Prevalence of overweight and obesity in children and adolescents from the age range of 2 to 19 years old in Brazil

Prevalence of childhood obesity in Brazil: systematic review and meta-analysis

OBJECTIVE

To estimate the prevalence of childhood obesity in Brazil by means of a systematic review of representative studies.

SOURCES

We searched for population-based studies that assessed obesity in Brazilian children aged < 10 years in MEDLINE, EMBASE, Scopus and other sources up to September, 2019. Paired researchers selected studies, extracted data and assessed the quality of these studies. Meta-analysis of prevalence and confidence interval (95% CI) was calculated, weighted by the population sizes using Freeman-Tukey double-arccosine transformation. Heterogeneity (I²) and publication bias were investigated by meta-regression and Egger's test, respectively.

SUMMARY OF THE FINDINGS

53 studies were included (n = 122,395), which were held from 1986 to 2015 and limited mainly due to inadequate response rates. Prevalence of obesity in the three-decade period was of 8.2% ([95% CI]: 8.1-8.4%, I² = 98.5%). Higher prevalence was observed in boys (9.7% [9.4-9.9%], I² = 97.4%) than girls (7.3% [7.1-7.5%], I² = 96.1%). Prevalence increased according to the decade (1990: 6.5% [6.0-7.0 %], I² = 96.8%; 2000: 7.9% [7.7-8.0 %], I² = 98.8%; 2010: 12.0% [11.5-12.6 %], I² = 95.8%), and Brazilian region (Northeast: 6.4% [6.2-6.7%], I² = 98.1%; North: 6.7% [6.3-7.2%], I² = 98.8%; Southeast:10.6% [10.2-11.0%], I² = 98.2%; South: 10.1 [9.7-10.4%], I² = 97.7%). Heterogeneity was affected by age and region (p < 0.05) and publication bias was discarded (p = 0.746).

CONCLUSION

For every 100 Brazilian children, over eight had obesity in the three-decade period and 12 in each 100 had childhood obesity in more recent estimates. Higher prevalence occurred in boys, recent decades and more developed Brazilian regions.

The Association Between High Body Mass Index and Technology Use Among Female Elementary School Students

Background Overweight and obesity among children are progressively turning into global issues. Numerous factors have been linked to the proliferation of pediatric obesity. However, there are still questions as to whether the corresponding proliferation in the use of technology could be linked to the increase in body mass index (BMI) among children. The aim of this study is to investigate the association between high BMI in female elementary school-age children and time spent using electronic devices. Methods This is a cross-sectional study that was conducted across three female elementary schools located in Jeddah between 2017 and 2018. All schools which are affiliated with the Ministry of National Guard in Jeddah were included. Demographic data, school performance, sleep routine, physical activity, parents' beliefs, and family demographic data were collected from the legal custodian of the children. The research group visited schools to obtain children's BMI measurements. Results The number of participants who responded to the survey was 681. The results showed that the increase in BMI was non-significantly linked with the period spent using electronic devices, the use of electronic devices before sleep, nor the kind of device used. However, there was a significant association between high BMI and one type of electronic device: the television. There was a significant association between high BMI and the denial by parents that their children were obese. Furthermore, 50% of children were obese while 92.9% of overweight children's parents did not believe that there was a problem with the weight of their children. Conclusion There is no significant association between screen time spent on electronic devices and high BMI among female elementary school-age children. However, lack of physical activity, fast food consumption, and genetic predispositions are still major contributing factors for childhood obesity and overweight. Nearly all parents of children who are overweight did not perceive their children as being overweight, which brings to the fore the subject of lack of awareness about childhood obesity among parents.

Waist Circumference Percentiles and Cut-Off Values for Obesity in a Large Sample of Students from 6 To 10 Years Old Of The São Paulo State, Brazil

Fundamento

A prevalência da obesidade vem aumentando sistematicamente na população, inclusive nas crianças e adolescentes, ao redor do mundo.

Objetivos

Descrever curvas percentílicas de referência para a circunferência abdominal (CA) nas crianças brasileiras e fornecer pontos de corte da CA para identificar crianças com risco de obesidade.

