Associação entre etnia e sobrepeso/obesidade populacional no Brasil / Association between ethnicity and population overweight/obesity in Brazil

Introdução: A obesidade é uma doença multifatorial, crônica e progressiva, que afeta parcelas consideráveis da população mundial e brasileira. Estudos mostram que sociedades e ambientes com maiores níveis de racismo estrutural podem desencadear maiores níveis de prevalência de obesidade nas suas populações marginalizadas. Assim, a maior vulnerabilidade das populações de etnia preta no Brasil, decorrentes do racismo estrutural e institucional instaurado, leva a maiores índices de sobrepeso e obesidade ocasionadas pela incapacidade de tais populações garantirem a segurança alimentar. Objetivo: O objetivo deste estudo foi analisar a evolução da prevalência do sobrepeso e obesidade nas populações da etnia branca e preta no Brasil, avaliando hábitos alimentares com potencial de promover a obesidade. Além disso, buscou-se relacionar o agravamento do IMC populacional no Brasil com a etnia e o racismo estrutural presente na sociedade brasileira. Método: Trata-se de um estudo descritivo de cunho transversal. Foram selecionadas 12 questões padronizadas do inquérito VIGITEL realizados nos anos de 2011 a 2020. Os dados foram analisados por meio de estatística descritiva, e para comparação entre os grupos étnicos aplicou-se o teste T de Student. Resultados: Os resultados, de modo geral, evidenciam que indivíduos da etnia preta apresentam maior grau de IMC (Kg/m2) em comparação à etnia branca. Os dados de IMC entre as capitais brasileiras demonstram que tanto em 2011, quanto em 2020, as médias do índice avaliado foram maiores entre a população de etnia preta, apresentando 26,03 Kg/m2 e 27,07 Kg/m2 respectivamente, enquanto os indivíduos declarados brancos tiveram médias de 25,7 Kg/m2 e 26,45 Kg/m2 nos mesmos anos. O IMC médio nos anos de 2011 a 2020, de 25,99 Kg/m2para a etnia branca, e de 26,50 Kg/m2 para a etnia preta indicam sobrepeso no âmbito nacional. Ademais, o consumo médio de verduras e legumes foi inferior entre a etnia preta, a qual manifestou uma frequência alimentar maior no consumo de refrigerante ou suco artificial do que a etnia branca, apresentando, de um modo geral, uma alimentação de menor qualidade. Conclusão: O IMC médio e a prevalência de sobrepeso estão aumentando nas populações das capitais do Brasil, sendo tal aumento mais acentuado nas populações da etnia preta. Também se observou que as populações da etnia preta possuem uma alimentação de menor qualidade, quando comparado à alimentação da população de etnia branca (AU).

Introduction: Obesity is a multifactorial, chronic, and progressive disease that affects considerable portions of the world and Brazilian populations. Studies show that societies and environments with higher levels of structural racism can trigger higher levels of obesity prevalence in their marginalized populations. Thus, the greater vulnerability of populations of black ethnicity in Brazil, resulting from the structural and institutional racism established, leads to higher rates of overweight and obesity caused by the inability of such populations to guarantee food security. Objective: This study aimed to analyze the evolution of the prevalence of overweight and obesity in white and black populations in Brazil, evaluating eating habits with the potential to promote obesity. In addition, we aimed to relate the worsening of the populational BMI in Brazil with ethnicity and structural racism present in Brazilian society. Method: This investigation is a descriptive cross-sectional study. Twelve standardized questions from the VIGITEL survey were selected from 2011 to 2020. Data were analyzed using descriptive statistics, and Student's T-test was applied to compare ethnic groups. Results: The results, in general, show that individuals of the black ethnic group have a higher degree of BMI (Kg/m2) compared to the white ethnic group. BMI (Kg/m2) data for Brazilian capitals show that both in 2011 and 2020, the averages of the evaluated index were higher among the black population, presenting 26.03 Kg/m2 and 27.07 Kg/m2, respectively, while individuals declared white had averages of 25.7 Kg/m2 and 26.45 Kg/m2 in the same years. The average BMI in 2011 to 2020, of 25.99 Kg/m2 for the white ethnicity, and of 26.50 Kg/m2 for the black ethnicity, indicates overweight at the national level. In addition, the average consumption of vegetables was lower among black people, which showed a higher food frequency in the consumption of soft drinks or artificial juice than the white people, presenting, in general, a lower quality diet. Conclusion: The average BMI and the prevalence of overweight are increasing in the populations of the capitals of Brazil, being this increase more accentuated in the populations of black ethnicity. It was also observed that the populations of black ethnicity have a lower quality in their diet compared to the diet of the white population (AU).

Comparison of the predictive value of anthropometric indicators for the risk of benign prostatic hyperplasia in southern China / 亚洲男科学杂志(英文版)

This study aimed to compare the predictive value of six selected anthropometric indicators for benign prostatic hyperplasia (BPH). Males over 50 years of age who underwent health examinations at the Health Management Center of the Second Xiangya Hospital, Central South University (Changsha, China) from June to December 2020 were enrolled in this study. The characteristic data were collected, including basic anthropometric indices, lipid parameters, six anthropometric indicators, prostate-specific antigen, and total prostate volume. The odds ratios (ORs) with 95% confidence intervals (95% CIs) for all anthropometric parameters and BPH were calculated using binary logistic regression. To assess the diagnostic capability of each indicator for BPH and identify the appropriate cutoff values, receiver operating characteristic (ROC) curves and the related areas under the curves (AUCs) were utilized. All six indicators had diagnostic value for BPH (all P ≤ 0.001). The visceral adiposity index (VAI; AUC: 0.797, 95% CI: 0.759-0.834) had the highest AUC and therefore the highest diagnostic value. This was followed by the cardiometabolic index (CMI; AUC: 0.792, 95% CI: 0.753-0.831), lipid accumulation product (LAP; AUC: 0.766, 95% CI: 0.723-0.809), waist-to-hip ratio (WHR; AUC: 0.660, 95% CI: 0.609-0.712), waist-to-height ratio (WHtR; AUC: 0.639, 95% CI: 0.587-0.691), and body mass index (BMI; AUC: 0.592, 95% CI: 0.540-0.643). The sensitivity of CMI was the highest (92.1%), and WHtR had the highest specificity of 94.1%. CMI consistently showed the highest OR in the binary logistic regression analysis. BMI, WHtR, WHR, VAI, CMI, and LAP all influence the occurrence of BPH in middle-aged and older men (all P ≤ 0.001), and CMI is the best predictor of BPH.

