ABSTRACT
This systematic review aimed to identify the influence of occupational stress on the body mass index of hospital workers. After registering the protocol at PROSPERO (CRD42022331846), we started this systematic review following a search in seven databases, gray literature, as well as manual search and contact with specialists. The selection of studies was performed independently by two evaluators following the inclusion criteria: observational studies evaluating adult hospital workers, in which occupational stress was considered exposure and body composition as a result. The risk of bias in the included studies was assessed using the Joanna Briggs Institute Critical Appraisal checklist. We used the Grading of Recommendations Assessment, Development and Evaluation to grade the certainty of the evidence. Qualitative results were presented and synthesized through a qualitative approach, with simplified information in a narrative form. A total of 12 studies met the eligibility criteria and were included. This review comprised 10,885 workers (2312 men; 1582 women; and 6991 workers whose gender was not identified). Ten studies were carried out only with health workers, and two included workers from other sectors besides health workers. This review showed a relationship between occupational stress and changes in body mass index in hospital workers. However, most studies presented a moderate or high risk of bias and low quality of the evidence. These findings can be useful for clinical practice, administrators and leaders and provide insights for future research in the field of worker health in the hospital setting.
ABSTRACT
INTRODUCTION: Micronutrient deficiencies are common in low-income and middle-income countries and are usually related to inadequate food intake, poor diet quality and low bioavailability. Copper, selenium and zinc are essential minerals in several enzymatic reactions and their deficiencies are associated with worse prognosis in pregnancy, compromising maternal health as well as her offspring. Thus, the objective of the present systematic review will be to describe the prevalence of copper, selenium and zinc deficiencies in women of childbearing age. METHODS AND ANALYSIS: The search will be performed by independent reviewers. The bases used will be PubMed/MEDLINE, Science direct, Lilacs, Adolec, Scopus, EMBASE, CINAHL, Web of Science, CENTRAL, IMSEAR, PAHOS, WPRIM, IMEMR, AIM for grey literature OpenGrey and OVID. National data will be searched in BDTD. A first search will be performed and a second search will be performed just before submission. Risk of bias assessment will be performed using the Joanna Briggs group prevalence study checklist. Combinable studies will be performed meta-analysis. Heterogeneity will be tested using Cochran's Q test and quantified by the inconsistency test (I²). In the presence of high heterogeneity, meta-analysis will be performed using the random effects model with Stata metaprop. Summary prevalence will be generated for each outcome, presented in Forest plot figures. ETHICS AND DISSEMINATION: This systematic review will be solely based on published and retrievable literature, no ethics approval will be obtained. Our dissemination strategy will involve the presentation in scientific meetings, as well as the publication of article(s), posters and presentations in congresses. PROSPERO REGISTRATION NUMBER: CRD42020165352.
Subject(s)
Copper , Selenium , Humans , Pregnancy , Female , Prevalence , Systematic Reviews as Topic , Meta-Analysis as Topic , ZincABSTRACT
Resumo O objetivo do estudo foi analisar a variação temporal da ocorrência do excesso de peso e da obesidade abdominal em adolescentes de escolas públicas de uma capital do nordeste brasileiro. Trata-se de um estudo incluindo informações de três levantamentos transversais realizados nos anos de 2001, 2009 e 2017, com 2.496 escolares de 10 a 18 anos de ambos os sexos, residentes na cidade de Salvador, Bahia. O excesso de peso foi avaliado por meio do Índice de Massa Corpórea para idade (IMC/I) e obesidade abdominal foi avaliada pela circunferência da cintura e razão cintura-estatura. A regressão Pooled OLS (Ordinary Least Squares), de efeito constante foi utilizada para avaliar a variação dos indicadores antropométricos ao longo do período. Os resultados deste estudo indicam que a prevalência de excesso de peso cresceu 103% e os indicadores da obesidade abdominal cresceram 153% e 142%, respectivamente no período analisado. Aumento na média do Índice de Massa Corpórea e da Razão cintura estatura foi maior entre as adolescentes e da média do IMC e da circunferência da cintura entre aqueles de 14 a 18 anos de idade. Conclui-se que houve expressivo crescimento nas prevalências do excesso de peso e da obesidade abdominal no período de 2001 a 2017 entre os adolescentes da cidade de Salvador.