Métodos

Um estudo multicêntrico, prospectivo, tranversal foi realizado em crianças com idades entre 6 e 10 anos, matriculadas no ensino fundamental de escolas públicas e particulares de 13 cidades do estado de São Paulo. A estatura, o peso e a CA foram medidos em duplicata em 22.000 crianças (11.199 meninos). Para estabelecer o melhor ponto de corte da CA para o diagnóstico da obesidade, foram calculadas curvas ROC com crianças classificadas como com peso normal e obesas, de acordo com as curvas do IMC, estratificadas por gênero e idade, e o índice Youden foi utilizado como a eficácia potencial máxima desse biomarcador. Valores de p < 0,05 foram considerados estatisticamente significativos.

Resultados

Os valores da CA aumentaram com a idade, tanto nos meninos quanto nas meninas. A prevalência de obesidade em cada grupo variou de 17% (6 anos de idade) a 21,6 % (9 anos de idade), dentre os meninos, e de 14,1% (7 anos de idade) a 17,3 % (9 anos de idade), dentre as meninas. As análises ROC mostraram o percentil 75 como ponto de corte para o risco de obesidade, e o diagnóstico de obesidade está classificado no percentil 85 ou acima.

Conclusão

Curvas de referência da CA específicas para idade e sexo em crianças brasileiras e pontos de corte para o risco de obesidade podem ser usados em triagem nacional e estudos intervencionais para reduzir a carga da obesidade no Brasil. (Arq Bras Cardiol. 2020; 114(3):530-537)

Cross-Cultural Adaptation of the Brazilian Portuguese Version of the Caregiver's Feeding Styles Questionnaire

The present study describes the cross-cultural adaptation of the Brazilian version (Rio de Janeiro) of the Caregiver's Feeding Styles Questionnaire (CFSQ) among caregivers of children aged 3 to 6 years enrolled in a family health service in Rio de Janeiro, Brazil. The cross-cultural adaptation process included the following phases: (1) literature review; (2) translation and back-translation of the instrument; (3) assessment of semantic equivalence through cognitive interviews with caregivers; (4) discussion with experts; (5) pretesting of the revised version; and (6) assessment of psychometric characteristics, including reliability and validity of the scale. Results showed the appropriateness of the caregiver's feeding styles concept within the Brazilian culture and that the instrument was understandable to caregivers enrolled in a family health service. The CFSQ measurements showed perfect intra-observer reliability for "demandingness" and almost perfect for "responsiveness". Inter-observer reliability was almost perfect for both dimensions, "demandingness" and "responsiveness". Factor analysis of the Brazilian CFSQ version proposed an instrument with one dimension and 13 items. The satisfactory results of the cross-cultural adaptation of the CFSQ suggest its applicability in the population of interest with the possible reduction of some scale items.

Prevalence and factors associated with excess weight in adolescents in a low-income neighborhood - Northeast, Brazil

Abstract Objectives: to study the prevalence of excess weight and associated factors among adolescents from a low-income neighborhood located in the city of Recife, Pernambuco. Methods: cross-sectional study, in which behavioral, socioeconomic and demographic information was collected from June to December 2014. Excess weight was calculated based on body mass index for age and the cut-off points, by the World Health Organization (2007). To analyze associations between predictor variables and the outcome, multivariate data analysis was performed following the Poisson Regression (Prevalence Ratio - PR) with their respective 95% confidence intervals (95%CI). Results: twenty-five adolescents participated in the study, with a prevalence of 36.4% of excess weight: 20.4% overweight (95%CI=15.1-25.7) and 16.0% obesity (95%CI= 11.2-20.8), predominantly in female gender (42.5%; p=0.031). The outcome was associated with internet access (PR=1.20; 95%CI=1.01-1.43), the number of people in the family (PR= 1.12; 95%CI=1.01-1.28) and screen time (PR=1.13; 95%CI=1.01-1.27), but only in male gender. Conclusions: the prevalence found was higher than that of other national researches, especially for the female gender. In the male gender, not having internet access, a lesser number of family members and a longer screen time proved to be factors associated with being excess weight.

