Fatores associados à prática de atividade física no lazer: análise dos brasileiros com doenças crônicas / Factors associated with leisure-time physical activity: analysis of Brazilians with chronic diseases

Resumo O objetivo desse estudo foi analisar a prevalência e os fatores associados à prática de atividade física no lazer (PAFL) suficiente em brasileiros com diagnósticos de hipertensão arterial, diabetes e/ou hipercolesterolemia. Trata-se de um estudo transversal de base populacional com representatividade para todo o território brasileiro. Foram entrevistados adultos com 20 ou mais anos de idade. Foram estimadas prevalências e, por meio de regressão logística, calculadas as razões de chance (OR) bruta e ajustada do desfecho segundo cada uma das variáveis exploratórias. A prevalência de PAFL suficiente foi de 15,9%, 15,3% e 21,4% entre as pessoas com hipertensão arterial (n=12.228), diabetes (n=3.577) e hipercolesterolemia (n=7.124), respectivamente. Tais valores foram inferiores ao observado entre os adultos que não referiram uma das três doenças. Análise ajustada mostrou que indivíduos com autopercepção positiva da saúde, com maior escolaridade, que referiram espaço público próximo ao domicílio para a realização de atividade física, presença no município de programas públicos que estimulem a prática de atividade física e recomendação de profissional de saúde para a PAFL estiveram associados a maior chance de serem suficientemente ativos.

Abstract The scope of this study was to analyze the prevalence and the factors associated with sufficient leisure-time physical activity (LTPA) among Brazilians diagnosed with hypertension, diabetes and/or hypercholesterolemia. It involved a representative, cross-sectional population-based study for the entire Brazilian territory. Adults aged 20 years and over were interviewed. Prevalences were estimated and, by means of logistic regression, the crude and adjusted odds ratios (OR) of the outcome were calculated in accordance with each of the exploratory variables. The prevalence of sufficient LTPA was 15.9%, 15.3% and 21.4% among people with hypertension (n=12,228), diabetes (n=3,577) and hypercholesterolemia (n=7,124), respectively. These values were lower than those observed among adults who did not report one of the three diseases. Adjusted analysis showed that individuals with positive self-perception of health and with more schooling, who reported a public space near their homes for physical activity, the existence in the city of public programs that encourage physical activity and the recommendation of health professionals to practice LTPA, were associated with a greater chance of being sufficiently active.

Prevalence and influencing factors of main chronic diseases among urban residents in Liaoning Province / 预防医学

Objective To investigate the prevalence of main chronic diseases and explore its influencing factors among urban residents in Liaoning Province. Methods Using multistage stratified and cluster random sampling method, 30 953 urban residents of 14 districts were investigated with a standard questionnaire and physical examination. The logistic regression was applied to explore the influencing factors of main chronic diseases. Results The prevalence rate of chronic diseases was 39.25% and the standardized prevalence rate was 32.29%. The top three chronic diseases were hypertension, diabetes mellitus, and dyslipidemia, and the standardized prevalence rates were 21.13%, 9.48% and 5.25%. The results of the logistic regression analysis showed that the three chronic diseases shared older age(OR: 1.266-7.325)and overweight or obesity(OR:1.107-2.982)as the risk factors .In addition, there existed certain interactions among hypertension, diabetes mellitus and dyslipidemia(OR: 2.424-3.121). Conclusion Hypertension, diabetes mellitus and dyslipidemia which shared older age, overweight and obesity as the risk factors are the main chronic diseases to damage the health of urban residents in Liaoning. The corresponding prevention and treatment strategies should be taken based on the key groups and related influencing factors.

