Introdução: Segundo a literatura, a incidência de hipertensão arterial sistêmica (HAS) tem aumentado, particularmente em idosos, e as evidências epidemiológicas mostram que o estado nutricional e gordura abdominal estão associados, positivamente, com o desenvolvimento dessa doença. Objetivo: Verificar a associação entre incidência de HAS referida e estado nutricional e gordura abdominal, em idosos do município de São Paulo/Brasil - 2000 e 2006. Casuística e métodos: Trata-se de estudo de coorte, epidemiológico, de base domiciliar, realizado no município de São Paulo, utilizando dados do Estudo SABE . Saúde, Bem-estar e Envelhecimento, em 2000 (2.143 idosos), e em 2006 (1.115 idosos). A população de estudo foi constituída por idosos (&#8805;66 anos), de ambos os sexos, selecionados por amostra probabilística, e que não referiram HAS, em 2000, e que apresentaram todos os dados necessários a este estudo. As variáveis analisadas foram: HAS referida, com alternativa de resposta dicotômica (sim ou não), estado nutricional, pelo índice de massa corporal - baixo peso (IMC< 23 kg/m2) e excesso de peso (IMC &#8805;30 kg/m2), gordura abdominal (circunferência da cintura - CC &#8805; 88 cm, para mulheres, e &#8805; 102 cm, para homens; e razão cintura/quadril - RCQ &#8805; 1, para homens, e &#8805; 0,85, para mulheres) e características sociodemográficas: sexo, grupos etários (60 a 74 anos; &#8805; 75 anos), escolaridade e tabagismo. Para verificar a associação entre as variáveis, utilizou-se teste Rao & Scott, para amostra complexa, regressão logística múltipla (p<0,05) e o programa Stata/SE 10.0 for Windows. Resultados: Dos 1.115 idosos, foram reavaliados 522, sendo 164 novos casos de HAS referida (33,61/ 1.000 pessoa/ano). A maior proporção de idosos que referiram HAS era composta por mulheres (55%), do grupo de 60 a 74 anos (86%). Excesso de peso e gordura abdominal foram associadas, positivamente, com referência de HAS em homens e mulheres, com diferença estatística para CC (OR= 3,18; IC95% 1,02-9,93; p=0,04), em mulheres. Conclusão: Constatou-se que a gordura abdominal esteve associada positiva e significativamente com incidência de HAS referida, em mulheres, após 6 anos de acompanhamento. / Introduction: According to scientific literature, the incidence of hypertension (HBP- high blood pressure) has increased, particularly in the elderly, and epidemiological evidence shows that both the nutritional status and abdominal fat are positively associated with the development of this disease. Objective: To verify the association between incidence of hypertension and both the nutritional status and abdominal fat of elderly people in São Paulo / Brazil - 2000 and 2006. Casuistic and methods: This is a cohort study, epidemiological and household based study, carried out in the city of São Paulo, using data from the SABE Survey - Health, Wellbeing and Aging in 2000 (2.143 individuals), and 2006 (1115 individuals). The study population consisted of elderly people (&#8805; 66 years) of both genders, selected by probabilistic sample, who did not reported HBP in 2000 and with all the necessary data for this study. The analyzed variables were: reported HBP (yes or no), nutritional status, by body mass index - underweight (BMI <23 kg / m2) and overweight (BMI &#8805; 30 kg / m2) , abdominal fat (waist circumference - WC &#8805; 88 cm for women and &#8805; 102 cm for men, waistto- hip ratio (WHR &#8805; 1, for men and &#8805; 0.85, for women) and socio-demographic characteristics: gender, age groups (60 to 74 years, &#8805; 75 years), educational status and smoking. To verify the association among the variables, we used the Rao Scott test, for complex samples, multiple logistic regression (p<0.05) and the Stata software (Stata/SE 10.0 for Windows). Results: Out of the 1,115 elderly individuals in 2006, 522 were reassessed, resulting in 164 elderly persons who referred being new cases of hypertension (33.61 / 1,000 person/years). The majority of individuals who reported HBP were women (55%), belonging to the group among 60 to 74 years of age (86%). Overweight and abdominal fat were positively associated to hypertension in men and women, with statistical significance, according to the waist-to-hip ratio WHR of women (OR = 3.18; 95% CI=1.02 - 9.93, p = 0.04). Conclusion: abdominal fat was positively associated with the incidence of hypertension in women, after 6 years of follow-up.

No description available.

