Higher Risk Of Chronic Disease Research Articles

EHealth literacy and Web 2.0 health information seeking behaviors among baby boomers and older adults.

BackgroundBaby boomers and older adults, a subset of the population at high risk for chronic disease, social isolation, and poor health outcomes, are increasingly utilizing the Internet and social media (Web 2.0) to locate and evaluate health information. However, among these older populations, little is known about what factors influence their eHealth literacy and use of Web 2.0 for health information.ObjectiveThe intent of the study was to explore the extent to which sociodemographic, social determinants, and electronic device use influences eHealth literacy and use of Web 2.0 for health information among baby boomers and older adults.MethodsA random sample of baby boomers and older adults (n=283, mean 67.46 years, SD 9.98) participated in a cross-sectional, telephone survey that included the eHealth literacy scale (eHEALS) and items from the Health Information National Trends Survey (HINTS) assessing electronic device use and use of Web 2.0 for health information. An independent samples t test compared eHealth literacy among users and non-users of Web 2.0 for health information. Multiple linear and logistic regression analyses were conducted to determine associations between sociodemographic, social determinants, and electronic device use on self-reported eHealth literacy and use of Web 2.0 for seeking and sharing health information.ResultsAlmost 90% of older Web 2.0 users (90/101, 89.1%) reported using popular Web 2.0 websites, such as Facebook and Twitter, to find and share health information. Respondents reporting use of Web 2.0 reported greater eHealth literacy (mean 30.38, SD 5.45, n=101) than those who did not use Web 2.0 (mean 28.31, SD 5.79, n=182), t 217.60=−2.98, P=.003. Younger age (b=−0.10), more education (b=0.48), and use of more electronic devices (b=1.26) were significantly associated with greater eHealth literacy (R 2 =.17, R 2adj =.14, F9,229=5.277, P<.001). Women were nearly three times more likely than men to use Web 2.0 for health information (OR 2.63, Wald= 8.09, df=1, P=.004). Finally, more education predicted greater use of Web 2.0 for health information, with college graduates (OR 2.57, Wald= 3.86, df =1, P=.049) and post graduates (OR 7.105, Wald= 4.278, df=1, P=.04) nearly 2 to 7 times more likely than non-high school graduates to use Web 2.0 for health information.ConclusionsBeing younger and possessing more education was associated with greater eHealth literacy among baby boomers and older adults. Females and those highly educated, particularly at the post graduate level, reported greater use of Web 2.0 for health information. More in-depth surveys and interviews among more diverse groups of baby boomers and older adult populations will likely yield a better understanding regarding how current Web-based health information seeking and sharing behaviors influence health-related decision making.

Effects of Legume-Enriched Diet on Cardiometabolic Risk Factors among Individuals at Risk for Diabetes: A Crossover Study

Aims: First-degree relatives of patients with diabetes are at high risk for chronic diseases, including type 2 diabetes and obesity. Our purpose was to determine the effects of consuming 4 servings of legumes per week on lipid profiles, glycemic indices, and blood pressure of participants with family history of diabetes over 6 weeks of intervention.Methods: A total of 26 first-degree relatives of patients with diabetes (14 women and 12 men) participated in this randomized crossover clinical trial study. Participants were randomly assigned to a legume-enriched diet or habitual diet for 6 weeks. Paired t test and repeated measures analysis of variance were used to compare data for the 2 experimental diets.Results: The mean ± SE of legumes intake during the legume phase was 111.12 ± 10.53 g/day that was significantly higher (p < 0.001) than the amounts of legumes during habitual diet (50.73 ± 7.10 g/d). Percentage changes for cardiovascular disease risk factors did not change significantly following 6 weeks of legume consumption.Conclusions: Consumption of 4 servings of legumes per week had no significant effect on anthropometric measurements, glycemic indices, and lipid profiles of participants with family history of diabetes, though it could reduce systolic and diastolic blood pressure at a marginally significant level.