El bajo peso al nacer y la programación temprana de la vida, un problema de actualidad y del futuro / Low birth weight and early programming of life, a present and future problem

El hecho de que el desarrollo fetal pueda ser un factor influyente en el desarrollo humano durante todo el ciclo de la vida ha sido explorado desde la primera mitad del siglo XX, cuando Kermack y otros analizan las tasas históricas de mortalidad en Gran Bretaña y Suiza, y observan que la expectativa de vida estaba determinada por las condiciones existentes durante las etapas tempranas de la vida. Los estudios de Forsdhal, en 1977, determinaron como factor de riesgo cardiovascular los estados de pobreza, seguidos de prosperidad durante la infancia y la adolescencia. Estas observaciones conllevaron a Barker a conformar su hipótesis acerca de la relación entre el bajo peso al nacer y el riesgo cardiovascular, la resistencia insulínica y la diabetes tipo II en la adultez. Aunque no se ha podido demostrar una relación causal única entre el bajo peso al nacer y el desarrollo de las enfermedades crónicas no transmisibles (siendo esta una relación multicausal, tanto los estudios in vitro como in vivo), han demostrado que un medio intrauterino deficiente, independiente de su causa, puede incrementar el riesgo de padecer esas enfermedades, al igual de que si persiste el medio adverso durante la infancia y la adolescencia (estados nutrimentales carenciales), se perpetúa el riesgo. El presente reporte tiene el objetivo de analizar algunos aspectos teóricos relacionados con la programación temprana de la vida y su relación con el desarrollo de las enfermedades crónicas no transmisibles, así como su importancia para el médico de familia y el pediatra general en la práctica médica diaria, encaminado a su prevención en etapas ulteriores del desarrollo humano(AU)

The fact that the fetal development may be an influential factor on the human development during the whole life cycle has been explored since the first half of the 20th century when Kermack and others analyzed the historical mortality rates in Great Britain and Switzerland, and observe that the life expectancies are determined by the existing conditions during the early phases of life. The studies by Forsdhal in 1977 determined that the poverty conditions, followed by prosperity in childhood and adolescence, were cardiovascular risk factors. These considerations led Barker to create his hypothesis on the relationship between the low birth weight and the cardiovascular risk, the insulin resistance and the type II diabetes in adulthood. Although a unique causative relationship has not been yet proved between the low birth weight and the development of non-communicable chronic diseases (a multi-causal relationship in both in vitro and in vivo studies), it has been demonstrated that a deficient intrauterine medium, regardless of the cause, may increase the risk of suffering these diseases as it may happen if the adverse medium persists during childhood and adolescents (deficient nutritional states) since the risk perpetuates. The present report is aimed at analyzing some theoretical aspects related to early programming of life and its relation with the development of non-communicable chronic diseases as well as its importance for the family physician and the general pediatrician in daily medical practice to prevent them in further stages of the human development(AU)

Study on the Chronic Diseases Curative Care Expenditure in Jilin under the Background of Health Care Grading System / 中国卫生经济

Objective:To comprehensively analyze the present situation and characteristics otthe curative care expenditure of chronic diseases in Jilin,and to provide data support and suggestions for health policy formulation.Methods:The System of Health Accounts 2011 (SHA2011) was used to analyze the total and composition of curative care expenditure of non-communicable chronic diseases in Jilin province.Results:In 2014,the curative care expenditure of chronic diseasesin Jilin province reached to 32.02 billion yuan,which accounted for 65.51％ of curative care expenditureof the all diseases in Jilin.From the perspective of disease costs,the curative care expenditure of chronic diseases occurred in cardiovascular disease,malignancy and other chronic diseases reachedto 66.22％.From the perspective of service composition,the curative care expenditure ofchronic diseases except oral disease occurred more in the hospital.From the perspective of medical institutions costs,thecurative care expenditureof chronic diseases occurred in urban medical institutions reached to 65.83％.From the perspective of care financing,the household out-of-pocket (OOP) accounted for 41.77％of curative care financing forchronic diseases in Jilin.Condusion:Thecurative care expenditureof chronic diseases in Jilin had a large scale.The distribution of medical institutions costsof chronic diseases showed as "inverted triangle" in Jilin.The financing structure of thecurative care expenditureof chronic diseases needed to be improved.

