Physical self-efficacy is associated to body mass index in schoolchildren

OBJECTIVE

The present study aimed to investigate the relationship between physical self-efficacy and body mass index in a large sample of schoolchildren.

METHODS

The Perceived Physical Ability Scale for Children was administered to 1560 children (50.4% boys; 8-12 years) from three different countries. Weight and height were also recorded to obtain the body mass index.

RESULTS

In agreement with the literature, the boys reported greater perceived physical self-efficacy than girls. Moreover, the number of boys who are obese is double that of girls, while the number of boys who are underweight is half that found in girls. In the linear regression model, the increase in body mass index was negatively related to the physical self-efficacy score, differently for boys and girls. Furthermore, age and nationality also were predictors of low physical self-efficacy only for girls.

CONCLUSION

The results of this study reinforce the importance of psychological aspect of obesity, as the perceived physical self-efficacy and body mass index were negatively associated in a sample of schoolchildren for boys and girls.

Relationship between caries, body mass index and social class in Spanish children

OBJECTIVE

To determine the association between caries, body mass index (BMI) and social class in child population of the Valencia region (Spain) at 6, 12 and 15 years, and study.

METHODS

In a cross sectional study of 1326 children aged 6 (n=488), 12 (n=409) and 15 years (n=433) who took part in the 2010 Oral Health Survey of the Valencia region, the ICDAS II criteria were employed for diagnosing and coding all the teeth examined. The quantitative BMI values on a continuous scale were grouped into 3 categories (normal weight, overweight, obese) based on a table adjusted for age and gender. The highest-ranking occupation of the parents was taken to indicate the social class of the child.

RESULTS

The mean BMI was 17.21 at 6 years, 21.39 at 12 years and 22.38 at 15 years. No significant differences in caries indexes (DMFT or dft) by degree of obesity stratified by social class were found in any of the age groups studied. There was no significant correlation between BMI and DMFT-dft in any of the age groups.

CONCLUSIONS

Obesity is not associated with dental caries in schoolchildren of this population.

[Maternal perception of her child's weight and unrelated children less than 1 year old]

AIMS

To evaluate the maternal perception of their child's weight (MPCW) and perception of unrelated children's weight.

DESIGN

Cross-sectional.

LOCATION

Maternal and Child Nursing Health Department at 6 Units of Family Medicine.

PARTICIPANTS

486 dyads (mother and child under 1 year).

MAIN MEASUREMENTS

The following question was applied: "I think my child is", and images were provided according the child's gender. Children's weight and height were measured.

RESULTS

A total of 20.5% of the mothers of overweight (OW) children accurately perceived this situation, while none of the mothers of obese (OB) children did (κ=0.14±0.03, Z=5.36, p=.001). By images, 63.3% of mothers of OW children and 33.3% of mothers of OB children perceived this situation (κ=0.01±0.02, Z=0.73, p=.46). Most mothers selected the image of OW child as the image of a healthy child (κ=-0.04±0.01, Z=-2.65, p=.008), the image of a child under 1 year (κ=-0.01±0.02, Z=-0.86, p=.38) and the image that they would like their child to look like (κ=0.0004±0.01, Z=0.02, p=.98).

CONCLUSION

The mothers do not perceive the OW-OB of their children.

Association between maternal socioeconomic factors and nutritional outcomes in children under 5 years of age

OBJECTIVE

To estimate the association between maternal socioeconomic factors and the occurrence of nutritional outcomes in children under five years of age in a representative sample of the Brazilian population.

METHODS

This was a cross-sectional study that evaluated data from the latest National Survey of Children and Women's Demographics and Health, carried out in Brazil in 2006-2007. Maternal employment and maternal level of schooling were the main exposures. The following nutritional outcomes in children were considered: height/age <-2 standard deviations (SD) for short stature and BMI/age >2SD for overweight. Generalized estimating equations (GEE) were utilized as the regression method.