Waist circumference as high blood pressure predictor in school age children

Childhood hypertension is becoming more common with the increasing numbers of child obesity, which has encouraged new studies to identify a good anthropometric marker for high blood pressure levels. The objective this study was to identify the best anthropometric predictor of risk of hypertension in children between 8-10 years of age. The Children were evaluated for socioeconomic status and their blood pressure (BP), weight, height, waist circumference (WC) and percentage of body fat (PBF) were measured. The study included 445 children, of which 50.1% were females. The prevalence of obesity defined by body mass index (BMI) was 14.6%. Increased BP was found in 3.4% and 2.2% of the children, considering the pre-hypertension and hypertension classifications respectively. The arithmetic mean of BP value correlated significantly with BMI, WC and PBF. After height control, the correlations that were maintained significant were between WC and systolic blood pressure (SBP) and between WC and diastolic blood pressure (DBP). The variable with the highest predictive power of the occurrence of hypertension was WC. The results indicate that, in this population of children between 8 and 10 years old, WC is a measurement of higher value in predicting increased BP.

Metabolic risk factors clustering among adolescents: a comparison between sex, age and socioeconomic status

The aim was to compare the metabolic risk factors (MRF) between sex, age and socioeconomic status in a sample of adolescents from Curitiba, Brazil. A cross-sectional school-based study was conducted on 997 adolescents (429 boys) aged 12-17 years old from public schools. Total Cholesterol (TC), LDL-c, HDL-c, Triglycerides, Glycemia, Blood Pressure, waist circumference and body mass index were measured. Sex, age and socioeconomic status information was obtained using a questionnaire. Descriptive analyses, Fisher Exact and Chi-Square Tests were used to establish the sample's characteristics and the MRF comparison between variables. We found that 27.4% were classified as overweight/obese, almost half of them had TC and LDL-c classified as limitrophe/altered, with a difference between the sexes (p < 0.01), and that a higher percentage of altered values was seen among girls. The percentage of 3 and 4 or more MRF was 13.8% and 6.3%, respectively. In addition, 86.5% of the participants had at least one and 39.7% had at least two MRF. We conclude that there was a high percentage of overweight/obese, as well as a great number of subjects with altered TC and HDL-c. We also pointed out the large percentage of aggregated metabolic risk factors in both sexes. Strategies to reduce metabolic risk factors are required.

Exercise Capacity Assessment by the Modified Shuttle Walk Test and its Correlation with Biochemical Parameters in Obese Children and Adolescents

OBJECTIVES

To evaluate exercise capacity of obese children and adolescents compared with normal-weight individuals and to investigate possible correlations with blood biochemical parameters.

METHODS

In this study, children and adolescents between 6 and 18 y were included and divided into control (eutrophic) and obese groups according to body mass index (BMI). Data were collected regarding demographic, anthropometric, waist circumference and exercise capacity through the Modified Shuttle Walk Test (MSWT). In the obese group, biochemical parameters in the blood (total cholesterol, HDL, LDL, triglycerides and glucose) were evaluated, and a physical activity questionnaire was applied.

RESULTS

Seventy seven participants were included; 27 in the control group and 50 obese. There was no significant difference between the two groups regarding sample characteristics, except for body weight, BMI and waist circumference. Most obese children presented results of biochemical tests within the desirable limit, though none were considered active. There was a significant exercise capacity reduction (p < 0.001) in the obese group compared to control subjects. Positive correlations were identified for the MSWT with age and height, and a negative correlation with BMI. However, there were no correlations with the biochemical parameters analyzed.

CONCLUSIONS

Obese children and adolescents have reduced exercise capacity when compared to normal individuals. The MSWT performance seems to have a negative association with BMI, but is not correlated with blood biochemical parameters.

Motivations for weight loss in adolescents with overweight and obesity: a systematic review

BACKGROUND

Adolescents with overweight and obesity report various motivations for weight loss other than the desire for better health. However, there is little evidence regarding the main motivations for weight loss in adolescents. The present systematic review aimed to identify the motivations for weight loss in adolescents with overweight and obesity.

METHODS

A systematic search for original articles published up to December 2016 was carried out in the PubMed, Scopus, LILACS, and ADOLEC databases. The terms used in the search were: motivation, motive, reason, "weight loss," "lose weight," and adolescent.