Living arrangements, chronic diseases, and prescription drug expenditures among Korean elderly: vulnerability to potential medication underuse.

BackgroundInsufficient social security combined with family structure changes has resulted in a poverty of the elderly. The objective of this study was to examine an association of living arrangements of the elderly with chronic disease prevalence and prescription drug use.Methods2008 Korea Health Panel Survey (KHPS) data were used in this study. Information on living arrangements, socio-demographics, health behaviors, chronic disease prevalence and healthcare expenditures including out-of-pocket (OOP) prescription drug expenditures for elderly aged 65 or older were collected from self-reported diaries and receipts. OOP prescription drug expenditure as a total cost that subject paid to a pharmacy for prescription drugs was examined. Logistic regression was used to identify differences in major chronic disease prevalence by living arrangements. The association of living arrangements with prescription drug use was analyzed using generalized linear model with a log link and a gamma variance distribution.ResultsProportions of elderly living alone, elderly living with a spouse only, and elderly living with adults aged 20–64 were 14.5%, 48.3%, and 37.2%, respectively. Elderly living alone showed 2.43 odds ratio (OR) (95% confidence interval (CI) = 1.66-3.56) for having major chronic diseases prevalence compared to elderly living with adults. Despite a higher major chronic disease prevalence, elderly living alone showed lower OOP prescription drug expenditures (Cost Ratio = 0.80, 95% CI = 0.67-0.97) after adjusting for the number of major chronic diseases. Total OOP prescription drug expenditures were significantly lower in patients with a low income level versus high income level.ConclusionsEven though elderly living alone had a higher risk of chronic disease, they spent less on OOP prescription drug expenditures. Optimal drug use is important for elderly with chronic diseases to achieve good health outcomes and quality of life. Public health policies should be supplemented to optimize medical treatment for vulnerable elderly living alone.

Anthropometric indicators of obesity in policemen: a systematic review of observational studies.

The aim of this paper was to summarize scientific literature on obesity in policemen through a systematic review of observational studies. For this purpose the following electronic databases were selected: Medline by Pubmed, CINAHL, and Scopus; and a manual search of the referenced studies concerning this topic was performed. There were no restrictions with respect to the year or language of the publication. Twenty-three studies were identified and 9 articles, considered as potentially relevant, were included. The labor time, shift and career progression promoted changes in body composition. Most of the policemen taking part in the studies included in this paper were overweight (BMI: 25.2-29.3), obese (body fat ≥ 25%), had increased waist (90.4-102 cm) and abdominal perimeters (18.9-90.5 cm), and had a higher risk of chronic disease, which is associated with depression and stress development. Interventional studies are needed for the purpose of proposing preventive and rehabilitation programs, which would result in providing physical and mental well-being, improvement of life quality and, especially, prevention of obesity related to police work.

Sexual dimorphism in epigenomic responses of stem cells to extreme fetal growth.

Extreme fetal growth is associated with increased susceptibility to a range of adult diseases through an unknown mechanism of cellular memory. We tested whether heritable epigenetic processes in long-lived CD34+ hematopoietic stem/progenitor cells (HSPCs) showed evidence for re-programming associated with the extremes of fetal growth. Here we show that both fetal growth restriction and over-growth are associated with global shifts towards DNA hypermethylation, targeting cis-regulatory elements in proximity to genes involved in glucose homeostasis and stem cell function. We find a sexually dimorphic response; intrauterine growth restriction (IUGR) is associated with substantially greater epigenetic dysregulation in males, whereas large for gestational age (LGA) growth predominantly affects females. The findings are consistent with extreme fetal growth interacting with variable fetal susceptibility to influence cellular aging and metabolic characteristics through epigenetic mechanisms, potentially generating biomarkers that could identify infants at higher risk for chronic disease later in life.