RESULTS

After adjustments, it was observed that children whose mothers had low level of schooling had a higher chance of having short stature (OR=3.97, 95% CI, 1.23-12.80) and children whose mothers worked outside the home were more likely to have excess weight (OR=1.57, 95% CI, 1.02-2.42). Maternal employment was not associated with short stature in children (OR=1.09, 95% CI, 0.67-1.77).

CONCLUSION

Maternal level of schooling was associated with short stature in children and maternal employment with overweight, indicating the need to take into account the socioeconomic factors when proposing programs and strategies aimed at health and nutrition improvement of children, considering inter-sectoral interventions.

[Nutritional assessment in hospitalized children in a Paediatric service]

INTRODUCTION

Malnutrition in hospitalized children is associated with increased morbidity and mortality.

OBJECTIVE

To determine the nutritional status in children admitted to the Hospital Clínico de la Universidad Católica de Chile.

PATIENTS AND METHOD

A retrospective, cross-sectional study was conducted on hospital patients less than 17 years old within the period from November 2010 to April 2011. A record was made of the demographic data, admission diagnosis, biochemistry results (albumin, haemoglobin, haematocrit), hospital stay, and anthropometry data. Nutritional diagnosis was expressed as standard deviation (SD) for weight-for-height (WFH) by WHO in children younger than 5 y, and body mass index (BMI) by CDC-NCHS in older children. Height-for-age (HFA) ≤-2SD indicated stunted growth.

RESULTS

A total of 365 children, including 201 boys (55.1%), were evaluated. The median age was 3.35 years (IQR: 1.2-8.2). The most frequent reason for admission was heart disease (30.4%). The median hospital stay was 2 days (IQR: 2.0-4.0). Undernutrition was observed in 3.3% of the children, 8% were nutritionally at risk, 15% were overweight, and 10.9% were obese. As regards HFA, short stature was reported in 12.9%. There was a significant relationship between lower age and heart disease, and higher age with gastrointestinal and neurological diseases. By ordinal logistic regression for each year of age, the weight/height ratio (ZP/T) increases by 6.9% (OR=1.07). The biochemistry results (albumin, haemoglobin and haematocrit levels) were not associated with nutritional status.

CONCLUSIONS

A high percentage of children at risk of undernutrition was found. The percentage overweight was similar to the general Chilean paediatric population. Early detection will allow an opportune intervention, and nutritional monitoring at discharge.

Serum TSH levels are associated with cardiovascular risk factors in overweight and obese adolescents

OBJECTIVE

To investigate the relationship between serum thyrotropin (TSH), insulin resistance (IR), and cardiovascular risk factors (CRF) in a sample of overweight and obese Brazilian adolescents.

METHODS

A retrospective, longitudinal analysis of 199 overweight and obese pubescent adolescents was performed. The TSH and free T4 (fT4) levels, anthropometric measurements, and laboratory test results of these patients were analyzed.

RESULTS

27 individuals (13.56%) presented with TSH levels above the normal level (subclinical hypothyroidism [SCH]). Their waist circumference (WC) was significantly higher than those of euthyroid individuals. Serum TSH was positively correlated with the homeostasis model assessment of insulin resistance (HOMA-IR) index, triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C). Using TSH and BMI as independent variables, TSH levels were shown to be independently related to HOMA-IR (p=0.001) and TG (p=0.007). Among euthyroid subjects, individuals with TSH values <2.5mIU/mL exhibited statistically significant decreases in waist-to-hip ratio, HDL-C levels, and HOMA-IR scores and a tendency toward lower WC values.

CONCLUSION

SCH in overweight and obese adolescents appears to be associated with excess weight, especially visceral weight. In euthyroid adolescents, there appears to be a direct relationship between TSH and some CRF. In conclusion, in the present sample of overweight and obese adolescents, TSH levels appear to be associated with IR and CRF.

Analysis of factors associated with excess weight in school children

OBJECTIVE

To determine the prevalence of overweight and obesity in schoolchildren aged 10 to 16 years and its association with dietary and behavioral factors.

