Insufficient consumption of micronutrients and common mental disorders in Brazilian adolescents

ABSTRACT The study aimed to estimate the association of insufficient consumption of vitamins A, C, E, B12 and zinc on the pathogenesis of Common Mental Disorders (CMD) in Brazilian adolescents who participated in the Estudo de Riscos Cardiovasculares em Adolescentes - ERICA (Study of Cardiovascular Risks in Adolescents) from February 2013 to November 2014. The sample corresponded to the number of students (71,971) who answered the the 24-hour dietary recall and the questionnaire that addressed mental health. Pearson's chi-square test and multivariate logistic regression analysis were performed between the CMD variable and insufficient micronutrient consumption, adjusting for sex, type of school and age group variables. The level of significance adopted was p<0.05. Associations between the existence of CMD and insufficient consumption of Vitamin B12 and zinc were significant. Zinc, when consumed in small quantities, was the element that most influenced the CMD variable. Therefore, it was found that insufficient consumption of Vitamin B12 and zinc influences the presence of CMD in adolescents.

RESUMEN El objetivo de este estudio fue estimar la asociación del consumo insuficiente de vitaminas A, C, E, B12 y zinc en la patogénesis de los trastornos mentales comunes (TMC) en adolescentes brasileños que participaron en el Estudio de Riesgos Cardiovasculares en Adolescentes (ERICA), en el período de febrero de 2013 a noviembre de 2014. La muestra correspondió al número de estudiantes (71.971) que respondieron una encuesta de alimentación recordatorio de 24 horas y un cuestionario que abordaba aspectos de la salud mental. La prueba de chi-cuadrado y el análisis de regresión logística multivariada se aplicaron entre la variable TMC y el consumo insuficiente de micronutrientes, ajustando por sexo, tipo de escuela y grupo de edad. El nivel de significación aceptado fue del p<0,05. Las asociaciones entre la existencia de TMC y el consumo insuficiente de vitamina B12 y zinc fueron significativas. El zinc, cuando se consume en pequeñas cantidades, fue el elemento que más influyó en la variable TMC. Por lo tanto, se encontró que el consumo insuficiente de vitamina B12 y zinc influye en la presencia de TMC en adolescentes.

ERICA: consumption of trans fats and saturated fats associated with dyslipidemia in obese and overweight adolescents / ERICA: consumo de grasas trans y grasas saturadas asociado a la dislipidemia en adolescentes con sobrepeso y obesidad

The study aimed to associate the consumption of trans and saturated fats with dyslipidemia in overweight and obese adolescents who participated in the Study of Cardiovascular Risks in Adolescents (ERICA) from February 2013 to November 2014. Anthropometry, food consumption data, and the lipidogram of 9,538 overweight Brazilian adolescents from macro-regions and Teresina were used in the study. We found an association between saturated fats and HDL-c in Teresina and in the Northeastern macro-region (p-value= 0.002 and p-value= 0.033, respectively), showing that adolescents in Teresina who consumed less than 10% of saturated fats were 2.04-fold more likely to have desirable HDL-c (OR= 2.04), while northeastern adolescents were 0.625 less likely to have desirable HDL-c (OR= 0.625). In Teresina, there was an association between saturated fat consumption and total cholesterol (p-value= 0.045), showing that adolescents consuming less than 10% of saturated fats had a 0.543- fold lower odds of having desirable total cholesterol levels (OR= 0.543). Lipid profile was not associated with consumption of trans fats, but with the consumption of saturated fats. It is important to monitor the lipid profile of adolescents, especially in the presence of overweight.

El objective fue asociar el consumo de grasas trans y saturadas y dislipidemia en adolescentes con sobrepeso y obesidad que participaron en el Estudio de Riesgos Cardiovasculares en Adolescentes (ERICA), en el período de febrero de 2013 a noviembre de 2014. Se utilizaron datos antropométricos, consumo alimentario y lipidograma de 9.538 adolescentes, residentes en Brasil, macrorregiones y Teresina. En Teresina y Macroregión Nordeste, hubo asociación entre el consumo de grasa saturada y HDL-c (p-valor= 0,002 y p-valor= 0,033), respectivamente, mostrando que, adolescentes teresinenses con consumo menor que 10% la grasa saturada tiene 2,04 veces más probabilidades de tener HDL-c deseables (OR= 2,04); mientras que los nordestinos que consumen menos del 10% de grasa saturada tienen 0,625 veces la probabilidad de tener HDL-c deseables (OR= 0,625). En Teresina, hubo asociación entre el consumo de grasa saturada y colesterol total (p-valor= 0,045), mostrando que adolescentes con consumo menor que 10% de grasa saturada tienen 0,543 veces la probabilidad de tener colesterol total deseable (OR= 0,543). El perfil lipídico no se asoció al consumo de grasa trans, sino al consumo de grasa saturada. Es importante realizar monitorización del perfil lipídico de adolescentes, especialmente en presencia del sobrepeso.

