Temporal patterns of food consumption and their association with cardiovascular risk in rotating shift workers.

OBJECTIVE: We aimed to evaluate the association of temporal patterns of food consumption with cardiovascular disease (CVD) risk. METHODS: This cross-sectional study included male rotating shift workers in an iron ore extraction company. Data on food consumption was collected using a 24 h recall, applied by trained interviewers. The variables for temporal patterns of food consumption were: eating window, eating at night, number of meals and omission of breakfast. CVD-risk was measured by calculating the Framingham coronary heart disease risk score (FCRS), and classified as low risk or intermediate to high risk. Descriptive, univariate and multivariate logistic regression analyses examined the association between variables related to temporal patterns of food consumption and CVD-risk. RESULTS: The study assessed 208 workers, the majority with 20-34 years (45.1%), non-white (77.2%), and 5 years or more in shift work (76.0%). Most participants had a feeding window exceeding 12 h (63.9%), consumed meals until 10 p.m. (68.1%), had five or more meals per day (54.8%), and did not skip breakfast (86.5%). Regarding CVD-risk, 43.8% of the participants were classified with intermediate to high risk for CVD. In the multivariate model, a feeding window (OR: 2.32; 95%CI: 1.01-5.35), eating after 10 p.m. (OR: 3.31; 95%CI: 1.01-11.0), and skipping breakfast (OR: 2.58; 95%CI: 1.07-6.19) increased the likelihood of intermediate to high CVD-risk. Conversely, having five or more meals per day decreased the odds (OR: 0.27; 95%CI: 0.08-0.92). CONCLUSION: Eating window longer than 12 h, eating after 10 p.m., less than four meals a day and omission of breakfast, are associated with cardiovascular risk in shift workers.

Rotating shift work time is directly associated with excess body adiposity.

OBJECTIVE: To analyze the association between changes in body adiposity and length of service on a schedule of rotating shifts. METHODS: The study was a cross-sectional investigation conducted during the years 2012, 2015, and 2018, involving individuals engaged in rotating shifts at a company involved in iron ore extraction situated within the Iron Quadrangle region of Minas Gerais and the southeastern region of Pará, Brazil. Sociodemographic and behavioral data were collected along with anthropometric parameters in order to calculate body mass index (BMI) and the waist-to-height ratio (WHtR). For data analysis, a multivariate logistic regression was employed to explore potential associations between indicators of body adiposity and the duration of shift work, employing a hierarchical determination model. RESULTS: The findings showed that in the multivariate model, controlling for confounding factors, workers with 5 to 10, 10 to 15, and more than 15 years of shift work had 41 to 96% greater odds of being overweight (BMI > 25.0 kg/m2), 71 to 82% of having altered neck circumference (> 40 cm), 33 to 120% of altered WC (>102 cm), and 57 to 214% of having altered WHtR (> 0.5 cm). CONCLUSION: The findings suggest that time spent in work has a significant effect on anthropometric indicators of body adiposity, especially if the worker has a previously established comorbidity such as dyslipidemia or hypertension and is frequently exposed to night work.

Fatty acid intake and prevalence of depression among Brazilian graduates and postgraduates (CUME Study).

BACKGROUND: Dietary fatty acids are related to the development of several inflammatory-related diseases, which may include depression. So, the association between fatty acids, culinary oils and fat intake and depression in highly educated Brazilians was evaluated. METHODS: Multicenter cross-sectional study using baseline data from the Cohort of Universities of Minas Gerais. The diagnosis of depression was self-reported, and the daily intake of fatty acids was assessed using a 144-item food frequency questionnaire (FFQ). RESULTS: A total of 7157 participants (68.83 % women) with a median age of 33 years were included. The prevalence of depression was 12.60 % (N = 902). In the adjusted analyses, it was observed that individuals with the highest intake of omega-6 fatty acids (n-6) (OR: 1.36, 95 % CI 1.11-1.67) had a higher prevalence of depression. This increased n-6 intake was identified as a risk factor for depression only among male participants, while among overweight participants, higher n-6 intake was also positively associated with depression. Conversely, a higher ratio of polyunsaturated to monounsaturated and saturated fatty acids (PM/S) was also found to be positively associated with depression, but this association was observed only among non-overweight participants. No associations were found between the consumption of culinary oils or fats and depression. LIMITATIONS: Cross-sectional design limits the assessment of causality. The use of the FFQ can make estimates more difficult. CONCLUSION: Higher consumption of n-6, and higher PM/S ratios were associated with depression, and individual factors can interfere. The mental health care policies should include specific nutritional strategies.

30-Year High Cardiovascular Risk Incidence and its Determinants: CUME Study.

