Cadernos de Saúde Públicahttps://www.scielosp.org/feed/csp/2010.v26n10/2017-01-28T00:11:00ZVol. 26 No. 10 - 2010WerkzeugHealth in the transition from childhood to adolescence: the 11-year follow-up of the 1993 Pelotas (Brazil) birth cohort studyS0102-311X20100010000012017-01-28T00:11:00Z2017-01-28T00:11:00ZMenezes, Ana M. B.Araújo, Cora LuizaHallal, Pedro C.
<em>Menezes, Ana M. B.</em>;
<em>Araújo, Cora Luiza</em>;
<em>Hallal, Pedro C.</em>;
<br/><br/>
A new cohort every 11 yearsS0102-311X20100010000022017-01-28T00:11:00Z2017-01-28T00:11:00ZBarros, Fernando C.Victora, Cesar G.
<em>Barros, Fernando C.</em>;
<em>Victora, Cesar G.</em>;
<br/><br/>
The 11-year follow-up of the 1993 Pelotas (Brazil) birth cohort study: methodsS0102-311X20100010000032017-01-28T00:11:00Z2017-01-28T00:11:00ZAraújo, Cora LuizaMenezes, Ana M. B.Vieira, Maria de Fátima A.Neutzling, Marilda B.Gonçalves, HelenAnselmi, LucianaDumith, Samuel C.Hallal, Pedro C.
<em>Araújo, Cora Luiza</em>;
<em>Menezes, Ana M. B.</em>;
<em>Vieira, Maria De Fátima A.</em>;
<em>Neutzling, Marilda B.</em>;
<em>Gonçalves, Helen</em>;
<em>Anselmi, Luciana</em>;
<em>Dumith, Samuel C.</em>;
<em>Hallal, Pedro C.</em>;
<br/><br/>
The aim of this study is to describe the methodology of the 2004-2005 follow-up visit of the 1993 Pelotas (Brazil) birth cohort. All children born in Pelotas in 1993 and whose mothers lived in the city at that time were eligible to be enrolled in a longitudinal study. Between July 2004 and March 2005, all cohort participants were sought for a follow-up visit. Several strategies were used to help trace cohort members, including a census of the city's schools and a census of all households in the municipality. The Mortality Information System was monitored in order to identify deaths among cohort members. Of the 5,249 cohort members, 4,452 were interviewed in 2004-5. When added to the 141 deaths, these represent 87.5% of the original cohort. In spite of the logistic and financial difficulties, it is possible to carry out prospective studies with long-term follow-up in the Brazilian context.Well-being in adolescents: the 11-year follow-up of the 1993 Pelotas (Brazil) birth cohort studyS0102-311X20100010000042017-01-28T00:11:00Z2017-01-28T00:11:00ZHallal, Pedro C.Dumith, Samuel C.Bertoldi, Andréa D.Scalco, Diogo L.Menezes, Ana M. B.Araújo, Cora Luiza
<em>Hallal, Pedro C.</em>;
<em>Dumith, Samuel C.</em>;
<em>Bertoldi, Andréa D.</em>;
<em>Scalco, Diogo L.</em>;
<em>Menezes, Ana M. B.</em>;
<em>Araújo, Cora Luiza</em>;
<br/><br/>
Studies on well-being and its possible determinants are rare in the international literature, and almost non-existent in Brazil, particularly among youth. The present study focused on the epidemiology of well-being among adolescents belonging to a birth cohort. Well-being was measured using face-to-face interviews, with a question whose answer was based on a graphic scale of faces. 4,452 adolescents were interviewed. Approximately half (49.4%) classified themselves as very happy (face 1); this proportion was higher among girls than boys. Poorer adolescents were more likely than their wealthier peers to identify with the happiest face (number 1), but were also more likely to report moderate to low levels of well-being (faces 3-7). Body mass index was inversely associated with well-being. Among girls, physical activity was directly associated with well-being.Nutritional status of adolescents: the 11-year follow-up of the 1993 Pelotas (Brazil) birth cohort studyS0102-311X20100010000052017-01-28T00:11:00Z2017-01-28T00:11:00ZAraújo, Cora LuizaDumith, Samuel C.Menezes, Ana M. B.Hallal, Pedro C.Vieira, Maria de Fátima A.Madruga, Samanta W.Victora, Cesar G.