Tooth loss and its association with dietary intake and diet quality in American adults

ObjectivesTo investigate associations between the number of natural teeth and energy intake, nutrient intake, and diet quality in adults. MethodsEligible adults who participated in the National Health and Nutrition Examination Survey during 2005–2008 were included in the present study (n=9140). Participants were classified into three groups depending on the total number of natural teeth (excluding third molars): full dentition (28 teeth), moderate dentition (21–27 teeth), and poor dentition (20 teeth or less). Dietary intake and diet quality were estimated from the first 24-h dietary recall data. ResultsParticipants in the poor dentition group had significantly lower energy intake than those with moderate dentition (P<0.05), however, both groups did not significantly differ from those who had full dentition. Adjusting for sociodemographic characteristics, physical activity, smoking status, and energy intake, the intake of protein as well as most vitamins and minerals were positively associated with the total number of natural teeth (P<0.05); an inverse association was observed for carbohydrate intake (P<0.001). Diet quality, as measured by the Healthy Eating Index 2005, was inversely associated with tooth loss (P<0.001). ConclusionsTooth loss in adults is associated with lower diet quality and reduced intake of most nutrients; this may partly explain for the higher risk of chronic diseases in this population. Clinical significancePeople with missing teeth are recommended to monitor their dietary intake to avoid nutrient deficiency and to improve their diet quality for better health.

Fetal Origin of Adult Disease

ABSTRACT Fetal origins of adult disease, a concept first popularized by Dr David Barker, has subsequently led to many studies which have provided the evidence that certain diseases do have links pointing to fetal origins—adverse influences early in development, and particularly during intrauterine life, can result in permanent changes in physiology and metabolism, which result in increased disease risk in adulthood. Links that are well-established are—reduced birth weight and increased risk of coronary heart disease, hypertension and stroke in adulthood. The concept of a fetal origin of adult disease have been extended well-beyond coronary heart disease and being a risk factor for coronary heart disease, and now includes investigations of the development of the central nervous system, early origins of adult mental health and cognitive function. By understanding fetal origin of adult disease, health care professionals and policy makers will make this issue a high health care priority and implement preventive measures and treatment for those at higher risk for chronic diseases. How to cite this article Malhotra N, Malhotra J, Bora NM, Bora R, Malhotra K. Fetal Origin of Adult Disease. Donald School J Ultrasound Obstet Gynecol 2014;8(2):164-177.

Perinatal growth restriction decreases diuretic action of furosemide in adult rats

Perinatal growth restriction programs higher risk for chronic disease during adulthood via morphological and physiological changes in organ systems. Perinatal growth restriction is highly correlated with a decreased nephron number, altered renal function and subsequent hypertension. We hypothesize that such renal maladaptations result in altered pharmacologic patterns for life. Maternal protein restriction during gestation and lactation was used to induce perinatal growth restriction in the current study. The diuretic response of furosemide (2mg/kg single i.p. dose) in perinatally growth restricted rats during adulthood was investigated. Diuresis, natriuresis and renal excretion of furosemide were significantly reduced relative to controls, indicative of decreased efficacy. While a modest 12% decrease in diuresis was observed in males, females experienced 26% reduction. It is important to note that the baseline urine output and natriuresis were similar between treatment groups. The in vitro renal and hepatic metabolism of furosemide, the in vivo urinary excretion of the metabolite, and the expression of renal drug transporters were unaltered. Creatinine clearance was significantly reduced by 15% and 19% in perinatally growth restricted male and female rats, respectively. Further evidence of renal insufficiency was suggested by decreased uric acid clearance. Renal protein expression of sodium–potassium–chloride cotransporter, a pharmacodynamic target, was unaltered. In summary, perinatal growth restriction could permanently imprint pharmacokinetic processes affecting drug response.

