Helen Gonçalves

We examined adiposity trajectories (body mass index - BMI and body fat percentage - BF%) from ages 11 to 22 years and described them according to sex and maternal characteristics. Data were analyzed from the 1993 Pelotas (Brazil) birth cohort. BMI (n = 3,072) and BF% (n = 3,058) measurements were assessed at four time points (11, 15, 18, and 22 years). Trajectories were found using a group-based modeling approach by sex and described according to maternal characteristics using the Pearson's chi-squared test. This study found three BMI trajectories: "always adequate", "always with overweight", and "always with obesity". Approximately 40% of the cohort was classified as "always with overweight" or "always with obesity". For BF%, three trajectories were observed among males, including one with a consistently low BF% over time, whereas women's trajectories showed an increase in BF% from adolescence onward. Maternal overweight was associated with higher adiposity trajectories in both sexes. Men with higher family income and lower maternal education had a higher prevalence of high adiposity trajectories for both BMI and BF%. In women, those from lower-income backgrounds had a higher prevalence of the "always with overweight" or "always with obesity" trajectories. The adiposity trajectories of men and women belonging to the 1993 birth cohort suggest significant increases in body fat from ages 11 to 22 years, and even more pronounced upward trajectories when these youths' mothers were overweight at the beginning of this trajectory.

Objective: To analyze sleep duration and quality at different ages according to sociodemographic factors. Methods: This was a cross-sectional study using data from the 1993 Pelotas Birth Cohort in Rio Grande do Sul, Brazil, with follow-ups conducted at ages 11, 18, and 22. Sleep duration and quality were self-reported; daily sleep duration was estimated from weekday bedtime and wake-up times, and sleep quality was assessed at 22 years of age using a question about sleep perception. Descriptive analyses were performed, and inequality measures were estimated according to sex, race/skin color, and wealth index. Results: A total of 4,439, 4,081, and 3,800 individuals were analyzed at ages 11, 18, and 22, respectively. Mean sleep duration was 9.7 (95% confidence interval [95%CI] 9.6; 9.7), 8.4 (95%CI 8.3; 8.5), and 8.0 (95%CI 7.9; 8.0) hours. The absolute inequality index at 18 years of age was -1.3 (95%CI -1.5; -1.0) among females and -0.7 (95%CI -1.0; -0.4) among males. At 22 years of age, the proportion reporting “very good” sleep quality was 19.2% (95%CI 17.4; 21.1) among males, while “very poor” sleep quality was 5.2% (95%CI 4.3; 6.2) among females. Conclusion: Sleep duration decreased between 11 and 22 years of age and was longer among females and more vulnerable groups, among whom very good sleep quality was less frequent.

Given the evidence linking ultra-processed food consumption to adverse health outcomes and the lack of longitudinal studies jointly addressing ultra-processed food consumption and body mass index (BMI), this study identified multi-trajectory groups from adolescence to early adulthood and described their demographic and behavioral characteristics. Data from the 1993 Pelotas (Brazil) birth cohort at ages 15, 18, and 22 (n = 2,890) were analyzed. Sex-stratified multi-trajectory groups of daily ultra-processed food consumption and BMI (z-scores for age and sex) were estimated using Group-Based Trajectory Modelling. Daily ultra-processed food consumption was defined as the number of ultra-processed food items consumed at least once per day. Sixteen NOVA-classified foods were grouped into six categories. Groups were described according to ultra-processed food types, poverty level, physical activity, screen time, smoking, alcohol use, and risk behaviors. Three multi-trajectory groups were identified: two with low ultra-processed food (group 1 and group 2) and one with increasing ultra-processed food intake (group 3). In group 1 (38.7% males; 34% females), BMI increased over time, while in group 2 (39.4% males; 44.5% females) it remained stable. In group 3 (21.9% males; 21.5% females), ultra-processed food consumption increased over time, particularly fast food, soft drinks, and processed meats, while BMI z-scores remained close to zero in males and increased in females. Risk behaviors increased over time in group 3, whereas poverty was less prevalent in group 1. Individuals in group 3 generally exhibited higher ultra-processed food intake and a greater prevalence of risk behaviors across follow-ups, despite BMI remaining within the normal range. Monitoring ultra-processed food consumption may help identify at-risk groups before excess weight becomes evident during adolescence and early adulthood.

