Quality of life of older adults in Family Health Strategy: a cross-sectional study

ABSTRACT BACKGROUND: With the increase in the older adult population, it is essential to identify the living and health conditions that can impact the quality of life of these individuals. OBJECTIVES: To identify the domains and factors associated with the quality of life of older adults under the Family Health Strategy program. DESIGN AND SETTING: This was a cross-sectional analytical study was conducted in the municipality of Palmas, Tocantins, Brazil. METHODS: We assessed 449 older adults enrolled in the Family Health Strategy program. Data were collected between April and July, 2018. World Health Organization Quality of Life Assessment (WHOQOL-OLD) was used to assess the quality of life (QoL) and multiple linear regression was used to estimate the factors associated with QoL. RESULTS: The QoL domain with the highest score was death and dying (mean = 70.4), and the lowest score was for sensory functions (mean = 61.0 points). The factors associated with QoL were single marital status (β = -4.55; P = 0.014), level of independence for daily living activities (β = 4.92; P < 0.001), self-assessment of regular health (β = 5.35; P < 0.001), and poor health (β = -8.67; P < 0.001). CONCLUSION: The death and dying domain of QoL presented the highest score. Marital status, impairment in daily activities, and health self-assessment were associated with QoL.

Quality of life of older adults in Family Health Strategy: a cross-sectional study.

BACKGROUND: With the increase in the older adult population, it is essential to identify the living and health conditions that can impact the quality of life of these individuals. OBJECTIVES: To identify the domains and factors associated with the quality of life of older adults under the Family Health Strategy program. DESIGN AND SETTING: This was a cross-sectional analytical study was conducted in the municipality of Palmas, Tocantins, Brazil. METHODS: We assessed 449 older adults enrolled in the Family Health Strategy program. Data were collected between April and July, 2018. World Health Organization Quality of Life Assessment (WHOQOL-OLD) was used to assess the quality of life (QoL) and multiple linear regression was used to estimate the factors associated with QoL. RESULTS: The QoL domain with the highest score was death and dying (mean = 70.4), and the lowest score was for sensory functions (mean = 61.0 points). The factors associated with QoL were single marital status (ß = -4.55; P = 0.014), level of independence for daily living activities (ß = 4.92; P < 0.001), self-assessment of regular health (ß = 5.35; P < 0.001), and poor health (ß = -8.67; P < 0.001). CONCLUSION: The death and dying domain of QoL presented the highest score. Marital status, impairment in daily activities, and health self-assessment were associated with QoL.

Central adiposity as a predictor of mortality in older adults: Identification of cutoffs using generalized additive models.

Background: Obesity is associated with premature mortality in adults; however, this association has been inconsistent in the older adult population. In addition, there is a lack of specific cutoff points for indicators of negative health outcomes in older adults. Methods: This is a prospective study with 796 non-institutionalized older adults. Data on sociodemographic characteristics, lifestyle, food consumption, and nutritional status were obtained at baseline. Generalized additive models were used to identify cutoff points for the waist circumference (WC) and waist-to-height ratio (WHtR) and Cox proportional hazards models to assess the independent association between adiposity and mortality. Results: Over the 9 years of follow-up, 197 deaths (24.7%) occurred, of which 51.8% were men, with a mean age of 76.1 ± 9.0 years. Older adults at higher risk of death had WHtR of <0.52 or ≥0.63 and WC of <83 cm or ≥101 cm. An increased risk of death was observed in older adults with high WC (HR: 2.03 95% CI: 1.20-3.41) and high WHtR (HR: 1.51 95% CI: 1.01-2.26) in the adjusted models, and an increase in WC was a risk factor for higher CVD mortality (HR: 2.09, 95% CI: 1.12-3.88) in the adjusted models. Conclusion: Adiposity was associated with an increased risk of death in older adults. In view of these results and considering the lack of cutoff points for anthropometric indices in Brazilian older adults, further studies are needed to confirm the WC and WHtR cutoff values found in this study.

COVID-19 Infodemic and Impacts on the Mental Health of Older People: Cross-sectional Multicenter Survey Study.