Prevalence of chronic kidney disease and its association with lifestyle factors in adults from 10 regions of China / 中华流行病学杂志

Objective: To investigate the distribution of chronic kidney disease (CKD) in participants from the China Kadoorie Biobank (CKB) study and evaluate the association between lifestyle risk factors and CKD. Methods: Based on the baseline survey data and follow-up data (as of December 31, 2018) of the CKB study, the differences in CKD cases' area and population distributions were described. Cox proportional hazards regression model was used to estimate the association between lifestyle risk factors and the risk of CKD. Results: A total of 505 147 participants, 4 920 cases of CKD were recorded in 11.26 year follow up with a incidence rate of 83.43/100 000 person-years. Glomerulonephropathy was the most common type. The incidence of CKD was higher in the urban area, men, and the elderly aged 60 years and above (87.83/100 000 person-years, 86.37/100 000 person-years, and 132.06/100 000 person-years). Current male smokers had an increased risk for CKD compared with non-smokers or occasional smokers (HR=1.18, 95%CI: 1.05-1.31). The non-obese population was used as a control group, both general obesity determined by BMI (HR=1.19, 95%CI: 1.10-1.29) and central obesity determined by waist circumference (HR=1.27, 95%CI: 1.19-1.35) were associated with higher risk for CKD. Conclusion: The risks for CKD varied with area and population in the CKB cohort study, and the risk was influenced by multiple lifestyle factors.

Analysis of the status of excess heart age and its risk factors among residents aged 35 to 64 years in China / 中华预防医学杂志

Objective: To analyze the status of excess heart age and its risk factors among Chinese residents aged 35 to 64 years. Methods: The study subjects were Chinese residents aged 35 to 64 years who completed the heart age assessment by WeChat official account "Heart Strengthening Action" through the internet from January 2018 to April 2021. Information such as age, gender, body mass index (BMI), blood pressure, total cholesterol (TC), smoking history, and diabetes history was collected. The heart age and excess heart age were calculated according to the characteristics of individual cardiovascular risk factors and the heart aging was defined as excess heart age≥5 years and 10 years respectively. The heart age and standardization rate were calculated respectively based on the population standardization of the 7th census in 2021.CA trend test was used to analyze the changing trend of excess heart age rate and population attributable risk (PAR) was used to calculate the contribution of risk factors. Results: The mean age of 429 047 subjects was (49.25±8.66) years. The male accounted for 51.17% (219 558/429 047) and the excess heart age was 7.00 (0.00, 11.00) years. The excess heart age rate defined by excess heart age≥5 years and ≥10 years was 57.02% (the standardized rate was 56.83%) and 38.02% (the standardized rate was 37.88%) respectively. With the increase of the age and number of risk factors, the excess heart age rate of the two definitions showed an upward trend according to the result of the trend test analysis (P<0.001). The top two risk factors of the PAR for excess heart age were overweight or obese and smoking. Among them, the male was smoking and overweight or obese, while the female was overweight or obese and having hypercholesterolemia. Conclusion: The excess heart age rate is high in Chinese residents aged 35 to 64 years and the contribution of overweight or obese, smoking and having hypercholesterolemia ranks high.

A case-control study on the association between a healthy lifestyle and obesity among adult twins in Shanghai / 中华流行病学杂志

Objective: To investigate the associations between the numbers of healthy lifestyles and overweight/obesity and abdominal obesity in adult twins in Shanghai. Methods: Based on the Shanghai Twin Registry System Phase Ⅱ survey data in 2017-2018, a case-control study was conducted to analyze the association between healthy lifestyles and obesity and further adjusted for confounders by a co-twin control study. Results: A total of 7 864 adult twins (3 932 pairs) were included. In the co-twin case-control analysis for monozygotic twins, compared with participants with 0 to 2 healthy lifestyles, those with 3 and 4 to 5 healthy lifestyles had a 49% (OR=0.51, 95%CI: 0.28-0.93) and 70% (OR=0.30, 95%CI: 0.13-0.69) lower risk of overweight/obesity, respectively, and a 17% (OR=0.83, 95%CI: 0.44-1.57) and 66% (OR=0.34, 95%CI: 0.14-0.80) lower risk of abdominal obesity, respectively. For each additional healthy lifestyle, the risk of developing overweight/obesity was reduced by 41% (OR=0.59, 95%CI: 0.42-0.85), and the risk of developing abdominal obesity was reduced by 37% (OR=0.63, 95%CI: 0.44-0.90). Conclusion: An increasing number of healthy lifestyles was associated with a marked decreased risk for both overweight/obesity and abdominal obesity.

Study on the obesity-related factors among primary and middle school students in Hangzhou / 中华流行病学杂志

Objective: To explore the obesity-related factors among primary and middle school students in Hangzhou. Methods: A stratified random cluster sampling cross-sectional study was conducted using Hangzhou city's 2016-2020 annual school health survey data. Finally, 9 213 primary and secondary school students with complete data were selected as the research objects. The standard of Overweight and Obesity Screening for School-age Children and Adolescents (WS/T 586-2018) was used to verify students' obesity. SPSS 25.0 software was applied to conduct statistical analysis on the related factors of obesity. Results: The overall obesity detection rate among primary and middle school students in Hangzhou was 8.52%. The results of logistic regression analysis showed that inadequate sleep (OR=6.507, 95%CI: 2.371-17.861, P<0.001), 3- hours (OR=5.666, 95%CI: 2.164-14.835, P<0.001) and ≥4 hours (OR=7.530, 95%CI: 2.804-20.221, P<0.001) of watching video every day in the past week, being beaten and scolded by parents in the past week (OR=1.627, 95%CI: 1.161-2.280, P=0.005), parents often reduce students' exercise time in order to let students have more time to study in the past week (OR=3.310, 95%CI: 1.243-8.819, P=0.017), age 16-18 years old (OR=0.137, 95%CI: 0.050-0.374, P<0.001), often suffering from campus violence in the past week (OR=0.332, 95%CI: 0.141-0.783, P=0.012), 1 hour of watching video every day in the past week (OR=0.023, 95%CI: 0.006-0.083, P<0.001), sometimes having breakfast (OR=0.151, 95%CI: 0.058-0.397, P<0.001) and eating breakfast every day (OR=0.020, 95%CI: 0.005-0.065, P<0.001) in the past week, eating vegetables and fruits sometimes (OR=0.015, 95%CI: 0.010-0.023, P<0.001) and every day (OR=0.020, 95%CI: 0.008-0.053, P<0.001) in the past week, eating sweet food sometimes (OR=0.089, 95%CI: 0.035-0.227, P<0.001) and every day (OR=2.568, 95%CI: 1.632-4.041, P<0.001) in the past week, eating fried food sometimes (OR=0.274, 95%CI: 0.094-0.800, P=0.018) in the past week, and having three physical education classes every week (OR=0.156, 95%CI: 0.057-0.423, P<0.001) were the main related factors affecting the occurrence of obesity in primary and secondary school students. Conclusions: With the higher obesity prevalence among primary and middle school students in Hangzhou, parents and teachers should strengthen health education for primary and middle school students, help children develop scientific eating behavior, develop positive and healthy living habits of children, and effectively prevent overweight/obesity in primary and middle school students.