The aim of the present study was to identify the prevalence of metabolic syndrome at 22 and 30 years of age, determine inequalities by sex, skin color, and socioeconomic status, and investigate the intersections of these variables. A cross-sectional analysis was conducted using data from the 1993 (22 years of age) and 1982 (22 and 30 years of age) Pelotas (Brazil) birth cohort. Metabolic syndrome was defined based on the criteria of the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) and the International Diabetes Federation (IDF). Inequalities in terms of sex, skin color, and socioeconomic status were described in Equiplots and analyzed by absolute measures (prevalence ratio and slope index of inequality - SII]) and relative measures (difference in prevalence and concentration index - CIX]). At 22 years of age, the prevalence of metabolic syndrome was 18.2% (IDF) and 13.5% (NCEP-ATP III) in the 1993 cohort, and 11.3% (IDF) and 8.6% (NCEP-ATP III) in the 1982 cohort. At 30 years of age (1982 cohort), the prevalence was 15.5% (IDF) and 10.7% (NCEP-ATP III). The greatest inequality in terms of socioeconomic status occurred in the 1982 cohort at 22 years of age based on the NCEP-ATP III criteria among women (SII: -8.7p.p. [95%CI: -13.2; -4.2]; CIX: -20.1% [95%CI: -29.7; -10.5]) and men (SII: 6.5p.p. [95%CI: 0.1; 12.9]; CIX: 7.9% [95%CI: 0.6; 15.3]). The most affected subgroups were White women with a lower socioeconomic status and Black/Mixed-race men (1993 cohort) and White men (1982 cohort) with a higher socioesconomic status. Our results demonstrate that metabolic syndrome is not evenly distributed in this population and that its occurrence may be influenced by intersections between socioeconomic status, sex, and skin color.

Este estudo buscou identificar a prevalência de síndrome metabólica aos 22 e 30 anos abordando desigualdades por sexo, cor da pele e posição socioeconômica, e suas intersecções. Análise transversal utilizando dados das coortes de nascimento de Pelotas, Rio Grande do Sul, Brasil, de 1993 (22 anos) e de 1982 (22 e 30 anos). A síndrome metabólica foi definida pelos critérios da National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) e da Federação Internacional de Diabetes (IDF). As desigualdades entre sexo, cor da pele e posição socioeconômica foram descritas em Equiplots e analisadas por medidas absolutas (diferença de prevalência e índice de inclinação da desigualdade – SII]) e relativas (razão de prevalência e índice de concentração – CIX]). Aos 22 anos, a prevalência de síndrome metabólica foi de 18,2% (IDF) e 13,5% (NCEP-ATP III) (coorte de 1993), e de 11,3% (IDF) e 8,6% (NCEP-ATP III) (coorte de 1982). Aos 30 anos (coorte de 1982), foi de 15,5% (IDF) e 10,7% (NCEP-ATP III). A maior desigualdade por posição socioeconômica ocorreu na coorte de 1982 aos 22 anos, pelo NCEP-ATP III: entre mulheres (SII: -8,7p.p.; [IC95%: -13,2; -4,2]; CIX: -20,1%; [IC95%: -29,7; -10,5]) e homens (SII: 6,5p.p.; [IC95%: 0,1; 12,9]; CIX: 7,9%; [IC95%: 0,6; 15,3]). Os subgrupos mais acometidos foram: mulheres brancas de posição socioeconômica inferior, homens pretos/pardos (coorte de 1993) e homens brancos (coorte de 1982) de posição socioeconômica superior. Nossos resultados reforçam que a síndrome metabólica não está distribuída de forma homogênea nesta população e que sua ocorrência pode ser influenciada por intersecções entre posição socioeconômica, sexo e cor da pele.

Suicidal and self-injurious behaviors are major public health issues, disproportionately affecting youth. While global suicide rates declined, Brazil has seen a significant rise over recent decades. Considering the persistent social inequality in Brazil, especially among Black/Mixed-race women, an intersectional approach is essential to understanding how the combination of social identities impacts health. This study analyzes reported intentional self-inflicted injury rates among Brazilian people (18-30 years) from 2014 to 2023, according to race/skin color, sex, and their intersection. Data were obtained from official public records (Brazilian Information System for Notifiable Diseases). Intentional self-inflicted injury rates were estimated nationally and by macroregion, for the population aged 18 to 30 years, according to race/skin color, sex, and their intersection. Brazilian national intentional self-inflicted injury rates increased 638% (24.2 to 178.5/100,000), with regional increases up to 969%. Females had higher rates than males, and Mixed-race individuals showed the steepest rise (890%). Intersectional analysis revealed that White females had the highest rates, but Mixed-race females experienced the most significant increase (914%). Regional variations were notable, Mixed-race females led in the North, Northeast and Central-West, while White females dominated the South and Southeast. Intentional self-inflicted injury rates surged among Brazilian people (18-30 years), particularly White/Mixed-race women and Mixed-race individuals, with substantial regional variation. Intersectional and contextual factors (healthcare access, gender, and socioeconomic) are likely contributors. These findings suggest combined effects of racial and gender inequities, policy responses must address intersectional vulnerabilities.

