Mudança no estado nutricional e na obesidade abdominal de idosos não institucionalizados pertencentes à uma coorte do sul do Brasil.

Abstract

This work is part of the cohort study conducted with older adults not institutionalized "COMO VAI?". The objective was to evaluate the change in nutritional status and abdominal adiposity of non-institutionalized elderly living in the city of Pelotas-RS in a period of up to six years. 1451 individuals aged 60 years or older were interviewed in 2014 and 537 were reassessed in 2019-20. The interviews took place in person in both years, where a questionnaire on the sociodemographic situation was applied, anthropometric measurements were taken and physical tests were carried out. Weight was measured with a digital scale, while standing height was estimated by checking knee height. The waist circumference (WC) was taken with a non-extensible measuring tape directly on the skin in the narrowest region of the trunk. Changes in body mass index (BMI) were considered when the difference between current BMI and baseline BMI was greater than 5%. Thus, older adults with a BMI difference greater than or equal to +5% were classified in the "gain" category, and those with a difference less than or equal to -5% were classified in the "loss" category. The same criterion was adopted to verify changes in WC measurements. The covariates used were collected in 2014: age, sex, skin color, marital status, education, economic class, diet quality, leisure-time physical activity and commuting, smoking, number of self-reported diseases, functional capacity, polypharmacy and the presence of depressive symptoms. The prevalences of BMI classifications were described, according to cutoff points proposed for the elderly, and WC for 2014 and 2019-20. To verify the associations of independent variables with changes in nutritional status and abdominal adiposity, simple and multiple multinomial logistic regression was used. It was observed that approximately 29% and 17% of the elderly evaluated at both times lost and gained body mass, respectively. Regarding WC, loss was observed in 15.6% and gain in 25.6% of the elderly. Older adults aged 80 years or older were more likely to lose body mass (OR=4.73; 95%CI: 2.31-9.69) and also to reduce WC (OR=2.47; 95%CI: 1.11-5.47). Elderly ex-smokers had an average 41% and 64% lower chance of losing and gaining body mass (95%CI: 0.37-0.94 and 95%CI: 0.19-0.65, respectively) and those who used five or more medications had a higher chance of gaining body mass (OR=1.91; 95%CI: 1.07-3.41) and WC (OR=1.70; 95%CI: 1.07-2.70). Despite the high proportion of older adults who maintained stable BMI and WC in this period, many older adults lost body mass and gained WC. The findings also highlighted the importance of age in the nutritional changes observed in the population. This volume presents the research project, followed by the report of the fieldwork, the original article and the publication norms of the journal British Journal of Nutrition, for which the article that composes this dissertation will be submitted.