OBJECTIVE: Estimate the incidence of the 30-year high cardiovascular risk and its determinants among graduates of federal universities in Minas Gerais. METHODS: This is a prospective cohort of 2,854 adults aged 20 to 59. The incidence of the outcome was calculated using the Framingham equation and its determinants were determined through multivariate Cox regression. RESULTS: After an average of 2.62 years, the incidence of high cardiovascular risk was 8.09 and 20.1 cases per 1,000 person-years, for females and males respectively. Being male (HR: 2.34; 95% CI: 1.58 - 3.46), employment (HR: 2.13; 95% CI: 1.13 - 3.99), high consumption of processed foods (HR: 2.44; 95% CI: 1.21 - 4.90), and being physically active (HR: 0.63; 95% CI: 0.41 - 0.98) were associated with high cardiovascular risk. CONCLUSIONS: Among highly educated adults, being male, employment, and high consumption of processed foods are predictors of high cardiovascular risk, while being physically active acts as a protective factor.

Arterial hypertension in rotating shift workers: The role of hypertriglyceridemic waist and hypertriglyceridemic waist-to-height ratio phenotypes.

OBJECTIVE: To examine the association of arterial hypertension and the hypertriglyceridemic waist phenotype (HWP) and hypertriglyceridemic waist-to-height phenotype (HWHP). METHODOLOGY: This cross-sectional study was conducted with 1422 male rotating shift workers in Brazil. The HWP was defined as having a waist circumference ≥94 cm and serum triglycerides ≥150 mg/dL, whereas the HWHP was determined by having a waist-to-height ratio ≥0.5 and serum triglycerides ≥150 mg/dL. To provide a characterization of the sample, data were presented in both absolute and relative values, and Pearson's chi-square test was employed. To investigate the potential association between arterial hypertension and the presence of HWP or HWHP, multivariate logistic regression was conducted, accounting for sociodemographic, behavioral, and clinical variables. Furthermore, we conducted a stratified multivariate logistic regression analysis, considering the duration of shift work, to assess whether the results remained consistent depending on the length of work experience in shifts. RESULTS: A noteworthy association was observed between arterial hypertension and both HWP and HWHP, with HWHP exhibiting a stronger association with the disease. Furthermore, a positive association between arterial hypertension and these phenotypes was identified in workers with five or more years of shift work. CONCLUSION: We recommend the utilization of HWHP as a screening tool, as it indicates a stronger association with arterial hypertension compared to HWP. Additionally, the duration of time spent working in shifts emerged as a significant factor influencing the presence of these phenotypes.

The 30-year cardiovascular risk trajectories and their independently associated factors in participants of a Brazilian cohort (CUME Study).

We aimed to analyze the different trajectories of 30-year cardiovascular risk (CVR) and its independently associated factors in participants of the CUME Study, a prospective study with alumni from federal universities of Minas Gerais State, Brazil. In this study, 1,286 participants who answered the baseline (2016) and follow-up (2018 and 2020) questionnaires were included. Trajectories of CVR, according to the Framingham score, were identified with the latent class growth modelling technique with the use of the censored normal model. Analysis of the factors independently associated with each of the trajectories was conducted with multinomial logistic regression technique. Three CVR trajectories were identified: Low-Low (68.3%), Medium-Medium (26.2%), and High-High (5.5%). Male sex, living in a stable union, and having moderate and high intakes of ultra-processed foods were positively associated with the Medium-Medium and High-High CVR trajectories. Having non-healthcare professional training and working were positively associated with the Medium-Medium CVR trajectory, whereas being physically active was negatively associated with the High-High CVR trajectory. In conclusion, more than one-third of participants had CVR trajectories in the Medium-Medium and High-High categories. Food consumption and physical activity are modifiable factors that were associated with these trajectories; thus, implementing health promotion measures could help prevent the persistence or worsen of CVR. On the other hand, sociodemographic and labor characteristics are non-modifiable factors that were associated with Medium-Medium and High-High trajectories, which could help identify people who should be monitored with more caution by health services.

The predictive values of BOAH and No-apnea score for screening obstructive sleep apnea in rotating shift worker drivers.

Objective: To evaluate the BOAH (Body mass index, Observed apnea, Age, and Hypertension) and No-apnea score's diagnostic values for detecting obstructive sleep apnea (OSA) risk in shift workers. Methods: Cross-sectional study with male rotating shift workers and drivers of heavy off-road machinery. The BOAH score is based on body mass index, witnessed apneas during sleep, age, and hypertension. The No-apnea score is based on neck circumference and age. Based on the apnea-hypopnea index (AHI), the severity of OSA was categorized as least mild OSA (AHI ≥5/h), moderate to severe OSA (AHI ≥15/h), and severe OSA (AHI ≥30/h). Sensitivity, specificity, positive predictive value, negative predictive value, and areas under the curve (AUC) were calculated. Results: Among 119 workers evaluated, 84.0% had AHI ≥5, 46.2% had AHI ≥15, and 14.3% had AHI ≥30. BOAH score with 2 points for AHI ≥5, the AUC was 0.679, and sensitivity and specificity were 41.0% and 94.7%, respectively. No-apnea score with 3 points AHI ≥5, the AUC was 0.692, and sensitivity and specificity were 70.0% and 68.4%, respectively. Furthermore, using at least one of the positive scores, the AUC was higher when compared to the single tests for AHI ≥5 (AUC = 0.727). And when both scores were positive, the AUC was higher for AHI ≥30 (AUC = 0.706). Conclusion: In rotating shift workers and drivers of heavy off-road machinery, BOAH, and No-apnea scores can be helpful tools in identifying individuals at risk for sleep apnea. In addition, matching the scores may increase the prediction of OSA.

