Academic trajectory of Prof. Ana Marlúcia Oliveira: contributions to the field of food and nutrition in Brazil. / Trajetória acadêmica da Profa. Ana Marlúcia Oliveira: contribuições para o campo da alimentação e nutrição no Brasil.

It will be presented the main academic contributions of Professor Ana Marlúcia Oliveira (AMO) (in memoriam), nutritionist, professor at the School of Nutrition at the Federal University of Bahia, Ph.D. in epidemiology and CNPQ Researcher level A, from 1980 to 2021. Professor Ana accumulated, throughout her academic career, scientific articles published in national and international journals; book and book chapters authored by her; papers presented at scientific events, in addition to guiding scientific projects, dissertations and theses. She has coordinated several research projects in the field of food and nutrition in public health, with a focus on nutritional epidemiology. The scope of the subjects addressed in her scientific production expressed the concern that mobilized her around the production of knowledge to face the complex health and nutrition problems in Brazil. Her way of being in the world, welcoming and caring for people who approached her seeking qualification opportunities, her example, words and teachings influenced, and still influence, the trajectory and training of nutritionists, professors and researchers at ENUFBA and other national and international institutions. She was a Brazilian researcher and intellectual committed to the health of the most vulnerable populations and the fight against malnutrition and hunger in our country. Her wide and fruitful work left us a legacy to be remembered and continued. Some of her friends, colleagues and collaborators pay this tribute to her memory, to her example and to the legacy she left for all of us and future generations.

São apresentadas neste artigo as principais contribuições acadêmicas da Profa. Marlúcia Oliveira (AMO) (in memoriam), nutricionista, docente da Escola de Nutrição da Universidade Federal da Bahia, Doutora em Epidemiologia e Pesquisadora A do Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPQ), no período de 1980 a 2021. A Profa. Ana acumulou, ao longo de sua carreira acadêmica, artigos científicos publicados em periódicos nacionais e internacionais; livro e capítulos de livro de sua autoria; trabalhos apresentados em eventos científicos, além de ter orientado projetos de iniciação científica, dissertações e teses. Coordenou vários projetos de pesquisa no campo da alimentação e nutrição em saúde coletiva, com foco na epidemiologia nutricional. O escopo dos assuntos abordados na sua produção científica expressou a inquietude que a mobilizava em torno da produção de conhecimentos para o enfrentamento dos complexos problemas de saúde e nutrição do Brasil. Sua forma de ser no mundo, acolhendo e cuidando das pessoas que se aproximavam em busca de oportunidades de qualificação, seu exemplo, suas palavras e ensinamentos influenciaram, e ainda influenciam, a trajetória e a formação de nutricionistas e de professores e pesquisadores na Escola de Nutrição da Universidade Federal da Bahia (ENUFBA) e em outras instituições nacionais e internacionais. Trata-se de uma pesquisadora e intelectual brasileira comprometida com a saúde das populações mais vulneráveis e com o combate contra a desnutrição e a fome no nosso país. Sua vasta e fecunda obra nos deixou um legado a ser lembrado e continuado. Alguns dos seus amigos, colegas e colaboradores prestam este tributo à sua memória e ao legado que ela deixou para todos nós e para as próximas gerações.

Trajetória acadêmica da Profa. Ana Marlúcia Oliveira: contribuições para o campo da alimentação e nutrição no Brasil / Academic trajectory of Prof. Ana Marlúcia Oliveira: contributions to the field of food and nutrition in Brazil

