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R Sichieri

Publications and source records attributed to R Sichieri.

30 records · Page 2Linked to original sources

Growth and body mass index of Brazilians ages 9 through 17 years.

Obesity during adolescence is considered a strong predictor of adult obesity, and obesity and overweight have been increasing among Brazilian adults. To gauge the relative frequency of overweight among adolescents in Brazil, we compared the distributions of body mass index (kg/m2) and stature in national population based samples of the U.S. and Brazil. U.S. adolescents were on average about 10 cm taller than Brazilians, although growth spurts occurred at the same age for both populations. Brazilian adolescents were leaner than their U.S. counterparts. This difference was reduced among girls in the postpubertal period. At age 17 years, U.S. boys were about 10 kg heavier than Brazilian boys, but the difference among girls was only 2 kg. In families above the poverty level in the more developed South region, body mass index distribution for boys was closer to that of the U.S., and older girls tended to have higher body mass index than U.S. girls. Within Brazil, body mass index varied by ethnicity with Mulattos, but not Blacks, of both sexes having lower body mass index than Whites of the same age. Urban adolescents had higher body mass index than those living in rural areas. In general, the patterns seen among Brazilian adults were found among children. Among girls, in particular, overweight has become an identifiable problem during adolescence.

Adolescent↗

High temporal, geographic, and income variation in body mass index among adults in Brazil.

OBJECTIVES: Population-based data on body mass index for developing countries are scarce. Body mass index data from two Brazilian surveys were examined to determine regional and temporal variations in the prevalences of underweight, overweight, and obesity. METHODS: Nationwide surveys in 1974/75 and 1989 collected anthropometric data in Brazil from 55,000 and 14,455 households, respectively. Trained interviewers used the same methods to measure weight and stature in both surveys, and survey designs were identical. Prevalences of underweight, overweight, and obesity were determined for persons 18 years of age and older. RESULTS: In the 1989 survey, body mass index varied greatly according to region of the country, urbanization, and income. In the wealthier South, the prevalence of overweight/obesity was the highest and the prevalence of underweight was the lowest; in the poorer rural Northeast, these patterns were reversed. For both surveys, overweight/obesity was more common among women than among men and peaked at age 45 to 64 years in both sexes. Over the 15 years between surveys, the prevalence of both overweight and obesity increased strikingly. CONCLUSIONS: In contrast to findings in developed countries, obesity in Brazil was positively associated with income and was much more prevalent among women than among men. For Brazilian women, the overall prevalence of overweight was nearly as high as that among women in the United States.

Adult↗

Geographical patterns of proportionate mortality for the most common causes of death in Brazil.

Mortality due to chronic diseases has been increasing in all regions of Brazil with corresponding decreases in mortality from infectious diseases. The geographical variation in proportionate mortality for chronic diseases for 17 Brazilian state capitals for the year 1985 and their association with socio-economic variables and infectious disease was studied. Calculations were made of correlation coefficients of proportionate mortality for adults of 30 years or above due to ischaemic heart disease, stroke and cancer of the lung, the breast and stomach with 3 socio-economic variables, race, and mortality due to infectious disease. Linear regression analysis included as independent variables the % of illiteracy, % of whites, % of houses with piped water, mean income, age group, sex, and % of deaths caused by infectious disease. The dependent variables were the % of deaths due to each one of the chronic diseases studied by age-sex group. Chronic diseases were an important cause of death in all regions of Brazil. Ischaemic heart diseases, stroke and malignant neoplasms accounted for more than 34% of the mortality in each of the 17 capitals studied. Proportionate cause-specific mortality varied markedly among state capitals. Ranges were 6.3-19.5% for ischaemic heart diseases, 8.3-25.4% for stroke, 2.3-10.4% for infections and 12.2-21.5% for malignant neoplasm. Infectious disease mortality had the highest (p < 0.001) correlation with all the four socio-economic variables studied and ischaemic heart disease showed the second highest correlation (p < 0.05). Higher socio-economic level was related to a lower % of infectious diseases and a higher % of ischaemic heart diseases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Relative weight classifications in the assessment of underweight and overweight in the United States.

