[Association between waist circumference and body mass index of Brazilian women: NDHS 2006]. / Associação entre circunferência da cintura e índice de massa corporal de mulheres brasileiras: PNDS 2006.

The scope of this study was to evaluate the association between waist circumference (WC) and body mass index (BMI) of Brazilian women of childbearing age studied in the most recent National Demographic and Health Survey (NDHS), in 2006. This study is an excerpt of the NDHS, which is a home-based cross-sectional study. The nutritional status of women was assessed by WC and BMI, considering excess weight to be BMI = 25 Kg/m2 and WC risk to be = 80 cm. To evaluate the statistical significance, Poisson Regression was applied to identify factors associated with WC risk in women with or without excess weight, presenting the p-value corresponding to the Wald test for heterogeneity or linear trend. Of the 14,101 women studied, 45.8% were overweight and 55.5% at WC risk. Regarding the association between BMI and WC, it was found that 23.5% of women who were not overweight showed WC risk. After a stratified analysis by BMI, the prevalence of WC risk among women without excess weight was greatest in the Northeast, 26.0%, and the Southeast, 24.5%, while the South region presented the lowest prevalence at 18.5%. It follows that the anthropometric WC and BMI measures should be used concomitantly since the use of only one of these measures may overlook individuals at risk for various diseases.

Associacao entre circunferencia da cintura e indice de massa corporal de mulheres brasileiras: PNDS 2006 / Association between waist circumference and body mass index of Brazilian women: NDHS 2006

O objetivo do estudo foi analisar a associação entre a circunferência da cintura (CC) e o índice de massa corporal (IMC) de mulheres brasileiras em idade fértil, estudadas na última Pesquisa Nacional de Demografia e Saúde (PNDS), no ano de 2006. Este estudo é um recorte da PNDS, a qual é um estudo seccional, de base domiciliar. O estado nutricional foi avaliado através do IMC e da CC, considerando-se excesso de peso IMC > 25 Kg/m2e CC de risco > 80 cm. Para a avaliação da significância estatística foi usada Regressão de Poisson, que identificou os fatores associados à CC de risco em mulheres com e sem excesso de peso, apresentando-se o valor p correspondente ao teste de Wald para heterogeneidade ou tendência linear. Das 14.101 mulheres estudadas, 45,8% apresentaram excesso de peso e 55,5% CC de risco. Em relação à associação entre IMC e CC, constatou-se que 23,5% das mulheres sem excesso de peso apresentavam CC de risco. Após análise estratificada pelo IMC, a prevalência de CC de risco entre as mulheres sem excesso de peso foi maior nas regiões Nordeste, 26,0%, e Sudeste, 24,5%, e menor na região Sul, 18,5%. Conclui-se que as medidas antropométricas IMC e CC devem ser empregadas concomitantemente, uma vez que a utilização isolada dessas medidas pode desprezar indivíduos com risco para várias patologias.

The scope of this study was to evaluate the association between waist circumference (WC) and body mass index (BMI) of Brazilian women of childbearing age studied in the most recent National Demographic and Health Survey (NDHS), in 2006. This study is an excerpt of the NDHS, which is a home-based cross-sectional study. The nutritional status of women was assessed by WC and BMI, considering excess weight to be BMI = 25 Kg/m2 and WC risk to be = 80 cm. To evaluate the statistical significance, Poisson Regression was applied to identify factors associated with WC risk in women with or without excess weight, presenting the p-value corresponding to the Wald test for heterogeneity or linear trend. Of the 14,101 women studied, 45.8% were overweight and 55.5% at WC risk. Regarding the association between BMI and WC, it was found that 23.5% of women who were not overweight showed WC risk. After a stratified analysis by BMI, the prevalence of WC risk among women without excess weight was greatest in the Northeast, 26.0%, and the Southeast, 24.5%, while the South region presented the lowest prevalence at 18.5%. It follows that the anthropometric WC and BMI measures should be used concomitantly since the use of only one of these measures may overlook individuals at risk for various diseases.

[Food intake among Brazilian children aged two to five years old: National Survey on Demography and Health (NSDH), 2006]. / Consumo alimentar entre crianças brasileiras de dois a cinco anos de idade: Pesquisa Nacional de Demografia e Saúde (PNDS), 2006.

