ABSTRACT
The current study aims to describe the consumption of ultra-processed foods, from 2 to 4 years old, and evaluate its association with growth outcomes during the same period. It is a prospective cohort study using data from the 2015 Pelotas-Brazil Birth Cohort. Outcomes assessed at the 2- and 4-year-old follow-ups were BMI-for-age Z-score and length/height-for-age Z-score. The exposure was a score of ultra-processed food consumption calculated at each follow-up by summing up the positive answers for the consumption of nine specific items/subgroups of ultra-processed foods: (i) instant noodles; (ii) soft drink; (iii) chocolate powder in milk; (iv) nuggets, hamburger or sausages; (v) packaged salty snacks; (vi) candies, lollipops, chewing gum, chocolate or jelly; (vii) sandwich cookie or sweet biscuit; (viii) juice in can or box or prepared from a powdered mix and (ix) yogurt. Crude and adjusted analyses between the score of ultra-processed foods and the outcomes were run using generalised estimating equations. Prevalence of consumption of ultra-processed foods increased from 2 to 4 years old, for all evaluated items/subgroups, except yogurt. In prospective analyses, higher scores of ultra-processed food consumption were associated with higher BMI-for-age Z-score and lower length/height-for-age Z-score, after adjustment for confounders. Ultra-processed food consumption, measured using a short questionnaire with low research burden, increased from 2 to 4 years old and was related to deleterious growth outcomes in early childhood. These results reinforce the importance of avoiding the consumption of these products in childhood to prevent the double burden of malnutrition and non-communicable chronic diseases throughout the life.
ABSTRACT
Influenza vaccination coverage in the elderly was analysed during the COVID-19 pandemic through the EPICOVID-19, a population-based study conducted in 133 cities from the 26 Brazilian states and Federal District. Twenty five census tracts were sampled with probability proportional to the size of the tract, 10 households by census tracts and one random person interviewed. A total of 33,250 people were interviewed being 8,262 ≥60 years old. The elderly were asked whether they had had a flu vaccine in 2020. Vaccination coverage was 82.3% (CI95%=8 0.1-84.2) with no difference by sex, age, and region. Higher vaccination coverage was observed in the richest compared to the poorest (84.7% and 80.1%; p=<0.001), and among those with higher schooling (87.3% and 83.2; p=0.007). The indigenous presented lower coverage (56.9%) than other ethnic groups (>80%) (p=0.056). A positive association existed between vaccination coverage and number of comorbidities for men, but not for women. Most of those who were vaccinated (97.5%) received the vaccine in the public health system. The private was chosen mostly in the south, by the rich and by those with more schooling. Vaccination coverage was seven percentage points lower than the government target, and inequalities should be reverted in future campaigns.
Avaliou-se a cobertura vacinal para influenza em idosos na pandemia COVID-19 através do EPICOVID-19, inquérito de base populacional realizado em 133 cidades sentinela dos 26 estados brasileiros e Distrito Federal. Selecionou-se 25 setores censitários por cidade com amostragem proporcional ao tamanho, 10 domicílios por setor e uma pessoa por domicílio, aleatoriamente. Foram entrevistadas 33.250 pessoas, sendo 8.265 idosos. Perguntou-se aos idosos se haviam sido vacinados contra gripe em 2020. A cobertura foi de 82,3% (IC 95% 80,184,2), sem diferenças por sexo, idade ou região. Foram observadas maiores coberturas no quintil mais rico (84,7% contra 80,1% no mais pobre; p<0.001) e naqueles com graduação completa (87,3% contra 83,2% com fundamental incompleto; p=0.007), e menor cobertura nos indígenas (56,9% comparado a coberturas superiores a 80% nos demais grupos étnicos) (p=0,056). Houve associação positiva da cobertura com número de comorbidades entre homens, mas não entre mulheres. A maioria vacinou-se na rede pública (97,5%), sendo a rede privada mais utilizada na região sul, pelos mais escolarizados e mais ricos. Conclui-se que a cobertura vacinal ficou sete pontos percentuais abaixo da meta governamental, e que desigualdades devem ser revertidas em futuras campanhas.
ABSTRACT
BACKGROUND: Over-the-counter analgesic use during pregnancy, particularly acetaminophen, may be associated with negative developmental outcomes in children. OBJECTIVE: Estimate associations of prenatal and early-life exposure to acetaminophen in early childhood with cognitive, motor, and language skills in two birth cohorts. METHODS: The American Project Viva cohort (1217 mother-child pairs enrolled 1999-2002) assessed cognition at approximately 3 years using the Peabody Picture Vocabulary Test and the Wide Range Achievement of Visual Motor Abilities (WRAVMA). The Brazilian 2015 Pelotas Birth Cohort (3818 mother-child pairs) assessed cognition at 2 years using the INTERGROWTH-21st Neurodevelopment Assessment. We used linear regression to estimate associations of acetaminophen use during pregnancy (Project Viva and Pelotas) and infancy (Project Viva) with children's cognitive scores adjusted for maternal age, pre-pregnancy body mass index, education, parity, race/ethnicity, smoking and alcohol use during pregnancy, depression during pregnancy, antibiotic and ibuprofen use during pregnancy, household income, and child's sex. RESULTS: In Project Viva, exposure to acetaminophen in both the 1st and 2nd trimester of pregnancy was associated with lower WRAVMA drawing scores (ß -1.51, 95% CI -2.92, -0.10). However, in Pelotas, exposure to acetaminophen in both the 1st and 2nd trimester of pregnancy was not associated with INTER-NDA motor scores (ß 0.02; 95% CI -0.05, 0.09) and was associated with higher INTER-NDA total scores (ß 0.08, 95% CI 0.01, 0.16). Other comparisons did not show evidence for any associations. CONCLUSIONS: Inconsistencies and lack of specificity of the findings did not clarify the research question considering that we still have a large variability and uncertainty to define the risk or safety in the use of acetaminophen related to cognition in early childhood. More studies using better exposure assessment and better confounding variables are needed to clarify these associations.