Obesidad: alternativas al paradigma pesocéntrico y patologizante. Primera entrega / Obesity: alternatives to the weight-centric and pathologizing paradigm. First part

Si bien para los médicos la obesidad es una palabra técnica, para muchas personas tiene la implicaría de un largo sufrimiento en relación a su cuerpo. Históricamente, la medicina tradicional se ha comportado como una barrera en la atención a las personas con exceso de peso debido a la gordofobia y a una perspectiva reduccionista pesocentrista. Es preocupante que las ciencias y prácticas de la salud aún tengan esta mirada sobre la gordura, ya que supone un sesgo que impide que las personas sean atendidas integralmente, vulnerando sus derechos en nombre de una preocupación médica y anteponiendo el descenso de peso frente a otras necesidades de los pacientes. Este artículo, si bien intenta modestamente abrir una reflexión filosófica sobre el cuerpo, la medicina hegemónica y la enfermedad, también tiene como objetivo brindar herramientas técnicas y no técnicas para abordar la obesidad desde otro lugar. En esta primera entrega, desarrollaremos el abordaje integral de la persona con cuerpo gordo. La segunda entrega estará enfocada en los tratamientos farmacológicos, no farmacológicos y quirúrgicos de la obesidad. (AI)

Although obesity is a technical word for doctors, it implies long-term suffering in relation to their bodies for many people. Historically, traditional medicine has behaved as a barrier in caring for people with excess weight due to fatphobia and aweight-centric reductionist perspective. It is worrying that health sciences and practices still have this view of fatness, sinceit implies a bias that prevents people from being thoroughly cared for, violating their rights in the name of medical concernand putting weight loss before other patients' needs. This article modestly attempts to open a philosophical reflection about the body, hegemonic medicine, and disease, while also aiming to provide technical and non-technical tools to approach obesity. In this first part, we will explain the comprehensive approach to the person with a fat body. The second part will focus on pharmacological, non-pharmacological, and surgical treatments for obesity. (AU)

Nutritional status and temporal trend of coverage of Brazilian adolescents monitored in the Food and Nutritional Surveillance System, 2008 to 2019 / Estado nutricional e tendência temporal da cobertura de adolescentes brasileiros acompanhados no Sistema de Vigilância Alimentar e Nutricional, 2008 a 2019

Abstract Objectives: to analyze the nutritional status and temporal trend of the coverage of Brazilian adolescents monitored in the Food and Nutritional Surveillance System in the period 2008-2019. Methods: ecological study of temporal series with SISVAN data collected from 2008 to 2019 with 45,869.266 registration. Body mass index data were collected and the registration coverage of adolescents monitored by the system was calculated. The percentage of annual variation in coverage and nutritional status was estimated using Prais-Winsten regression, with a significance level of 5%. Results: an increase in the prevalence of obesity was observed between 2008 and 2019, during this period thinness remained stable in Brazil. National coverage evolved from 9.3% in 2008 to 19.6% in 2019, with an annual variation of 9% and a statistically significant increase trend. In Brazil, obesity in this age group increased between 2008 and 2019, with an annual variation of 8.7% (CI95% = 7.8-9.6). Conclusion: modifications were observed in nutritional status suggest the occurrence of nutritional transition in the adolescents' population. The percentage of coverage available in the system has growth potential, however, the current scenario impacts on a possible insufficient analysis to support the elaboration and reorientation of public policies.

Resumo Objetivos: analisar o estado nutricional e a tendência temporal da cobertura de adolescentes brasileiros acompanhados no Sistema de Vigilância Alimentar e Nutricional no período de 2008-2019. Métodos: estudo ecológico de séries temporais com dados do SISVAN coletados no período de 2008 a 2019 com 45.869.266 de registos. Foram coletados dados de índice de massa corporal e calculadas as coberturas dos registros dos adolescentes acompanhados pelo sistema. Estimou-se a percentagem da variação anual da cobertura e estado nutricional pela regressão de Prais-Winsten, com nível de significância de 5%. Resultados: observa-se crescimento da prevalência de obesidade entre 2008 a 2019, nesse período a magreza manteve-se estável no Brasil. A cobertura nacional evoluiu de 9,3% em 2008 para 19,6% em 2019, com variação anual de 9% e tendência de aumento estatisticamente significativa. No Brasil, a obesidade nessa faixa etária apresentou um aumento entre os anos de 2008 e 2019, com uma variação anual de 8,7% (IC95%= 7,8-9,6). Conclusão: modificações observadas no estado nutricional sugerem a ocorrência da transição nutricional na população de adolescentes. O percentual de cobertura disponível no sistema tem potencial de crescimento, entretanto, o atual cenário impacta em possível análise insuficiente para subsidiar a elaboração e reorientação de políticas públicas.

Desfechos maternos e neonatais em servidoras públicas estaduais de São Paulo com idade materna avançada / Maternal and neonatal outcomes in state public servants of São Paulo with advanced maternal age

Objetivo: Caracterizar a população das gestantes em diferentes faixas etárias; avaliar desfechos maternos e neonatais em pacientes com idade materna avançada; determinar a faixa etária a partir da qual os desfechos adversos foram mais prevalentes. Métodos: Parturientes atendidas no Hospital do Servidor Público Estadual de São Paulo entre junho/2019 e maio/2020 foram divididas em três grupos ­ 20 a 34 anos; 35 a 39 anos; 40 anos ou mais ­ e analisadas quanto a diversas variáveis. Resultados: Entre as gestantes do Serviço, 44,2% tinham idade materna avançada. A amostra foi composta por 927 pacientes, a maioria com relacionamento conjugal estável (75,2%) e ensino de nível superior (74,7%). Independentemente do grupo etário, foram observados elevados índices de obesidade (25,9%), sobrepeso (39,7%) e cesariana (76,4%). A frequência de iteratividade, diabetes gestacional e doença hipertensiva específica da gestação foi maior a partir dos 35 anos, e a frequência de hipertensão arterial crônica foi maior a partir dos 40 anos. Neonatos de pacientes com 40 anos ou mais tiveram maiores índices de baixo peso ao nascer, óbito neonatal, Apgar de quinto minuto < 7 e necessidade de reanimação neonatal. Conclusão: Pacientes com idade materna avançada representaram porcentagem expressiva da população e tiveram maior frequência de desfechos adversos. Complicações obstétricas foram mais prevalentes a partir dos 35 anos, com destaque para diabetes gestacional e distúrbios hipertensivos. Resultados neonatais desfavoráveis, como baixo peso ao nascer e óbito neonatal, foram mais prevalentes a partir de 40 anos.

Objective: Featuring the population of pregnant women in different age groups; assessing maternal and neonatal outcomes in patients at advanced maternal age; determining the threshold age for the potential prevalence of adverse outcomes. Methods: Women in labor assisted at Hospital do Servidor Público Estadual de São Paulo between June/2019 and May/2020 were divided into three age groups ­ 20 to 34 years; 35 to 39 years; over 40 years ­, who were assessed for several variables. Results: 44.2% of pregnant women in this Service were at advanced maternal age. The sample counted on 927 patients, most of them declared stable marital relationships (75.2%) and College degree (74,7%). High obesity levels (25.9%), overweight (39.7%) and cesarean delivery (76.4%) were observed, regardless of age group. Maternal request was the main indication for cesarean surgery. Iteration frequency, gestational diabetes and pregnancy-specific hypertensive disease was higher from the age of 35 years, on. Chronical high blood pressure was higher in the age group over 40 years. Newborns from patients older than over 40 years presented higher low weight at birth index, neonatal death, 5th minute Apgar score < 7 and the need of neonatal resuscitation. Conclusion: Patients at advanced maternal age recorded higher obstetric adversity frequency in the age group over 35 years, with emphasis on gestational diabetes and high blood pressure. Unfavorable neonatal outcomes related to low weight at birth and neonatal death were more prevalent in the age group over 40 years.