BACKGROUND: The COVID-19 pandemic received widespread media coverage due to its novelty, an early lack of data, and the rapid rise in deaths and cases. This excessive coverage created a secondary "infodemic" that was considered to be a serious public and mental health problem by the World Health Organization and the international scientific community. The infodemic particularly affected older individuals, specifically those who are vulnerable to misinformation due to political positions, low interpretive and critical analysis capacity, and limited technical-scientific knowledge. Thus, it is important to understand older people's reaction to COVID-19 information disseminated by the media and the effect on their lives and mental health. OBJECTIVE: We aimed to describe the profile of exposure to COVID-19 information among older Brazilian individuals and the impact on their mental health, perceived stress, and the presence of generalized anxiety disorder (GAD). METHODS: This cross-sectional, exploratory study surveyed 3307 older Brazilians via the web, social networks, and email between July 2020 and March 2021. Descriptive analysis and bivariate analysis were performed to estimate associations of interest. RESULTS: Major proportions of the 3307 participants were aged 60 to 64 years (n=1285, 38.9%), female (n=2250, 68.4%), and married (n=1835, 55.5%) and self-identified as White (n=2364, 71.5%). Only 295 (8.9%) had never started or completed a basic education. COVID-19 information was mainly accessed on television (n=2680, 81.1%) and social networks (n=1943, 58.8%). Television exposure was ≥3 hours in 1301 (39.3%) participants, social network use was 2 to 5 hours in 1084 (32.8%) participants, and radio exposure was ≥1 hour in 1223 (37%) participants. Frequency of exposure to social networks was significantly associated with perceived stress (P=.04) and GAD (P=.01). A Bonferroni post hoc test revealed significantly different perceived stress in participants who were exposed to social networks for 1 hour (P=.04) and those who had no exposure (P=.04). A crude linear regression showed that "some" social media use (P=.02) and 1 hour of exposure to social media (P<.001) were associated with perceived stress. Adjusting for sociodemographic variables revealed no associations with this outcome variable. In a crude logistic regression, some social media use (P<.001) and 2 to 5 hours of exposure to social media (P=.03) were associated with GAD. Adjusting for the indicated variables showed that some social network use (P<.001) and 1 hour (P=.04) and 2 to 5 hours (P=.03) of exposure to social media were associated with GAD. CONCLUSIONS: Older people, especially women, were often exposed to COVID-19-related information through television and social networks; this affected their mental health, specifically GAD and stress. Thus, the impact of the infodemic should be considered during anamnesis for older people, so that they can share their feelings about it and receive appropriate psychosocial care.

Obesogenic environment around schools is associated with atherogenic risk in Brazilian children.

INTRODUCTION: Cardiometabolic risk factors often emerge in childhood, increasing the risk of cardiovascular diseases in adulthood. The school environments represent an important active space in a child's routine and may influence their health status. METHODS: In this cross-sectional study, we aimed to evaluate the clustering of cardiometabolic risk factors and its association with the obesogenic and leptogenic environment around schools. A total of 378 children (181 boys; 197 girls) aged 8 and 9 years, enrolled in all urban schools of Viçosa, Minas Gerais, Brazil, were evaluated. Concentrations of high-density lipoprotein-cholesterol (HDL-c) and triglycerides (TG), and the insulin resistance (HOMA-IR), waist circumference (WC), and mean arterial pressure (MAP) were measured. The neighborhood income, walkability index, predominantly ultra-processed food stores, public spaces for leisure and/or physical activities, traffic accidents, crime and green spaces densities were assessed in 400 road network buffers around schools. To test association of the obesogenic and leptogenic environment around schools with cardiometabolic risk clustering, binary logistic regression models were performed with generalized estimating equations. RESULTS: "Obesogenic school environments" had greater densities of ultra-processed food stores, crime and traffic accidents, and higher walkability. The "↓ Atherogenic risk" cluster consisted of higher HDL-c values. There was an inverse association between the obesogenic environment around schools and a child's "↓ atherogenic risk" clustering (OR = 0.63; p < 0.001). CONCLUSION: We concluded that public policies aimed at modifying the environment around schools, by providing healthier food options and safe conditions for active mobility, are essential to prevent child's atherogenic risk.

Neighborhood obesogenic environment and cardiometabolic risk in Brazilian children: The mediation role of the mother's body mass index.

OBJECTIVE: We aimed to evaluate the association of neighborhood obesogenic and leptogenic environments with cardiometabolic risk clustering among Brazilian schoolchildren, mediated by child's ultra-processed food consumption and the mother's body mass index (BMI). METHODS: A total of 367 children aged 8-9 years, enrolled in urban schools of Viçosa, Minas Gerais, Brazil, were evaluated. Waist circumference, insulin resistance, blood pressure, high-density lipoprotein-cholesterol, and triglycerides concentrations were measured. The child's ultra-processed food consumption assessment was performed by applying three 24-hour dietary recall. The mother's weight and height values were used to calculate the BMI. The neighborhood income, walkability index, predominantly ultra-processed food stores, public spaces for leisure, and/or physical activities, traffic accidents, crime, and green spaces densities were assessed in four hundred road network buffers around households. From neighborhood and cardiometabolic risk variables, four latent variables were obtained from confirmatory factor analysis: neighborhood "obesogenic", and "leptogenic" environments; "high cardiometabolic risk," and "low atherogenic risk". A structural equation model was used to test the direct and indirect associations between neighborhood environment and cardiometabolic risk clusters. RESULTS: The neighborhood obesogenic environment had a significant total association (Standardized Coefficient = 0.172, p = .011) and was indirectly associated with the child's "high cardiometabolic risk" cluster, mediated by the mother's body mass index (Standardized Coefficient = 0.066, p = .049). CONCLUSIONS: Our results reinforce the role of the urban environment on maternal obesity and child's cardiometabolic risk and provide evidence for public health policies aimed to prevent such conditions.

