Navegando por Palavras-chave "Body mass index"

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    Association between body mass index and sleep duration assessed by objective methods in a representative sample of the adult population
    (Elsevier B.V., 2013-04-01) Moraes, Walter André dos Santos [UNIFESP]; Poyares, Dalva [UNIFESP]; Zimberg, Ioná Zalcman [UNIFESP]; Mello, Marco Tulio de [UNIFESP]; Bittencourt, Lia Rita Azeredo [UNIFESP]; Santos-Silva, Rogerio [UNIFESP]; Tufik, Sergio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Sleep duration has been associated with overweight individuals in many epidemiological studies; however, few studies have assessed sleep using objective methods. Our study was designed to evaluate the association between body mass index (BMI) and sleep duration measured by actigraphy (Acti), polysomnography (PSG) and the Pittsburgh Sleep Quality Index questionnaire (PSQIO). Furthermore, we evaluated other biochemical and polysomnographic parameters.Methods: A representative sample of 1042 individuals from São Paulo, Brazil, including both genders (20-80 yrs), participated in our protocol. Weight and other anthropometric parameters were measured at the onset of the study. Sleep duration was calculated by Acti, PSG, and the PSQIQ. the population was sorted by sleep duration, body, slow wave sleep (SWS) and REM sleep (REMS) duration subsets. in addition, other biochemical and polysomnographic parameters were analyzed. Differences between population subsets were analyzed by one-way analysis of variance (ANOVA). Linear regression analysis was performed between sleep and anthropometric parameters.Results: Shorter sleep duration was associated with higher BMI and waist and neck circumference when measured by Acti and PSG (p < 0.05). Lower leptin levels were associated with short sleep in normal-weight (BMI > 18 and <= 25) individuals (p < 0.01). the association between short sleep duration Acti and higher BMI was present when apnea-hypopnea index (AHI) was less than 15 (p = 0.049). Shorter REMS and SWS also were associated with higher BMI (p < 0.01). Normal-weight individuals tended to sleep longer, have higher sleep efficiency and longer SWS and REMS than obese individuals (Acti, PSG; p = 0.05). Sleep duration was negatively correlated with BMI (Acti, PSG; p < 0.05). Short SWS and REMS were associated with higher cardiovascular risk factors (p < 0.05).Conclusion: Shorter sleep, SWS, and REMS duration were associated with higher BMI, central adiposity measurements, and cardiovascular risk factors when measured by objective methods. (c) 2012 Elsevier B.V. All rights reserved.
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    Atividade física da população nipo-brasileira de Bauru, SP: associações com a síndrome metabólica
    (Universidade Federal de São Paulo (UNIFESP), 2006-12-31) Doro, Antonio Roberto [UNIFESP]; Vivolo, Sandra Roberta Gouvea Ferreira [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Doenças associadas ao sedentarismo podem ser prevenidas por mudanças no estilo de vida. Parte dos benefícios cardiovasculares da atividade física (AF) poderiam advir de menor grau de inflamação. Este estudo descreve a AF de uma população de origem japonesa e analisa sua associação à síndrome metabólica (SM), ajustada para diversas variáveis. Baseou-se em banco de dados previamente constituído a partir de estudo de base populacional em nipo-brasileiros. Foram incluídos 1330 indivíduos 􀀀 ambos os sexos, residentes em Bauru, submetidos a entrevistas, sendo obtidos dados sócio-demográficos, de saúde, AF e de dieta, além de exames médico e laboratoriais. A avaliação da AF enfocou atividades no trabalho e nas horas vagas. O diagnóstico de SM foi baseado em adaptação para asiáticos dos critérios do NCEP. Empregou-se regressão logística, tendo a SM como variável resposta. Homens (46,1%) e mulheres apresentaram médias de idade semelhantes (57,0±12,8 e 56,9±12,2 anos, respectivamente). Houve leve predomínio do sexo feminino. Os homens apresentavam grau de instrução mais elevado e mais freqüentemente eram fumantes (p<0,001); seus valores médios de IMC, cintura e de pressão arterial (p<0,001) foram superiores aos das mulheres. Para ambos os sexos, a maioria referia praticar atividades de intensidade leve ou moderada nas horas vagas (81,2% dos homens e 86,6% das mulheres). Quanto ao esforço do trabalho, 87,8% dos homens classificaram seu esforço como leve ou moderado, contra 96,1% das mulheres. A distribuição por níveis de AF invariavelmente revelou que as mulheres eram mais inativas (p=0,01). Estratificando-se pela presença da SM, as mulheres e homens com SM eram significantemente mais velhos e apresentavam maiores valores antropométricos. Considerando a duração da caminhada ao trabalho, notou-se tendência a tempo menor entre aqueles com SM (p<0,078). Conforme esperado, indivíduos com SM apresentaram níveis significantemente maiores de pressão arterial, glicemia, lípides e HOMA-IR quando comparado aos sem SM. O HDL foi menor no grupo com SM, sendo significante no sexo feminino. Os valores médios da PCR foram maiores nos indivíduos com SM. Na regressão logística, a idade, IMC, HOMA-IR e PCR se associaram independentemente à SM, o que não ocorreu com os parâmetros usados para mensurar AF. Nossos achados não permitem afirmar que a inatividade física associa-se à presença de SM numa população nipobrasileira, mas sim um estado inflamatório sub-clínico. Limitações de ordem metodológica devem ter contribuído para achados negativos quanto a efeitos protetores da AF.