Overweight/obesity in college students: a systematic review / Excesso de peso/obesidade em estudantes universitários: uma revisão sistemática / Sobrepeso/obesidad en estudiantes universitarios: una revisión sistemática

This article aims to characterize the prevalence and the factors associated with overweight/obesity in college students, through a systematic review. For doing so, the PRISMA protocol has been utilized. Articles about overweight/obesity were selected in college students on the databases of the National Library of Medicine (PUBMED), Scientific Electronic Library Online (SciELO), Biblioteca Virtual em Saúde (BVS), Web of Science and Scopus, it was considered the publication period from 2014 to 2019. We found 4,740 articles and 28 met the eligibility criteria. The overweight/obesity prevalence in college students varied from 9.5% to 47.0%. The Odds Ratio was the most used association measure (comparison) in studies. As characteristics that favor overweight/obesity, inadequate diet, income, male gender, low level of physical activity and family history of overweight/obesity are mentioned. The factors associated with protection against overweight/obesity were a healthy diet, regular physical activity and screen time. Finally, this review showed that university students are prone to overweight/obesity, as they have behavioral factors related to inadequate diet, low level of physical activity, income, being male, and sociocultural and family aspects due to a history of overweight/obesity. In counterpart, this review argues that healthy diet and physical activity and reduced screen time represent a health maintenance factor against overweight/obesity.

Este artigo tem como objetivo caracterizar a prevalência e os fatores associados ao sobrepeso/obesidade em universitários, por meio de uma revisão sistemática. Para isso, foi utilizado o protocolo PRISMA. Foram selecionados os artigos sobre sobrepeso/obesidade de universitários nas bases de dados da National Library of Medicine (PUBMED), Scientific Electronic Library Online (SciELO), Biblioteca Virtual em Saúde (BVS), Web of Science e Scopus, considerou-se o período de publicação de 2014 a 2019. Dos 4.740 artigos encontrados, 28 atenderam aos critérios de elegibilidade. A prevalência de sobrepeso/obesidade em universitários variou de 9,5% a 47,0%. Dentre as medidas de associação (comparação), houve maior utilização do Odds Ratio. Como destaques os fatores associados com o sobrepeso/obesidade, cita-se a dieta inadequada, renda, sexo masculino, baixo nível de atividade física e o histórico familiar de sobrepeso/obesidade. Os fatores associados como proteção ao sobrepeso/obesidade foram a dieta saudável, prática regular de atividade física e o tempo de tela. Por fim, esta revisão mostrou que os universitários são propensos ao sobrepeso/obesidade, por apresentarem fatores comportamentais relacionados a dietas inadequadas, baixo nível de atividade física, renda, ser do sexo masculino e aspectos socioculturais e familiares em função de histórico de sobrepeso/obesidade. Em contrapartida, esta revisão sustenta que a dieta saudável e atividade física e a redução do tempo de tela representam um fator de manutenção da saúde contra o sobrepeso/obesidade.

Este artículo pretende caracterizar la prevalencia y los factores asociados al sobrepeso/obesidad en estudiantes universitarios, a través de una revisión sistemática. Para ello se ha utilizado el protocolo PRISMA. Se seleccionaron artículos sobre sobrepeso/obesidad en estudiantes universitarios en las bases de datos de la National Library of Medicine (PUBMED), Scientific Electronic Library Online (SciELO), Biblioteca Virtual em Saúde (BVS), Web of Science y Scopus, se consideró el periodo de publicación de 2014 a 2019. Se encontraron 4.740 artículos y 28 cumplieron los criterios de elegibilidad. La prevalencia de sobrepeso/obesidad en estudiantes universitarios varió del 9,5% al 47,0%. El Odds Ratio fue la medida de asociación (comparación) más utilizada en los estudios. Como características que favorecen el sobrepeso/obesidad se mencionan la dieta inadecuada, los ingresos, el sexo masculino, el bajo nivel de actividad física y los antecedentes familiares de sobrepeso/obesidad. Los factores asociados a la protección contra el sobrepeso/obesidad fueron la dieta saludable, la actividad física regular y el tiempo de pantalla. Por último, esta revisión mostró que los estudiantes universitarios son propensos al sobrepeso/obesidad, ya que tienen factores de comportamiento relacionados con la dieta inadecuada, el bajo nivel de actividad física, los ingresos, el hecho de ser varones y aspectos socioculturales y familiares debido a una historia de sobrepeso/obesidad. En contrapartida, esta revisión sostiene que la dieta y la actividad física saludables y la reducción del tiempo de pantalla representan un factor de mantenimiento de la salud contra el sobrepeso/obesidad.

Eficacia de un programa de estilo de vida de salud en Chile / Efficacy of a Lifestyle Health Program in Chile

Introducción: La situación de salud en Chile frente a las enfermedades crónicas no transmisibles ha empeorado en los últimos años. Por ello, son necesarios programas de cambio de hábitos que promuevan factores protectores y disminuyan factores de riesgo cardiovascular, y así intervenir desde donde surge el problema. Objetivo: Evaluar la eficacia del programa Consultores de Salud Familiar mediante un trabajo de seguimiento de los indicadores de salud medidos. Métodos: Estudio analítico, cuasiexperimental y longitudinal. Se llevó a cabo en las ciudades de Concepción y Temuco, Chile, y se realizaron las mediciones de indicadores biométricos (IMC, peso, porcentaje de grasa corporal, porcentaje de músculo esquelético, nivel de grasa visceral, presión arterial sistólica y diastólica, perímetro de cintura y glucemia) en dos planes de seguimiento (general de un mes y personalizado, dos meses). Resultados: Al comparar ambos planes, se observó que en el plan de seguimiento general existieron diferencias en peso, porcentaje grasa corporal, porcentaje músculo esquelético e IMC (p < 0,01), y en el plan de seguimiento personalizado se observaron diferencias en presión arterial sistólica, perímetro de cintura, peso, porcentaje grasa corporal e IMC (p < 0,01) y glucemia (p < 0,05). No se observaron diferencias estadísticamente significativas entre el plan de seguimiento general y personalizado. Conclusiones: El programa es efectivo en aumentar factores protectores como mantener un peso normal, realizar actividad física regular y consumir al menos 5 porciones de frutas y verduras, consumo de agua, entre otros, lo que permite al participante disminuir los factores de riesgo con independencia del plan de seguimiento(AU)