RESULTS

Six studies (all cross-sectional) met the selection criteria and were included in the review. The instruments used to assess the participants' motivations for weight loss were interviews and questionnaires with open questions. Seventeen motivations for weight loss were identified, the main ones being better health, esthetic/cosmetic reasons, improvements in self-esteem, and avoidance of provocation/bullying.

CONCLUSIONS

The results of the present review show the need for validated instruments to assess the motivations for weight loss in adolescents with overweight and obesity. Moreover, the high frequency of motivations for weight loss related to appearance and social acceptance evidences the need for multidisciplinary weight loss interventions that consider not only the biological factors, but also the psychological and social aspects.

Impulse oscillometry and obesity in children

OBJECTIVE

To compare impulse oscillometry system parameters of normal-weight children with overweight and obese children.

METHOD

All participants were submitted to the evaluation of lung function (spirometry and impulse oscillometry) following the American Thoracic Society standards. The evaluation of respiratory mechanics was performed using the Jaeger™ MasterScreen™ Impulse Oscillometry System (Erich Jaeger, Germany), three tests were recorded, with acquisition for at least 20seconds.

RESULTS

The study included 81 children (30 in the control group, 21 in the overweight group, and 30 the in obesity group), matched for age and sex. Regarding spirometry data, obesity group showed higher numerical values in relation to the control group; however, there were no significant differences among the three groups. For impulse oscillometry parameters, there was a difference between control group and obesity group for respiratory impedance (p=0.036), resistance at 5hertz (p=0.026), resonant frequency (p=0.029), and reactance area (p=0.014). For the parameters expressed in percentage of predicted, there were differences in resistance at 5 hertz, resonant frequency, and reactance area between control group and obesity group.

CONCLUSIONS

Obese children showed increased oscillometry parameters values representative of airway obstruction, compared to normal-weight children. Changes in some oscillometry parameters can already be observed in overweight school-aged children.

A higher number of school meals is associated with a less-processed diet

OBJECTIVE

To compare the participation of food groups - fresh and minimally processed, processed, and ultra-processed - in the diet of students (n=1357) from Belo Horizonte, MG, Brazil, in accordance with the number of school meals consumed daily.

METHODS

Four groups were defined: children that did not consume school meals and children that consumed one, two, or three school meals daily. Food groups participation, in g/1000kcal, was obtained using two 24-hour recalls. Three linear regression models were analyzed, in which the consumption of each of the food groups was the dependent variable, the number of school meals was the independent variable, and sociodemographic data (gender, age, health vulnerability) and overweight condition were the control variables.

RESULTS

Children that consumed 2 or 3 school meals daily showed, respectively, 7.3% and 10.5% higher ingestion of fresh and minimally processed food in comparison to children that did not consume school meals. Moreover, ultra-processed food participation was 18.0% lower among students that consumed two school meals and 26.0% lower among children that consumed three meals daily, in comparison to students that did not consume school meals.

CONCLUSION

The study showed a possible dose-response effect in children's daily diets with two or three school meals and highlighted the relevance of the prolonged stay at school for healthy eating promotion in children.

Fundamental motor skills, nutritional status, perceived competence, and school performance of Brazilian children in social vulnerability: Gender comparison

Being at risk or in social vulnerability situations can affect important aspects of child development. The aim of this study was to investigate fundamental motor skills (locomotor and object control) and school (writing, arithmetic, reading) performances, the perceived competence and the nutritional status of girls and boys living in social vulnerability in the poorest regions of Brazil. Two hundred eleven (211) children (87 girls, 41%), 7-10-year-old (M = 8.3, SD = 0.9), from public schools in Ceará (Brazil), living in social vulnerability, participated in the study. Children were assessed using the Test of Gross Motor Development - 2, the Body Mass Index (BMI), the Self-Perception Profile for Children, and the School Performance Test. Multivariate analysis of covariance (MANCOVA), adjusted for age, did not show any significant effect for locomotion. There was an effect of gender on the object control. Boys showed higher scores in striking, kicking, throwing, and rolling a ball. Quade's nonparametric analysis showed no difference in BMI between the genders. Most children presented healthy weight. The MANCOVA showed no effect of gender on children's scores on perceived competence on the subscales; moderate scores were found for most children. There were no gender effects on school performance; both boys and girls demonstrated inferior performance. Boys and girls in social vulnerability showed inferior performance in most motor skills, moderate perceived competence and inferior school performance. These results reveal that the appropriate development of these children is at risk and that intervention strategies should be implemented to compensate the difficulties presented.

