Prevalência e tendência temporal do excesso de peso em mães de crianças menores de cinco anos do estado de Alagoas

Abstract

Excess of weight, defined by Body Mass Index (BMI) ≥ 25 kg/m2, has been widely used in population-based studies as an indicator of overweight/obesity. It is about a condition which consists in one of the main problems in world public health, affecting 39.0% of adult population, which means 1.9 billion people inside the different social layers. In Brazil, according to data from VIGITEL, prevalence of overweight reaches about 55% of the population, from these, 18% present cases of obesity. These data are alarming, because overweight has strong relation with non transmittable chronic diseases, such as diabetes mellitus type 2 and coronary diseases, being the main cause of mortality in Brazil. In women, this condition can be even more worrisome, it may cause other kinds of disorders such as cancer of the uterine cervix, ovary and breast. Among Brazilian women, overweight prevalence presented considerable increase in the period from 1975-1975 to 2008-2009 moving from 28.7% to 48%. On the other hand, obesity (BMI ≥30 kg/m2), specifically, more than doubled its prevalence in the same period, moving from 8,0% to 16,9%. Alagoas is a state from Northeastern Brazil characterized by the worst socioeconomic and health indicators in the country. More recent studies have suggested that the overweight prevalence has been increased more intensely on the poorest strata of the population. However, no study was conducted on the temporal evolution of this condition in the adult female population of Alagoas and, specifically, involving mothers of preschoolers, although several studies with women in general have shown an association between overweight and reproductive characteristics. In order to fill this gap and contribute to the discussion of this problem, we made the presenting dissertation, which is composed by a literature review and an original research communication. This one aimed to investigate the prevalence, time tendency and associated factors to overweight in mothers of children under five years old from Alagoas State. It is about a time series study using data from I and II Health Diagnosis from maternal-child population of Alagoas State, performed, respectively, in 2005 and 2015. In the year of 2005 we evaluated 1.436 mothers and in 2015 we evaluated 690. Overweight was defined by (BMI) ≥25.0 Kg/m². Abdominal obesity was identified by Waist Circumference (WC) >80 cm. Percentage of Body Fat (%PBF) was estimated by means of Electrical Bioimpedance (BIA) presuming a cutoff ≥33% to define the excess of body fat. To express the modifications occurred in the variables prevalence analyzed between the two surveys, we used the following equation: ((P2-P1)/P1 × 100)), in which P1 is the prevalence in 2005 and P2 is the prevalence in 2015. To determine the factors associated with the occurrence of overweight; socioeconomic, demographic, health and lifestyle variables (independent variables) were investigated. Associations with independent variables that in the gross analysis obtained p<0.2 (chi-squared), were submitted to multi variable analysis (Poisson regression with robust variance adjustment). Between 2005 and 2015 there was a positive and significant percentage evolution in all evaluated parameters: 33.2% in overweight prevalence (42,8% vs. 57,0%), 59.2% in the values referring to abdominal obesity (33,6% vs. 53,5%) and 31.0% in the prevalence of high %BF (22,9% vs. 30,0%). The factors independently associated to overweight and abdominal obesity were advanced age, early menarche and higher parity. We observed the same for high %BF, except by the loss of significance for the variable early menarche. The high prevalence and the growing variations of overweight, abdominal obesity and high %BF are worrying and reveal the need to implement prevention and control actions. Studies such as the present are important in order to monitor the evolution of the problem and contribute to the planning of suitable public policies.