The scope of this study was to describe aspects of the food intake of Brazilian children and its association with social and demographic factors. The 2006 food intake data of the National Survey on Demography and Health for women and children were analyzed. The analysis considered the complexity of the sample and included 3,083 children aged two to five years old. The outcome was evaluated by considering food intake markers. The estimates of these markers was described taking into account the children's gender, age and neighborhood as well as their mothers' age and education. Chi-square heterogeneity and linear tendency tests were used in the statistical analyses. It was seen that during the seven days before the interview 50% and 25.9% of the children evaluated, respectively, had not eaten greens and vegetables. In at least one day during the previous week the prevalence of consumption of fried food was of approximately 60% and for soda and artificial juice was of 82%. Female children whose mothers were older and had more education presented the highest prevalence in consumption of healthy food. As a result of these data, it is possible to say that the intensification of campaigns of nutritional education with innovatory approaches might help improve the food intake of children.

Consumo alimentar entre crianças brasileiras de dois a cinco anos de idade: Pesquisa Nacional de Demografia e Saúde (PNDS), 2006 / Food intake among Brazilian children aged two to five years old: National Survey on Demography and Health (NSDH), 2006

O objetivo deste estudo foi descrever características do consumo alimentar de crianças brasileiras e sua associação com fatores sociodemográficos. Foram analisados os dados de consumo alimentar da Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher realizada em 2006. A análise considerou a complexidade amostral e incluiu 3.083 crianças de dois a cinco anos de idade. O desfecho foi avaliado a partir de marcadores alimentares. As estimativas desses marcadores foram descritas segundo sexo e idade da criança, local de residência, idade e escolaridade materna. Nas análises estatísticas foram utilizados testes qui-quadrado de heterogeneidade e de tendência linear. Verificou-se que 50% e 25,9% das crianças avaliadas não haviam consumido verduras de folhas e legumes nos sete dias anteriores ao da entrevista, respectivamente. A prevalência de consumo de pelo menos um dia na última semana de frituras foi cerca de 60% e de refrigerantes e sucos artificiais foi de 82%. Crianças do sexo feminino, cujas mães possuíam maior idade e escolaridade, apresentaram as maiores prevalências de consumo de alimentos marcadores de alimentação saudável. Diante desses dados, a intensificação de campanhas de educação nutricional com abordagens inovadoras pode ajudar a melhorar a alimentação das crianças.

The scope of this study was to describe aspects of the food intake of Brazilian children and its association with social and demographic factors. The 2006 food intake data of the National Survey on Demography and Health for women and children were analyzed. The analysis considered the complexity of the sample and included 3,083 children aged two to five years old. The outcome was evaluated by considering food intake markers. The estimates of these markers was described taking into account the children's gender, age and neighborhood as well as their mothers' age and education. Chi-square heterogeneity and linear tendency tests were used in the statistical analyses. It was seen that during the seven days before the interview 50% and 25.9% of the children evaluated, respectively, had not eaten greens and vegetables. In at least one day during the previous week the prevalence of consumption of fried food was of approximately 60% and for soda and artificial juice was of 82%. Female children whose mothers were older and had more education presented the highest prevalence in consumption of healthy food. As a result of these data, it is possible to say that the intensification of campaigns of nutritional education with innovatory approaches might help improve the food intake of children.

Fatores associados à frequência de consumo de leites ou iogurtes em escolares de Pelotas-RS / Factors associated with intake frequency of milk or yogurt in school in Pelotas/RS

In this study, we aimed to describe the factors associated with intakefrequency of milk or yogurt by 1st to 4th grade elementary schoolchildren.A cross-sectional study was carried out with 356 schoolchildren in themunicipality of Pelotas, state of Rio Grande do Sul, in 2011. In order toassess the consumption of milk or yogurt, we used the Markers of DietaryIntake Form proposed by the System of Food and Nutrition Surveillance.Prevalence of frequent consumption of milk or yogurt (5 or more timesa week) was described according to gender, age, socioeconomic status,maternal education level, and nutritional status. For statistical significanceassessment, we used the chi-square test for heterogeneity and/orlinear trend (p<0.05). The prevalence of frequent consumption of milkor yogurt was 73.3% (IC95% 68.7 to 77.9). It was possible to observe thatthe frequent consumption of milk or yogurt showed a direct linear trendwith socioeconomic status and maternal education level. Milk intake isextremely important to ensure the formation and maintenance of bonemass. In this way, incentive programs for healthy practices, with emphasison food, during school hours must be strengthened.