Vitamin D deficiency and hyperglycemia in male rotating shift workers: A disturbed circadian rhythms influence.

BACKGROUND: Shift work is related to several negative impacts on the health of workers. This study aimed to evaluate the association between vitamin D deficiency (VDD) and hyperglycemia in shift workers. METHODOLOGY: This cross-sectional study included male rotating shift workers in an iron ore extraction company. Participants were classified as VDD when 25(OH)D < 20 ng/mL for a healthy population and 25(OH)D < 30 ng/mL for groups at risk for VDD. Hyperglycemia was classified when fasting glucose ≥100 mg/dL or HbA1c ≥ 5.7%. Data were compared using chi-square analysis with Cramer's V as effect size, and Bonferroni correction. Multivariate logistic regression, from a model of determination, was performed to investigate whether VDD was associated with hyperglycemia. RESULTS: The study evaluated 1411 workers, most workers were aged 30-39 years (53.2%), and 77.5% self-declared as black, brown, with up to complete high school (71.4%) and working alternate shifts for more than 5 years (76.1%). Regarding glucose and vitamin D, 32.0% and 29.1% of the workers had hyperglycemia and VDD, respectively. In multivariate analysis, controlled for confounding factors, workers with VDD had a 119% increased chance of hyperglycemia (OR: 2.19; IC95%: 1.56-3.08). Furthermore, vitamin D levels in distribution quintiles showed a dose-response gradient in relation to hyperglycemia, where increased vitamin D values were associated with a reduction in the occurrence of hyperglycemia. CONCLUSION: Rotating shift workers with vitamin D deficiency are more likely to have hyperglycemia.

Association of Hypovitaminosis D with Sleep Parameters in Rotating Shift Worker Drivers.

Objective To evaluate the association between sleep parameters and hypovitaminosis D in rotating shift drivers. Material and Methods We conducted a cross-sectional study on 82 male rotating shift workers (24-57 years old) with at least one cardiovascular risk factor (such as hyperglycemia, dyslipidemia, abdominal obesity, physical inactivity, hypertension, and smoking). Polysomnography was used to evaluate sleep parameters. Logistic regression was used to model the association between hypovitaminosis D and sleep parameters after adjustment for relevant covariates. Results Hypovitaminosis D (< 20 ng/mL) was seen in 30.5% of the workers. Shift workers with hypovitaminosis D had lower sleep efficiency (odds ratio [OR]: 3.68; 95% confidence interval [CI]: 1.95-5.53), lower arterial oxygen saturation (OR: 5.35; 95% CI: 3.37-6.12), and increased microarousal index (OR: 3.85; 95% CI: 1.26-5.63) after adjusting. Conclusion We suggest that hypovitaminosis D is associated with greater sleep disturbances in rotating shift workers.

Spatial clusters of diabetes: individual and neighborhood characteristics in the ELSA-Brasil cohort study.

This study identified spatial clusters of type 2 diabetes mellitus among participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) residing in two cities and verified individual and neighborhood socioeconomic environmental characteristics associated with the spatial clusters. A cross-sectional study was conducted with 4,335 participants. Type 2 diabetes mellitus was defined as fasting blood glucose ≥ 126mg/dL (7.0mmol/L), oral glucose tolerance test ≥ 200mg/dL (11.1mmol/L), or glycated hemoglobin ≥ 6.5% (48mmol/L); by antidiabetic drug use; or by the self-reported medical diagnosis of type 2 diabetes mellitus. Neighborhood socioeconomic characteristics were obtained from the 2011 Brazilian census. A spatial data analysis was conducted with the SaTScan method to detect spatial clusters. Logistic regression models were fitted to estimate the magnitude of associations. In total, 336 and 343 participants had type 2 diabetes mellitus in Belo Horizonte, Minas Gerais State (13.5%) and Salvador, Bahia State (18.5%), respectively. Two cluster areas showing a high chance of type 2 diabetes mellitus were identified in Belo Horizonte and Salvador. In both cities, participants living in the high type 2 diabetes mellitus cluster area were more likely to be mixed-race or black and have a low schooling level and manual work; these were also considered low-income areas. On the other hand, participants in the low type 2 diabetes mellitus cluster area of Salvador were less likely to be black and have low schooling level (university degree) and live in a low-income area. More vulnerable individual and neighborhood socioeconomic characteristics were associated with living in clusters of higher type 2 diabetes mellitus occurrence , whereas better contextual profiles were associated with clusters of lower prevalence.

Rotating shift workers with vitamin D deficiency have a higher risk of obstructive sleep apnea.

