RESUMO Objetivo Analisar a sobrevida de portadores da doença de Chagas, beneficiários da previdência e da assistência social no Brasil, 1942-2016. Métodos Estudo de coorte retrospectivo com dados do Ministério da Previdência Social. O evento de interesse foi o óbito, e as funções de sobrevida foram estimadas pelos métodos Kaplan-Meier e de regressão de Cox. Resultados No período “início da doença até o óbito”, o sexo feminino (HR=0,54; IC95% 0,43–0,53) e recebimento de benefícios previdenciários (HR=0,13; IC95% 0,11–0,23) foram associados a maior sobrevida. A menor sobrevida esteve associada à forma cardíaca da doença (HR=2,64; IC95% 2,23–3,12), residência em zona rural (HR=1,23; IC95% 1,14–1,21) e manifestação da doença entre os anos de 2000 e 2016 (HR=5,32; IC95% 4,74–5,93). Da mesma forma, no período “incapacidade laboral até o óbito”, o sexo feminino (HR=0,51; IC95% 0,41–0,52) e o recebimento de benefícios previdenciários (HR=0,24; IC95% 0,14–0,45) foram associados a maior sobrevida, assim como forma cardíaca da doença (HR=1,95; IC95% 1,83–2,13), residência em zona rural (HR=1,31; IC95% 1,21–1,54) e manifestação da doença entre os anos de 2000 e 2016 (HR=1,53; IC95% 1,33–1,71) associaram-se a menor sobrevida. Conclusão Os principais preditores de mortalidade e sobrevida de portadores de doença de Chagas que recebem benefícios previdenciários e assistenciais no Brasil foram apresentados. Estes achados podem nortear a definição de prioridades de ações de acompanhamento pela atenção primária à saúde, preconizada atualmente para o manejo longitudinal da doença.

ABSTRACT Objective To analyze the survival of patients with Chagas disease, beneficiaries of social security and social assistance, in Brazil, from 1942 to 2016. Methods This is a retrospective cohort study with data from the Brazilian Ministry of Social Security. The event of interest was death, and the survival functions were estimated by the Kaplan-Meier and Cox regression methods. Results In the period “onset of the disease until death”, women (HR=0.54; 95%CI 0.43–0.53) and receiving social security benefits (HR=0.13; 95%CI 0.11–0.23) were associated with longer survival. Lower survival was associated with the cardiac form of the disease (HR=2.64; 95%CI 2.23–3.12), living in a rural area (HR=1.23; 95%CI 1.14–1.21), and manifestation of the disease between the years 2000 and 2016 (HR=5.32; 95%CI 4.74–5.93). Likewise, in the period “work disability until death”, women (HR=0.51; 95%CI 0.41–0.52) and receiving social security benefits (HR=0.24; 95%CI 0,14–0.45) were associated with longer survival, as well as the cardiac form of the disease (HR=1.95; 95%CI 1.83–2.13), living in a rural area (HR=1.31; 95%CI 1.21–1.54), and manifestation of the disease between 2000 and 2016 (HR=1.53; 95%CI 1.33–1.71) were associated with lower survival. Conclusion The main predictors of mortality and survival of patients with Chagas disease who receive social security and assistance benefits in Brazil were presented. These findings can guide the definition of priorities for follow-up actions by Primary Health Care, currently recommended for the longitudinal management of the disease.

ABSTRACT Objective: To analyze the compliance with the commercialization of children's products included in the Brazilian Code of Marketing of Infant and Toddlers Food and Childcare-Related Products (NBCAL) in drugstores in Uberlândia/MG. Methods: A cross-sectional study was carried out in 143 drugstores that sold infant products: infant formula (IF), follow-up IF, nipples, teats, pacifiers and nipple shields; FI for young children, transition foods and cereal-based foods, fluid or powdered milk, modified/similar milks of plant origin and dairy compounds. The location of drugstores in the five geographic sectors was performed by geoprocessing. The data collected were: types of promotion and types of drugstore administration (drugstore chains/drugstores with independent administration). Irregular commercial promotion was expressed as absolute and relative frequencies. Results: Irregular commercial promotion was found in 11.7% of nipples, pacifiers and bottles, in 10.0% of IF and follow-up formula, in 9.5% of IF for young children, in 11.1% fluid or powdered milk, in 25.0% of transition foods and cereal-based foods and in 59.1% of dairy compounds. In commercial drugstore chains, the presence of promotion for dairy (81.8 vs. 28.6%, respectively) was higher than in drugstores with independent administration. The opposite ocurred for fluid or powdered milk, modified and similar milks of plant origin. The downtown and eastern sectors had the highest percentages of promotions (26%). Conclusions: NBCAL violations still occur in drugstores, mainly in the sale of young children's foods and in the commercial network drugstores. Objective childrens children s ChildcareRelated Childcare Related (NBCAL UberlândiaMG Uberlândia MG Uberlândia/MG Methods crosssectional cross sectional 14 , (IF) followup follow up nipples teats shields cerealbased cereal based milk modifiedsimilar compounds geoprocessing were chainsdrugstores chains . administration) frequencies Results 117 11 7 11.7 bottles 100 10 0 10.0 95 9 5 9.5 111 1 11.1 250 25 25.0 591 59 59.1 81.8 818 81 8 (81. vs 286 28 6 28.6% respectively 26%. 26 26% (26%) Conclusions (IF 11. 10. 9. 2 25. 59. 81. (81 28.6 (26% (8 28. (26 ( (2

RESUMO Objetivo: Analisar a conformidade da comercialização dos produtos infantis incluídos na Norma Brasileira de Comercialização de Alimentos para Lactentes e Crianças de Primeira Infância, Bicos, Chupetas e Mamadeira (NBCAL) e de compostos lácteos em drogarias de Uberlândia/MG. Métodos: Estudo transversal realizado em 143 drogarias que vendiam produtos infantis: fórmulas infantis (FI) para lactentes, FI de seguimento para lactentes, mamadeiras, bicos, chupetas e protetores de mamilo; FI para crianças de primeira infância, alimentos de transição e alimentos à base de cereais, leites fluidos/em pó, leites modificados/similares de origem vegetal e composto lácteo. A localização das drogarias nos cinco setores geográficos foi realizada por geoprocessamento. Os dados coletados foram: tipos de promoção comercial irregular e tipo de administração da drogaria (rede/independente). As promoções comerciais irregulares foram expressas em frequências absoluta e relativa. Resultados: Verificamos a presença de promoção comercial irregular em 11,7% dos bicos, chupetas e mamadeiras, em 10,0% das FI lactentes/seguimento de lactentes, em 9,5% das FI para crianças de primeira infância, em 11,1% dos leites, em 25,0% de alimentos de transição e em 59,1% dos compostos lácteos. Nas drogarias de rede, a presença de promoção comercial irregular foi maior para compostos lácteos (81,8 vs. 28,6%, respectivamente) e, para leites, foi maior nas drogarias independentes (30,8 vs. 6,0%). Os setores central e leste apresentaram os maiores percentuais de promoção comercial irregular (26%). Conclusões: As violações à NBCAL ainda ocorrem nas drogarias, principalmente para os produtos destinados às crianças de primeira infância, e nas drogarias de rede. Objetivo Infância Bicos (NBCAL UberlândiaMG Uberlândia MG Uberlândia/MG Métodos 14 (FI lactentes mamadeiras bicos mamilo infância cereais fluidosem fluidos pó modificadossimilares modificados similares lácteo geoprocessamento rede/independente. redeindependente rede/independente . rede independente (rede/independente) relativa Resultados 117 11 7 11,7 100 10 0 10,0 lactentesseguimento 95 9 5 9,5 111 1 11,1 250 25 25,0 591 59 59,1 81,8 818 81 8 (81, vs 286 28 6 28,6% respectivamente 30,8 308 30 (30, 6,0%. 60 6,0% 6,0%) 26%. 26 26% (26%) Conclusões (rede/independente 11, 10, 9, 2 25, 59, 81, (81 28,6 30, 3 (30 6,0 (26% (8 28, (3 6, (26 ( (2

