Survey Vigitel Research Articles

Smoking And The Risk Of Developing Diabetes Mellitus Type 2 In Young Adult Patients

“According to the latest data from the Vigitel survey (Surveillance of Risk Factors and Protection for Chronic Diseases by Telephone Survey), from the Ministry of Health, the rate of young consumers between 18 and 24 years old jumped from 7.4% in 2016, to 8.5% in 2017.” This statement demonstrates that even with public policies to combat smoking, the prevalence of this problem is still specific in Brazil and has become a common practice among young people. Smoking is a public health problem and can be defined as a chronic disease characterized by nicotine dependence, which is acquired through the consumption of products containing tobacco. Several health problems related to tobacco use, such as pulmonary emphysema, lung cancer, tongue cancer, chronic bronchitis, cataracts, osteoporosis and several studies demonstrate their relationship with the development of diabetes mellitus, this is because cigarettes increase resistance insulin by decreasing its peripheral action. Therefore, the use of tobacco deregulates glycemic control and increases the manifestation of the disease, or generates decompensation for those patients who already have the pathology. According to Dr. Fernanda Pena (endocrinologist specializing in metabolism), the risk of developing diabetes is 30 to 40% higher in smokers than in non-smokers and studies suggest that 10% of all cases of type 2 diabetes can be directly targeted to smoking.

Use of electronic devices in leisure time modifies the prevalence and factors associated with sedentary behavior derived exclusively from excessive television viewing among Brazilian adults

The growing interest in the study of sedentary behavior is justified by its increasing presence in people's daily lives, particularly in leisure time. The aim of this study was to compare the prevalence and factors associated with sedentary behavior derived exclusively from TV time and from its combination with the time spent using other electronic devices among Brazilian adults (n = 52,443). This cross-sectional study used data from the Vigitel survey (2019), which included subjects ≥ 18 years old who resided in the capitals of the 26 Brazilian states and Federal District. High TV time (≥ 4 h/day), and its combination with computer, tablet, or cell phone use (≥ 4 h/day), as well as sociodemographic, behavioral, and health characteristics were self-reported. Adjusted logistic regression was used to estimate odds ratios and 95% confidence intervals (95%CI). The prevalence of high sedentary behavior almost tripled when TV viewing was added to the time spent using other electronic devices (from 12.2%; 95%CI: 11.6; 12.8, to 34.7%; 95%CI: 33.8; 35.6), notably among the youngest (32.0 percentage points). Individuals living without a partner, who smoked, consumed alcohol and processed foods excessively, were physically inactive, and had hypertension were more likely to have both outcomes than their counterparts. Older and less educated individuals were more likely to spend excessive time watching TV and less likely to have high use of other electronic devices in addition to TV viewing than their peers. Including computer, tablet, or cell phone led to an increase in the prevalence of high sedentary behavior. The magnitude and direction of the associations of age and education with high sedentary behavior varied according to the method how high sedentary behavior was defined. Projects, programs, and policies must consider the different indicators of sedentary behavior in monitoring and promoting a healthier lifestyle.

Temporal Trend of Severe Obesity in Brazilian State Capitals (2006–2021)

The aim of this study was to analyze the trend of severe obesity in the capitals of the Brazilian states and the Federal District, from 2006 to 2021. For this purpose, a time-series, population-based, observational study was designed using data from the VIGITEL Survey. The dependent variable of this study was the prevalence of severe obesity, which was defined as a body mass index ≥ 40 kg/m2. Time series analysis was conducted using Joinpoint Regression Analysis Software v.4.9.1.0. In this study, a normal distribution was assumed, and the average annual percentage change (AAPC) and 95% confidence intervals (95% CIs) were presented. In total, 778,445 individuals participated in the study (38.2% were male and 61.8% were female). The prevalence of severe obesity has increased from 1.1% in 2006 to 1.9% in 2021. The average annual percentage change indicates an upward trend for the period (AAPC: 4.7; 95% CI: 3.8; 5.7). When stratifying the trend of severe obesity by sex, a significant upward trend was observed for females (AAPC: 4.3; 95% CI: 1.9; 6.8). There was a significant upward trend for all age groups, skin colors, and education levels. However, the older age groups and those with less education had lower AAPC.

