Complex multimorbidity in hemodialysis patients: Study in a metropolitan region in Brazil.

The objective of this article was to analyze the factors associated with complex multimorbidity (CMM) among hemodialysis patients in a metropolitan region in southeastern Brazil. To this end, a cross-sectional epidemiological survey was carried out with 1,024 individuals in the year 2019. CMM data were collected through the application of a questionnaire to hemodialysis patients. The binary logistic regression model was used to estimate odds ratios (OR) and 95% confidence intervals (95%CI) between independent variables and CMM. The prevalence of CMM was 81% and the results indicated that: living in cities with a low rate of general mortality (OR = 0.395, 95%CI = 0.179-0.870), being aged between 18 and 29 (OR = 0.402, 95%CI = 0.196-0.825), having an elementary education (OR = 0.536, 95%CI = 0.290-0.966) and assessing health as good/very good (OR = 0.446, 95%CI = 0.301-0.661) are factors that reduced the chances of having CMM, whereas a longer period of hemodialysis (OR = 1.779 and 95%CI = 1.057-2.997) increased the chances of CMM. The findings show that characteristics of the social and individual context are associated with CMM in hemodialysis patients, signaling the need for public health policies that include monitoring the complex multimorbidity condition among individuals undergoing hemodialysis treatment.

Metabolic Syndrome and Associated Factors in Farmers in Southeastern Brazil: A Cross-Sectional Study.

(1) Background: Metabolic syndrome is a strong predictor of cardiovascular disease thus the objective of the study was to verify the prevalence of metabolic syndrome in farmers, as well as to verify the association with sociodemographic, work and lifestyle factors. (2) Methods: Cross-sectional, observational study, conducted with 790 individuals. For the diagnosis of metabolic syndrome, the National Cholesterol Education Program's Adult Treatment Panel III (NCEP-ATP III) and International Diabetes Federation (IDF) criteria were used. Pearson's chi-square test and binary logistic regression were used to verify factors associated with metabolic syndrome (3) Results: The prevalence of MS according to the IDF criteria was 16.3% overall, with 9.7% of women (95% CI: 6.66-16.16) and 6.6% of men (95% CI: 5.17-11.97). According to the NCEP/ATP III criterion, it was 12.3% overall, with 7.5% corresponding to women (95% CI: 6.62-13.13) and 4.8% to men (95% CI: 3.5-8.70). With regard to the conditions that make up metabolic syndrome, it was found that high density lipoprotein, high blood pressure and high waist circumference were the most prevalent. (4) Conclusions: The prevalence of metabolic syndrome is considerable in the population when compared to other regions, both rural and urban, in Brazil.

Overweight, obesity and risk of multimorbidity: A systematic review and meta-analysis of longitudinal studies.

This study aimed to review and quantify the association between overweight and obesity in the risk of multimorbidity among the general population. We conducted a systematic review and meta-analysis in the databases of Pubmed, Lilacs, Web of Science, Scopus, and Embase. We included cohort studies that assessed the association between overweight and/or obesity with the risk of multimorbidity. The Newcastle-Ottawa assessed the studies' individual quality. A random-effect model meta-analysis was performed to evaluate the association between overweight and obesity with the relative risk (RR) of multimorbidity; the I2 test evaluated heterogeneity. After excluding duplicates, we found 1.655 manuscripts, of which eight met the inclusion criteria. Of these, seven (87.5%) evidenced an increased risk of multimorbidity among subjects with overweight and/or obesity. Overall, we observed an increased risk of multimorbidity among subjects with overweight (RR: 1.26; CI95%: 1.12; 1.40, I2 = 98%) and obesity (RR: 1.99; CI95%: 1.45;2.72, I2 = 99%) compared to normal weight. According to the I2 test, the heterogeneities of the meta-analyses were high. The Newcastle-Ottawa scale showed that all studies were classified as high quality. Further longitudinal studies are needed, including different populations and stratifications by sex, age, and other variables.

Consumption of minimally processed and ultra-processed foods by individuals on hemodialysis in southeastern Brazil

Introduction: the individuals with chronic kidney disease show low adherence to a diet rich in vegetables. Objective: to evaluate the association of minimally processed and ultra-processed food consumption with socioeconomic factors, lifestyle habits, and clinical characteristics of hemodialysis service users in southeastern Brazilian.Methods: cross-sectional study with 1,024 individuals on hemodialysis from southeastern Brazil. The individuals answered a questionnaire of sociodemographic data, lifestyle habits, and food consumption. After stipulating the frequency of consumption, we classified the foods as minimally processed and ultra-processed. We investigated the association between independent variables and the consumption of minimally processed and ultra-processed foods through the binary logistic regression model with Odds Ratio (OR) and their confidence intervals (95%CI).Results: users with less than eight years of education (OR=1.706; 95%CI1.125­2.589) and with income less than two minimum wages (OR=1.349; 95%CI1.007­1.806) had lower consumption of minimally processed foods. However, individuals aged 19 to 29 years (OR=2,857, 95%CI1.464­5.576), smokers (OR=2.349; 95%CI1.237­4.462), drinkers (OR=1.835; 95%CI1.122­3.001), and with more than 6 years on hemodialysis (OR=1.975; 95%CI1.227­3.180) were more likely to have higher consumption of ultra-processed foods. Individuals that did not practice physical activity were less likely to this consumption (OR=0.638; 95%CI0.459­0.888). Conclusion: being younger, smoking, consuming alcohol, and having been on hemodialysis for more than 6 years increased the chances of greater consumption of ultra-processed foods. In addition, we associated less education and lower income with a lower consumption of minimally processed foods.

