This study aimed to evaluate the association of body composition components and obesity with bone density. Prospective study with data on 2968 members of the 1993 Pelotas Birth Cohort from follow-ups at 18 and 22 years of age. Areal bone mineral density (aBMD, g/cm2) was evaluated for whole body, lumbar spine, and femoral neck at 22 years using dual-energy X-ray absorptiometry. Simple and multiple linear regression, stratified by sex, were used to assess the effect of BMI, fat mass (FMI) and lean mass index (LMI), evaluated at 18 and 22 years, and obesity trajectories classified by FMI and categorized as “never”, “only at 18 years”, “only at 22 years” or “always” on aBMD. Among men, the largest coefficients were observed for BMI, followed by lean mass and fat mass. Compared to fat mass, lean mass presented the largest coefficients for all sites, with the strongest associations observed for the femoral neck (β: 0.035 g/cm2; 95% CI: 0.031; 0.039 for both follow-ups), while the largest effect for FMI was observed for whole-body aBMD at 18 years (β: 0.019 g/cm2; 95% CI: 0.014; 0.024). Among women, the strongest associations were observed for LMI. The largest coefficients for LMI and FMI were observed for femoral neck at age 18, presented β: 0.030 g/cm2, 95% CI: 0.026, 0.034 for LMI and β: 0.012 g/cm2; 95% CI: 0.009; 0.015) for FMI. Men who were “always obese” according to FMI had smallest aBMD for spine (β: -0.014; 95%CI: − 0.029; − 0.001). Women who were obese “only at 18 years” had smallest aBMD for the whole-body (β: -0.013; 95%CI: − 0.023; − 0.002), whereas those who were obese “only at 22 years” had larger whole-body and femoral neck aBMD (β: 0.013; 95%CI: 0.009; 0.017 and β: 0.027; 95%CI: 0.016; 0.038, respectively) and those “always obese” for whole-body aBMD (β: 0.005; 95%CI: 0.001; 0.011) compared to the reference category. The indexes were positively associated with aBMD in this sample. Fat mass had smaller positive influence on these outcomes than lean mass, suggesting the most important body composition component for bone density is the lean mass.
9 November 2023 in International Journal of Epidemiology
The 2004 Pelotas Birth Cohort is a large population-based study of all live babies born from 1 January to 31 December 2004 to women living in the urban area of the city of Pelotas, Brazil. All hospitals with maternity wards were visited daily, and all live births (N = 4263) were eligible for enrolment in the cohort. A total of 4231 newborns, 99.2% of all births in the city that year, were included in the study. 1 The main objectives of the original study were to investigate the impact of early life exposures on health outcomes, and to study social inequities in health conditions. 1 After a first assessment at the time of birth, all cohort participants were assessed at ages 3, 12, 24, and 48 months and at age 6 years, with follow-up rates of 95.7%, 94.3%, 93.5%, 92.0% and 90.2%, respectively. 2 A wide range of measures have already been taken, including assessment of general and mental health, body composition, development and cognitive ability of the participants, family environment and maternal general and health. More recently, participants were assessed at ages 11, 15 and 17 years.
This article aimed to systematically review the association between socioeconomic status according to the life course models and the body mass index (BMI) in adults. A review was performed following the guidelines of the PRISMA. The studies were identified in the MEDLINE/PubMed, LILACS and Web of Science databases. The eligible articles investigated the association between at least one life course model (risk accumulation, critical period or social mobility) and BMI. In order to assess the quality of the selected articles, the NOS checklist was applied to each study. Eleven articles were selected for the systematic review, and seven articles were selected for the meta-analysis. The average score and the median in the NOS checklist were 6.4, within a maximum possible score of 8 points. The most used model was social mobility. Regarding meta-analysis, there was association between lower life course socioeconomic status and BMI among women. BMI mean difference (MD) was higher among those who remained with low socioeconomic status throughout life when compared with those who maintained a high socioeconomic status (MD: 2.17, 95%CI: 1.48; 2.86). Before that, the BMI MD was higher among those with upward mobility, compared with those who maintained a high socioeconomic status throughout life (MD: 1.20, 95%CI: 0.73; 1.68). The risk of overweight was also higher among women who maintained low socioeconomic status (summary RR: 1.70, 95%CI: 1.05; 2.74); however, according to the GRADE, the studies presented very low quality evidence. For men, no association was observed. Having low socioeconomic status sometime during life is associated with higher BMI in adulthood.