We compared five recent relative weight classifications based on body mass index for their estimates of prevalence of underweight and overweight in the adult population of the United States and for their ability to predict subsequent morbidity and mortality. The sources of the classifications were: the 1990 Dietary Guidelines for Americans of the US Departments of Agriculture and Health and Human Services, the National Academy of Sciences, the National Center for Health Statistics, the World Health Organization, and the Canadian Minister of National Health and Welfare. These classifications were applied to the body mass index distributions of the second National Health and Nutrition Examination Survey (1976-1980) and to the Hispanic Health and Nutrition Examination Survey (1982-1984). Depending on classification, a wide range of prevalence for the total population was found: 9-17% of the US population were categorized as underweight, and 25-45% were categorized as overweight. White women had the highest prevalence of underweight in all but the National Center for Health Statistics classification. Black and Mexican American women had the highest prevalence of overweight under all classifications (range: 38.4-58.6%). Associations with health outcomes were determined using all cause hospitalization and mortality in the 1971-1987 follow-up of the first National Health and Nutrition Examination Survey. Underweight and overweight as defined by the National Academy of Sciences classification had the highest population attributable risk for hospitalization and death: 5.0% of hospitalizations and 11.0% of deaths among men and 4.2% of hospitalizations and 11.4% of deaths among women were associated with weights outside the healthy range. Under this classification a greater proportion of both hospitalizations and mortality were associated with overweight than underweight. For all classifications, a higher proportion of hospitalizations were associated with overweight than underweight. All classifications performed better at predicting death than hospitalization.

Adult↗

A prospective study of hospitalization with gallstone disease among women: role of dietary factors, fasting period, and dieting.

BACKGROUND: Dietary risk factors for the development of gallstones have not been clearly established. We analyzed data from a population-based prospective study to determine dietary risk factors for hospitalization with gallstone disease. METHODS: We evaluated the role of dietary constituents, fasting, and dieting on subsequent hospitalization with gallstone disease among 4,730 women, ages 25 to 74 years, who participated in the first follow-up of the first National Health and Nutrition Examination Survey. Baseline dietary variables were established through a 24-hour dietary recall and a medical history. Proportional hazards models were used to calculate the effects of dietary variables while controlling for baseline risk factors. RESULTS: After an average of 10 years follow-up, gallstone disease was confirmed by hospital records among 216 women who denied gallstone disease at the baseline examination. The hazard rate of hospitalization with gallstone disease increased with increasing overnight fasting period and with dieting. Intake of fiber showed a small protective effect. The effect of energy intake was significant only among women younger than age 50 years at baseline. Results were not affected by adjustment for known risk factors for gallstone disease or other dietary factors. CONCLUSION: A long overnight fasting period, dieting, and low fiber intake may increase the risk of hospitalization with gallstone disease.

Adult↗

Low incidence of hospitalization with gallbladder disease among blacks in the United States.

Low rates of gallbladder disease among blacks have been reported but not systematically studied. The authors investigated the rate of hospitalization with a diagnosis of gallbladder disease in the follow-up in 1982-1984 of the first National Health and Nutrition Examination Survey, a population-based study conducted across the United States in 1971-1975. Based on hospital discharge diagnoses of gallbladder disease, 368 cases were identified for the period 1971-1984 among 10,551 persons, aged 25-74 years, who denied gallbladder disease at the baseline examination. The crude incidence of gallbladder disease per 1,000 person-years was 2.59 for white men, 1.45 for black men, 4.09 for white women, and 2.35 for black women. Controlling for obesity, parity, ethanol consumption, use of diuretics, use of oral contraceptives, and two indicators of socioeconomic status, the authors found that the hazard rate of hospitalization with gallbladder disease increased with age for white women and decreased for black women. The hazard ratio for black women compared with white women at 30 years of age was 0.71 with a 95% confidence interval of 0.52-0.96, but at age 70, it was 0.18 with a 95% confidence interval of 0.09-0.37. For women, obesity and parity were important risk factors for gallbladder disease (p less than or equal to 0.001), and the use of diuretics was marginally associated (p = 0.08). Black men compared with white men had a hazard rate of gallbladder disease of 0.53 with a 95% confidence interval of 0.24-1.16. For men, increasing age was related to gallbladder disease (p less than 0.001), and obesity was weakly related (p = 0.06). The black/white hazard ratios decreased further when controlling for socioeconomic status, persisted if the study population was limited to those hospitalized during follow-up, and increased slightly for cases with an acute complication of gallbladder disease. Thus, differential access to medical care may not explain the lower rate among blacks.

Adult↗

Influence of ambient temperature on the sleep-wakefulness cycle in the golden hamster.