Abstract The scope of this study was to analyze the temporal variation in the incidence of overweight and abdominal obesity among adolescents from public schools in a capital in northeastern Brazil. It is a study including information from three cross-sectional surveys carried out in 2001, 2009 and 2017, with 2,496 students aged 10 to 18 years of both sexes living in the city of Salvador, Bahia. Overweight was assessed using the Body Mass Index for Age (BMI/A) and abdominal obesity was assessed using waist circumference and waist-to-height ratio. Pooled OLS (Ordinary Least Squares) regression, with constant effect, was used to assess the variation of anthropometric indicators over the period. The results of this study indicate that the prevalence of overweight increased by 103% and the indicators of abdominal obesity increased by 153% and 142%, respectively, in the period under analysis. The increase in the mean body mass index and waist-to-height ratio was greater among adolescents and in the mean BMI and waist circumference among those aged 14 to 18 years old. The conclusion reached was that there was a significant increase in the prevalence of overweight and abdominal obesity in the period 2001 to 2017 among adolescents in the city of Salvador.
ABSTRACT
The scope of this study was to analyze the temporal variation in the incidence of overweight and abdominal obesity among adolescents from public schools in a capital in northeastern Brazil. It is a study including information from three cross-sectional surveys carried out in 2001, 2009 and 2017, with 2,496 students aged 10 to 18 years of both sexes living in the city of Salvador, Bahia. Overweight was assessed using the Body Mass Index for Age (BMI/A) and abdominal obesity was assessed using waist circumference and waist-to-height ratio. Pooled OLS (Ordinary Least Squares) regression, with constant effect, was used to assess the variation of anthropometric indicators over the period. The results of this study indicate that the prevalence of overweight increased by 103% and the indicators of abdominal obesity increased by 153% and 142%, respectively, in the period under analysis. The increase in the mean body mass index and waist-to-height ratio was greater among adolescents and in the mean BMI and waist circumference among those aged 14 to 18 years old. The conclusion reached was that there was a significant increase in the prevalence of overweight and abdominal obesity in the period 2001 to 2017 among adolescents in the city of Salvador.
O objetivo do estudo foi analisar a variação temporal da ocorrência do excesso de peso e da obesidade abdominal em adolescentes de escolas públicas de uma capital do nordeste brasileiro. Trata-se de um estudo incluindo informações de três levantamentos transversais realizados nos anos de 2001, 2009 e 2017, com 2.496 escolares de 10 a 18 anos de ambos os sexos, residentes na cidade de Salvador, Bahia. O excesso de peso foi avaliado por meio do Índice de Massa Corpórea para idade (IMC/I) e obesidade abdominal foi avaliada pela circunferência da cintura e razão cintura-estatura. A regressão Pooled OLS (Ordinary Least Squares), de efeito constante foi utilizada para avaliar a variação dos indicadores antropométricos ao longo do período. Os resultados deste estudo indicam que a prevalência de excesso de peso cresceu 103% e os indicadores da obesidade abdominal cresceram 153% e 142%, respectivamente no período analisado. Aumento na média do Índice de Massa Corpórea e da Razão cintura estatura foi maior entre as adolescentes e da média do IMC e da circunferência da cintura entre aqueles de 14 a 18 anos de idade. Conclui-se que houve expressivo crescimento nas prevalências do excesso de peso e da obesidade abdominal no período de 2001 a 2017 entre os adolescentes da cidade de Salvador.
