Sobrepeso e obesidade abdominal em adultos: estudo de base populacional em Comunidades Quilombolas no Nordeste do Brasil

Abstract

The nutritional transition, linked to rapid demographic and epidemiological changes contributes to increase the morbi-mortality associated with chronic non-communicable diseases in Brazil and Worldwide. However, very little is known on the pace of the nutritional transition among racial and ethnic minorities in Brazil, especially among communities reminiscent of African slaves in Brazil (Quilombos). The main objective of this thesis was to estimate the prevalence of overweight and abdominal obesity, separately and in combination, among adults living in Quilombo Communities in Northeastern Brazil and to investigate sociodemographic and health-related factors associated with these conditions. Overweight was assessed by body mass index (BMI) >25kg/m2 and abdominal obesity by waist-to-height ratio >0,50 (WHR). Two combinations were used to compose the indicators nutritionals: BMI+WHR: (BMI >25kg/m2 for adults and BMI >27kg/m2 for elderly plus WHR >0,50) and BMI+WC (WC-waist circumference): (BMI >25kg/m2 for adults and BMI >27kg/m2 for elderly plus WC >80cm, if woman, or >94cm, if man). All adults (>18 years of age) included in the "Project Comquista: Quilombo Communities of Vitória da Conquista - health assessment and its determinants", a population-based cross-sectional study carried out in 2011. A two-stage random sample of 739 adults >20 years were selected. Univariate and multivariate logistic regression analysis were used to identify the factors independently associated with overweight and abdominal obesity, isolated and in combination, and the Hosmer&Lemeshow test to verify for model fitting. The prevalence of overweight and obesity were 31,8% and 10,2%, respectively, and of increased WHR 55,7%. Prevalence of overweight was higher among 30-39 years-old and abdominal obesity was more frequent at older ages. Female sex, eating chicken or meat with fat and hypertension increased the chances of overweight and abdominal obesity, while smoking and being unmarried decreased the chances. Lower education and no work increased the chance of abdominal obesity. Prevalence of nutritional risk (BMI+WHR) was higher among 40-59 years-old and nutritional risk (BMI+WC) was more frequent among 40-49 years-old. Female sex and hypertension increased the chances of both combined nutritional risk, while being unmarried decreased the chances. Lower education increased the risk of elevated BMI+WHR and watch television for two or more hours per day the risk of elevated BMI+WC. The findings show high prevalences of both overweight and abdominal adiposity, alone and in combination in population of high social vulnerability. They indicate the need for actions directed to improve nutritional and health conditions of this African descent segment of the population.