Introdução: os indivíduos com doença renal crônica apresentam baixa adesão à dieta rica em vegetais.Objetivo: avaliar a associação do consumo de alimentos minimamente processados e ultraprocessados com fatores socioeconômicos, hábitos de vida e características clínicas de usuários de serviços de hemodiálise no sudeste brasileiro.Método: estudo transversal com 1.024 indivíduos em hemodiálise da região sudeste do Brasil. Os indivíduos responderam a um questionário de dados sociodemográficos, hábitos de vida e consumo alimentar. Após estipular a frequência de consumo, classificamos os alimentos em minimamente processados e ultraprocessados. Investigamos a associação entre as variáveis independentes e o consumo de alimentos minimamente processados e ultraprocessados por meio do modelo de regressão logística binária com Odds Ratio (OR) e seus intervalos de confiança (IC 95%). Resultados: usuários com escolaridade inferior a oito anos (OR=1,706; IC95%1,125­2,589) e com renda inferior a dois salários mínimos (OR=1,349; IC95%1,007­1,806) apresentaram menor consumo de alimentos minimamente processados. No entanto, indivíduos de 19 a 29 anos (OR=2.857, IC95%1,464­5,576), tabagistas (OR=2,349; IC95%1,237­4,462), etilistas (OR=1,835; IC95%1,122­3,001), e com mais de 6 anos em hemodiálise (OR=1,975; IC 95%1,227­3,180) apresentaram maior probabilidade de ter maior consumo de alimentos ultraprocessados. Indivíduos que não praticavam atividade física foram menos propensos a esse consumo (OR=0,638; IC95%0,459­0,888). Conclusão: ser mais jovem, fumar, consumir álcool e estar em hemodiálise há mais de 6 anos aumentaram as chances de maior consumo de alimentos ultraprocessados. Além disso, associamos menor escolaridade e menor renda ao menor consumo de alimentos minimamente processados.

Quality of life and associated factors in patients with hematological cancer according to EORTCQLQ-C30 / Qualidade de vida e fatores associados em pacientes com câncer hematológico segundo o EORTC QLQ-C30

Introduction: hematological cancers account for 9% of all cancers and their progression and treatment directly affect quality of life (QoL).Objective: this study assessed QoL and associated factors in patients with hematological cancer according to the EORTC QLQ-C30.Methods: cross-sectional study carried out from August 2017 to June 2019. We included adults and the elderly of both sexes, with hematological cancer, undergoing oral or venous chemotherapy. Nutritional status was assessed by the Patient-Generated Subjective Global Assessment (PG-SGA) and QoL by EORTC QLQ-C30.Results: fifty-one patients aged in average 60.0 ± 15 years were evaluated. Of these, 51.0% were women, 80.4% were non-white, 37.3% had B lymphoid cell neoplasia, 60.8% had been diagnosed for ≤ 3 years, 77.1% were on chemotherapy, and 64.7% were well- nourished. The scores for global health status and functional scales were high and for symptoms and single items they were low, indicating good QoL and functionality and low symptomatology. After multivariate linear regression, the time of diagnosis ≤ 3 years was associated with functional performance (p <0.05) and malnutrition was associated with cognitive function (p <0.05) and with symptoms of fatigue, nausea and vomiting, and insomnia (p <0.05).Conclusions: quality of life and functionality considered adequate were observed. Time of diagnosis and malnutrition were the variables that were associated with physical and cognitive function and with the presence of fatigue, nausea and vomiting and insomnia, according to the EORTC QLQ-C30.

Introdução: os cânceres hematológicos são responsáveis por 9% de todos os cânceres e sua progressão e tratamento afetam diretamente a qualidade de vida (QV).Objetivo: avaliar a QV e fatores associados em pacientes com câncer hematológico de acordo com o EORTC QLQ-C30.Método: estudo transversal realizado de agosto de 2017 a junho de 2019. Foram incluídos adultos e idosos de ambos os sexos, com câncer hematológico, em quimioterapia oral ou venosa. O estado nutricional foi avaliado pela Avaliação Subjetiva Global Gerada pelo Paciente (PG-SGA) e a QV pelo EORTC QLQ-C30.Resultados: foram avaliados 51 pacientes com idade média de 60,0 ± 15 anos. Destes, 51,0% eram mulheres, 80,4% eram não brancos, 37,3% apresentavam neoplasia de células linfoides B, 60,8% tinham diagnóstico ≤ 3 anos, 77,1% estavam em quimioterapia e 64,7% estavam bem nutridos. As pontuações para o estado de saúde global e escalas funcionais foram altas e para sintomas e itens únicos foram baixas, indicando boa QV e funcionalidade e baixa sintomatologia. Após regressão linear multivariada, o tempo de diagnóstico ≤ 3 anos foi associado ao desempenho funcional (p <0,05) e a desnutrição foi associada à função cognitiva (p <0,05) e aos sintomas de fadiga, náuseas e vômitos e insônia (p <0,05).Conclusões: foi observada qualidade de vida e funcionalidade consideradas adequadas. O tempo de diagnóstico e a desnutrição foram as variáveis que se associaram com o comprometimento da função física e cognitiva e com a presença de fadiga, náuseas e vômitos e insônia, segundo o EORTC QLQ-C30.