Abstract Objectives: to investigate the association between dietary patterns, physical activity, and body phenotypes in adolescents. Methods: this school-based cross-sectional study involved 1,022 adolescents aged ten to 19 years. Dietary patterns and body phenotypes were defined using a principal component analysis. Body phenotype was defined using anthropometry, body composition, biochemistry, sexual maturation, and dietary patterns from 19 food groups, using a food frequency questionnaire. The association between the dietary patterns and body phenotypes was assessed using a linear regression model. Results: five body phenotypes (BP1adiposity, BP2puberty, BP3biochemical, BP4muscular, BP5lipids_biochemical) and five dietary patterns (DP1ultraprocessed_foods, DP2fresh_foods, DP3bread_rice_beans, DP4culinary_preparations, DP5cakes_rice_beans) were identified. There were higher BP_adiposity scores for obese adolescents, but energy expenditure was similar for obese and non-obese adolescents. Physical activity was positively associated with BMI, BP_adiposity, and BP_puberty. We observed a negative association between DP_ultraprocessed_foods and BMI, and a positive association between DP_fresh_food. DP_fresh_foods was positively associated with BP_adiposity; DP_ultraprocessed_foods and DP_culinary_preparations were negatively associated with this phenotype. BP_biochemical was negatively associated with DP_fresh_foods. Conclusion: we identified a negative association between a dietary pattern composed mainly of ultra-processed foods, fresh foods, and BP_adiposity. These associations need to be better explored, especially in adolescents, as both dietary patterns and phenotypes were defined using multivariate analysis. Objectives Methods schoolbased school based crosssectional cross sectional 1022 1 022 1,02 years analysis anthropometry composition biochemistry maturation groups questionnaire model Results BP1adiposity, BP1adiposity BPadiposity BP adiposity (BP1adiposity BP2puberty BPpuberty puberty BP3biochemical BPbiochemical biochemical BP4muscular BPmuscular muscular BP5lipids_biochemical BP5lipidsbiochemical BPlipidsbiochemical BP5lipids lipids DP1ultraprocessed_foods, DP1ultraprocessedfoods DPultraprocessedfoods DP1ultraprocessed foods DP ultraprocessed (DP1ultraprocessed_foods DP2freshfoods DPfreshfoods DP2fresh DP2fresh_foods DP3breadricebeans DPbreadricebeans DP3bread rice beans bread DP3bread_rice_beans DP4culinarypreparations DPculinarypreparations DP4culinary preparations culinary DP4culinary_preparations DP5cakes_rice_beans DP5cakesricebeans DPcakesricebeans DP5cakes cakes nonobese non BMI BP_puberty DPfreshfood DP_fresh_food Conclusion ultra processed explored 102 02 1,0 lipidsbiochemical BPlipids DP1ultraprocessed_foods ultraprocessedfoods DPultraprocessed freshfoods DPfresh breadricebeans DPbread culinarypreparations DPculinary cakesricebeans DPcakes 10 0 1,

Resumo Objetivos: investigar associação entre padrão alimentar (PA), atividade física (AF) e fenótipos corporais (FC) em adolescentes. Métodos: estudo transversal de base escolar com 1.022 adolescentes de dez a 19 anos. Padrão alimentar e fenótipo corporal foram definidos por meio da análise de componentes principais. O fenótipo corporal foi definido usando antropometria, composição corporal, bioquímica e maturação sexual, e padrão alimentar a partir de 19 grupos de alimentos de um questionário de frequência alimentar. A associação entre padrão alimentar e fenótipo corporal foi avaliada por modelo de regressão linear. Resultados: foram identificados cinco fenótipos corporais (FC1adiposidade, FC2puberdade, FC3bioquímico, FC4muscular, FC5lipídios_bioquímico) e cinco padrões alimentares (PA1alimentos_ultraprocessados, PA2alimentos_frescos, PA3pão_arroz_feijão, PA4preparações_culinárias, PA5bolos_arroz_feijão). Há maiores escores de FC_adiposidade para adolescentes com obesidade, mas o gasto energético foi semelhante para adolescentes com e sem diagnóstico de obesidade. Atividade física associou-se positivamente com IMC, FC_adiposidade e FC_puberdade. Observamos associação negativa entre PA_ultraprocessados e IMC, e positiva entre PA_alimentos_frescos. PA_alimentos_frescos associou-se positivamente com FC_adiposidade; PA_ultraprocessados e PA_preparações_culinárias se associaram negativamente a este fenótipo. FC_bioquímico associou-se negativamente com PA_alimentos_frescos. Conclusão: identificamos associação negativa entre padrão alimentar composto principalmente por alimentos ultraprocessados e alimentos in natura e FC_adiposidade. Essas associações devem ser exploradas com o mesmo público em estudos futuros, principalmente em adolescentes, pois tanto o padrão alimentar quanto o fenótipo foram definidos por meio de análise multivariada. Objetivos PA, PA , (PA) AF (AF FC (FC Métodos 1022 1 022 1.02 anos principais antropometria sexual linear Resultados FC1adiposidade, FC1adiposidade FCadiposidade adiposidade (FC1adiposidade FC2puberdade FCpuberdade puberdade FC3bioquímico FCbioquímico bioquímico FC4muscular FCmuscular muscular FC5lipídios_bioquímico FC5lipídiosbioquímico FClipídiosbioquímico FC5lipídios lipídios PA1alimentos_ultraprocessados, PA1alimentosultraprocessados PAalimentosultraprocessados PA1alimentos (PA1alimentos_ultraprocessados PA2alimentosfrescos PAalimentosfrescos PA2alimentos frescos PA2alimentos_frescos PA3pãoarrozfeijão PApãoarrozfeijão PA3pão arroz feijão pão PA3pão_arroz_feijão PA4preparaçõesculinárias PApreparaçõesculinárias PA4preparações culinárias preparações PA4preparações_culinárias PA5bolos_arroz_feijão. PA5bolosarrozfeijão PAbolosarrozfeijão PA5bolos_arroz_feijão . PA5bolos bolos PA5bolos_arroz_feijão) obesidade associouse associou IMC FC_puberdade PAultraprocessados Conclusão futuros multivariada (PA 102 02 1.0 lipídiosbioquímico FClipídios PA1alimentos_ultraprocessados alimentosultraprocessados PAalimentos alimentosfrescos pãoarrozfeijão PApão preparaçõesculinárias PApreparações bolosarrozfeijão PAbolos 10 0 1.