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    Avaliação de duas classificações para excesso de peso em adolescentes brasileiros
    (Faculdade de Saúde Pública da Universidade de São Paulo, 2007-08-01) Vítolo, Márcia Regina [UNIFESP]; Campagnolo, Paula Dal Bó; Barros, Maria Elisa; Gama, Cintia Mendes [UNIFESP]; Ancona Lopez, Fábio [UNIFESP]; Fundação Faculdade Federal de Ciências Médicas de Porto Alegre Departamento de Saúde Coletiva; Universidade Estadual do Rio de Janeiro Departamento de Nutrição; Universidade Federal de São Paulo (UNIFESP)
    A cross-sectional study carried out among 418 adolescents between ten and 19 years old at a private school in the city of São Paulo in 1998. The objective of the study was to evaluate the proposed thresholds for diagnosing overweight among Brazilian adolescents. The percentage body fat was measured by dual energy X-ray absorptiometry. The cutoff points used for excess body fat were 25% for boys and 30% for girls. The body mass index was classified in accordance with Cole et al and with Conde & Monteiro. The Brazilian reference (Conde & Monteiro) presented higher sensitivity among younger girls (44.2% vs. 32.6%), older girls (18.9% vs. 17%) and older boys (83.3% vs. 50%). The Conde & Monteiro proposal presented higher positive and negative predictive values and provided higher-sensitivity predictions of excess body fat among the study population.
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    Avaliação do coração fetal no primeiro trimestre de gestação: influência do comprimento cabeça-nádega e índice de massa corporal materna
    (Sociedade Brasileira de Cirurgia Cardiovascular, 2013-12-01) Pares, David Baptista da Silva [UNIFESP]; Lima, Angélia Iara Felipe [UNIFESP]; Araujo Júnior, Edward [UNIFESP]; Nardozza, Luciano Marcondes Machado [UNIFESP]; Martins, Wellington P.; Moron, Antonio Fernandes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)
    OBJECTIVE: To evaluate the influence of the crown-rump length and body mass index on sonographic evaluation of the fetal heart using abdominal and vaginal routes in the first trimester of pregnancy. METHODS: We conducted a cross-sectional study with 57 pregnant women between 12-14 weeks (CRL< 84 mm). We evaluated the following fetal cardiac plans using the abdominal and vaginal routes: four-chamber view, right ventricle outflow tract, left ventricle outflow tract and aortic arch. We used the B-mode, color Doppler and four-dimensional ultrasonography (spatio-temporal image correlation). To evaluate the influence of crown-rump length and body mass index in the assessment of fetal cardiac planes, we used the t test unpaired. RESULTS: There were no statistically significant differences in the rates of success and failure between abdominal and vaginal routes in relation to body mass index, however, there was a higher failure rate in vaginal assessment using B mode associated with color Doppler (P<0.01). CONCLUSION: The crown-rump length and body mass index had no interference in fetal cardiac assessment in the first trimester of pregnancy.
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    Body mass index percentiles in adolescents of the city of São Paulo, Brazil, and their comparison with international parameters
    (Sociedade Brasileira de Endocrinologia e Metabologia, 2010-03-01) Passos, Maria Aparecida Zanetti [UNIFESP]; Cintra, Isa de Pádua [UNIFESP]; Branco, Lúcia Maria; Machado, Helymar da Costa; Fisberg, Mauro [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Centro Paula Souza Escola Técnica Estadual (ETEC) Getúlio Vargas; Universidade Estadual de Campinas (UNICAMP)
    OBJECTIVE: To describe the percentile distribution of body mass index (BMI) in school adolescents, by gender and age, comparing them with international parameters. SUBJECTS AND METHODS: The study included 8,020 adolescents aged 10-15 years from 43 schools in the city of São Paulo, southeastern Brazil. BMI values of the study sample were distributed in percentiles and compared to international parameters (CDC, Must and cols. and Cole and cols.). RESULTS: Both male and female adolescents aged 10 to 14 years showed BMI cut-offs over the international parameters, especially in the P50-P85 percentile range. At the age of 15, the observed values were very similar to reference data; however, BMI values in the 95th percentile were much higher than international parameters. CONCLUSIONS: The study results show how important it is to use adequate BMI values for Brazilian adolescents aged 10-15 since international parameters may not reflect the actual nutritional status of this group.