Prevalência de uso de medicamentos em população rural brasileira / Prevalence of medication use in a rural Brazilian population

Resumo Introdução Apesar da vulnerabilidade social existente na população rural brasileira, o uso de medicamentos entre agricultores é um tema ainda pouco estudado no país. Objetivo Analisar o uso de medicamentos e sua associação com características sociodemográficas, laborais, comportamentais e autoavaliação do estado de saúde em agricultores. Método Estudo epidemiológico transversal com 790 agricultores de 18 a 59 anos, de ambos os sexos, do município de Santa Maria de Jetibá. Os medicamentos foram agrupados segundo o Sistema de Classificação Anatômico-Terapêutico-Químico (ATC) nos níveis 1 e 2. Foram realizadas análise descritiva (frequências absolutas e relativas) e associações entre as variáveis e o uso de medicamentos pelo teste de qui-quadrado. As variáveis que se mostraram associadas com o desfecho com nível de significância de 5% no teste de qui-quadrado foram testadas por regressão logística binária. Resultados A prevalência de uso de medicamentos foi de 44,2%, sendo menor no sexo masculino (30,3%) do que no feminino (59,4%). Após a análise ajustada, o uso de medicamentos esteve associado ao sexo feminino, à faixa etária de 40 anos ou mais e à pior autoavaliação do estado de saúde. A prevalência de polifarmácia foi de 6,6%. Os medicamentos mais utilizados foram os anti-hipertensivos (19,3%). Conclusão O estudo evidenciou a importância de se avaliar populações rurais a fim de subsidiar políticas e recursos em saúde pública.

Abstract Background Despite the social vulnerability that exists in the Brazilian rural population, the drug use is a topic still little studied in the country. Objective The present work aims to analyze drug use and its association with sociodemographic, occupational, behavioral, and self-rated health characteristics in farmers. Method A cross-sectional epidemiological study of 790 male and female farmers from 18 to 59 years old, from Santa Maria de Jetibá. The drugs were grouped according to the Anatomical Therapeutic Classification System (ATC) at levels 1 and 2. Descriptive analysis of the data was performed (in absolute and relative frequencies) and associations between study variables and drug use by the chi-square test. The variables that were associated with the outcome with a significance level of 5% in the chi-square test were tested by binary logistic regression. Results The prevalence of drug utilization was 44.2%, being lower in males (30,3%) than in females (59,4%). After adjusted analysis, the drug use was associated with female gender, age 40 years and older and worse self-rated health status. The prevalence of polypharmacy was 6,6%. The most used drugs were antihypertensive (19,3%). Conclusion The study showed the importance of evaluating rural populations to subsidize policies and resources in Public Health.

Prevalence and determinants of obesity and abdominal obesity among rural workers in Southeastern Brazil.

The objectives of this study were to assess the nutritional status of rural workers from a municipality in Southeastern Brazil and estimate the association of sociodemographic, labor, lifestyle, and dietary pattern factors with obesity and abdominal obesity of men and women of this rural area. This is a cross-sectional, epidemiological study of 740 farmers (51.5%, n = 381 males; 48.5%, n = 359 females). The sociodemographic, labor, lifestyle and dietary patterns determinants were assessed. Food intake data were obtained by applying three 24-hour recalls and dietary patterns were determined by Principal Component Analysis with Varimax orthogonal rotation. Poisson regression with robust variance stratified by sex was applied. The general prevalence of overweight status was 31.5% (95% CI 28.2-34.8%), 19.7% of obesity (95% CI 16.8-22.6%) and 31.5% of abdominal obesity (95% CI 28.2-34.8%), with higher rates in women (P < 0.001). Men of higher socioeconomic class had a 2.3 times higher prevalence of obesity (95% CI 1.08-4.90). In addition, the shorter travel time to purchase food increased the prevalence of abdominal obesity in males. For women, the older the age group, the greater the general and central obesity. A lower adherence to traditional dietary patterns (approximately PR [prevalence ratio] 1.6 for general obesity and PR 1.3 for abdominal obesity) and a greater number of places to buy food were associated with higher rates of obesity in women. Finally, women farmers with a higher workload had a 20% lower prevalence of central obesity (PR 0.80; 95% CI 0.65-0.97). Such findings demonstrate that obesity must be an issue in the health care of remote and rural populations. There is a need to promote healthier environments that respect traditional food culture through multiple approaches that consider the heterogeneity of rural areas and the differences between sexes.

Exogenous pesticide poisoning in the state of Espírito Santo, Brazil, 2007-2016: spatial distribution and temporal trend in the incidence rate and case fatality ratio of notified cases. / Intoxicações exógenas por agrotóxicos no Espírito Santo, 2007-2016: distribuição espacial e tendências da taxa de incidência e letalidade dos casos notificados.