Effects of an aquatic physical exercise program on glycemic control and perinatal outcomes of gestational diabetes: study protocol for a randomized controlled trial

BackgroundGestational diabetes mellitus (GDM) is increasing worldwide and has been associated with adverse perinatal outcomes and high risk for chronic disease both for the mother and for the child. Physical exercise is feasible for diabetic pregnant women and contributes to better glycemic control and to a decrease in adverse perinatal outcomes. However, there are no randomized controlled trials (RCT) assessing the effects of aquatic physical exercise on GDM control and adverse maternal and fetal outcomes.Methods/DesignAn RCT will be conducted at Instituto de Medicina Integral Prof Fernando Figueira (IMIP), Brazil. A total of 72 pregnant women will be studied; 36 gestational diabetics will undergo an aquatic physical exercise program in a thermal pool, 3 times per week over 2 months. The primary endpoint will be glucose level control and use of insulin; secondary endpoints will be the following maternal and fetal outcomes: weight gain during pregnancy, blood pressure, pre-eclampsia diagnosis, intrauterus growth restriction, preterm birth, Cesarean section, macrosomia and maternal or neonatal intensive care admission. Endpoints between intervention and control group will analyzed by t test for unpaired data and χ2 test, and the level of significance will set at <0.05.DiscussionThe physical proprieties of water make aquatic exercises ideal for pregnant women. An aquatic physical exercise program developed for GDM women will be trialed in a thermal pool and under the supervision of physiotherapist to ensure compliance. It is expected that this study will provide evidence as to the effect of aquatic physical exercise on GDM control.Trial registrationClinicalTrial.gov, NCT01940003.

Variation of serum metabolites related to habitual diet: a targeted metabolomic approach in EPIC-Potsdam

Serum metabolites have been linked to higher risk of chronic diseases but determinants of serum metabolites are not clear. We aimed to investigate the association between habitual diet as a modifiable risk factor and relevant serum metabolites. This cross-sectional study comprised 2380 EPIC-Potsdam participants. Intake of 45 food groups was assessed by food frequency questionnaire and concentrations of 127 serum metabolites were measured by targeted metabolomics. Reduced rank regression was used to find dietary patterns that explain the maximum variation of metabolites. In the multivariable-adjusted model, the proportion of explained variation by habitual diet was ranked as follows: acyl-alkyl-phosphatidylcholines (5.7%), sphingomyelins (5.1%), diacyl-phosphatidylcholines (4.4%), lyso-phosphatidylcholines (4.1%), acylcarnitines (3.5%), amino acids (2.2%) and hexose (1.6%). A pattern with high intake of butter and low intake of margarine was related to acylcarnitines, acyl-alkyl-phosphatidylcholines, lyso-phosphatidylcholines and hydroxy-sphingomyelins, particularly with saturated and monounsaturated fatty acid side chains. A pattern with high intake of red meat and fish and low intake of whole-grain bread and tea was related to hexose and phosphatidylcholines. A pattern consisting of high intake of potatoes, dairy products and cornflakes particularly explained methionine and branched chain amino acids. Dietary patterns related to type 2 diabetes-relevant metabolites included high intake of red meat and low intake of whole-grain bread, tea, coffee, cake and cookies, canned fruits and fish. Dietary patterns characterized by intakes of red meat, whole-grain bread, tea and coffee were linked to relevant metabolites and could be potential targets for chronic disease prevention.

The role of the temporal environment in shaping Dominican women's food routines in New York City and the Santo Domingo, D.R.

In the US, foreign born individuals adopt food behaviors that are associated with higher risk of chronic disease. However, the mechanism of change in food behaviors is not well understood. The purpose of this research was to explore food behaviors in Dominican women living in New York City (NYC) and Santo Domingo (SD) in order to better understand the process of change. Qualitative interviews addressed social, cultural, environmental and personal influences on food behavior in twelve Dominican women. Study findings revealed that women constructed food routines that characterized the way in which they procured, prepared and consumed food. Household temporal environment, which is the perceived time available to procure, prepare and consume food, shaped food routines. In SD, the day was structured around the main meal, allowing for a leisurely food routine. In NYC, temporal environment varied and women developed a range of food routines including, a) maintenance of home cooked family meals, b) reliance on fast food and maintenance of family meals c) abandonment of cooking and family meals. While Latino neighborhoods may provide access to traditional foods, the temporal environment may necessitate dietary change. It is important for health professionals to consider the temporal environment when planning policies and interventions. Supported by Cornell University DNS, LALSP, GSGrant Funding Source: Cornell University DNS, LALSP, Grad School

Are non-attenders a concern for primary care practice?

