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      Relationship between alcohol drinking and arterial hypertension in indigenous people of the Mura ethnics, Brazil

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          Abstract

          Objective

          To identify the consumption of alcoholic beverage and the relation with hypertension, their prevalence and associated factors, in indigenous Mura, Brazil.

          Methods

          A cross-sectional population-based study was conducted with 455 adult indigenous aged 18 years or more of Mura ethnics in Amazonia, Brazil. Interview was conducted and the alcohol intake was assessed by the Alcohol Use Disorders Identification Test. Blood pressure was measured in three measurements and the mean of the last two measurements was used. Physical examination included the following data: weight, height, waist and neck circumference, bioimpedance, and capillary measurement of glucose, triglycerides and cholesterol. Through multivariate Logistic regression in stepwise, the odds ratios for alcohol consumption and associated factors were identified.

          Results

          The prevalence of alcoholic beverage was 40.2%, with no significant difference for hypertension in those who drink (23.0%) and those who did not drink (29.0%). Referred hypertension in indigenous was associated to less use of alcoholic beverages (14.2% vs 24.3%, P = 0.009). After an adjusted analysis (Odds Ratio, 95% CI), there was a positive association between alcoholic drink intake and male sex (10.27, CI: 5.76–18.30), smoking (4.72, CI: 2.35–9.46) and live in rural areas (9.77, CI: 5.08–18.79). On the other hand, age (0.95, IC: 0.94–0.97), and absence of dyslipidemia (0.41, CI: 0.19–0.89) were associated to lower alcohol consumption.

          Conclusion

          The prevalence of alcoholic beverage was high and associated with referred hypertension, but this association was not maintained after adjusted analysis. Changes to habits and inappropriate lifestyles in indigenous populations and living in urban areas may contribute to increase risk for cardiovascular diseases. Therefore, health policies should be implemented to meet the uniqueness of indigenous people.

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          Most cited references28

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          Neck circumference as a simple screening measure for identifying overweight and obese patients.

          There are numerous methods of assessing overweight and obesity. We undertook an observational study to test a method of identifying overweight or obese patients solely by measuring the circumference of the neck. A test sample and a second validation sample included 979 subjects (460 men and 519 women), who visited a family medicine clinic in a southern Israeli urban district for any reason between the randomly chosen months of January and September 1998. Main outcome included neck, waist, and hip circumferences; body mass index (BMI); and waist:hip ratio measures. Pearson's correlation coefficients indicated a significant association between neck circumference (NC) and: BMI (men, r = 0.83; women, r = 0.71; each, p or=37 cm for men and > or =34 cm for women were the best cutoff levels for determining the subjects with BMI > or =25.0 kg/m(2) using the receiver output curve analysis. In the validation unrelated group, the test characteristics were excellent with 98% sensitivity, 89% specificity, and 94% accuracy for men, and 100% sensitivity, 98% specificity, and 99% accuracy for women. NC > or =39.5 cm for men and > or =36.5 cm for women were the best cutoff levels for determining the subjects with BMI > or =30 kg/m(2) using the receiver output curve analysis. In the validation unrelated group, the test characteristics were excellent with 93% sensitivity, 90% specificity, and 91% accuracy for men, and 93% sensitivity, 98% specificity, and 97% accuracy for women. NC measurement is a simple and time-saving screening measure that can be used to identify overweight and obese patients. Men with NC or =37 cm for men and > or =34 cm for women require additional evaluation of overweight or obesity status.
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            Blood pressure, sodium intake, and sodium related hormones in the Yanomamo Indians, a "no-salt" culture.

            The Yanomamo Indians are an unacculturated tribe inhabiting the tropical equatorial rain forest of northern Brazil and southern Venezuela who do not use salt in their diet. The group therefore presented an unusual opportunity to study the hormonal regulation of sodium metabolism in a culture with life-long extreme restriction of dietary sodium, with parallel observations on blood pressure. Blood pressures increased from the first to second decade but, in constrast to civilized populations, do not systematically increase during subsequent years of life. In twenty-four hour urine collections on adult male Indians, excretion of sodium averaged only 1 plus or minus 1.5 (SD) mEq. Simultaneous plasma renin activities were elevated and comparable to those of civilized subjects placed for brief periods on 10 mEq sodium diets. Similarly, excretion rates of aldosterone equaled those of acculturated subjects on low sodium diets. The findings suggest that the hormonal adjustments to life-long low sodium intakes are similar to those achieved in acute sodium restriction of civilized man. Parenthetically, these elevated levels of aldosterone and renin were probably the norm for man during much of human evolution and suggest that the values observed in civilized controls are depressed by an excessive salt intake in contemporary diets.
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              Waist circumference, waist-to-hip ratio and body mass index as predictors of adipose tissue compartments in men.