RESUMO São apresentadas neste artigo as principais contribuições acadêmicas da Profa. Marlúcia Oliveira (AMO) (in memoriam), nutricionista, docente da Escola de Nutrição da Universidade Federal da Bahia, Doutora em Epidemiologia e Pesquisadora A do Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPQ), no período de 1980 a 2021. A Profa. Ana acumulou, ao longo de sua carreira acadêmica, artigos científicos publicados em periódicos nacionais e internacionais; livro e capítulos de livro de sua autoria; trabalhos apresentados em eventos científicos, além de ter orientado projetos de iniciação científica, dissertações e teses. Coordenou vários projetos de pesquisa no campo da alimentação e nutrição em saúde coletiva, com foco na epidemiologia nutricional. O escopo dos assuntos abordados na sua produção científica expressou a inquietude que a mobilizava em torno da produção de conhecimentos para o enfrentamento dos complexos problemas de saúde e nutrição do Brasil. Sua forma de ser no mundo, acolhendo e cuidando das pessoas que se aproximavam em busca de oportunidades de qualificação, seu exemplo, suas palavras e ensinamentos influenciaram, e ainda influenciam, a trajetória e a formação de nutricionistas e de professores e pesquisadores na Escola de Nutrição da Universidade Federal da Bahia (ENUFBA) e em outras instituições nacionais e internacionais. Trata-se de uma pesquisadora e intelectual brasileira comprometida com a saúde das populações mais vulneráveis e com o combate contra a desnutrição e a fome no nosso país. Sua vasta e fecunda obra nos deixou um legado a ser lembrado e continuado. Alguns dos seus amigos, colegas e colaboradores prestam este tributo à sua memória e ao legado que ela deixou para todos nós e para as próximas gerações.

RESUMO It will be presented the main academic contributions of Professor Ana Marlúcia Oliveira (AMO) (in memoriam), nutritionist, professor at the School of Nutrition at the Federal University of Bahia, Ph.D. in epidemiology and CNPQ Researcher level A, from 1980 to 2021. Professor Ana accumulated, throughout her academic career, scientific articles published in national and international journals; book and book chapters authored by her; papers presented at scientific events, in addition to guiding scientific projects, dissertations and theses. She has coordinated several research projects in the field of food and nutrition in public health, with a focus on nutritional epidemiology. The scope of the subjects addressed in her scientific production expressed the concern that mobilized her around the production of knowledge to face the complex health and nutrition problems in Brazil. Her way of being in the world, welcoming and caring for people who approached her seeking qualification opportunities, her example, words and teachings influenced, and still influence, the trajectory and training of nutritionists, professors and researchers at ENUFBA and other national and international institutions. She was a Brazilian researcher and intellectual committed to the health of the most vulnerable populations and the fight against malnutrition and hunger in our country. Her wide and fruitful work left us a legacy to be remembered and continued. Some of her friends, colleagues and collaborators pay this tribute to her memory, to her example and to the legacy she left for all of us and future generations.

Weight stigma in the COVID-19 pandemic: a scoping review.

BACKGROUND: Weight stigma is a phenomenon associated with adverse behavioural and psychological consequences. Although experts suggest that its increase during the COVID-19 pandemic may be associated with worse health outcomes for people with obesity, a thorough analysis of the main findings and gaps is still needed when relating to this subject. OBJECTIVE: We aim to answer three questions: (1) How does weight stigma manifest in the COVID-19 pandemic? (2) How can weight stigma affect people with overweight or obesity in times of COVID-19? (3) What are the perceptions and experiences of weight stigma during the pandemic in individuals who experience overweight or obesity? METHODS: We conducted a scoping review of studies addressing weight stigma and the COVID-19 pandemic in electronic databases (Medline/PubMed, CINAHL, Embase, PsycInfo, BVS/Lilacs, Scopus, Web of Science, Google Scholar, and OpenGrey) published until 10th August 2021. All relevant studies were reviewed in full by two researchers. In addition, a narrative synthesis of the data was performed. RESULTS: The results included 35 studies out of 8,090 records and identified 13 original research publications, 14 text and opinion papers, and 6 narrative reviews. The results revealed the presence of weight stigma in the media, healthcare settings, interpersonal relationships, and public campaigns during the COVID-19 pandemic. The evidence of increasing weight stigma in the COVID-19 outbreak is limited, though. Many weight discrimination consequences were described during this time, such as impairment in accessing healthcare, worst COVID-19 outcomes, and maladaptive eating. However, only maladaptive behaviours and decline in mental health outcomes were demonstrated empirically in all age groups. This effect occurred regardless of body mass index, but people with high body weight were more likely to experience weight stigma. For some people with obesity, weight stigma in the pandemic has made activities of daily routine difficult. CONCLUSIONS: The results suggest that weight stigma in the COVID-19 pandemic occurs in several settings; moreover, although weight discrimination impacts mental health, whether before or during the pandemic, this influence between the pandemic and pre-pandemic scenario is still unclear. Therefore, more research is required in this field while the pandemic lasts, especially with people with obesity. Overall, people with overweight or obesity are more vulnerable to weight stigma than individuals without overweight. In addition, weight stigma refers to discrimination or prejudice based on a person's weight and relates to several consequences, for instance, poor healthcare treatment and mental health problems. In the COVID-19 outbreak, these weight stigma effects tend to become even more critical because they may be associated with unfavourable COVID-19 outcomes and eating disorder risks. Thus, it is crucial to investigate how weight stigma occurs during the pandemic and its impact on health, mainly for the most affected people. We investigated 35 studies published between 2019 and 2021 to map and explore how weight stigma was manifested and the related consequences for people with overweight or obesity in the COVID-19 pandemic. Only about a third of them were quantitative or qualitative, limiting the evidence of weight stigma in the COVID-19 context. The available evidence suggests that weight stigma manifests in several settings such as media, healthcare, public campaigns, and is more common in people with excess weight. However, weight discrimination experiences before or during the pandemic were associated with adverse psychological and behavioural consequences across all age groups, regardless of body weight. For some people with obesity, for instance, weight stigma made it difficult to accomplish their activities of daily routine. Nevertheless, it remains unclear whether weight stigma has increased in the pandemic, thus, more studies are required, especially about people with overweight or obesity.

