Teses e Dissertações

• Teses
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Autor: David Alejandro González-Chica Data da Defesa: 23/06/2009

 

Resumo dos Artigos:

 

Artigo 1

Pobreza na infância e obesidade abdominal na vida adulta: revisão sistemática

 

 

Resumo

Condições socioeconômicas adversas na infância podem exercer efeitos duradouros na saúde de adultos, mas são poucos os estudos longitudinais que avaliaram os efeitos sobre a obesidade abdominal. Estudos transversais em adultos de países de renda média e alta mostram uma associação inversa entre obesidade e posição socioeconômica (PSE) atual em mulheres, mas para os homens não se observa um padrão consistente. Entre homens e crianças de ambos os sexos não existe um padrão definido. Foi realizada uma

revisão sistemática dos estudos que avaliaram a PSE precoce e o seu efeito na circunferência da cintura, a circunferência do quadril e/ou na razão cintura-quadril em adultos. Dos 13 trabalhos incluídos (cinco transversais e oito coortes), apenas um foi realizado em um país de renda média e sendo os demais provenientes de países de renda alta. Em todos os estudos a pobreza na infância esteve associada com maiores níveis de obesidade abdominal em mulheres. Em homens as associações foram de menor magnitude e não houve consistência entre os estudos em termos da direção do efeito da

PSE.

 

Palavras chave: gordura abdominal; obesidade; relação cintura-quadril; fatores

socioeconômicos; estudos longitudinais

.........

 

Artigo 2

 

Life-course socioeconomic factors, skin color and abdominal obesity in adulthood in a Brazilian birth cohort

 

Abstract

 

Background: Obesity is an increasingly prevalent nutritional disorder throughout the world. In particular, abdominal obesity is associated with cardiovascular and metabolic risk.

 

Objective: To evaluate the effects of skin color and life-course socioeconomic indicators on waist circumference (WC), hip circumference (HC) and waist-hip ratio (WHR) in young adults.

 

Design: Population-based birth cohort study. Individuals born in 1982 in Pelotas (southern Brazil) were visited on a number of occasions from birth to age 23-24y. A sample of the cohort was sought in 2006 and 972 individuals were located. The analysis was restricted to individuals with complete data available (442 males, 414 females).

 

Results: In men, family income at birth and in 2004-05 were positively associated with WC and HC, but not with WHR. Regardless of current income, men born to wealthier families had larger WC and HC as adults. Skin color was not associated with any of the outcomes. In women, early poverty was associated with smaller HC, and current poverty with larger WC. Poverty at any age thus led to higher WHR. Black women had larger WC and HC than white women, but there were no differences in WHR. All the associations were partially mediated by education and behavioral variables.

 

Conclusions: The effects of early socioeconomic position on WC and HC persist even after adjustment for adult socioeconomic position, highlighting the importance of interventions during the first years of life.

 

Key words

Abdominal Adipose Tissue, Waist-Hip Ratio, Cohort Study, Socioeconomic Status

 

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Artigo 3

 

Growth from birth to adulthood and abdominal obesity in a Brazilian birth cohort

 

Abstract:

 

Background: Rapid weight gain in childhood may increase the risk of chronic adult diseases. Few studies have examined the effects of lifecourse weight gain on waist circumference (WC), hip circumference (HC) or waist-to-hip ratio (WHR).

 

Objective: To evaluate the effects of birthweight and weight gain from birth to age 23 years on WC, HC and WHR in young adults.

 

Design: Population-based birth cohort study started in 1982. A sample of 856 individuals was examined in 2006. Conditional growth analyses were carried out with adjustment for confounders. WC and HC were also mutually adjusted.

 

Results: Weight gains during all age ranges studied (birthweight, 0-2, 2-4, 4-15, 15-18/19 and 18/19-23 years) were positively associated with WC and HC in both sexes. These effects were strongest from the 4-15 years range (β=5.0 cm for both circumferences). Proxies for visceral adipose tissue (WHR, and WC adjusted for HC) were associated with weight gain after 2 years in females and after 4 years in males. Subcutaneous adipose and muscular tissues, assessed by HC adjusted for WC, were associated with birthweight and weight gain from 0-2 years in both sexes, and again with weight gains from 4-18 years in males and 4-15 years in females.

 

Conclusions: Weight gains in utero and in the first two years had long term effects on HC, but weight gain after age four years was strongly associated with WC. Weight gains up to age 2 years may reduce cardiovascular risk associated with adult fat patterns in a middle-income

setting.

 

Key words

Abdominal Adipose Tissue, Waist-Hip Ratio, Cohort Study, Weight gain, Growth