The article by Eshel et al. describes major differences, in terms of demography and health status, between elderly patients who did and those who did not visit primary care physicians for general health check-ups. The authors conclude that non-attenders are not at risk for developing health conditions.While this study by Eshel et al. provides a better understanding of the primary care population, the conclusion (no need for reaching out to the non-attenders) should be viewed with caution. In this study, non-attenders ‘have a higher probability of being women, older, not married and from a lower socio-economic’ segment of the population, a population that is known to be at higher risk for chronic disease. In addition, outreach programs in primary care would be key in providing essential preventive measures for this vulnerable population (e.g., osteoporosis prevention, vaccination, lifestyle, etc.).This is a commentary on http://www.ijhpr.org/content/2/1/7.

Associations of Circadian Disruption of Sleep and Nutritional Factors with Risk of Cancer

Background: Daily entrainment of the human circadian clock is important for good human health. In previous studies, shift work has been linked to higher risk of chronic diseases, including certain types of cancers. Exposure to light at night suppresses the physiologic production of melatonin, a hormone that has antiproliferative effects on intestinal cancers. In the present review, we examine the available evidence on sleep disruption, changes in nutrient intake and nutritional factors and risk of cancers. Methods: Internet search of PubMed and discussion with colleagues. Results: Recent studies indicate that night shift work appears to have independent influence on the function of the endocrine system, gastrointestinal tract and circadian brain function. Sleep disruption enhances cortisol secretion and ghrelin release from the stomach and decreases melatonin and leptin which interfere with functioning of beta cells of pancreas. Apart from biological dysfunctions, behavioral changes, increased intake of refined carbohydrates, w-6 fats and low w-3 fats, physical inactivity, excess of tobacco and alcoholism appear to be common among night shift workers. Leptin signals the brain to feel satiety whereas ghrelin, produced in the stomach, signals hunger. Recent studies also indicate that sleep-deprived individuals with hormonal changes have greater cravings for sweet and fatty foods. Apart from this, stress hormone cortisol, which increases with sleep deprivation also contribute to hunger. In addition to altered hormone levels, late night awakening provides greater opportunity to eat, smoke and drink alcohol and eating often includes high-caloric foods. Epidemiological studies indicate that sleep disruption may be associated with obesity and other chronic diseases including cancers. Since electric light at night has adverse effects among night shift workers compared to day shift workers, it has been proposed that a portion of the high and rising risk of breast and prostate cancer worldwide may be because of night shift work. The suppression of melatonin by exposure to light at night may be one reason for the higher rates of breast, prostate and colorectal cancers in the developed world. Suppression of nocturnal melatonin by exposure to light at night results in lack of protection by melatonin on cancer cell receptor sites which allows the uptake of linoleic acid (LA) which in turn enhances the growth of cancer cells. Melatonin is a protective, oncostatic hormone and strong antioxidant having evolved in all plants and animals over the millennia. It is possible that rotating night shift at least three nights per month for 15 or more years may increase the risk of colorectal cancer and other cancers. Conclusions: Experimental evidence and limited human evidence allowed the International Agency for Research on Cancer (IARC) to classify circadian disruption of sleep, as a probable human carcinogen, group 2A. Behavioral changes, intake of fast foods, physical inactivity, excess of tobacco and alcoholism are common among night shift workers which may also apart from deficiency of melatonin.

Health behaviors of native Hawaiian and Pacific Islander adults in California.