Prevalência e fatores associados ao excesso de peso em adolescentes de Salvador, Bahia, Brasil / Prevalence and associated factors of surplus weight in adolescents from Salvador, Bahia, Brazil

OBJETIVO: Estimar a prevalência e identificar fatores associados ao excesso de peso em adolescentes. MÉTODOS: Trata-se de um estudo transversal. Foram selecionados 426 adolescentes de 10 a 18 anos, da cidade de Salvador, região Nordeste do Brasil, por um processo de amostragem por conglomerados, aleatória em três estágios. Os dados sobre a frequência de consumo alimentar e atividade física, maturação sexual, medidas antropométricas e covariáveis foram coletados. O estado nutricional foi classificado por meio dos pontos de corte baseados no índice de massa corporal de crianças e adolescentes brasileiros. As características sexuais secundárias foram autorreferidas pelos avaliados. Os adolescentes que realizaram mais de 300 minutos de atividade física moderada por semana, foram considerados fisicamente ativos. A etnia foi classificada pela cor da pele e atributos físicos. RESULTADOS: A prevalência de excesso de peso para ambos os sexos foi de 14,3 por cento. Estimou-se que a maturação sexual precoce (Razão de Prevalência ajustada = 2,12, IC95 por cento = 1,10-4,05) e insuficientes níveis de atividade física (RP ajustada = 1,85, IC95 por cento = 1,01-3,41), ajustados pela idade (RP ajustada = 1,77, IC95 por cento = 0,97-3,24), são associados, de forma independente, ao excesso de peso em adolescentes de Salvador. CONCLUSÕES: O excesso de peso pode ser considerado elevado entre os adolescentes da cidade de Salvador. Consideram-se necessárias a adoção de políticas públicas de prevenção e combate precoce ao excesso de peso corporal que melhorem o estimulo, disponibilidade e acesso à prática continuada e sistemática da atividade física em nível populacional.

OBJECTIVE: To estimate the prevalence and identify associated factors of surplus weight in adolescents. METHODS: a cross-sectional study design was employed. 426 adolescents, 10 to 18 years old, from the city of Salvador, northeast region of Brazil were selected in a three stage stratified random sampling scheme. Data on the frequency of food consumption and physical activity, sexual maturation, anthropometric measurements and covariates were collected. The nutritional status was classified with cutoff points based on body mass index mean values from Brazilian children and adolescents, while the secondary sexual characteristics were self-reported. The adolescents who performed more than 300 minutes of moderate physical activity per week were considered physically active. Ethnicity was classified by skin color and physical attributes. RESULTS: Total prevalence of surplus weight was of 14.3 percent. Early sexual maturation (Prevalence Rate - /PR/_adjusted =2.12, /CI95 percent/=1.10-4.05) and physical inactivity (/PR/_adjusted =1.85, /CI95 percent/=1.01-3.41), adjusted for age (PR/ adjusted =1.77, /CI0.97 percent/=3.24) were independently associated with surplus weight in adolescents from Salvador, Bahia. CONCLUSIONS: Surplus weight was high among adolescents in Salvador. Public prevention policies should be adopted in order to early prevent surplus weight through improved encouragement to continuous and systematic practice of physical activity at population level.