METHODS

Cross-sectional study that evaluated 505 adolescents using a structured questionnaire and anthropometric data. The data was analyzed through the T Test for independent samples and Mann-Whitney Test to compare means and medians, respectively, and Chi² Test for proportions. Prevalence Ratio (RP) and the 95% confidence interval was used to estimate the degree of association between variables. The logistic regression was employed to adjust the estimates to confounding factors. The significance level of 5% was considered for all analysis.

RESULTS

Excess weight was observed in 30.9% of the schoolchildren: 18.2% of overweight and 12.7% of obesity. There was no association between weight alterations and dietary/behavioral habits in the bivariate and multivariate analyses. However, associations were observed in relation to gender. Daily consumption of sweets [PR=0.75 (0.64-0.88)] and soft drinks [PR=0.82 (0.70-0.97)] was less frequent among boys; having lunch daily was slightly more often reported by boys [OR=1.11 (1.02-1.22)]. Physical activity practice of (≥3 times/week) was more often mentioned by boys and the association measures disclosed two-fold more physical activity in this group [PR=2.04 (1.56-2.67)] when compared to girls. Approximately 30% of boys and 40% of girls stated they did not perform activities requiring energy expenditure during free periods, with boys being 32% less idle than girls [PR=0.68 (0.60-0.76)].

CONCLUSIONS

A high prevalence of both overweight and obesity was observed, as well as unhealthy habits in the study population, regardless of the presence of weight alterations. Health promotion strategies in schools should be encouraged, in order to promote healthy habits and behaviors among all students.

Maternal breastfeeding, early introduction of non-breast milk, and excess weight in preschoolers

OBJECTIVE

Investigate associations between excess weight in preschool children, breastfeeding duration and age of non-breast milk introduction.

METHODS

Cross-sectional study of a representative sample of 817 preschool children, aged 2 to 4 years, attending municipal day care centers in the city of Taubaté. The weight and height of children were measured in the day care centers in 2009, 2010 and 2011. The body mass index z-score (BMIz) was calculated and children were classified as risk of overweight (BMIz≥1 to<2) or excess weight (BMIz≥2). Data analysis was carried out by comparison of proportions, coefficient of correlation and multivariate linear regression.

RESULTS

The prevalence of risk of overweight was 18.9% and of excess weight (overweight or obesity) was 9.3%. The median duration of breastfeeding and age of introduction of non-breast milk was 6 months. The child's BMIz showed direct correlation with birth weight (r=0.154; p<0.001) and maternal Body Mass Index (BMI) (r=0.113; p=0.002). The correlation was inverse with the total duration of breastfeeding (r=-0.099; p=0.006) and age at non-breast milk introduction (r=-0.112; p=0.002). There was no correlation between the child's BMIz with birth length, duration of exclusive breastfeeding and mother's age.

CONCLUSIONS

The earlier the introduction of non-breast milk, the higher the correlation with excess weight at preschool age.

[Validity of anthropometric measurements and weight perceptions reported by relatives of children under 4 years old]

OBJECTIVE

To assess the validity of weight and height measurements reported by parents and the perception of their children's weight status in order to assess the prevalence of overweight children under 4 years old.

METHODS

Cross-sectional study. Anthropometric data was collected by self-report questionnaires completed by parents of children 3-45 months old: 1) information from paediatric check-ups (gold standard); 2) information reported from the home environment; and 3) data from individual perceptions. WHO standards were used.

RESULTS

Reported height was underestimated, thus reported weight/height and BMI/age were overestimated. Overweight prevalence according to paediatric check-ups was 18.6%, compared to 26.5% reported prevalence, showing a moderate concordance (Kappa: 0.47 [0.34-0.60]), 70% sensitivity and 84% specificity. Subjective perception was 11.2%, representing 30% sensitivity and 93% specificity.

CONCLUSIONS

The reported information has little validity for population-based studies, as height is underestimated and overweight status is not correctly perceived due to distortion of individual perception. Questionnaires must be validated and awareness raised among families.