The sleep-wakefulness cycle (SWC) of euthermic golden hamsters (Mesocricetus auratus) after 5 weeks of warm (30 degrees C) and of cold (5 degrees C) acclimation, was recorded at ambient temperatures between 5 degrees and 35 degrees C. Significant influences both of acclimation and of recording temperature were detected. Amount of paradoxical sleep (P%) after warm acclimation was maximal at 30 degrees C decreasing markedly at lower and higher temperatures. Variations in P% were mainly consequent to alterations in the frequency of occurrence of paradoxical sleep (PS) episodes. After cold acclimation (CA) P% was maximal at 20 degrees C but no strong decreases occurred at lower temperatures. Influences of CA upon SWC were already detectable after 3 days of cold exposure. Significant individual differences as well as strong fluctuations in P% during CA occurred. Acute oscillations in abdominal temperature along the SWC were recorded. Reductions in abdominal temperature during PS episodes, in relation to ambient temperature and to the length of the episode tended to occur.

Acclimatization↗

[Waist:hips girth ratio as a predictor of arterial hypertension].

This study aims to define cut-off points for the waist:hips girth ratio (WHR), using arterial hypertension as the outcome. The data refer to 3,282 individuals over twenty years of age examined in a survey conducted in the municipality of Rio de Janeiro in 1995-1996, using a two-stage sample. Sixty census tracts were drawn initially; subsequently, 34 households were selected systematically from each tract. Stature, weight, waist and hips girths, and blood pressure were measured in the households. The criterion for hypertension was a systolic blood pressure of ( 140 mmHg or diastolic pressure of ( 90 mmHg, or use of medication to reduce blood pressure. The sensitivity and specificity of different cut-off points for WHR were calculated in the prediction of arterial hypertension according to sex, age, and presence of overweight, classified according to World Health Organization guidelines. The best cut-off points for WHR were 0.95 for men and 0.80 for women. Compared to the waist:stature ratio and waist circumference, the WHR proved more capable of predicting arterial hypertension and less correlated with body mass index.

Adult↗

[Reliability of the WPPSI-R test in the evaluation of cognitive development in preschool children].

The WPPSI-R scale (Wechsler Preschool and Primary Scale of Intelligence - Revised) is a psychometric test chosen as the evaluation tool in a study on preschool-age cognitive development in a cohort of very low birth weight (VLBW) premature children from the Fernandes Figueira Institute (IFF), applied by four previously trained psychologists. The objective of this study was to verify inter-observer reliability in the test application. Two types of reliability study design were used: balanced incomplete blocks, to verify agreement in the application of the scale, and crossed design, to verify agreement in scoring of items. We studied 12 preschool children born at IFF (birthweight < 1,500g). The intraclass correlation coefficients (ICC) were: 0.82 (full-scale IQ), 0.89 (verbal IQ), and 0.91 (performance IQ), in the incomplete block design study, and 0.99, 0.98, and 0.99, respectively, in the crossed design study, indicating good reliability. Application of the WPPSI-R scale in the study of cognitive development of VLBW premature children at IFF proved adequate, as shown by these results.

Child Development↗

[Physical activity in a probabilistic sample in the city of Rio de Janeiro].

This study evaluated physical activity in a probabilistic sample of 4,331 individuals 12 years of age and older residing in the city of Rio de Janeiro, who participated in a household survey in 1996. Occupation and leisure activity were grouped according to categories of energy expenditure. The study also evaluated number of hours watching TV, using the computer, or playing video-games. Only 3.6% of males and 0.3% of females reported heavy occupational work. A full 59.8% of males and 77.8% of females reported never performing recreational physical activity, and there was an increase in this prevalence with age, especially for men. Women's leisure activities involved less energy expenditure and had a lower median duration than those of men. Mean daily TV/video/computer time was greater for women than for men. The greater the level of schooling, the higher the frequency of physical activity for both sexes. Analyzed jointly, these data show the low energy expenditure through physical activity by the population of the city of Rio de Janeiro. Women, the middle-aged, the elderly, and low-income individuals were at greatest risk of not performing recreational physical activity.

Adolescent↗

[Assessment of the nutritional status of Brazilian adolescents by body mass index].

The assessment of nutritional status of adolescents is not an easy task because it should take into account sex, age, weight, stature and sexual maturation of the adolescents. In addition, an adequate classification should also be related to subsequent health-related outcomes during adult life. On the other side, screening for overweight and underweight among adolescents is highly desirable since nutritional status during adolescence correlates with adult body habitus. The objective of this study was to propose a classification for screening the nutritional status of Brazilian adolescents based on the body mass index (kg/m(2)) provided by the Pesquisa Nacional sobre Saúde e Nutrição-PNSN, a national survey of the Brazilian population carried out on 1989. We defined as cutoff the 10th and 90th percentile of the body mass index distribution and the 10th percentile for stature.

English Abstract↗