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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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        Class of antiretroviral drugs and the risk of myocardial infarction.

        We have previously demonstrated an association between combination antiretroviral therapy and the risk of myocardial infarction. It is not clear whether this association differs according to the class of antiretroviral drugs. We conducted a study to investigate the association of cumulative exposure to protease inhibitors and nonnucleoside reverse-transcriptase inhibitors with the risk of myocardial infarction. We analyzed data collected through February 2005 from our prospective observational study of 23,437 patients infected with the human immunodeficiency virus. The incidence rates of myocardial infarction during the follow-up period were calculated, and the associations between myocardial infarction and exposure to protease inhibitors or nonnucleoside reverse-transcriptase inhibitors were determined. Three hundred forty-five patients had a myocardial infarction during 94,469 person-years of observation. The incidence of myocardial infarction increased from 1.53 per 1000 person-years in those not exposed to protease inhibitors to 6.01 per 1000 person-years in those exposed to protease inhibitors for more than 6 years. After adjustment for exposure to the other drug class and established cardiovascular risk factors (excluding lipid levels), the relative rate of myocardial infarction per year of protease-inhibitor exposure was 1.16 (95% confidence interval [CI], 1.10 to 1.23), whereas the relative rate per year of exposure to nonnucleoside reverse-transcriptase inhibitors was 1.05 (95% CI, 0.98 to 1.13). Adjustment for serum lipid levels further reduced the effect of exposure to each drug class to 1.10 (95% CI, 1.04 to 1.18) and 1.00 (95% CI, 0.93 to 1.09), respectively. Increased exposure to protease inhibitors is associated with an increased risk of myocardial infarction, which is partly explained by dyslipidemia. We found no evidence of such an association for nonnucleoside reverse-transcriptase inhibitors; however, the number of person-years of observation for exposure to this class of drug was less than that for exposure to protease inhibitors. Copyright 2007 Massachusetts Medical Society.
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          Cardiovascular risk and body-fat abnormalities in HIV-infected adults.

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            Author and article information

            Affiliations
            [1 ] Universidade Federal de Pernambuco Brazil
            [2 ] Fundação Oswaldo Cruz Brazil
            [3 ] Instituto Materno Infantil de Pernambuco Brazil
            [4 ] Hospital Correia Picanço Brazil
            Contributors
            Role: ND
            Role: ND
            Role: ND
            Role: ND
            Role: ND
            Role: ND
            Role: ND
            Role: ND
            Role: ND
            Journal
            csp
            Cadernos de Saúde Pública
            Cad. Saúde Pública
            Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz (Rio de Janeiro )
            1678-4464
            October 2011
            : 27
            : 10
            : 1997-2008
            S0102-311X2011001000013

            http://creativecommons.org/licenses/by/4.0/

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            Product Information: SciELO Brazil
            Categories
            Health Policy & Services

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