Results and publications

End of ERICA's data collection

ERICA's data collection was finished on November 2014.

The field work was initiated in February 2013. It was collected data about 85,000 teenagers from all Brazilian states, with approximately 43,000 blood samples.

This is the first nationwide study, funded by the Ministry of Health for assessment of cardiovascular risk factors in adolescents.

It was presented by the general coordinator of the study Prof. Moyses Szklo in the end of 2014 some preliminary results of ERICA in the Science, Technology and Innovation in Health event, sponsored by the Ministry of Health, through the Department of Science and Technology Bureau of Science, Technology and Strategic Inputs (Decit / SCTIE / MS). The main objective was to strengthen exchanges between scientific research and health policies and brought together researchers and managers from all over Brazil. The event was a unique opportunity to combine the bulk of State and Deputy Coordinators ERICA who participated in the data collection, also responsible for the great success of the study.

 

Pilot Study Preliminary Results: April to June, 2012

ERICA is a country-wide multicenter study that aims at evaluating cardiovascular risk factors - such as obesity, hypertension, and metabolic disorders (lipids and glucose) - in adolescents. Approximately 75.000 students between 12 and 17 years old will be examined in 1.251 public and private Brazilian schools located in 124 randomly selected geographic locations with populations of 100 000 or more, including all Brazilian state capitals.

Results from ERICA will help in the development of public policies and health education of Brazilian teenagers. In addition to producing a youth health profile, the study results will allow setting up national standards for the basic health characteristics of this population, such as weight, height, blood pressure, and waist circumference. 

In order to assess the feasibility and logistical aspects of the study as well as the quality of the procedures, a pilot study was conducted in five cities: Rio de Janeiro (Rio de Janeiro), Cuiabá (Mato Grosso), Feira de Santana (Bahia), Campinas (São Paulo) and Botucatu (São Paulo). In each city, all students in grades 7th through 12th of two public schools and one private school were selected. 

A total of 1.136 adolescents were evaluated in the pilot study, corresponding to 84.3% of those eligible. Among the 1.001 morning class students invited to have blood colletion, the response rate was 60.2% (603 students).Table 1 shows the number of students assessed in each city.

Table 1 shows the number of students assessed in each city.

 

 

Among the adolescents assessed, 52.4% were male and the mean age was 13.8 years (Table 2).

 

 

The nutritional assessment of the adolescents was done by calculating body mass index (BMI = weight/height²). Among the adolescents assessed, approximately 20% were overweight and 10% obese, for an overall prevalence of excess weight of 30% (Table 3).

 

 

In order to increase reliability and regression towads the mean, both In the pilot study and in the actual study, the blood pressure protocol calls for three measurements. The results correspond to the mean of the last two measurements. The adolescents were classified as having: normal blood pressure, borderline blood pressure or high blood pressure, according to sex, age, and height percentile distributions (see definitions in Table 4’s footnote). Approximately 12%  in the pilot sample had borderline high blood pressure and 10% had high blood pressure (Table 4).

 

The most frequent metabolic abnormalities were low HDL cholesterol ("good cholesterol") (10.9% min. and max. 36.2%) and high total cholesterol (14,0% min. and max. 21.1 %). High blood glucose was observed in 5.3% of the adolescents (min. 1.4% and max. 10.1%) (all definitions in table 5’s footnote).

 

 

All adolescents received the results of their blood test, blood pressure, and anthropometric measurements. ERICA’s team referred the adolescents to ERICA’s site, where the reference values of laboratory tests and blood pressure measurements within the normal limits are posted.About 32% of the adolescents were referred to a primary care health unit because of the presence of  obesity, high blood pressure, or metabolic alterations (Table 6).

 

 

Adolescents answered a questionnaire using an electronic data entry instrument. The questionnaire contained questions about sociodemographic characteristics (skin color, parents' education, possession of goods, work-related activities) and various life-style health behaviors, including smoking, alcohol consumption, physical activity, diet, and oral and reproductive health.

Forty four percent of adolescents reported that they were white, 41% brown, 10% black, and 5% other color / race.

Twelve percent said they did not live with their mother and 37.5% that did not live with their father.

The presence of computer with internet at home was mentioned by 78% of the adolescents.

Approximately 20% of the adolescents reported not having breakfast and 28%, having breakfast sometimes. Only 34% reported that they had lunch with their parents / guardians every day and 45% that they had dinner with their parents / guardians daily. About 30% of the teenagers mentioned having lunch and dinner watching TV every day and 85%, eating snacks while watching TV.

Approximately 50% of the adolescents spend more than 3 hours per day in front of a computer, television, or video games; of these, 10% reported spending more than 7 hours per day.

About 13% of the girls and 27% of the boys reported that they had started their sexual activity.

Nearly 50% of the adolescents reported that did not use dental floss for cleaning their teeth.

Regarding physical activity, 11% of the adolescents mentioned not practicing any kind of activity, while 33% said they practiced at least one, and 20% at least two activities per week.

Approximately 16% reported they had already tried smoking cigarettes, but only 2% were current smokers. About 26% have contact with cigarette smoke at home and 45% have contact with smoke outside their homes.

About 54% of the teenagers have already tried or actually drank alcohol. Approximately 14% of the adolescents used alcohol for 1 or 2 days in the last 30 days, and 3.2% drank 5 or more drinks. The types of beverages most often consumed were: beer, drinks based on tequila, vodka or rum.

Excluding some extreme / improbable answers about sleep duration (< 3h or > 14h), and combining sleeping hours on weekdays and weekends, about 5.5% of the teenagers reported sleeping less than 6 hours per night and 13%, more than 10h.

More detailed analyses will be conducted to see if the frequency of different characteristics varies by gender, ethnicity, and social class, expressed as socioeconomic status, education of household head / mother, and attendance to a public or a  private school.

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