ABSTRACT Objective To analyze the survival of patients with Chagas disease, beneficiaries of social security and social assistance, in Brazil, from 1942 to 2016. Methods This is a retrospective cohort study with data from the Brazilian Ministry of Social Security. The event of interest was death, and the survival functions were estimated by the Kaplan-Meier and Cox regression methods. Results In the period “onset of the disease until death”, women (HR=0.54; 95%CI 0.43–0.53) and receiving social security benefits (HR=0.13; 95%CI 0.11–0.23) were associated with longer survival. Lower survival was associated with the cardiac form of the disease (HR=2.64; 95%CI 2.23–3.12), living in a rural area (HR=1.23; 95%CI 1.14–1.21), and manifestation of the disease between the years 2000 and 2016 (HR=5.32; 95%CI 4.74–5.93). Likewise, in the period “work disability until death”, women (HR=0.51; 95%CI 0.41–0.52) and receiving social security benefits (HR=0.24; 95%CI 0,14–0.45) were associated with longer survival, as well as the cardiac form of the disease (HR=1.95; 95%CI 1.83–2.13), living in a rural area (HR=1.31; 95%CI 1.21–1.54), and manifestation of the disease between 2000 and 2016 (HR=1.53; 95%CI 1.33–1.71) were associated with lower survival. Conclusion The main predictors of mortality and survival of patients with Chagas disease who receive social security and assistance benefits in Brazil were presented. These findings can guide the definition of priorities for follow-up actions by Primary Health Care, currently recommended for the longitudinal management of the disease. 194 Security death KaplanMeier Kaplan Meier methods onset , death” HR=0.54 HR054 HR 0 54 (HR=0.54 95CI CI 95 0.43–0.53 043053 43 53 HR=0.13 HR013 13 (HR=0.13 0.11–0.23 011023 11 23 HR=2.64 HR264 2 64 (HR=2.64 2.23–3.12, 223312 2.23–3.12 3 12 2.23–3.12) HR=1.23 HR123 1 (HR=1.23 1.14–1.21, 114121 1.14–1.21 14 21 1.14–1.21) 200 201 HR=5.32 HR532 5 32 (HR=5.32 4.74–5.93. 474593 4.74–5.93 . 4 74 93 4.74–5.93) Likewise work HR=0.51 HR051 51 (HR=0.51 0.41–0.52 041052 41 52 HR=0.24 HR024 24 (HR=0.24 0,14–0.45 014045 45 HR=1.95 HR195 (HR=1.95 1.83–2.13, 183213 1.83–2.13 83 1.83–2.13) HR=1.31 HR131 31 (HR=1.31 1.21–1.54, 121154 1.21–1.54 1.21–1.54) HR=1.53 HR153 (HR=1.53 1.33–1.71 133171 33 71 presented followup follow up Care 19 HR=0.5 HR05 (HR=0.5 9 0.43–0.5 04305 HR=0.1 HR01 (HR=0.1 0.11–0.2 01102 HR=2.6 HR26 6 (HR=2.6 22331 2.23–3.1 HR=1.2 HR12 (HR=1.2 11412 1.14–1.2 20 HR=5.3 HR53 (HR=5.3 47459 4.74–5.9 7 0.41–0.5 04105 HR=0.2 HR02 (HR=0.2 0,14–0.4 01404 HR=1.9 HR19 (HR=1.9 18321 1.83–2.1 8 HR=1.3 HR13 (HR=1.3 12115 1.21–1.5 HR=1.5 HR15 (HR=1.5 1.33–1.7 13317 HR=0. HR0 (HR=0. 0.43–0. 0430 0.11–0. 0110 HR=2. HR2 (HR=2. 2233 2.23–3. HR=1. HR1 (HR=1. 1141 1.14–1. HR=5. HR5 (HR=5. 4745 4.74–5. 0.41–0. 0410 0,14–0. 0140 1832 1.83–2. 1211 1.21–1. 1.33–1. 1331 HR=0 (HR=0 0.43–0 043 0.11–0 011 HR=2 (HR=2 223 2.23–3 HR=1 (HR=1 114 1.14–1 HR=5 (HR=5 474 4.74–5 0.41–0 041 0,14–0 014 183 1.83–2 121 1.21–1 1.33–1 133 HR= (HR= 0.43– 04 0.11– 01 22 2.23– 1.14– 47 4.74– 0.41– 0,14– 18 1.83– 1.21– 1.33– (HR 0.43 0.11 2.23 1.14 4.74 0.41 0,14 1.83 1.21 1.33 0.4 0.1 2.2 1.1 4.7 0,1 1.8 1.2 1.3 0. 2. 1. 4. 0,

RESUMO Objetivo Analisar a sobrevida de portadores da doença de Chagas, beneficiários da previdência e da assistência social no Brasil, 1942-2016. Métodos Estudo de coorte retrospectivo com dados do Ministério da Previdência Social. O evento de interesse foi o óbito, e as funções de sobrevida foram estimadas pelos métodos Kaplan-Meier e de regressão de Cox. Resultados No período “início da doença até o óbito”, o sexo feminino (HR=0,54; IC95% 0,43–0,53) e recebimento de benefícios previdenciários (HR=0,13; IC95% 0,11–0,23) foram associados a maior sobrevida. A menor sobrevida esteve associada à forma cardíaca da doença (HR=2,64; IC95% 2,23–3,12), residência em zona rural (HR=1,23; IC95% 1,14–1,21) e manifestação da doença entre os anos de 2000 e 2016 (HR=5,32; IC95% 4,74–5,93). Da mesma forma, no período “incapacidade laboral até o óbito”, o sexo feminino (HR=0,51; IC95% 0,41–0,52) e o recebimento de benefícios previdenciários (HR=0,24; IC95% 0,14–0,45) foram associados a maior sobrevida, assim como forma cardíaca da doença (HR=1,95; IC95% 1,83–2,13), residência em zona rural (HR=1,31; IC95% 1,21–1,54) e manifestação da doença entre os anos de 2000 e 2016 (HR=1,53; IC95% 1,33–1,71) associaram-se a menor sobrevida. Conclusão Os principais preditores de mortalidade e sobrevida de portadores de doença de Chagas que recebem benefícios previdenciários e assistenciais no Brasil foram apresentados. Estes achados podem nortear a definição de prioridades de ações de acompanhamento pela atenção primária à saúde, preconizada atualmente para o manejo longitudinal da doença. 19422016. 19422016 1942 2016. 1942-2016 Social óbito KaplanMeier Kaplan Meier Cox início , óbito” HR=0,54 HR054 HR 0 54 (HR=0,54 IC95 IC 0,43–0,53 043053 43 53 HR=0,13 HR013 13 (HR=0,13 0,11–0,23 011023 11 23 HR=2,64 HR264 2 64 (HR=2,64 2,23–3,12, 223312 2,23–3,12 3 12 2,23–3,12) HR=1,23 HR123 1 (HR=1,23 1,14–1,21 114121 14 21 200 201 HR=5,32 HR532 5 32 (HR=5,32 4,74–5,93. 474593 4,74–5,93 . 4 74 93 4,74–5,93) incapacidade HR=0,51 HR051 51 (HR=0,51 0,41–0,52 041052 41 52 HR=0,24 HR024 24 (HR=0,24 0,14–0,45 014045 45 HR=1,95 HR195 95 (HR=1,95 1,83–2,13, 183213 1,83–2,13 83 1,83–2,13) HR=1,31 HR131 31 (HR=1,31 1,21–1,54 121154 HR=1,53 HR153 (HR=1,53 1,33–1,71 133171 33 71 associaramse associaram se apresentados saúde 1942201 194 1942-201 HR=0,5 HR05 (HR=0,5 IC9 0,43–0,5 04305 HR=0,1 HR01 (HR=0,1 0,11–0,2 01102 HR=2,6 HR26 6 (HR=2,6 22331 2,23–3,1 HR=1,2 HR12 (HR=1,2 1,14–1,2 11412 20 HR=5,3 HR53 (HR=5,3 47459 4,74–5,9 7 9 0,41–0,5 04105 HR=0,2 HR02 (HR=0,2 0,14–0,4 01404 HR=1,9 HR19 (HR=1,9 18321 1,83–2,1 8 HR=1,3 HR13 (HR=1,3 1,21–1,5 12115 HR=1,5 HR15 (HR=1,5 1,33–1,7 13317 194220 19 1942-20 HR=0, HR0 (HR=0, 0,43–0, 0430 0,11–0, 0110 HR=2, HR2 (HR=2, 2233 2,23–3, HR=1, HR1 (HR=1, 1,14–1, 1141 HR=5, HR5 (HR=5, 4745 4,74–5, 0,41–0, 0410 0,14–0, 0140 1832 1,83–2, 1,21–1, 1211 1,33–1, 1331 19422 1942-2 HR=0 (HR=0 0,43–0 043 0,11–0 011 HR=2 (HR=2 223 2,23–3 HR=1 (HR=1 1,14–1 114 HR=5 (HR=5 474 4,74–5 0,41–0 041 0,14–0 014 183 1,83–2 1,21–1 121 1,33–1 133 1942- HR= (HR= 0,43– 04 0,11– 01 22 2,23– 1,14– 47 4,74– 0,41– 0,14– 18 1,83– 1,21– 1,33– (HR 0,43 0,11 2,23 1,14 4,74 0,41 0,14 1,83 1,21 1,33 0,4 0,1 2,2 1,1 4,7 1,8 1,2 1,3 0, 2, 1, 4,

