[Show abstract][Hide abstract] ABSTRACT: Few studies have focused on the National School Nutrition Program (PNAE) in indigenous schools in Brazil. The current study describes the program's operations, management, and menus in 35 Kaingáng indigenous schools in Rio Grande do Sul State, Brazil. A cross-sectional study design was used to obtain information on the program through questionnaires submitted to the Regional Educational Offices (CRE) and to the schools. The menus suggested to the schools by the regional offices were obtained. There were no Centers for Indigenous Education in the regional offices. All the assistant principals were indigenous, 26 schools (74.6%) practiced local management of the meal program, and 34 (97.1%) reported purchasing food from local markets. Most cooks (63.9%) had temporary work contracts with the schools and 65.7% were indigenous. Low offerings of veges, milk and dairy products were observed in around 60% of the menus, and legumes and fruits low in around 80%. It points out the need for more studies about the indigenous PNAE and intends to support public policies in health, food and nutrition for the national indigenous school .
Preview · Article · Nov 2014 · Cadernos de Saúde Pública
[Show abstract][Hide abstract] ABSTRACT: To study the prevalence and factors associated with excess weight in children enrolled in public schools in the states of Rio Grande do Sul (RS) and Santa Catarina (SC).
This was a cross-sectional study, carried out with children aged 4 to 6 years. The studied outcome was excess weight, defined by z-score > two standard deviations for body mass index (BMI)/age, compared with the World Health Organization (WHO) reference population of 2006/2007. Anthropometric measurements of body mass and height were measured in duplicate using standard techniques, in accordance with the WHO. Data were double entered using EPI-INFO software, release 6.04. Absolute and relative frequencies were calculated, as well as mean values and standard deviations. Associations between excess weight and other variables were assessed by using Poisson model with robust variance. STATA software release 12.0 was used (p < 0.05).
A total of 4,914 children were evaluated (2,578 in RS and 2,336 in SC). In RS, the incidence of excess weight was 14.4% (95% CI = 13.1% to 15.8%) and in SC, 7.5% (95% CI = 6.5% to 8.7%). The variables associated with excess weight were number of household members, maternal education, marital status, number of children, mother's age at birth of first child, gestational age, and birth weight.
Children enrolled in public preschools in RS had a two-fold higher excess weight prevalence than that identified in SC, demonstrating a significant difference in the magnitude of childhood obesity in two Brazilian states located in the same region.
Full-text · Article · Mar 2013 · Jornal de pediatria
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to describe the distribution of waist circumference (WC) and WC to height (WCTH) values among Kaingáng indigenous adolescents in order to estimate the prevalence of high WCTH values and evaluate the correlation between WC and WCTH and body mass index (BMI)-for-age. A total of 1,803 indigenous adolescents were evaluated using a school-based cross-sectional study. WCTH values > 0.5 were considered high. Higher mean WC and WCTH values were observed for girls in all age categories. WCTH values > 0.5 were observed in 25.68% of the overall sample of adolescents. Mean WC and WCTH values were significantly higher for adolescents with BMI/age z-scores > 2 than for those with normal z-scores. The correlation coefficients of WC and WCTH for BMI/age were r = 0.68 and 0.76, respectively, for boys, and r = 0.79 and 0.80, respectively, for girls. This study highlights elevated mean WC and WCTH values and high prevalence of abdominal obesity among Kaingáng indigenous adolescents.
Full-text · Article · Nov 2012 · Cadernos de saúde pública / Ministério da Saúde, Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública
[Show abstract][Hide abstract] ABSTRACT: To investigate the prevalence of malnutrition and associated factors in children under the age of 60 months in two cities in the state of Acre, Brazil.
A population-based cross-sectional study was carried out with 667 children living in urban areas of the cities of Acrelândia and Assis Brasil. The prevalence of malnutrition was calculated by height for age (stunting) and weight for height (W/H) indexes, which were calculated with a cutoff point of -2 for Z scores as determined by the 2006 World Health Organization child growth standards. A structured questionnaire was used to gather information on socioeconomic conditions, access to services and child care, birth weight and morbidity. Poisson regression was used to identify the factors associated with child malnutrition.