El objetivo del estudio fue describir los factores asociados a la frecuencia del consumo de leche o yogurt en escolares de 1º a 4º año de la escuelaprimaria. Se realizó un estudio transversal, con 365 escolares, en la ciudad de Pelotas, Rio Grande do Sul, en 2011. Para la evaluación del consumode leche o yogurt se utilizó el Formulario de Marcadores de Consumo Alimentario, propuesto por el Sistema de Vigilancia Alimentaria yNutricional. Se describió la prevalencia del consumo frecuente de leche o yogurt (5 o más veces por semana) según el sexo, la franja etaria,el nivel socioeconómico, la escolaridad materna y el estado nutricional. La significancia estadística se evaluó con la prueba de Chi-cuadrado para laheterogeneidad y/o la tendencia linear (p<0,05). La prevalencia del consumo frecuente de leche o yogurt fue 73,3% (IC95% 68,7-77,9). Se Observó que el consumo frecuente de leche o de yogurt presentó una tendencia linear directa con el nivel socioeconómico y con la escolaridad materna. La ingestión de leche es extremadamente importante para garantizar la formación y el mantenimiento de la masa ósea. Por lo tanto, se concluye que deben fortalecerse los programas de incentivo a las prácticas saludables, con énfasis en la alimentación en el período escolar.

O objetivo deste estudo foi descrever os fatores associados à frequência do consumo de leite ou iogurte em escolares do 1º ao 4º ano do EnsinoFundamental. Foi realizado um estudo transversal, com 356 escolares, na cidade de Pelotas, Estado do Rio Grande do Sul, no ano de 2011.Para a avaliação do consumo de leite ou iogurte, foi utilizado o Formulário de Marcadores de Consumo Alimentar, proposto pelo Sistema deVigilância Alimentar e Nutricional. Foi descrita a prevalência do consumo frequente de leite ou iogurte (cinco ou mais vezes na semana), segundogênero, faixa etária, nível socioeconômico, escolaridade materna e estado nutricional. Para avaliar a significância estatística, foi utilizado teste de Qui-quadrado para heterogeneidade e/ou tendência linear (p<0,05). A prevalência de consumo frequente de leite ou iogurte foi 73,3% (IC95% 68,7-77,9). Observou-se que o consumo frequente de leite ou iogurte apresentou uma tendência linear direta com ?nível socioeconômico?e ?escolaridade materna?. A ingestão de leite é de extrema importância para garantir a formação e a manutenção da massa óssea. Desta maneira, programas de incentivo a práticas saudáveis, com ênfase na alimentação no período escolar, devem ser fortalecidos.

Consumo de refrigerantes e sucos artificiais por crianças menores de cinco anos: uma análise da Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher, 2006 / Soft drinks and artificial juices consumption by children under 5 years old: a National Research of Demography and Children and Women Health (NRDH), 2006

The aim of this study was to describe the consumption frequency of soft drinks and artificial juices by children under 5 years old and its associated factors. The food consumption data from the National Research of Demography and Health (NRDH) for children and women in 2006 was analyzed. The analysis considered the complexity of the sample and included 3789 children under 5 years old. The conclusion was assessed through questions that approached the frequency of soft drinks and artificial juices consumption seven days prior to the interview. The consumption frequency of soft drinks and artificial juices was described according to child's sex, age, nutritional status, area of residence and age, as well as to mother's education. More than 70% of the children consumed soft drinks and artificial juices at least once a week during the period surveyed. The prevalence of daily consumption of soft drinks and artificial juices was 22.1%. The only variables that were significantly associated (p<0,001) to the daily consumption of these beverages were child's age and area of residence. The daily consumption of soft drinks was larger among children who live in urban zones (25.3%), compared to those from the rural zone (9.1%). Child's age presented direct and meaningful association with the daily consumption of soft drinks and artificial juices. The prevalence of soft drinks and artificial juices by children under 5 years old assessed in the NRDH/2006 was high, and it was positively associated with the area of residence and age increase.

El objetivo de este estudio fue describir la frecuencia del consumo de bebidas gaseosas y jugos artificiales, y sus factores asociados, en niños menores de cinco años de edad. Fueron analizados los datos de consumo alimentar de la Encuesta Nacional de Demografía y Salud del Niño y de la Mujer (PNDS) del año 2006. El análisis consideró la complejidad de la muestra e incluyó 3789 niños menores de cinco años. El resultado fue evaluado a través de preguntas que abordaban la frecuencia del consumo de bebidas gaseosas y jugos artificiales en los siete días anteriores a la entrevista. La frecuencia de consumo de bebidas gaseosas y jugos artificiales fue descrita según sexo, edad y estado nutricional del niño, zona de residencia, edad y escolaridad materna. Más de 70% de los niños consumieron bebidas gaseosas y jugos artificiales por lo menos una vez a la semana. La prevalencia de consumo diario de bebidas gaseosas y jugos artificiales fue de 22,1%. Las únicas variables que se mostraron significativamente asociadas al consumo de esas bebidas (p<0,001) fueron "edad del niño" y "zona de residencia". El consumo diario de bebidas gaseosas y jugos artificiales fue mayor entre los niños que vivían en la zona urbana (25,3%), comparado con aquellos de la zona rural (9,1%). La edad del niño presentó asociación directa y significativa con el consumo diario de bebidas gaseosas y jugos artificiales. La prevalencia de consumo de gaseosas y jugos artificiales en niños menores de cinco años evaluados en la PNDS 2006 fue elevada, y se mostró asociada positivamente con el aumento de la edad y la zona de residencia.