Study on the Chronic Diseases Curative Care Expenditure in Jilin under the Background of Health Care Grading System / 中国卫生经济

Objective:To comprehensively analyze the present situation and characteristics otthe curative care expenditure of chronic diseases in Jilin,and to provide data support and suggestions for health policy formulation.Methods:The System of Health Accounts 2011 (SHA2011) was used to analyze the total and composition of curative care expenditure of non-communicable chronic diseases in Jilin province.Results:In 2014,the curative care expenditure of chronic diseasesin Jilin province reached to 32.02 billion yuan,which accounted for 65.51％ of curative care expenditureof the all diseases in Jilin.From the perspective of disease costs,the curative care expenditure of chronic diseases occurred in cardiovascular disease,malignancy and other chronic diseases reachedto 66.22％.From the perspective of service composition,the curative care expenditure ofchronic diseases except oral disease occurred more in the hospital.From the perspective of medical institutions costs,thecurative care expenditureof chronic diseases occurred in urban medical institutions reached to 65.83％.From the perspective of care financing,the household out-of-pocket (OOP) accounted for 41.77％of curative care financing forchronic diseases in Jilin.Condusion:Thecurative care expenditureof chronic diseases in Jilin had a large scale.The distribution of medical institutions costsof chronic diseases showed as "inverted triangle" in Jilin.The financing structure of thecurative care expenditureof chronic diseases needed to be improved.

Primera información de los resultados del proyecto Determinantes individuales y sociales de salud en la medicina familiar / First information of the results of the project called Individual and social determinants of health in family medicine

Introducción: el proyecto Determinantes individuales y sociales de salud en la medicina familiar, concebido con una duración de dos años, se propone desarrollar la opción de evitar la aparición de enfermedades crónicas no trasmisibles interviniendo en los determinantes sociales e individuales de la salud. Objetivo: describir los resultados preliminares después de un año de trabajo en el citado proyecto. Métodos: estudio descriptivo prospectivo en 1 496 individuos dispensarizados en el policlínico universitario Tomás Romay. La muestra se dividió en dos grupos homogéneos: el grupo intervenido, cuyos miembros fueron invitados cuatro veces en el año a una consulta salutogénica y un grupo control, al que se le realizó dos consultas, una al inicio y otra al final del mismo año. Se utilizó una entrevista que actualiza el estado de los determinantes individuales y sociales y permite ofrecer orientaciones salutogénicas. Resultados: en el grupo intervenido disminuyó la frecuencia del tabaquismo (p< 0,0001), el bebedor de riesgo (p< 0,05), el peso (p< 0,05) y el valor del índice de masa corporal (p< 0,05), así como el número de personas con sobrepeso (p< 0,001), la presión arterial diastólica (p< 0,05), y la presión arterial sistólica (p< 0,001). Por otro lado, durante el período de intervención, aumentó la incidencia de diabetes mellitus en el grupo control en comparación con el grupo intervenido (p< 0,05). Conclusiones: los resultados son aun modestos, pero avalan una posibilidad racional para disminuir el riesgo de la aparición de enfermedades crónicas no trasmisibles...

Introduction: the project Individual and social determinants of health in family medicine conceived for two years, is aimed at developing the option of preventing the occurence of non-communicable chronic diseases by intervening in the individual and social determinants of health. Objective: to describe the preliminary results after one-year work in the mentioned project. Methods: prospective and descriptive study of 1 496 subjects classified in Tomas Romay university polyclinics. The sample was divided into two homogeneous groups: the intervened group whose members were invited to salutogenic consultation four times a year, and a control group which went to two consultations, one at the beginning and other at the end of the year. An interview was made to update the state of the individual and social determinants and allowed providing salutogenic guiding. Results: the intervened group reduced the frequency of smoking (p< 0.001), risky drinking (p< 0.05), weight (p< 0.05) and the body mass index (p< 0.05) as well as the number of overweighed persons (p< 0.001), diastolic blood pressure ((p< 0.005), and systolic blood pressure (p< 0.001). On the other hand, the incidence of diabetes mellitus rose during the intervention period in the control group compared with that of the intervened group (p< 0.05). Conclusions: the results are still modest, but they support a rational possibility to diminish the risk of emergence of non-communicable chronic diseases...