Background: Obesity has been associated with increased health care use, but it is unclear whether this is consistent across all measures of obesity. The objectives of this thesis were to compare obesity defined by four anthropometric measures, body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and percent body fat (%BF), and to estimate their associations with health care use among Canadian adults. Methods: A secondary data analysis was conducted from 30,097 individuals aged 45-85 years from the Canadian Longitudinal Study on Aging. Anthropometric measures were collected by trained research assistants and %BF, the reference standard, was measured using dual-energy x-ray absorptiometry. Obesity was defined as BMI≥30.0 kg/m2, WC≥88cm for females and ≥102cm for males, WHR≥0.85 for females and ≥0.90 for males, and %BF>35% for females and >25% for males. Approximately 18 months after baseline data collection, self-reported health care use in the past 12 months was collected, including any contact with a general practitioner, medical specialist, emergency department, and being a patient in a hospital overnight. Pearson correlation coefficients and sensitivity and specificity analyses were conducted to compare anthropometric measures to %BF. Relative risks and risk differences were calculated for measures of health care use, adjusted for sex, age, education, income, urban/rural, marital status, smoking status, and alcohol use. Secondary analyses were also stratified by sex and age. Results: The prevalence of obesity defined by BMI was 29%, by WC was 42%, by WHR was 62%, and by %BF was 73%. BMI and WC were highly correlated with %BF (r=0.75 and r=0.70, respectively) and WHR was weakly correlated with %BF (r=0.29). BMI and WC cut points demonstrated high specificity (>93%) and lower sensitivity (<58%) in predicting obesity defined by %BF. WHR cut points demonstrated high sensitivity (95%) and lower specificity (28%) in males, but lower sensitivity (44%) and high specificity (83%) in females in predicting %BF- defined obesity. There was an increased relative and absolute risk of health care use for all measures of obesity and all health care services. For example, WC-defined obesity was associated with increased relative risk (RR) of hospital overnight stay (RR: 1.40, 95% CI: 1.28- 1.54) and the risk difference (per 100) was 2.6 (95% CI:1.9-3.3). The risk of health care use was similar amongst females and males with obesity although relative risks and risk differences attenuated in the oldest adult group aged 75 and older compared to the youngest group aged 45- 54. Conclusion: The prevalence of obesity among Canadian adults varied substantially by anthropometric measure. BMI and WC have stronger correlations and concordance with %BF than does WHR, however all measures were positively associated with increased health care use. Further research should be conducted on obesity cut points to discern the best measure to predict health care use. / Thesis / Master of Public Health (MPH)

Abstract Depression is a common mental disorder in the Finnish population. There are several biological, psychological and social factors in the background of depression. The aim of this study was to investigate depression in association with birth weight, age at menarche, obesity and metabolic syndrome using data from the Northern Finland 1966 Birth Cohort. A large, prospectively collected general population-based birth cohort of originally 12058 liveborn children was used as study population. The database provided information on birth characteristics and features of the primary family. The follow-up studies were performed at the age of 14 years by postal inquiry, and at the age of 31 years by postal inquiry and clinical examination. Information on age at menarche and weight and height was obtained from the postal questionnaire at 14 and 31 years and clinical examination at 31 years. Data on abdominal obesity and metabolic syndrome were gathered from the clinical examination. Data on depressive symptoms measured by the Hopkins Symptom Checklist-25 (HSCL-25), self-reported physician-diagnosed lifetime depression and the use of antidepressants were gathered from the postal questionnaire at 31 years. Females with high birth weight and high ponderal index (index of the birth measures, kg/m3) had a higher risk of depressive symptoms at 31 years measured by the HSCL-25 compared with females with normal birth weight and ponderal index. Males with ponderal index belonging to the lowest 5 percentile had an increased risk for physician-diagnosed depression at 31 years. Females with late menarche (≥ 16 years) had an elevated risk of depression measured by the HSCL-25, the use of antidepressants and self-reported physician-diagnosed depression compared with females with menarche at 12–15 years. Obesity measured by BMI at 14 years increased the risk of depressive symptoms measured by the HSCL-25 at 31 years among both males and females. Females who were obese both at baseline and at follow-up had an increased risk of depressive symptoms, and the proportion of those who used antidepressants was higher among females who had gained weight compared to females who had stayed normal-weighted. Males with abdominal obesity measured by waist-to-hip ratio had an increased risk of depressive symptoms and physician-diagnosed depression, and the proportion of those who used antidepressants was higher