O objetivo deste estudo foi descrever a frequência de consumo de refrigerantes e sucos artificiais por crianças menores de cinco anos de idade e seus fatores associados. Foram analisados os dados de consumo alimentar da Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher (PNDS) do ano de 2006. A análise considerou a complexidade amostral e incluiu 3789 crianças menores de cinco anos. O desfecho foi avaliado por meio de questões que abordavam a frequência de consumo de refrigerantes e sucos artificiais nos sete dias anteriores ao da entrevista. A frequência de consumo de refrigerantes e sucos artificiais foi descrita segundo gênero, idade e estado nutricional da criança, zona de residência, idade e escolaridade materna. Mais de 70% das crianças consumiram refrigerantes e sucos artificiais pelo menos uma vez na semana. A prevalência de consumo diário de refrigerantes e sucos artificiais foi de 22,1%. As únicas variáveis que se mostraram associadas de forma significativa (p<0,001) ao consumo diário dessas bebidas foram idade da criança e zona de residência. O consumo diário de refrigerantes e sucos artificiais foi maior entre as crianças que residiam na zona urbana (25,3%), comparado ao consumo das crianças da zona rural (9,1%). A idade da criança apresentou associação direta e significativa com o consumo diário de refrigerantes e sucos artificiais. A prevalência de consumo de refrigerantes e sucos artificiais em crianças menores de cinco anos avaliadas na PNDS 2006 foi elevada e mostrou-se associada positivamente com o aumento da idade e a zona de residência.

[Prevalence of grade retention and associated factors among adolescents from the 1993 Pelotas, Brazil, birth cohort]. / Prevalência de retenção escolar e fatores associados em adolescentes da coorte de nascimentos de 1993 em Pelotas, Brasil.

OBJECTIVE: To evaluate the occurrence of grade retention until 11 years of age and the factors associated with retention. METHODS: This prospective study included 4 452 adolescents from the 1993 city of Pelotas birth cohort (state of Rio Grande do Sul, Brazil). This sample represents 87.5% of the original cohort. Grade retention was defined as the repetition of at least one school grade until the date of the interview. The following independent variables were analyzed: sex, skin color, birth weight, ownership of goods, age, maternal schooling, type of school (private, state, or city), age at school entry, and employment. RESULTS: The overall frequency of grade retention was 36.3%, vs. 42.8% for boys and 30.0% for girls. The adjusted analysis showed that the lower the level of maternal schooling, ownership of goods, and birth weight, the higher the risk of grade retention for both boys and girls. Black/brown adolescents, those studying in public schools, and those who were 7 years of age or older at school entry had a higher risk of grade retention. For boys, childhood labor was associated with grade retention. CONCLUSIONS: Low socioeconomic and low maternal schooling levels were the factors most strongly associated with grade retention. Strategies to reduce this situation must take into account demographic and socioeconomic characteristics.

Prevalência de retenção escolar e fatores associados em adolescentes da coorte de nascimentos de 1993 em Pelotas, Brasil / Prevalence of grade retention and associated factors among adolescents from the 1993 Pelotas, Brazil, birth cohort

Objetivo. Avaliar a ocorrência de retenção escolar até os 11 anos de idade e os fatores associadosà retenção. Métodos. Estudo prospectivo, incluindo 4 452 adolescentes da coorte de nascidos emPelotas, Estado do Rio Grande do Sul, Brasil, em 1993. A amostra representa 87,5% da coorte original. A retenção escolar foi definida como a repetição de pelo menos uma série escolar atéa data da entrevista. As variáveis independentes analisadas foram: sexo, cor da pele, peso ao nascer, índice de bens, idade e escolaridade materna, tipo de escola (privada, estadual oumunicipal), idade de ingresso na escola e trabalho. Resultados. A frequência de retenção escolar foi de 36,3%, sendo de 42,8% entre os meninos e 30,0% entre as meninas. Na análise ajustada, quanto menor a escolaridade da mãe,o índice de bens e o peso ao nascer, maior foi o risco de retenção escolar em ambos os sexos. Adolescentes cuja cor da pele era parda/preta, aqueles que frequentavam escolas públicas e aquelesque ingressaram na escola com 7 anos ou mais apresentaram maior risco de retenção escolar. Apenas entre os meninos, o trabalho infantil esteve associado com a ocorrência de retenção.Conclusões. O baixo nível socioeconômico e a baixa escolaridade materna foram os fatores mais fortemente associados com a retenção escolar. Estratégias para a redução desse evento devem levar em consideração características demográficas e socioeconômicas.