Introduction: The health situation in Chile with regard to chronic noncommunicable diseases has worsened in recent years. Therefore, programs to change habits that promote protective factors and reduce cardiovascular risk factors are necessary in order to intervene whore the problem arises. Objective: To assess the efficacy of a program with family health advisors through a follow-up study of the measured health indicators. Methods: Analytical, quasiexperimental and longitudinal study carried out in the Chilean cities of Concepción and Temuco. Biometric indicators (BMI, weight, body fat percentage, skeletal muscle percentage, visceral fat level, systolic and diastolic blood pressure, waist circumference and blood glucose) were measured in two follow-up plans (general, one month; and personalized, two months). Results: Upon comparing both plans, it was observed that, in the general follow-up plan, there were differences in weight, body fat percentage, skeletal muscle percentage and BMI (p<0.01), while in the personalized follow-up plan, differences were observed in systolic blood pressure, waist circumference, weight, body fat percentage and BMI (p<0.01), as well as for glycemia (p<0.05). No statistically significant differences were observed between the general and personalized follow-up plans. Conclusions: The program is effective in increasing protective factors such as maintaining a normal weight, performing regular physical activity and consuming at least five servings of fruits and vegetables, water consumption, among others, which allows the participant to decrease risk factors regardless of the follow-up plan(AU)

Determinantes Sociales de la Salud", "Habitus" y "Embodiment" detrás de un IMC elevado. Un análisis social del actual escenario epidemiológico / Social Determinants of Health", "Habitus" and "Embodiment" behind a high BMI. A social analysis of the current epidemiological scenario

El índice de masa corporal (IMC) elevado marcaría hoy una nueva etapa dentro de la transición epidemiológica, siendo posible develar el origen social del nuevo perfil de morbimortalidad. Esta revisión busca integrar diferentes conceptos teóricos para explicar los mecanismos a través de los cuales lo social se incorpora en el individuo, delimitando su comportamiento en salud y con ello, su estado nutricional. Las estructuras que representan los determinantes sociales de la salud operarían de manera sistemáticamente distinta sobre las personas, generando posiciones más o menos ventajosas dentro del campo de juego sanitario. Este patrón traduce una realidad que se encarna (embodiment) de manera inconsciente y duradera a través de un habitus, favoreciendo prácticas sociales diferenciadas que terminan por construir clases de cuerpos como expresión biológica de la desigualdad. La toma de decisiones estratégicas en salud dependerá de capacidades y libertades individuales primeramente restringidas por aquellos contextos sociales, entendiéndose estos como las causas estructurales de la salud poblacional(AU)

A high body mass index (BMI) would characterize a new stage in the epidemiological transition, making it possible to reveal the social origin of the new morbidity and mortality burden. This review seeks to integrate different theoretical concepts to explain the mechanisms through which the social is incorporated into the individual, delimiting their health behavior and with it, their nutritional status. The structures that represent the social determinants of health would operate systematically differently on different social groups, generating positions that are more or less advantageous in the playing field of health. This pattern translates a reality embodied unconsciously and long-lasting through a habitus, favoring differing social practices that result in the construction of bodily classes as a biological expression of social inequality. Strategic decision-making in health will depend on individual capacities and freedoms, which are firstly restricted by those social contexts, being those understood as the structural causes of population health(AU)

Prevalencia de síndrome de ovario poliquístico en pacientes que acudieron a una consulta de ginecología-obstetricia y endocrinología en La Romana, República Dominicana, durante el período enero 2019-enero 2020 / Prevalence of polycystic ovary syndrome in patients who attended a gynecology-obstetrics and endocrinology private practice in La Romana, Dominican Republic during the period January 2019-January 2020

Introducción: el síndrome de ovario poliquístico (SOP) es un trastorno endocrino metabólico altamente dominante, el cual es considerado como una de las afecciones más comunes en las mujeres, tanto adolescentes como adultas durante su etapa fértil. Presenta una prevalencia de aproximadamente un 21 % a nivel global. Objetivo: determinar la prevalencia del síndrome de ovario poliquístico en pacientes que acudieron a una consulta de ginecología-obstetricia y endocrinología en la Romana, República Dominicana. Metodología: estudio observacional, retrospectivo, analítico y de corte transversal en el que se analizaron 252 récords médicos de distintas pacientes con y sin SOP para determinar la prevalencia de esta. Como herramienta de estudio se utilizó un formulario creado por el asesor y colaboradores, que se aplicó a los récords médicos empleando los criterios de Rotterdam como determinantes para el diagnóstico del SOP. Resultados: los resultados mostraron que un 67 % de las mujeres no presentaron SOP, correspondiendo a 170 pacientes, mientras que las 82 pacientes restantes presentaron SOP, representando un 33 %. Asimismo, el grupo etario con mayor frecuencia de SOP correspondió al rango de 26 a 35 años con un 52.4 %. Por otra parte, se presentaron más pacientes con SOP no obesas con un 71 %. Con relación a la presencia de ciclos menstruales regulares e irregulares, las pacientes irregulares con SOP indicaron un 47.6 % y las pacientes regulares sin SOP indicaron un 16.7 %, resultando que se acepta la hipótesis nula. Conclusiones: la prevalencia de síndrome de ovario poliquístico fue de un 33 %. El rango de edad más frecuente fue de 26 a 35 años. Predominó la presencia de pacientes con SOP no obesas. La comparación de las pacientes con ciclos menstruales irregulares fue mayor para aquellas que padecen SOP

Introduction: Polycystic ovary syndrome (PCOS) is a highly dominant endocrine metabolic disorder, which is considered one of the most common conditions in women, both adolescents and adults during their fertile stage. It has a prevalence of approximately 21% globally. Objectives: To determine the prevalence of polycystic ovary syndrome in patients who attended a gynecology-obstetrics and endocrinology consultation in la Romana, Dominican Republic. Methodology: An observational, retrospective, analytical and cross-sectional study in which 252 medical records of different patients with and without PCOS were analyzed to determine its prevalence. As a study tool, a form created by the advisor and collaborators was used, which was applied to medical records, the Rotterdam criteria were employed as determinants for the diagnosis of PCOS. Results: The results showed that 67% of the women did not present PCOS corresponding to 170 patients, while the remaining 82 patients presented PCOS representing 33%. Likewise, the age group with the highest frequency of PCOS corresponded to the range of 26 to 35 years with 52.4%. On the other hand, there were more non-obese PCOS patients with 71%. Regarding the presence of regular and irregular menstrual cycles, irregular patients with PCOS indicated 47.6% and regular patients without PCOS indicated 16.7%, resulting in the acceptance of the null hypothesis. Conclusions: The prevalence of polycystic ovary syndrome was 33%. The most frequent age range was 26 to 35 years. The presence of non-obese PCOS patients predominated. The comparison of patients with irregular menstrual cycles was higher for those with PCOS

Sarcopenia, obesity and sarcopenic obesity among community-dwelling and institutionalized older women in Caxias do Sul, Brazil / Sarcopenia, obesidade e obesidade sarcopênica em idosas da comunidade e institucionalizadas de Caxias do Sul, Brasil