Smoking, diet and physical activity are associated with chronic diseases, but representative prevalence data on these behaviors for Native Hawaiian and Pacific Islander (NHPI) adults are scarce. Data from the 2005 California Health Interview Survey were analyzed for self-identified NHPI and non-Hispanic white (NHW) adults. Ethnic and NHPI gender differences were examined for socio-demographic variables, obesity and health behaviors. Compared to NHW, NHPI displayed higher prevalence of obesity (p<0.001), smoking (p<0.05) and consumption of unhealthy foods and beverages (p<0.05). NHPI males were more likely than females to smoke (p<0.001). NHPI adults appear to be at higher risk for chronic disease than NHW due to obesity, smoking and intake of unhealthy foods and beverages. Culturally-specific health promotion interventions are needed to reduce risks among the underrepresented NHPI population.

Effectiveness of multicultural health workers in chronic disease prevention and self-management in culturally and linguistically diverse populations: a systematic literature review

With a large and increasing culturally and linguistically diverse (CALD) population, the Australian health care system faces challenges in the provision of accessible culturally competent health care. Communities at higher risk of chronic disease include CALD communities. Overseas, multicultural health workers (MHWs) have been increasingly integrated in the delivery of culturally relevant primary health care to CALD communities. The objective of this systematic review was to examine the effectiveness of MHW interventions in chronic disease prevention and self-management in CALD populations with the aim to inform policy development of effective health care in CALD communities in Australia. A systematic review protocol was developed and computerised searches were conducted of multiple electronic databases from 1 January 1995 until 1 November 2010. Thirty-nine studies were identified including 31 randomised controlled trials. Many of the studies focussed on poor and underserved ethnic minorities. Several studies reported significant improvements in participants' chronic disease prevention and self-management outcomes and meta-analyses identified a positive trend associated with MHW intervention. Australian Government policies express the need for targeted inventions for CALD communities. The broader systemic application of MHWs in Australian primary health care may provide one of the most useful targeted interventions for CALD communities.

Prevalence and Risk of Homelessness Among US Veterans

Understanding the prevalence of and risk for homelessness among veterans is prerequisite to preventing and ending homelessness among this population. Homeless veterans are at higher risk for chronic disease; understanding the dynamics of homelessness among veterans can contribute to our understanding of their health needs. We obtained data on demographic characteristics and veteran status for 130,554 homeless people from 7 jurisdictions that provide homelessness services, and for the population living in poverty and the general population from the American Community Survey for those same jurisdictions. We calculated prevalence of veterans in the homeless, poverty, and general populations, and risk ratios (RR) for veteran status in these populations. Risk for homelessness, as a function of demographic characteristics and veteran status, was estimated by using multivariate regression models. Veterans were overrepresented in the homeless population, compared with both the general and poverty populations, among both men (RR, 1.3 and 2.1, respectively) and women (RR, 2.1 and 3.0, respectively). Veteran status and black race significantly increased the risk for homelessness for both men and women. Men in the 45- to 54-year-old age group and women in the 18- to 29-year-old age group were at higher risk compared with other ages. Our findings confirm previous research associating veteran status with higher risk for homelessness and imply that there will be specific health needs among the aging homeless population. This study is a basis for understanding variation in rates of, and risks for, homelessness in general population groups, and inclusion of health data from US Department of Veterans Affairs records can extend these results to identifying links between homelessness and health risks.

Exploring weight status, dietary intake and acculturation in South Asian women living in Brisbane, Queensland