The prevalence of height-for-age and weight-for-height deficit was 9.9% and 4.1%, respectively. The factors associated with height-for-age deficit were low household wealth index (prevalence ratio [PR]: 1.74; 95% confidence interval [95% CI]: 0.95-3.18); having an illiterate father or stepfather (PR: 1.82; 95% CI: 1.01-3.27); having 2 or more younger siblings (PR: 2.88; 95% CI: 1.45-5.72); biological mother not living in the home (PR: 2.63; 95% CI: 1.32-5.24); and exposure to open wastewater near the home environment (PR: 2.46; 95% CI: 1.51-4.00). "Low weight at birth" was the only factor associated with weight-for-height deficit (PR: 2.91; CI95%: 1.16-7.24).
In the cities studied, malnutrition in children under 60 months is an important public health problem, and is associated with indicators of social inequality, access to health services and biological mother not living in the home.
Full-text · Article · Mar 2012 · Revista Brasileira de Epidemiologia
[Show abstract][Hide abstract] ABSTRACT: To describe prevalence and the distribution of risk factors to non-communicable chronic diseases among adults from Lages, Santa Catarina, Brazil.
Probabilistic sample of adult urban population, of both genders and aged from 20 to 59 years old was interviewed (n=2022). The sample process was made through conglomerates. It was applied a structured questionnaire with questions related to demographical, socio-economical, and behavior and self-referred diseases. In this study the following informations, related to the risk/protection factors for non-communicable chronic diseases, were used: gender, age, school background, body mass index, waist circumference, smoking, physical activity, pressure levels, self-referred mellitus diabetes and feeding characteristics. Prevalence for risk/protection factors for non-communicable chronic diseases, in the total population and according to gender and school background, was calculated.
The studied population is prone to non-communicable chronic diseases, presenting substantial proportions of hypertension (33.78%), overweight individuals (33.46%), obesity (23.46%) and abdominal obesity (43.81%). In relation to feeding characteristics, women presented higher prevalence of behaviors considered as protection factors, relative to men. It was found less than 30.0% of physically inactive individuals and 45.9% of smokers or ex-smokers.
Descriptive studies such as this could be the basis for the development of public policies specific to the adult population of Lages, in order to guide the organization, planning and quality improvement of health assistance services, aiming the reduction in the occurrence and in the impact of non-communicable chronic diseases.
Full-text · Article · Dec 2011 · Revista Brasileira de Epidemiologia
[Show abstract][Hide abstract] ABSTRACT: This study aimed to evaluate: the coverage of the Food and Nutritional Surveillance System (SISVAN) in the State of Rio Grande do Sul, Brazil, and it Regional Health Offices in 2006; the nutritional status of children 0-10 years of age; and the reliability of data on nutritional status recorded in the system. A cross-sectional descriptive study was conducted with secondary data on 63,320 children. Coverage was defined as the proportion of children younger than 10 years covered by the Family Health Strategy in the State's various municipalities (counties). Height-for-age (H/A) and body mass index for age (BMI/A) were classified according to World Health Organization (WHO) criteria. Agreement between the nutritional classifications recorded in the system and those calculated in this study was evaluated with the weighted kappa coefficient (at 5%). The system's coverage in the State of Rio Grande do Sul was 10.5%. Low height-for-age was found in 7.1% of children and overweight in 8.4%. Agreement between the classifications showed a kappa coefficient of 0.43. The system's coverage and agreement between classifications were both low, and the study showed the coexistence of high overweight and stunting rates in this age group.
Full-text · Article · Nov 2011 · Cadernos de saúde pública / Ministério da Saúde, Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública
[Show abstract][Hide abstract] ABSTRACT: To describe the nutritional status of indigenous children and adolescents in Rio Grande do Sul, Brazil, through bioelectrical values, and to compare the nutritional classifications of the anthropometric method to those of the body composition method.
