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      Body mass index in individuals with HIV infection and factors associated with thinness and overweight/obesity Translated title: Índice de massa corporal em indivíduos com infecção pelo HIV e fatores associados com magreza e sobrepeso/obesidade

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          Abstract

          A cross-sectional study was conducted using body mass index (BMI) to estimate the prevalence of thinness and overweight/obesity and associated factors in 2,018 individuals with HIV/AIDS attending health services referral centers. The dependent variable was classified as thinness, overweight/obesity and eutrophy. Multinomial logistic regression analyses were performed considering eutrophy as the reference level. The prevalence of thinness was 8.8% and of overweight/obesity, 32.1%. The variables associated with thinness were anemia and CD4 cell count < 200mm³. The variables associated with risk of overweight/obesity were age > 40 years and diabetes, and the variables identified as decreasing likelihood of overweight/obesity were having no long-term partner, smoking, presence of an opportunistic disease, anemia, and albumin levels < 3.5mg/dL. The main nutritional problem observed in this population was overweight and obesity, which were much more prevalent than thinness. Older individuals with diabetes should be targeted for nutritional interventions and lifestyle changes.

          Translated abstract

          Estudo seccional para estimar a prevalência de magreza e sobrepeso/obesidade e fatores associados em 2.018 indivíduos com HIV/AIDS, atendidos em serviços de referência em Recife, Pernambuco, Brasil, utilizando o índice de massa corporal. A variável dependente foi classificada como magreza, sobrepeso/obesidade e eutrofia. Realizou-se análise de regressão logística multinomial considerando-se como referência os eutróficos. A prevalência de magreza foi de 8,8% e a de sobrepeso/obesidade de 32,1%. Permaneceram associados à magreza ter anemia e contagem de células TCD4 < 200mm³. Os fatores associados à maior chance de sobrepeso/obesidade foram: idade > 40 anos e presença de diabetes, e aqueles inversamente associados com sobrepeso/obesidade: não ter companheiro fixo, tabagismo, história recente de doença oportunista, anemia e níveis de albumina < 3,5mg/dL. O principal desvio nutricional observado foi o sobrepeso/obesidade, superando a magreza. Os indivíduos mais velhos com diabetes devem ser alvos de intervenções nutricionais e de estilo de vida.

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          Diet, nutrition and the prevention of chronic diseases.

          Shifting dietary patterns, a decline in energy expenditure associated with a sedentary lifestyle, an ageing population--together with tobacco use and alcohol consumption--are major risk factors for noncommunicable diseases and pose an increasing challenge to public health. This report of a Joint WHO/FAO Expert Consultation reviews the evidence on the effects of diet and nutrition on chronic diseases and makes recommendations for public health policies and strategies that encompass societal, behavioural and ecological dimensions. Although the primary aim of the Consultation was to set targets related to diet and nutrition, the importance of physical activity was also emphasized. The Consultation considered diet in the context of the macro-economic implications of public health recommendations on agriculture and the global supply and demand for fresh and processed foodstuffs. In setting out ways to decrease the burden of chronic diseases such as obesity, type 2 diabetes, cardiovascular diseases (including hypertension and stroke), cancer, dental diseases and osteoporosis, this report proposes that nutrition should be placed at the forefront of public health policies and programmes. This report will be of interest to policy-makers and public health professionals alike, in a wide range of disciplines including nutrition, general medicine and gerontology. It shows how, at the population level, diet and exercise throughout the life course can reduce the threat of a global epidemic of chronic diseases.
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            Cardiovascular risk and body-fat abnormalities in HIV-infected adults.

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              HIV lipodystrophy: risk factors, pathogenesis, diagnosis and management.

              HIV lipodystrophy is a heterogeneous syndrome, which has yet to be objectively defined, comprising peripheral lipoatrophy, central fat accumulation and lipomata, along with hyperlipidaemia, insulin resistance and lactic acidaemia. Both nucleoside analogues and protease inhibitors are involved, but there are also host factors that probably place some patients at greater risk. The pathogenesis is increasingly understood, with evidence of interference of several regulatory proteins such as sterol regulatory enhancer binding protein-1, the proteasome, mitochondrial DNA polymerase gamma and GLUT-4. Along with the issues of cosmesis and stigmatization, a principal clinical concern that arises with lipodystrophy is a possible increased risk of accelerated atherosclerosis. A variety of therapeutic interventions, designed to limit these risks, are under evaluation, but none is conclusively shown to be of value.
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                Author and article information

                Journal
                csp
                Cadernos de Saúde Pública
                Cad. Saúde Pública
                Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz (Rio de Janeiro, RJ, Brazil )
                0102-311X
                1678-4464
                October 2011
                : 27
                : 10
                : 1997-2008
                Affiliations
                [02] Recife Rio de Janeiro orgnameFundação Oswaldo Cruz orgdiv1Centro de Pesquisa Aggeu Magalhães Brazil
                [01] Recife Pernambuco orgnameUniversidade Federal de Pernambuco Brazil
                [04] Recife Pernambuco orgnameHospital Correia Picanço Brazil
                [03] Recife Pernambuco orgnameInstituto Materno Infantil de Pernambuco Brazil
                Article
                S0102-311X2011001000013 S0102-311X(11)02701013
                10.1590/S0102-311X2011001000013
                22031204
                f610c3ca-9733-4301-b23c-90b78ac0fe31

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 28 November 2010
                : 27 May 2011
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 48, Pages: 12
                Product

                SciELO Public Health

                Self URI: Full text available only in PDF format (EN)
                Categories
                Article

                Acquired Immunodeficiency Syndrome,Índice de Massa Corporal,Infecções por HIV,HIV Infections,Body Mass Index,Síndrome de Imunodeficiência Adquirida

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