Relationship between stature, overweight and central obesity in the adult population in São Paulo, Brazil.

OBJECTIVE: To test association between overweight, central obesity and stature. DESIGN: Cross-sectional study carried-out between 1990-1991. SUBJECTS: 951 adults (387 male and 564 female) aged 20-64 y, resident in the metropolitan area of São Paulo, Brazil. MEASUREMENTS: Anthropometry, blood lipid concentrations (total, high density lipoprotein (HDL) and low density lipoprotein (LDL)-cholesterol, triglycerides (TGs) and blood glucose. Body mass index (BMI), waist-to-hip ratio (WHR) and waist circumference were used to identify overweight (BMI > 25 kg/m2), abdominal obesity (WHR tertile 3 and waist circumference tertile 3), respectively. The subjects were categorised as those of short stature (women < 150 cm, men < 162cm) and those of normal stature (women > or = 150 cm, men > or = 162 cm). RESULTS: Prevalence of short stature was 19.6% and 15.4% in men and women, respectively. Short stature women had higher serum concentrations of total cholesterol, LDL-cholesterol, TGs and glucose than those of normal stature. Among men, this difference was not observed, except for glucose concentrations. Short stature women had high BMI and WHR means in some age categories, compared with those of normal stature. Both overweight and high WHR frequencies were greater in short stature women than in those of normal ones. In multivariate analysis, adjusted by age, income, marital status, education, physical activity and tobacco use, only women group with short stature compared with normal stature had significantly risk of overweight an high WHR. In the same group there was no association with waist circumference. Among the men there was significant opposite association with waist circumference. CONCLUSION: Short stature in women can potentially be an independent risk factor for overweight and high WHR.

[Nutritional status of social groups in greater metropolitan São Paulo, Brazil]. / Estado Nutricional de grupamentos sociais da área metropolitana de São Paulo, Brasil.

This paper focuses on prevalence of nutritional status (Body Mass Index, BMI) in social groups in greater metropolitan São Paulo, in Southeastern Brazil. The population was stratified in four socioeconomic groups. Prevalence of malnutrition (BMI<18.5kg/m2), low body mass (BMI<20.0kg/m2), and overweight (BMI>25.0kg/m2) and obesity (BMI(30.0kg/m2) were calculated. Prevalence of malnutrition was 3.9% in men and 6.2% in women. Prevalence of overweight ranged from 27.5% to 34.1% in men and from 25.8% to 43.6% in women. Obesity ranged from 2.5% to 11.1% in men and from 7.1% to 20.5 in women. Prevalence of overweight and obesity was greater among women than men (p<0.01). In relation to excess weight (BMI>25.0kgm/2), the study showed that prevalence in men was 43, 51, 35, and 30% for strata I, II, III, and IV, respectively. Among women, prevalence was 12, 61, 55 and 46% for strata I, II, III, and IV, respectively. In women there were an abrupt increase in excess weight just before 40 years of age. A high percentage of overweight and obesity was observed in all population groups.

[Regular diet and cardiovascular disease risk factors]. / Dieta habitual e fatores de risco para doenças cardiovasculares.

INTRODUCTION: A survey by sampling in a county of the State of S. Paulo in 1990 sought, by means of home interviews, to analyse the habitual diet and risk factors for cardiovascular disease of people over 20 years of age. METHODOLOGY: Of the sub-specimen of a comprehensive study population, 557 individuals, aged between 20 and 88, were interviewed. The habitual diet, characterized by the dietary history, was compared with the recommendations on energy and nutrients of the WHO and the risk factors (obesity, lipemic disorders and diabetes mellitus) diagnosed by the Body Mass Index and biochemical measurements. RESULTS AND CONCLUSIONS: It was observed that 60% of the population consume a diet with total energy below the estimated need and that the caloric contribution of carbohydrates was of 56%, of the lipids 29% and of the proteins 15%. However, by percentile analysis, the caloric contribution of lipids and of proteins was far above the recommended levels to the detriment of the carbohydrates. Energy, caloric distribution and quantity of cholesterol were satisfactory in only 5% of diets. Among the risk factors for the cardiovascular disease studied, obesity was found to be present in 38% of individuals, lipemic disorders in 26% and diabetes mellitus in 5%. Preponderantly light physical activity together with unsatisfactory diet, both in qualitative as in quantitative terms, aggravated this scenario still further.

[Vitamin and mineral intake of adults living in a metropolitan area of São Paulo, Brazil]. / Consumo alimentar de vitaminas e minerais em adultos residentes em área metropolitana de São Paulo, Brasil.