A cross-sectional survey was conducted of 3 204 subjects at 35 schools in the 12 Kaingang indigenous lands of Rio Grande do Sul, Brazil. Following World Health Organization recommendations, the weight and height (H) of each subject was measured twice and the body mass index/age (BMI/A) was classified. Body composition was assessed by Bioelectrical Impedance Vector Analysis (BIVA). Resistance (R) and reactance (Xc) were estimated using a bioelectrical impedance analyzer. Divergences between these two methods were performed on RXc graph.
Of the sample, 56.8% were adolescents and 50.6% were males. The mean values of phase angle were higher in adolescents, in males, and in individuals overweight by BMI/A. Mean values of R, Xc, R/H, and Xc/H were higher among children and among those with BMI/A < +2 z scores. Divergences in overweight classification were: male children, 94.6%; male adolescents, 77.1%; female children, 85.4%; and female adolescents, 94.8%.
The mean values of bioelectrical measures observed among the Kaingang children and adolescent were similar to those found for different populations in other studies. For both gender and age groups, differences were observed between nutritional classifications by BMI/age and by BIVA. These results reinforce the importance of employing multiple techniques, such as anthropometry and BIVA, when conducting nutritional assessments of a population.
Full-text · Article · Jul 2011 · Revista Panamericana de Salud Pública
[Show abstract][Hide abstract] ABSTRACT: This cross-sectional population-based study investigated prevalence rates and associated factors for anemia, iron deficiency anemia, and iron deficiency among children 6 to 60 months of age in two towns in Acre State, Brazil (N = 624). Hemoglobin, plasma ferritin, and soluble transferrin receptor were measured in venous blood samples. Socioeconomic, demographic, and disease data were obtained using a questionnaire. Prevalence ratios were calculated by Poisson regression in a hierarchical model. Prevalence rates for anemia, iron deficiency anemia, and iron deficiency were 30.6%, 20.9%, and 43.5%, respectively. Children younger than 24 months showed higher risk of anemia, iron deficiency anemia, and iron deficiency. The highest family income tertile was a protective factor against iron deficiency anemia (PR: 0.62; 95%CI: 0.40-0.98). The highest height-for-age quartile was protective against anemia (0.62; 0.44-0.86) and iron deficiency anemia (0.51; 0.33-0.79), and recent history of diarrhea was associated with increased risk of anemia (1.47; 1.12-1.92) and iron deficiency anemia (1.44; 1.03-2.01). Geohelminth infection was associated with increased risk of anemia, iron deficiency anemia, and iron deficiency.
Preview · Article · Jan 2011 · Cadernos de saúde pública / Ministério da Saúde, Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública
[Show abstract][Hide abstract] ABSTRACT: The study's objective was to characterize the nutritional status of 3,254 Kaingáng Indians in indigenous schools in Rio Grande do Sul State, Brazil. This was a school-based study. Weight (W), height (H), and waist circumference (WC) were measured according to World Health Organization guidelines (1995). Children's nutritional status classification included H/A, W/A, and W/H according to the National Center for Health Statistics (WHO, 1995) and H/A, W/A, and body mass index/age (BMI/A) according to WHO (2006). Adolescents were classified for BMI/A (WHO, 1995 and 2006) and H/A (WHO, 2006). Adults were classified for BMI (WHO, 1995) and WC (WHO, 2003). Adolescents represented 56% of the sample, children 42.5%, adults 1.4%, and elderly 0.1%. Prevalence rates for stunting were 15.1% (WHO, 1983) and 15.5% (WHO, 2006) in children and 19.9% in adolescents. Prevalence rates for overweight were 11% (WHO, 1983) and 5.7% (WHO, 2006) in children, 6.7% in adolescents, and 79.2% in adults. 45.3% of adults were at increased risk of metabolic diseases. A nutritional transition was observed in the group, characterized by significant prevalence of stunting in children and adolescents and prominent overweight in all age groups.