Cardiovascular Risk and Metabolic Syndrome in Individuals with Mental Disorders

Patients with mental disorders are more susceptible to cardiovascular diseases and metabolic disorders compared to the general population. Objective: To evaluate cardiovascular risk and metabolic syndrome in individuals with mental disorders. Materials and methods: A cross-sectional study, conducted at the Psychosocial Care Centers. Socioeconomic, clinical, biochemical and anthropometric data were collected using a standard form. Cardiovascular risk was assessed by the Framingham risk score. Metabolic syndrome (MS) was determined by the World Health- Organization (WHO), the National Cholesterol Education Program (NCEP) and the International Diabetes Federation (IDF) criteria. Data were analyzed by descriptive statistics, and associations were evaluated by the chi-square test and Fisher's exact test, as well as Odds Ratio. The significance level adopted for all statistical tests was 5%. Results: The chance of individuals diagnosed with MS be at intermediate-to-high cardiovascular risk was greater (12.22, 8.01 and 6.23 times higher according to WHO, NCEP and IDF criteria, respectively) than those without MS. Conclusion: A high percentage of patients with mental disorders were at intermediate / high cardiovascular risk, and this was significantly associated with MS

Relação bilateral entre excesso de peso e transtornos mentais / Bilateral relationship between excess weight and mental disorders / Relación bilateral entre el exceso de peso y trastornos mentales

Objetivo: Determinar a prevalência de excesso de peso em indivíduos com e sem transtornos mentais. Métodos: Estudo quantitativo, transversal e analítico, realizado com 167 voluntários adultos, de ambos os sexos, com ou sem transtornos mentais, e com idade superior a 18 anos, no período de outubro a dezembro de 2015. Os participantes foram recrutados no Centro de Atenção Psicossocial e em uma Unidade Básica de Saúde de Teresina, Piauí, Brasil. Utilizou-se formulário estruturado com variáveis sociodemográficas (idade, sexo, escolaridade, estado civil e renda) e antropométricas (peso e altura). O diagnóstico antropométrico foi realizado de acordo com índice de massa corporal, e o psiquiátrico conforme a Classificação Internacional de Doenças (CID 10). A análise dos dados foi feita de forma descritiva, utilizando-se o teste Qui-Quadrado de Independência (ᵡ²) para avaliar associações. Para a análise de variância aplicou-se o teste ANOVA seguido do de Tukey, com 5% de significância. Resultados: Do total de participantes, 77,2% (n=129) tinham diagnóstico de transtornos mentais e 22,8% (n=38), não. O excesso de peso foi verificado em 73,1% (n=122) dos investigados, com maior prevalência na população psiquiátrica (89,4%, n=109). As médias de IMC entre os grupos mostraram diferenças significativas entre esquizofrênicos ( ¯X= 31,62 kg/m2; p<0,01), depressivos ( ¯X = 31,23 kg/m2; p=0,04) e outros transtornos de humor ( ¯X = 31,09 kg/m2; p=0,01) quando comparados ao grupo sem transtornos mentais ( ­­¯X= 25,51 kg/m2). Conclusão: Evidencia-se a superioridade de excesso de peso na população psiquiátrica, especialmente em esquizofrênicos e depressivos, quando comparada à população sem transtornos mentais.

Objective: To determine the prevalence of excess weight in individuals with and without mental disorders. Methods: A cross-sectional, quantitative and analytical study carried out with 167 adult volunteers of both sexes, with and without mental disorders, and aged over 18 years, in the period from October to December 2015. The participants were recruited at the Psychosocial Care Center and at a Basic Health Unit of Teresina, Piauí, Brasil. A structured form was used to collect sociodemographic variables (age, sex, schooling, marital status and income) and anthropometric variables (weight and height). The anthropometric diagnosis was determined by the Body Mass Index, and the psychiatric diagnosis was according to the International Classification of Diseases (ICD 10). The data analysis was performed in a descriptive way, using the Chi-square test of independence (ᵡ²) to evaluate associations. For analysis of variance, the study applied the ANOVA test followed by Tukey's, with significance level at 5%. Results: Of the total of participants, 77.2% (n=129) had been diagnosed with mental disorders, and 22.8% (n=38) had not. Excess weight was observed in 73.1% (n=122) of those investigated, with a higher prevalence in the psychiatric population (89.4%, n=109). The mean BMI of the groups showed significant differences among schizophrenics ( ¯X = 31.62 kg/m2; p<0.01), depressives ( ¯X= 31.23 kg/m2; p=0.04), and those with other mood disorders ( ¯X= 31.09 kg/m2; p=0.01) when compared to the group without mental disorders ( ¯X= 25.51 kg/m2). Conclusion: It is evidenced the superiority of excess weight in the psychiatric population, especially in schizophrenics and depressives when compared to the population without mental disorders.