INTRODUCTION: Sarcopenia, obesity, and sarcopenic obesity are considered risk factors for the health of the elderly, which may cause or worsen the reduction in functional capacity. OBJECTIVE: To determine the prevalence of sarcopenia, obesity, and sarcopenic obesity among community-dwelling and institutionalized female elderly in Caxias do Sul, Brazil. METHODS: Observational epidemiological study, with cross-sectional design. 423 elderly women (≥60 years old) institutionalized and community-dwellers, participated in the study. Sarcopenia was identified according to the criteria established by the European Working Group on Sarcopenia in Older People (EWGSOP). The gait speed test estimated low skeletal muscle mass (SMM) by bioimpedance, low handgrip strength using a hand dynamometer, and low physical performance. Obesity was defined as Body Mass Index ≥27.0kg/m² and sarcopenic obesity by the simultaneous occurrence of obesity and sarcopenia. The Chi-Square test was performed, with a 5% significance level. RESULTS: The overall prevalence of obesity was 53.9%. Sarcopenia was observed in 16.3% of the total sample, affecting 7.5% of the elderly in the community and 25.1% in institutions (p≤0.0001). Regarding sarcopenic obesity, 0.9% of the community and 3.8% of institutionalized elderly presented the dysfunction. Non-sarcopenic elderly women had a high prevalence of obesity. In the elderly of both groups, sarcopenia was more frequent in those with advanced age. CONCLUSION: Institutionalized elderly women had a higher prevalence of sarcopenia, emphasizing the importance of paying attention to the health of this population and highlighting the need for preventive measures.

INTRODUÇÃO: Sarcopenia, obesidade e obesidade sarcopênica são consideradas fatores de risco à saúde dos idosos, podendo ocasionar ou agravar a redução da capacidade funcional. OBJETIVO: Determinar a prevalência de sarcopenia, obesidade e obesidade sarcopênica entre idosas da comunidade e institucionalizadas de Caxias do Sul/RS. MÉTODOS: Estudo epidemiológico observacional, com delineamento transversal. Participaram do estudo 423 idosas (≥60 anos) institucionalizadas e da comunidade. A sarcopenia foi identificada conforme os critérios estabelecidos pelo Grupo de Trabalho Europeu sobre Sarcopenia em Idosos (EWGSOP), utilizando baixa massa muscular esquelética (MME) por bioimpedância, baixa força de preensão manual em dinamômetro manual e baixo desempenho físico no teste de velocidade de marcha. Identificou-se a obesidade pelo Índice de Massa Corporal ≥27,0kg/m² e a obesidade sarcopênica pelo diagnóstico simultâneo de obesidade e sarcopenia. Realizou-se o teste Qui-Quadrado e regressão de Poisson, com nível de significância de 5%. RESULTADOS: A prevalência geral de obesidade foi de 53,9%. 16,3% da amostra total apresentava sarcopenia, presente em 7,5% das idosas da comunidade e 25,1% das institucionalizadas (p≤0.0001). Referente a obesidade sarcopênica 0,9% da comunidade e 3,8% das institucionalizadas apresentaram a disfunção. Idosas não sarcopênicas apresentaram elevada prevalência de obesidade. Nas idosas de ambos os grupos, a sarcopenia foi mais frequente naquelas com idade avançada. CONCLUSÃO: Idosas institucionalizadas apresentaram maior prevalência de sarcopenia, acentuando a importância em atentar à saúde desta população e evidenciando a necessidade de medidas preventivas.

Consumo de alimentos y actividad física en pacientes hipertensos de un centro de atención primaria / Food Consumption and Physical Activity in Hypertensive Patients from Primary Healthcare

Introducción: Con el estudio de las enfermedades cardiovasculares se ha logrado identificar las variables biológicas y estilos de vida, lo que ha permitido que la hipertensión arterial y sus complicaciones sean prevenibles y controlables. Objetivo: Determinar la frecuencia del consumo de alimentos y actividad física en pacientes hipertensos del Centro de Atención Primaria III Huaycán, Lima, Perú. Métodos: Se realizó un estudio observacional descriptivo, transversal y cuantitativo en pacientes hipertensos pertenecientes al programa del adulto mayor. Se recolectaron datos sociodemográficos, antropometría y presión arterial. Se aplicó el cuestionario internacional de actividad física y frecuencia de consumo de alimentos. Se analizaron estadísticas descriptivas, prueba de Chi cuadrado, ANOVA y Rho Spearman en SPSS 23. Resultados: Se evaluaron 570 pacientes, 61,8 por ciento pertenecía al sexo femenino, 39,5 por ciento tenía estudios de secundaria, 65,3 por ciento consumía antihipertensivos regularmente. La media del índice de masa corporal para mujeres fue 28,23±4,66 kg/m2. La presión arterial sistólica para el sexo masculino fue 132,89±13,42 mmHg y para el femenino, de 130,92±13,19 mmHg. El 13,5 por ciento tenía obesidad y cifras tensionales hipertensivas, 71,1 por ciento consumía pollo, 77,2 por ciento pan, cereales, arroz, pastas y trigo todos los días a la semana, mientras que 50,9 por ciento consumía frituras cuatro días por semana; 44,7 por ciento tenía bajo nivel de actividad física y cifras tensionales hipertensivas (p = 0,03). Conclusiones: La alimentación en la población de estudio era diversa, basada en alta ingesta de carbohidratos y grasas. Se evidenció que las personas con menos actividad física tenían mayores cifras tensionales. Es de considerar que la dieta saludable y la actividad física son factores complementarios al tratamiento farmacológico para el control de estos pacientes(AU)

Introduction: The study of cardiovascular diseases has permitted the identification of biological variables and lifestyles, which, in turn, has made hypertension and its complications preventable and controllable. Objective: To determine the frequency of food consumption and physical activity in hypertensive patients in the primary care center III Huaycán, Lima, Peru. Methods: A descriptive, cross-sectional, observational and quantitative study was carried out with hypertensive patients belonging to the elderly program. Sociodemographic, anthropometric and blood pressure data were collected. The international questionnaire of physical activity and frequency of food consumption was applied. Descriptive statistics, chi-square test, ANOVA and Rho Spearman were analyzed using SPSS 23. Results: 570 patients were assessed: 61.8 percent were female, 39.5 percent had high school education, and 65.3 percent consumed antihypertensive drugs regularly. The mean body mass index for women was 28.23±4.66 kg/m2. Systolic blood pressure for the male sex was 132.89±13.42 mmHg and 130.92±13.19 mmHg for the female sex. 13.5 percent had obesity and hypertensive blood pressure levels, 71.1 percent ate chicken, 77.2 percent consumed bread, cereals, rice, pasta and wheat every day of the week, while 50.9 percent consumed fried foods four days a week. 44.7 percent had a low level of physical activity and hypertensive blood pressure levels (P=0.03). Conclusions: The diet in the study population was diverse, based on high intake of carbohydrates and fats. People who did less physical activity evidently showed higher blood pressure numbers. A healthy diet and physical activity are to be considered complementary factors to pharmacological treatment for controlling these patients(AU)