[Change in anthropometric parameters: the impact of a nutritional intervention program and physical exercise on adult women]. / Mudança nos parâmetros antropométricos: a influência de um programa de intervenção nutricional e exercício físico em mulheres adultas.

Obesity prevalence is increasing worldwide, with inadequate nutrition and physical inactivity as the main risk factors. The objective was to evaluate the impact of a nutritional intervention and physical activity program on body mass index (BMI) and waist circumference (WC) in adult women. This quasi-experimental study, lasting 12 months, enrolled 69 adult women that reported physical activity three times a week, besides receiving nutritional counseling and lectures on healthy living, evaluated at baseline and at 6 and 12 months of follow-up. Lower levels of physical activity and higher intake of high-risk foods were associated with a 2.28 cm increase in mean WC, has compared to higher physical activity and lower intake of high-risk foods (p < 0.01). Lower levels of physical activity associated with high intake of protective foods increased the mean BMI by 0.68 kg/m(2), as compared to higher physical activity and high intake of protective foods. The intervention was positively associated with the target parameters.

Mudança nos parâmetros antropométricos: a influência de um programa de intervenção nutricional e exercício físico em mulheres adultas / Change in anthropometric parameters: the impact of a nutritional intervention program and physical exercise on adult women

A obesidade apresenta ocorrência crescente em todo o mundo, sendo alimentação inadequada e sedentarismo seus importantes fatores de risco. O objetivo foi avaliar a influência de um programa de intervenção nutricional e exercício físico sobre o índice de massa corporal (IMC) e circunferência da cintura (CC) de mulheres adultas. Trata-se de um estudo quasi-experimental, duração de 12 meses, participando 69 mulheres adultas, submetidas à atividade física três vezes na semana, orientação nutricional e palestras sobre vida saudável, avaliadas ao início, 6 e 12 meses do seguimento. Menores níveis de atividade física e alto consumo de alimentos de risco elevaram em 2,28cm a média da CC das mulheres, quando comparado àquelas que tiveram maiores níveis de atividade física e baixo consumo de alimentos de risco (p < 0,01). Menores níveis de atividade física associados ao elevado consumo de alimentos protetores aumentaram a média do IMC em 0,68 kg/m², em comparação com maiores níveis de atividade física e alto consumo de alimentos protetores. A intervenção mostrou associação positiva com os parâmetros avaliados.

Obesity prevalence is increasing worldwide, with inadequate nutrition and physical inactivity as the main risk factors. The objective was to evaluate the impact of a nutritional intervention and physical activity program on body mass index (BMI) and waist circumference (WC) in adult women. This quasi-experimental study, lasting 12 months, enrolled 69 adult women that reported physical activity three times a week, besides receiving nutritional counseling and lectures on healthy living, evaluated at baseline and at 6 and 12 months of follow-up. Lower levels of physical activity and higher intake of high-risk foods were associated with a 2.28cm increase in mean WC, has compared to higher physical activity and lower intake of high-risk foods (p < 0.01). Lower levels of physical activity associated with high intake of protective foods increased the mean BMI by 0.68kg/m², as compared to higher physical activity and high intake of protective foods. The intervention was positively associated with the target parameters.

[Factors associated with overweight and abdominal fat in adults in Salvador, Bahia State, Brazil]. / Fatores associados a excesso de peso e concentração de gordura abdominal em adultos na cidade de Salvador, Bahia, Brasil.

This cross-sectional study of 570 adults aimed to identify factors associated with overweight and abdominal fat in adults of both sexes in the city of Salvador, Bahia State, Brazil. Body mass index (BMI) and waist circumference were the dependent variables, and Poisson regression was used for statistical analysis. For women, high BMI and waist circumference were associated with increased age and current dieting (< or = 3 meals a day), while family history of obesity was only associated with increased BMI. In men, BMI increased in the 30-39 and 50-59-year age brackets. Waist circumference increased in association with < or = 3 meals a day, arterial hypertension, and alcohol consumption, and was lower among blacks and mixed-race individuals. High BMI and waist circumference were both associated with family history of myocardial infarction. Thus, factors associated with overweight and abdominal fat differ between men and women, but adopting healthier lifestyles can help modify many of these factors.