Objective. To evaluate the occurrence of grade retention until 11 years of age and the factors associated with retention. Methods. This prospective study included 4 452 adolescents from the 1993 city of Pelotas birth cohort (state of Rio Grande do Sul, Brazil). This sample represents 87.5% of the original cohort. Grade retention was defined as the repetition of at least oneschool grade until the date of the interview. The following independent variables were analyzed: sex, skin color, birth weight, ownership of goods, age, maternal schooling, type of school (private, state, or city), age at school entry, and employment. Results. The overall frequency of grade retention was 36.3%, vs. 42.8% for boysand 30.0% for girls. The adjusted analysis showed that the lower the level of maternal schooling, ownership of goods, and birth weight, the higher the risk of grade retention for both boys and girls. Black/brown adolescents, those studying in public schools, and those who were 7 years of age or older at school entry had a higher risk of grade retention. For boys, childhood labor was associated with grade retention.Conclusions. Low socioeconomic and low maternal schooling levels were the factors most strongly associated with grade retention. Strategies to reduce this situation must take into account demographic and socioeconomic characteristics.

[Consumption of fruits and vegetables in the public school in southern Brazil]. / Consumo de frutas e vegetais em escolares da rede pública no Sul do Brasil.

Consumption of fruits and vegetables in the public school in southern Brazil. Cross-sectional study was conducted with 356 schoolchildren from public city of Pelotas, southern Brazil. The objective was to describe the frequency of consumption of fruits and vegetables and its association with sociodemographic and nutritional status. Variables were collected on gender, age and maternal education. The classification of socioeconomic status was according to the Brazilian Association of Research and nutritional status according to Body Mass Index (Ministry of Health of Brazil). For the evaluation of the consumption of fruits and vegetables Consumption Labels Form of the National Nutritional Surveillance was used. The categorization of frequency of consumption was defined when and how often fruits and vegetables were consumed at least five of the seven days preceding the interview. We used the chi-square test for heterogeneity and linear trend to detect statistically significant differences. Prevalence of frequent use were 42.1% (CI 95% 36.9 to 47.3) for fruits and 20.1% (CI 95% 16.0 to 24.4) for vegetables. High consumption of fruit was associated with lower age of the students (p=0.022), and linear trend directly with socioeconomic status and maternal education (p < 0.001). High consumption of vegetables was associated with maternal education (p < 0.001). There was no association between consumption of these foods with gender and nutritional status. The results show low percentages of frequent consumption of fruits and vegetables, pointing to the need for actions aimed at primary schools in an attempt to stimulate consumption.

Dietary assessment in the 1993 Pelotas (Brazil) birth cohort study: comparing energy intake with energy expenditure.

The study aims to describe and compare two methods of energy intake assessment and one measure of energy expenditure applied in adolescents from a birth cohort. In a sub-sample of the 1993 Pelotas (Brazil) birth cohort, followed up in 2006-7, information on intake was obtained through a food-frequency questionnaire (FFQ) and three 24-hour-recalls (24hR), while energy expenditure was assessed using an accelerometer. Bland & Altman plots were used in the analyses in order to compare the methods. The mean difference between FFQ and 24hR was 592 ± 929cal/day. Compared to energy expenditure, intake was overestimated when measured by FFQ (357 ± 968cal/day) and underestimated by 24hR (-278 ± 714cal/day). In spite of the great differences between energy intake obtained using the two methods, lower differences were observed when these methods were compared to expenditure.

Dietary assessment in the 1993 Pelotas (Brazil) birth cohort study: comparing energy intake with energy expenditure / Avaliação dietética da coorte de nascimentos de Pelotas, Rio Grande do Sul, Brasil, 1993: uma comparação da ingestão e do gasto de energia

The study aims to describe and compare two methods of energy intake assessment and one measure of energy expenditure applied in adolescents from a birth cohort. In a sub-sample of the 1993 Pelotas (Brazil) birth cohort, followed up in 2006-7, information on intake was obtained through a food-frequency questionnaire (FFQ) and three 24-hour-recalls (24hR), while energy expenditure was assessed using an accelerometer. Bland & Altman plots were used in the analyses in order to compare the methods. The mean difference between FFQ and 24hR was 592 ± 929cal/day. Compared to energy expenditure, intake was overestimated when measured by FFQ (357 ± 968cal/day) and underestimated by 24hR (-278 ± 714cal/day). In spite of the great differences between energy intake obtained using the two methods, lower differences were observed when these methods were compared to expenditure.