Relación entre la diabetes mellitus y el cáncer / Relationship between Diabetes Mellitus and Cancer

Introducción: La diabetes mellitus y el cáncer son dos problemas de salud que afectan a la población mundial. Considerar previamente el riesgo de desarrollo de cáncer en pacientes con diabetes mellitus puede contribuir de manera significativa a su prevención en este grupo de riesgo. Objetivo: Describir la relación existente entre la diabetes mellitus y el cáncer. Métodos: Se realizó una revisión bibliográfica, entre septiembre de 2019 y marzo de 2020. Se consultaron artículos científicos en Pubmed; la estrategia de búsqueda fue: diabetes mellitus [Mesh] OR diabetes mellitus[TIAB] OR diabetes mellitus, type 2[Mesh] OR type 2 diabetes mellitus[TIAB] OR obesity[Mesh] OR obesity[TIAB] OR hyperglycemia[Mesh] OR hyperglycemia[TIAB]) AND (cancer[Mesh] OR cancer[TIAB] OR neoplasia[Mesh] OR neoplasia[TIAB] OR neoplasias[Mesh] OR neoplasias[TIAB] OR neoplasm[Mesh] OR neoplasm[TIAB] OR tumors[Mesh] OR tumors[TIAB] OR tumor[Mesh] OR tumor[TIAB] OR cancers[Mesh] OR cancers[TIAB]). Se consultaron además artículos de SCOPUS, Scielo, LILACS, Biblioteca Virtual de Salud de Cuba y Google Scholar. Se seleccionaron artículos publicados a partir de 2005, con 63 por ciento de los últimos cinco años (2016‒2020). Se trabajó con 51 publicaciones. Conclusiones: Existe consenso sobre la relación entre la diabetes y el cáncer. La diabetes mellitus es un factor de riesgo para el desarrollo de cáncer, fundamentalmente en las localizaciones de páncreas, riñón, colon y recto y cuerpo uterino, ovarios y mama en la mujer; y factor protector para el cáncer de próstata en hombres. Ambas enfermedades comparten factores de riesgo no modificables (edad y sexo), modificables (dieta, actividad física, alcoholismo, entre otros) y condiciones biológicas (hiperglucemia e hiperinsulinemia)(AU)

Introduction: Diabetes mellitus and cancer are two health problems affecting the world population. Prior consideration of the risk for cancer development in patients with diabetes mellitus can contribute significantly to its prevention in this risk group. Objective: To describe the relationship between diabetes mellitus and cancer. Methods: A literature review was carried out between September 2019 and March 2020. Scientific articles were consulted in Pubmed; the search strategy was defined as it follows: diabetes mellitus[Mesh] OR diabetes mellitus[TIAB] OR diabetes mellitus, type 2[Mesh] OR type 2 diabetes mellitus[TIAB] OR obesity[Mesh] OR obesity[TIAB] OR hyperglycemia[Mesh] OR hyperglycemia[TIAB]) AND (cancer[Mesh] OR cancer[TIAB] OR neoplasia[Mesh] OR neoplasia[TIAB] OR neoplasias[Mesh] OR neoplasias[TIAB] OR neoplasm[Mesh] OR neoplasm[TIAB] OR tumors[Mesh] OR tumors[TIAB] OR tumor[Mesh] OR tumor[TIAB] OR cancers[Mesh] OR cancers[TIAB]). Articles from SCOPUS, Scielo, LILACS, the Virtual Health Library of Cuba, and Google Scholar were also reviewed. Articles published from 2005 onwards were selected, with 63 percent from the last five years (2016-2020). Fifty-one publications were analyzed. Conclusions: There is consensus regarding the relationship between diabetes and cancer. Diabetes mellitus is a risk factor for the development of cancer, fundamentally in the locations of pancreas, kidney, colon and rectum, as well as the uterine body, ovaries and breast in women; while being a protective factor for prostate cancer in men. Both diseases share nonmodifiable risk factors (age and sex), modifiable risk factors (diet, physical activity, alcoholism, among others) and biological conditions (hyperglycemia and hyperinsulinemia)(AU)

Asociación entre enfermedades cardiometabólicas y depresión en un hospital de referencia peruano / Association between cardiometabolic diseases and depression in a Peruvian reference hospital

INTRODUCCIÓN: Se ha postulado la relación entre la presencia de enfermedades cardiometabólicas con problemas de salud mental, en particular la depresión. OBJETIVOS: Determinar la asociación entre la presencia de enfermedades cardiometabólicas y la presencia de sintomatología depresiva evaluada mediante el cuestionario PHQ-9 en pacientes atendidos en consultorios externos de medicina interna del Hospital Nacional Hipólito Unanue. METODOLOGÍA: Estudio observacional, analítico, transversal. Se definió enfermedad cardiometabólica como la presencia de diabetes mellitus, hipertensión arterial, dislipidemia, y/u obesidad. Se utilizó el cuestionario PHQ-9 para evaluar la presencia de síntomas sugerentes de depresión. Se evaluó la asociación cruda y ajustada a posibles confusores. Para el análisis multivariado se utilizó un modelo de regresión de Poisson para hallar razones de prevalencia con sus respectivos intervalos de confianza al 95%. Se consideró un p<0,05 como estadísticamente significativo. Resultados: Se incluyeron 252 pacientes, de los que 205 (81,4%) presentaron enfermedades cardiometabólicas y 181 (71,9%) presentaron síntomas consistentes con algún grado de depresión. La presencia de enfermedades cardiometabólicas se asoció a síntomas depresivos tanto en el análisis crudo (RPc 1,43; IC 95% 1,08-1,89; p=0,012) como en el ajustado (RPa 1,31; IC 95% 1,00-1,71; p=0,048). Adicionalmente se encontró asociación entre el sexo femenino y sintomatología depresiva (RPa 1,35; IC 95% 1,11-1,63; p=0,002). CONCLUSIONES: La presencia de enfermedades cardiometabólicas se asoció con la presencia de síntomas depresivos en pacientes atendidos en la consulta externa de medicina interna. El abordaje de la salud mental debe ser parte integral del manejo multidisciplinario del paciente con enfermedad cardiometabólica.