Subject(s)
Obesity, Abdominal , Overweight , Adolescent , Body Mass Index , Brazil/epidemiology , Cross-Sectional Studies , Female , Humans , Incidence , Male , Obesity/epidemiology , Obesity, Abdominal/epidemiology , Overweight/epidemiology , Prevalence , Waist Circumference , Waist-Height RatioABSTRACT
Excessive consumption of ultra-processed foods is associated with the development of metabolic changes in children and adolescents. However, the consumption of total sugars, monosaccharides and disaccharides present in these ultra-processed foods and other food groups and its association with anthropometric indicators must be evaluated. Therefore, this study aimed at analysing the influence of sugar consumption from foods with different degrees of processing on anthropometric indicators of children and adolescents after 18 months of follow-up. This cohort study was conducted among 492 children and adolescents aged 7-15 years. Information on food consumption and anthropometry was collected during three follow-up stages. NOVA classification was used for food categorisation. The influence of sugar consumption on the variation of anthropometric measurements over time was evaluated using generalised estimation equation models. During the analysis period, for each increase of 1 g/d in the consumption of total sugars and monosaccharides from ultra-processed foods, there was an increase of 0·002 kg/m2 (P = 0·030) and 0·001 kg/m2 (P = 0·019) in BMI/Age; increase of 0·073 (P < 0·001), 0·032 (P < 0·001) and 0·100 (P < 0·001) in the BMI/Age z-score; and increase of 0·001 cm (P = 0·001), 0·001 cm (P = 0·003) and 0·003 cm (P < 0·001) in waist circumference, with the consumption of total sugars, monosaccharides and disaccharides, respectively. Our study findings support the evidence that the consumption of total sugars, monosaccharides and disaccharides from ultra-processed foods is associated with weight gain and abdominal fat in children and adolescents, which may represent an important risk factor for excess weight in this age group.
Subject(s)
Diet , Sugars , Humans , Child , Adolescent , Cohort Studies , Follow-Up Studies , Fast Foods , Anthropometry , Food Handling , Dietary Carbohydrates , Weight Gain , Monosaccharides , Disaccharides , Dietary SugarsABSTRACT
Recent studies on early infant feeding suggest that the type of diet and age of starting complementary foods may have a positive correlation with overweight in adolescence and adulthood. This study aimed to systematically review the evidence on the relationship between the age of introduction of complementary feeding and excess weight in adolescence and adulthood (PROSPERO: CRD42017067764). The preferred reporting items for systematic reviews and meta-analyses standards were used as a reference. Articles were researched on Medline via PubMed, Web of Science, Embase, Lilacs, Ovid, and Scopus, between June and December 2017. Descriptors were defined according to Medical Subject Heading. Of the 103 articles selected for complete reading, nine were included in the review. Of these, only three found an association between the age of introduction of complementary feeding and overweight. Despite these findings, the studies presented a high heterogeneity, mainly due to the difference in cut-off points for the age of introduction of complementary feeding and the classification of overweight. We concluded that the evidence was not consistent enough to confirm the existence of the association.
Subject(s)
Infant Nutritional Physiological Phenomena , Obesity/etiology , Overweight/etiology , Adolescent , Adult , Age Factors , Child , Humans , InfantABSTRACT
BACKGROUND: Social programs can improve the conditions required for families provide sufficient care and attention for an adequate health and nutrition. OBJECTIVE: This study evaluates the effectiveness of the Brazilian's conditional cash transfer program--Bolsa Alimentacao (PBA) on children anthropometric status. METHODS: A cohort of 1847 children, followed for 12 months: 1615 PBA children; 232 non-PBA. There were 316 (14.6%) missing children during the study. A quasi-experimental study adopting the before-after strategy was applied and the effectiveness approach was used to assess the impact of the program on children nutritional status. Multilevel analysis with three levels was used in the statistical analysis. The mean increment variations of height-for-age and weight-for-age were the outcome variables and the participation in the PBA was the exposition. Four participation groups were established: children not exposed to the program (internal control group); exposed to the program throughout the 12 months, exposed to the program only in the last 6 months; and exposed to the program only in the first 6 months. Repeated measures were obtained at baseline and at 12 months. RESULTS: It was found that the exposure to the program was associated to a mean variation in weight-for-age of 0.34 Z-score (IC = 0.04; 0.63) and height-for-age of 0.38 (IC = 0.05; 0.70) for children who were regular program beneficiaries during the follow-up. The exposure to the program in other periods was not statistically associated with a mean variation in the indicators. CONCLUSIONS: Cash transfers direct to the family were associated to anthropometric deficits reduction in childhood.