              The accumulation of fat in visceral and posterior subcutaneous adipose tissue compartments is highly correlated with the metabolic abnormalities that contribute to increased risk of diabetes mellitus and cardiovascular disease. To determine which of waist circumference (WC), waist-to-hip ratio (WHR) and body mass index (BMI) was the best predictor of intraperitoneal and posterior subcutaneous abdominal adipose tissue mass in men. We studied 59 free-living men with a wide range of BMI. WC, WHR and BMI were determined using standard methods. Intraperitoneal, retroperitoneal, anterior subcutaneous and posterior subcutaneous abdominal adipose tissue masses (IPATM, RPATM, ASAATM and PSAATM, respectively) were quantified using magnetic resonance imaging. In univariate regression analysis, WC, WHR and BMI were all significantly and positively correlated (all p 0.05); there was no significant difference between BMI and WHR in predicting IPATM and RPATM (p>0.05), but BMI was a stronger predictor of ASAATM (p = 0.036) and PSAATM (p < 0.001) than WHR. In men WC is the anthropometric index that most uniformly predicts the distribution of adipose tissue among several fat compartments in the abdominal region, there apparently being little value in measuring WHR or BMI.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: MethodologyRole: SupervisionRole: Writing – original draftRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                4 August 2017
                2017
                : 12
                : 8
                : e0182352
                Affiliations
                [1 ] Escola de Enfermagem de Manaus, Universidade Federal do Amazonas, Manaus, Amazonas, Brazil
                [2 ] Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz, Manaus, Amazonas, Brazil
                [3 ] Escola de Enfermagem da Universidade de São Paulo, São Paulo, Brazil
                Medizinische Fakultat der RWTH Aachen, GERMANY
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                http://orcid.org/0000-0001-8553-7269
                Article
                PONE-D-16-50000
                10.1371/journal.pone.0182352
                5544198
                28777805
                8edad4fa-f747-4b30-88db-a58f5cc843cc
                © 2017 Ferreira et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 19 December 2016
                : 17 July 2017
                Page count
                Figures: 2, Tables: 4, Pages: 17
                Funding
                The publication fee of this article was supported by the ‘Pró-Reitoria de Pesquisa e Pós-Graduação’ of the ‘Universidade Federal do Amazonas.’
                Categories
                Research Article
                Biology and Life Sciences
                Nutrition
                Diet
                Alcohol Consumption
                Medicine and Health Sciences
                Nutrition
                Diet
                Alcohol Consumption
                Medicine and Health Sciences
                Vascular Medicine
                Blood Pressure
                Hypertension
                Biology and Life Sciences
                Nutrition
                Diet
                Beverages
                Alcoholic Beverages
                Medicine and Health Sciences
                Nutrition
                Diet
                Beverages
                Alcoholic Beverages
                People and places
                Geographical locations
                South America
                Brazil
                Biology and Life Sciences
                Physiology
                Physiological Processes
                Food Consumption
                Medicine and Health Sciences
                Physiology
                Physiological Processes
                Food Consumption
                Medicine and Health Sciences
                Vascular Medicine
                Blood Pressure
                Medicine and Health Sciences
                Public and Occupational Health
                Physical Activity
                Biology and Life Sciences
                Behavior
                Habits
                Custom metadata
                The data used in this research were collected in indigenous populations, protected by specific laws to these populations in Brazil. That way, the authors cannot make this data available. According to Brazilian legislation ( http://www.planalto.gov.br/ccivil_03/_ato2011-2014/2011/lei/l12527.htm), the authors are responsible for the confidentiality of the analyzed data. Therefore, free access to the data used in their research is not allowed. If some researcher need to access the data set, can request to Ethics Committee of the São Paulo University, where the macro project is registered. Details for contact: Project Protocol: CAAE USP N° 34559614.0.0000.5392, Comitê de Ética em Pesquisa da Escola de Enfermagem da USP, Av. Dr. Enéas de Carvalho Aguiar, 419 - 2° andar, sala 202, CEP: 05403-000 - Cerqueira César - São Paulo - SP. Phone: +55(11) 3061-8858. E-mail: cepee@ 123456usp.br .

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