Resumo Nosso objetivo foi analisar a associação entre a duração do trabalho remoto e o diagnóstico positivo da COVID-19 entre pessoas ocupadas no Brasil. Foram utilizados dados da PNAD COVID19 (2020). As variáveis sobre a situação do trabalho descritas foram: afastamento do trabalho em função do distanciamento físico, segmento de trabalho (setor de trabalho e formalidade: privado formal/informal, militar, servidor público estatutário, setor público CLT/informal, empregador, conta-própria/trabalhador não remunerado) e duração do trabalho remoto (sem trabalho remoto, 1-2 meses, 3-4 meses, 5-7 meses). Associação entre duração do trabalho remoto (exposição) e diagnóstico positivo para COVID-19 (desfecho) foi estimada por regressão de Cox, com ajuste para variáveis sociodemográficas e segmento de trabalho. O diagnóstico positivo da COVID-19 aumentou de 2,1% para 4,8% entre julho e novembro, e a frequência de trabalho remoto reduziu de 11,6% para 9,5% entre maio e novembro. O risco de diagnóstico positivo da COVID-19 foi menor para pessoas que trabalharam remotamente por 3-4 meses (RR=0,79; IC95%=0,67;0,92) e 5 meses (RR=0,57; IC95%=0,48;0,67) comparadas àquelas que não trabalharam remotamente. Houve discreta redução do percentual de trabalhadores em trabalho remoto e sua maior extensão reduziu o risco de diagnóstico positivo para COVID-19.

Abstract The scope of this work was to assess the association between the duration of remote work and a positive diagnosis of COVID-19 among individuals employed in Brazil. Data from the PNAD COVID19 (2020) survey were consulted. The variables in the work situation described included: absence from work due to physical distancing, work segment (work sector and formality: formal or informal private, military, statutory civil servant, CLT public sector, informal public sector, employer, self-employed/unpaid worker) and duration of remote work (no remote work for 1-2 months, 3-4 months, 5-7 months, respectively). The association between duration of remote work (exposure) and positive diagnosis for COVID-19 (outcome) was estimated by Cox regression, with adjustment for sociodemographic variables and work segment. The positive diagnosis of COVID-19 increased from 2.1% to 4.8% between July and November, and the frequency of remote work decreased from 11.6% to 9.5% between May and November. The risk of a positive diagnosis of COVID-19 was lower for people working remotely for 3-4 months, (HR=0.79; CI95%=0.67;0.92) and 5-7 months (HR=0.57; CI95%=0.48;0.67) compared to those who did not work remotely. There was a slight decrease in the percentage of remote work employees, and a longer duration reduced the risk of a positive diagnosis for COVID-19.

Abstract The scope of this work was to assess the association between the duration of remote work and a positive diagnosis of COVID-19 among individuals employed in Brazil. Data from the PNAD COVID19 (2020) survey were consulted. The variables in the work situation described included: absence from work due to physical distancing, work segment (work sector and formality: formal or informal private, military, statutory civil servant, CLT public sector, informal public sector, employer, self-employed/unpaid worker) and duration of remote work (no remote work for 1-2 months, 3-4 months, 5-7 months, respectively). The association between duration of remote work (exposure) and positive diagnosis for COVID-19 (outcome) was estimated by Cox regression, with adjustment for sociodemographic variables and work segment. The positive diagnosis of COVID-19 increased from 2.1% to 4.8% between July and November, and the frequency of remote work decreased from 11.6% to 9.5% between May and November. The risk of a positive diagnosis of COVID-19 was lower for people working remotely for 3-4 months, (HR=0.79; CI95%=0.67;0.92) and 5-7 months (HR=0.57; CI95%=0.48;0.67) compared to those who did not work remotely. There was a slight decrease in the percentage of remote work employees, and a longer duration reduced the risk of a positive diagnosis for COVID-19. COVID 19 COVID-1 Brazil COVID1 2020 (2020 consulted included distancing formality private military servant employer selfemployed/unpaid selfemployedunpaid self employed/unpaid unpaid worker no 12 1 2 1- 34 3 4 3- 57 5 7 5- respectively. respectively . respectively) exposure (exposure outcome (outcome regression 21 2.1 48 8 4.8 November 116 11 6 11.6 95 9 9.5 HR=0.79 HR079 HR 0 79 (HR=0.79 CI95%=0.670.92 CI95067092 CI CI95%=0.67 0.92 CI95 67 92 CI95%=0.67;0.92 HR=0.57 HR057 (HR=0.57 CI95%=0.480.67 CI95048067 CI95%=0.48 0.67 CI95%=0.48;0.67 employees COVID19. 19. COVID- 202 (202 selfemployed employedunpaid 2. 4. 11. 9. HR=0.7 HR07 (HR=0.7 670 CI95%=0.670.9 CI9506709 CI95067 CI95%=0.6 092 0.9 CI9 CI95%=0.67;0.9 HR=0.5 HR05 (HR=0.5 480 CI95%=0.480.6 CI9504806 CI95048 CI95%=0.4 067 0.6 CI95%=0.48;0.6 20 (20 HR=0. HR0 (HR=0. CI95%=0.670. CI950670 CI9506 CI95%=0. 09 0. CI95%=0.67;0. CI95%=0.480. CI950480 CI9504 06 CI95%=0.48;0. (2 HR=0 (HR=0 CI95%=0.670 CI950 CI95%=0 CI95%=0.67;0 CI95%=0.480 CI95%=0.48;0 ( HR= (HR= CI95%= CI95%=0.67; CI95%=0.48; (HR CI95%