Eating Behavior of Older Adults with and Without Diabetes: The Vigitel Survey, Brazil, 2016.

ResumoFundamentos A alimentação saudável é um fator de proteção contra o diabetes tipo 2 e desempenha importante papel no tratamento do diabetes e das comorbidades associadas.Objetivo Caracterizar o hábito alimentar de idosos diabéticos e não diabéticos com 65 anos ou mais, residentes nas capitais brasileiras e no Distrito Federal.Métodos Estudo transversal com dados da pesquisa Vigilância de Fatores de Risco e Proteção para as Doenças Crônicas por Inquérito Telefônico (Vigitel, 2016). Foram estimadas as prevalências de diabetes melito segundo variáveis sociodemográficas, inatividade física, autoavaliação da saúde e índice de massa corporal (IMC). O hábito alimentar foi avaliado pela frequência (semanal e diária) de consumo de alimentos saudáveis e não saudáveis, e pela substituição da comida por lanches. As diferenças foram verificadas por meio do teste Qui-quadrado de Pearson (Rao-Scott) com nível de significância de 5%.Resultados Foram entrevistados 13.649 idosos, e a prevalência de diabetes autorreferido foi de 27,2% (IC95%:25,5; 29,0). Nos pacientes diabéticos, observou-se maior consumo de hortaliças cruas (32,1% vs. 26,5%/3-4 dias/semana) e menor de frango (3,8% vs. 6,4%/quase nunca/nunca), suco (24,0% vs. 29,6%) e doces (6,8% vs. 16,2%) ≥5 dias/semana. Os percentuais de idosos com consumo de leite desnatado (51,5% vs. 44,6%) e refrigerante dietético (60,0% vs. 17,3%) ≥5 dias/semana, hortaliças cruas (9,1% vs. 2,5%/no jantar) e doces (37,7% vs. 20,5%/2 vezes/dia) 3-4 dias/semana foram maiores nos diabéticos, comparados aos não diabéticos.Conclusão As diferenças observadas sinalizam a necessidade de promover intervenções para alimentação saudável entre todos os idosos, bem como orientações específicas para os diabéticos.

Recreational physical activity in Brazilian older adults: secondary analysis of the 2018 Vigitel survey

Objective: To assess sociodemographic data and patterns of leisure time physical activity in older adults (≥ 60 years of age). Methods: This descriptive study analyzed secondary data from older adults interviewed for the 2018 Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey. Results: Of 53395 adults who completed the survey, 20981 were aged ≥60 years (6468 men and 14 513 women). Walking was the most prevalent physical activity. Most older adults engaged in physical activity 3-4 days per week for 30 minutes or longer. Sessions lasting more than 60 minutes were reported by 54.33% of participants. The rate of older people engaging in leisure time physical activity decreased with age and low education. Older adults engaging in physical activity were more optimistic about perceived health status and were less likely to be smokers than their inactive peers. Conclusions: In this sample, older adults with a higher level of education were more active in their leisure time and were more optimistic about their health status; however, the level of physical activity decreased with age in both sexes.

Using Multilevel Regression and Poststratification to Estimate Physical Activity Levels from Health Surveys.

Background: Large-scale health surveys often consider sociodemographic characteristics and several health indicators influencing physical activity that often vary across subpopulations. Data in a survey for some small subpopulations are often not representative of the larger population. Objective: We developed a multilevel regression and poststratification (MRP) model to estimate leisure-time physical activity across Brazilian state capitals and evaluated whether the MRP outperforms single-level regression estimates based on the Brazilian cross-sectional national survey VIGITEL (2018). Methods: We used various approaches to compare the MRP and single-level model (complete-pooling) estimates, including cross-validation with various subsample proportions tested. Results: MRP consistently had predictions closer to the estimation target than single-level regression estimations. The mean absolute errors were smaller for the MRP estimates than single-level regression estimates with smaller sample sizes. MRP presented substantially smaller uncertainty estimates compared to single-level regression estimates. Overall, the MRP was superior to single-level regression estimates, particularly with smaller sample sizes, yielding smaller errors and more accurate estimates. Conclusion: The MRP is a promising strategy to predict subpopulations’ physical activity indicators from large surveys. The observations present in this study highlight the need for further research, which could, potentially, incorporate more information in the models to better interpret interactions and types of activities across target populations.