Food consumption frequency and excess body weight in adolescents in the context of financial crisis in Barcelona (Spain)

OBJECTIVES

To describe food consumption frequency in adolescents in the context of the financial crisis in 2012, and to analyse potential fluctuations in excess body weight between 2008 and 2012.

METHOD

A cross-sectional study of eating habits and excess body weight was conducted in adolescents aged 13 to 19 years old from public, subsidised and private secondary schools in Barcelona, Spain. The FRESC lifestyle risk factors survey was used, and food frequency consumption, food recommendations and body mass index were analysed according to gender, year of education and socioeconomic status.

RESULTS

Girls ate vegetables and fruits more frequently than boys, while the prevalence of junk food consumption was higher in boys. The prevalence of compliance with food recommendations was lower than 50% for all foods, and gender and socioeconomic differences were found for eggs, red meat and soft drinks. Regarding excess body weight, boys had a higher prevalence than girls in the 2 years analysed. Furthermore, a reduction in excess body weight was observed among girls in secondary education in the highest socioeconomic groups (28.7% [95% CI: 24.8-32.6%] in 2008 to 20.5% [95% CI: 17.1-23.8%] in 2012).

CONCLUSIONS

The prevalence of adolescents following food recommendations is low, and gender differences were found in terms of food consumption frequency, even in the context of financial crisis. There is a need to promote programmes and policies to reduce inequalities related to eating habits and excess body weight in adolescents.

[Effect of an intervention based on child-care centers to reduce risk behaviors for obesity in preschool children]

BACKGROUND

Preschool age is a critical stage for health promotion and prevention of obesity, which is an emerging public health problem in children. The aim of this study was to design and evaluate the effect of a multifaceted intervention based on child-care centers to reduce risk behaviors for obesity among preschool children.

METHODS

A 12-month cluster-randomized community trial was conducted in 16 Mexican Institute of Social Security child-care centers in Mexico City. Children between 2 and 4 years of age enrolled in the selected child-care centers participated in the study. Intervention comprised 12 weekly curriculum sessions for the children, and six family workshops. Changes in children's dietary and physical activity, food availability at home, and maternal feeding styles were determined after 6 and 12 months. Changes within groups among stages, and between groups by stage were analyzed through χ² test.

RESULTS

The intervention showed decrease of home availability for some non-recommended foods and increase in physical activity in the intervention group compared to the usual care group.

CONCLUSIONS

Improvement in physical activity can be effective in the long term; innovative strategies aimed to modify family dietary risk behaviors are required.

Deuterium oxide dilution and body composition in overweight and obese schoolchildren aged 6-9 years

OBJECTIVE

To correlate different methods of body composition assessment in overweight or obese schoolchildren, using deuterium oxide (D2O) dilution as a reference.

METHODS

Percentage of total body water (%TBW), fat free mass (%FFM), and body fat (%BF) were assessed by D2O and tetrapolar electrical bioimpedance analysis (BIA) in 54 obese and overweight students aged 6-9 years. Skinfold thickness (ST), body mass index (BMI), conicity index (CI), waist circumference (WC), waist-to-height ratio (WHtR), and waist-to-hip (WHR) ratio were also used.

RESULTS

Mean values for body composition were 38.4%±8.4% BF, 44.9%±6.1% TBW and 61.6%±8.4% FFM. There was no significant difference in body weight, body fat mass (FM), TBW, and FFM between genders. Regarding D2O, ST underestimated %BF, and overestimated %FFM in both genders (p<0.05). BIA overestimated %TBW in the group as a whole and in males (p<0.05). The only positive and strong correlations occurred in females regarding the WC (σ=0.679), CI (r=0.634), and WHtR (r=0.666).

CONCLUSIONS

In this sample of obese and overweight children, there were strong correlations between body composition measured by D2O and some indices and anthropometric indicators in females, but there was no positive and strong correlation of fat tissue with the indices/indicators at all ages and in both genders.

Parents' perception of health-related quality of life in children and adolescents with excess weight

OBJECTIVE

To evaluate the perception of parents or caregivers on the health-related quality of life (HRQOL) of children/adolescents with overweight/obesity and possible factors associated with this perception.