<em>Araújo, Cora Luiza</em>;
<em>Dumith, Samuel C.</em>;
<em>Menezes, Ana M. B.</em>;
<em>Hallal, Pedro C.</em>;
<em>Vieira, Maria De Fátima A.</em>;
<em>Madruga, Samanta W.</em>;
<em>Victora, Cesar G.</em>;
<br/><br/>
We evaluate the influence of demographic, socioeconomic, and maternal variables on the nutritional status of adolescents aged 11 years. We conducted a prospective cohort study including 4,452 adolescents born in Pelotas, Southern Brazil, in 1993, accounting for 87.5% of the original cohort. Nutritional status was evaluated based on World Health Organization criteria. Subjects were classified according to nutritional status into thin, normal, overweight and obese. Independent variables analyzed included skin color, socioeconomic status, maternal schooling, and maternal body mass index (BMI). Analyses were stratified by sex, and multivariable regression was performed using the multinomial logistic approach. Overall, 7% of adolescents were classified as thin, 11.6% as overweight, and 11.6% as obese. Among boys, thinness was inversely associated with maternal schooling and maternal BMI. Among girls, thinness was directly associated with maternal BMI. Overweight and obesity were directly associated with socioeconomic status and maternal BMI, the former showing the strongest association with nutritional status among adolescents.Intake of fat and fiber-rich foods according to socioeconomic status: the 11-year follow-up of the 1993 Pelotas (Brazil) birth cohort studyS0102-311X20100010000062017-01-28T00:11:00Z2017-01-28T00:11:00ZNeutzling, Marilda B.Araújo, Cora LuizaVieira, Maria de Fátima A.Hallal, Pedro C.Menezes, Ana M. B.Victora, Cesar G.
<em>Neutzling, Marilda B.</em>;
<em>Araújo, Cora Luiza</em>;
<em>Vieira, Maria De Fátima A.</em>;
<em>Hallal, Pedro C.</em>;
<em>Menezes, Ana M. B.</em>;
<em>Victora, Cesar G.</em>;
<br/><br/>
This study describes the food intake of adolescents participating in the 1993 birth cohort from Pelotas, Southern Brazil, according to socioeconomic position. We carried out a cross-sectional analysis of data collected in the 2004-2005 follow-up visit. Food intake in the previous year was evaluated using the Block questionnaire. Socioeconomic status was evaluated based on an assets index, divided into quintiles. Foods with the highest frequency of daily intake were white bread (83%), butter or margarine (74.6%), beans (66.4%) and milk (48.5%). Intake of butter or margarine, bread, and beans was more frequent among poorer adolescents, and the inverse was true for milk. Intake of fruits and vegetables was low in all socioeconomic strata, but particularly low among the poor. In early adolescence, all socioeconomic groups showed high consumption of foods rich in fat and low consumption of foods rich in fiber.Factors associated with weight loss dieting among adolescents: the 11-year follow-up of the 1993 Pelotas (Brazil) birth cohort studyS0102-311X20100010000072017-01-28T00:11:00Z2017-01-28T00:11:00ZMadruga, Samanta W.Azevedo, Mario Renato deAraújo, Cora LuizaMenezes, Ana M. B.Hallal, Pedro C.
<em>Madruga, Samanta W.</em>;
<em>Azevedo, Mario Renato De</em>;
<em>Araújo, Cora Luiza</em>;
<em>Menezes, Ana M. B.</em>;
<em>Hallal, Pedro C.</em>;
<br/><br/>
Evidence has shown the negative effects of unsupervised diets and those with excessive calorie restriction. The aim of this study was to determine the proportion of adolescents engaging in weight loss dieting and associated factors. This was a cross-sectional study of 4,452 adolescents born in Pelotas, Rio Grande do Sul State, Brazil, in 1993. The outcome was defined as adolescents that reported having practiced some type of weight loss dieting in the previous 12 months. Prevalence of such dieting was 8.6% (95%CI: 7.7;9.4), and was higher in girls. Elevated maternal body mass index (BMI) was associated with dieting among girls. The adolescent's and parents' view of the adolescent's weight, excess weight, and consumption of diet or light soft drinks were associated with adolescent dieting. There was a positive association between dieting and socioeconomic status. The findings provide important backing for policies aimed at improving adolescents' diet, since they express a major concern over weight and thus a significant percentage of individuals with erroneous and unhealthy behaviors.Self-reporting versus parental reporting of physical activity in adolescents: the 11-year follow-up of the 1993 Pelotas (Brazil) birth cohort studyS0102-311X20100010000082017-01-28T00:11:00Z2017-01-28T00:11:00ZReichert, Felipe F.Menezes, Ana M. B.Araújo, Cora LuizaHallal, Pedro C.