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    Can sibutramine alter systemic blood pressure in obese patients? Systematic review and meta-analysis
    (Associação Paulista de Medicina - APM, 2008-11-01) Lemos Júnior, Hernani Pinto de [UNIFESP]; Atallah, Álvaro Nagib [UNIFESP]; Lemos, André Luis Alves de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    CONTEXT: Systemic arterial hypertension is part of the metabolic syndrome resulting from obesity. OBJECTIVE: To evaluate the effect of sibutramine on overweight and obese patients' blood pressure through a systematic review. METHODS: All the studies included needed to be randomized controlled trials. The methodological quality of the selected trials was assessed using the criteria described in the Cochrane Handbook. The participants were overweight and obese patients; the intervention was sibutramine compared with placebo. The primary outcome measurement was systolic and diastolic blood pressure and the secondary measurement was blood pressure. Studies were identified by searching the following sources: Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs), Medline, Cochrane reviews, manual searches, personal communication and contact with the pharmaceutical industry. There were no language, date or other restrictions. Data collection and extraction was performed by two reviewers, who independently obtained the full articles of all eligible papers. RESULTS: Three meta-analyses were produced: 1) systolic blood pressure outcome (eight studies) did not show statistical significance between sibutramine and placebo: weighted mean difference (WMD) 1.57, confidence interval (CI) -0.03 to 3.18; 2) diastolic blood pressure outcome (ten studies) did not show statistical significance between sibutramine and placebo: WMD 1.13, CI -0.49 to 2.76; 3) blood pressure outcome (two studies) also did not show statistical significance between the groups: relative risk (RR) 0.69, CI 0.07 to 7.01. CONCLUSIONS: The meta-analyses presented in this systematic review show that sibutramine does not have a statistically significant effect on blood pressure, compared with placebo.
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    Carga de trabalho de enfermagem relacionada ao índice de massa corporal de pacientes críticos
    (Univ Fed Sao Paulo, Dept Enfermagen, 2017) Goulart, Luana Loppi [UNIFESP]; Carrara, Fernanda Souza Angotti [UNIFESP]; Zanei, Suely Sueko Viski [UNIFESP]; Whitaker, Iveth Yamaguchi [UNIFESP]
    Objective: To measure and compare the nursing workload and the frequency of the items scored in the Nursing Activities Score (NAS) considering the different groups of BMI of patients hospitalized in Intensive Care Units (ICU). Methods: Longitudinal study conducted in the ICU of a university hospital in Sao Paulo in which the BMI of patients was calculated by dividing the weight by the square of the height and the nursing workload was measured through the NAS. Results: Analysis of 529 patients showed that the NAS did not differ between the groups according to the BMI. Obese patients demanded more time for hygiene procedures and more people to support the mobilization/positioning process. Underweight patients received treatment for improving lung function with a higher frequency. Conclusion: The results showed no difference in the nursing workload when the BMI of the patient was considered.
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    Clinical characteristics associated with hepatic steatosis on ultrasonography in patients with elevated alanine aminotransferase
    (Associação Paulista de Medicina - APM, 2010-12-01) Narciso-Schiavon, Janaína Luz [UNIFESP]; Schiavon, Leonardo de Lucca [UNIFESP]; Carvalho-Filho, Roberto José de [UNIFESP]; Hayashida, Débora Yumi [UNIFESP]; Wang, Jenny Hue Jiuan [UNIFESP]; Souza, Tatiana Santana [UNIFESP]; Emori, Christini Takemi [UNIFESP]; Ferraz, Maria Lucia Cardoso Gomes [UNIFESP]; Silva, Antonio Eduardo Benedito [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    CONTEXT AND OBJECTIVE: The main causes of hepatic steatosis (HS) are alcoholic liver disease and nonalcoholic fatty liver disease (NAFLD). Although liver biopsy is the gold standard for NAFLD diagnosis, the finding of abnormal aminotransferases in abstinent individuals, without known liver disease, suggests the diagnosis of NAFLD in 80-90% of the cases. Identification of clinical factors associated with HS on abdominal ultrasound may enable diagnoses of fatty liver non-invasively and cost-effectively. The aim here was to identify clinical variables associated with HS in individuals with elevated alanine aminotransferase (ALT) levels. DESIGN AND SETTING: Cross-sectional study in a single tertiary care center. METHODS: Individuals with elevated ALT, serologically negative for hepatitis B and C, were evaluated by reviewing medical files. Patients who did not undergo abdominal ultrasonography were excluded. RESULTS: Among 94 individuals included, 40% presented HS on ultrasonography. Compared with individuals without HS, those with fatty liver were older (P = 0.043), with higher body mass index (BMI) (P = 0.003), diabetes prevalence (P = 0.024), fasting glucose levels (P = 0.001) and triglycerides (P = 0.003). Multivariate analysis showed that BMI (odds ratio, OR = 1.186; 95% confidence interval, CI: 1.049-1.341; P = 0.006) and diabetes mellitus (OR = 12.721; 95% CI: 1.380-117.247; P = 0.025) were independently associated with HS. CONCLUSIONS: Simple clinical findings such as history of diabetes and high BMI may predict the presence of HS on ultrasonography in individuals with elevated ALT and negative serological tests for hepatitis.