METHODS

This was a cross-sectional study involving 297 caregivers of children and adolescents with normal weight (n=170) and with overweight/obesity (n=127), from public and private schools in the study municipality. HRQOL scores obtained through the Child Health Questionnaire - Parent Form 50 (CHQ-PF50) were compared according to the nutritional status and gender of the children/adolescents. Multiple regression analysis was used to determine the predictive value of studied variables for the variation in HRQOL scores.

RESULTS

Parents of children/adolescents with overweight/obesity attributed lower HRQOL scores to their children in the following domains: physical functioning (p<0.01; d=0.49), self-esteem (p<0.01; d=0.38), parental impact-emotional (p<0.05; d=0.29), family cohesion (p<0.05; d=0.26), physical summary score (p<0.05; d=0.29), and psychosocial summary score (p<0.05; d=0.25). In the multiple regression models, the variables with the highest contribution to the variation in HRQOL scores were: in the physical functioning domain, parental impact-time (β=0.23; p<0.05); self-esteem, nutritional status (β=-0.18; p≤0.01); emotional impact on parents, impact on parents' time (β=0.31; p<0.05); and in family cohesion, global behavior (β=0.30; p<0.05).

CONCLUSIONS

A negative impact on HRQOL of children/adolescents with overweight/obesity was observed in the physical and psychosocial aspects. The nutritional status was the variable with the greatest contribution for the assessment the self-esteem of children and adolescents in this study.

Physical activity and nutrition education at the school environment aimed at preventing childhood obesity: evidence from systematic reviews

OBJECTIVE

To organize the main findings and list the most frequent recommendations from systematic reviews of interventions developed at the school environment aimed at reducing overweight in children and adolescents.

DATA SOURCE

Searches for systematic reviews available until December 31, 2014 were conducted in five electronic databases: Cochrane, PubMed, SciELO, SPORTDiscus, and Web of Science. Manual search for cross-references were also performed.

SUMMARY OF THE FINDINGS

Of the initial 2139 references, 33 systematic reviews adequately met the inclusion criteria and were included in the descriptive summary. In this set, interventions with periods of time greater than six months in duration (nine reviews), and parental involvement in the content and/or planned actions (six reviews) were identified as the most frequent and effective recommendations. Additionally, it was observed that boys respond more effectively to structural interventions, whereas girls respond to behavioral interventions. None of the included reviews was able to make inferences about the theoretical basis used in interventions as, apparently, those in charge of the interventions disregarded this component in their preparation.

CONCLUSIONS

Although the summary identified evidence with important applications in terms of public health, there are still gaps to be filled in this field of knowledge, such as the effectiveness of different theoretical models, the identification of the best strategies in relation to gender and age of participants and, finally, the identification of moderating variables to maximize the benefits provided by the interventions.

Relationship between dietary calcium intake and adiposity in female adolescents

BACKGROUND AND OBJECTIVE

The prevalence and magnitude of obesity in children and adolescents increase rapidly. Besides genetic and environmental factors, calcium intake has recently been identified as a dietary factor that is inversely related with body mass index and development of overweight and obesity. The purpose of this study was to assess the correlation between dietary calcium intake and body mass index and fat distribution in female adolescents.

MATERIALS AND METHODS

This was a cross-sectional study where anthropometric variables (weight, height, body mass index, waist and hip circumference) were collected in 244 female adolescents to establish total body adiposity and fat distribution. A 24-hour recall and a food frequency questionnaire were used to assess total calorie, calcium, and dairy products intake.

RESULTS

Calcium intake was inversely related to body mass index (P<.05), waist circumference(P<.05), hip circumference (P>.05), and waist to hip ratio (P<.05).Overweight (8.3%) and obese (0.7%) adolescents had a lower mean calcium intake than adolescents of normal weight (P=.06).

CONCLUSIONS

Dietary calcium intake and, to a lesser extent, consumption of dairy products are inversely related to total and abdominal adiposity, and also to the prevalence of overweight in this group of adolescents.