O objetivo do estudo foi descrever e comparar dois métodos de avaliação de consumo calórico e uma medida de gasto energético aplicados em adolescentes de uma coorte de nascimentos. Em uma subamostra da coorte de 1993 de Pelotas, Rio Grande do Sul, Brasil, acompanhada em 2006-2007, informações sobre consumo calórico foram obtidas através de questionário de frequência alimentar (QFA) e três recordatórios de 24 horas (R24h), enquanto gasto energético foi avaliado por acelerômetro. Gráficos de Bland & Altman foram usados na comparação dos métodos. A diferença média entre QFA e R24h foi 592 ± 929cal/dia. Ao comparar com gasto energético, o consumo foi superestimado se medido pelo QFA (357 ± 968cal/dia) e subestimado pelo R24h (-278 ± 714cal/dia). Apesar da grande diferença no consumo, menores diferenças foram observadas quando os dois métodos foram comparados ao gasto energético.

The 11-year follow-up of the 1993 Pelotas (Brazil) birth cohort study: methods.

The aim of this study is to describe the methodology of the 2004-2005 follow-up visit of the 1993 Pelotas (Brazil) birth cohort. All children born in Pelotas in 1993 and whose mothers lived in the city at that time were eligible to be enrolled in a longitudinal study. Between July 2004 and March 2005, all cohort participants were sought for a follow-up visit. Several strategies were used to help trace cohort members, including a census of the city's schools and a census of all households in the municipality. The Mortality Information System was monitored in order to identify deaths among cohort members. Of the 5,249 cohort members, 4,452 were interviewed in 2004-5. When added to the 141 deaths, these represent 87.5% of the original cohort. In spite of the logistic and financial difficulties, it is possible to carry out prospective studies with long-term follow-up in the Brazilian context.

Nutritional status of adolescents: the 11-year follow-up of the 1993 Pelotas (Brazil) birth cohort study.

We evaluate the influence of demographic, socioeconomic, and maternal variables on the nutritional status of adolescents aged 11 years. We conducted a prospective cohort study including 4,452 adolescents born in Pelotas, Southern Brazil, in 1993, accounting for 87.5% of the original cohort. Nutritional status was evaluated based on World Health Organization criteria. Subjects were classified according to nutritional status into thin, normal, overweight and obese. Independent variables analyzed included skin color, socioeconomic status, maternal schooling, and maternal body mass index (BMI). Analyses were stratified by sex, and multivariable regression was performed using the multinomial logistic approach. Overall, 7% of adolescents were classified as thin, 11.6% as overweight, and 11.6% as obese. Among boys, thinness was inversely associated with maternal schooling and maternal BMI. Among girls, thinness was directly associated with maternal BMI. Overweight and obesity were directly associated with socioeconomic status and maternal BMI, the former showing the strongest association with nutritional status among adolescents.

Intake of fat and fiber-rich foods according to socioeconomic status: the 11-year follow-up of the 1993 Pelotas (Brazil) birth cohort study.

This study describes the food intake of adolescents participating in the 1993 birth cohort from Pelotas, Southern Brazil, according to socioeconomic position. We carried out a cross-sectional analysis of data collected in the 2004-2005 follow-up visit. Food intake in the previous year was evaluated using the Block questionnaire. Socioeconomic status was evaluated based on an assets index, divided into quintiles. Foods with the highest frequency of daily intake were white bread (83%), butter or margarine (74.6%), beans (66.4%) and milk (48.5%). Intake of butter or margarine, bread, and beans was more frequent among poorer adolescents, and the inverse was true for milk. Intake of fruits and vegetables was low in all socioeconomic strata, but particularly low among the poor. In early adolescence, all socioeconomic groups showed high consumption of foods rich in fat and low consumption of foods rich in fiber.

The 11-year follow-up of the 1993 Pelotas (Brazil) birth cohort study: methods / A visita de 11 anos da coorte de nascimentos de Pelotas, Rio Grande do Sul, Brasil, 1993: métodos

The aim of this study is to describe the methodology of the 2004-2005 follow-up visit of the 1993 Pelotas (Brazil) birth cohort. All children born in Pelotas in 1993 and whose mothers lived in the city at that time were eligible to be enrolled in a longitudinal study. Between July 2004 and March 2005, all cohort participants were sought for a follow-up visit. Several strategies were used to help trace cohort members, including a census of the city's schools and a census of all households in the municipality. The Mortality Information System was monitored in order to identify deaths among cohort members. Of the 5,249 cohort members, 4,452 were interviewed in 2004-5. When added to the 141 deaths, these represent 87.5 percent of the original cohort. In spite of the logistic and financial difficulties, it is possible to carry out prospective studies with long-term follow-up in the Brazilian context.