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    The effect of participation in school-based nutrition education interventions on body mass index: A meta-analysis of randomized controlled community trials
    (Elsevier B.V., 2013-03-01) Cardoso da Silveira, Jonas Augusto [UNIFESP]; Aguiar Carrazedo Taddei, Jose Augusto de [UNIFESP]; Guerra, Paulo Henrique; Cuce Nobre, Moacyr Roberto; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)
    Objective. the aim of this study was to evaluate the effectiveness of school-based nutrition education interventions in reducing or preventing overweight and obesity among children and adolescents.Methods. We conducted a systematic search of 14 databases until May 2010 and cross-reference check in 8 systematic reviews (SRs) for studies published that described randomized controlled trials conducted in schools to reduce or prevent overweight in children and adolescents. An additional search was carried out using PubMed for papers published through May 2012, and no further papers were identified. Body mass index (BMI) was the primary outcome. the title and abstract review and the quality assessment were performed independently by two researchers. the software EPPI-Reviewer3 was used to store, manage and analyze all data. This SR is registered at ClinicalTrials.gov (NCT00985972).Results. From the 4888 references initially retrieved, only 8 met the eligibility criteria for a random-effects meta-analysis. the total population consisted of 8722 children and adolescents. Across the studies, there was an average treatment effect of -0.33 kg/m(2) (-0.55, 0.11 95% CI) on BMI, with 84% of this effect explained by the highest quality studies.Conclusion. This systematic review provides evidence that school-based nutrition education interventions are effective in reducing the BMI of children and adolescents. (c) 2013 Elsevier Inc. All rights reserved.
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    Ethnic disparity in spontaneous preterm birth and maternal pre-pregnancy body mass index
    (Springer, 2012-04-01) Torloni, Maria Regina [UNIFESP]; Fortunato, Stephen J.; Betran, Ana Pilar; Williams, Scott; Brou, Lina; Drobek, Cayce Owens; Merialdi, Mario; Menon, Ramkumar; Universidade Federal de São Paulo (UNIFESP); Centennial Womens Hosp; World Hlth Org; Vanderbilt Univ; Emory Univ; Univ Texas Med Branch Galveston
    To investigate differences in pre-pregnancy BMI status in patients with spontaneous preterm birth (PTB) compared with term birth and assess the role of ethnicity as a risk modifier in BMI-associated PTB.A case-control study involving self-reported African American and Caucasian women delivering singletons in Nashville, TN, USA, 2003-2009. Maternal pre-pregnancy BMI was recorded in 447 PTB-cases (African American = 145, Caucasian = 302) and 1315 term-birth controls (African American = 522; Caucasian = 793). Crude and adjusted odds ratio (OR and AOR) for PTB were calculated using normal BMI (18.5-24.9 kg/m(2)) as reference. Age, education, marital status, income, smoking, parity, previous PTB and pregnancy weight gain were included as covariates in logistic regression.No significant differences were noted in the OR for PTB among different BMI categories when women of different ethnicity were combined. Odds of PTB were greater in obese than in normal weight Caucasian women, even after adjusting for confounders (AOR = 1.84, 95%CI [1.15, 2.95]). Obese African American women had a decreased crude OR for PTB, although this was not significant after adjusting for confounders (AOR = 0.72, 95%CI [0.38, 1.40]). the odds for early PTB (< 32 weeks) were decreased in obese compared with normal weight African American women (OR = 0.23, 95%CI [0.08, 0.70]), whereas they were increased in obese compared with normal weight Caucasian women (OR = 2.30, 95%CI [1.32, 4.00]).The risk for PTB in women with different pre-pregnancy BMI categories differs according to ethnicity.
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    Excess of adiposity in female children and adolescents with juvenile idiopathic arthritis
    (Springer, 2012-06-01) Caetano, Michelle Cavalcante [UNIFESP]; Sarni, Roseli Oselka Saccardo [UNIFESP]; Lemos Terreri, Maria Teresa [UNIFESP]; Ortiz, Thais Tobaruela [UNIFESP]; Pinheiro, Marcelo [UNIFESP]; Suano de Souza, Fabiola Isabel [UNIFESP]; Hilario, Maria Odete [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    This study aims to evaluate the body composition (BC) of female children and adolescents with juvenile idiopathic arthritis (JIA). A cross-sectional, controlled study was performed to compare the BC between 42 JIA girls and 35 healthy controls, matched for age and gender. Weight and height were used to calculate body mass index (BMI), classified as a Z-score (Z-BMI). BC was evaluated by dual-energy X-ray absorptiometry (DXA; DPX-L, Lunar). the fat mass index (FMI) was calculated as the ratio between total fat mass and height squared (kilograms per square metre). the lean mass index (LMI) was calculated as the ratio between total lean mass and height squared (kilograms per square metre). in JIA patients, the median of age was 13 years (6-19) and median disease duration was 84 months (10.0-215.0). the main disease subtype was polyarticular arthritis (54.8%). We observed that 61.9% of patients had normal Z-BMI. JIA girls had higher median Z-BMI scores (0.17 vs. -0.48, p=0.034), total body fat percentages (26.5% vs. 16.4%, p=0.001), truncal fat (4.52 vs. 2.32, p=0.011) and FMI (4.83 vs. 2.23, p<0.001). for LMI, there was no difference between JIA girls and controls (13.45 vs. 12.45, p=0.212). We did not find association between FMI and age, disease subtype, number of limited and/or active joints, months since diagnosis and use of corticosteroids or methotrexate. BC changes found in JIA girls, such as fatness and adiposity, indicate a potentially greater risk for developing hypertension, diabetes mellitus and cardiovascular diseases. These findings emphasise the importance of evaluating nutritional status and body composition to minimise the emergence of chronic diseases later in life.