OBJECTIVES: The study aimed to evaluate the association between obstructive sleep apnea (OSA) and vitamin D deficiency (VDD) in shift workers. METHODS: This cross-sectional study included male rotating shift workers in an iron ore extraction company. Participants were classified as VDD when 25(OH)D < 20 ng/mL for a healthy population and 25(OH)D < 30 ng/mL for groups at risk for VDD. Risk of developing OSA was classified by Berlin questionnaire (BQ) and NoSAS score. Data were compared using chi-square analysis with Cramer's V as effect size, and Bonferroni correction. Multivariate logistic regression analysis was performed to investigate whether or not VDD was associated with OSA risk assessment. RESULTS: Among 1423 male workers, mostly younger, aged 30 to 39 years (53%), worked shifts for more than 5 years (76%). The prevalence of high risk of OSA by BQ was 16%, and 33% by NoSAS score. Additionally, 29% had VDD. In multivariate analysis, controlled for confounding factors, workers with VDD had a 52% increased chance of OSA by BQ (OR 1.52; CI95% 1.06-2.18) and a 64% increased chance of OSA by NoSAS score (OR 1.64; CI95% 1.09-2.48). After subgroup analyses, similar results were not observed in workers aged 20-29 and 30-39 years. CONCLUSION: Rotating shift workers with vitamin D deficiency are more likely to have obstructive sleep apnea, assessed by the Berlin questionnaire and NoSAS score.

Effects of minimally and ultra-processed foods on blood pressure in Brazilian adults: a two-year follow up of the CUME Project.

AIM: To assess the association of food consumption according to degree of processing with changes in systolic (SBP) and diastolic (DBP) blood pressure in adult participants of a Brazilian cohort. METHODS: Longitudinal study with 2496 adult participants of the Cohort of Universities of Minas Gerais (CUME Project). Food consumption was categorized by food groups according to degree of processing following the NOVA grading system: unprocessed/minimally processed foods/culinary ingredients (U/MPF&CI), processed foods (PFs) and ultra-processed foods (UPFs). unprocessed/minimally processed foods/culinary ingredients (U/MPF&CI), processed foods (PFs) and ultra-processed foods (UPFs). Changes in SBP and DBP were categorized (decreased, maintained, increased). Independent associations between exposure and outcomes were verified using multiple generalized ordered logistic models adjusted for potential confounders. RESULTS: After a two-year follow-up, the consumption of U/MPF&CI (% daily caloric intake) reduced the chance of increasing DBP (P for trend = 0.014), with a more evident effect among participants within the 5th quintile of this food group (odds ratio (OR) = 0.55; 95% confidence interval (CI): 0.34-0.97]. On the other hand, the consumption of UPFs (% daily caloric intake) raised the chance of increasing DBP (P for trend = 0.005) and was more evident among participants within the quintiles of higher consumption (4th quintile - OR = 1.97; 95% CI: 1.25-3.10; 5th quintile - OR = 1.79; 95% CI = 1.12-2.86). No associations were found between food consumption according to degree of processing and changes in SBP. CONCLUSION: Higher consumption of U/MPF&CI and UPFs were independently associated to lower and greater chances of increased DBP in adult participants from CUME Project.

30-Year High Cardiovascular Risk Incidence and its Determinants: CUME Study / Incidencia del alto riesgo cardiovascular de 30 años y sus determinantes: Estudio CUME / Incidência do alto risco cardiovascular de 30 anos e seus determinantes: Estudo CUME

ABSTRACT Objective: Estimate the incidence of the 30-year high cardiovascular risk and its determinants among graduates of federal universities in Minas Gerais. Methods: This is a prospective cohort of 2,854 adults aged 20 to 59. The incidence of the outcome was calculated using the Framingham equation and its determinants were determined through multivariate Cox regression. Results: After an average of 2.62 years, the incidence of high cardiovascular risk was 8.09 and 20.1 cases per 1,000 person-years, for females and males respectively. Being male (HR: 2.34; 95% CI: 1.58 - 3.46), employment (HR: 2.13; 95% CI: 1.13 - 3.99), high consumption of processed foods (HR: 2.44; 95% CI: 1.21 - 4.90), and being physically active (HR: 0.63; 95% CI: 0.41 - 0.98) were associated with high cardiovascular risk. Conclusions: Among highly educated adults, being male, employment, and high consumption of processed foods are predictors of high cardiovascular risk, while being physically active acts as a protective factor.

RESUMEN Objetivo: Estimar la incidencia del alto riesgo cardiovascular de 30 años y sus determinantes en graduados de universidades federales de Minas Gerais. Métodos: Cohorte prospectiva con 2.854 adultos de 20 a 59 años. Se calculó la incidencia del desenlace usando la ecuación de Framingham y sus determinantes a través de la regresión multivariante de Cox. Resultados: Después de un promedio de 2,62 años, la incidencia del alto riesgo cardiovascular fue de 8,09 y 20,1 casos por 1.000 personas-año, respectivamente, en los géneros femenino y masculino. Ser masculino (HR: 2,34; IC95%: 1,58 - 3,46), trabajar (HR: 2,13; IC95%: 1,13 - 3,99), un alto consumo de alimentos procesados (HR: 2,44; IC95%: 1,21 - 4,90) y ser activo físicamente (HR: 0,63; IC95%: 0,41 - 0,98) se asociaron con el alto riesgo cardiovascular. Conclusiones: En adultos con alta educación, ser masculino, trabajar y el alto consumo de alimentos procesados son predictores del alto riesgo cardiovascular, mientras que ser activo físicamente es un factor de protección.

