Objectives. To investigate socioeconomic and ethnic group inequalities in prevalence of antibodies against SARS-CoV-2 in the 27 federative units of Brazil. Methods. In this cross-sectional study, three household surveys were carried out on May 14-21, June 4-7, and June 21-24, 2020 in 133 Brazilian urban areas. Multi-stage sampling was used to select 250 individuals in each city to undergo a rapid antibody test. Subjects answered a questionnaire on household assets, schooling and self-reported skin color/ethnicity using the standard Brazilian classification in five categories: white, black, brown, Asian or indigenous. Principal component analyses of assets was used to classify socioeconomic position into five wealth quintiles. Poisson regression was used for the analyses. Results. 25 025 subjects were tested in the first, 31 165 in the second, and 33 207 in the third wave of the survey, with prevalence of positive results equal to 1.4%, 2.4%, and 2.9% respectively. Individuals in the poorest quintile were 2.16 times (95% confidence interval 1.86; 2.51) more likely to test positive than those in the wealthiest quintile, and those with 12 or more years of schooling had lower prevalence than subjects with less education. Indigenous individuals had 4.71 (3.65; 6.08) times higher prevalence than whites, as did those with black or brown skin color. Adjustment for region of the country reduced the prevalence ratios according to wealth, education and ethnicity, but results remained statistically significant. Conclusions. The prevalence of antibodies against SARS-CoV-2 in Brazil shows steep class and ethnic gradients, with lowest risks among white, educated and wealthy individuals.
OBJECTIVE: To systematically review the evidence for the association between food consumption according to processing and cardiometabolic factors in adults and/or the elderly. METHOD: Two independent evaluators analyzed the electronic databases PubMed, Web of Science and Lilacs until December 2018. We used the following terms: (convenience foods OR food processing OR highly-processed OR industrialized foods OR minimally-processed OR prepared foods OR processed foods OR ultra-processed OR ultraprocessed OR ultra processed OR unprocessed) AND (metabolic syndrome OR hypertension OR blood pressure OR diabetes mellitus OR glucose OR glycaemia OR insulin OR cholesterol OR triglycerides OR blood lipids OR overweight OR obesity) AND (adult OR adults OR adulthood OR aged OR elderly OR old). We assessed methodological and evidence qualities, and also extracted information for the qualitative synthesis from the selected studies. RESULTS: Of the 6,423 studies identified after removing duplicates, eleven met the eligibility criteria. The main food classification we used was Nova. The consumption of ultra-processed foods was positively associated with overweight and obesity, high blood pressure and metabolic syndrome. All articles included met more than 50% of the methodological quality criteria. The quality of evidence was considered moderate for the outcome overweight and obesity and weak for hypertension and metabolic syndrome. CONCLUSIONS: The Nova food classification stands out in the area of nutritional epidemiology when assessing the effects of food processing on health outcomes. Although caution is required in the interpretation, the results indicated that the consumption of ultra-processed foods can have an unfavorable impact in the health of individuals.
Aim To update a systematic review and meta‐analysis of the association of breastfeeding with overweight or obesity that had been commissioned by the World Health Organization. We also assessed the likelihood of residual confounding. Methods Two independent reviewers searched MEDLINE, LILACS and Web of Science for manuscripts published between August 2014 and May 2021. Studies that only evaluated infants were excluded. Random‐effects models were used to pool the estimates. Results The review comprised 159 studies with 169 estimates on the association of breastfeeding with overweight or obesity, and most of the studies were carried out among individuals aged 1–9 years (n = 130). Breastfeeding protected against overweight or obesity (pooled odds ratio:0.73, 95% confidence interval:0.71; 0.76). And, even among the 19 studies that were less susceptible to publication bias, residual confounding and misclassification, a benefit was observed (pooled odds ratio:0.85, 95% confidence interval:0.77; 0.93). Among those studies that were clearly susceptible to positive confounding by socioeconomic status, a benefit of breastfeeding was observed even after adjusting for socioeconomic status (pooled odds ratio:0.76, 95% confidence interval: 0.69; 0.83). Conclusion Breastfeeding reduced the odds of overweight or obesity, and this association was unlikely to be due to publication bias and residual confounding.
AIMS: To describe the methodological and operational aspects of a health survey, conducted by means of a multidisciplinary research consortium.METHODS: A cross-sectional, population-based study was conducted with individuals 18 years or older, living in the urban area of the municipality of Rio Grande, in Rio Grande do Sul state, Brazil. The sampling was probabilistic, with census tracts as the primary sample unit. The research instrument consisted of a standardized and previously tested questionnaire, with closed questions, applied by face-to-face in dwellings. A brief questionnaire was administered to 10.5% of subjects for quality control purposes. Fieldwork lasted from April to July 2016, and the study was approved by an ethics committee.RESULTS: Of the 70 sampled census tracts, 711 households were randomly selected, comprising 1,429 eligible individuals. Overall, 1,300 individuals (91.0%) of 676 households (95.1%) answered the questionnaire. Losses and refusals were more prevalent for males and downtown's sectors. The questionnaire reproducibility was satisfactory (mean kappa = 0.80).CONCLUSIONS: The main methodological aspects of a multidisciplinary research consortium were pointed out, which may be of interest to other researchers. We highlight the importance of these type of study to yield information on various health conditions of the population.
Objective: We aimed at evaluating the association of maternal pre-pregnancy nutritional status with offspring anthropometry and body composition. We also evaluated whether these associations were modified by gender, diet and physical activity and mediated by birthweight. Design: Birth cohort study. Setting: Waist circumference was measured with an inextensible tape, fat and lean mass were measured using Dual-energy X-ray Absorptiometry. Multiple linear regression was used to adjust for possible confounders, and allele score of body mass index. We carried out mediation analysis using G-formula. Participants: In 1982, 1993 and 2004, all maternity hospitals in Pelotas (South Brazil) were visited daily and all livebirths whose families lived in the urban area of the city were evaluated. These subjects have been followed-up at different ages. Results: Offspring of obese mothers had on average higher body mass index, waist circumference, and fat mass index than those of normal weight mothers, and these differences were higher among daughters. The magnitudes of the association were similar in the cohorts, except for height, where the association pattern was not clear. In the 1982 cohort, further adjustment for a body mass index allele score had no material influence on the magnitude of the associations. Mediation analyses showed that birthweight captured part of this association. Conclusions: Our findings suggest that maternal pre-pregnancy nutritional status is positively associated with offspring body mass index and adiposity in offspring. And this association is higher among daughters whose mother were overweight or obese and, birthweight explain part of this association.
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