Correlation of overweight condition and obesity with mortality by COVID-19 in Brazil's state capitals.

To evaluate the correlation between the prevalence of overweight condition and obesity with mortality rates due to COVID-19 in Brazil's state capitals. This is an ecological study, whose units of analysis were the 26 state capitals and the Federal District of Brazil. Prevalence was estimated by the results of the Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico 2019 (VIGITEL). The general mortality rates due to COVID-19 were collected on the official website of the Brazilian Ministry of Health (MH) and stratified by the same Brazilian capitals evaluated in the VIGITEL survey. The rates included the period between the 1st and 29th Epidemiological Weeks of 2020. The Partial Correlation Test (r) was used, controlled for confounding factors, to evaluate the correlation between the prevalence of overweight/obesity and the overall mortality rates due to COVID-19. The mean mortality rate for COVID-19 in the period was 65.1 deaths per 100,000 inhabitants. Regarding the prevalence of obesity and overweight, 20.2% and 54.7% were the mean values observed in the state capitals, respectively. The prevalence of obesity was positively correlated with the overall mortality rate due to COVID-19, with mean positive correlation (r=0.380) and statistically significant correlation (p=0.034). This study pointed out that, at the aggregate level, there is a concomitant and correlated increase in mortality rates due to COVID-19 and prevalence of obesity in Brazilian capitals. The data found may contribute to actions to cope with the pandemic aimed at this population.

Metabolic health in Brazil: trends and challenges

Metabolic health in Brazil: trends and challenges

Tendência do beber episódico excessivo nas capitais brasileiras e no Distrito Federal, 2006-2018: um estudo ecológico de séries temporais *

To assess heavy episodic drinking trends in the 26 Brazilian state capitals and Federal District, overall and according to sex. This was an ecological time series study of heavy episodic drinking patterns among adults, from 2006 to 2018. The data were obtained from VIGITEL Survey time series. Prais-Winsten regression was used. In the period studied a stationary heavy episodic drinking trend was found in 23 out of the 27 state capitals, with the exception of Macapá, where there was a decrease in this practice, and in São Paulo, Florianópolis and the Federal District, where an increase was found. There were important differences by sex in relation to heavy episodic drinking, with a tendency to increased consumption among women in seven state capitals. There was no reduction in heavy episodic drinking in most capitals, showing the urgency of implementing interventions to reduce alcohol consumption among the Brazilian population.

Behavioral Patterns with the Coexistence of Risk and Protective Factors for Cancer in Brazil

About one third of the most common cancers could be prevented by the reduction of modifiable behavioral risk factors. We aimed to identify behavioral patterns of risk and protective factors for cancer in Brazil, between 2014 and 2015. Data from Vigitel Survey (n = 95,027 adults aged ≥ 18 years) from all Brazilian capitals and Federal District were used. Thirteen risk (RBF) and protective behavioral factors (PBF) for cancer were investigated. RBF included the consumption of red meat, meat with high-fat content, soft drinks, sweets and abusive alcohol, replacement of lunch/dinner for snacks, television viewing, obesity, and smoking. PBF included the consumption of beans, fruits and vegetables, and physical activity practice. Patterns were identified by principal component analysis and linear regressions models assessed its association with sociodemographic characteristics. Four behavioral patterns for cancer were identified. The ‘healthy behavior pattern’ and the ‘unhealthy food consumption pattern’ were positively associated to females and schooling. The ‘unhealthy behavior pattern’ and the ‘mixed behavior pattern’ were both negatively associated to females, age and schooling. Our data revealed different vulnerable population groups for cancer. Actions for reduction of modifiable behavioral risk factors aiming at cancer prevention should consider distinct approaches by sex, age, and schooling.