RESUMO Objetivo: Estimar a incidência do alto risco cardiovascular de 30 anos e seus determinantes em egressos de universidades federais mineiras. Métodos: Coorte prospectiva com 2.854 adultos de 20 a 59 anos. Calculou-se a incidência do desfecho pela equação de Framingham e seus determinantes pela regressão de Cox multivariada. Resultados: Após uma média de 2,62 anos, a incidência do alto risco cardiovascular foi de 8,09 e 20,1 casos/1.000 pessoas-ano, respectivamente, nos sexos feminino e masculino. O sexo masculino (HR: 2,34; IC95%: 1,58 - 3,46), trabalhar (HR: 2,13; IC95%: 1,13 - 3,99), elevado consumo de alimentos processados (HR: 2,44; IC95%: 1,21 - 4,90) e ser ativo fisicamente (HR: 0,63; IC95%: 0,41 - 0,98) associaram-se ao alto risco cardiovascular. Conclusões: Em adultos com alta escolaridade, o sexo masculino, trabalhar e o elevado consumo de alimentos processados são preditivos do alto risco cardiovascular, enquanto ser ativo fisicamente é um fator de proteção.

Spatial clusters of diabetes: individual and neighborhood characteristics in the ELSA-Brasil cohort study / Aglomerados espaciais de diabetes: características individuais e de vizinhança no estudo longitudinal ELSA-Brasil / Grupos espaciales de diabetes: características individuales y vecinales en el estudio longitudinal ELSA-Brasil

This study identified spatial clusters of type 2 diabetes mellitus among participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) residing in two cities and verified individual and neighborhood socioeconomic environmental characteristics associated with the spatial clusters. A cross-sectional study was conducted with 4,335 participants. Type 2 diabetes mellitus was defined as fasting blood glucose ≥ 126mg/dL (7.0mmol/L), oral glucose tolerance test ≥ 200mg/dL (11.1mmol/L), or glycated hemoglobin ≥ 6.5% (48mmol/L); by antidiabetic drug use; or by the self-reported medical diagnosis of type 2 diabetes mellitus. Neighborhood socioeconomic characteristics were obtained from the 2011 Brazilian census. A spatial data analysis was conducted with the SaTScan method to detect spatial clusters. Logistic regression models were fitted to estimate the magnitude of associations. In total, 336 and 343 participants had type 2 diabetes mellitus in Belo Horizonte, Minas Gerais State (13.5%) and Salvador, Bahia State (18.5%), respectively. Two cluster areas showing a high chance of type 2 diabetes mellitus were identified in Belo Horizonte and Salvador. In both cities, participants living in the high type 2 diabetes mellitus cluster area were more likely to be mixed-race or black and have a low schooling level and manual work; these were also considered low-income areas. On the other hand, participants in the low type 2 diabetes mellitus cluster area of Salvador were less likely to be black and have low schooling level (university degree) and live in a low-income area. More vulnerable individual and neighborhood socioeconomic characteristics were associated with living in clusters of higher type 2 diabetes mellitus occurrence , whereas better contextual profiles were associated with clusters of lower prevalence.

Este estudo identificou aglomerados espaciais de diabetes mellitus tipo 2 entre participantes do Estudo Longitudinal de Saúde do Adulto no Brasil (ELSA-Brasil) em duas cidades e verificou características socioeconômicas ambientais individuais e de vizinhança associadas aos aglomerados espaciais. Se trata de um estudo transversal com 4.335 participantes. Diabetes mellitus tipo 2 foi definido com base em glicemia de jejum ≥ 126mg/dL (7,0mmol/L); teste oral de tolerância à glicose ≥ 200mg/dL (11,1mmol/L); hemoglobina glicada ≥ 6,5% (48mmol/L); uso de drogas antidiabéticas; ou pelo autodiagnóstico médico de diabetes mellitus tipo 2. As características socioeconômicas do bairro foram obtidas a partir do censo brasileiro de 2011. A análise dos dados espaciais foi realizada pelo método SaTScan para detectar os aglomerados espaciais. Os modelos de regressão logística foram ajustados para estimar a magnitude das associações. Um total de 336 e 343 participantes apresentaram diabetes mellitus tipo 2 em Belo Horizonte, Minas Gerais (13,5%) e Salvador, Bahia (18,5%), respectivamente. Foram identificadas duas áreas de aglomerados com alta probabilidade de diabetes mellitus tipo 2 em Belo Horizonte e Salvador. Em ambas as cidades, os participantes residentes nos aglomerados com alta taxa de diabetes mellitus tipo 2 tinham maior probabilidade de relatar cor de pele parda ou preta, baixa escolaridade e ocupação de trabalho manual; essas áreas também foram consideradas de baixa renda. Por outro lado, os participantes do aglomerado com baixa taxa de diabetes mellitus tipo 2 de Salvador tinham menor probabilidade de serem negros e maior probabilidade de terem diploma universitário, além de morarem em áreas de alta renda. Características socioeconômicas individuais e de vizinhança mais vulneráveis estavam associadas à residência em aglomerados de maior ocorrência de diabetes mellitus tipo 2, enquanto o oposto foi observado para perfis contextuais melhores.