Subject(s)
Social Welfare/statistics & numerical data , Weight Gain , Anthropometry , Body Height , Brazil/epidemiology , Child , Child, Preschool , Cost-Benefit Analysis , Family , Female , Humans , Infant , Infant, Newborn , Male , Nutritional Status , Social Welfare/economicsABSTRACT
Background: social programs can improve the conditions required for families provide sufficient care and attention for an adequate health and nutrition. Objective: This study evaluates the effectiveness of the Brazilians conditional cash transfer program - Bolsa Alimentação (PBA) on children anthropometric status. Methods: a cohort of 1847 children, followed for 12 months: 1615 PBA children; 232 non-PBA. There were 316 (14.6%) missing children during the study. A quasi-experimental study adopting the before-after strategy was applied and the effectiveness approach was used to assess the impact of the program on children nutritional status. Multilevel analysis with three levels was used in the statistical analysis. The mean increment variations of height-for-age and weight-for-age were the outcome variables and the participation in the PBA was the exposition. Four participation groups were established: children not exposed to the program (internal control group); exposed to the program throughout the 12 months, exposed to the program only in the last 6 months; and exposed to the program only in the first 6 months. Repeated measures were obtained at baseline and at 12 months. Results: it was found that the exposure to the program was associated to a mean variation in weight-for-age of 0.34 Z-score (IC = 0.04; 0.63) and height-for-age of 0.38 (IC = 0.05; 0.70) for children who were regular program beneficiaries during the follow-up. The exposure to the program in other periods was not statistically associated with a mean variation in the indicators. Conclusions: Cash transfers direct to the family were associated to anthropometric deficits reduction in childhood (AU)
Objetivo: evaluar la eficacia del programa de transferencia de ingreso brasileño -Bolsa Alimentação (PBA)- sobre la variación media del incremento del peso y de la talla de niños. Métodos: cohorte de 1.847 niños seguida durante 12 meses: 1.615 eran niños PBA; 232 eran niños no PBA. Se ha registrado la pérdida de 316 (14,6%) niños durante el estudio. Se adopta el diseño casi-experimental y la estrategia antes-después con el enfoque de eficacia para evaluar el impacto del programa sobre el estado antropométrico de los niños. La regresión lineal multinivel fue usada en el análisis estadístico. La variación media del incremento del crecimiento de la talla y del peso para la edad fueron los resultados, y la participación en el programa la variable de exposición principal. Se establecieron cuatro grupos de participación en el programa: niños no expuestos al programa (control interno; expuestos al programa durante 12 meses de acompañamiento, expuestos al programa solo en los últimos 6; niños expuestos al programa solo en los primeros 6 meses. Las medidas repetidas se obtuvieron al inicio y a los 12 meses del seguimiento. Resultados: después de ajustar los efectos por los factores de confusión, la exposición al programa se asoció a una variación media de peso por edad de 0,34 Z-score (IC = 0,04; 0,63) y talla para la edad de 0,38 Z-score (IC = 0,05; 0,70) para los niños que fueron expuestos al programa durante los 12 meses. La exposición al programa en otros períodos de seguimiento no fue estadísticamente asociado con una variación media de peso o talla para la edad. Conclusiones: transferencias directas de ingresos a la familia se asociaron con la reducción de los déficits antropométricos en la infancia (AU)
Subject(s)
Child , Humans , Nutrition Programs/organization & administration , Body Weights and Measures/statistics & numerical data , Food Assistance/statistics & numerical data , Brazil , Program Evaluation , Food Supply/statistics & numerical data , Economic Cooperation/policies , Malnutrition/epidemiologyABSTRACT