OBJECTIVE: To describe the spatial distribution of pesticide poisoning cases and analyze the temporal trend in the incidence rate and case fatality ratio of this event in the state of Espírito Santo, Brazil. METHODS: This was a time series study of confirmed cases of pesticide poisoning registered on the Notifiable Health Conditions Information System (SINAN) between 2007 and 2016. Incidence rates were presented in thematic maps. Scatter plots were used to show the incidence and case fatality ratio of cases. RESULTS: There was an increasing incidence rate of poisoning in the period regarding the total number of cases, by sex and age group - except for those aged 70 years and over. There was a decreasing case fatality ratio until 2012, with a subsequent increase. Eight municipalities presented the highest notification rates (30 to 46 new cases/100,000 inhabitants). CONCLUSION: There was an increase in the incidence of notifications in the period. There was a decrease in case fatality ratio until 2012, subsequently followed by an increase.

Depression in Brazilian farmers: prevalence and associated factors.

BACKGROUND: The unique characteristics of rural areas and agricultural work can contribute to the genesis of diseases, including mental disorders such as depression. AIMS: To estimate the prevalence of and factors associated with depression symptoms in Brazilian farmers. METHODS: A cross-sectional epidemiological study involving 784 farmers of the state of Espírito Santo/Brazil was carried out. Depression was identified using the Mini-International Neuropsychiatric Interview. Hierarchical logistic regression was used to assess the associated factors. RESULTS: The prevalence of depression symptoms among farmers was 16.8% (n = 132). Of those experiencing symptoms, 6.1% (n = 48) we're currently experiencing a depressive episode, and 10.7% (n = 84) a recurrent depressive episodes. The associated factors were: female gender (OR 1.63; 95% CI 1.04-2.54), not owning the land (OR 1.79; 95% CI 1.11-2.89), professional dissatisfaction (OR 1.99; 95% CI 1.18-3.35), previous pesticide poisoning (OR 2.87; 95% CI 1.45-5.67), complex multimorbidity (OR 1.95; 95% CI 1.15-3.31) and occurrence of previous depressive episodes (OR 9.83; 95% CI 4.39-21.99). CONCLUSIONS: A high prevalence of depression symptoms was identified among rural workers. Sociodemographic, occupational, clinical, and professional dissatisfaction factors were associated with a higher risk of depression symptoms in this population.

Exogenous pesticide poisoning in the state of Espírito Santo, Brazil, 2007-2016: spatial distribution and temporal trend of incidence and lethality of notified cases / Intoxicación por plaguicidas exógenos en el estado de Espírito Santo, Brasil, 2007-2016: distribución espacial y tendencia temporal de la incidencia y letalidad de los casos notificados / Intoxicações exógenas por agrotóxicos no Espírito Santo, 2007-2016: distribuição espacial e tendências da incidência e letalidade dos casos notificados

Objective: To describe the spatial distribution of cases of pesticide poisoning and analyze a temporal trend of incidence and lethality from this event in the state of Espírito Santo, Brazil. Methods: Time series study of confirmed cases of pesticide poisoning reported to the Notifiable Diseases Information System (Sinan) from 2007 to 2016. Incidence rates were based on thematic maps. Scatter plots were used to report the incidence and case fatality. Results: Incident increase in poisoning in the period for the total number of cases and by sex and age group, except for those over 70 years old. The lethality was decreasing until 2012 with a later increase. Eight associations had the highest notification rates (30 to 46 new cases/100,000 population). Conclusion: There was an increase in the incidence of notifications in the period. The lethality was decreasing until 2012 followed by further increase.

Objetivo: Describir la distribución espacial de casos de intoxicación por plaguicidas y analizar su tendencia temporal de incidencia y letalidad en estado de Espírito Santo, Brasil. Métodos: Estudio de series de tiempo de casos confirmados de intoxicación por plaguicidas notificados al Sistema de Información de Enfermedades Notificables de 2007 a 2016. Las tasas de incidencia se basaron en mapas temáticos. Se utilizaron gráficos de dispersión para presentar la incidencia y la letalidad. Resultados: Incremento de la incidencia de intoxicaciones en período para total de casos, sexo y grupo de edad. La letalidad fue disminuyendo hasta 2012 con un aumento posterior. Ocho asociaciones tuvieron las tasas de notificación más altas (30 a 46 nuevos casos/100.000 habitantes). Conclusión: Hubo un aumento en la incidencia de notificaciones en el período. La letalidad fue disminuyendo hasta 2012, seguida de un aumento adicional.

Objetivo: Descrever a distribuição espacial de casos de intoxicação por agrotóxicos e analisar a tendência temporal da incidência e letalidade por esse evento no estado do Espírito Santo, Brasil. Métodos: Estudo de série temporal dos casos confirmados de intoxicação por agrotóxicos reportados ao Sistema de Informação de Agravos de Notificação (Sinan) entre 2007 e 2016. As taxas de incidência foram apresentadas em mapas temáticos. Foram utilizados gráficos de dispersão, para apresentar a incidência e letalidade dos casos. Resultados: Houve incidência crescente de intoxicações no período, para o total dos casos, por sexo e faixa etária ­ exceto para maiores de 70 anos. A letalidade foi decrescente até 2012, com posterior aumento. Oito municípios apresentaram as maiores taxas de notificação (30 a 46 casos novos/100 mil habitantes). Conclusão: Houve aumento na incidência de notificações, no período. A letalidade mostrou-se decrescente até 2012, seguindo-se posterior crescimento. 