Nutritional indicators of food and nutrition security of families: 2008/2009 Household Budget Survey / Indicadores nutricionais da segurança alimentar e nutricional de famílias: Pesquisa de Orçamentos Familiares 2008/2009

ABSTRACT Objective To evaluate the food and nutrition insecurity of Brazilian families, according to indicators of food consumption and nutritional status, by location and situation of the households investigated using the 2008/2009 Household Budget Survey. Methods Inadequate consumption of macronutrients and nutritional dystrophies (underweight, short stature or overweight) in at least one family member were used as indicators, according to location and geographical situation of households. The prevalence of food and nutritional insecurity and their confidence intervals were calculated. Results Food consumption was assessed in a total of 13,569 households; a total of 67.55%, 43.96% and 6.85% revealed inadequacy for lipids, carbohydrates and proteins, respectively. Among the 53,640 households assessed by nutritional status, 15.10%, 35.15% and 45.50% had, at least one resident with low weight, short stature or overweight respectively. The Northeastern Region showed statistically higher prevalence than other Brazilian macro-regions for inadequate lipids (24.88%) and carbohydrates (15.32%), as well as for the presence of underweight (6.15%), overweight (14.77%) and short stature (15.17%), in at least one of the residents of the household. Conclusion Assessing the nutritional aspect of food insecurity allows for a better understanding of the dimensions of this situation by considering the effects of access and availability of food, as well as biological use and stability, based on indicators of inadequate food consumption and the presence of nutritional dystrophy. The results found in this study enhance the need to include nutritional indicators in the assessment of food security.

RESUMO Objetivo Avaliar a insegurança alimentar e nutricional de famílias brasileiras segundo indicadores de consumo alimentar e estado nutricional, por localização e situação dos domicílios investigados pela Pesquisa de Orçamento Familiar 2008/2009. Métodos Foram utilizados, como indicadores de insegurança alimentar e nutricional, o consumo inadequado de macronutrientes e distrofias nutricionais (baixo peso, baixa estatura ou excesso de peso) em pelo menos um membro da família, conforme localização e situação geográfica dos domicílios. Calculou-se a prevalência de insegurança alimentar e nutricional e seus intervalos de confiança. Resultados Foram avaliados 13.569 domicílios pelo consumo alimentar, sendo que 67,55%, 43,96% e 6,85% apresentaram inadequação para lipídios, carboidratos e proteínas, respectivamente. Entre os 53.640 domicílios avaliados pelo estado nutricional, 15,10%, 35,15% e 45,50% apresentam, respectivamente, pelo menos um morador com baixo peso, baixa estatura ou excesso de peso. O Nordeste apresentou prevalências estatisticamente maiores do que as demais macrorregiões para as inadequações de lipídios (24,88%) e de carboidratos (15,32%), bem como para presença de baixo peso (6,15%), excesso de peso (14,77%) e baixa estatura (15,17%), em pelo menos um dos moradores do domicílio. Conclusão Avaliar a vertente nutricional da insegurança alimentar permite maior compreensão das dimensões dessa situação por considerar os reflexos do acesso e disponibilidade de alimentos, bem como a utilização biológica e estabilidade, a partir dos indicadores de consumo alimentar inadequado e presença de distrofia nutricional. Os resultados encontrados reforçam a necessidade de incluir indicadores nutricionais na avaliação da segurança alimentar.

Availability of food stores around Brazilian schools.

The aim of this study was to analyze the availability of food stores in the territory of schools. Ecological study conducted in Viçosa, Minas Gerais, Brazil, with all schools (N=42) and food stores (N=656). Data were collected through the objective evaluation of the environment, and the stores were categorized into healthy, unhealthy, mixed and supermarkets. Bivariate Ripley´s K function assessed the existence of clustering of categories of stores in the territory of schools. All the schools had at least one food store in their territory. Unhealthy stores were the most common and closest to the schools. There were more stores around private schools, offering high school education, located in the central region and in the highest per capita income tercile. The bivariate Ripley´s K function showed evidence of clustering of stores at all analyzed distances (400 to 1.5 km) with up to 3 times more establishments than would be expected if they were randomly distributed. Therefore, schoolchildren were likely exposed to unhealthy food environments, regardless of neighborhood income and location, which may contribute to inadequate food choices.