Nutritional profile and presence of risk factors and protection for non-communicable chronic diseases in diabetics / Perfil nutricional e presença de fatores de risco e proteção para doenças crônicas não-transmissíveis em diabéticos

This study aimed to delineate the nutritional profile and to investigate the presence and distribution of factors of risk and protection for Non-Communicable Diseases (NCD) in diabetic participants. For this, 54 individuals of both sexes participated in this study, aged 28 to 87 years who have been attended by a health center of the municipality of Maringá, Paraná State. It was measured the weight, height and waist circumference and applied two questionnaires related to risk factors and food frequency (FFQ) respectively. The study design is cross-sectional and the descriptive analysis was performed using the statistical software Epi info version 3.32 (2005). The results showed that the most relevant risk factors in the diabetic population in relation to NCD have been related to the overweight, lack of physical activity and self-reported hypertension. The protection factors were healthy diet and quitting of smoking. Based on nutritional assessment, the BMI (Body Mass Index) and waist circumference have been positively correlated with high significance. Health education is necessary for the prevention and health promotion of these individuals through the change of lifestyle.

Este estudo teve como objetivo traçar o perfil nutricional e investigar a presença e a distribuição dos fatores de risco e de proteção para Doenças Crônicas Não-Transmissíveis (DCNT) em portadores de Diabetes Mellitus (DM). Participaram do estudo 54 indivíduos de ambos os sexos, com idade entre 28 a 87 anos, que frequentam um posto de saúde da cidade de Maringá, Estado do Paraná. Foram aferidos o peso, a estatura e a circunferência da cintura e aplicados dois questionários relacionados com fatores de risco e frequência alimentar (QFA), respectivamente. O delineamento da pesquisa é transversal e foi feita análise descritiva pelo programa estatístico Epi info, versão 3.32 (2005). Os resultados demonstraram que os fatores de risco mais relevantes encontrados na população diabética em relação às DCNT´s foram relacionados ao excesso de peso, falta de atividade física e hipertensão autorreferida Os fatores de proteção encontrados foram alimentação saudável e suspensão de tabagismo. Pela avaliação nutricional, o IMC (Índice de Massa Corpórea) e a Circunferência da Cintura tiveram correlação positiva e alta significância. A educação em saúde é necessária para que haja prevenção e promoção da saúde desses indivíduos por meio da mudança dos hábitos de vida.

Fatores de risco para doenças crônicas não transmissíveis identificados em trabalhadores atendidos em um ambulatório de nutrição / Risk factors for non-communicable chronic diseases identified in workers that received assistance at a nutrology clinic / Factores de riesgo para enfermedades crónicas no transmisibles identificadas en trabajadores atendidos en un ambulatorio de nutrición

As doenças crônicas não transmissíveis (DCNT), em particular as cardiovasculares (DCV) e o diabetes melito (DM), têm um importante papel no atual perfil de saúde da população mundial, com projeções de crescimento. O objetivo deste artigo é identificar fatores de risco para doenças crônicas não transmissíveis (DCNT) associados à alimentação em trabalhadores atendidos em um ambulatório de nutrição. Trata-se de estudo de corte transversal. Os dados foram obtidos por meio de entrevista, avaliação antropométrica e bioquímica. A amostra foi selecionada entre trabalhadores de ambos os sexos, que frequentavam oambulatório de nutrição do Centro Estadual de Referência em Saúde do Trabalhador em Salvador, Bahia, em 2010. Os resultados indicam que o IMC ? 25,0 kg/m2 foi o fator de risco de maior frequência (91,8%), seguido da hipercolesterolemia (61,8%) e da hipertrigliceridemia (50,0%). Simultaneidade de dois ou mais fatores de risco foi encontrada em 70,6% dos trabalhadores. Baixo consumo diário de frutas (14,3%), hortaliças (44,4%) e tubérculos (8,0%) e elevado consumo de alimentos ricos em gordura saturada (embutidos ? 48,9%) e açúcar simples (76,0%). O tabagismo era hábito de 3,6% dos trabalhadores. A análise das frequências das dislipidemias segundo a idade mostrou níveis elevados de colesterol total (p=0,02) e triglicérides (p=0,03) em trabalhadores com idade ?41anos. Concluiu-se que as elevadas frequências de fatores de risco modificáveis são preocupantes e reforçam a necessidade de implementação de ações que visem a promoção da saúde e a prevenção de DCNT.