Health risk behaviors in elderly Brazilian widowers.

The objective of this study was to compare the prevalence of health risk behaviors among elderly widowers with that of elderly partnered males, as well as single or divorced/separated men. Additionally, we set out to examine the prevalence of risk behaviors in elderly widowered men according to age, education level, and race/skin color. A cross-sectional study was conducted with elderly men (≥ 60 years) who were interviewed through the Surveillance System of Risk and Protective Factors for Chronic Diseases by Telephone Survey (Vigitel) in 2016 (n=5,384) and 2017 (n=5,801). The Vigitel survey includes representative samples of adults residing in the capitals of Brazilian states and the Federal District, and of those surveyed, 886 were widowers. Identified risk behaviors included physical inactivity during leisure time, irregular consumption of fruits, vegetables and legumes, smoking and alcohol abuse. The prevalence of smoking was lower among partnered elderly men [PR=0.68, CI95% (0.52-0.90)] than among widowers. There were no differences in the prevalence of other risk behaviors between widowers and other groups. When only widowers were taken into account, there was significant association of risk behaviors with age and educational level, but not with race/skin color.

Trends in different domains of physical activity in Brazilian adults: data from the Vigitel survey, 2006-2016

The study aimed to analyze trends in different domains of physical activity in Brazilian adults according to sex, age bracket, and schooling. The data were from the Risk and Protective Factors Surveillance System for Chronic Non-Comunicable Diseases Through Telephone Interview (Vigitel) from 2006 to 2016 in all the state capitals and the Federal District. The main questions in the Vigitel survey that were relevant to this study were leisure-time, commuting, occupational, and household physical activity. Trend analysis was obtained with Prais-Winsten regression, with significance set at 5%. The overall results showed an upward trend in leisure-time physical activity, from 14.9% in 2006 to 20.8% in 2016, with a significant annual increase of 3.6%, while physical activity was stationary in the other domains. The trend was also upward for both sexes in leisure time, while there were downward annual trends for men in the occupational domain (-0.6%) and for women in the household domain (-1.9%), from 71.6% in 2006 to 55.6% in 2016. There were downward trends in individuals from 20 to 29 years of age in the occupational domain (-1.6%) and household domain (-4.3%), from 30 to 39 years in the commuting domain (-5.9%) and household domain (-1.6%), and for individuals with ≥ 12 years of schooling in the occupational domain (-0.6%). The most important public health target related to physical activity is to increase this practice among individuals that are currently inactive in all domains.

Predictive Mean Matching as an alternative imputation method to hot deck in Vigitel

This study aimed to describe the estimated means for weight, height, and body mass index (BMI) according to two imputation methods, using data from Vigitel (Risk and Protective Factors Surveillance System for Chronic Non-Communicable Diseases Through Telephone Interview). This was a cross-sectional study that used secondary data from the Vigitel survey from 2006 to 2017. The two imputation methods used in the study were hot deck and Predictive Mean Matching (PMM). The weight and height variables imputed by hot deck were provided by Vigitel. Two models were conducted with PMM: (i) explanatory variables - city, sex, age in years, race/color, and schooling; (ii) explanatory variables - city, sex, and age in years. Weight and height were the outcome variables in the two models. PMM combines linear regression and random selection of the value for imputation. Linear prediction is used as a measure of distance between the missing value and the possible donors, thereby creating the virtual space with the candidate cases for yielding the value for imputation. One of the candidates from the pool is randomly selected, and its value is assigned to the missing unit. BMI was calculated by dividing weight in kilograms by height squared. The result shows the means and standard deviations for weight, height, and BMI according to imputation method and year. The estimates used the survey module from Stata, which considers the sampling effects. The mean values for weight, height, and BMI estimated by hot deck and PMM were similar. The results with the Vigitel data suggest the applicability of PMM to the set of health surveys.