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    Excesso de peso e gordura abdominal para a síndrome metabólica em nipo-brasileiros
    (Faculdade de Saúde Pública da Universidade de São Paulo, 2002-02-01) Lerario, Daniel D G [UNIFESP]; Gimeno, Suely Godoy Agostinho [UNIFESP]; Franco, Laercio Joel [UNIFESP]; Iunes, Magid [UNIFESP]; Ferreira, Sandra Roberta Gouvea [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: Obesity, especially abdominal, has been associated with cardiovascular risk factors such as dyslipidemia, hypertension and diabetes mellitus (DM). The importance of these risk factors among Japanese-Brazilians was previously shown, although obesity is not a typical characteristic of Japanese migrants. In this study the prevalence of weight excess and central adiposity (CA) among Japanese-Brazilians and their association with metabolic disorders was evaluated. METHODS: A sample of 530 1st and 2nd generation Japanese-Brazilians (aged 40--79 years) went through anthropometric and blood pressure measurements, lipid profile and oral glucose tolerance tests. The prevalence rate (point and confidence interval) of overweight was calculated using a cut-off value of >26.4 kg/m². CA diagnosis was based on waist-to-hip circumference ratio (WHR):> or =0.85 and 0.95 in women and men, respectively. RESULTS: The prevalence of weight excess was 22.4% (CI 95% 20.6--28.1), and CA was 67.0% (95% CI 63.1--70.9). In addition to higher prevalence of DM, hypertension and dyslipidemia, stratifying by BMI and WHR, people with weight excess and CA revealed a poorer metabolic profile: blood pressure levels were significantly higher among those with weight excess with or without CA; CA individuals had higher glucose, triglycerides, total and LDL cholesterol, and lower HDL than those without weight excess or CA; fasting insulinemia was significantly higher among subjects with weight excess (with or without CA) than among those without weight excess or CA. CONCLUSION: Comparing subgroups with and without CA supports the hypothesis that abdominal fat accumulation represents a risk factor for insulin resistance-related diseases, even among Japanese descendants. The increased prevalence of metabolic syndrome among Japanese migrants could be attributed to visceral fat deposition, which has been implicated in the genesis of insulin resistance.
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    Family meals and eating practices among mothers in Santos, Brazil: A population-based study
    (Academic Press Ltd- Elsevier Science Ltd, 2016) Sato, Priscila de Morais [UNIFESP]; Lourenço, Bárbara Hatzlhoffer; Bizzotto Trude, Angela Cristina; Unsain, Ramiro Fernandez [UNIFESP]; Pereira, Patricia Rocha [UNIFESP]; Martins, Paula Andrea [UNIFESP]; Scagliusi, Fernanda Baeza; Universidade Federal de São Paulo (UNIFESP)
    This study investigates family meals among mothers and explores associations between eating with family and sociodemographic characteristics, body mass index, and eating practices. A population-based cross-sectional study, using complex cluster-sampling, was conducted in the city of Santos, Brazil with 439 mothers. Frequency of family meals was assessed by asking if mothers did or did not usually have a) breakfast, b) lunch, and c) dinner with family. Linear regression analyses were conducted for the number of meals eaten with family per day and each of the potential explanatory variables, adjusting for the mother's age. Poisson regression with robust variance was used to analyze each factor associated with eating with family as classified categorically: a) sharing meals with family, b) not eating any meals with family. Only 16.4% (n = 72) of participants did not eat any meals with family. From the 83.6% (n = 367) of mothers that had at least one family meal per day, 69.70% (n = 306) ate dinner with their families. Mothers aged ≥40 years reported significantly fewer meals eaten with family compared to mothers aged 30–39 years (β: −0.26, p = 0.04). Having family meals was 54% more prevalent among mothers with ≥12 years of education (PR for no meals eaten with family: 0.54, 95% CI: 0.30; 0.96, p = 0.03), when compared to mothers with less than nine years of education. Eating no meals with family was 85% more prevalent among mothers who reported that eating was one of the biggest pleasures in their lives (PR: 1.85, 95% CI: 1.21; 2.82, p = 0.004). We suggest the need for further research investigating the effects of family meals on mothers' health through nutritional and phenomenological approaches
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    Fatores modificáveis da degeneração macular relacionada à idade
    (Conselho Brasileiro de Oftalmologia, 2009-06-01) Torres, Rogil José De Almeida [UNIFESP]; Maia, Maurício [UNIFESP]; Muccioli, Cristina [UNIFESP]; Winter, Guilherme; Souza, Greyce Kelly De; Pasqualotto, Luca Rodrigo; Luchini, Andréa; Précoma, Dalton Bertolim; Hospital Angelina Caron; Universidade Federal de São Paulo (UNIFESP); Hospital de Olhos Oeste Paulista Serviço de Cirurgia Vitreorretiniana; Pontifícia Universidade Católica do Paraná; PUCPR; Centro Oftalmológico de Curitiba; PUCPR Departamento de Cardiologia
    The authors present the main modifiable risk factors that may trigger and/or worsen age-related macular degeneration. Mechanisms of action related to these factors as well as preventive measures and intervention effectiveness are discussed.