Availability of food stores around Brazilian schools / Disponibilidade de estabelecimentos de venda de alimentos no entorno de escolas brasileiras

Abstract The aim of this study was to analyze the availability of food stores in the territory of schools. Ecological study conducted in Viçosa, Minas Gerais, Brazil, with all schools (N=42) and food stores (N=656). Data were collected through the objective evaluation of the environment, and the stores were categorized into healthy, unhealthy, mixed and supermarkets. Bivariate Ripley´s K function assessed the existence of clustering of categories of stores in the territory of schools. All the schools had at least one food store in their territory. Unhealthy stores were the most common and closest to the schools. There were more stores around private schools, offering high school education, located in the central region and in the highest per capita income tercile. The bivariate Ripley´s K function showed evidence of clustering of stores at all analyzed distances (400 to 1.5 km) with up to 3 times more establishments than would be expected if they were randomly distributed. Therefore, schoolchildren were likely exposed to unhealthy food environments, regardless of neighborhood income and location, which may contribute to inadequate food choices.

Resumo O objetivo deste estudo foi analisar a disponibilidade de estabelecimentos de venda de alimentos no território das escolas. Estudo ecológico conduzido em Viçosa, Minas Gerais, Brasil, com todas as escolas (N=42) e estabelecimentos de venda de alimentos (N=656). Dados foram coletados através de avaliação objetiva do ambiente, e estabelecimentos foram categorizados em saudáveis, não saudáveis, mistos e supermercados. Função K de Ripley bivariada avaliou a existência de agrupamento das categorias de estabelecimentos no território das escolas. Todas as escolas tinham no mínimo um estabelecimento de venda de alimentos em seu território. Estabelecimentos não saudáveis foram mais frequentes e próximos das escolas. Havia mais estabelecimentos no entorno de escolas particulares com ensino médio, localizadas na região central e de maior tercil de renda per capita. A função K de Ripley bivariada evidenciou o agrupamento de estabelecimentos em todas as distâncias analisadas (400 a 1,5 km), com três vezes mais estabelecimentos do que o esperado em uma distribuição aleatória. Portanto, escolares provavelmente estavam expostos a um ambiente alimentar não saudável, independentemente da renda da vizinhança e da localização das escolas, o que pode contribuir para escolhas alimentares inadequadas.

Maternal and child characteristics correlated with frequency of consuming ultra-processed food by children aged 6 to 24 months old / Características maternas e infantis correlacionadas à frequência do consumo de alimentos ultraprocessados por crianças de 6 a 24 meses

Abstract Objectives: to verify the correlation between the consumption of ultra-processed food among mothers and children under two years of age and the main characteristics related to this consumption. Methods: cross-sectional study conducted in public health services. Three 24-hour recalls were applied to assess food intake. The ultra-processed food was grouped into: sugary drinks; meat; sauces and creams; dairy products; snacks; pastas; and mucilage. Themother's body mass index and waist/hip ratio, and the child's weight/height, height/age, weight/age and body mass index/age were calculated. The children's ultra-process frequency as correlated with: anthropometric dyadic variables; ultra-process frequency on breastfeeding. The children's average ultra-process intake was compared to pacifier, bottle, breastfeeding and socioeconomic status. Linear regression models were conducted. Results: 172 pairs were evaluated. Similarity was found in the mothers and children's consumption of ultra-processed products. The higher frequency of ultra-processed products was correlated with older child and the higher body mass/age index and weight/age index. Of the 39 ultra-processed food present in the mothers' diet, 22 were correlated to child's Conclusion: the consumption of ultra-processed food by children is similar to their mothers and correlates with higher z-score values of weight/age and body mass/age index.

Resumo Objetivos: verificar a correlação do consumo de alimentos ultraprocessados de mães e filhos menores de dois anos de idade e as principais características relacionadas a este consumo. Métodos: estudo transversal conduzido nos serviços públicos de saúde. Aplicaram-se três recordatórios de 24 horas para avaliar o consumo alimentar. Os alimentos ultraprocessados foram agrupados em: bebidas açucaradas; carnes; molhos e cremes; lácteos; lanches; massas; e mucilagens. Calculou-se o Índice de Massa Corporal e a relação cintura/quadril da mãe, índice peso/estatura, estatura/idade, peso/idade e índice de massa corporal/idade da criança. Correlacionou-se a frequência de ultraprocessados na alimentação das crianças com: variáveis antropométricas da díade; frequência de ultraprocessados na alimentação materna. Comparou-se a média do consumo de ultraprocessados das crianças com uso de chupeta, mamadeira, aleitamento materno e condição socioeconômica. Modelos de regressão linear foram conduzidos. Resultados: avaliou-se 172 pares. Foi verificada semelhança no consumo de ultraprocessados de mães e filhos. A maior frequência de ultraprocessados correlacionou-se a maior idade da criança e ao maior índice de massa corporal/idade e índice peso/idade. Dos 39 alimentos ultraprocessados presentes na alimentação das mães, 22 correlacionaram com os da criança. Conclusão: o consumo de ultraprocessados pelas crianças se assemelha ao das mães e correlacionase com maiores valores dos índices peso/idade e índice de massa corporal/idade.