Este estudio identificó grupos espaciales de diabetes mellitus tipo 2 entre los participantes del Estudio Longitudinal de Salud del Adulto en Brasil (ELSA-Brasil) en dos ciudades y verificó las características socioeconómicas ambientales individuales y de vecindario asociadas con los grupos espaciales. Se trata de un estudio transversal con 4.335 participantes. La diabetes mellitus tipo 2 se definió en base a glucosa en ayunas ≥ 126mg/dL (7,0mmol/L); prueba de tolerancia oral a la glucosa ≥ 200mg/dL (11,1mmol/L); hemoglobina glicosilada ≥ 6,5% (48mmol/L); uso de medicamentos antidiabéticos; o por autodiagnóstico médico de diabetes mellitus tipo 2. Las características socioeconómicas del barrio se obtuvieron a partir del censo brasileño de 2011. El análisis de datos espaciales se realizó utilizando el método SaTScan para detectar grupos espaciales. Los modelos de regresión logística se ajustaron para estimar la magnitud de las asociaciones. Un total de 336 y 343 participantes presentaron diabetes mellitus tipo 2 en Belo Horizonte, Minas Gerais (13,5%) y Salvador, Bahia (18,5%), respectivamente. Se identificaron dos áreas de grupos con alta probabilidad de diabetes mellitus tipo 2 en Belo Horizonte y Salvador. En ambas ciudades, los participantes que residían en las áreas del grupo con una alta tasa de diabetes mellitus tipo 2 tenían más probabilidades de informar el color de piel pardo o negro, la baja educación y la ocupación del trabajo manual; estas áreas también se consideraron de bajos ingresos. Por el contrario, los participantes en el área del grupo con baja tasa de diabetes mellitus tipo 2 de Salvador tenían menos probabilidades de ser negros y más probabilidades de tener un título universitario, además de vivir en áreas de altos ingresos. Las características socioeconómicas individuales y de vecindario más vulnerables se asociaron con la residencia en grupos de mayor incidencia de diabetes mellitus tipo 2, mientras que se observó lo contrario para mejores perfiles contextuales.

The 30-year cardiovascular risk trajectories and their independently associated factors in participants of a Brazilian cohort (CUME Study) / As trajetórias de risco cardiovascular de 30 anos e seus fatores independentemente associados em participantes de uma coorte brasileira (Estudo CUME) / Las trayectorias de riesgo cardiovascular de 30 años y sus factores asociados de forma independiente en participantes de una cohorte brasileña (Estudio CUME)

Abstract: We aimed to analyze the different trajectories of 30-year cardiovascular risk (CVR) and its independently associated factors in participants of the CUME Study, a prospective study with alumni from federal universities of Minas Gerais State, Brazil. In this study, 1,286 participants who answered the baseline (2016) and follow-up (2018 and 2020) questionnaires were included. Trajectories of CVR, according to the Framingham score, were identified with the latent class growth modelling technique with the use of the censored normal model. Analysis of the factors independently associated with each of the trajectories was conducted with multinomial logistic regression technique. Three CVR trajectories were identified: Low-Low (68.3%), Medium-Medium (26.2%), and High-High (5.5%). Male sex, living in a stable union, and having moderate and high intakes of ultra-processed foods were positively associated with the Medium-Medium and High-High CVR trajectories. Having non-healthcare professional training and working were positively associated with the Medium-Medium CVR trajectory, whereas being physically active was negatively associated with the High-High CVR trajectory. In conclusion, more than one-third of participants had CVR trajectories in the Medium-Medium and High-High categories. Food consumption and physical activity are modifiable factors that were associated with these trajectories; thus, implementing health promotion measures could help prevent the persistence or worsen of CVR. On the other hand, sociodemographic and labor characteristics are non-modifiable factors that were associated with Medium-Medium and High-High trajectories, which could help identify people who should be monitored with more caution by health services.