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    Imagem corporal, índice de massa corporal, perímetro da cintura, alteração da pressão arterial e intolerância à glicose entre os povos indígenas do Xingu, Brasil
    (Universidade Federal de São Paulo (UNIFESP), 2016-12-05) Santos, Kennedy Maia dos [UNIFESP]; Gimeno, Suely Godoy Agostinho [UNIFESP]; http://lattes.cnpq.br/9976167885272728; http://lattes.cnpq.br/9976167885272728; Universidade Federal de São Paulo (UNIFESP)
    Objective: To assess body self-image, nutritional status and the cutoff points of body mass index (BMI) and waist circumference (WC) and the association with alteration in blood pressure (BP) and glucose intolerance (GI) among indigenous peoples of the Xingu, Brazil. Methods: Cross-sectional study that evaluated data from 131 individuals of Khisêdjê ethnicity with twenty years or more and 919 natives in the same age group, belonging to fourteen ethnic groups in the Xingu Indigenous Park (PIX), including Panará, who lived in the PIX up 1997. Data collection was carried out in the indigenous villages by trained professionals at different times: in 1999 (Suyá/Khisêdjê), 2000-2002 (ethnic groups of the Upper Xingu), 2006-2007 (Panará) and 2010 - 2011 (Khisêdjê). We collected data on BMI by weight and height, WC, blood pressure and fasting glucose, body self-image (only Khisêdjê) and physical activity (only Khisêdjê). Data analysis was performed using the chi-square, Student's t test, Kappa statistics, prevalence ratios by Poisson regression. To identify cutoff points of BMI and WC from which there was an increased prevalence of alteration in blood pressure and glucose intolerance was used the logistic regression, calculating the sensitivity, specificity and percentage of individuals correctly classified by BMI and WC according to percentiles 25, 50, 75, 90 and 95 and ROC curve analysis (receiver operating characteristic) to assess the accuracy of tests. Results: Among the Khisêdjê, satisfaction with body image was 61.8%, with no difference between sexes. There was good agreement between real and ideal self-image among men and women (p<0.001) but low correlation between real and ideal self-image and nutritional status. There was higher prevalence of dissatisfaction overweight among individuals with central obesity (PR = 2.76 and 95% CI: 1.10-6.92), overweight (PR = 2.77 and 95% CI: 1.19-6.47), among those with GI (PR = 2.44 and 95% CI: 1.19-5.01) and among subjects with average performance in trunk flexion test (PR = 7.53 95% CI: 1.37-41.31). In the analysis including indigenous PIX, the percentages of overweight and obesity were 39.7% and 7.8% respectively. The prevalences of hypertension and diabetes mellitus were 5.5% and 1.2%, respectively. There has been no trend of increased prevelence of GI and alteration in blood pressure according to the increase in WC values. As for BMI values between 32.0 and 32.9 kg/m2 were associated with higher prevalence of GI (OR = 12.26, 95% CI 2.25-66.65). Also, BMI values from 30.0 to 30.9 kg/m2 (OR = 3.59, 95% CI 1.21-10.61) and from 31.0 to 31.9 kg/m2 (OR = 6. 05, 95% CI 1.53-23.86) were associated with the occurrence of alteration in BP. The values of the X and Y axes regarding the intersection between the sensibility and sensitivity curves in predicting the GI for the WC test were respectively 89 cm and 0.54 for females, and 84.3 cm and 0.54 for males; in prediction of alteration BP values were respectively 85.7 cm and 0.52 for both sexes. As for BMI, the values were 24.9 kg/m2 and 0.53 in prediction of alteration BP and 25 kg/m2 and 0.53 in predicting GI. Conclusions: Despite the high prevalence of overweight identified between men and central obesity among women, satisfaction with body image was high in both sexes. These findings, together with the observed low correlation between nutritional status and real and ideal self-image suggests that it is possible that among the Khisêdjê, the ideal body shape is the one with the larger body size compared to the idealized in Western populations. The best cutoff points for discriminating the presence of GI and alteration BP among PIX Indians were close to recommended for the WC and similar to those recommended for BMI. However, both WC and BMI had low discriminatory power in predicting two outcomes in question.