<em>Reichert, Felipe F.</em>;
<em>Menezes, Ana M. B.</em>;
<em>Araújo, Cora Luiza</em>;
<em>Hallal, Pedro C.</em>;
<br/><br/>
The aim of this study was to verify the agreement between different approaches for estimating levels of physical activity in adolescents. One questionnaire was administered to parents and two were administered to the adolescents. This was a cross-sectional analysis of data collected in the 2004-2005 follow-up of the 1993 Pelotas (Brazil) birth cohort study. Parents or guardians answered the following question: "Compared to most children the same age, would you say that your child exercises more, less, or the same amount?" A similar question was addressed to adolescents, as was a detailed questionnaire on physical activity. Agreement between the questionnaires was measured by the weighted kappa statistic. A total of 4,254 adolescents and parents/guardians answered the questionnaires. Kappa values indicated low agreement for all comparisons (kappa < 0.33 for all analyses). Measurement of physical activity in adolescents is complex, and available instruments should be validated prior to their use.Sedentary behavior in adolescents: the 11-year follow-up of the 1993 Pelotas (Brazil) birth cohort studyS0102-311X20100010000092017-01-28T00:11:00Z2017-01-28T00:11:00ZDumith, Samuel C.Hallal, Pedro C.Menezes, Ana M. B.Araújo, Cora Luiza
<em>Dumith, Samuel C.</em>;
<em>Hallal, Pedro C.</em>;
<em>Menezes, Ana M. B.</em>;
<em>Araújo, Cora Luiza</em>;
<br/><br/>
The aim of this study was to estimate the prevalence of sedentary behavior and investigate associated factors in adolescents 11 years of age from the 1993 birth cohort in Pelotas, Rio Grande do Sul State, Brazil. Sedentary behavior was investigated with a questionnaire, and was defined as spending more than two hours per day watching television, playing videogames, or using the computer. Of the 4,452 adolescents interviewed, 98% reported watching television, 44% playing videogames, and 22% using the computer. The average time spent on each of these electronic media was 197, 36, and 17 minutes per day, respectively. Prevalence of sedentary behavior was 79.7% (95%CI: 78.6; 80.9) and showed a positive association with socioeconomic level and nutritional status and a negative association with well-being. These 11-year-olds spent extensive time at TV viewing, videogames, and the computer. Special attention should be given to the most exposed groups of adolescents, including the more affluent, overweight, and those with limited schooling.Experimental use of alcohol in early adolescence: the 11-year follow-up of the 1993 Pelotas (Brazil) birth cohort studyS0102-311X20100010000102017-01-28T00:11:00Z2017-01-28T00:11:00ZNoal, Ricardo B.Menezes, Ana M. B.Araújo, Cora LuizaHallal, Pedro C.
<em>Noal, Ricardo B.</em>;
<em>Menezes, Ana M. B.</em>;
<em>Araújo, Cora Luiza</em>;
<em>Hallal, Pedro C.</em>;
<br/><br/>
The aim of this study was to estimate the prevalence of experimental alcohol intake and associated factors in early adolescence. The overall sample consisted of 4,452 adolescents (mean age = 11.3 years; SD = 0.3) from the 1993 birth cohort in Pelotas, Rio Grande do Sul State, Brazil. Experimental use of alcohol was reported by 17.5% of the interviewees (95%CI: 16.3-18.6), and 5% reported having tried alcohol at nine years of age or younger. Prevalence of experimental alcohol use was higher among adolescents whose mothers had consumed alcohol during pregnancy, whose parents consumed alcohol, who worked outside the home themselves, and who had ever tried smoking. Family strife, parental alcohol intake, and adolescent smoking were strong predictors of experimental alcohol use in early adolescence. Special attention should be targeted to these groups in order to avoid heavy and premature alcohol use in early adolescence.Medicine use among adolescents: the 11-year follow-up of the 1993 Pelotas (Brazil) birth cohort studyS0102-311X20100010000112017-01-28T00:11:00Z2017-01-28T00:11:00ZBertoldi, Andréa D.Tavares, Noemia U. L.Hallal, Pedro C.Araújo, Cora LuizaMenezes, Ana M. B.