AbstractAim: To investigate the relationship between socio‐demographic characteristics, acculturation, weight status and dietary intake among a group of women from India and Pakistan living in Brisbane, Australia.Methods: Cross‐sectional survey of a convenience sample of 22 women that collected: socio‐demographic details; levels of acculturation; food intake using a specifically designed food frequency questionnaire and food diary; and anthropometric measurements. Data were compared with women from South Australia.Results: Women had a mean age of 38 years (24–50) and had been in Australia for an average of 4 years (1–25). Half (50%) of the women were categorised as overweight or obese and over two‐thirds (68%) had a waist measurement indicative of a high risk of chronic disease. A higher proportion of women from Pakistan were overweight and obese compared with Indian women. Women in this sample appeared to have a higher consumption of dairy, bread and cereals, vegetables and baked goods/snacks and were more likely to consume full‐fat milk compared with other Australian women. Breakfast was the meal most likely to have been ‘Australianised’.Conclusion: Despite the results not reaching statistical significance, these findings do point to areas worthy of further investigation. These include the relationship between acculturation factors with dietary intake and the prevalence of overweight and obesity. Given the high prevalence of overweight and obesity in this small sample, there appears to be a need to investigate diet and physical activity in specific groups to inform the development of culturally relevant chronic disease identification and management programmes.

Sedentary Behavior and Physical Activity in University Students: A Pilot Study.

The effectiveness of physical activity as primary and secondary prevention strategy of several chronic diseases is well documented. Sedentary behavior , a factor that has been recently introduced, is associated with these disorders and seems to act independently of the level of physical activity. Sedentary behavior refers to activities that do not increase energy expenditure substantially above the resting level. Increased levels of sedentary behaviors, independent of physical activity levels, are associated with increased risk of obesity, metabolic syndrome, cardiovascular mortality and all cause mortality. We analyzed the sedentary behavior in a local university population of a group of students from the University of Flores (n = 425). The sedentary behavior and the level of physical activity were studied using the self reporting questionnaire GPAQ. We found that the sedentary behavior is a variable with a heterogeneous response. Sedentary behaviors were more frequent in women, yet the differences were non-significant. Sixteen percent of students had high levels of sedentary behaviors and, simultaneously, low levels of physical activity, with higher risk of chronic diseases. Further surveys are needed about sedentary behaviors during work, motorized transportation and spare time in the general population.

Talking About Health

Describe health risks/obstacles to health among correctional employees. Mixed-methods approach combined results from four focus groups, 10 interviews, 335 surveys, and 197 physical assessments. Obesity levels were higher than national averages (40.7% overweight and 43.3% obese), with higher levels associated with job tenure, male gender, and working off-shift. Despite widespread concern about the lack of fitness, leisure exercise was higher than national norms. Respondents had higher levels of hypertension than national norms, with 31% of men and 25.8% of women hypertensive compared with 17.1% and 15.1% for national norms. Stress levels were elevated. Officers related their stress to concerns about security, administrative requirements, and work/family imbalance. High stress levels are reflected in elevated levels of hypertension. Correctional employees are at high risk for chronic disease, and environmental changes are needed to reduce risk factors.

Avaliação dos marcadores de consumo alimentar do VIGITEL (2007-2009)

To evaluate markers of food intake of the telephone-based risk factor surveillance system for chronic diseases (VIGITEL) and the trend of these markers. A total of 135,249 subjects from 27 Brazilian cities interviewed in the 2007 - 2009 surveys were evaluated. Eating habits were evaluated based on the frequency of intake of fruit, vegetables, beans, whole and skim milk, regular and diet/light soft drinks and visible fat in meat and poultry. These items were used to create a diet quality score and to identify dietary patterns in a cluster analysis. Time trends indicated statistically significant increase in the frequency of intake of beans, whole milk and regular soft drinks and decline in vegetables and skim milk. There was an increase in the frequency of individuals who reported consuming beans daily, from 11 to 13%. Beans are considered as a protective factor and the prevalence of usual intake is still low. Over the past three years, less than 15% of the studied population reported eating the Brazilian recommended number of 3 servings of fruits and 3 servings of vegetables per day. As to the vegetable intake, a decrease from 5 to 3% was reported. The consumption of regular soft drinks had the highest increase, ranging from 60 to 67%. The assessed items showed a weak correlation and did not represent a sole healthy eating construct. The diet quality of the Brazilians has gotten worst and eating markers that are associated with high risk of chronic diseases should be better qualified.