Multicomponent exercise training is effective in improving health and behavior indicators in Brazilian elderly women: A non-randomized trial.

OBJECTIVE: The aim was to evaluate the effects of a supervised 12-week Multicomponent exercise training on elderly women health and behavior indicators. METHODS: Anthropometric characteristics and body composition, functional capacity, sedentary behavior, physical activity level and biochemical profile were evaluated in the control group (67.2 ± 5.2 years, n = 14) and in the experimental group (67.4 ± 6.1 years, n = 41). The experimental group were composed by 41 elderly women who performed 12 weeks of Multicomponent exercise training involving strength, aerobic, flexibility and balance exercises. The inclusion criteria for the study were women aged 60 years or more and presentation of a medical certificate authorizing the practice of physical exercise. RESULTS: Maintenance of anthropometric characteristics and body composition was observed in both groups (p > 0.05). There was an improvement in aerobic capacity, lower and upper limb strength in the experimental group (p < 0.01), while the control group showed a reduction in aerobic capacity, lower limb strength, agility and dynamic balance (p < 0.01), as shown in Fi.gure 3. There was a reduction in sedentary behavior and an increase in physical activity level in experimental group (p < 0.05), but not in control group. Experimental group showed an improvement in glucose levels and lipid profile (p < 0.01). CONCLUSION: Multicomponent exercise training was efficient to improve health and behavior indicators of the elderly women.

Calf circumference is an independent predictor of mortality in older adults: An approach with generalized additive models.

BACKGROUND: There is a wide variation in the cutoff points of body mass index (BMI) and calf circumference (CC) , and it is necessary to assess their adequacy in predicting mortality, especially in the older adults in the community. This study aimed to investigate the association of low muscle mass and underweight with mortality in older adults, comparing different cutoff points. METHODS: This was a prospective study that included 796 older adults, not institutionalized, from a Brazilian city. Generalized additive models (GAMs) were used to identify cutoff points for CC and BMI, which were compared with values available in the literature. Survival analysis using Cox regression models was used to assess the independent association between these nutrition indicators and mortality. RESULTS: Over the 9 years of follow-up, 197 deaths (24.7%) occurred. Cutoff points established for CC and BMI as predictors of mortality were, respectively, <34.5 cm and <24.5. In the adjusted Cox models, older adults with a BMI <18.5 showed a significant increase in the risk of death (hazard ratio [HR], 2.57; 95% CI, 1.23-5.35). Higher mortality was observed among older adults with CC <34.5 cm (HR, 1.72; 95% CI, 1.27-2.33) and CC <31 cm (HR, 2.11; 95% CI, 1.44-3.10). CONCLUSION: CC was an independent predictor of mortality, and the cutoff point identified by GAMs was higher than recommended by literature (31 cm). This study suggests a review of cutoff points for CC currently adopted to assess low muscle mass in older adults.

STRONGkids nutrition screening tool in pediatrics: An analysis of cutoff points in Brazil.

BACKGROUND: Studies have indicated the Screening Tool for Risk on Nutritional Status and Growth (STRONGkids) as a method of pediatric nutrition screening with good validity in the hospital setting. However, we need to analyze whether the cutoff values originally proposed are suitable for use in Brazil. METHODS: A cross-sectional study was performed in patients admitted to the pediatric ward of a public hospital. STRONGkids was used to assess nutrition risk (low risk, 0 points; moderate risk, 1-3 points; and high risk, 4-5 points). The indexes weight/height or body mass index/age were used to indicate acute malnutrition, and length or height/age was used to indicate chronic malnutrition. Receiver operating characteristic curves were constructed and the areas under the curve were calculated, with respective 95% confidence intervals, to assess the ability of STRONGkids to predict malnutrition and longer hospital stay. RESULTS: The study included 599 patients, with a median age of 2.6 years. The frequency of nutrition risk (medium or high) was 83.6%. In comparison with anthropometric indexes, STRONGkids was the only scoring system with the discriminatory capacity to identify patients with longer hospital stays. The comparative analysis of the means of hospital stay according to STRONGkids showed that patients with a score equal to 3 behaved similarly to those classified as high nutrition risk (4-5 points). CONCLUSIONS: Considering the best cutoff point to predict prolonged hospitalization, STRONGkids used in Brazil should consider patients with 3 points as having high nutrition risk, as well those scoring 4 and 5.