Objetivo: Determinar la prevalencia de exceso de peso de individuos con y sin trastornos mentales. Métodos: Estudio cuantitativo, transversal y analítico realizado con 167 adultos voluntarios, de ambos los sexos, con o sim trastornos mentales y más de 18 años de edad en el período entre octubre y diciembre de 2015. Los participantes fueron reclutados del Centro de Atención Psicosocial y de una Unidad Básica de Salud de Teresina, Piauí, Brasil. Se utilizó un formulario estructurado con las variables sociodemográficas (edad, sexo, escolaridad, estado civil y renta) y antropométricas (peso y altura). El diagnóstico antropométrico se dio según el índice de masa corporal y el psiquiátrico según la Clasificación Internacional de Enfermedades (CIE 10). El análisis de los datos fue de manera descriptiva, utilizándose la prueba de Chi-cuadrado de Independencia (ᵡ²) para evaluar las asociaciones. Para el análisis de la variancia se aplicó la prueba ANOVA seguida de la de Tukey con el 5% de significación. Resultados: Del total de participantes, el 77,2% (n=129) tenían el diagnóstico de trastornos mentales y el 22,8% (n=38) no. El exceso de peso ha sido identificado en el 73,1% (n=122) de los investigados con mayor prevalencia en la población psiquiátrica (89,4%, n=109). Las medias del IMC entre los grupos mostraron diferencias significantes entre los que sufren de esquizofrenia (­­ ¯X= 31,62 kg/m2; p<0,01), depresión (­­ ¯X = 31,23 kg/m2; p=0,04) y otros trastornos del humor ( ¯X­­ = 31,09 kg/m2; p=0,01) comparados con el grupo sin trastornos mentales (­­ ¯X =25,51 kg/m2). Conclusión: Se evidencia la superioridad de exceso de peso en la población psiquiátrica, especialmente en los esquizofrénicos y depresivos comparados con la población sin trastornos mentales.

Fatores que influenciam a escolha do tipo de parto na percepção das puérperas / Factores que influyen en la elección del tipo de nacimiento en la percepción de las puerperas / Factors that influence the choice of birth type regarding the perception of puerperal women

Objective: To understand the factors that influence the process of choosing the type of delivery, from the perception of mothers. Methods: This is a qualitative and descriptive research, held at the Women’s Hospital Midwife Maria Correia, Mossoró/RN. A total of 14 mothers were interviewed. Data were analyzed according to the Collective Subject Discourse technique. The study was submitted to the Ethics Committee in Research of Universidade Potiguar approved under the number CAAE: 38520214.0.0000.5296. Results: Women’s desire a birth delivery without complications and fast recovery. The influences of the “fear of pain” and individual experiences and other women for choosing the type of delivery are significant. Conclusion: We emphasize the importance of access to prenatal quality actions that provide safe choices, clarifying doubts and future mother’s wishes, reassuringly for delivery.

Objetivo: Comprender, a partir de la percepción de las madres, los factores que influyen en la elección del tipo de parto. Métodos: Se trata de una investigación cualitativa y descriptiva, que tuvo lugar en el Hospital de la Mujer de la partera María Correia, em Mossoró/RN. Fueron entrevistadas 14 madres. Los datos fueron analizados de acuerdo a la técnica del Discurso del Sujeto Colectivo. El estudio fue presentado al Comité de Ética en Investigación de la Universidad Potiguar con número de autorización CAAE: 38520214.0.0000.5296. Resultados: Las mujeres apuntan al deseo de un nacimiento sin complicaciones y una recuperación rápida. Las influencias del “miedo al dolor” y las experiencias individuales y otras mujeres para elegir el tipo de parto son significativos. Conclusión: Destacamos la importancia del acceso a las acciones de calidad prenatales que proporcionan opciones seguras, aclarar dudas y deseos futuros de la madre, de modo tranquilizador para la entrega.

Objetivo: Compreender, a partir da percepção das puérperas, os fatores que influenciam na escolha ao tipo de parto. Métodos: Trata-se de uma pesquisa do tipo qualitativo e descritivo, realizado no Hospital da Mulher Parteira Maria Correia, município de Mossoró/RN. Foram entrevistadas 14 parturientes. Os dados foram analisados de acordo com a Técnica do Discurso do Sujeito Coletivo. A pesquisa foi submetida ao Comitê de Ética em Pesquisa da Universidade Potiguar, aprovado, sob o número do CAAE: 38520214.0.0000.5296. Resultados: As puérperas apontam o desejo de um parto sem intercorrências e com recuperação rápida. São significativas as influências do “medo da dor” e das experiências individuais e de outras mulheres para a escolha da via de parto. Conclusão: Ressalta-se a relevância do acesso ao pré-natal de qualidade, com ações que proporcionem escolhas seguras, esclarecendo dúvidas e anseios da futura mãe, tranquilizando-a para o momento do parto.