[Beta 2-adrenergic receptor gene association with overweight and asthma in children and adolescents and its relationship with physical fitness]

Objective:

To investigate the association of Arg16Gly and Gln27Glu polymorphisms of β2-adrenergic receptor gene (ADRB2 ) with the occurrence of asthma and overweight and the gene's influence on anthropometric, clinic, biochemical and physical fitness variables in children and adolescents.

Methods:

Subjects were evaluated for allelic frequencies of the β2-adrenergic receptor gene, height, weight, body mass index (BMI), BMI Z -score, waist circumference (WC), pubertal stage, resting heart rate (HRres), blood pressure (BP), total cholesterol (TC), glucose, insulin, high density lipoprotein (HDL-C), low density lipoprotein (LDL-C), triglyceride (TG), Homeostasis Metabolic Assessment (HOMA2-IR), Quantitative Insulin Sensitivity Check Index (QUICKI) and maximal oxygen uptake (VO2max). The participants were divided in four groups: overweight asthmatic (n =39), overweight non-asthmatic (n =115), normal weight asthmatic (n =12), and normal weight non-asthmatic (n =40).

Results:

Regarding the Gln27Glu polymorphism, higher total cholesterol was observed in usual genotype individuals than in genetic variant carriers (p =0.04). No evidence was found that the evaluated polymorphisms are influencing the physical fitness. The Arg16 allele was found more frequently among the normal weight asthmatic group when compared to the normal weight non-asthmatic group (p =0.02), and the Glu27 allele was more frequently found in the overweight asthmatics group when compared to the normal weight non-asthmatic group (p =0.03).

Conclusions:

The association of Arg16 allele with the occurrence of asthma and of the Glu27 allele with overweight asthmatic adolescents evidenced the contribution of the β2-adrenergic receptor gene to the development of obesity and asthma.

[Frequency of overweight and obesity in children and adolescents with autism and attention deficit/hyperactivity disorder]

OBJECTIVE

To assess the frequency of overweight and obesity in children and adolescents with autism spectrum disorder (ASD) and with attention deficit/hyperactivity disorder (ADHD) and their parents, in comparison with children and adolescents without developmental disorders.

METHODS

Anthropometric measures were obtained in 69 outpatients with ASD (8.4±4.2 years old), 23 with ADHD (8.5±2.4) and 19 controls without developmental disorders (8.6±2.9) between August and November 2014. Parents of patients with ASD and ADHD also had their anthropometric parameters taken. Overweight was defined as a percentile ≥85; obesity as a percentile ≥95; and underweight as a percentile ≤5. For adults, overweight was defined as a BMI between 25 and 30kg/m(2) and obesity as a BMI higher than 30kg/m(2).

RESULTS

Children and adolescents with ASD and ADHD had higher BMI percentile (p<0.01) and z-score (p<0.01) than controls, and increased frequency of overweight and obesity (p=0.04). Patients with ASD and ADHD did not differ between them in these variables, nor regarding abdominal circumference. Parents of children with ASD and ADHD did not differ between themselves.

CONCLUSIONS

Children and adolescents with ASD and ADHD are at a higher risk of overweight and obesity than children without developmental problems in the community.

[Frequency of overweight and obesity in children and adolescents with autism and attention deficit/hyperactivity disorder]

Objective:

To assess the frequency of overweight and obesity in children and adolescents with autism spectrum disorder (ASD) and with attention deficit/hyperactivity disorder (ADHD) and their parents, in comparison with children and adolescents without developmental disorders.

Methods:

Anthropometric measures were obtained in 69 outpatients with ASD (8.4±4.2 years old), 23 with ADHD (8.5±2.4) and 19 controls without developmental disorders (8.6±2.9) between August and November 2014. Parents of patients with ASD and ADHD also had their anthropometric parameters taken. Overweight was defined as a percentile ≥85; obesity as a percentile ≥95; and underweight as a percentile ≤5. For adults, overweight was defined as a BMI between 25 and 30kg/m² and obesity as a BMI higher than 30kg/m².