Baixa reserva muscular em pessoas idosas e fatores associados / Low muscle reserve in older adults and associated factors

Resumo Objetivo Estimar a prevalência de baixa reserva muscular e identificar os fatores associados em pessoas idosas. Método Estudo transversal realizado com 784 idosos (60 anos ou mais) não institucionalizados, residentes em Viçosa, Minas Gerais no ano de 2009. As características de interesse foram sociodemográficas, hábitos de vida, condições de saúde e antropométricas. A baixa reserva muscular (BRM) foi definida como o perímetro da perna (PP) < 33 cm para mulheres e < 34 cm para homens. Realizou-se análise descritiva, análise bivariada e múltipla, por meio da regressão de Poisson com variância robusta, para identificar os fatores independentemente associados ao desfecho de interesse. Resultados Mais da metade da amostra era composta por mulheres (52,9%), maior frequência de idosos mais jovens (60 - 69 anos :49,5%), com no máximo quatro anos de estudo (79,9%). A prevalência de baixa reserva muscular foi de 21,7% (IC 95% 18,9%-24,7%) e os fatores independentemente associados foram a faixa etária de 70 a 79 anos (RP:1,31; IC95%: 0,96-1,795), 80 anos ou mais (RP:1,64; IC95%:1,12-2,70), histórico de internação hospitalar (RP: 1,46; IC95%: 1,02-2,09) e baixo peso (RP: 5,45; IC95%:3,77-7,88). Conclusões A prevalência da BRM na amostra é expressiva, se relaciona com a idade mais avançada, hospitalização e com o baixo peso. O monitoramento do PP mostra-se importante para o rastreamento de alterações relacionadas à baixa reserva muscular na pessoa idosa e os fatores associados devem ser considerados nas avaliações antropométricas destinadas a esta população.

Abstract Objective To estimate the prevalence of low muscle reserve and identify associated factors in older people. Method Cross-sectional study carried out with 784 non-institutionalized older people (60 years or older), living in Viçosa, Minas Gerais, in 2009. The characteristics of interest were sociodemographic, life habits, health and anthropometric conditions. Low muscle reserve (LMR) was defined as leg circumference (LC) < 33 cm for women and < 34 cm for men. Descriptive analysis, bivariate and multiple analysis were performed, using Poisson regression with robust variance, to identify the factors independently associated with the outcome of interest. Results More than half of the sample consisted of women (52.9%), more frequently younger seniors (60 - 69 years old :49.5%), with a maximum of four years of study (79.9%). The prevalence of low muscle reserve was 21.7% (95%CI 18.9%-24.7%) and the independently associated factors were the age group from 70 to 79 years (PR:1.31; 95%CI: 0.96-1.795), 80 years or older (PR:1.64; 95%CI:1.12-2.70), history of hospitalization (PR: 1.46; 95%CI: 1.02-2.09) and low weight (PR: 5.45; 95%CI: 3.77-7.88). Conclusions The prevalence of LMR in the sample is expressive, it is related to older age, hospitalization and low weight. LC monitoring is important for tracking changes related to low muscle reserve in older people and associated factors should be considered in anthropometric assessments for this population.

Maternal overweight and its relation with child's anthropometric indices / Excesso de peso materno e sua relação com os índices antropométricos infantis

Abstract Objectives: to investigate the relation between maternal overweight and child's anthropometric indices, identifying the interaction with the child's age. Methods: a cross-sectional study with mothers and their children under 2 years old. The mothers' body mass index (BMI), waist-to-hip ratio and waist-to-height ratio was calculated. In children, we calculated height/age (H/A), body mass index/age (BMI/A), weight/height (W/H) and weight/age (W/A) indices. The means of the anthropometric indices of children with excess weight and maternal cardiometabolic risk were compared. Mothers and children's anthropometric indices were correlated. Linear regression models were proposed. We investigated the child's age interaction with anthropometric variables of the dyad. Results: the means of BMI/A and W/H were higher in children of overweight mothers and the means of BMI/A, W/H and W/A were higher when mothers had increased risk for cardiometabolic diseases. There was an association of maternal weight and height with the W/A index; maternal BMI with W/H; maternal height with H/A; maternal weight, BMI and waist circumference with BMI/A. The children's age did not interact with the assessed parameters. Conclusion: children under 2 years of age, whose mothers are overweight, tend to show changes in weight, regardless of age.