compared with subjects without abdominal obesity. Abdominal obesity did not associate with depression in females. Metabolic syndrome did not associate with depression. The results indicate an increased risk of depression at 31 years in females with high birth weight, late menarche, adolescent obesity and weight gain and in males with adolescent obesity and abdominal obesity. / Tiivistelmä Depressio on yleinen mielenterveyden häiriö suomalaisväestössä. Depression taustalla on monia biologisia, psykologisia ja sosiaalisia tekijöitä. Tämän tutkimuksen tavoitteena oli tutkia depressiota selvittäen, onko syntymäpainolla, menarkeiällä, lihavuudella ja metabolisella oireyhtymällä yhteyttä depressioon Pohjois-Suomen vuoden 1966 syntymäkohorttiaineistossa. Tutkimusaineistoon kuului alun perin 12058 elävänä syntynyttä lasta. Tietokantaan oli jo aiemmin kerätty aineistoa syntymään ja primaariperheeseen liittyen. Kohortin jäsenten ollessa 14-vuotiaita tehtiin seurantatutkimus postikyselynä ja 31-vuotiaana tehtiin sekä postikysely että kliininen tutkimus. Tiedot menarkeiästä kerättiin 31-vuotispostikyselystä, paino- ja pituustiedot sekä 14- ja 31-vuotispostikyselyistä että kliinisen tutkimuksen tiedoista. Kliininen tutkimus sisälsi tiedot myös keskivartalolihavuuden ja metabolisen oireyhtymän määrittämiseksi. 31-vuotispostikyselyssä depressio-oireita kysyttiin HSCL-25 -oirekyselyllä; lisäksi kysyttiin, oliko lääkäri todennut aiemmin masennusta sekä oliko tutkittavilla käytössä masennuslääkkeitä. Naisilla, joiden syntymäpaino ja ponderaali-indeksi (syntymäpainon ja pituuden suhdetta kuvaava indeksi, kg/m3) oli korkea, depressio-oireiden riski 31-vuotiaana mitattuna HSCL-25:lla oli suurentunut verrattuna naisiin, joilla oli normaali syntymäpaino ja ponderaali-indeksi. Miehillä, joilla oli hyvin alhainen ponderaali-indeksi kuuluen alimpaan 5 % ryhmään, riski lääkärin toteamaan masennukseen oli suurentunut. Naisilla, joiden menarkeikä oli 16-vuotta tai myöhemmin, riski depressio-oireiden esiintyvyyteen, depressiolääkkeiden käyttöön ja lääkärin toteaman depression esiintyvyyteen oli suurentunut verrattuna naisiin, joiden menarkeikä oli 12–15-vuotta. Lihavuus 14-vuotiaana lisäsi masennusoireiden riskiä mitattuna HSCL-25:lla sekä 31-vuotiailla miehillä että naisilla. Naisilla, jotka olivat lihavia sekä 14- että 31-vuotiaana, masennusoireiden riski oli suurentunut. Naisilla, joiden paino oli noussut, masennuslääkkeitten käyttö oli yleisempää verrattuna naisiin, joilla paino oli pysynyt normaalina. Keskivartalolihavuus oli miehillä yhteydessä suurentuneeseen depressio-oireiden ja lääkärin toteaman masennuksen riskiin, ja he käyttivät yleisemmin masennuslääkkeitä verrattuna miehiin ilman keskivartalolihavuutta. Naisilla keskivartalolihavuus ei ollut yhteydessä masennukseen. Metabolinen oireyhtymä ei ollut yhteydessä masennukseen. Tulokset osoittavat korkean syntymäpainon, myöhäisen menarkeiän ja nuoruusiän lihavuuden sekä painon nousun lisäävän masennusriskiä 31-vuotiailla naisilla, 31-vuotiailla miehillä nuoruusiän lihavuus sekä keskivartalolihavuus olivat yhteydessä suurentuneeseen masennusriskiin.

Syfte och frågeställningar Syftet med den här studien har varit att undersöka och jämföra kvinnor och män i åldersgrupperna 30-39 år respektive 40-49 år avseende antropometriska mått samt prestation på GIH:s hälsotester. En vidare målsättning var att undersöka om det förekom några skillnader mellan två separata testtillfällen. Frågeställningarna har varit om resultaten på hälsotesterna skiljer sig mellan könen, åldersgrupperna samt mellan två separata testtillfällen. Metod Totalt fullföljde 41 deltagare GIH:s hälsotester, av dem var 20 kvinnor och 21 män mellan 30-49 år. Det enda som krävdes för att delta var att man uppfattade sig själv som frisk. Personer som tidigare haft stroke, hjärtinfarkt eller opererats på grund av hjärtproblem har inte inkluderats, ej heller gravida och personer med ledbesvär. Testerna utfördes på LTIV (Laboratoriet för tillämpad idrottsvetenskap) mellan februari och mars 2016. Resultat Signifikanta skillnader mellan de två separata testtillfällena noterades för några av styrketesterna framför allt hos männen: axelpressar, handgrip och stolresningar. Mellan könen sågs signifikanta skillnader i de antropometriska måtten, samt i flera konditions- och styrketester. Bland dessa kunde signifikant högre värden ses för kvinnorna än för männen i ryggstyrketestet.  Signifikanta skillnader mellan åldersgrupperna 30-39 år och 40-49 år sågs näst intill endast för kvinnor. De yngre jämfört med de äldre kvinnorna presterade bättre i flera av testerna, de vägde mindre och hade mindre kroppsmått. Slutsats Det framkom vanligtvis inte några signifikanta skillnader mellan det första och andra testtillfället, med enstaka undantag. När så är fallet behövs bara ett test utföras initialt inför en period med exempelvis fysisk aktivitet som senare kanske ska följas upp med ett återtest. Skillnader mellan könen och olika åldersgrupper framkom i vissa tester men inte i alla. Resultaten i denna studie beror bland annat på urvalet av individer. Eftersom att syftet med den här studien har varit att endast utföra de tester som ingår i GIH:s hälsotester har inga tester lagts till eller exkluderats. I arbetet diskuteras bland annat hur optimala testerna är som ett mått på hälsa. För att effektivisera hälsotestundersökningar framöver behöver nödvändigtvis inte alla tester utföras.