Resumo: Nosso objetivo foi analisar as diferentes trajetórias de risco cardiovascular (RCV) de 30 anos e seus fatores independentemente associados em participantes do Estudo CUME, um estudo prospectivo com ex-alunos de universidades federais de Minas Gerais, Brasil. Este estudo incluiu 1.286 participantes que responderam aos questionários de linha de base (2016) e acompanhamento (2018 e 2020). As trajetórias de RCV, de acordo com o escore de Framingham, foram identificadas por modelagem de crescimento de classe latente com o uso do modelo normal censurado. A análise dos fatores independentemente associados a cada uma das trajetórias foi realizada por regressão logística multinomial. Foram identificadas três trajetórias de RCV: Baixo-Baixo (68,3%), Médio-Médio (26,2%) e Alto-Alto (5,5%). Sexo masculino, união estável e consumo moderado e alto de alimentos ultraprocessados foram positivamente associados às trajetórias de RCV Médio-Médio e Alto-Alto. Formação profissional e trabalhar em áreas não relacionadas à saúde foram positivamente associados à trajetória de RCV Médio-Médio, enquanto ser fisicamente ativo foi negativamente associado à trajetória de RCV Alto-Alto. Em conclusão, mais de um terço dos participantes apresentou trajetórias de RCV nas categorias Médio-Médio e Alto-Alto. Fatores modificáveis foram associados a essas trajetórias (consumo de alimentos e atividade física); assim, medidas de promoção da saúde podem evitar a manutenção ou a piora do RCV. Por outro lado, os fatores não modificáveis associados às trajetórias Médio-Médio e Alto-Alto (características sociodemográficas e laborais) permitem traçar o perfil das pessoas que devem ser monitoradas com mais cautela pelos serviços de saúde.

Resumen: Nuestro objetivo fue analizar las diferentes trayectorias de riesgo cardiovascular (RCV) de 30 años y sus factores asociados de forma independiente en participantes del Estudio CUME, un estudio prospectivo con exalumnos de universidades federales de Minas Gerais, Brasil. Este estudio incluyó a 1.286 participantes que completaron los cuestionarios de referencia (2016) y de seguimiento (2018 y 2020). Las trayectorias de RCV, según el índice de Framingham, se identificaron mediante el modelado de crecimiento de clase latente utilizando el modelo normal censurado. El análisis de los factores asociados de forma independiente a cada una de las trayectorias se realizó mediante regresión logística multinomial. Se identificaron tres trayectorias de RCV: Bajo-Bajo (68,3%), Medio-Medio (26,2%) y Alto-Alto (5,5%). El género masculino, la unión estable y el consumo moderado y alto de alimentos ultraprocesados se asociaron positivamente con las trayectorias de RCV Medio-Medio y Alto-Alto. La formación profesional y el trabajo en áreas no relacionadas con la salud se asociaron positivamente con la trayectoria de RCV Medio-Medio, mientras que la actividad física se asoció negativamente con la trayectoria de RCV Alto-Alto. En conclusión, más de la tercera parte de los participantes presentó trayectorias de RCV en las categorías Medio-Medio y Alto-Alto. A estas trayectorias se asociaron factores modificables (consumo de alimentos y actividad física); por lo tanto, las medidas de promoción de la salud pueden prevenir el mantenimiento o el empeoramiento del RCV. Por otra parte, los factores no modificables asociados a las trayectorias Medio-Medio y Alto-Alto (características sociodemográficas y laborales) permiten delinear el perfil de las personas que deben ser monitoreadas con más atención por los servicios de salud.

Ultra-processed food consumption and dietary, lifestyle and social determinants: a path analysis in Brazilian graduates (CUME project).

OBJECTIVE: To explore the relationship between ultra-processed foods (UPF) consumption and dietary, lifestyle and social determinants using pathway analysis in the baseline of the Cohort of Universities of Minas Gerais (CUME project). DESIGN: Cross-sectional study, in which path analysis was used to estimate direct and indirect effects of dietary practices, sleep, time on the computer and professional status on UPF consumption. SETTING: Data were collected in 2016, through an online questionnaire composed of sociodemographic, anthropometric, lifestyle and dietary practices questions, and a FFQ. PARTICIPANTS: Baseline participants from the CUME Project (n 2826), adults who graduated from Universidade Federal de Viçosa or Universidade Federal de Minas Gerais, Brazil. RESULTS: Being employed (P = 0·024), the time spent on the computer (P = 0·031) and the frequency of fried food intake (P < 0·001) were positively and directly associated with UPF consumption, whereas the sleep duration (P = 0·007) and the number of meals per d (P < 0·001) were negatively and directly associated with UPF consumption. Indirect effects were observed between being employed, mediated by the sleep duration (P = 0·032) and fried food intake (P = 0·005), whereas being a student is mediated by the time on the computer (P = 0·048). CONCLUSION: The time spent on the computer, sleep duration and fried food consumption showed direct effects on UPF consumption. They also acted as mediators on the relationship between professional status and UPF consumption. Besides, the number of meals eaten each day also was directly associated with UPF consumption.