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    Inactivity and clinical and metabolic variables associated with adolescent obesity
    (Pontificia Universidade Catolica Campinas, 2011-07-01) Abbes, Priscila Trapp; Lavrador, Maria Silvia Ferrari [UNIFESP]; Schimith Escrivão, Maria Arlete Meil [UNIFESP]; Taddei, Jose Augusto de Aguiar Carrazedo [UNIFESP]; Univ Fed Amazonas; Universidade Federal de São Paulo (UNIFESP)
    ObjectiveThis study investigated the association of obesity with metabolic and clinical variables and inactivity in post-pubertal adolescents attending public schools in Sao Paulo City.MethodsThis was a case-control study with 128 obese adolescents (body mass indices >= the 95(th) percentile), and 151 normal weight adolescents (body mass indices between the 5(th) and 85(th) percentiles). Physical examination and biochemical and body composition assessments were done. A pretested questionnaire was administered, generating an inactivity score. Analysis of variance was performed with multiple comparison tests (Bonferroni and Pearson's chi-Square). A multiple regression model was used to ascertain the association among clinical variables, metabolic variables, inactivity score and nutritional status.ResultsAnalysis of variance allowed the identification of a gradient of mean metabolic and clinical variables which worsened as activity decreased, confirmed by the chi-square test. In the bivariate analysis for obesity risk, obese adolescents were more frequently inactive, presented low high-density lipoprotein and high triglyceride levels, hyperinsulinemia, high homeostasis model assessment for insulin resistance, and high blood pressure (p<0.05). The multiple logistic model showed associations between obesity and inactivity (OR=2.23), low high-density lipoprotein levels (OR=3.05), high blood pressure (OR=3.57), high triglyceride levels (OR=4.13) and high homeostasis model assessment for insulin resistance (OR=11.65).ConclusionInactivity, low high-density lipoprotein, hypertriglyceridemia, insulin resistance and hypertension are strongly associated with obesity in adolescents. Strategies to reduce body weight by changing life habits should be part of public health programs and policies, especially for this age group.
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    Increased MMA concentration and body mass index are associated with spontaneous abortion in Brazilian women A pilot study
    (Elsevier B.V., 2010-03-02) Guerra-Shinohara, Elvira M.; Pereira, Perla M.; Kubota, Ananka M.; Silva, Thaiomara A.; Reis, Jucilene L.; Miyashita, Gerson S.; D'Almeida, Vania [UNIFESP]; Allen, Robert H.; Stabler, Sally P.; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP); Univ Colorado
    Background: the pathophysiology of spontaneous abortion is complex and may involve the interaction of genetic and environmental factors. We evaluated the predictors of spontaneous abortion in Brazilian pregnant women. the effects of age, gestational age. body mass index (BMI), cigarette smoking, alcohol ingestion, use of multivitamins and concentrations of vitamins (folate, cobalamin and vitamin 136) and vitamin-dependent metabolites were analyzed.Methods: Study population included 100 healthy women that attended pre-natal care in 2 health centers of São Paulo, Brazil, and in whom pregnancy outcome was known. Folate and cobalamin status was measured in blood specimens collected between 4 and 16 weeks. the genotypes for 8 gene polymorphisms were evaluated by PCR-RFLP.Results: Eighty-eight women had normal pregnancy outcome (Group 1), while 12 experienced a miscarriage after blood collection (Group 2). Increased methylmalonic acid (MMA) concentrations were found in Group 2 (median [25th-75th percentile]=274 [149-425] nmol/l) relative to Group 1 (138 [98-185]) (P<0.01). No differences between the groups were observed for serum cobalamin, serum or red cell folate, and serum total homocysteine or allele frequencies for 8 polymorphisms. in a conditional logistic regression analysis including age, gestational age, serum creatinine, MMA, cystathionine, body mass index (BMI), cigarette smoking, alcohol ingestion and use of multivitamins the risk of abortion was significantly associated with MMA (OR [95% CI] = 3.80 [1.36, 10.62] per quartile increase in MMA), BMI (OR [95% CI] = 5.49 [1.29,23.39] per quartile) and gestational age (OR [95% CI] = 0.10 [0.01, 0.77] per increase of interval in gestational age).Conclusions: Increased serum MMA and BMI concentrations are associated with spontaneous abortion in Brazilian women. (C) 2009 Elsevier B.V. All rights reserved.