Preview · Article · Sep 2010 · Cadernos de saúde pública / Ministério da Saúde, Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública
[Show abstract][Hide abstract] ABSTRACT: Introduction: In Latin America the Indigenous population is a minority. In Brazil they represent 0.2% of the total population. Studies on nutritional and health status in this group are scarce. Objective: Assess the nutritional status of Indigenous (Kaingng ethnicity) enrolled in schools located in the Indigenous Territories of Inhacor, Rio da Vrzea, Monte Caseros, Carreteiro, Cacique Doble and Ventarra in the State of Rio Grande do Sul, Brazil. Metodology: It´s a school-based cross-sectional study. Weight, height and waist circumference (WC) were measured according to WHO (1995) in 634 Kaingngs. The classification of nutritional status used the following criteria: Children (N=273; 4-10 years): height for age and weight for height indices, according to the National Center for Health Statistics - NCHS, 1977 (WHO, 1983); Adolescents (N= 344): Body Mass Index (BMI) for age according to WHO (2007); Adults (N= 17): BMI according to WHO (1995). WCs values were classified according WHO (2003). Double digitization and data analysis were conducted in SPSS 13.0. Relative and absolute frequencies were calculated. Results: 76.9% of the total students enrolled in the schools were evaluated. The mean ages (SD) was 11.9 (5.9) years and 52.1% were males. Frequencies of overweight in children, adolescents and adults were 11.0%, 4.1% and 58.8% respectively. WCs showed 52.9% of adults in high risk for metabolic diseases. Stunting occurred in14.6% of the children. Conclusion: Partial results indicate a trend of overweight in all age groups studied and high WCs values in half of adults. Stunting has still an important occurrence among children.
Funding Source: National Fund for Development of Education - Ministry of Education. Support for Research Foundation of the State of Rio Grande do Sul (FAPERGS process nº 07500944)
[Show abstract][Hide abstract] ABSTRACT: To assess the nutritional status and dietary practices of 0-24-month-old children living in Brazilian Amazonia.
Cross-sectional study. Information on children's dietary intakes was obtained from diet history data. Weight and length were measured for anthropometric evaluation. Fe status was assessed using fasting venous blood samples; Hb, serum ferritin and soluble transferrin receptor concentrations were measured.
The towns of Assis Brasil and Acrelândia in the state of Acre, north-west Brazil.
A total of sixty-nine randomly selected 0-24-month-old children.
Of these children, 40.3 % were anaemic, 63.1 % were Fe-deficient, 28.1 % had Fe-deficiency anaemia and 11.6 % were stunted. Breast-feeding was initiated by 97.1 % of mothers, followed by early feeding with complementary foods. The dietary pattern reflected a high intake of carbohydrate-rich foods and cow's milk, with irregular intakes of fruit, vegetables and meat. All infants and 92.3 % of toddlers were at risk of inadequate Fe intakes. Fe from animal foods contributed on average 0.5 % and 14.3 % to total dietary Fe intake among infants and toddlers, respectively.
Poor nutritional status and inadequate feeding practices in this study population reinforce the importance of exclusive breast-feeding during the first 6 months of life. Greater emphasis is required to improve the bioavailability of dietary Fe during complementary feeding practices.
Full-text · Article · Apr 2009 · Public Health Nutrition
[Show abstract][Hide abstract] ABSTRACT: The article presents prevalence rates for malnutrition, intestinal parasitic infections, anemia, and iron deficiency in under-five children in a population-based cross-sectional survey performed in the urban area of two counties in the Western Brazilian Amazon, Assis Brasil (n = 200) and Acrelandia (n = 477). Available data included: (a) weight and height measurements, standardized as z-scores using the 1977 NCHS reference population, (b) diagnosis of current intestinal parasitic infection, (c) blood hemoglobin levels, and (d) plasma ferritin and soluble transferrin receptor levels. Overall prevalence rates of low weight-for-height, low weight-for-age, and low height-for-age were 3.7%, 8.7%, and 7.5%, respectively, with similar figures in the two towns. Intestinal parasites were detected in 32.5% children; helminths were uncommon. Anemia and iron deficiency were diagnosed in 30.6% and 43.5% of the children, respectively. Evidence of anemia was found in only 47.6% of the children with depleted iron reserves, indicating that hemoglobin measurement alone would severely underestimate the magnitude of iron deficiency in this population. In both towns, anemia and malnutrition were significantly more prevalent among children in the lowest socioeconomic stratum.