Non-communicable Chronic diseases (NCCD), predominantly cardiovascular (CVD) and diabetes mellitus (DM), play a major role in the current health profile of the world population and are expected to increase its numbers. The purpose of this article is to identify the risk factors for non-communicable chronic diseases (NCCD) in workers that received assistance at a neurology clinic. This is a cross sectional study whose data were collected through interviews, anthropometric and biochemical assessments. The sample was selected between workers of both sexes, who received assistance in the nutrition clinic at the State Centre of Reference on Health of Workers in Salvador, Bahia, in 2010. The results indicate that the body mass index (BMI) ?25.0 kg/m2 was the most frequent risk factor (91.8%), followed by hypercholesterolemia (61.8%) and hypertriglyceridemia (50.0%). Simultaneity of two or more risk factors was found in 70.6% of the workers. Low daily ingestion of fruits (14.3%), vegetables (44.4%), and tubers (8.0%) and a high consumption of foods rich in saturated fat (embedded: 48.9%) and simple sugars (76.0%) were verified. Smoking was a habit in 3.6% of workers. Analysis of frequencies of dyslipidemias according to age showed high levels of total cholesterol (p=0.02) and triglycerides (p=0.03) in workers of age ?41 years. It was concluded that the elevated frequency of modifiable risk factors is worrisome, reinforcing the need for implementation of actions aimed at health promotion and prevention of NCCD.

Las enfermedades crónicas no transmisibles (ECNT), en particular las cardiovasculares (DCV) y la Diabetes Mellitus (DM), desempeñan un importante rol en el actual perfil de la salud de la población mundial, con proyecciones de crecimiento. El propósito de este artículo es identificar los factores de riesgo para las enfermedades crónicas no transmisibles (ECNT), asociadas a la alimentación de trabajadores atendidos en un ambulatorio de nutrición. Estudio de enfoque transversal. Los datos fueron recolectados a través de entrevistas, evaluación antropométrica y bioquímica. La muestra fue seleccionada entre trabajadores de ambos sexos, que frecuentaban, en 2010, el ambulatorio de nutrición del Centro Estatal de Referencia en Salud del Trabajador, en Salvador, Bahía. Los resultados indican que el IMC ? 25,0kg/m2 fue el factor de riesgo de mayor frecuencia (91,8%), seguido de la hipercolesterolemia (61,8%), y de la hipertrigliceridemia (50,0%). Simultaneidad de dos o más factores de riesgo fue encontrada en 70,6% de los trabajadores. Bajo consumo diariode frutas (14,3%), hortalizas (44,4%) y tubérculos (8,0%) y un elevado consumo de alimentos con grasa saturada (embutidos: 48,9%) y azúcar simple (76,0%). El tabaquismo era hábito en el 3,6% de los trabajadores. El análisis de las frecuencias de las dislipidemias según la edad, constató niveles elevados de colesterol total (p=0,02) y triglicéridos (p=0,03) en trabajadores con edad ?41años. Se concluye que las elevadas frecuencias de factores de riesgo cambiables son inquietantes, reforzando la necesidad de implementación de acciones que visen a lapromoción de la salud y a la prevención de ECNT.

Coaching de salud: un nuevo enfoque en el empoderamiento del paciente con enfermedades crónicas no transmisibles / Health coaching: a new approach to the empowering of the patient with non - communicable chronic diseases

Se describe el coaching de salud como nueva tendencia en la promoción y educación sanitarias en el nivel primario de atención, tendiente a lograr el empoderamiento y autocontrol de pacientes con enfermedades crónicas no transmisibles. Se exponen las limitantes en la educación para la salud tradicional y las funciones del profesional en el citado nivel que decida ser coach; también se ofrecen ejemplos de técnicas de coaching, se evalúan las evidencias científicas de efectividad, así como se valoran la posibilidad de la intersectorialidad para apoyar los cambios conductuales y la necesidad de entrenar a los profesionales del sector para tales fines.

Health coaching is described as a new tendency in the health promotion and education in the primary health care, aimed at achieving the empowerment and self-control of patients with non-communicable chronic diseases. Restrictions in the education are exposed for the traditional health and the professional's activities in the mentioned level in which to be a coach; examples of coaching techniques are also offered, the scientific evidences of effectiveness are evaluated, and the possibility of intersectors participation to support the behavioral changes and the necessity of training the professionals of the Branch for such aims are evaluated as well.