Intoxicações exógenas por agrotóxicos no Espírito Santo, 2007-2016: distribuição espacial e tendências da taxa de incidência e letalidade dos casos notificados / Intoxicación por plaguicidas exógenos en el estado de Espírito Santo, Brasil, 2007-2016: distribución espacial y tendencia temporal de la tasa de incidencia y letalidad de los casos notificados / Exogenous pesticide poisoning in the state of Espírito Santo, Brazil, 2007-2016: spatial distribution and temporal trend in the incidence rate and case fatality ratio of notified cases

Objetivo: Descrever a distribuição espacial de casos de intoxicação por agrotóxicos e analisar a tendência temporal da taxa de incidência e letalidade por esse evento no estado do Espírito Santo, Brasil. Métodos: Estudo de série temporal dos casos confirmados de intoxicação por agrotóxicos reportados ao Sistema de Informação de Agravos de Notificação (Sinan) entre 2007 e 2016. As taxas de incidência foram apresentadas em mapas temáticos. Foram utilizados gráficos de dispersão, para apresentar a incidência e letalidade dos casos. Resultados: Houve taxa de incidência crescente de intoxicações no período, para o total dos casos, por sexo e faixa etária - exceto para maiores de 70 anos. A letalidade foi decrescente até 2012, com posterior aumento. Oito municípios apresentaram as maiores taxas de notificação (30 a 46 casos novos/100 mil habitantes). Conclusão: Houve aumento na incidência de notificações, no período. A letalidade mostrou-se decrescente até 2012, seguindo-se posterior crescimento.

Objetivo: Describir la distribución espacial de casos de intoxicación por plaguicidas y analizar su tendencia temporal de la tasa incidencia y letalidad en estado de Espírito Santo, Brasil. Métodos: Estudio de serie temporal de casos confirmados de intoxicación por plaguicidas notificados al Sistema de Información de Enfermedades de Notificación (Sinan) de 2007 a 2016. Las tasas de incidencia se basaron en mapas temáticos. Se utilizaron gráficos de dispersión para presentar la incidencia y la letalidad. Resultados: Incremento de la tase de incidencia de intoxicaciones en el período para el total de los casos, sexo y grupos de edad - excepto para mayores de 70 años. La letalidad fue disminuyendo hasta 2012, con un aumento posterior. Ocho asociaciones tuvieron las tasas de notificación más altas (30 a 46 nuevos casos/100.000 habitantes). Conclusión: Hubo un aumento en la incidencia de notificaciones en el período. La letalidad fue disminuyendo hasta 2012, seguida de un aumento posterior.

Objective: To describe the spatial distribution of pesticide poisoning cases and analyze the temporal trend in the incidence rate and case fatality ratio of this event in the state of Espírito Santo, Brazil. Methods: This was a time series study of confirmed cases of pesticide poisoning registered on the Notifiable Health Conditions Information System (SINAN) between 2007 and 2016. Incidence rates were presented in thematic maps. Scatter plots were used to show the incidence and case fatality ratio of cases. Results: There was an increasing incidence rate of poisoning in the period regarding the total number of cases, by sex and age group - except for those aged 70 years and over. There was a decreasing case fatality ratio until 2012, with a subsequent increase. Eight municipalities presented the highest notification rates (30 to 46 new cases/100,000 inhabitants). Conclusion: There was an increase in the incidence of notifications in the period. There was a decrease in case fatality ratio until 2012, subsequently followed by an increase.

Corrigendum: Association of Selenium Intake and Development of Depression in Brazilian Farmers.

[This corrects the article DOI: 10.3389/fnut.2021.671377.].

Association of Selenium Intake and Development of Depression in Brazilian Farmers.

Introduction: Depression and deficiency in the consumption of micronutrients are a public health problem, especially in the rural population. The deficiency in selenium consumption affects mental health, contributing to the development of major depressive disorders. Thus, this study aimed to evaluate selenium intake and its association with depressive symptoms in farmers in southeastern Brazil. Material and Methods: Epidemiological, cross-sectional, and analytical study with 736 farmers aged between 18 and 59. A semistructured questionnaire was used to collect sociodemographic, lifestyle and clinical condition data. For evaluation of food intake, three 24-h recalls were applied, and for identification of depressive episodes, the Mini-International Neuropsychiatric Interview was conducted. Results: A total of 16.1% (n = 119) of the farmers presented symptoms of major depressive episodes, 5.8% (n = 43) presented symptoms of current depressive episodes, and 10.3% (n = 76) presented symptoms of recurrent major depressive episodes. Sociodemographic factors associated with depression were gender (p < 0.001), marital status (p = 0.004), and socioeconomic class (p = 0.015). The consumption of high doses of selenium was associated with a reduction of ~54% in the chances of occurrence of depression (OR = 0.461; 95% CI = 0.236-0.901). Conclusion: High selenium intake is associated with a lower prevalence of depression even after adjusting for sociodemographic variables, lifestyle, and pesticide intoxication. The findings of this study contributed to highlighting the high prevalence of depression in rural areas and its relationship with selenium intake.