Ultra-processed food consumption and adiposity trajectories in a Brazilian cohort of adolescents: ELANA study

Background/objectives

In Brazil, the increase in obesity rates has been accompanied by increased consumption of ultra-processed food (UPF). The objective of this paper was to evaluate body mass index (BMI) and body fat percentage (%BF) trajectories in adolescents over a 3-year follow-up according to the frequency of UPF consumption.

Subjects/methods

Data of three consecutive years (2010, 2011, and 2012) were obtained from the Adolescent Nutritional Assessment Longitudinal Study (ELANA) that aimed to assess changes in anthropometric indicators of nutritional status, and 1035 adolescents enrolled in the 1st year of high school from six schools (four private and two public) in the metropolitan area of Rio de Janeiro, Brazil were included. At three follow-ups, they had their weights and heights measured. Body composition was measured at the first and second follow-ups. Mixed linear regression models were used to estimate BMI and %BF trajectories based on quartiles of UPF intake, adjusting for type of school, sex, physical activity, and underreporting.

Results

Compared to their counterparts in the 1st quartile, adolescents in the 4th quartile of UPF consumption had a lower daily intake of fruits, cooked vegetables, and raw vegetables and a higher intake of total sugar and physical activity levels (p < 0.001). There was an inverse association between UPF consumption and BMI both at baseline and at follow-up. Values for %BF followed the same trend. Adolescents in the 4th quartile had the greatest level of physical activity and lowest total energy intake.

Conclusion

This study confirmed that greater intake of UPF is a marker of an unhealthy diet, but did not support the hypothesis of a high rate of change in BMI associated with greater UPF consumption, even after adjusting for physical activity.

Clinical and Vitamin Response to a Short-Term Multi-Micronutrient Intervention in Brazilian Children and Teens: From Population Data to Interindividual Responses

SCOPE

Micronutrients are in small amounts in foods, act in concert, and require variable amounts of time to see changes in health and risk for disease. These first principles are incorporated into an intervention study designed to develop new experimental strategies for setting target recommendations for food bioactives for populations and individuals.

METHODS AND RESULTS

A 6-week multivitamin/mineral intervention is conducted in 9-13 year olds. Participants (136) are (i) their own control (n-of-1); (ii) monitored for compliance; (iii) measured for 36 circulating vitamin forms, 30 clinical, anthropometric, and food intake parameters at baseline, post intervention, and following a 6-week washout; and (iv) had their ancestry accounted for as modifier of vitamin baseline or response. The same intervention is repeated the following year (135 participants). Most vitamins respond positively and many clinical parameters change in directions consistent with improved metabolic health to the intervention. Baseline levels of any metabolite predict its own response to the intervention. Elastic net penalized regression models are identified, and significantly predict response to intervention on the basis of multiple vitamin/clinical baseline measures.

CONCLUSIONS

The study design, computational methods, and results are a step toward developing recommendations for optimizing vitamin levels and health parameters for individuals.

Obesity and Overweight Among Brazilian Early Adolescents: Variability Across Region, Socioeconomic Status, and Gender

INTRODUCTION

As with most emerging nations, Brazil lacks up-to-date data on the prevalence of obesity and overweight among its children. Of particular concern is the lack of data on children in early adolescence, considered by many to be the crucial stage for weight-related healthcare.

OBJECTIVE

To assess regional, socioeconomic, and gender differences in the prevalence of obesity and overweight among Brazilian early adolescents.