La dispensarización en el policlínico universitario docente de Playa un año después de la reorganización / Dispensarization in the \"Playa\" teaching and university polyclinic after one year of the reorganization

Introducción: aunque concebida originalmente en la antigua Unión Soviética, la dispensarización en nuestro país se llegó a constituir, junto con el Análisis de la Situación de Salud, en elementos fundamentales de la medicina familiar, en otras palabras, en la organización del trabajo del Médico de Familia. Objetivos: determinar la situación de la dispensarización a un año de haberse implementado la reorganización de nuestros consultorios de medicina familiar. Métodos: se desarrolló un estudio descriptivo de corte transversal de una muestra tomada al azar, 400 de las historias clínicas individuales del total de pacientes dispensarizados con enfermedades crónicas no transmisibles en los 9 consultorios del Médico y Enfermera de Familia del Policlínico Universitario Docente de Playa. Se revisaron igualmente las historias de salud familiar de los pacientes cuyas historias individuales seleccionamos. Se obtuvo también información de los registros del Departamento de Estadísticas del propio policlínico, con relación a la actividad realizada por los equipos básicos de salud en consulta y en terreno en el mes de enero del presente año. Resultados: la mayoría de los pacientes pertenecen a los grupos de edades por encima de los 50 años, igualmente al sexo femenino y sufren de una sola enfermedad crónica. La hipertensión arterial es la enfermedad crónica que más los afecta, seguida de la diabetes mellitus. El 40 por ciento de los pacientes no ha recibido control, y el 81 por ciento de los pacientes ha sido consultado, ambas situaciones en el último año. Conclusiones: la dispensarización ha mejorado, pero se mantiene presentando un grupo importante de insuficiencias. La reorganización ofrece un potencial aún sin explotar para garantizar una mejor e integral atención médica a nuestra población

Introduction: although originally conceived in the former Soviet Union, the dispensarization in our country was implemented together with the Health Situation Analysis, in main elements of family medicine, in other words, in the work organization of the Family Physician. Objectives: to determine the dispensarization situation after a year of the reorganization implementation of our family physician consulting rooms. Methods: a cross-sectional and descriptive study was conducted in our randomized sample, 400 individual medical records from the total of dispensarized patients presenting with chronic non-communicable diseases from the 9 Family and Nurse Family consulting rooms of the Playa Teaching and University polyclinic. Also, we analyzed the family health medical records of patients whose individual records were selected, as well as information from the Statistic Department registries of this polyclinic related to the activity carried out by health basic teams at consultation and in ground practice during January of current year. Results: most of patients are included in age groups over 50 years and of female sex suffering of only one chronic disease. The high blood pressure is the more prevalent chronic disease, followed by diabetes mellitus. The 40 percent of patients has not a control, the 81 percent of patients has been treated, both situations occurred in past year. Conclusions: the dispensarization has improved but still has many insufficiencies. Reorganization offers a potential still non explored to guarantee a better and integral medical care to our population

Desenvolvimento de um Questionário de Frequência Alimentar (QFA-açúcar)para quantificar o consumo de sacarose / Development of a food frequency questionnaire (FFQ-sugar) to quantify sucrose consumption

Evidências indicam a relação entre o consumo excessivo de açúcar pela população mundial e o desenvolvimento de doenças crônicas como cárie, obesidade, diabetes e câncer. Objetivo: descrever o desenvolvimento de um QFA que permita quantificar em massa o consumo de açúcar em amostra da população adulta de Porto Alegre, com base na adaptação do QFA-Porto Alegre. Métodos: a lista de alimentos e o modelo de registro de QFA foram elaborados por meio da abordagem de pesquisa qualitativa denominada grupo focal. A quantificação do açúcar dos alimentos seguiu o método físico-químico de análise de alimentos de Fehling, ou a leitura da tabela de composição de alimentos do Departamento de Agricultura dos Estados Unidos (USDA). O QFA-açúcar foi avaliado por juízes com experiência na elaboração e aplicação de QFA. Resultados: dos 135 itens alimentares do QFA-Porto Alegre, o grupo focal selecionou 105 para a quantificação. Dentre estes, 40 alimentos não apresentaram sacarose, 7 alimentos agrupados no mesmo item foram individualizados, 5 itens considerados sem açúcar foram mantidos na lista, 1 item foi acrescentado e 1 foi modificado. Os juízes acrescentaram 4 itens e incluíram legenda referente à unidade de tempo e medidas caseiras médias. O QFA-açúcar final contém 94 itens. Conclusão: o QFA-açúcar possui relevâncias e limitações, contudo pode ser aprimorado. Encontra-se em processo de reprodutibilidade e validação e, após, poderá ser utilizado em estudos epidemiológicos para investigar a associação entre consumo de açúcar, doenças crônicas não transmissíveis e cárie na população adulta de Porto Alegre