Presence of dynapenia and association with anthropometric variables in cancer patients.

BACKGROUND: Dynapenia is defined as an age-related loss of muscle strength. There is little information on dynapenia in cancer patients and on how it relates to anthropometric variables. The aim of this study was to analyze the presence of dynapenia and its association with anthropometric variables in hospitalized cancer patients. METHODS: Participants comprised adult and elderly cancer patients evaluated within the first 48 h of hospital admission to a tertiary public hospital, a referral center for gastrointestinal tract surgery. Anthropometric variables were measured according to standardized protocols. Dynapenia was identified based on handgrip strength (HGS), according to the cutoff points defined by the European Working Group on Sarcopenia in Older People (EWGSOP2), with values for women < 16 kg and for men < 27 kg. Statistical analysis was performed using SPSS software, version 22.0, with a significance level of 5%. RESULTS: This study included 158 patients aged in average 59.5 ± 14.0 years; of these, 53.6% were elderly, 58.9% non-white and 59.5% had some degree of malnutrition. The most prevalent type of cancer was that of the lower gastrointestinal tract (33.5%). The presence of dynapenia was observed in 23.4% of the patients and cachexia in 36.1%. There was an association between dynapenia with age (p < 0.001), life stage (p = 0.002) and race/color (p = 0.027), and also with body mass index (BMI) (p = 0.001) and adductor pollicis muscle thickness (APMT) of both hands (p < 0.05). After logistic regression analysis, adjusted for the sociodemographic variables, the APMT of the dominant hand and the low weight determined by body mass index remained associated with the occurrence of dynapenia (p < 0.05). CONCLUSIONS: In this study we confirmed that dynapenia was present in cancer patients, being associated with APMT of the dominant hand and low weight. HSG was proven to be a reliable and complementary measure to be added to the process of assessing nutritional status, contributing to the nutritional diagnosis of these patients and to the detection of early muscle depletion.

Energy contribution of NOVA food groups and the nutritional profile of the Brazilian rural workers' diets.

We estimated the caloric contribution of minimally processed foods, processed culinary ingredients, processed foods and ultra-processed foods in Brazilian farmers' diets and their association with the nutritional profile of the diet. It is an epidemiological study of cross-sectional, analytical and quantitative design with 740 farmers adults of Southeastern Brazil. Food intake data were obtained by applying three 24-hour recalls and were classified according to the degree and purpose of processing. The largest caloric contribution came from the group of minimally processed foods (64.7%), followed by ultra-processed foods (17.7%), processed culinary ingredients (12.4%), and processed foods (5.2%). Individuals in the fourth quartile of caloric contribution from minimally processed foods showed lower energy consumption (ß -0.16, P<0.001) and greater consumption of all 15 micronutrients analyzed. In contrast to what was identified for this food group, the higher caloric contribution from ultra-processed foods was associated with a greater caloric content of the diet (ß 0.17, P<0.001) and lower consumption of all 23 analyzed nutrients. Therefore, the caloric contribution from the consumption of ultra-processed foods in the rural area is still lower than the national average. However, measures aimed at delaying isocaloric exchanges for the group of ultra-processed foods must be carried out, maintaining the local food culture, since this group had worse nutritional levels. In addition, incentives to the greater consumption of minimally processed foods should be carried out, due to their nutritional quality.

Fatores de risco cardiovascular em uma população rural brasileira / Cardiovascular risk factors in a Brazilian rural population

Resumo Diante da extensão dos custos decorrentes das doenças cardiovasculares e do aumento na prevalência dessas doenças em agricultores este estudo tem como objetivo estimar a prevalência de fatores de risco cardiovascular nesta população e avaliar seus fatores associados. Foi realizado estudo transversal envolvendo 790 agricultores do município de Santa Maria de Jetibá-ES. Seis em cada dez agricultores avaliados apresentaram pelo menos um fator de risco cardiovascular (FRC). A hipertensão arterial foi o fator de risco mais prevalente, presente em 35,8% (IC95% 32-39, n=283) dos agricultores seguido pela dislipidemia (34,4%, IC95% 31-38, n = 272). Ter mais que 50 anos aumentou em 5,6 vezes (IC95% 2,03-15,43) a chance de apresentar dois ou mais FRC, possuir perímetro da cintura elevado ou dobra cutânea triciptal indicando excesso de peso aumentou esta chance em 2,35 vezes (IC95% 1,47-3,76) e em 1,6 vezes (IC95% 1,05-2,44), respectivamente. Estes achados revelam a elevada prevalência de FRC em trabalhadores rurais e o significativo impacto da idade e do acúmulo de gordura corporal no desenvolvimento destes fatores, demonstrando a necessidade de intensificar políticas públicas de saúde voltadas para esta população.