Resumo Objetivos: investigar a relação do excesso de peso materno com índices antropométricosinfantis, identificando a interação da idade da criança. Métodos: estudo transversal com mães e seus filhos menores de 2 anos. Calculou-se o índice de massa corporal (IMC), relação cintura quadril e relação cintura estaturadas mães. Nas crianças, calculou-se os índices estatura/idade (E/I), índice de massa corporal/idade (IMC/I), peso/estatura (P/E) e peso/idade (P/I). Comparou-se as médias dos índices antropométricos das crianças com excesso de peso e risco cardiometabólico materno. Correlacionou-se índices antropométricos infantis e maternos. Modelos de regressão linear foram propostos. Foi investigada interação da idade da criança com variáveis antropométricas da díade. Resultados: as médias do IMC/I e P/E foram maiores em filhos de mães com excesso de peso e as médias do IMC/I, P/E e P/I foram maiores quando mães apresentaram risco aumentado para doenças cardiometabólicas. Verificou-se associação do peso e estatura materna com o índice P/I; do IMC materno com P/E; da estatura materna com E/I; do peso, IMC e perímetro da cintura materna com IMC/I. A idade das crianças não interagiu com os parâmetros avaliados. Conclusão: crianças menores de 2 anos, cujas mães têm excesso de peso, tendem a apresentar alteração no peso, independente da idade.

Qualidade da alimentação de idosos longevos e doenças crônicas não transmissíveis / Food quality of long elderly and non-communicable chronic diseases

Avaliou-se a qualidade da alimentação de idosos longevos e sua relação com doenças crônicas não transmissíveis. Foi um estudo transversal, de base populacional, realizado em Viçosa, Minas Gerais, Brasil, o qual integra um projeto maior intitulado "Condições de saúde, nutrição e uso de medicamentos por idosos do município de Viçosa (MG): um inquérito de base populacional". As entrevistas com os idosos foram realizadas por meio de questionário semiestruturado, com a maioria das questões fechadas e pré-codificadas. Os dados do consumo alimentar foram obtidos por recordatório de ingestão habitual e a qualidade da dieta avaliada por meio do Índice de Alimentação Saudável Revisado (IAS-R), validado para a população brasileira. A amostra foi composta por 94 idosos longevos, a maioria do sexo feminino. Os mesmos apresentaram alta ingestão de sódio, baixa ingestão de cereais integrais e IAS-R = 62,22. Idosos diabéticos apresentaram maior ingestão de frutas totais, baixa ingestão de Gord_AA (açúcares, gorduras sólidas e álcool) e IAS-R total maior em comparação aos não diabéticos. As presenças de dislipidemia e hipertensão não alteraram o consumo de nenhum dos componentes. Os resultados indicaram a necessidade de adequação na ingestão alimentar. Assim, intervenções e orientações nutricionais específicas destinadas à promoção da saúde devem ser incentivadas.

The quality of the food of long-lived elderly and its relationship with non-communicable chronic diseases was evaluated. This a cross-sectional study with a population basis that was conducted in Viçosa, Minas Gerais, Brazil, which is part of a larger project entitled "Health, nutrition and drug use by older people in Viçosa (MG): a population-based survey". The interviews with the elderly was conducted through a semi-structured questionnaire, with most questions closed and pre-coded. Food intake data were obtained from the usual intake recall and the quality of the diet was assessed using the Revised Healthy Eating Index (HEI-R), validated for the Brazilian population. The sample consisted of 94 long-lived elderly, most of them female. They presented high sodium intake, low whole grains intake and HEI-R = 62.22. Diabetic older adults had higher total fruit intake, lower intake of Gord_AA (sugars, solid fats, and alcohol) and higher total HEI-R compared to non-diabetics. The presences of dyslipidemia and hypertension did not alter the consumption of any of the components. The results indicated the need for adequacy in food intake. Thus, specific nutritional interventions and guidelines for health promotion should be encouraged.

Equation of height estimation from knee height: Performance in the composition of body adiposity INDICES in older adults.

AIM: To propose an equation to estimate height and evaluate it's performance in the composition of adiposity indicators in community-dwelling older adults in Brazil. METHODS: It is a cross-sectional study with 675 community-dwelling older adults (≥60 anos). Interviews and anthropometric measurements were taken at subjects' homes. Body mass index (BMI), body adiposity index (BAI), waist height ratio (WHR), and conicity index (CI) were calculated. The height estimation equation was obtained by multiple linear regression. Concordance between height and the indicators measured and estimated was evaluated by the intraclass correlation coefficient (ICC) and Cohen's Kappa and Weighted Kappa indexes. Concordance was also evaluated by the Bland and Altman graphical approach. RESULTS: Equations of height estimation composed of knee height, sex, and schooling were proposed and stratified by age group (60-74 years and ≥75 years). In both age groups, almost perfect agreement (ICC ≥ 0.915 and Kappa ≥0.81) was found between height and adiposity indicators estimated and measured. CONCLUSION: The equation proposed is suitable to estimate height of the older adults, and can be a valuable tool for the evaluation of the nutritional status of Brazilian older adults in the community.

Prevalence, diagnostic criteria, and factors associated with sarcopenic obesity in older adults from a low middle income country: A systematic review.