[Show abstract][Hide abstract] ABSTRACT: We investigated the prevalence and risk factors for wheezing and asthma in young Amazonian children. A population-based cross-sectional
survey of 606 children aged 6–59 months was performed in two small towns in Acre State, Northwestern Brazil. Information on
outcome variables (recent wheezing and medical diagnosis of asthma) and demographic, socioeconomic, environmental, maternal
and nutritional variables was obtained by interviewing children's mothers or guardians. Infections with intestinal parasites
and antibodies to the zoonotic nematode Toxocara were diagnosed using standard laboratory techniques. Multiple unconditional logistic regression models were used to describe
associations between independent variables and outcomes. The prevalence of recent wheezing (one or more reported episodes
in the past 12 months) was 42.6%, but only 19.8% of wheezing children were also reported to have a medical diagnosis of asthma
(prevalence, 8.5%); 21.5% of the children examined had antibodies to Toxocara. Increased risk of asthma was independently associated with early introduction of bottle feeding, defined as <4 months of
exclusive breastfeeding [adjusted odds ratio (aOR) = 2.21, 95% confidence interval (95% CI), 1.07–4.59, P = 0.033], and seropositivity to Toxocara (aOR = 2.37, 95% CI 1.17–4.77, P = 0.016), suggesting two potential targets for public health interventions.
No preview · Article · Apr 2007 · Journal of Tropical Pediatrics
[Show abstract][Hide abstract] ABSTRACT: Cross-sectional surveys were performed in 1993 and 2000 on Japanese-Brazilians (n = 328) of both sexes, aged 40 to 79 years in 1993, living in Bauru, São Paulo State. Both surveys examined food intake using food frequency questionnaires. Dietary intake in both surveys was compared to Wilcoxon tests according to gender (p < 0.05). Calories from dietary fat increased by 16% in both genders (mean values in 2000: 31.5% for women and 30.8% for men). When the surveys were compared, the main dietary changes were: (a) a 40% increase in oleic and linoleic acids and calories from fat and (b) a 20% reduction in dietary cholesterol in both sexes. Among women, an increase in total calorie intake with reduced consumption of vegetables and calories from sweets were observed. Despite increased intake of total dietary fat, there was a decrease in cholesterol intake and an increase in oleic and linoleic acids, fruit, and calcium. However, calcium and vegetable consumption is still short of international recommendations.
Full-text · Article · Dec 2006 · Cadernos de Saúde Pública
[Show abstract][Hide abstract] ABSTRACT: The present study examined the association between dietary factors and metabolic syndrome in a 7-year follow-up of Japanese-Brazilians. In 1993, a survey estimated the prevalence of diabetes in a Japanese-Brazilian population aged 40-79 years. From 647 subjects studied at baseline, 394 (60.9 %) participated in a second survey (2000); after exclusion of subjects with self-reported diseases, 23.4 % (n 151) were included in the present analysis. Metabolic syndrome diagnosis was based on the National Cholesterol Education Program criteria modified for Asians. Food intake was assessed by a validated food-frequency questionnaire. At baseline, mean ages were 56.1 (sd 9.7) and 54.7 (sd 10.6) years for men and women, respectively. Similar cumulative incidence rates of the metabolic syndrome were found in both sexes (36.9 (95 % CI 26.6, 48.1)% for men and 38.8 (95 % CI 27.1, 51.4) % for women). In 1993, mean values of blood pressure, waist circumference for men and 2 h plasma glucose for both sexes were higher among subjects who developed metabolic syndrome when compared with those who did not. Comparisons of nutrient intakes between subsets of subjects who developed or did not develop metabolic syndrome showed an association of protein intake with the syndrome only in men (96.4 (sd 56.8) v. 74.3 (sd 26.0) g/d; P<0.05). Odds ratios of the metabolic syndrome across tertiles of food groups intake showed that among men the highest tertile of red meat consumption was associated with a 4.7-fold increase in risk of developing the syndrome, after adjustments for confounders. However, the statistical significance of this model disappeared when saturated fatty acids were added. The data raised the possibility of a role of red meat consumption for the occurrence of metabolic syndrome in Japanese-Brazilian men. The present findings may have implications for the prevention of metabolic syndrome in this high-risk population.