O estresse crônico está associado a diversas morbidades, mas seus efeitos fisiológicos ainda demandam maior compreensão, especialmente em relação a biomarcadores inflamatórios. Este estudo investigou a associação entre eventos estressores e níveis médios de proteína-C reativa (PCR) e interleucina-6 (IL-6), transversalmente (aos 18 e 22 anos) e longitudinalmente (exposição aos 18 e desfecho aos 22 anos). Foram incluídos participantes da coorte de nascimentos de Pelotas, Rio Grande do Sul, Brasil, de 1993, com dados completos nas duas idades (n = 2.871 aos 18 anos; n = 2.444 aos 22 anos). A exposição foi avaliada como número de eventos estressores (nenhum, 1, ≥ 2) e em grupos de eventos estressores (6 grupos aos 18 anos; 8 grupos aos 22 anos). Modelos de regressão linear avaliaram as associações, incluindo análise de interação por sexo. As associações não estratificadas foram nulas ou controversas. Após estratificação por sexo, observaram-se associações transversais: aos 22 anos, homens expostos a abuso físico apresentaram níveis mais elevados de PCR (β logPCR: 0,41, IC95%: 0,04; 0,78) e IL-6 (β logIL-6: 0,26, IC95%: 0,06; 0,46) do que os não expostos; aos 18 anos, mulheres expostas a mudanças indesejadas tiveram maiores níveis de IL-6 (β: 0,15, IC95%: 0,02; 0,28), enquanto aos 22 anos, aquelas com problemas nas relações apresentaram níveis mais baixos de PCR (β: -0,15, IC95%: -0,29; -0,01) em comparação às não expostas. Os resultados sugerem que o impacto dos eventos estressores na inflamação varia conforme o tipo de eventos estressores, idade e sexo, possivelmente refletindo diferenças em mecanismos biopsicológicos.

We examined adiposity trajectories (body mass index - BMI and body fat percentage - BF%) from ages 11 to 22 years and described them according to sex and maternal characteristics. Data were analyzed from the 1993 Pelotas (Brazil) birth cohort. BMI (n = 3,072) and BF% (n = 3,058) measurements were assessed at four time points (11, 15, 18, and 22 years). Trajectories were found using a group-based modeling approach by sex and described according to maternal characteristics using the Pearson’s chi-squared test. This study found three BMI trajectories: “always adequate”, “always with overweight”, and “always with obesity”. Approximately 40% of the cohort was classified as “always with overweight” or “always with obesity”. For BF%, three trajectories were observed among males, including one with a consistently low BF% over time, whereas women’s trajectories showed an increase in BF% from adolescence onward. Maternal overweight was associated with higher adiposity trajectories in both sexes. Men with higher family income and lower maternal education had a higher prevalence of high adiposity trajectories for both BMI and BF%. In women, those from lower-income backgrounds had a higher prevalence of the “always with overweight” or “always with obesity” trajectories. The adiposity trajectories of men and women belonging to the 1993 birth cohort suggest significant increases in body fat from ages 11 to 22 years, and even more pronounced upward trajectories when these youths’ mothers were overweight at the beginning of this trajectory.

Stressful events are avoidable and potentially traumatic situations that cause damage to physical and mental health. Research on this topic is generally carried out in contexts without significant social inequalities. We described the prevalence and inequality measures for exposure to different stressful events according to sex, skin color, family income, and schooling using data from five follow-ups of the 1993 Pelotas (Brazil) birth cohort. We evaluated stressful events until adolescence (< 18 years, n = 2,755), in adulthood (18-30 years, n = 1,752), and in both periods (n = 1,400). The characteristics of the analytical samples were approximated to baseline using inverse probability weighting. Simple and complex measures were used to measure inequalities (difference, ratio, SII, and CIX). Until adolescence, the most prevalent stressful events were parental separation (67.5% of men) and the death of a relative (66.1% of women). The death of a relative was the most prevalent stressful event for both sexes in adulthood (men: 65.8%; women: 63.2%) and in both periods (men: 44.1%; women: 44.2%). Regardless of the period of life, black, less educated, and poorer individuals were the most exposed to the majority of stressful events. Emotional neglect, incarceration, parental separation, and discrimination were among the most unequal exposures, with blacks, those with less schooling, and the poorest being most affected, women being more exposed to emotional neglect and discrimination, and men to the other exposures. Physical and mental health care programs should be developed to prevent such exposures and minimize their damage to health, especially in the most vulnerable groups.