Two researchers conducted independent searches on five different electronic databases: PubMed/ MEDLINE, Embase, SciELO, LiLACS and Web of Science. Studies were selected that covered crosscultural adaptation methodology and validation in Brazil with type 1 and type 2 diabetes patients of any age. After reading the full-text articles, data related to psychometric characteristics were extracted from each study selected. Reliability was assessed with Cronbach's α (Cα). The initial searches identified 2,211 studies. After exclusions, 26 were included, covering a total of 31 questionnaires. Questionnaires were grouped into 11 domains based on their main focus of interest: adherence (n = 8), quality of life (n = 7), diabetes knowledge (n = 3), hypoglycemia (n = 3), self-efficacy (n = 3), satisfaction with pharmaceutical services (n = 1), emotional stress (n = 2), hope (n = 1), attitude towards diabetes (n = 1), perception of disease severity (n=1), and risk of developing diabetes (n = 1). This study identified and reviewed all of the diabetes-specific questionnaires that have been validated for Brazilian Portuguese, which should facilitate selection of the most appropriate instrument for each domain of interest in future research and clinical settings. Arch Endocrinol Metab. 2020;64(2):111-20
Objective: To estimate the burden of weight excess in Brazilian adolescents. Design: Systematic review with meta-analysis. Setting: We searched the literature in four databases (MEDLINE/PubMed, EMBASE, SciELO and LILACS). Studies were included if they had cross-sectional or cohort design and enrolled Brazilian adolescents. Studies based on self-reported measures were excluded. Random effect models were used to calculate prevalence estimate and its 95% confidence interval (95%CI). Participants: Brazilian adolescents (10 to 19 years old). Results: One hundred and fifty-one studies were included. Trend analyses showed a significant increase in the prevalence of excess weight in the last decades: 8.2% (95%CI:7.7-8.7) until year 2000, 18.9 (95%CI:14.7-23.2) from 2000 to 2009, and 25.1% (95%CI:23.4-26.8) in 2010 and after. A similar temporal pattern was observed in the prevalence of overweight and obesity separately. In sensitivity analyses, lower prevalence of excess weight was found in older adolescents and those defined using IOTF cutoff points. The Southeast and South regions had the highest prevalence of excess weight, overweight and obesity. No significant difference in prevalence by sex was found, except for studies before the year 2000. Conclusions: The prevalence of overweight and obesity in Brazilian adolescents is high and continues to rise. Public policies on an individual level and targeting modifications in the obesogenic environment are necessary.
Objective: To evaluate the association between body weight perception and quality of diet among Brazilian adolescents. Methods: The sample was composed of 71,740 adolescents aged from 12 to 17 years-old enrolled in the Study of Cardiovascular Risks in Adolescents (Estudo de Riscos Cardiovasculares em Adolescentes - ERICA), carried out during 2013-2014. Body weight perception was self-reported. Food consumption was assessed by food record and quality of diet index for Brazilian adolescents (DQIA-BR) was calculated, considering the balance, diversity, and diet composition. The quality of diet was compared according to weight perception for the entire sample and after stratification by nutritional status. Linear regression models were used to assess the association between body weight perception and quality of diet. Results: Among the studied adolescents, 14.7 and 30.3% reported to be underweight or overweight in relation to their desired weight, respectively. Those who perceived themselves as overweight had lower quality of diet (DQIA-BR=16.0 vs. 17.4 points; p<0.001). After stratification by BMI, adolescents with normal weight (DQIA-BR=15.3 points) or overweight (DQIA-BR=16.1 points), but who perceived themselves as overweight showed lower quality of diet when compared to their peers. In adjusted analysis, overweight perception (β= -0.51; 95%CI -0.77; -0.24) was associated to lower quality of diet. However, this association was no longer significant after stratification by BMI status. Conclusions: Body weight perception can influence the consumption of healthy foods and the quality of diet, especially for those who consider themselves overweight. However, this association is influenced by nutritional status.
Introduction: The consumption of ultra-processed foods (UPF), associated with overweight among adolescents, has increased in the last decades. However, few studies have investigated the association between UPF consumption and cardiovascular risk factors in adolescents from developing countries. Objective: To evaluate the association between UPF consumption and cardiometabolic risk factors in Brazilian adolescents. Methods: The sample consisted of Brazilian students aged 12–17 years from the Study of Cardiovascular Risk in Adolescents. Food consumption was assessed using a 24-hour food recall and the foods were classified according to their processing degree, based on the NOVA classification. Blood samples were collected after overnight fasting, and laboratorial analyses (triglycerides, total cholesterol, HDL-c, LDL-c, fasting glucose, insulin, and HbA1c) were performed. Overweight/obesity and blood pressure were included in cardiometabolic outcomes. Poisson regression analyses were used to evaluate associations. Results: The analysis was composed of 36,952 adolescents. The average energy consumption from UPF was 30.7% (95%CI: 29.7–31.6) per day. Adolescents with high UPF consumption (top tertile, ≥38.7% per day) ingest more sodium, saturated and trans-fat, as well as few proteins, fibers, polyunsaturated fats, vitamins, and minerals. After adjusting for possible confounders, higher UPF consumption was directly associated with high LDL-c (PR=1.012; 95%CI: 1.005–1.029), and inversely associated with low HDL-c (PR=0.972; 95%CI: 0.952–0.993). We did not find associations between UPF consumption and other cardiometabolic risk factors evaluated in this study. Conclusion: UPF consumption among Brazilian adolescents is high and can be associated with poor diet quality and changes in LDL-c.
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