OBJECTIVE: This study aims to conduct a literature review to evaluate the effectiveness of intervention programs in the prevention and control of obesity in children and to map the locations where the studies were carried out. METHODS: A systematic review using the PubMed / MEDLINE and LILACS databases to trace the published literature on intervention programs for prevention and control of obesity in the period of January 2004 to October 2013. The initial search was conducted using the terms "body mass index", " Intervention" and "children" or "adolescent" and only articles published in English, Spanish or Portuguese were selected. RESULTS: We found that interventions based only on advice had modest results in identifying changes in the anthropometric indicators of children and adolescents over time, although they appear to be effective in promoting positive changes in the eating habits of this population. Among the studies identified, 77.8 % were conducted in high-income countries, 22.2 % in middle to high income countries and no intervention studies were found in middle to low income countries. CONCLUSION: Intervention programs based only on counseling are effective in promoting changes in dietary patterns, but show poor results in the changes of anthropometric parameters of children and adolescents.
Objetivo: Este trabajo pretende realizar una revisión de literatura para evaluar la efectividad de programas de intervención en la prevención y en el control del exceso de peso infantil y hacer el mapeamiento de los sitios donde los estudios fueron hechos. Métodos: Estudio de revisión sistemática utilizando las bases de datos de PUBMED/MEDLINE y LILACS para rastrear la literatura publicada sobre programas de intervenciones para prevención y control de exceso de peso entre el período de enero de 2004 a octubre de 2013. La búsqueda inicial fue realizada utilizando los términos "body mass index" and "Intervention" and "children" or "adolescent" y fueron seleccionados apenas los artículos publicados en Inglés, español y portugués. Resultados: se observó que intervenciones pautadas unicamente en el aconsejamiento presentaron resultados modestos para identificar alteraciones en los indicadores antropométricos de niños y adolescentes a lo largo del tiempo, aunque parezcan ser efectivos para realizar cambios positivos en los hábitos alimentares de esa población. Entre los estudios identificados, 77.8% fueron realizados en países con renta alta, 22.2% en los países con renta media-alta y no hay estudios de intervención en países con renta media-baja y baja. Conclusión: Los programas de intervenciones basados solamente en el aconsejamiento son efectivos para promover cambios en la calidad alimentar, pero presentan insignificantes resultados en la alteración de los parámetros antropométricos de niños y adolescentes.
Subject(s)
Early Medical Intervention/methods , Obesity/prevention & control , Adolescent , Body Mass Index , Child , Child, Preschool , Feeding Behavior , Humans , Infant , Infant, NewbornABSTRACT
Background: Social programs can improve the conditions required for families provide sufficient care and attention for an adequate health and nutrition. Objective: This study evaluates the effectiveness of the Brazilians conditional cash transfer program - Bolsa Alimentação (PBA) on children anthropometric status. Methods: A cohort of 1847 children, followed for 12 months: 1615 PBA children; 232 non-PBA. There were 316 (14.6%) missing children during the study. A quasi- experimental study adopting the before-after strategy was applied and the effectiveness approach was used to assess the impact of the program on children nutritional status. Multilevel analysis with three levels was used in the statistical analysis. The mean increment variations ofheight-for-age and weight-for-age were the outcome variables and the participation in the PBA was the exposition. Four participation groups were established: children not exposed to the program (internal control group); exposed to the program throughout the 12 months, exposed to the program only in the last 6 months; and exposed to the program only in the first 6 months. Repeated measureswere obtained at baseline and at 12 months. Results: It was found that the exposure to the program was associated to a mean variation in weight-for-age of 0.34 Z-score (IC=-0.44; 0.63) and height-for-age of 0.38 (IC=0.05; 0.70) for children who were regular program beneficiaries during the follow-up. The exposure to the program in other periods was not statistically associated with a mean variation in the indicators. Conclusions: Cash transfers direct to the family were associated to anthropometric deficits reduction in childhood (AU)