METHODS

A cross-sectional study was conducted on a racially diverse sample of students aged 10-13 years, from schools in three geographic regions (north, northeast, south) (N = 1,738). Data on gender, age, race, socioeconomic status (SES), weight, and height were obtained. Weight class was calculated from age- and gender-adjusted body mass index, based on children's weight and height. Bivariate and multivariable analyses, with post hoc tests, were conducted to estimate differences between groups and were corrected for multiple comparisons. Procedures were approved by institutional review boards at study sites.

RESULTS

Analyses revealed a higher prevalence of obesity and/or overweight among: (1) children of higher SES; (2) children in southern Brazil; (3) males; and (4) Black females.

CONCLUSION

The most salient predictor of weight risk among Brazilian early adolescents is higher SES. This finding is consistent with previous findings of an inverse social gradient, in weight risk, among emerging-nation population groups.

Child Nutritional Status in the Changing Socioeconomic Region of the Northern Amazon, Brazil

The living conditions (i.e., socioeconomic, healthcare-related, nutritional, and environmental) to which children are exposed may influence their ability to reach their optimal growth potential. This review focuses on the relationship between the nutritional status of children under five years of age and social and environmental factors in Northern Brazil. Children living in this region have limited access to healthcare and face precarious socioeconomic and environmental conditions. This analysis was based on data from national health surveys, the consolidated food, nutrition surveillance system (SISVAN), and indicators of the DPSEEA (driving force, pressure, state, exposures, health effects, and actions) framework. The northern region has the worst living conditions in the country, and children under five years of age have significant height-for-age, weight-for-age, and weight-for-height deficits. Concomitantly, the prevalence of children who are overweight has increased significantly, although it remains lower than that in more developed Brazilian regions. Insufficient and/or inadequate dietary practices and early exposure to unfavorable living conditions are risk factors for nutritional deviations. Further advances in public health policies that consider regional characteristics, particularly in the north, where progress has been slower, are needed.

Childhood overweight, obesity and associated factors among primary school children in dire dawa, eastern Ethiopia; a cross-sectional study

Background

Obesity in children is increasing worldwide. Malnutrition has become a double burden challenge of public health concern in developing countries. Childhood obesity increases the risk of chronic disease in childhood as well as adulthood. However, information is very scarce about childhood obesity in developing countries specifically in Ethiopia. Therefore, we aimed to assess childhood overweight, obesity and associated factors among primary school children at Dire Dawa, Eastern Ethiopia.

Methods

A school based cross-sectional study was conducted in Dire Dawa from 1^st to 30^th March, 2016. Study participants were selected using multistage sampling method. Pre-tested self-administered questionnaire, face to face interview technique and anthropometric measurements were used to collect data by eight well trained data collectors. Data were coded, cleaned and entered into EpiData software version 3.5.1, and exported into SPSS (version 21.0) statistical software, for data analysis. Bivariate and multivariate logistic regression were carried out to identify associated factors with childhood overweight and obesity. Statistical significance was declared using Adjusted Odds Ratio (AOR) at 95% CI and p-value less than 0.05.

Results

The prevalence of overweight and obesity were 14.7% (95% CI: 11.7, 18.0) and 5.8% (95% CI: 3.6, 8.0), respectively. Children who were from private school (AOR = 3.4, 95% CI: 1.4, 8.5), from families belonged to high socioeconomic class (AOR = 16.9, 95% CI: 6.5, 23.9), preferred sweetened foods (AOR = 2.3, 95% CI: 1.1, 5.1), had not engaged in regular physical exercise (AOR = 3.8, 95% CI: 1.5, 9.8), had experienced sedentary life style like spent their free time watching TV (AOR = 3.6, 95% CI: 1.6, 7.9), play computer game (AOR = 4.6, 95% CI:1.4,15.4), and were not having close friends (AOR = 2.9, 95% CI: 1.4, 6.2) were significantly associated with overweight/obesity risk.

Conclusion

Overweight/obesity in children is on alarming stage in the study area. Therefore, more attention should be given to creating awareness about healthy diet and improving life style through school and public media in collaboration with concerned bodies.