Resumo Nosso objetivo foi analisar a associação entre a duração do trabalho remoto e o diagnóstico positivo da COVID-19 entre pessoas ocupadas no Brasil. Foram utilizados dados da PNAD COVID19 (2020). As variáveis sobre a situação do trabalho descritas foram: afastamento do trabalho em função do distanciamento físico, segmento de trabalho (setor de trabalho e formalidade: privado formal/informal, militar, servidor público estatutário, setor público CLT/informal, empregador, conta-própria/trabalhador não remunerado) e duração do trabalho remoto (sem trabalho remoto, 1-2 meses, 3-4 meses, 5-7 meses). Associação entre duração do trabalho remoto (exposição) e diagnóstico positivo para COVID-19 (desfecho) foi estimada por regressão de Cox, com ajuste para variáveis sociodemográficas e segmento de trabalho. O diagnóstico positivo da COVID-19 aumentou de 2,1% para 4,8% entre julho e novembro, e a frequência de trabalho remoto reduziu de 11,6% para 9,5% entre maio e novembro. O risco de diagnóstico positivo da COVID-19 foi menor para pessoas que trabalharam remotamente por 3-4 meses (RR=0,79; IC95%=0,67;0,92) e 5 meses (RR=0,57; IC95%=0,48;0,67) comparadas àquelas que não trabalharam remotamente. Houve discreta redução do percentual de trabalhadores em trabalho remoto e sua maior extensão reduziu o risco de diagnóstico positivo para COVID-19. COVID 19 COVID-1 Brasil COVID1 2020. 2020 . (2020) foram físico formalidade formalinformal formal informal formal/informal militar estatutário CLTinformal CLT CLT/informal empregador contaprópria/trabalhador contaprópriatrabalhador conta própria/trabalhador própria trabalhador remunerado sem 12 1 2 1- 34 3 4 3- 57 7 5- meses. meses) exposição (exposição desfecho (desfecho Cox 21 2,1 48 8 4,8 novembro 116 11 6 11,6 95 9 9,5 RR=0,79 RR079 RR 0 79 (RR=0,79 IC95%=0,670,92 IC95067092 IC IC95%=0,67 0,92 IC95 67 92 IC95%=0,67;0,92 RR=0,57 RR057 (RR=0,57 IC95%=0,480,67 IC95048067 IC95%=0,48 0,67 IC95%=0,48;0,67 COVID19. 19. COVID- 202 (2020 contaprópria própriatrabalhador 2, 4, 11, 9, RR=0,7 RR07 (RR=0,7 670 IC95%=0,670,9 IC9506709 IC95067 IC95%=0,6 092 0,9 IC9 IC95%=0,67;0,9 RR=0,5 RR05 (RR=0,5 480 IC95%=0,480,6 IC9504806 IC95048 IC95%=0,4 067 0,6 IC95%=0,48;0,6 20 (202 RR=0, RR0 (RR=0, IC95%=0,670, IC950670 IC9506 IC95%=0, 09 0, IC95%=0,67;0, IC95%=0,480, IC950480 IC9504 06 IC95%=0,48;0, (20 RR=0 (RR=0 IC95%=0,670 IC950 IC95%=0 IC95%=0,67;0 IC95%=0,480 IC95%=0,48;0 (2 RR= (RR= IC95%= IC95%=0,67; IC95%=0,48; ( (RR IC95%

Abstract Objective: To describe the trend of participation in group and individual support by human milk banks (HMBs) provided between 2010 and 2019 in Brazil. Methods: Ecological study with data from participation in group and individual support provided by the HMBs between 2010 and 2019, available in the production report of the Brazilian Network of Human Milk Banks. The number of participation in group and individual support was expressed for Brazil and for Brazilian macroregions in absolute numbers. Trend analysis was performed from the analysis of index numbers, considering the year 2010 as a reference. It was calculated the ratio of the number of participation in group and individual support by HMBs for each macroregion and year. Results: There was an increase of 42% in participation in group support (300,595 in 2010 vs 425,570 in 2019) and an increase of 69% in individual support (1,157,038 in 2010 vs 1,962,162 in 2019). The North and Northeast macroregions had the highest growth rates in the provision of these services (122 and 131%, respectively), above the national growth rate in the study period. In contrast, the Midwest region showed a downward trend throughout this period, for both types of support. However, in the Midwest, there was a higher ratio of participation in groups by HMBs between 2010 and 2016 and for individual support by HMBs between 2010 and 2012. Conclusion: Individual and group support provided by the HMB as a strategy to support breastfeeding increased considerably in Brazil during the study period, especially in the North and Northeast regions.

Abstract Objective Assess the mediating role of breastfeeding self-efficacy in the association between the Kangaroo Neonatal Intermediate Care Unit and exclusive breastfeeding. Method Cross-sectional study nested in a cohort, carried out in the Neonatal Unit of a Brazilian university hospital between September 2018 and March 2020. The sample consisted of 114 newborns weighing ≤1800 g and their mothers who were divided into those who participated in the first and second stages of the Kangaroo Method and those who only passed through the first stage, categorized as the Conventional group. To assess the self-efficacy of breastfeeding, the Breastfeeding Self Efficacy Scale - Short-Form was used. The Mann-Whitney test was used to compare the breastfeeding self-efficacy score between the groups, and Fisher's exact test to compare rates of exclusive breastfeeding. The adjusted structural equation model was used to check for the mediating effect of breastfeeding self-efficacy. The significance level adopted was 5%. Results The kangaroo group had a higher rate of exclusive breastfeeding at hospital discharge (p= 0.000). There was a positive association between having remained in the kangaroo (p= 0.003) and the breastfeeding self-efficacy score (p= 0.025) with the rate of exclusive breastfeeding at hospital discharge. Breastfeeding self-efficacy did not act as a mediator. Conclusion The self-efficacy of breastfeeding and the stay of the low birth weight newborn baby in the kangaroo unit acted positively and independently in exclusive breastfeeding, and the self-efficacy of breastfeeding did not act as a mediator in this association.

RESUMO OBJETIVOS Descrever a tendência da atividade física (AF) em quatro domínios realizada por gestantes residentes nas capitais brasileiras e no Distrito Federal (DF) e verificar a associação entre fatores sociodemográficos e a prática de atividade física de lazer entre 2007 e 2017. MÉTODOS Estudo de tendência temporal realizado com dados do Sistema de Vigilância de Fatores de Risco para doenças crônicas por inquérito telefônico (Vigitel). Foram estudadas 3.730 gestantes no período, considerando as variáveis sociodemográficas (idade, macrorregião, trabalho, estado civil, escolaridade, cor) e de atividade física nos quatro domínios (lazer, trabalho, deslocamento, doméstico – sim/não). Para as gestantes que realizavam atividade física de lazer, foi questionada a duração, expressa na variável AF ≥ 150 minutos/semana (sim/não). A tendência temporal foi avaliada por regressão linear ponderada pela variância (variação anual média foi expressa em pontos percentuais – p.p.) e a associação de fatores sociodemográficos com a atividade física de lazer por regressão de Poisson, com estimativa da razão de prevalência (RP). RESULTADOS A prevalência de gestantes com 12 anos ou mais de estudo aumentou no período analisado (+1,37 p.p./ano), assim como a prevalência de gestantes com mais de 35 anos (+1,11 p.p./ano) e aquelas que trabalham (+0,75 p.p./ano). A prevalência de atividade física de lazer pelas gestantes aumentou de 29,3%, em 2007, para 37,6%, em 2017 (+1,37 p.p./ano), e de AF ≥ 150min/semana de 2,3% para 20,6% (+2,33 p.p./ano), respectivamente, e houve redução de atividades físicas domésticas de 63,9% para 38,9% (-1,65 p.p./ano). A prevalência da prática de atividade física de lazer foi superior entre as gestantes com mais de 12 anos de estudo (RP = 2,22; IC95% 1,73–2,84), quando comparadas àquelas com menos de 8 anos, e menor entre gestantes pretas/pardas/indígenas, comparadas às brancas/amarelas (RP = 0,87; IC95% 0,78–0,97). A prevalência da AF ≥ 150min/semana aumentou conforme os anos de escolaridade e idade. CONCLUSÕES A prevalência da prática de atividade física de lazer e sua realização por ≥ 150minutos/semana aumentou no período analisado, e ambas se associaram diretamente à maior escolaridade.