Objetivo: Evaluar la eficacia del programa de transferencia de ingreso brasileño - Bolsa Alimentação (PBA) sobre la variación media del incremento del peso e de la talla de niños. Métodos: Cohorte de 1.847 niños fue seguida durante 12 meses: 1.615 eran niños PBA; 232 eran niños no PBA. Se han registrado la pierda de 316 (14,6%) niños durante el estudio. Se adopta el diseño casi-experimental y la estrategia antes-después con el enfoque de eficacia para evaluar el impacto del programa sobre el estado antropométrico de los niños. La regresión lineal multinivel fue usada en el análisis estadístico. La variación media del incremento del crecimiento de la talla y del peso para la edad fueron los outcomes and la participación en el programa la variable de exposición principal. Se establecieron cuatro grupos de participación en el programa: niños no expuesto al programa (control interno; expuestos al programa durante 12 meses de acompañamiento, expuesto al programa sólo en los últimos 6; niños expuestos al programa sólo en los primeros 6 meses. Las medidas repetidas se obtuvieron al inicio y a los 12 meses del seguimiento. Resultados: Después de ajustar los efectos por los factores de confusión, la exposición al programa se asoció a una variación media de peso por edad de 0,34 Z-score (IC = -0,44- 0,63) y talla para la edad de 0,38 Z-score (IC = 0,05-0,70) para los niños que fueron expuestos al programa durante los 12 meses. La exposición al programa en otros períodos de seguimiento no fue estadísticamente asociado con una variación media de peso o la talla para la edad. Conclusiones: Transferencias directas de ingreso a la familia se asociaron con la reducción de los déficits antropométricos en la infancia (AU)
Subject(s)
Humans , Male , Female , Child , Nutritional Status , Child Health Services/economics , Cost-Benefit Analysis , Child Nutritional Physiological Phenomena , Anthropometry , BrazilABSTRACT
Background: the risk factors associated to metabolic syndrome (MS) have been extensively studied in adults, but in children and adolescents it is poorly explored. Objective: To identify the prevalence of MS and associated factors in children and adolescents. Methods: A cross-sectional study with 540 children and adolescents from 7 to 14 years of age. The socioeconomic, demographic and lifestyle data and the family history of chronic diseases were reported by the individual and/or guardian and recorded in a structured questionnaire. Biochemical tests (fasting blood glucose, triacylglycerols, reduced high-density lipoprotein, very-low-density lipoprotein, homocysteine and cysteine), an anthropometric assessment and a blood pressure measurement were performed. MS was defined according to the criteria of The National Cholesterol Education Program Adult Treatment Panel III adapted by Ferranti. A Poisson regression was used to identify the factors statistically associated with MS. Results: The MS prevalence was 12.8%, in which the most frequent component was a decreased high-density lipoprotein level (58.2%), followed by hypertriglyceridemia (41.8%), elevated blood pressure (29.1%), increased waist circumference (26.7%) and hyperglycemia (7.2%). Associations between metabolic syndrome and overweight [prevalence ratio (PR): 2.2 (1.22-3.95)], father education [PR: 2.19 (1.10-4.37)], serum very low-density lipoprotein concentration [PR: 1.08 (1.04-1.11)] and concomitantly increased serum homocysteine and cysteine concentrations [PR: 2.58 (1.32-5.04)] were observed. Conclusions: The MS prevalence is high in children and adolescents and it is increased in patients with overweight, higher father education, increased serum very-low-density lipoprotein concentrations and a concomitant serum homocysteine and cysteine high levels (AU)