O objetivo deste artigo é descrever a metodologia do acompanhamento realizado em 2004-2005 da coorte de nascidos em 1993 na cidade de Pelotas, Rio Grande do Sul, Brasil. Todas as crianças nascidas em 1993 nessa cidade, cujas mães residiam no município, foram elegíveis para um estudo longitudinal. Entre os meses de julho de 2004 e março de 2005, todos os participantes da coorte foram procurados para um acompanhamento. Diversas estratégias de busca foram utilizadas para auxiliar na localização dos participantes, sendo as principais um censo em todas as escolas do município e um censo domiciliar. O Sistema de Informações sobre Mortalidade foi monitorado para detecção de óbitos de participantes da coorte. Dos 5.249 participantes da coorte, 4.452 foram entrevistados em 2004-2005, os quais, somados aos 141 óbitos detectados, representam 87,5 por cento da coorte original. Apesar das dificuldades logísticas e financeiras, é possível realizar estudos prospectivos com altas taxas de acompanhamento em longo prazo no contexto brasileiro.

Nutritional status of adolescents: the 11-year follow-up of the 1993 Pelotas (Brazil) birth cohort study / Estado nutricional de adolescentes: a visita de 11 anos da coorte de nascimentos de Pelotas, Rio Grande do Sul, Brasil, 1993

We evaluate the influence of demographic, socioeconomic, and maternal variables on the nutritional status of adolescents aged 11 years. We conducted a prospective cohort study including 4,452 adolescents born in Pelotas, Southern Brazil, in 1993, accounting for 87.5 percent of the original cohort. Nutritional status was evaluated based on World Health Organization criteria. Subjects were classified according to nutritional status into thin, normal, overweight and obese. Independent variables analyzed included skin color, socioeconomic status, maternal schooling, and maternal body mass index (BMI). Analyses were stratified by sex, and multivariable regression was performed using the multinomial logistic approach. Overall, 7 percent of adolescents were classified as thin, 11.6 percent as overweight, and 11.6 percent as obese. Among boys, thinness was inversely associated with maternal schooling and maternal BMI. Among girls, thinness was directly associated with maternal BMI. Overweight and obesity were directly associated with socioeconomic status and maternal BMI, the former showing the strongest association with nutritional status among adolescents.

O objetivo deste estudo foi avaliar a influência de fatores demográficos, sócioeconômicos e maternos sobre o estado nutricional de adolescentes, nascidos em 1993, em Pelotas, Rio Grande do Sul, Brasil. A amostra estudada (n = 4.452) representa 87,5 por cento da coorte original. O estado nutricional foi avaliado conforme as recomendações da Organização Mundial da Saúde, categorizado em magro, eutrófico, sobrepeso e obeso. As variáveis independentes foram cor da pele, índice de bens, escolaridade e índice de massa corporal (IMC) maternos. As análises foram estratificadas por sexo, e a regressão logística multinomial foi usada. Ao todo, 7 por cento dos adolescentes eram magros, 11,6 por cento tinham sobrepeso e 11,6 por cento eram obesos. Entre os meninos, a prevalência de adolescentes magros apresentou associação inversa com escolaridade e IMC maternos. Entre as meninas, ser magra se associou inversamente com o IMC materno. Sobrepeso e obesidade mostraram-se associados diretamente com índice de bens e IMC maternos, sendo esta última, a principal variável associada com o estado nutricional dos adolescentes.

Intake of fat and fiber-rich foods according to socioeconomic status: the 11-year follow-up of the 1993 Pelotas (Brazil) birth cohort study / Consumo de alimentos com alto teor de gordura e fibras entre adolescentes, segundo posição socioeconômica: a visita de 11 anos da coorte de nascimentos de Pelotas, Rio Grande do Sul, Brasil, 1993

This study describes the food intake of adolescents participating in the 1993 birth cohort from Pelotas, Southern Brazil, according to socioeconomic position. We carried out a cross-sectional analysis of data collected in the 2004-2005 follow-up visit. Food intake in the previous year was evaluated using the Block questionnaire. Socioeconomic status was evaluated based on an assets index, divided into quintiles. Foods with the highest frequency of daily intake were white bread (83 percent), butter or margarine (74.6 percent), beans (66.4 percent) and milk (48.5 percent). Intake of butter or margarine, bread, and beans was more frequent among poorer adolescents, and the inverse was true for milk. Intake of fruits and vegetables was low in all socioeconomic strata, but particularly low among the poor. In early adolescence, all socioeconomic groups showed high consumption of foods rich in fat and low consumption of foods rich in fiber.