Fatores associados a excesso de peso e concentração de gordura abdominal em adultos na cidade de Salvador, Bahia, Brasil / Factors associated with overweight and abdominal fat in adults in Salvador, Bahia State, Brazil

O objetivo foi identificar os fatores associados ao excesso de peso e concentração de gordura abdominal em adultos de ambos os sexos. Um estudo transversal envolvendo amostra representativa de 570 adultos de Salvador, Bahia, Brasil. A regressão de Poisson foi utilizada na análise, adotando-se o índice de massa corporal (IMC) e a circunferência da cintura como variáveis dependentes. Para as mulheres, a inadequação do IMC e da circunferência da cintura ocorreu com o aumento da idade e entre as que faziam dieta no momento do estudo, a história familiar de obesidade associou-se apenas com o IMC elevado. Para os homens, o IMC elevou-se na faixa etária de 30 a 39 e 50 a 59 anos. A circunferência da cintura elevou-se com a realização de três ou menos refeições-dia, com a hipertensão arterial, uso de bebida alcoólica e diminuiu entre mulatos e negros. Tanto IMC quanto circunferência da cintura elevaram-se com a historia familiar de infarto. Portanto são distintos os fatores que se associam ao excesso de peso e da gordura abdominal em homens e mulheres. Mas muitos deles podem ser modificados com a adoção do estilo de vida saudável.

This cross-sectional study of 570 adults aimed to identify factors associated with overweight and abdominal fat in adults of both sexes in the city of Salvador, Bahia State, Brazil. Body mass index (BMI) and waist circumference were the dependent variables, and Poisson regression was used for statistical analysis. For women, high BMI and waist circumference were associated with increased age and current dieting (< 3 meals a day), while family history of obesity was only associated with increased BMI. In men, BMI increased in the 30-39 and 50-59-year age brackets. Waist circumference increased in association with < 3 meals a day, arterial hypertension, and alcohol consumption, and was lower among blacks and mixed-race individuals. High BMI and waist circumference were both associated with family history of myocardial infarction. Thus, factors associated with overweight and abdominal fat differ between men and women, but adopting healthier lifestyles can help modify many of these factors.

Determinants of mild-to-moderate malnutrition in preschoolers in an urban area of Northeastern Brazil: a hierarchical approach.

OBJECTIVE: To investigate the determinants of mild-to-moderate malnutrition in preschoolers. DESIGN: Cross-sectional study conducted in October and November 1996, with a representative sample of 1740 children less than 5 years old from the city of Salvador, situated in the Brazilian Northeastern region. Socio-economic and dietary data were collected through a structured questionnaire. Anthropometric measures were performed in duplicate and data analysis was based upon the hierarchical model approach. Logistic regression analysis was used to estimate the prevalence ratio and to identify the determinants of mild-to-moderate deficits in weight-for-age and height-for-age Z-scores. RESULTS: Family monthly income under US$67.00 per capita and family headed by a woman were the main basic determinants of mild-to-moderate weight-for-age and height-for-age deficits in the studied children. Household agglomeration, an underlying determinant, was associated with weight-for-age and height-for-age deficits. Among the immediate determinants, age above 6 months and dietary caloric availability in the lowest tertile (<930 kcal day-1) were also associated with weight-for-age deficits. In addition to these, hospitalisation in the 12 months preceding the interview was shown to be a predictor of mild-to-moderate weight-for-age and height-for-age deficits. CONCLUSION: Adverse social and economic factors interact with family environmental factors to define food consumption and morbidity patterns that culminate in a high prevalence of mild-to-moderate malnutrition. The strengthening and restructuring of nutrition and healthcare actions, the definition of public policies that improve family income, and the adequate insertion of women in the labour market are possible strategies to reduce mild-to-moderate malnutrition and to sustain the decline already observed in severe malnutrition.