ABSTRACT OBJECTIVES To describe the trend of physical activity (PhA) in four domains performed by pregnant women living in Brazilian capitals and the Federal District (FD) and to verify the association between sociodemographic factors and the practice of leisure-time physical activity between 2007 and 2017. METHODS Time trend study carried out with data from the Surveillance System of Risk Factors for chronic diseases by telephone survey (Vigitel). A total of 3,730 pregnant women were interviewed in the period, considering sociodemographic variables (age, macro-region, work, marital status, schooling, skin color) and physical activity in the four domains (leisure-time, work, commuting, domestic – yes/no). For pregnant women who performed leisure-time physical activity, its duration was inquired, expressed in the variable PhA ≥ 150 minutes/week (yes/no). The time trend was evaluated by variance-weighted linear regression (average annual variation was expressed in percentage points – pp) and the association of sociodemographic factors with leisure-time physical activity by Poisson regression, with prevalence ratio (PR) estimation. RESULTS The prevalence of pregnant women with 12 years of schooling or more increased in the analyzed period (+1.37 pp/year), as well as the prevalence of pregnant women with more than 35 years of age (+1.11 pp/year) and those who work (+0.75 pp/year). The prevalence of leisure-time physical activity by pregnant women increased from 29.3% in 2007 to 37.6% in 2017 (+1.37 pp/year), and of PhA ≥ 150min/week from 2.3% to 20.6% (+2.33 pp/year), respectively, and there was a reduction in domestic physical activities from 63.9% to 38.9% (-1.65 pp/year). The prevalence of leisure-time physical activity was higher among pregnant women with more than 12 years of schooling (PR = 2.22; 95%CI: 1.73–2.84) as compared to those with less than 8 years of age, and lower among black/brown/indigenous pregnant women, compared to white/yellow ones (PR = 0.87; 95%CI: 0.78–0.97). The prevalence of PhA ≥ 150min/week increased according to years of schooling and age. CONCLUSIONS The prevalence of leisure-time physical activity and its performance for ≥ 150 minutes/week increased in the analyzed period, and both were directly associated with greater schooling.

RESUMO OBJETIVOS Descrever a tendência da atividade física (AF) em quatro domínios realizada por gestantes residentes nas capitais brasileiras e no Distrito Federal (DF) e verificar a associação entre fatores sociodemográficos e a prática de atividade física de lazer entre 2007 e 2017. MÉTODOS Estudo de tendência temporal realizado com dados do Sistema de Vigilância de Fatores de Risco para doenças crônicas por inquérito telefônico (Vigitel). Foram estudadas 3.730 gestantes no período, considerando as variáveis sociodemográficas (idade, macrorregião, trabalho, estado civil, escolaridade, cor) e de atividade física nos quatro domínios (lazer, trabalho, deslocamento, doméstico – sim/não). Para as gestantes que realizavam atividade física de lazer, foi questionada a duração, expressa na variável AF ≥ 150 minutos/semana (sim/não). A tendência temporal foi avaliada por regressão linear ponderada pela variância (variação anual média foi expressa em pontos percentuais – p.p.) e a associação de fatores sociodemográficos com a atividade física de lazer por regressão de Poisson, com estimativa da razão de prevalência (RP). RESULTADOS A prevalência de gestantes com 12 anos ou mais de estudo aumentou no período analisado (+1,37 p.p./ano), assim como a prevalência de gestantes com mais de 35 anos (+1,11 p.p./ano) e aquelas que trabalham (+0,75 p.p./ano). A prevalência de atividade física de lazer pelas gestantes aumentou de 29,3%, em 2007, para 37,6%, em 2017 (+1,37 p.p./ano), e de AF ≥ 150min/semana de 2,3% para 20,6% (+2,33 p.p./ano), respectivamente, e houve redução de atividades físicas domésticas de 63,9% para 38,9% (-1,65 p.p./ano). A prevalência da prática de atividade física de lazer foi superior entre as gestantes com mais de 12 anos de estudo (RP = 2,22; IC95% 1,73–2,84), quando comparadas àquelas com menos de 8 anos, e menor entre gestantes pretas/pardas/indígenas, comparadas às brancas/amarelas (RP = 0,87; IC95% 0,78–0,97). A prevalência da AF ≥ 150min/semana aumentou conforme os anos de escolaridade e idade. CONCLUSÕES A prevalência da prática de atividade física de lazer e sua realização por ≥ 150minutos/semana aumentou no período analisado, e ambas se associaram diretamente à maior escolaridade.

ABSTRACT OBJECTIVES To describe the trend of physical activity (PhA) in four domains performed by pregnant women living in Brazilian capitals and the Federal District (FD) and to verify the association between sociodemographic factors and the practice of leisure-time physical activity between 2007 and 2017. METHODS Time trend study carried out with data from the Surveillance System of Risk Factors for chronic diseases by telephone survey (Vigitel). A total of 3,730 pregnant women were interviewed in the period, considering sociodemographic variables (age, macro-region, work, marital status, schooling, skin color) and physical activity in the four domains (leisure-time, work, commuting, domestic – yes/no). For pregnant women who performed leisure-time physical activity, its duration was inquired, expressed in the variable PhA ≥ 150 minutes/week (yes/no). The time trend was evaluated by variance-weighted linear regression (average annual variation was expressed in percentage points – pp) and the association of sociodemographic factors with leisure-time physical activity by Poisson regression, with prevalence ratio (PR) estimation. RESULTS The prevalence of pregnant women with 12 years of schooling or more increased in the analyzed period (+1.37 pp/year), as well as the prevalence of pregnant women with more than 35 years of age (+1.11 pp/year) and those who work (+0.75 pp/year). The prevalence of leisure-time physical activity by pregnant women increased from 29.3% in 2007 to 37.6% in 2017 (+1.37 pp/year), and of PhA ≥ 150min/week from 2.3% to 20.6% (+2.33 pp/year), respectively, and there was a reduction in domestic physical activities from 63.9% to 38.9% (-1.65 pp/year). The prevalence of leisure-time physical activity was higher among pregnant women with more than 12 years of schooling (PR = 2.22; 95%CI: 1.73–2.84) as compared to those with less than 8 years of age, and lower among black/brown/indigenous pregnant women, compared to white/yellow ones (PR = 0.87; 95%CI: 0.78–0.97). The prevalence of PhA ≥ 150min/week increased according to years of schooling and age. CONCLUSIONS The prevalence of leisure-time physical activity and its performance for ≥ 150 minutes/week increased in the analyzed period, and both were directly associated with greater schooling.

ABSTRACT OBJECTIVE To verify the compliance with Law No. 11,265/2006 in the promotion strategies for infant formula in Brazilian websites of manufacturers and drugstore networks. METHODS This was a cross-sectional study conducted in 2017. We analyzed the compliance to attributes of the Law No.11,265/2006 (Law for Marketing of Foods for Infants and Toddlers, Feeding Bottles, Teats and Pacifiers) in five websites of infant formula manufacturers and nine websites of drugstore networks. The main attributes assessed were: the presence of drawings or representations of children, the presence of warning statements displayed in conspicuous and prominent spaces informing if products are intended for infants aged under or over 6 months, the adequate display of infant formulas/similar products, and the presence of pop-ups with other infant formulas or links to websites for children’s products. All compliances and non compliances verified were described in absolute and relative frequencies. RESULTS We verified that 80% of the websites of infant formula manufacturers displayed advertisements for other children’s food products. The main non compliance in infant formula manufacturer’s websites was the absence of warning statements about products intended for infants over 6 months of age. Only 33% of the drugstores’ websites complied with Law No. 11,265/2006. The main non compliances in these websites were the absence of warning statements on products intended for infants over 6 months of age (100%), the presence of pop-up advertisements for other infant foods (77%) and the presence of advertisements for other children’s food products (92%). CONCLUSION We identified non compliances with the Law No. 11,256/2006 in almost all websites of infant formula manufacturers and in all the websites of drugstore networks. Most promotion strategies were found at drugstore websites, which are the main channels for online sales.