Resumo Este estudo teve como objetivo avaliar o efeito de fatores demográficos e socioeconômicos, de doenças crônicas e do recebimento de orientações em saúde no padrão alimentar de idosos. O consumo alimentar foi avaliado por meio de questionário de frequência alimentar reduzido aplicado a 1.426 idosos residentes em Pelotas, RS, Brasil e os padrões alimentares foram obtidos por análise de componentes principais. Dois padrões foram identificados: saudável (alimentos integrais, frutas, legumes/verduras e leite) e ocidental (doces, frituras, alimentos congelados, embutidos e “fast food”). Mulheres, não fumantes e não dependentes alcoólicos aderiam mais ao padrão saudável, enquanto que homens, fumantes, dependentes alcóolicos e indivíduos com sobrepeso aderiam mais ao padrão ocidental. Maior renda e escolaridade estiveram associadas à maior adesão de ambos os padrões e a presença de doenças crônicas não esteve associada a nenhum padrão. O recebimento de orientações para hábitos saudáveis esteve associado à maior adesão ao padrão saudável e menor ao padrão ocidental. Há necessidade do fortalecimento de orientações eficazes sobre hábitos saudáveis nos serviços de saúde, com especial atenção para idosos do sexo masculino, tabagistas, dependentes alcoólicos e indivíduos com sobrepeso.
Little is known about the repercussions of intimate partner violence (IPV) on nutritional outcomes in pregnancy, especially regarding diet. The aim was to investigate whether the occurrence of physical IPV at any time during pregnancy is associated with gestational dietary patterns. 161 adult pregnant women were enrolled in a prospective cohort study in Rio de Janeiro, Brazil. Overall and severe physical IPV were measured to evaluate IPV at any time during pregnancy. Three gestational dietary patterns (“Healthy”, “Common-Brazilian”, and “Processed”) were established by principal component analysis. The effect of physical IPV was tested in relation to the score of adherence to each of the dietary patterns. The occurrence of overall and severe physical IPV at any time during pregnancy was 20.4% and 6.8%, respectively. Women living in intimate relationships in which overall and severe physical IPV occurred had an average increase of 0.604 units (95%CI 0.149-1.058) and 1.347 units (95%CI 0.670-2.024), respectively, in the Processed dietary pattern adherence score. No association with “Healthy” and “Common-Brazilian” dietary patterns was observed. Physical IPV was associated with greater adherence to a dietary pattern of lower nutritional quality.
Resumo O estudo objetivou descrever a dependência relacionada às atividades de compra, preparo e ingestão de alimentos em idosos residentes na cidade de Pelotas, Rio Grande do Sul. Análise bivariada e regressão logística ordinal avaliaram a relação entre as três dependências e as exposições estudadas. Dentre os 1.451 idosos estudados, 21,1% precisavam de ajuda para alguma atividade e o cuidado foi principalmente realizado por filhos e cônjuges. A maior prevalência foi encontrada na atividade de comprar alimentos (20,7%), seguida por preparar a refeição (11,5%) e alimentar-se (2,0%). Idosos com 80 anos ou mais apresentaram mais chance de estar em uma categoria de maior dependência em relação aos de 60 a 69 anos, atingindo um odds de 5,0 para homens e 7,1 para mulheres. Para os que consideravam sua saúde regular, ruim ou muito ruim, a chance foi em torno de 2,3 vezes maior, sendo similar entre os sexos. As mulheres sem companheiro apresentaram 1,7 vezes mais chance e as com maior escolaridade apresentaram 70,0% de proteção em relação às suas categorias de referência; homens mais pobres apresentaram 5,3 vezes mais chance em comparação aos mais ricos. Os resultados apontam os subgrupos mais vulneráveis para apresentarem dependências e a importância do familiar cuidador.