Evidence indicates the relationship between excessive consumption of sugar by the world population and the development of chronic diseases such as dental caries, obesity, diabetes, and cancer. Aim: to describe the development of a food frequency questionnaire (FFQ) to quantify the mass consumption of sugar in a sample of the adult population from Porto Alegre, based on the adaptation of the FFQ-Porto Alegre. Methods: the list of foods and the FFQ model of registration were developed through the qualitative research approach called focus group. The food sugar quantification followed the Fehling method of food physical-chemical analysis or the reading of the food composition table from the United States Department of Agriculture (USDA). The FFQ-sugar was evaluated by judges with experience in FFQ development and implementation. Results: from the 135 food items of the FFQ-Porto Alegre, the focus group selected 105 for quantification. From these, 40 had no sucrose, seven foods grouped in the same item were individualized, five items considered sugar-free were kept in the list, one item was added, and one was modified. The judges added four items and included a legend for the unit of time and the average portion sizes. The final FFQ-sugar contains 94 items. Conclusion: the FFQ-sugar has relevance and limitations, but can be improved. It is in the process of reproducibility and validation and, in the future, may be used in epidemiological studies to investigate the association between sugar consumption, non-communicable chronic diseases and dental caries in the adult population from Porto Alegre

La dispensarización en el Policlínico Universitario Docente de Playa previo a la reorganización de los equipos básicos de salud / The dispensarization in the Playa Teaching University Polyclinic prior to reorganization of basic health kits

Se desarrolló un estudio descriptivo de corte transversal de una muestra tomada al azar, 400 de las historias clínicas individuales e igual número de historias de salud familiar, del total de pacientes dispensarizados con enfermedades crónicas no transmisibles en los 17 consultorios del Médico y la Enfermera de Familia, del área de salud del Policlínico Universitario Docente de Playa. También se obtuvo información de los registros del Departamento de Estadísticas del policlínico con relación a la actividad realizada por los equipos básicos de salud, tanto en consulta como en terreno, en el mes de enero del presente año. Se consideró como dispensarizado todo aquel paciente que se demostró en la historia clínica individual que ha recibido un control integral en el último año en relación con el momento de la revisión de esta. La mayoría de los pacientes estudiados fue mayor de 50 años, del sexo femenino y padecía solamente una enfermedad crónica. Más del 70 por ciento de estos pacientes no recibe control hace más de un año. Existen verdaderas dificultades en la utilización de las historias clínicas individuales y en las de salud familiar. Igualmente se muestran fisuras en la aplicación del método científico en el acto médico. En conclusión, la dispensarización no está siendo utilizada como el elemento fundamental que debe ser en el trabajo del Médico de Familia, y existe una marcada diferencia entre lo establecido y lo que se realiza con relación a la dispensarización en este policlínico

A cross-sectional and descriptive study was conducted in a randomized sample including 400 individual medical records and a similar number of individual family histories from the total of dispensarization patients presenting with non-communicable chronic diseases seen in the 17 consulting rooms of Family and Nurse Family from the health area of the "Playa" Teaching University Polyclinic, as well as the information from the registries of the Statistics Department of this polyclinic with relation to the activity carried out as the patient's visits in January of present year. All patients in whose medical record was demonstrated that received an integral control in past year in relation to time of its review were considered for the dispensarization. Most of study patients were over 50 years, of female sex and suffering only one chronic disease. More than the 70 percent of these patients not receive such control from more than one year. There are real difficulties in use of individual medical records and in those related to the family health. Also, there were failures in application of scientific method in the medical act. We conclude that dispensarization has not been used as the main element present in the Family Physician task and there is a marked difference between that to be established and the reality with relation to dispensarization in this polyclinic