Results:

Children and adolescents with ASD and ADHD had higher BMI percentile (p<0.01) and z-score (p<0.01) than controls, and increased frequency of overweight and obesity (p=0.04). Patients with ASD and ADHD did not differ between them in these variables, nor regarding abdominal circumference. Parents of children with ASD and ADHD did not differ between themselves.

Conclusions:

Children and adolescents with ASD and ADHD are at a higher risk of overweight and obesity than children without developmental problems in the community.

Rheumatoid cachexia and other nutritional alterations in rheumatologic diseases

The prevalence of nutritional alterations in rheumatologic diseases ranges from 4 to 95%, depending on the detection method used. Formerly described as the single term rheumatoid cachexia, nutritional alterations can currently be grouped and subdivided based on the physiopathological mechanisms involved: chronic disease-related inflammatory conditions (cachexia), malnutrition associated to acute malnutrition inflammatory conditions (protein-caloric malnutrition) and starvation-related malnutrition. Clinical manifestations of malnutrition associated to rheumatic diseases vary from the patient with low weight or overweight and obesity; with lean body mass depletion as well as functional repercussions, and impact of quality of life as a common denominator. Additionally, the associated increase in body fat mass increases the risk for cardiovascular morbidity. A multidisciplinary approach towards rheumatic diseases should include aspects oriented towards prevention, early identification, diagnosis and correction of nutritional alterations.

[Body weight and food consumption scores in adolescents from northeast Brazil]

Objective:

The aim of the present study was to determine the prevalence of excess weight and analyze eating habits in relation to cardiovascular disease in adolescents from the city of Vitória de Santo Antão, state of Pernambuco, northeast Brazil.

Methods:

A cross-sectional study was carried out with male and female students (10-19 years old) enrolled at public and private schools in Vitória de Santo Antão. Sociodemographic, anthropometric and lifestyle variables were collected. Food consumption was evaluated using a Food Frequency Questionnaire and subsequently converted to monthly intake pattern scores, obtaining the intake distribution for a group of foods associated with the risk of developing cardiovascular disease and for a group of protective foods. The significance level for the statistical tests was set at 5.0%.

Results:

The sample consisted of 2866 students. The female gender accounted for 54.2% of the sample, and median age was 14 years (interquartile range: 12-16 years). The food intake scores showed greater dispersion in the group of protective foods (51.1%). Higher median scores for consumption of risk foods were found among adolescents whose mothers had more than 9 years of schooling (p<0.001).

Conclusions:

Excess weight was prevalent among the students analyzed. The consumption of risk foods was only associated with maternal schooling, which shows the need for nutritional interventions directed at families, regardless of socioeconomic status.

Effects of programmed physical activity on body composition in post-pubertal schoolchildren

OBJECTIVE

To assess body composition modifications in post-pubertal schoolchildren after practice of a physical activity program during one school year.

METHODS

The sample consisted of 386 students aged between 15 and 17 years and divided into two groups: the study group (SG) comprised 195 students and the control group (CG), 191. The SG was submitted to a physical activity program and the CG attended conventional physical education classes. Body composition was assessed using body mass index (BMI), percentage of body fat (%BF), fat mass (FM), and lean mass (LM).

RESULTS

A positive effect of the physical activity program on body composition in the SG (p<0.001) was observed, as well as on the interaction time x group in all the variables analyzed in both genders. A reduction in %BF (mean of differences = -5.58%) and waist circumference (-2.33 cm), as well as an increase in LM (+2.05 kg) were observed in the SG for both genders, whereas the opposite was observed in the CG.

CONCLUSION

The practice of programmed physical activity promotes significant reduction of body fat in post-pubertal schoolchildren.

[Low agreement between the fitnessgram criterion references for adolescents]

OBJECTIVE:

To analyze the association and agreement of fitnessgram reference criteria (RC) for cardiorespiratory fitness, body mass index (BMI) and strength in youth.