Desigualdade, pobreza e condições de saúde e nutrição na infância no Nordeste brasileiro / Inequality, poverty, and childhood health and nutritional conditions in Northeast Brazil

Estudo transversal, envolvendo 2.001 crianças das áreas rural e urbana de dez municípios da Bahia, Brasil. Avalia-se a relação entre os gradientes da desigualdade e os fatores do ambiente familiar, de saúde e nutrição, utilizando-se a regressão logística multinomial multivariada. As crianças do tercil intermediário das condições de vida e aquelas do tercil mais pobre têm chances significantes e crescentes de viverem na área rural, em domicílio chefiado pela mulher, ter o pai desempregado, mãe com baixa escolaridade, de dormir com mais de uma pessoa na mesma cama, déficit linear grave e consumir retinol abaixo da mediana. A existência de mais de uma criança no domicílio, ser portadora de déficit ponderal e ter o consumo de lipídeo abaixo da mediana foram eventos também significantes para as crianças mais pobres. A anemia foi identificada entre as crianças do tercil intermediário. A desigualdade expõe as crianças a chances crescentes de inadequado estado de saúde e nutrição. Políticas de saúde podem implementar medidas emergenciais no sentido de minimizar os males impostos pela desigualdade à saúde e nutrição na infância.

This cross-sectional study analyzes the relationship between gradients of social inequalities and the household environment and health and nutritional conditions among 2,001 preschool children in ten counties (municipalities) in the State of Bahia, Brazil. The analysis used multinomial multivariate logistic regression. Children in the middle and lower tertiles on the poverty scale had significant and increasing odds of living in a household headed by a woman, an unemployed father, a mother with £ years of schooling, more than one child sharing the same bed, severe stunting, and retinol consumption below the median as compared to those in the upper tertile. More than one child in the home, weight deficit, and lipid consumption below the median were also significantly associated with the poorest tertile. Specific emergency health policies and measures must be implemented to minimize the burden imposed by poverty and social inequalities on childhood health and nutrition.

[Inequality, poverty, and childhood health and nutritional conditions in Northeast Brazil]. / Desigualdade, pobreza e condições de saúde e nutrição na infância no Nordeste brasileiro.

This cross-sectional study analyzes the relationship between gradients of social inequalities and the household environment and health and nutritional conditions among 2,001 preschool children in ten counties (municipalities) in the State of Bahia, Brazil. The analysis used multinomial multivariate logistic regression. Children in the middle and lower tertiles on the poverty scale had significant and increasing odds of living in a household headed by a woman, an unemployed father, a mother with

Childhood anemia prevalence and associated factors in Salvador, Bahia, Brazil.

A cross-sectional study was conducted in 1996 to estimate the prevalence of anemia in a stratified sample of 603 preschool children and identify factors associated with the disease. Hemoglobin assays were conducted in finger-prick blood samples using a Hemocue hemoglobinometer. Anemia was defined as hemoglobin below 11.0 g/dl. Logistic regression analysis was used to evaluate the potential associations. Observed anemia prevalence was 46.3%. Associated factors were: the 6-12-month and 12-24-month age brackets, the lowest tertiles for iron density and protein content dietary intake, and any degree of deficit in the height-for-age anthropometric parameter. Inadequate physical, sanitary, and environmental conditions in the home were associated with a significantly increased risk of anemia. Anemia constitutes an important health problem in this study's child population. Improvements in living conditions and dietary quality could contribute to a reduction in anemia prevalence.

Childhood anemia prevalence and associated factors in Salvador, Bahia, Brazil

Este é um estudo transversal, realizado na cidade de Salvador, Bahia, Brasil, em 1996, envolvendo 603 pré-escolares com o objetivo de estimar a prevalência e identificar os fatores associados à ocorrência da anemia. A concentração da hemoglobina foi determinada utilizando-se o hemoglobinômetro (Hemocue). Níveis de hemoglobina abaixo de 11,0g/dl caracterizaram a anemia. Utilizou-se a análise de regressão logística para avaliar as associações de interesse. A prevalência da anemia foi de 46,3 por cento. As faixas etárias de 6 a 12 e 12 a 24 meses, a densidade de ferro e a quantidade de proteína, situados no terceiro tercil da distribuição de consumo e quaisquer níveis de inadequação da altura em relação à idade constituíram-se em fatores de risco para a ocorrência da anemia. Inadequadas condições físicas, sanitárias e ambientais do domicilio imprimiram riscos crescentes e significantes na ocorrência da anemia A anemia é um importante problema de saúde nas crianças investigadas. Melhorias das condições de moradia e da qualidade da dieta consumida podem contribuir para diminuir a ocorrência da enfermidade.