Introducción: Los factores asociados al Síndrome metabólico (SM) han sido ampliamente estudiados en adultos, pero aún son poco explorado en niños y adolescentes Objetivo: Identificar la superioridad de SM y los factores asociados en niños y adolescentes. Métodos: Se trata de estudio transversal, con 540 niños de 7 a 14 años de edad. Los datos socioeconómicos, demográficos, estilo de vida e historia familiar de enfermedades crónicas fueron informados por la persona y/o responsable y registrados en cuestionario estructurado. Fueron realizadas dosificaciones bioquímicas (glicemia en ayuno, triglicérides, lipoproteína de alta densidad reducida, lipoproteína de muy baja densidad, homocisteina y cisteina), evaluación antropométrica y verificación de la presión arterial. La SM fue definida de acuerdo con los criterios del The National Cholesterol Education Program Adult Treatment Panel III adaptado por Ferranti. Se utilizó regresión de Poisson como técnica estadística para identificar los factores asociados a la SM. Resultados: La superioridad de la SM fue del 12,8%, siendo a lipoproteína de alta densidad reducida (58,2%) el componente más frecuente, seguido por la hipertrigliceridemia (41,8%), presión arterial aumentada (29,1%), circunferencia de la cintura aumentada (26,7%) e hiperglicemia (7,2%). Fue observada asociación entre SM y exceso de peso (RP: 2,2 [1,22-3,95]), escolaridad paterna (RP: 2,19 [1,10-4,37]), concentración sérica de la lipoproteína de muy baja densidad (RP: 1,08 [1,04-1,11]) y concentraciones séricas simultáneamente aumentadas de homocisteina y cisteina (RP: 2,58 [1,32-5,04]). Conclusiones: La superioridad de SM es elevada en niños y adolescentes y se encuentra aumentada en paciente con exceso de peso, mayor escolaridad paterna, concentraciones séricas aumentadas de la lipoproteína de muy baja densidad, y elevación simultánea de los niveles séricos de homocisteína y cisteína (AU)
Subject(s)
Adolescent , Child , Humans , Metabolic Syndrome/epidemiology , Pediatric Obesity/epidemiology , Overweight/epidemiology , Homocysteine/analysis , Cysteine/analysis , Cross-Sectional Studies , Anthropometry/methods , Body Weights and Measures/statistics & numerical data , Body Composition/physiology , Biomarkers/analysisABSTRACT
BACKGROUND: Social programs can improve the conditions required for families provide sufficient care and attention for an adequate health and nutrition. OBJECTIVE: This study evaluates the effectiveness of the Brazilian's conditional cash transfer program - Bolsa Alimentacao (PBA) on children anthropometric status. METHODS: A cohort of 1847 children, followed for 12 months: 1615 PBA children; 232 non-PBA. There were 316 (14.6%) missing children during the study. A quasi- experimental study adopting the before-after strategy was applied and the effectiveness approach was used to assess the impact of the program on children nutritional status. Multilevel analysis with three levels was used in the statistical analysis. The mean increment variations of height-for-age and weight-for-age were the outcome variables and the participation in the PBA was the exposition. Four participation groups were established: children not exposed to the program (internal control group); exposed to the program throughout the 12 months, exposed to the program only in the last 6 months; and exposed to the program only in the first 6 months. Repeated measures were obtained at baseline and at 12 months. RESULTS: It was found that the exposure to the program was associated to a mean variation in weight-for-age of 0.34 Z-score (IC=-0.44; 0.63) and height-for-age of 0.38 (IC=0.05; 0.70) for children who were regular program beneficiaries during the follow-up. The exposure to the program in other periods was not statistically associated with a mean variation in the indicators. CONCLUSIONS: Cash transfers direct to the family were associated to anthropometric deficits reduction in childhood.