INTRODUCTION: It has been postulated the relationship between presence of cardiometabolic diseases with mental health problems, particularly depression. Objectives: To determine the association between cardiometabolic diseases and presence of depressive symptoms, evaluated by PHQ-9 questionnaire, in patients attended at the outpatient clinic of internal medicine service at Hospital Nacional Hipolito Unanue. METHODS: Observational analytical cross-sectional study. Cardiometabolic disease was defined as the presence of diabetes mellitus, high blood pressure, dyslipidemia, and/or obesity. The PHQ-9 questionnaire was used to evaluate the presence of symptoms suggestive of depression. The association was evaluated crude and adjusted for possible confounders. For the multivariate analysis, a Poisson regression model was used to find prevalence ratios with their respective 95% confidence intervals. A p<0.05 was considered statistically significant. RESULTS: 252 patients were included, of which 205 (81,4%) presented cardiometabolic diseases and 181 (71,9%) presented symptoms consistent with some grade of depression. The presence of cardiometabolic diseases was associated with depressive symptoms both in the crude analysis (PRc 1.43; CI 95% 1.08-1.89; p=0.012) and in the adjusted one (PRa 1.31; CI 95% 1.00-1.71; p=0.048). Additionally, an association was found between female sex and depressive symptoms (PRa 1,35; CI 95% 1,11-1,63; p=0,002). CONCLUSIONS: The presence of cardiometabolic diseases was associated with the presence of depressive symptoms in patients seen at the outpatient clinic of internal medicine. The mental health approach should be an integral part of the multidisciplinary management for the patient with cardiometabolic disease.

Overview of Cardiovascular Disease Risk Factors in Adults in São Paulo, Brazil: Prevalence and Associated Factors in 2008 and 2015

Abstract Background Cardiovascular diseases (CVDs) are the main cause of morbidity and mortality in Brazil. Objective To provide population-based data on prevalence and factors associated with CVD risk factors. Methods Individuals aged ≥20 years from two editions of the cross-sectional Health Survey of São Paulo focusing on Nutrition (ISA-Nutrition), performed in Sao Paulo city in 2008 (n=590) and 2015 (n=610), were evaluated for: obesity, central obesity, waist/height ratio, high blood pressure (HBP), dyslipidemia, diabetes, and number of CVD risk factors ≥3. Prevalence was estimated according to complex survey procedures. Factors associated with cardiovascular risk factors were assessed using logistic regression, with statistical significance of p<0.05. Results Obesity and older age were associated with higher odds of all cardiovascular risk factors investigated, except for dyslipidemia. HBP was positively associated with being Black/Brown and negatively associated with being physicaly active in leisure time. Women were more likely to have increased adiposity indicators and three or more cardiovascular risk factors than men. Those with higher education had lower chances of having diabetes, HBP and dyslipidemia, and those with higher income had higher chances of having three or more risk factors. Former smokers had higher odds of diabetes, obesity, and high waist/height ratio, and smokers had higher odds of high non-HDL cholesterol levels. From 2008 to 2015, there was an increase (p<0.001) in the prevalence of diabetes (6.9% to 17.3%), HBP (31.9% to 41.8%), dyslipidemia (51.3% to 67.6%), and number of CVD risk factors ≥3 (18.9% to 34.1%). Conclusion This study shows increasing prevalence of CVD risk factors in adult population in Sao Paulo and may support the definition of target groups and priority actions on CVD prevention and treatment.

Caracterización epidemiológica de pacientes diabéticos e hipertensos en consultorio en Quinta Normal, 2018-2019 / Epidemiological features of patients ascribed to a primary care cardiovascular health program in Santiago, Chile

BACKGROUND: Hypertension and diabetes are highly prevalent conditions in Chilean adults. AIM: To describe the demographic and clinical profiles, risk factors and complications associated with arterial hypertension (AH) and diabetes mellitus (DM) in patients ascribed to a cardiovascular health program at a public primary health care center in Santiago. MATERIAL AND METHODS: Review of medical records of 583 patients aged 37 to 95 years (56% women). Gender, age, smoking habits, blood pressure, glycated hemoglobin levels, LDL cholesterol and triglycerides levels, nutritional status in the last control carried out, and associated cardiovascular complications were recorded. RESULTS: Thirty four percent (201 participants) and 36% (210 participants) had a decompensated DM and AH, respectively. Dyslipidemia was the main associated cardiovascular risk factor. The prevalence of obesity was 43% (249 participants). Twenty percent had chronic kidney disease and 13% had diabetic retinopathy. CONCLUSIONS: These patients have a high frequency of obesity, dyslipidemia, and chronic kidney disease.

Relationship between body mass index and sexual development in Chinese children / 中华儿科杂志

Objective: To investigate the relationship between body mass index (BMI) and sexual development in Chinese children. Methods: A nationwide multicenter and population-based large cross-sectional study was conducted in 13 provinces, autonomous regions and municipalities of China from January 2017 to December 2018. Data on sex, age, height, weight were collected, BMI was calculated and sexual characteristics were analyzed. The subjects were divided into four groups based on age, including ages 3-<6 years, 6-<10 years, 10-<15 years and 15-<18 years. Multiple Logistic regression models were used for evaluating the associations of BMI with sexual development in children. Dichotomous Logistic regression was used to compare the differences in the distribution of early and non-early puberty among normal weight, overweight and obese groups. Curves were drawn to analyze the relationship between the percentage of early puberty and BMI distribution in girls and boys at different Tanner stages. Results: A total of 208 179 healthy children (96 471 girls and 111 708 boys) were enrolled in this study. The OR values of B2, B3 and B4+ in overweight girls were 1.72 (95%CI: 1.56-1.89), 3.19 (95%CI: 2.86-3.57), 7.14 (95%CI: 6.33-8.05) and in obese girls were 2.05 (95%CI: 1.88-2.24), 4.98 (95%CI: 4.49-5.53), 11.21 (95%CI: 9.98-12.59), respectively; while the OR values of G2, G3, G4+ in overweight boys were 1.27 (95%CI: 1.17-1.38), 1.52 (95%CI: 1.36-1.70), 1.88 (95%CI: 1.66-2.14) and in obese boys were 1.27 (95%CI: 1.17-1.37), 1.59 (95%CI: 1.43-1.78), and 1.93 (95%CI: 1.70-2.18) (compared with normal weight Tanner 1 group,all P<0.01). Analysis in different age groups found that OR values of obese girls at B2 stage and boys at G2 stage were 2.02 (95%CI: 1.06-3.86) and 2.32 (95%CI:1.05-5.12) in preschool children aged 3-<6 years, respectively (both P<0.05). And in the age group of 6-10 years, overweight girls had a 5.45-fold risk and obese girls had a 12.54-fold risk of B3 stage compared to girls with normal BMI. Compared with normal weight children, the risk of early puberty was 2.67 times higher in overweight girls, 3.63 times higher in obese girls, and 1.22 times higher in overweight boys, 1.35 times higher in obese boys (all P<0.01). Among the children at each Tanner stages, the percentage of early puberty increased with the increase of BMI, from 5.7% (80/1 397), 16.1% (48/299), 13.8% (27/195) to 25.7% (198/769), 65.1% (209/321), 65.4% (157/240) in girls aged 8-<9, 10-<11 and 11-<12 years, and 6.6% (34/513), 18.7% (51/273), 21.6% (57/264) to 13.3% (96/722), 46.4% (140/302), 47.5% (105/221) in boys aged 9-<10, 12-<13 and 13-<14 years, respectively. Conclusions: BMI is positively correlated with sexual development in both Chinese boys and girls, and the correlation is stronger in girls. Obesity is a risk factor for precocious puberty in preschool children aged 3-<6 years, and 6-<10 years of age is a high risk period for early development in obese girls.