PMU13 A MULTI-CRITERIA APPROACH TO THE STUDY OF CHRONIC NON-COMMUNICABLE DISEASES IN BRAZIL

To establish a ranking for Brazilian capitals and the Federal District through lifestyle data published in the Vigitel 2017 (Surveillance System of Risk and Protective Factors for Chronic Diseases by Telephone Survey). This ranking aims to know which Brazilian capital is more likely to develop chronic non-communicable diseases in order to support the decision-making on preventive actions. The TOPSIS and PROMÉTHÉE II multi-criteria methods were applied to establish the ranking. Firstly, TOPSIS was applied to identify the 5 capitals closer to developing chronic diseases. Brazilian capitals and the Federal District composed the set of alternatives. Four attributes from Vigitel survey formed the set of criteria: percentage of adults who smoke ≥20 cigarettes/day, percentage of adults with insufficient physical activity, percentage of adults with obesity (BMI ≥30 kg m2) and percentage of adults who consume soda on ≥5 days. After that, PROMÉTHÉE II was applied to build the ranking for those 5 capitals through an outranking relation. Thus, these 5 capitals form the set of alternatives. The ranking established by PROMÉTHÉE II for the five capitals pre-selected by TOPSIS takes place in the following order: Porto Alegre, Curitiba, São Paulo, Rio de Janeiro and Florianopolis. Through the outranking relation established by PROMÉTHÉE II the main attributes to develop chronic diseases on each capital in comparison with the others are: the 4 studied attributes in Porto Alegre; consume of soda and cigarettes smoking in Curitiba; insufficient physical activity, consume of soda and cigarettes smoking in São Paulo; obesity in Rio de Janeiro; and none criteria in Florianopolis. The TOPSIS-PROMÉTHÉE II approach allowed the ranking of Brazilian capitals according to 4 different attributes from Vigitel survey generating relevant information to aid the decision-making process about chronic diseases prevention.

First choice for use of health services by the adult population of the Federal District, Brazil, 2015: a cross-sectional study.

to describe the first choice for use of health services and to analyze sociodemographic factors associated with seeking Primary Health Care (PHC) by the adult population of Brazil's Federal District in 2015. this was a population-based study, with 2,007 individuals, using a sample from the 2015 VIGITEL survey conducted by landline telephone, including questions on use of health services; we used logistic regression to identify factors associated with seeking PHC services. participants' first choice was predominantly for private health services (57.6%), respondents reported seeking public health services less (39.5%), particularly PHC services (primary health centers: 24.6%); multivariate analysis showed that educational level (postgraduate [OR=0.15 - 95% CI 0.04;0.59] and high school [OR=0.37 - 95%CI 0.18;0.75]), and not having private health insurance (OR=27.77 - 95%CI 10.61;72.70) were variables associated with seeking PHC services. individuals with low educational level and without private health insurance are those who mostly seek PHC services as their first choice in Brazil's Federal District.

Association of excess weight and obesity and mortality in Brazilian state capitals and Argentine provinces

This study aimed to assess the association between prevalence of excess weight and obesity and overall and disease-specific mortality rates in Brazilian state capitals and Argentine provinces. This was an ecological study with secondary data, where the principal exposures were prevalence rates for excess weight and obesity, estimated with data from Brazil's Vigitel survey (Risk and Protective Factors Surveillance System for Chronic Non-Communicable Diseases Through Telephone Interveiew) in 2014 and Argentina's National Risk Factor Survey in 2013. Overall and specific mortality rates for the year 2015 were obtained from the Brazilian Mortality Information System in the Brazilian Health Informatics Department and the Division of Health Statistics and Information of the Argentine Ministry of Health. Brazilian mortality rates were standardized with the age structure of the Argentine population as the standard. Crude and adjusted linear regressions were used to assess the association between the prevalence rates for excess weight and obesity and the overall and specific mortality rates. After adjusting for potential confounding factors, prevalence of obesity was positively associated with the overall mortality rate both in Brazil (β = 0.18; 95%CI: 0.01; 0.35) and in Argentina (β = 0.06; 95%CI: 0.01; 0.13). There was no association with the specific cardiovascular and cancer mortality rates. We conclude that the Brazilian state capitals and Argentine provinces with the highest prevalence of obesity present higher overall mortality rates, while this association was inconsistent for the specific rates.