Doenças crônicas não transmissíveis: fatores de risco e repercussão na qualidade de vida / Non-communicable chronic diseases: risk factors and impact on quality of life

Os principais fatores de risco para as Doenças Crônicas Não Transmissíveis DCNT,responsáveis por 45,9 porcento da carga mundial de doenças, são hipertensão arterial, tabagismo, consumo excessivo de álcool, inatividade física, sobrepeso e obesidade, consumo inadequado de frutas e hortaliças, hiperglicemia. Este artigo tem como objetivo descrever os principais fatores de risco para as DCNT, com ênfase na repercussão destes na qualidade de vida QV dos indivíduos.A metodologia utilizada foi uma revisão de literatura com dados fundamentados nas bases de dados on-line, fontes bibliográficas, documentos governamentais, não governamentais e estatísticas de saúde. Como resultados apresentam-se os documentos encontrados com ênfase na repercussão dos fatores de risco na qualidade de vida dos indivíduos. Concluiu-se que realizar um diagnóstico precoce das DCNT, verificar o impacto desses fatores na QV é muito importante, já que essas doenças atuam silenciosamente; a prevenção e o controle das DCNT e seus fatores de risco são fundamentais para evitar um crescimento epidêmico dessas doenças e suas consequências nefastas para a QV dos indivíduos e sua repercussão no sistema de saúde do país.

The main risk factors for Non-communicable Chronic Diseases NCCD responsible for 45.9 porcent of world disease load are hypertension, smoking, excessive alcohol consumption, physical inactivity, overweight and obesity, inadequate intake of fruits and vegetables, hyperglycemia. This article aims at describing the main risk factors for NCCDs, with emphasis on its impact on individuals? quality of life QOL. Methodology entailed documentary research based on data from databases, online library resources, government documents, non-governmental and health statistics. Results present literature review of documents found on the impact of risk factors on individuals? quality of life. By way of conclusion, it was assumed that early non-communicable diseases diagnosis to investigate the impact of factors on QOL is very important. As these diseases work quietly, prevention and control of NCCDs and their risk factors are essential to prevent these diseases epidemic growth and their adverse effects on individuals QOL and their impact on the country?s health system.

Fatores associados à prática de atividade física na população adulta de Goiânia: monitoramento por meio de entrevistas telefônicas / Factors associated with physical activity in Goiania's adult population: surveillance through telephone interviews

INTRODUÇÃO: A prática regular de atividades físicas entre os níveis moderados e vigorosos tem relação inversa com a morbidade-mortalidade por doenças cardiovasculares e obesidade. É fundamental a identificação dos determinantes desta prática para serem propostas estratégias populacionais com vista à adoção de um estilo de vida fisicamente ativo. OBJETIVO: O presente estudo teve por objetivo determinar os fatores associados à prática de atividade física e ao sedentarismo na população adulta de Goiânia. MATERIAL E MÉTODOS: Trata-se de parte de um estudo multicêntrico, transversal, realizado na cidade de Goiânia/GO com amostra probabilística da população adulta atendida por linhas telefônicas fixas. Foram realizadas 2.002 entrevistas por meio de ligações telefônicas, definindo uma taxa de sucesso de 73,1 por cento. A construção do banco de dados e as análises estatísticas foram realizadas com auxílio do aplicativo STATA, versão 8.0. RESULTADOS: O sedentarismo foi mais prevalente entre as mulheres (55,5 por cento) que entre os homens (42,0 por cento). A prevalência de hipertensão foi menor naqueles indivíduos que praticavam atividade física (p=0,0002). Em relação à atividade física no lazer, as mulheres foram mais inativas (79,3 por cento) que os homens (66,9 por cento). Houve relação inversa entre sedentarismo e escolaridade em ambos os sexos. CONCLUSÃO: Diante do quadro encontrado de alta freqüência de sedentarismo na população, sugere-se a implementação de estratégias de prevenção primária para melhorar o perfil de risco para doenças crônicas não transmissíveis.