Full-text · Article · Sep 2006 · British Journal Of Nutrition
[Show abstract][Hide abstract] ABSTRACT: To examine dietary intakes in relation to long-term serum lipoprotein changes in a prospective cohort study with 7 y of follow-up, serum lipids were analyzed by enzymatic methods, while food intake was calculated from validated food frequency questionnaires. First- and second-generation Japanese-Brazilians (n = 316) living in Bauru, São Paulo/Brazil, of both genders, aged 40 to 79 y were assessed at baseline in 1993. Multiple linear regression models were used with changes in serum lipoproteins as the dependent variable and changes in dietary intakes as the independent variables, adjusted for confounding factors. In energy-adjusted analyses, changes in serum total cholesterol were inversely associated with changes in total dietary fiber, fruits/fruit juices and vegetables after adjustment for age and gender. Each increase of 10 g in the consumption of total dietary fiber was associated with a reduction of 12.5 mg/dL in the serum total cholesterol (p<0.05). Our results highlight the importance of increased intakes of total fiber, fruits and vegetables to prevent and control dyslipidemia in Japanese migrants.
No preview · Article · Jun 2006 · Journal of Nutritional Science and Vitaminology
[Show abstract][Hide abstract] ABSTRACT: This study describes the contribution of changes in trans fatty acid intake in relation to serum lipoproteins. A total of 328 Japanese-Brazilians of the first (Issei) and second (Nisei) generations, aged 40-79 years in 1993, were assessed in two cross-sectional surveys on health and nutritional status in 1993 and 2000. Multiple linear regression models were used with changes (2000/ 1993) in serum lipoproteins as the dependent variable and changes in dietary trans fatty acids (adjusted for total calories) as independent variable. In both genders a significant reduction was observed in total intake of trans fatty acids with lower LDL and increased HDL serum levels during 7-year follow-up. The mean intakes of trans fatty acids (% of total energy) in 1993 and 2000 were: 5.1% and 3.4% for women and 4.7% and 3.3% for men, respectively. Although the association between changes in dietary trans fatty acids and serum lipoprotein was not statistically significant, on average the intake of this trans fat was higher than the WHO recommendation (up to 1% of total energy).
No preview · Article · Mar 2006 · Cadernos de Saúde Pública
[Show abstract][Hide abstract] ABSTRACT: OBJETIVO: Analisar o consumo alimentar, o ambiente socioeconômico, a freqüência de anemia ferropriva e o estado nutricional de pré-escolares. MÉTODOS: A população estudada constituiu-se de 89 crianças de 24 a 72 meses de idade, assistidas em creches municipais de Viçosa, MG. Foram avaliados: nível de hemoglobina, peso, estatura, presença de parasitose, consumo alimentar dos pré-escolares e o perfil biossocioeconômico de suas famílias. RESULTADOS: O estado nutricional do grupo foi considerado satisfatório, e a prevalência de anemia relativamente baixa (11,2%). Condições adequadas de saneamento, nível razoável de escolaridade dos pais, baixo número de filhos e ausência de parasitas envolvidos com a gênese da anemia podem justificar o perfil observado. Não foi observada associação da anemia ferropriva nem com desnutrição nem com parasitose. CONCLUSÃO: Apesar de alguns fatores biossocioeconômicos apresentarem-se favoráveis ao estado nutricional e à baixa prevalência de anemia, observa-se, entretanto, que a insuficiente renda per capita e a dieta deficiente poderão levar esse grupo de pré-escolares, no futuro, a um pior estado de saúde.
Preview · Article · Jun 2005 · Revista de Nutrição