Prevalência simultânea de hipertensão e diabetes em idosos brasileiros: desigualdades individuais e contextuais

The simultaneous occurrence of specific diseases in older adults is explored little in the literature. The aim of this study was to estimate the prevalence of concomitant hypertension and diabetes in Brazilian older adults and determine associated contextual and individual factors. A population-based cross-sectional study was conducted with 10,991 older adults (≥ 60 years of age) interviewed during the 2012 Vigitel Survey. Statistical analysis involved multi-level Poisson regression. Mean age was 69.4. The prevalence of the concomitant occurrence of hypertension and diabetes was 16.2%, with differences found among the capital cities. Higher prevalence rates were found in cities located in the southern, southeastern and central-western regions of the country as well as among black and brown older adults, those with up to eight years of schooling, non-smokers, ex-smokers and those with excess weight. The effect of geographic region was demonstrated by the 23.5% increase in the prevalence of the concomitant diseases after adjusting for individual variables. The present findings enabled gauging the effect of context (region of residence) on the prevalence of the main diseases related to an increased mortality rate in the older population.

Risk and protection factors for self-reported hypertension and diabetes in João Pessoa, Brazil. The VIGITEL survey, 2014. A cross-sectional study.

Chronic diseases are the main cause of death among adults and are responsible for most outpatient and hospital care expenses in Brazil. The objective here was to determine the prevalence of hypertension and diabetes and to analyze the associations with risk and protection factors among adults. Cross-sectional study in a state capital in northeastern Brazil. Data on adults of both sexes aged ≥ 45 years who were interviewed in the Vigitel telephone survey in 2014 were analyzed. Prevalence ratios were estimated using Poisson regression, to identify associated factors. Among women, the prevalence of hypertension was 48.4% and of diabetes, 12.7%; among men, the prevalences were 41.9% and 13.8%, respectively. Multivariate analysis showed that for women, age group ≥ 65 years, overweight, self-assessed poor health and dyslipidemia remained associated with higher prevalence of hypertension. For men, overweight and self-assessed poor health remained associated with higher prevalence of hypertension. Regarding diabetes, in the multivariate model for women, age group 55-64 years, schooling level between zero and four years and no regular consumption of beans remained associated with higher prevalence. For men, age groups 55-64 years and ≥ 65 years and being married or in a stable partnership were associated with higher prevalence of diabetes. The results indicated that the prevalences of hypertension and diabetes were high and that preventable factors were associated with this situation, thus providing support for public policies aimed towards coping with this.

Factors associated with the contraindicated use of oral contraceptives in Brazil.

ABSTRACTOBJECTIVE To estimate the prevalence of the contraindicated use of oral contraceptives and the associated factors in Brazilian women.METHODS 20,454 women who answered the VIGITEL survey in 2008 also participated in this study, of which 3,985 reported using oral contraceptives. We defined the following conditions for the contraindicated use of contraceptives: hypertension; cardiovascular diseases such as heart attack, stroke/cerebrovascular accident; diabetes mellitus; being smoker and 35 years old or older. We estimated the prevalence and 95% confidence intervals of contraindicated use in users of oral contraceptives and the factors associated with contraindication by prevalence ratio and 95% confidence intervals.RESULTS In the total population, 21% (95%CI 19.7–21.9) of women showed some contraindication to the use of oral contraceptives, of which 11.7% (95%CI 10.6–13.7) belonged to the group of users of oral contraceptives. The most frequent contraindication in users of oral contraceptives was hypertension (9.1%). The largest proportion of women with at least one contraindication was aged between 45 and 49 years (45.8%) and with education level between zero and eight years (23.8%). The prevalence of contraindication to oral contraceptives was higher in women less educated (zero to eight years of study) (PR = 2.46; 95%CI 1.57–3.86; p < 0.05) and with age between 35-44 years (PR = 4.00; 95%CI 2.34–6.83) and 45-49 years (PR = 5.59; 95%CI 2.90–10.75).CONCLUSIONS Age greater than or equal to 35 and low education level were demographic and iniquity factors, respectively, in the contraindicated use of oral contraceptives.