ABSTRACT OBJECTIVE To verify the compliance with Law No. 11,265/2006 in the promotion strategies for infant formula in Brazilian websites of manufacturers and drugstore networks. METHODS This was a cross-sectional study conducted in 2017. We analyzed the compliance to attributes of the Law No.11,265/2006 (Law for Marketing of Foods for Infants and Toddlers, Feeding Bottles, Teats and Pacifiers) in five websites of infant formula manufacturers and nine websites of drugstore networks. The main attributes assessed were: the presence of drawings or representations of children, the presence of warning statements displayed in conspicuous and prominent spaces informing if products are intended for infants aged under or over 6 months, the adequate display of infant formulas/similar products, and the presence of pop-ups with other infant formulas or links to websites for children’s products. All compliances and non compliances verified were described in absolute and relative frequencies. RESULTS We verified that 80% of the websites of infant formula manufacturers displayed advertisements for other children’s food products. The main non compliance in infant formula manufacturer’s websites was the absence of warning statements about products intended for infants over 6 months of age. Only 33% of the drugstores’ websites complied with Law No. 11,265/2006. The main non compliances in these websites were the absence of warning statements on products intended for infants over 6 months of age (100%), the presence of pop-up advertisements for other infant foods (77%) and the presence of advertisements for other children’s food products (92%). CONCLUSION We identified non compliances with the Law No. 11,256/2006 in almost all websites of infant formula manufacturers and in all the websites of drugstore networks. Most promotion strategies were found at drugstore websites, which are the main channels for online sales.

Resumo: O objetivo deste trabalho é analisar o efeito da maturação sexual sobre os fenótipos corporais gerados por análise multivariada do estado nutricional de adolescentes. Este é um estudo transversal e a amostra foi composta por 833 adolescentes escolares de 10 a 15 anos, selecionados por amostragem complexa em Piracicaba, São Paulo, Brasil. Os fenótipos corporais foram definidos por análise de componentes principais (ACP), a partir da idade, dados antropométricos (massa corporal, altura, dobras cutâneas e circunferência da cintura), composição corporal (ângulo de fase medido por impedância bioelétrica) e bioquímicos (triglicerídeos, glicose, razão colesterol total/LDL, hemoglobina). Os fenótipos corporais definidos foram: F1adiposidade caracterizada pela associação positiva com as variáveis dobras cutâneas, massa corporal e circunferência da cintura; F2crescimento caracterizado pela associação positiva entre altura e idade; F3bioquímico caracterizado pela associação positiva com razão colesterol/LDL, triglicerídeos e glicose; e F4metabólico caracterizado pela associação positiva com ângulo de fase, hemoglobina e negativa com glicose. Posteriormente, os fenótipos corporais foram considerados desfechos na análise dos efeitos mistos, incorporando o sexo no primeiro nível e as variáveis maturação sexual, idade, sexo e escore socioeconômico no segundo nível. Esta análise permitiu dimensionar o efeito da maturação sexual nos fenótipos corporais. Nossos resultados indicam que a maturação sexual apresentou variabilidade de explicação relevante somente sobre o fenótipo corporal que representa crescimento linear (altura e idade). Dessa forma, não é necessário ajustar as medidas antropométricas pela maturação sexual.

Abstract: This study aimed to analyze the effect of sexual maturation on body phenotypes, based on multivariate analysis of adolescents’ nutritional status. This was a cross-sectional study with a sample of 833 adolescent schoolchildren 10 to 15 years of age, selected by complex sampling in Piracicaba, São Paulo State, Brazil. Body phenotypes were defined by principal components analysis (PCA), based on age, anthropometric data (body mass, height, skinfolds, and waist circumference), body composition (phase angle measured by bioelectrical impedance), and biochemical parameters (triglycerides, glucose, total cholesterol/LDL ratio, hemoglobin). Body phenotypes were classified as: P1adiposity characterized as positive association with skinfolds, body mass, and waist circumference; P2growth characterized as positive association between height and age; P3biochemical characterized as positive association with total cholesterol/LDL ratio, triglycerides, and glucose; and P4metabolic characterized as positive association with phase angle and hemoglobin and negative association with glucose. The phenotypes were later considered outcomes in the mixed effects analysis, incorporating sex at the first level and sexual maturation, age, sex, and socioeconomic score at the second level. This analysis allowed measuring the effect of sexual maturation on body phenotypes. Our results indicate that sexual maturation only a displayed relevant explanation of body phenotype that represents linear growth (height and age). Thus, it is not necessary to adjust anthropometric measures by sexual maturation.

Resumen: El objetivo de este trabajo es analizar el efecto de la madurez sexual sobre los fenotipos corporales generados por análisis multivariado del estado nutricional de adolescentes. Este es un estudio transversal, cuya la muestra estuvo compuesta por 833 adolescentes escolares de 10 a 15 años, seleccionados por muestra compleja en Piracicaba, São Paulo, Brasil. Los fenotipos corporales se definieron por análisis de componentes principales (ACP), a partir de la edad, datos antropométricos (masa corporal, altura, pliegues cutáneos y circunferencia de la cintura), composición corporal (ángulo de fase medido por impedancia bioeléctrica) y bioquímicos (triglicéridos, glucosa, razón colesterol total/LDL, hemoglobina). Los fenotipos corporales definidos fueron: F1adiposidad, caracterizada por la asociación positiva con las variables pliegues cutáneos, masa corporal y circunferencia de la cintura; F2crecimiento, caracterizado por la asociación positiva entre altura y edad; F3bioquímico, caracterizado por la asociación positiva con razón colesterol/LDL, triglicéridos y glucosa; y F4metabólico, caracterizado por la asociación positiva con ángulo de fase, hemoglobina y negativa con glucosa. Posteriormente, los fenotipos corporales fueron considerados resultados en el análisis de los efectos mixtos, incorporando el sexo en el primer nivel y las variables de madurez sexual, edad, sexo y marcador socioeconómico en el segundo nivel. Este análisis permitió dimensionar el efecto de la madurez sexual en los fenotipos corporales. Nuestros resultados indican que la madurez sexual presentó variabilidad de explicación relevante solamente sobre el fenotipo corporal que representa crecimiento lineal (altura y edad). De esta forma, no es necesario ajustar las medidas antropométricas por la madurez sexual.

