Overweight and associated factors in young adult student girls / Exceso Ponderal y factores asociados en mujeres adultas jóvenes escolares / Excesso Ponderal e fatores associados em mulheres adultas jovens escolares

ABSTRACT Objective: To analyze overweight and associated factors in young adult student girls children in a capital city of Northeast Brazil. Method: An analytical, quantitative study was conducted with 546 young adults from 26 schools in a capital city of the Brazilian Northeast. After obtaining the data by the application of a specific questionnaire, the hierarchical logistic regression was used to identify the confounding variables and predictors of overweight. Results: The frequency of cases of overweight in this group was 36.6%. In the bivariate analysis, Overweight presented a statistically significant association with ethnicity, marital status, weight in childhood and overweight in adolescence, overweight in the family and exposure to alcohol, number of children, and age of menarche. In the final regression model, overweight remained associated with weight in childhood and age of menarche. Conclusion: Characteristics related to nutritional status in earlier life stages and gynecological issues were associated with Overweight during the young adult stage of the woman.

RESUMEN Objetivo: Analizar el Exceso Ponderal (EP) y los factores asociados en mujeres adultas jóvenes escolares de una capital del Nordeste brasileño. Método: Estudio analítico, cuantitativo, realizado con 546 adultos jóvenes de 26 escuelas de una capital del Nordeste brasileño. Después de obtener los datos por la aplicación de cuestionario específico, se utilizó la regresión logística jerarquizada para identificación de las variables confundidoras y predictoras del EP. Resultados: La frecuencia de casos de EP en ese grupo fue del 36,6%. En el análisis bivariado, el EP presentó asociación estadísticamente significativa con raza, situación conyugal, peso en la infancia y peso elevado en la adolescencia, EP en la familia y exposición al alcohol, número de hijos, y edad de la menarca. En el modelo final de la regresión, el EP permaneció asociado con peso en la infancia y edad de la menarca. Conclusión: Las características relacionadas con el estado nutricional en fases anteriores de la vida y las cuestiones ginecológicas estuvieron asociadas al EP durante la fase adulta joven de la mujer.

RESUMO Objetivo: Analisar o Excesso Ponderal (EP) e os fatores associados em mulheres adultas jovens escolares de uma capital do Nordeste brasileiro. Método: Estudo analítico, quantitativo, realizado com 546 adultas jovens de 26 escolas de uma capital do Nordeste brasileiro. Após obtenção dos dados pela aplicação de questionário específico, utilizou-se a regressão logística hierarquizada para identificação das variáveis confundidoras e preditoras do EP. Resultados: A frequência de casos de EP nesse grupo foi de 36,6%. Na análise bivariada, o EP apresentou associação estatisticamente significativa com raça, situação conjugal, peso na infância e peso elevado na adolescência, EP na família e exposição ao álcool, número de filhos, e idade da menarca. No modelo final da regressão, o EP permaneceu associado com peso na infância e idade da menarca. Conclusão: Características relacionadas ao estado nutricional em fases anteriores da vida e questões ginecológicas estiveram associadas ao EP durante a fase adulta jovem da mulher.

Las diferencias de sexo y género en la depresión: proclividad en la mujer / Sex and gender differences in depression: proclivity in women

El presente artículo es una exposición y análisis de los principales factores que intervienen en la depresión, considerando aquellos que se circunscriben a las características biológicas, psicológicas y sociales relacionadas con el sexo y el género. En última instancia, éstos determinan que dicho trastorno se presente con más frecuencia en mujeres que en varones, casi duplicando los casos. Además se explican las cualidades de los trastornos depresivos en los diferentes períodos reproductivos, cuando esta enfermedad adquiere peculiaridades clínicas muy individuales según el desarrollo de las funciones sexuales y hormonales. Por último, se plantea la forma en que los roles asignados a los géneros pueden intervenir en las formas de afrontar la depresión de mujeres y hombres.

The article presents and analyzes the major factors involved in depression, taking into account those related to biological, psychological and social issues linked to sex and gender. Ultimately, these sex and gender-associated factors determine that the condition is present more often in women than in men, nearly doubling the cases. In addition, the article describes the singularities of depressive disorders in different reproductive periods when the disease acquires clinical specificity in accordance with sexual and hormonal functions. Finally, the way in which gender roles can intervene in how depression is approached in women vis-à-vis men is covered.