METHODS:

The study included 781 youth, 386 females, aged 10 to 18 years of Londrina-PR. It were performed cardiorespiratory fitness and muscular strength tests and was calculated body mass index. The association between the tests was analyzed using Poisson regression to obtain prevalence ratio (PR) and confidence intervals of 95%, while agreement of the reference criteria was tested by Kappa index.

RESULTS:

Significant associations were found between cardiorespiratory fitness and BMI (PR=1,49, 1,27-1,75), muscle strength and BMI (PR=1,55, 1,17-2,08), cardiorespiratory fitness and muscle strength (PR=1,81, 1,47-2,24). The agreement between reference criteria ranged from weak to fair, 48.8% (k=0.05, p=0.10) for cardiorespiratory fitness and BMI, 52.9% (k=0.09, p=0.001) for muscle strength and BMI and 38.4% (k=0.22, p<0.001) for cardiorespiratory fitness and muscle strength.

CONCLUSIONS:

Although RC for cardiorespiratory fitness, muscle strength and BMI are associated, the agreement between them ranged from weak to fair. To evaluate health related physical fitness it is suggest the execution of all tests, since each test has specific characteristics.

Cardiovascular risk stratification in overweight or obese patients in primary prevention. Implications for use of statins

BACKGROUND AND OBJECTIVES

Cardiovascular risk estimation in patients with overweight/obesity is not standardized. Our objectives were to stratify cardiovascular risk using different scores, to analyze use of statins, to report the prevalence of carotid atherosclerotic plaque (CAP), and to determine the optimal cut-off point (OCP) of scores that discriminate between subjects with or without CAP.

MATERIAL AND METHODS

Non-diabetic patients with overweight or obesity in primary prevention were enrolled. The Framingham score (FS), the European score (ES), and the score proposed by the new American guidelines (NS) were calculated, and statin indication was evaluated. Prevalence of CAP was determined by ultrasound examination. A ROC analysis was performed.

RESULTS

A total of 474 patients (67% with overweight and 33% obese) were enrolled into the study. The FS classified the largest number of subjects as low risk. PAC prevalence was higher in obese as compared to overweight subjects (44.8% vs. 36.1%, P=.04). According to the FS, ES, and NS respectively, 26.7%, 39.1%, and 39.1% of overweight subjects and 28.6%, 39.0%, and 39.0% of obese subjects had an absolute indication for statins. All three scores were shown to acceptably discriminate between subjects with and without CAP (area under the curve>0.7). The OCPs evaluated did not agree with the risk category values.

CONCLUSIONS

Risk stratification and use of statins varied in the overweight/obese population depending on the function used. Understanding of the relationship between scores and presence of CAP may optimize risk estimate.

Usability of an internet-based platform (Next.Step) for adolescent weight management

OBJECTIVE

The current study evaluates the usability perception of an e-therapeutic platform (supported by electronic processes and communication), aiming to promote the behavior change and to improve the adolescent health status through increased and interactive contact between the adolescent and the clinical staff.

METHODS

This was a correlational study with a sample of 48 adolescents (12-18 years) who attended a Pediatric Obesity Clinic between January and August of 2012. Participants were invited to access, during 24 weeks, the e-therapeutic multidisciplinary platform (Next.Step) in addition to the standard treatment program. A usability questionnaire was administered and the platform performance and utilization indicators were analyzed.

RESULTS

The users' perception of satisfaction, efficiency, and effectiveness regarding the Next.Step platform was clearly positive. However, only 54.17% of the enrolled adolescents accessed the platform, with a mean task-completion rate of 14.55% (SD=18.853). The higher the number of the platform consulted resources, the greater the tendency to enjoy the platform, to consider it exciting and quick, to consider that the time spent in it was useful, to consider the access to information easy, and to login easier. Post-intervention assessment revealed a significant reduction in anthropometric and behavioral variables, including body mass index z-score, waist circumference percentile, hip circumference, and weekly screen time.

CONCLUSION

These results highlight the importance of information and communication technologies in the health information access and the healthcare provision. Despite the limited adherence rate, platform users expressed a positive overall perception of its usability and presented a positive anthropometric and behavioral progress.