OBJECTIVE: The objective of the study is to quantify mineral and vitamin concentration in habitual diet of adults of between 20 and 88 years of age. A dietary survey was carried out between 1990-1991 as a part of the cross-sectional study: "Atherosclerotic cardiovascular disease, lipemic disorders, hypertension, obesity and diabetes mellitus in a population of the metropolitan area of S. Paulo, Brazil". MATERIAL AND METHOD: The vitamin and mineral intake was examined in relation to age and sex using dietary intake based on the diet history method. Data were obtained from a sub-sample of 548 individuals. RESULTS AND CONCLUSION: In general, it was observed that the respective intakes of thiamin, riboflavin, niacin, calcium and iron were more concentrated in the men's diet than in that of the women (p < 0.001). There are no statistical differences in the intake of vitamin A and vitamin C by sex. Elderly persons presented a lower intake of vitamins and minerals than did younger people. The intake of vitamin C had no association with age. This cross-sectional study showed that the habitual diet of the residents in the study area has low intake and low density of vitamin A and calcium.

[Atherosclerotic cardiovascular disease, lipemic disorders, hypertension, obesity and diabetes mellitus in the population of a metropolitan area of southeastern Brazil. III--Hypertension]. / Doenças cardiovasculares ateroscleróticas, dislipidemias, hipertensão, obesidade e diabetes melito em população da área metropolitana da região sudeste do Brasil. III--Hipertensão.

OBJECTIVE: The prevalencies of hypertension are analysed by sex and age group, in social groupings established in accord with social criteria. With a view better to understanding the social dimension of the disease, prevalencies were characterised by type of occupation. MATERIAL AND METHODS: The sample consisted of 1,041 people and corresponds to the sum of the samples representing the "study areas" established by the use of socio-economic and geographical criteria. Four social strata were defined in obedience to a socioeconomic gradient. Hypertension was defined by the Joint National Committee (JNC), 140/90 mmHg, and of the World Health Organization (WHO), 160/95 mmHg, standard references. RESULTS: According to the JNC and WHO standard references the prevalencies of hypertension, age adjusted, were of approximately the following: stratum (I + II) 60 and 37%; stratum III 50 and 39%; stratum IV 55 e 46%. Among women the prevalencies were 40 and 38% (stratum I + II); 56 and 47% (stratum III) and 55 and 46% (stratum IV). For the men belonging to the economically active population, classified by occupation, it was showed that the freelance professionals, consisting of businessmen of small firms, small traders and liberal professionals, presented a prevalence of about 60 and 37%; the skilled workers, employed in factories of 35 and 14%; the daily freelance workers, unskilled laborers and unemployed, of 59 and 40%. The women were divided by occupation as belonging or not to the economically active population (EAP) and presented the following prevalencies: 39 and 47%, respectively, according to the JNC standard, and 27 and 45%, respectively, according to the WHO standard. Thus it may be seen that these results run counter to the hypothesis that women integrated into the labour market are more exposed to the risk factors for non-transmissible diseases. CONCLUSION: Thus it may be concluded that the categories most affected by the present economic were those most affected by hypertension. On the other hand the possibility of there being and a intense social determination in the etiology of hypertension in this population is demonstrated.

[Atherosclerotic cardiovascular disease, lipemic disorders, hypertension, obesity and diabetes mellitus in the population of a metropolitan area of southeastern Brazil. II--Lipemic disorders]. / Doenças cardiovasculares ateroscleróticas, dislipidemias, hipertensão, obesidade e diabetes melito em população da área metropolitana da região Sudeste Do Brasil: II--dislipidemias.

This study has sought to characterize the prevalence of lipemic disorders and other risk factors of atheroschlerotic cardiovascular disease in population groups of Cotia county in Greater S. Paulo, Brazil. The population groups were defined on the basis of socio-economic characteristics and geographical location within the county such as provided elements for the delimitation of the "study areas". A sample representative of each of these areas was taken, constituting in all 1,041 individuals. The data related to eating habits were collected from a sub-sample of 568 people. The lipemic disorders diagnosed were as follows: high risk hypercholesterolemias with values approximately 240 mg/dl for total cholesterol and approximately 160 mg/dl for LDL-cholesterol; borderline risk hypercholesterolemias with values > 200 mg/dl and > 130 mg/dl for total cholesterol and LDL-cholesterol respectively; hypertriglyceridemia, with values approximately 250 mg/dl. The following risk factors were included: atherogenic eating habits (consumption of proteins of animal origin, saturated fats and cholesterol), smoking, drinking, sedentary life style, obesity (IMC > 25 kg/m2), hypertension (140/90 mmHg) and diabetes mellitus (glycemia > 120 mg/dl). The results found were the following: 1--the average number of risk factors was significant by greater among men than among women, for the age groups below 50 years of age (p < 0.01): between 50 and 55 years of age they were equal for the two groups, reaching their greatest value at 60 years of age with a sharp reduction after this latter age as regard the men but presenting a constant gradual increase for the women; 2--the average number of risk factors increased with age for both sexes (p < 0.01); 3--the prevalences of high risk hypercholesterolemias together with hypertriglyceridemia (> = 250 mg/dl) were significantly greater in the classes of higher socio-economic level; 4--the lipemic profile associated with lipemic disorders show that these latter rarely occur with just one constituent in isolation; 5--when the high-risk hypercolesterolemias are added to the borderline cases accompanied by two or more risk factors and hypertriglyceridemia they give a total of 39.2% of men and 32.8% of women, that is to say, 35.4% of the sample need immediate clinical-educational intervention.