O estudo descreve alimentos consumidos por adolescentes pertencentes à coorte de nascimentos de 1993 de Pelotas, Rio Grande do Sul, Brasil, conforme o nível socioeconômico. Foi feita uma análise transversal com dados coletados no acompanhamento de 2004-2005. A freqüência alimentar no último ano foi avaliada pelo questionário Block. A posição socioeconômica foi verificada com base no índice de bens, dividido em quintis. Os alimentos mais consumidos diariamente foram: pão branco (83 por cento), manteiga ou margarina (74,6 por cento), feijão (66,4 por cento) e leite (48,5 por cento). O consumo de manteiga ou margarina, pão e feijão foram mais freqüentes entre adolescentes pertencentes ao primeiro (menor) quintil do índice de bens, e o consumo de leite foi maior no último quintil. Frutas, vegetais e salada verde tiveram baixo consumo principalmente entre os mais pobres. Todos os grupos socioeconômicos apresentaram consumo elevado de alimentos ricos em gordura e baixo consumo de alimentos ricos em fibra.

Height and weight gains in a nutrition rehabilitation day-care service.

OBJECTIVE: To evaluate nutritional recovery patterns in 106 undernourished children assisted by the Center of Nutritional Recovery and Education (CREN, in Portuguese) between January 1995 and December 1999. DESIGN: CREN assists undernourished children aged 0 to 72 months living in the southern regions of Sao Paulo, in an outpatient setting. Nutritional status was assessed by Z-scores of weight-for-age, height-for-age and weight-for-height. Nutritional recovery evaluation considered Z-score gains in weight-for-age and height-for-age, grouping into four categories (Z-score increment of 0.50 between groups). Children with birth weight less than 2500 g were classified as low birth weight (LBW), while those born at term and with LBW were classified as small for gestational age. SETTING: CREN (Center of Nutritional Recovery and Education in Portuguese), Sao Paulo, Brazil. SUBJECTS: One hundred and six children from CREN. RESULTS: Among the 106 evaluated children, ninety-eight (92.5 %) recovered their weight or height and seventy-two (67.9 %) recovered both. Nearly half of studied children presented a nutritional recovery (increase in Z-score) of more than 0.50 in height-for-age (46.2 %) and about 40 % in weight-for-age (38.7 %). Multivariate analysis showed that treatment duration and initial weight-for-age contributed to weight-for-age Z-score increment, explaining 25 % of the variation; and treatment duration, initial height-for-age and weight-for-age Z-score increment contributed to height-for-age Z-score increment, explaining 62 % of the variation. CONCLUSIONS: Our findings show that nutritional recovery among children who attended CREN was influenced primarily by the degree of nutritional deficit at admission. It has also been shown that biological variables are more important than socio-economic status in determining the rate of nutritional recovery.

Infant feeding and obesity at 11 years: prospective birth cohort study.

OBJECTIVE: To evaluate the association between breastfeeding duration, introduction of solid or semi-solid foods before four months of age and overweight/obesity at 11 years. METHODS: Prospective population-based birth cohort study, including 1 204 adolescents aged 11 years who were born in Pelotas (Brazil), in 1993, and were previously interviewed at birth, six and 12 months of age. Five explanatory variables were used: duration of any breastfeeding, duration of exclusive or predominant breastfeeding, ever breastfeeding, introduction of solid or semi-solid foods before four months of age, and feeding pattern at four months of age. Risk of overweight was defined as body mass index (BMI) > or = 85(th) percentile, and obesity was defined as BMI > or = 85(th) percentile plus triceps and subscapular skinfolds > or = 90(th) percentile, using the National Center for Health Statistics curves. RESULTS: The prevalence of risk of overweight and obesity at 11 years were 23.2% and 11.6%, respectively. The lowest prevalence of both outcomes was found among subjects who were breastfed for one to three months. However, tests for linear trend or heterogeneity did not result in a significant association between breastfeeding indicators and anthropometry at 11 years. Adjustment for sex, skin color, birth weight, maternal schooling, smoking during pregnancy and maternal pre-pregnancy BMI did not alter the findings. CONCLUSIONS: Our results do not support the hypothesis that breastfeeding has a long-term lasting effect on anthropometry in this population.