Objetivo: Evaluar la eficacia del programa de transferencia de ingreso brasileno - Bolsa Alimentacao (PBA) sobre la variacion media del incremento del peso e de la talla de ninos. Métodos: Cohorte de 1.847 ninos fue seguida durante 12 meses: 1.615 eran ninos PBA; 232 eran ninos no PBA. Se han registrado la pierda de 316 (14,6%) ninos durante el estudio. Se adopta el diseno casi-experimental y la estrategia antes-despues con el enfoque de eficacia para evaluar el impacto del programa sobre el estado antropometrico de los ninos. La regresion lineal multinivel fue usada en el analisis estadistico. La variacion media del incremento del crecimiento de la talla y del peso para la edad fueron los outcomes and la participacion en el programa la variable de exposicion principal. Se establecieron cuatro grupos de participacion en el programa: ninos no expuesto al programa (control interno; expuestos al programa durante 12 meses de acompanamiento, expuesto al programa solo en los ultimos 6; ninos expuestos al programa solo en los primeros 6 meses. Las medidas repetidas se obtuvieron al inicio y a los 12 meses del seguimiento. Resultados: Despues de ajustar los efectos por los factores de confusion, la exposicion al programa se asocio a una variacion media de peso por edad de 0,34 Z-score (IC = -0,44- 0,63) y talla para la edad de 0,38 Z-score (IC = 0,05-0,70) para los ninos que fueron expuestos al programa durante los 12 meses. La exposicion al programa en otros periodos de seguimiento no fue estadisticamente asociado con una variacion media de peso o la talla para la edad. Conclusiones: Transferencias directas de ingreso a la familia se asociaron con la reduccion de los deficits antropometricos en la infancia.
Subject(s)
Child Health Services/economics , Nutritional Status , Anthropometry , Brazil , Child , Child Nutritional Physiological Phenomena , Cost-Benefit Analysis , Female , Humans , MaleABSTRACT
Objetivo: avaliar a validade do índice de massa corporal (IMC) calculado a partir de medidas autorreferidas e aferidas, para uso na classificação antropométrica. Métodos: estudo de validação realizado com 65 adultos residentes em Salvador, que responderam a entrevista telefônica e tiveram peso e estatura aferidos. Utilizou-se teste t-pareado e coeficiente de correlação intraclasse (CCIC); estimou-se sensibilidade, especificidade e valor preditivo positivo (VPP) do IMC obtido a partir do peso e estatura autorreferidos e aferidos. Resultados: mulheres superestimaram sua estatura em 3,15cm (p<0,001), resultando em subestimação do IMC de 1,39kg/m² (p<0,001), sem comprometimento da classificação antropométrica (p>0,05). Foram encontrados CCIC maiores que 60,0 por cento para peso, estatura e IMC, segundo idade, sexo e escolaridade, exceto para estatura entre homens; e boa acurácia para medidas autorreferidas. As medidas gerais de sensibilidade, especificidade e VPP foram 92,9 por cento, 78,4 por cento e 76,5 por cento, respectivamente. Conclusão: o IMC autorreferido mostou-se válido para ser utilizado na classificação antropométrica populacional.
Objective: to evaluate the validity of body mass index (EMI) calculated from self-reported weight and height and measured for use in anthropometric classification. Methods: validation study involving 65 adults from Salvador city, Brazil, using a telephone interview with weight and height measured in person. Paired t-test and interclass correlation coefficient (ICC) were calculated; sensitivity, specificity and positive predictive value (PPV) of self-reported EMI were estimated and verified. Results: women overestimated height by 3.15cm (p<0.001) with EMI underestimation of 1.39kg/m² (p<0.001), but without impairment on anthropometric classification (p>0.05). The study showed ICC greater than 60.0 percent for weight, height and EMI, considering age, gender and schooling, except for male height; and accuracy for self-reported measures. The general measures of sensitivity, specificity and PPV were 92.9 percent, 78.4 percent and 76.5 percent, respectively. Conclusion: self-reported EMI showed to have been valid to be used on population anthropometric classification and monitoring.