Resumo: O objetivo deste trabalho é analisar o efeito da maturação sexual sobre os fenótipos corporais gerados por análise multivariada do estado nutricional de adolescentes. Este é um estudo transversal e a amostra foi composta por 833 adolescentes escolares de 10 a 15 anos, selecionados por amostragem complexa em Piracicaba, São Paulo, Brasil. Os fenótipos corporais foram definidos por análise de componentes principais (ACP), a partir da idade, dados antropométricos (massa corporal, altura, dobras cutâneas e circunferência da cintura), composição corporal (ângulo de fase medido por impedância bioelétrica) e bioquímicos (triglicerídeos, glicose, razão colesterol total/LDL, hemoglobina). Os fenótipos corporais definidos foram: F1adiposidade caracterizada pela associação positiva com as variáveis dobras cutâneas, massa corporal e circunferência da cintura; F2crescimento caracterizado pela associação positiva entre altura e idade; F3bioquímico caracterizado pela associação positiva com razão colesterol/LDL, triglicerídeos e glicose; e F4metabólico caracterizado pela associação positiva com ângulo de fase, hemoglobina e negativa com glicose. Posteriormente, os fenótipos corporais foram considerados desfechos na análise dos efeitos mistos, incorporando o sexo no primeiro nível e as variáveis maturação sexual, idade, sexo e escore socioeconômico no segundo nível. Esta análise permitiu dimensionar o efeito da maturação sexual nos fenótipos corporais. Nossos resultados indicam que a maturação sexual apresentou variabilidade de explicação relevante somente sobre o fenótipo corporal que representa crescimento linear (altura e idade). Dessa forma, não é necessário ajustar as medidas antropométricas pela maturação sexual.

Abstract: This study aimed to analyze the effect of sexual maturation on body phenotypes, based on multivariate analysis of adolescents’ nutritional status. This was a cross-sectional study with a sample of 833 adolescent schoolchildren 10 to 15 years of age, selected by complex sampling in Piracicaba, São Paulo State, Brazil. Body phenotypes were defined by principal components analysis (PCA), based on age, anthropometric data (body mass, height, skinfolds, and waist circumference), body composition (phase angle measured by bioelectrical impedance), and biochemical parameters (triglycerides, glucose, total cholesterol/LDL ratio, hemoglobin). Body phenotypes were classified as: P1adiposity characterized as positive association with skinfolds, body mass, and waist circumference; P2growth characterized as positive association between height and age; P3biochemical characterized as positive association with total cholesterol/LDL ratio, triglycerides, and glucose; and P4metabolic characterized as positive association with phase angle and hemoglobin and negative association with glucose. The phenotypes were later considered outcomes in the mixed effects analysis, incorporating sex at the first level and sexual maturation, age, sex, and socioeconomic score at the second level. This analysis allowed measuring the effect of sexual maturation on body phenotypes. Our results indicate that sexual maturation only a displayed relevant explanation of body phenotype that represents linear growth (height and age). Thus, it is not necessary to adjust anthropometric measures by sexual maturation.

Resumen: El objetivo de este trabajo es analizar el efecto de la madurez sexual sobre los fenotipos corporales generados por análisis multivariado del estado nutricional de adolescentes. Este es un estudio transversal, cuya la muestra estuvo compuesta por 833 adolescentes escolares de 10 a 15 años, seleccionados por muestra compleja en Piracicaba, São Paulo, Brasil. Los fenotipos corporales se definieron por análisis de componentes principales (ACP), a partir de la edad, datos antropométricos (masa corporal, altura, pliegues cutáneos y circunferencia de la cintura), composición corporal (ángulo de fase medido por impedancia bioeléctrica) y bioquímicos (triglicéridos, glucosa, razón colesterol total/LDL, hemoglobina). Los fenotipos corporales definidos fueron: F1adiposidad, caracterizada por la asociación positiva con las variables pliegues cutáneos, masa corporal y circunferencia de la cintura; F2crecimiento, caracterizado por la asociación positiva entre altura y edad; F3bioquímico, caracterizado por la asociación positiva con razón colesterol/LDL, triglicéridos y glucosa; y F4metabólico, caracterizado por la asociación positiva con ángulo de fase, hemoglobina y negativa con glucosa. Posteriormente, los fenotipos corporales fueron considerados resultados en el análisis de los efectos mixtos, incorporando el sexo en el primer nivel y las variables de madurez sexual, edad, sexo y marcador socioeconómico en el segundo nivel. Este análisis permitió dimensionar el efecto de la madurez sexual en los fenotipos corporales. Nuestros resultados indican que la madurez sexual presentó variabilidad de explicación relevante solamente sobre el fenotipo corporal que representa crecimiento lineal (altura y edad). De esta forma, no es necesario ajustar las medidas antropométricas por la madurez sexual.

RESUMO Objetivo: Descrever a idade mediana de introdução e consumo regular de alimentos por crianças menores de 24 meses em unidades da Estratégia Saúde da Família. Métodos: Estudo transversal realizado com 283 crianças selecionadas por amostragem por conglomerado estratificada uniforme. Foram coletados dados sociodemográficos da mãe e do consumo alimentar da criança (idade de introdução e frequência semanal). Os alimentos foram agrupados em: in natura/minimamente processados (G1); ingredientes culinários (G2); processados (G3) e ultraprocessados (G4). Utilizou-se análise de sobrevida para definição da idade mediana de introdução dos alimentos e teste do qui-quadrado para comparação da frequência de consumo segundo a faixa etária (0 a 5,9; 6 a 11,9; e 12 a 23,9 meses). Resultados: A duração mediana do aleitamento materno exclusivo foi de três meses e do aleitamento materno, de 19 meses. A mediana de introdução dos alimentos do G1 foi de seis meses, exceto para ovo, leite e café (12 meses). Para óleo e sal (G2), a mediana foi de 6 meses e para o açúcar (G2), de sete meses. A mediana da maioria dos alimentos do G4 foi de 12 meses, para fórmulas foi de sete meses, biscoitos e alimentos infantis, oito meses. A maioria dos alimentos ainda não tinha sido introduzida para crianças menores de seis meses. Para crianças de seis a 11,9 meses, o consumo regular (≥5 dias/semana) de G4 foi superior para biscoitos (23,8%), pão (21,2%), fórmulas (21,2%) e alimentos infantis (35,0%); e para crianças de 12 a 23,9 meses foi para biscoitos (31,2%), pão (57,5%) e alimentos infantis (48,7%). Conclusões: Os alimentos introduzidos e consumidos regularmente foram principalmente alimentos in natura, em todas as idades. Alimentos processados e ultraprocessados apresentaram maior frequência de consumo após os 12 meses.

ABSTRACT Objective: To describe the median age of introduction and regular food intake by young children in units of the Family Health Strategy. Methods: Cross-sectional study with 283 young children chosen by uniform stratified cluster sampling. Socio-demographic data on the mother and the child’s food intake were collected (age of food introduction and weekly frequency). Foods were grouped into in natura/minimally processed (G1); culinary ingredients (G2); processed (G3) and ultra-processed (G4). The survival analysis was applied to define the median age of food introduction and the chi-square test was used to compare the frequency of food intake, according to the age range (0-5.9; 6-11.9; and 12-23.9 months old). Results: The median duration of exclusive breastfeeding and breastfeeding were three and 19 months, respectively. The age of median food introduction of G1 was six months, except for eggs, milk and coffee (12 months). For oil and salt (G2), the median was 6 months, and for sugar (G2), seven months. The median age of introduction of most food of G4 was 12 months; for infant formulas, it was seven months; cookies and baby food, eight months. Most food had not yet been introduced for children under six months old. For children from six to 11.9 months old, the regular consumption of G4 (≥5 days/week) was higher for cookies (23.8%), bread (21.2%), infant formulas (21.2%) and baby food (35%); and for children from 12 to 23.9 months old, it was higher for cookies (31.2%), bread (57.5%) and baby food (48.7%). Conclusions: Food introduced and consumed on a regular basis was mainly in natura, at all ages. Processed and ultra-processed food presented a higher frequency of consumption after 12 months old.