Abstract Given the extensive costs due to cardiovascular diseases and the increased prevalence of these diseases in farmers, this study aims to estimate the prevalence of cardiovascular risk factors in this population and to evaluate their associated factors. A cross-sectional study was carried out involving 790 farmers from the municipality of Santa Maria de Jetibá-ES, Brazil. Six out of ten evaluated farmers had at least one cardiovascular risk factor (CRF). High blood pressure was the most prevalent risk factor in 35.8% (95%CI 32-39, n = 283) followed by dyslipidemia (34.4%, 95%CI 31-38, n = 272). Those aged more than 50 years were 5.6 times (95%CI 2.03-15.43) more likely to evidence two or more CRFs. High waist circumference or tricipital skinfold indicating overweight increased 2.35 times (95%CI 1.47-3.76) and 1.6 times (95%CI 1.05-2.44) this likelihood, respectively. These findings reveal the high prevalence of CRF in rural workers and the significant impact of age and the accumulation of body fat in the development of these factors, showing the need to intensify public health policies geared to this population.

SARC-CalF-assessed risk of sarcopenia and associated factors in cancer patients.

INTRODUCTION: Introduction: sarcopenia is considered a risk factor for cancer patients, as it increases mortality and post-surgical complications, and reduces response to treatment and quality of life. Objective: to identify the risk of sarcopenia by SARC-CalF, as well as the factors associated with this outcome in patients with cancer of the gastrointestinal tract (GIT) and adnexal glands. Methods: this cross-sectional study included patients with cancer of the GIT and adnexal glands, without edema or ascites, of both sexes and aged ≥ 20 years. Conventional anthropometric variables and handgrip strength (HGS) were measured. The risk of sarcopenia was assessed through the SARC-CalF questionnaire, and nutritional status by the Patient-Generated Subjective Global Assessment (PG-SGA). The data analysis was performed using the SPSS® software, 22.0, with a significance of 5 %. Results: seventy patients took part in the study. Of these, 55.7 % were female, 52.9 % were aged over 60 years, and 64.3 % were non-white. PG-SGA identified 50.0 % of patients as well-nourished and 50.0 % as having some degree of malnutrition. The prevalence of risk of sarcopenia was 28.6 %. There were different correlations between the SARC-CalF score and anthropometric variables (p < 0.05) according to life stage (adults and elderly). After a linear regression analysis the measures that most influenced the SARC-CalF score were arm circumference (AC) and adductor pollicis muscle thickness in the dominant hand (DAPMT) for adults, while for the elderly current weight and DAPTM (p < 0.05) were more relevant. Conclusion: SARC-CalF identified 28.6 % of patients at risk for sarcopenia and was associated with body weight and anthropometric variables indicative of muscle reserve in adults and the elderly.

INTRODUCCIÓN: Introducción: se considera la sarcopenia un factor de riesgo, especialmente para los pacientes con cáncer, ya que aumenta la mortalidad y las complicaciones posquirúrgicas, reduciendo la respuesta al tratamiento y la calidad de vida. Objetivo: identificar el riesgo de sarcopenia por el SARC-CalF y los factores asociados en pacientes con cáncer del tracto gastrointestinal (TGI) y las glándulas anexas. Métodos: estudio transversal descriptivo. Se incluyeron pacientes con cáncer del TGI y glándulas anexas, sin edema o ascitis, de ambos sexos y de edad ≥ 20 años. Se midieron las variables antropométricas convencionales y la fuerza de presión manual (FPM). El riesgo de sarcopenia se obtuvo mediante el cuestionario SARC-CalF y el estado nutricional mediante la valoración global subjetiva generada por el propio paciente (VGS-GP). El análisis de los datos se realizó con el software SPSS®, versión 22.0, con una significancia del 5 %. Resultados: Participaron 70 pacientes. De estos, el 55,7 % eran mujeres, el 52,9 % eran mayores de 60 años y el 64,3 % eran de etnia no caucásica (64,3 %). La VGS-GP identificó un 50,0 % de pacientes bien alimentados y un 50,0 % con algún grado de desnutrición. El riesgo de sarcopenia fue del 28,6 %. Hubo diferentes correlaciones entre el puntaje SARC-CalF y las variables antropométricas (p < 0,05) según la etapa de la vida (adultos y ancianos). Después del análisis de regresión lineal, las medidas que más influyeron en el puntaje SARC-CalF fueron la circunferencia muscular del brazo (CMB) y el espesor del músculo aductor del pulgar de la mano dominante (EMAPD) en los adultos, mientras que en los ancianos fueron el peso actual y elEMAPD (p < 0,05). Conclusión: el SARC-CalF identificó al 28,6 % de los pacientes con riesgo de sarcopenia y se asoció con el peso corporal y las variables antropométricas indicativas de reserva muscular en adultos y ancianos.

Cardiovascular risk factors in a Brazilian rural population. / Fatores de risco cardiovascular em uma população rural brasileira.