The monthly rhythm of incidence and age at menarche: thirty five years of research: The circa-vacation-study expectancy rhythm of incidence and age at menarche

The hypothesis that the vacation-study-expectancy scholar regime produces most of the monthly rhythm of the age at menarche (AaM) was tested. Studies on monthly menarche incidence (MI) refuted climatic factors as a main factor in this rhythm, and indicated that the main factor of this rhythm is the succession of expectancies of study (Stu-months) or vacation (Vac-months) months within a year. Thus the hypothesis of seasonal circa-annual rhythm should be modified to the circa-[vacation (fiesta)]-[study (non-fiesta)]-expectancies rhythm for the MI and age at menarche annual rhythms. In several countries Vac-months had higher MI than Stu-months. The high MI of Vac-months was followed by a large decrease when girls started their studies and a MI increase occurred as vacations approached. The hypothesis proposes that at the end of vacations and at the beginning of the study period the AaM should be lowest, and then the mean of AaM should increase because of the menarche delay of girls whose menarche was arrested by the initiation of school work. This pattern was found in four independent samples, from Chile, Colombia, USA and Brazil. The probability that this result be due to random fluctuation of means is extraordinarily low (P<10-8). I conclude that the influence of the expectancy of vacation and study periods on the monthly rhythm of the age at menarche is a real process that accounts for most of this rhythm.

Obesidade na população feminina: Município de Xangri-lá: perfil de risco / Obesity and risk factors among the feminine population of Xangri-lá

Objetivos: Avaliar, na população feminina do município de Xangri-Lá, balneário do sul do estado, a prevalência da obesidade e seus fatores de risco. Métodos: Estudo de base populacional, prospectivo e transversal com aplicação de questionário estruturado com as variáveis: idade, cor, estado civil, escolaridade, renda familiar, idade da menarca e paridade. Critérios de inclusão: idade ≥ 20 anos, assinatura do consentimento informado e presença no posto de saúde do Programa de Saúde da Família (PSF) para exame das mamas e medidas da estatura, peso e pressão arterial. A obesidade foi definida pelo índice de massa corporal (IMC) ≥ 30 Kg/m². Resultados: Foram incluídas 728 mulheres com mais de 20 anos atendidas no PSF. A média de idade da amostra foi de 41 anos, com desvio padrão de 12,2. O IMC médio foi de 27,4 e verificou-se que 60,6% da população avaliada estava com peso acima do saudável, ou seja, IMC ≥ 25. A obesidade ocorreu em 26,9% dos casos e mostrou correlação positiva com a idade (p=0,000), sendo que 49,3% das mulheres a partir dos 60 anos eram obesas. A menarca precoce mostrou-se um preditor à obesidade (p=0,003). A multiparidade e a baixa renda familiar foram fatores predisponentes. Cerca de 67% das mulheres com menor nível de escolaridade (até 5 anos) estavam obesas ou com sobrepeso. Conclusões: A prevalência da obesidade nesta população feminina foi de 26,9%. A idade e a menarca precoce parecem ser os principais fatores de risco, mas também a paridade, a baixa escolaridade e a baixa renda familiar contribuem para a prevalência deste agravo.

Background: To evaluate the prevalence of obesity and its associated risk factors among women from Xangri-Lá, state of Rio Grande do Sul, Brazil. Methods: This was a population-based cross-sectional study. A structured questionnaire including the following variables: age, color, marital status, educational level, family income, age at first menstruation, and parity was administered. The inclusion criteria were: being ≥ 20 year old, having signed the informed consent form, and attending the outpatient clinic of the Family Health Program for breast exam and measurement of height, weight, and arterial pressure. Obesity was defined as body mass index (BMI) ≥ 30 Kg/m². Results: Seven hundred and twenty-eight women were included. Mean age was 41 years (SD = 12.2). Mean BMI was 27.4, and 60.6% of the sample was overweight (BMI ≥ 25). The prevalence of obesity among the subjects was 26.9%, showing a positive correlation with age (p=0.00), and 49.3% of the women older than 60 years old were obese. Early menarche was a predictor for obesity (p=0.003). Multiparity and low family income were contributing factors. About 67% of the women with low educational level (< 5 years) were obese or overweight. Conclusions: The prevalence of obesity in this female population was 26.9%. Age and early menarche seem to be the most important risk factors; however, parity, low educational level, and low family income contribute to the prevalence of obesity.

