Graduate Program in Collective Health, Federal University of Espírito Santo, Vitória/ES, Brazil.
Department of Family Medicine, Mental and Collective Health, Federal University of Ouro Preto, Ouro Preto/MG, Brazil.
PLoS One. 2022 Jul 7;17(7):e0270233. doi: 10.1371/journal.pone.0270233. eCollection 2022.
The objectives of this study were to assess the nutritional status of rural workers from a municipality in Southeastern Brazil and estimate the association of sociodemographic, labor, lifestyle, and dietary pattern factors with obesity and abdominal obesity of men and women of this rural area. This is a cross-sectional, epidemiological study of 740 farmers (51.5%, n = 381 males; 48.5%, n = 359 females). The sociodemographic, labor, lifestyle and dietary patterns determinants were assessed. Food intake data were obtained by applying three 24-hour recalls and dietary patterns were determined by Principal Component Analysis with Varimax orthogonal rotation. Poisson regression with robust variance stratified by sex was applied. The general prevalence of overweight status was 31.5% (95% CI 28.2-34.8%), 19.7% of obesity (95% CI 16.8-22.6%) and 31.5% of abdominal obesity (95% CI 28.2-34.8%), with higher rates in women (P < 0.001). Men of higher socioeconomic class had a 2.3 times higher prevalence of obesity (95% CI 1.08-4.90). In addition, the shorter travel time to purchase food increased the prevalence of abdominal obesity in males. For women, the older the age group, the greater the general and central obesity. A lower adherence to traditional dietary patterns (approximately PR [prevalence ratio] 1.6 for general obesity and PR 1.3 for abdominal obesity) and a greater number of places to buy food were associated with higher rates of obesity in women. Finally, women farmers with a higher workload had a 20% lower prevalence of central obesity (PR 0.80; 95% CI 0.65-0.97). Such findings demonstrate that obesity must be an issue in the health care of remote and rural populations. There is a need to promote healthier environments that respect traditional food culture through multiple approaches that consider the heterogeneity of rural areas and the differences between sexes.
本研究旨在评估巴西东南部一市级农村工人的营养状况,并估计社会人口统计学、劳动、生活方式和饮食模式因素与该农村地区男女肥胖和腹型肥胖的相关性。这是一项横断面、流行病学研究,共纳入 740 名农民(51.5%,n=381 名男性;48.5%,n=359 名女性)。评估了社会人口统计学、劳动、生活方式和饮食模式决定因素。通过应用三份 24 小时回顾法获得食物摄入量数据,并通过主成分分析(采用 Varimax 正交旋转)确定饮食模式。按性别分层应用稳健方差的泊松回归。超重的总体流行率为 31.5%(95%CI 28.2-34.8%),肥胖的流行率为 19.7%(95%CI 16.8-22.6%),腹型肥胖的流行率为 31.5%(95%CI 28.2-34.8%),女性的流行率更高(P<0.001)。社会经济地位较高的男性肥胖的流行率高出 2.3 倍(95%CI 1.08-4.90)。此外,购买食物的旅行时间越短,男性腹型肥胖的流行率越高。对于女性,年龄越大,一般肥胖和中心性肥胖的发生率越高。与女性肥胖相关的因素有较低的传统饮食模式的依从性(一般肥胖的 PR[患病率比]约为 1.6,腹型肥胖的 PR 为 1.3)和购买食物的场所数量更多。最后,劳动负荷较高的女性农民中心性肥胖的流行率降低 20%(PR 0.80;95%CI 0.65-0.97)。这些发现表明,肥胖必须成为偏远和农村地区人群保健的一个问题。需要通过多种方法促进更健康的环境,尊重传统的食物文化,同时考虑到农村地区的异质性和性别差异。