Given the extensive costs due to cardiovascular diseases and the increased prevalence of these diseases in farmers, this study aims to estimate the prevalence of cardiovascular risk factors in this population and to evaluate their associated factors. A cross-sectional study was carried out involving 790 farmers from the municipality of Santa Maria de Jetibá-ES, Brazil. Six out of ten evaluated farmers had at least one cardiovascular risk factor (CRF). High blood pressure was the most prevalent risk factor in 35.8% (95%CI 32-39, n = 283) followed by dyslipidemia (34.4%, 95%CI 31-38, n = 272). Those aged more than 50 years were 5.6 times (95%CI 2.03-15.43) more likely to evidence two or more CRFs. High waist circumference or tricipital skinfold indicating overweight increased 2.35 times (95%CI 1.47-3.76) and 1.6 times (95%CI 1.05-2.44) this likelihood, respectively. These findings reveal the high prevalence of CRF in rural workers and the significant impact of age and the accumulation of body fat in the development of these factors, showing the need to intensify public health policies geared to this population.

Diante da extensão dos custos decorrentes das doenças cardiovasculares e do aumento na prevalência dessas doenças em agricultores este estudo tem como objetivo estimar a prevalência de fatores de risco cardiovascular nesta população e avaliar seus fatores associados. Foi realizado estudo transversal envolvendo 790 agricultores do município de Santa Maria de Jetibá-ES. Seis em cada dez agricultores avaliados apresentaram pelo menos um fator de risco cardiovascular (FRC). A hipertensão arterial foi o fator de risco mais prevalente, presente em 35,8% (IC95% 32-39, n=283) dos agricultores seguido pela dislipidemia (34,4%, IC95% 31-38, n = 272). Ter mais que 50 anos aumentou em 5,6 vezes (IC95% 2,03-15,43) a chance de apresentar dois ou mais FRC, possuir perímetro da cintura elevado ou dobra cutânea triciptal indicando excesso de peso aumentou esta chance em 2,35 vezes (IC95% 1,47-3,76) e em 1,6 vezes (IC95% 1,05-2,44), respectivamente. Estes achados revelam a elevada prevalência de FRC em trabalhadores rurais e o significativo impacto da idade e do acúmulo de gordura corporal no desenvolvimento destes fatores, demonstrando a necessidade de intensificar políticas públicas de saúde voltadas para esta população.

Prevalence and factors associated with arterial hypertension in a Brazilian rural working population.

OBJECTIVES: To determine the prevalence of hypertension and associated factors in farmers in a rural region of Brazil. METHODS: A cross-sectional study was conducted involving a sample of 790 farmers who were residents of Espírito Santo, Brazil. RESULTS: The prevalence of hypertension was 35.8% (95%CI: 32.5-39.1%, n=283); however, it was higher in men (36.6%, n=151, p<0.001) and in those with excess weight (48.9%, n=197, p<0.001). Of the 283 hypertensive patients, 125 (44.2%) did not use antihypertensive drugs. In men, lower level of schooling (p=0.004), working in the field for fewer daily hours (p<0.001), and having greater abdominal adiposity (p=0.039) were associated with the presence of increased blood pressure. In women, age (p=0.002), lower schooling (p=0.021), and increased central adiposity (p=0.003) were independent predictors of blood pressure. CONCLUSION: The highest prevalence of hypertension was observed in men, with elevated blood pressure being strongly associated with social and economic factors. In women, the association with the classic factors (age, increase in abdominal adiposity, and low schooling) was stronger. In addition, most hypertensive patients are not adequately diagnosed or treated.

Dietary patterns of Brazilian farmers and their relation with sociodemographic, labor, and lifestyle conditions.

BACKGROUND: The eating habits have changed in the last few decades, but few studies prioritize the food consumption of farmers and the rural population. Therefore, the objective of this study was explore the sociodemographic, occupational and lifestyle factors to the high adherence these dietary patterns. METHODS: This is a cross-sectional epidemiological study of 740 farmers (51.5%, n = 381 males; 48.5%, n = 359 females) from a municipality in Southeastern Brazil. Food intake data were obtained by applying multipass 24-h recall and dietary intake was presented in dietary patterns determined by Principal Component Analysis with varimax orthogonal rotation. RESULTS: Three dietary patterns were identified. The first pattern, "local traditional", was associated with sociodemographic and labor variables, being considered typical of the region's farmer as white race/color (p = 0.003), not extra-physical activity (p = 0.014) and cultivating 5 or more crops (p = 0.005). The permanence of a "traditional Brazilian" pattern and the occurrence of an "industrialized" pattern were also observed. Farmers working in non-conventional agriculture were 54% less adhere to "traditional Brazilian" pattern (OR 0.46, 95% CI 0.25-0.86, p = 0.014). Individuals aged 50 and over years were 82% less likely (OR 0.18, 95% CI 0.10-0.30) to adhere to "industrialized" pattern. Still, individuals of lower socioeconomic class were 52% less likely to adhere to this pattern (OR 0.48, 95% CI 0.24-0.96). Farmers who spent R$ 200 or more per capita to buy food were more than twice as likely to adhere to this food pattern (OR 2.22, 95% CI 1.32-3.73), and who had the habit of frequently eating out were 1.62 as likely adhere to "industrialized" pattern (95% CI 1.11-2.36). CONCLUSIONS: The findings indicate changes in dietary patterns in rural areas of the country, maintaining a traditional Brazilian pattern, as well as a local and an industrialized pattern. This last pattern demonstrates that the contemporary rural population also opts for a diet with ultra-processed products, being associated with the characteristic habits of a more urbanized rural region.