<em>Bertoldi, Andréa D.</em>;
<em>Tavares, Noemia U. L.</em>;
<em>Hallal, Pedro C.</em>;
<em>Araújo, Cora Luiza</em>;
<em>Menezes, Ana M. B.</em>;
<br/><br/>
The aim of this study was to investigate medicine use and associated factors among adolescents. This was a prospective cohort study including 4,452 adolescents born in Pelotas, Rio Grande do Sul State, Brazil, in 1993. Information on medicine use in the 15 days prior to the interviews was collected from the mothers. Overall prevalence of medicine use was 30.9%, and 64.7% of the medicines had been prescribed by a physician. The most frequently used pharmacological groups were medicines for the nervous (35.9%) and respiratory systems (25.7%). Medicine use was directly associated with socioeconomic status, maternal schooling, complications during pregnancy or delivery, and neonatal problems resulting in the need for intensive care. Underweight and obese adolescents were more likely to use medicines as compared to those with normal body mass index. A direct association was observed between maternal use of hypnotic drugs and sedatives and adolescent medicine use. It is essential to implement educational policies aimed at promoting rational use of medicines by adolescents.Early determinants of attention and hyperactivity problems in adolescents: the 11-year follow-up of the 1993 Pelotas (Brazil) birth cohort studyS0102-311X20100010000122017-01-28T00:11:00Z2017-01-28T00:11:00ZAnselmi, LucianaMenezes, Ana M. B.Barros, Fernando C.Hallal, Pedro C.Araújo, Cora LuizaDomingues, Marlos R.Rohde, Luis A.
<em>Anselmi, Luciana</em>;
<em>Menezes, Ana M. B.</em>;
<em>Barros, Fernando C.</em>;
<em>Hallal, Pedro C.</em>;
<em>Araújo, Cora Luiza</em>;
<em>Domingues, Marlos R.</em>;
<em>Rohde, Luis A.</em>;
<br/><br/>
The aim of this study was to assess early determinants of attention and hyperactivity problems in adolescents. In 1993, all hospital births in the city of Pelotas, Rio Grande do Sul State, Brazil, were monitored and mothers were interviewed (N = 5,249). At 11 years of age, 4,423 mothers answered the Strengths and Difficulties Questionnaire (SDQ) in order to evaluate attention and hyperactivity problems in the adolescents. Crude and adjusted prevalence ratios were calculated using Poisson regression. Prevalence of attention and hyperactivity problems was 19.9%. Factors associated with the outcome in the adjusted analysis were: male gender, low family income, smoking during pregnancy, minor psychiatric disorders in the mother, and history of child's behavioral/emotional problems at four years of age. Early life events impacted attention and hyperactivity problems in adolescence. Risk factors for attention and hyperactivity problems found in this study were similar to those reported in other cultures.Resting pulse rate among adolescents: the 11-year follow-up of the 1993 Pelotas (Brazil) birth cohort studyS0102-311X20100010000132017-01-28T00:11:00Z2017-01-28T00:11:00ZHallal, Pedro C.Menezes, Ana M. B.Bertoldi, Andréa D.Dumith, Samuel C.Araújo, Cora Luiza
<em>Hallal, Pedro C.</em>;
<em>Menezes, Ana M. B.</em>;
<em>Bertoldi, Andréa D.</em>;
<em>Dumith, Samuel C.</em>;
<em>Araújo, Cora Luiza</em>;
<br/><br/>
The aim of this study was to describe resting pulse rate and associated factors among adolescents. This was a cross-sectional analysis nested in a prospective cohort study, including 4,452 adolescents born in Pelotas, Rio Grande do Sul State, Brazil in 1993, representing 87.5% of the original cohort. Pulse rate was measured with an electronic device at the beginning and end of the interview, and the mean value was used in the analyses. Mean pulse rate was 78.4bpm (SD = 11.0) in the total sample, 76.5bpm (SD = 10.7) in boys, and 80.2bpm (SD = 10.9; p < 0.001) in girls. Black adolescents showed lower mean pulse rates. There was a direct association between pulse rate and blood pressure. Physical activity was inversely associated with pulse rate in the crude analysis only. Elevated pulse rate is strongly associated with high blood pressure, and both variables are predictors of risk of chronic disease in adulthood.Concurrent determinants of blood pressure among adolescents: the 11-year follow-up of the 1993 Pelotas (Brazil) birth cohort studyS0102-311X20100010000142017-01-28T00:11:00Z2017-01-28T00:11:00ZMenezes, Ana M. B.Hallal, Pedro C.Araújo, Cora LuizaBarros, Fernando C.Victora, Cesar G.