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    The influence of 6 months of oral anabolic steroids on body mass and respiratory muscles in undernourished COPD patients
    (Amer Coll Chest Physicians, 1998-07-01) Ferreira, Ivone Martins [UNIFESP]; Verreschi, Ieda Therezinha do Nascimento [UNIFESP]; Nery, Luiz Eduardo [UNIFESP]; Goldstein, Roger S. [UNIFESP]; Zamel, Noe [UNIFESP]; Brooks, Dina; Jardim, Jose Roberto [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Univ Toronto
    Study objective: To evaluate the influence of oral anabolic steroids on body mass index (BMI), lean body mass, anthropometric measures, respiratory muscle strength, and functional exercise capacity among subjects with COPD,Design: Prospective, randomized, controlled, double-blind study.Setting: Pulmonary rehabilitation program.Participants: Twenty-three undernourished male COLD patients in whom BMI was below 20 kg/m(2) and the maximal inspiratory pressure (PImax) was below 60% of the predicted value,Intervention: the study group received 250 mg of testosterone IM at baseline and 12 mg of oral stanozolol a day for 27 weeks, during which time the control group received placebo. Both groups participated in inspiratory muscle exercises during weeks 9 to 27 and cycle ergometer exercises during weeks 18 to 27,Measurements and results: Seventeen of 23 subjects completed the study. Weight increased in nine of 10 subjects who received anabolic steroids (mean, +1.8+/-0.5 kg; p<0.05), whereas the control group lost weight (-0.4+/-0.2 kg), the study group's increase in BMI differed significantly from that of the control group from weeks 3 to 27 (p<0,05). Lean body mass increased in the study group at weeks 9 and 18 (p<0,05), Arm muscle circumference and thigh circumference also differed between groups (p<0.05), Changes in PImax (study group, 41%; control group, 20%) were not statistically significant. No changes in the 6-min walk distance or in maximal exercise capacity were identified in either group,Conclusion: the administration of oral anabolic steroids for 27 weeks to malnourished male subjects with COPD was free of clinical or biochemical side effects. It was associated with increases in BMI, lean body mass, and anthropometric measures of arm and thigh circumference, with no significant changes in endurance exercise capacity.
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    Influência do índice de massa corporal na incontinência urinária feminina
    (Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2010-09-01) Oliveira, Emerson; Lozinsky, Adriana Chebar [UNIFESP]; Palos, Claudia Cristina; Ribeiro, Daniela D'amelio Melara; Souza, Angela Mara Bentes De; Barbosa, Caio Parente; Faculdade de Medicina do ABC Departamento de Obstetrícia e Ginecologia Setor de Uroginecologia e Cirurgia Vaginal; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: to evaluate and compare the effects of body mass index (BMI) on the severity of female urinary incontinence (UI) using the quality of life questionnaire King's Health Questionnaire (KHQ), variables of urodynamic studies and the medical history taken. METHODS: cross-sectional clinical study. We selected 65 patients with stress urinary incontinence (SUI) who were divided into three groups: Group I (BMI: 18-25 kg/m²), Group II (BMI: 25-30 kg/m²) and Group III (BMI>30 kg/m²). The KHQ domains were compared between these groups. In addition, some clinical history urodynamic data (presence of nocturia, enuresis, urgency and urge incontinence) were also related to BMI by calculating the Odds Ratio (OR). The BMI in the presence and absence of non-inhibited detrusor contractions and Valsalva leak point pressure (VLPP) <60 or > 60 cmH2O were evaluated. Finally, the correlation between BMI and the nine KHQ domains has been tested in order to detect some association. RESULTS: the KHQ did not record deterioration of quality of life in women with UI with increasing BMI in any of its areas. The OR for the presence of enuresis in relation to a BMI was 1.003 [CI: 0.897-1.121], p=0.962. The OR for nocturia was 1.049 [CI: 0.933-1.18], p=.425. The OR for urgency was 0.975 [CI: 0.826-1.151], p=0.762, and the OR for incontinence was 0.978 [CI: 0.85-1.126], p=0.76. We studied the BMI in patients with and without non-inhibited detrusor contractions and detected medians of 26.4±4.8 and 28.3±5.7 kg/m², respectively (p=0.6). Similarly, the median BMI values for the groups with VLPP <60 and >60 cmH2O were 29.6±4.1 and 27.7±5.7 kg/m², respectively (p=0.2). Finally, we failed to demonstrate an association between BMI and any of the nine KHQ domains by means of the Spearman correlation. CONCLUSION: there was no association of KHQ scores with BMI. There was also no correlation between the parameters of clinical history and of the urodynamic study with BMI.
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    Is the chronotype associated with obstructive sleep apnea?
    (Springer, 2015-05-01) Kim, Lenise Jihe [UNIFESP]; Coelho, Fernando Morgadinho [UNIFESP]; Hirotsu, Camila [UNIFESP]; Bittencourt, Lia [UNIFESP]; Tufik, Sergio [UNIFESP]; Andersen, Monica Levy [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Chronotype and obstructive sleep apnea (OSA) appear to have a similar lifelong evolution, which could indicate a possible effect of morningness or eveningness in the apnea-hypopnea index (AHI). the present study aimed to examine the prevalence of chronotypes in a representative sample of So Paulo city residents and to investigate the effect of chronotypes on the severity of OSA.We performed a cross-sectional analysis using the So Paulo Epidemiologic Sleep Study (EPISONO). All participants underwent a full-night polysomnography and completed the Morningness-eveningness, Epworth Sleepiness Scale, and UNIFESP Sleep questionnaires. Chronotypes were classified as morning-type, evening-type, and intermediate.Morning-type individuals represented 52.1 % of the sample, followed by intermediate (39.5 %), and evening-type (8.4 %) individuals. After stratifying the sample by body mass index (BMI) (> 26.8 kg/m(2)) and age (> 42 years), we observed increased AHI values in morning- and evening-type individuals.We demonstrated, for the first time, an age- and BMI-related effect of morning- and evening-types in OSA severity, suggesting that the intermediate chronotype might play a role as a protective factor in older and overweight patients.