Estado nutricional e hábitos alimentares de escolares de Campina Grande, Paraíba, Brasil

Resumo Avaliou-se o estado nutricional e sua associação com os hábitos alimentares de crianças escolares que frequentam a rede pública de ensino do município de Campina Grande, Paraíba. Estudo transversal, realizado com 1081 crianças de 5 a 10 anos. Analisaram-se os índices antropométricos estatura/idade (E/I) e Índice de Massa Corporal/idade (IMC/I), e os hábitos alimentares dos escolares. Verificaram-se prevalências de déficit de estatura, sobrepeso e obesidade de 2,4%, 12,3% e 9,2%, respectivamente. O E/I apresentou-se com média inferior (p = 0,029) nas crianças que indicaram quase nunca tomar café da manhã (-0,130 ± 1,053 Escore-z) em comparação com as que faziam essa refeição todas ou na maioria das vezes (0,183 ± 0,912 Escore-z), associação similar foi observada quando a merenda escolar não era consumida (p = 0,001). Para o IMC/I, crianças com hábito de fazer todas as refeições apresentaram menor média (p = 0,034); resultado similar foi observado em relação ao hábito de tomar café da manhã em que menor média foi constatada entre as crianças com esse costume (p = 0,020). Conclui-se que o estado nutricional dos escolares é marcado por altas taxas de sobrepeso/obesidade. Sugere-se que os prejuízos no estado nutricional estejam relacionados ao não consumo do café da manhã e da alimentação oferecida na escola.

C. SOARES R, CASTRO RD. Association between Periodontal Condition and Nutritional Status of Brazilian Adolescents: A Population-based Study

BACKGROUND

Obesity is a serious problem of public health and affects all socio-economic groups, irrespective of age, sex or ethnicity. The aim of this study was to evaluate the association between periodontal condition and nutritional status of adolescents.

METHODS

This was a cross-sectional study using a probability cluster sampling, and the sample was defined by statistical criterion, consisting of 559 students aged 15-19 yr enrolled in public schools of adolescents of Campina Grande, PB, Brazil in 2012. Socioeconomic characteristics were analyzed, as well as self-reported general and oral health, anthropometric data and periodontal condition (CPI and OHI-S). Descriptive and analytical analysis from bivariate and multivariate Poisson regression analysis with 5% significance level was performed.

RESULTS

Of the 559 adolescents, 18.6% were overweight and 98.4% had some form of periodontal changes such as: bleeding (34.3%), calculus (38.8%), shallow pocket (22.9%) and deep pocket (2.3%). There was association between presence of periodontal changes with obesity (P<0.05; CI 95%: 0.99 [0.98 - 0.99]).

CONCLUSION

The association between presence of periodontal changes and obesity status in adolescents was indicated.

Unchanging pattern of prevalence of esophageal cancer, overall and by histological subtype, in the endoscopy service of the main referral hospital in the central region of Rio Grande do Sul State, in Southern Brazil

Squamous cell carcinoma (SCC) and adenocarcinoma (ADC) are the two main histological types of esophageal cancer. Southern Brazil has the highest rates of esophageal cancer in South America, and the most prevalent subtype of esophageal cancer has been SCC. This study assessed the trend changes in the histological types of esophageal cancer, in a 20-year period, in the central region of Rio Grande do Sul State, Brazil. We searched all cases of esophageal cancer from 1993 to 2012 by their histological diagnosis, grouping the patients in 4-year time periods to evaluate time trends. Among 18 441 upper gastrointestinal endoscopies we identified 686 cases of esophageal cancer. Histological study confirmed the diagnosis of SCC in 640 (93.3%) patients and ADC in 46 (6.7%). Overall, 522 men were diagnosed with esophageal carcinoma; from these, 489 (93.6%) presented SCC, and 33 (6.3%) ADC. Among women, 164 had the diagnosis of esophageal cancer, 151 (92%) SCC, and 13 (7.9%) ADC. The proportion found among men and women was 3.1:1, respectively. The prevalence rate of esophageal cancer, along a 20 year-period, remained stable, as well as the rates of SCC and ADC. SCC was the most common type of esophageal cancer, and ADC presented very low prevalence.