Cardiovascular Risk Factors in Haul Truck Operators of the Mining Sector Working a Rotational Schedule

Abstract Background: Due to the growing concern about work-related social and health aspects, occupational health and safety has become relevant. Objective: This work aims to develop a model to assist cardiovascular risk management in a team of haul truck operators, who work in rotating shifts at a mining company in Brazil. Methods: This longitudinal study evaluated risk factors for cardiovascular diseases of 191 mineworkers at three times points - 2010, 2012, and 2015. In addition, the risk of developing cardiovascular diseases was calculated, and the risk factors were analyzed using the chi-square test, the U Mann-Whitney test, and binary logistic regression. The significance level was set at 5%. Results: In the study period, body weight, body mass index (BMI), waist-to-height ratio (WHR), systolic (SBP), and diastolic blood pressure (DBP), total cholesterol, high-density lipoprotein cholesterol (HDL-C), and triglycerides levels of the study group increased. In 2015, there was a high prevalence of alcohol intake, overweight or obesity, central obesity, inadequate WHR, high blood pressure, total cholesterol above 190 mg/dL, and triglycerides above 150 mg/dL. An association was identified between increased cardiovascular risk and age, SBP, HDL-C, low-density lipoprotein cholesterol (LDL-C), and elevated glucose levels. Conclusion: Intense interventions for reduction and prevention of elevated alcohol intake, blood pressure levels, WHR, metabolic syndrome, blood glucose, and LDL-C levels, and low HDL-C levels are needed. In addition, a close monitoring of mine workers over 38 years of age who smoke, consume alcoholic beverages, and have altered blood glucose levels is important.

Work hours as a risk factor for SARS-CoV-2 infections: cardiometabolic and sleep characteristics in rotating shift workers.

Objective: This study aims to describe the health characteristics of rotating shift mining workers that may be related to a worse course scenario for COVID-19, according to literature data. Methods: Is a cross-sectional from three studies with 1478 shift workers. Social, demographic, clinical, and biochemical variables were analyzed. Risk factors for COVID-19 analyzed: hyperglycemia, altered blood pressure, dyslipidemia, hypovitaminosis D, obesity, presence of pre-existing cardiovascular diseases, and smokers. Results: Evaluating the grouped risk factors for an unfavorable evolution of COVID-19 most workers (91.0%) presented at least one risk factor. Discussion: With coronavirus in pandemic circulation, we noticed that mineworkers are in a vulnerable position. Their exposure to occupational risk factors, to the shift system, which directly affects sleep and negatively influences immunity, added to the conditions of favorable transmissibility by the flow of people from the mines leads us to believe in their greater susceptibility to acquiring the most serious forms of the disease.

Built and social environments and overweight among Brazilian adults from medium-sized city: CUME Project.

A cross-sectional study enrolled participants from the CUME project (n = 289) who lived in Viçosa, Brazil. The neighborhood unit adopted was the buffer (200 meters), considering the participant's residence as central point. We measure the number of public and private facilities inside the buffer as well as violent criminal occurrences. Food establishments were categorized into establishments with predominant sale of natural or minimally processed foods, mixed establishments, and establishments with predominant sale of ultra-processed foods. Those who attended the face-to-face interview filled two scales of perception of the environment. Overall, 33.6% of participants reported overweight. We observed a higher concentration of individuals close to the central region of the city. Access to different establishments, food environments, and criminal occurrences differed between normal-weight and overweight individuals. The groups deferred in the perception of the location of squares, open public spaces, clubs, and soccer fields. The results indicate the association between environmental characteristics and overweight in Brazilian adults.

Diagnostic accuracy of the Berlin questionnaire and the NoSAS score in detecting risk for obstructive sleep apnea in rotating shift workers.

BACKGROUND: Data on the validity of tools for sleep apnea risk detection in rotating shift workers are limited. The aim was to evaluate the Berlin questionnaire (BQ) and the Neck, Obesity, Snoring, Age, Sex (NoSAS) score for the detection of obstructive sleep apnea risk in shift workers. METHODS: This cross-sectional study included male rotating shift workers, drivers of heavy off-road machinery in an iron ore extraction company. Polysomnography was the gold standard for evaluation. Obstructive sleep apnea (OSA) was defined as an apnea-hypopnea index (AHI) of ≥ 5 events/h. The Shapiro-Wilk test verified the data distribution and comparative analysis was conducted using the chi-square analyses and U Mann-Whitney with Bonferroni correction. Receiver operating characteristic curve analysis, sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios, and accuracy were used for evaluate BQ and NoSAS with OSA diagnosis by polysomnograph. RESULTS: Among 119 male shift workers, ages 24 to 57 years, polysomnography showed that 84% had obstructive sleep apnea (AHI ≥ 5), and 46% had moderate to severe sleep apnea (AHI ≥ 15). For AHI ≥ 5, the NoSAS score had higher sensitivity and specificity than the BQ. For AHI ≥ 15 and AHI ≥ 30, the NoSAS score had a sensitivity higher than 70% while BQ was 60% and 58%, respectively. The accuracy of the NoSAS score was higher for all OSA criteria than that of BQ. CONCLUSION: In rotating shift workers, drivers of heavy off-road machinery, the NoSAS score showed higher accuracy in identifying patients at risk for sleep apnea than the BQ.