o esquema e as instruções para a construção de um Detector de Peixes Elétricos - um amplificador portátil de banda larga utilizado para detectar os campos elétricos de peixes gymnotiformes. Este aparelho pode ser adaptado para encontrar peixes elétricos em diversos ambientes aquáticos. É resistente, à prova d'água e energizado por baterias alcalinas. Esta contribuição faz parte de uma série de artigos técnicos que pretende encorajar estudantes de ictiologia neotropical a explorar a ecologia, sistemática e comunicação elétrica de peixes gymnotiformes

Epidemiology of leisure-time physical activity: a population-based study in southern Brazil

O objetivo deste estudo foi avaliar a prevalência de inatividade física (IF) no lazer e fatores associados, em uma população adulta (20-69 anos), residente no sul do Brasil. Um estudo transversal de base populacional foi conduzido, com amostragem em múltiplos estágios. A prática semanal de atividade física foi avaliada. Para cada atividade, o gasto energético foi calculado usando dados de duração, equivalentes metabólicos e peso corporal. Os gastos energéticos das atividades foram somados para calcular-se um gasto semanal total. IF foi definida como gasto semanal inferior a 1.000kcal/semana. A prevalência de IF foi de 80,7 por cento (IC95 por cento: 78,9-82,4). Após análise ajustada, as seguintes variáveis se associaram positivamente com IF: sexo feminino, idade, viver com companheiro e tabagismo. Escolaridade e nível econômico se associaram inversamente com IF. Indivíduos com índice de massa corporal baixo (< 18,5kg/m2) apresentaram prevalência significativamente maior de IF. Não foram encontradas diferenças estatisticamente significativas de acordo com a cor da pele e consumo de álcool. A prevalência de IF nesta população adulta foi maior do que em populações de países desenvolvidos, mas as variáveis associadas foram similares.