Índices antropométricos de crianças assistidas em creches e sua relação com fatores socioeconômicos, maternos e infantis

Resumo Os índices antropométricos peso/estatura e peso/idade destacam-se, respectivamente, por sua importância na identificação de mudanças recentes de peso e de alterações no estado nutricional de forma precoce. O objetivo deste estudo foi analisar fatores associados ao peso/estatura e peso/idade em crianças pré-escolares. Trata-se de um estudo transversal com amostra probabilística que analisou 299 crianças assistidas em creches públicas municipais. As informações foram obtidas por meio de entrevista com as mães, mediante aplicação de um questionário com informações socioeconômicas, maternas e infantis. O peso e a estatura/comprimento das crianças foram medidos seguindo as recomendações da Organização Mundial de Saúde. Os resultados evidenciaram que nenhuma das variáveis maternas associou-se ao estado nutricional das crianças e que apenas o peso ao nascer, dentre as variáveis infantis, apresentou associação aos escores de peso/estatura (p = 0,0030) e peso/idade (p = 0,0018). O bloco de variáveis socioeconômicas, por sua vez, mostrou-se como o mais representativo fator de variação dos resultados encontrados, sobretudo no peso/idade. Conclui-se sobre a relevância do peso ao nascer no peso/estatura e peso/idade das crianças, bem como das condições socioeconômicas, marcadamente, no peso/idade .

Effects of obesity on lung volume and capacity in children and adolescents: a systematic review

OBJECTIVE

To assess the effects of obesity on lung volume and capacity in children and adolescents.

DATA SOURCE

This is a systematic review, carried out in Pubmed, Lilacs, Scielo and PEDro databases, using the following Keywords: Plethysmography; Whole Body OR Lung Volume Measurements OR Total Lung Capacity OR Functional Residual Capacity OR Residual Volume AND Obesity. Observational studies or clinical trials that assessed the effects of obesity on lung volume and capacity in children and adolescents (0-18 years) without any other associated disease; in English; Portuguese and Spanish languages were selected. Methodological quality was assessed by the Agency for Healthcare Research and Quality.

DATA SYNTHESIS

Of the 1,030 articles, only four were included in the review. The studies amounted to 548 participants, predominantly males, with sample size ranging from 45 to 327 individuals. 100% of the studies evaluated nutritional status through BMI (z-score) and 50.0% reported the data on abdominal circumference. All demonstrated that obesity causes negative effects on lung volume and capacity, causing a reduction mainly in functional residual capacity in 75.0% of the studies; in the expiratory reserve volume in 50.0% and in the residual volume in 25.0%. The methodological quality ranged from moderate to high, with 75.0% of the studies classified as having high methodological quality.

CONCLUSIONS

Obesity causes deleterious effects on lung volume and capacity in children and adolescents, mainly by reducing functional residual capacity, expiratory reserve volume and residual volume.

Effects of obesity on lung volume and capacity in children and adolescents: a systematic review

OBJECTIVE

To assess the effects of obesity on lung volume and capacity in children and adolescents.

DATA SOURCE

This is a systematic review, carried out in Pubmed, Lilacs, Scielo and PEDro databases, using the following Keywords: Plethysmography; Whole Body OR Lung Volume Measurements OR Total Lung Capacity OR Functional Residual Capacity OR Residual Volume AND Obesity. Observational studies or clinical trials that assessed the effects of obesity on lung volume and capacity in children and adolescents (0-18 years) without any other associated disease; in English; Portuguese and Spanish languages were selected. Methodological quality was assessed by the Agency for Healthcare Research and Quality.

DATA SYNTHESIS

Of the 1,030 articles, only four were included in the review. The studies amounted to 548 participants, predominantly males, with sample size ranging from 45 to 327 individuals. 100% of the studies evaluated nutritional status through BMI (z-score) and 50.0% reported the data on abdominal circumference. All demonstrated that obesity causes negative effects on lung volume and capacity, causing a reduction mainly in functional residual capacity in 75.0% of the studies; in the expiratory reserve volume in 50.0% and in the residual volume in 25.0%. The methodological quality ranged from moderate to high, with 75.0% of the studies classified as having high methodological quality.

CONCLUSIONS

Obesity causes deleterious effects on lung volume and capacity in children and adolescents, mainly by reducing functional residual capacity, expiratory reserve volume and residual volume.