OBJECTIVE: To evaluate the scientific evidences on the prevalence, diagnostic criteria, and factors related to sarcopenic obesity (SO) in Brazilian older adults. METHODS: this systematic review was based on searches of the databases PubMed, Science Direct, Excerpta Medica Database (Embase), Web of Science, Scientific Electronic Library Online (SciELO), and Scopus. The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). The inclusion criteria were: original articles of observational design that evaluated the presence of sarcopenic obesity in Brazilian older adults (≥60 years). Therefore, studies that investigated only obesity or sarcopenia, animal studies, review studies, congress publications, theses, dissertations, book chapters, editorials, letters to the editor, and newspaper articles were not included. RESULTS: The initial screening identified 549 records. After removing the duplicates, assessing the titles and abstracts, and the complete analysis of the papers, 12 studies were included in the review. The sample size of the studies ranged from 56 to 1373 subjects, most of them selected by convenience sampling (n = 11) and exclusively with women (n = 9). The prevalence of SO varied from 4.4% to 48.4%. No consensus was found on the diagnostic criteria for SO. The main associations identified were between SO and decrease in muscle strength, aerobic fitness, gait speed, and increase in frequency of frailty and cardiometabolic and inflammatory alterations. CONCLUSIONS: Epidemiological studies conducted so far in Brazil are heterogeneous, which limits the possibility of comparison between prevalence and distribution of sarcopenic obesity among older adults. Further studies with representative samples of the population are required to understand the magnitude of SO in this group.

Fruit and vegetable consumption among older adults: influence of urban food environment in a medium-sized Brazilian city.

OBJECTIVE: To examine the association between urban food environment and regular consumption of fruits and vegetables (FV) by older adults from a medium-sized Brazilian city. DESIGN: Cross-sectional study based on data related to (1) objective assessment of establishments with predominant sale of unprocessed/minimally processed foods, mixed establishments and establishments with predominant sale of ultra-processed foods; (2) regular consumption of FV (≥ 5 times/week), health and socio-demographic variables of community-dwelling older adults. Tertiles of proximity between food establishments and older adults' residence were calculated. Poisson generalised estimating equations with robust variance, adjusted for individual and contextual variables, were used to estimate the independent association between the proximity of establishments and regular consumption of FV. SETTING: Medium-sized Brazilian city. SUBJECTS: Representative sample of community-dwelling older adults (n 549). RESULTS: Older adults travelled the longest distances to establishments with predominant sale of unprocessed/minimally processed foods. The longer the distance to establishments with predominant sale of unprocessed/minimally processed foods, the lower the prevalence of regular consumption of FV (tertile 2: prevalence ratio (PR) = 0·86; 95 % CI = 0·74, 0·99; tertile 3: PR = 0·84; 95 % CI = 0·72, 0·97). Older adults living larger distance tertiles from establishments with predominant sale of ultra-processed foods, mixed establishments or all categories of establishments had 16 % (PR = 0·84; 95 % CI = 0·73, 0·96), 19 % (PR = 0·81; 95 % CI = 0·71, 0·93) and 19 % (PR = 0·81; 95 % CI = 0·70, 0·94) lower prevalence of regular consumption of FV, respectively. CONCLUSION: The food environment is associated with regular consumption of FV among older adults. Longer distances from the residence of older adults to food establishments are independently associated with lower prevalence of regular consumption of FV.

Socioeconomic Disparities in the Community Food Environment of a Medium-Sized City of Brazil.

Objective: The purpose of this ecological study was to characterize the community food environment according to the socioeconomic condition of census tracts (CTs) in the urban area of a medium-sized city of southeastern Brazil in 2016.Method: Food establishments were identified on the streets covered by raters and information about type was collected through objective assessment. Geocoding was carried out from address observed by raters. 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. The distribution of the number of establishments, by category, was evaluated according to tertiles of per capita income of the CT. The kernel estimation was used to analyze the density of establishments by category. The spatial pattern of the categories of establishments was investigated using the univariate Ripley's K-function.Results: A total of 656 establishments were evaluated. In all, 11.1% had predominant sale of natural or minimally processed foods, 44.5% were mixed, and 44.4% had predominant sale of ultra-processed foods. The average of establishments with predominant sale of natural or minimally processed foods, of ultra-processed foods, and all categories increased according to the income of the CT. There was a clustering of all categories of establishments in high-income CTs downtown. However, peripheral and low-income CTs were composed of a higher number of mixed establishments or those with predominant sale of ultra-processed foods than establishments with predominant sale of natural or minimally processed foods.Conclusions: On average, the number of all categories of establishments increased according to the per capita income of the CT and were clustered in central and higher-income regions of the city. These findings may have practical implications for the development of public policies to increase the availability of healthy foods and to reduce the sale of unhealthy foods.