Factores psicosociales y culturales que influyen en el evento de la menarquia en adolescentes posmanárquicas / Psychosocial and cultural factors in post-menarcheal adolescents

Introducción: La menarquia es un evento de vida significativo con importantes implicaciones culturales, sociales y personales. Objetivo: Conocer y entender mejor el contexto psicosocial en que ocurre la menarquia considerando la edad de ocurrencia, fuentes y calidad de la información o preparación recibida, y las reacciones emocionales experimentadas. Método: Se entrevistaron adolescentes entre 11 y 19 años que consultaron en CEMERA entre 2005 y 2006. Se aplicó un cuestionario especialmente diseñado y se aseguró confidencialidad y anonimato de sus respuestas. Resultados: Participaron 826 adolescentes. 34,6 por ciento de ellas tuvieron la menarquia entre los 9 y 11 años, 53,1 por ciento entre 12 y 13 años y 12,3 por ciento entre los 14 y 16 años. 88,6 por ciento recibieron información sobre el tema previo a la menarquia. 81,3 por ciento de las madres fueron quienes informaron a sus hijas, seguidas por familiares mujeres en 6,8 por ciento, colegio en 4,6 por ciento; 78 por ciento de las adolescentes que recibieron información indicaron no sentirse preparadas al momento del evento. 23,6 por ciento reportó sentirse muy mal, 21 por ciento asustada, 20,5 por ciento extraña, 4 por ciento indiferente y 30,8 por ciento indicó sentirse feliz con la menarquia. Conclusión: Si bien en la actualidad las niñas tienen acceso a una serie de fuentes de información acerca de la menstruación es principalmente la madre, el colegio y los profesionales de salud quienes juegan un rol primordial en su preparación en este aspecto. Pero esta información tiende a estar focalizada solo en aspectos higiénicos y biológicos inmediatos y obvios pero desconectados de la experiencia del propio cuerpo de las niñas como de su emocionalidad.

Background: Menarche is a significant life event with important cultural, social and personal implications. Objectives: To know and to understand in a better way, the psychosocial context in which menarche takes place, considering age occurrence, sources and quality of information, training received and the emotional reactions experienced. Methods: In 2005 and 2006, adolescents from 12 to 19 years old, who consulted at an Adolescents Clinic, took a specially designed questionnaire and they were guaranteed confidentiality and anonymity in their answers. Results: 826 adolescents took part in this study; 34.6 percent of them had the menarche between 9-12 years old, 53.1 percent between 12-13 years old and 12.3 percent between 12-14 years old; 88.6 percent got information previously to menarche; 81.3 percent mothers were who gave the corresponding information to their daughters, followed by their female relatives in a 6.8 percent, school in a 4.6 percent; 78 percent of the total number of adolescents who got adequate information, pointed out that they did not feel prepared enough at the moment of the event; 23.6 percent reported they felt very bad, 21 percent were frightened, 20.5 percent awkward, 4 percent unconcerned and only 30.8 percent reported they felt happy when they experienced menarche. Conclusion: Although, nowadays girls have a major access to a various sources of information about menarche, it is mainly mother, school and health professionals who participate in their training on this area. But this information tends to be focused on hygienically and biological aspects that are immediate and obvious, but it is disconnected from the experience of the girl bodies as of their emotionality.

Confirmación de la expectativa vacación-estudio como factor principal del ritmo anual de incidencia y edad de menarquia / Expectancy of vacation as a determining factor of the annual rhythm of menarche

Background: Our previous studies have shown that the monthly rhythm of menarche is associated to the expectancy of holidays or vacations. If this hypothesis is true, menarche episodes in Chile should cluster in December, the month prior to summer vacations. Aim: To study whether the expectancy of holidays or vacations is the main determinant of the annual rhythm of menarche. Material and methods: During 1990 and 1991, a questionnaire about the date of birth and date of menarche, was applied to girls living in Santiago (Chile) and Medellin (Colombia), aged 8 to 18.5 years. They were requested to register the year, month or day of menarche, only if they recalled it precisely. Results: Discarding clerical errors, data was obtained from 3,225 Chilean and 3,435 Colombian girls. Of these 73 and 63% of Chilean and Colombian girls recalled the day of menarche. Among Chilean girls an excess of menarche episodes was observed in December, January and February. The mean age per month of menarche reached its highest value of 155.6±15 months in December and fell to 148±17 months in January (p <0.001). Among Colombian girls, mean age per month of menarche was also higher in December and lower in January (152±15 and 147±14 months respectively, p <0.001). However a peak of 152±15 months was also observed in June. Conclusions: A similar distribution of menarche episodes was observed among Chilean and Colombian girls, with a peak in the months preceding holidays. The influence of the photoperiod is unlikely since Medellin is located in parallel 6 and there are little variations in daylight exposure in the different seasons. Therefore, our data supports the hypothesis that the prospect of holidays is a determinant of menarche.