<em>Menezes, Ana M. B.</em>;
<em>Hallal, Pedro C.</em>;
<em>Araújo, Cora Luiza</em>;
<em>Barros, Fernando C.</em>;
<em>Victora, Cesar G.</em>;
<br/><br/>
The aim of this study was to evaluate concurrent risk factors for high blood pressure in adolescents. This is a prospective cohort study including 4,452 adolescents born in Pelotas, Rio Grande do Sul State, Brazil, in 1993. Blood pressure was measured before and after the interview, and the mean value was used in the analyses. Mean systolic blood pressure was 101.9mmHg (SD = 12.3) and mean diastolic pressure was 63.4mmHg (SD = 9.9). Adolescents with black skin had higher blood pressure than those with white skin. Mean systolic pressure among subjects in the top quartile of body mass index (BMI) was 11.6mmHg higher than among those in the lowest quartile. Mean systolic pressure among postmenarcheal girls was 5.4mmHg higher than among premenarcheal girls. Similar trends were found for diastolic arterial pressure. Our findings suggest that blood pressure control must begin already in childhood and adolescence.Hospital admissions from birth to early adolescence and early-life risk factors: the 11-year follow-up of the 1993 Pelotas (Brazil) birth cohort studyS0102-311X20100010000152017-01-28T00:11:00Z2017-01-28T00:11:00ZMenezes, Ana M. B.Noal, Ricardo B.Cesar, Juraci A.Hallal, Pedro C.Araújo, Cora LuizaDumith, Samuel C.Barros, Fernando C.Victora, Cesar G.
<em>Menezes, Ana M. B.</em>;
<em>Noal, Ricardo B.</em>;
<em>Cesar, Juraci A.</em>;
<em>Hallal, Pedro C.</em>;
<em>Araújo, Cora Luiza</em>;
<em>Dumith, Samuel C.</em>;
<em>Barros, Fernando C.</em>;
<em>Victora, Cesar G.</em>;
<br/><br/>
The aim of this prospective analysis was to describe the cumulative incidence of hospital admissions in the first year of life and between 1 and 11 years of age and to explore associated factors. Hospital admissions were collected through regular monitoring in the first year of life, and through maternal report on admissions between 1 and 11 years. Analyses were stratified by sex and adjusted for confounding factors. 18.1% of children were hospitalized in the first year of life, and 30.7% between ages 1 and 11 years. Among boys, hospital admission in the first year was associated with low family income, paternal smoking during pregnancy, preterm delivery, and low birthweight. Among girls, in addition to the variables described for boys, black/mixed skin color was also a risk factor for hospital admission. For admissions between 1 and 11 years of age, low family income and gestational age > 37 weeks were found to be significant risk factors.Oral health follow-up studies in the 1993 Pelotas (Brazil) birth cohort study: methodology and principal resultsS0102-311X20100010000162017-01-28T00:11:00Z2017-01-28T00:11:00ZPeres, Marco A.Barros, Aluísio JardimPeres, Karen GlazerAraújo, Cora LuizaMenezes, Ana M. B.Hallal, Pedro C.Victora, Cesar G.
<em>Peres, Marco A.</em>;
<em>Barros, Aluísio Jardim</em>;
<em>Peres, Karen Glazer</em>;
<em>Araújo, Cora Luiza</em>;
<em>Menezes, Ana M. B.</em>;
<em>Hallal, Pedro C.</em>;
<em>Victora, Cesar G.</em>;
<br/><br/>
The aim of this study was to describe oral health follow-up studies nested in a birth cohort. A population-based birth cohort was launched in 1993 in Pelotas, Rio Grande do Sul State, Brazil. Two oral health follow-up studies were conducted at six (n = 359) and 12 (n = 339) years of age. A high response rate was observed at 12 years of age; 94.4% of the children examined at six years of age were restudied in 2005. The mean DMF-T index at age 12 was 1.2 (SD = 1.6) for the entire sample, ranging from 0.6 (SD = 1.1) for children that were caries-free at age six, 1.3 (SD = 1.5) for those with 1-3 carious teeth at six years, and 1.8 (SD = 1.8) for those with 4-19 carious teeth at six years (p < 0.01). The number of individuals with severe malocclusions at 12 years was proportional to the number of malocclusions at six years. Oral health problems in early adolescence were more prevalent in individuals with dental problems at six years of age.