A relação cintura quadril e o perímetro da cintura associados ao índice de massa corporal em estudo com escolares

PREVALENCE AND FACTORS ASSOCIATED WITH PHYSICAL ACTIVITY IN SOCIALLY VULNERABLE CHILDREN

ABSTRACT Introduction: Although the benefits of physical activity are widely recognized, insufficient levels have been identified among young people, especially those experiencing social vulnerability. Therefore, there is an ongoing search for health incentive strategies, especially in the early stages of life, aimed at reversing this situation. Objective: Investigate the prevalence of physical activity, weight status and motivation to participate in sports among socially vulnerable children who are participating in social projects of the state of Santa Catarina focused on sports, and compare these results according to age and sex. Methods: This is a cross-sectional descriptive study, composed of 3066 children aged seven to 11 years. Results: The study was made up of “active” and “moderately active” children of “normal weight”, considering the domains of motivation to participate in physical activities and sports: pleasure, physical fitness, technical competence, general affiliation, specific affiliation and “very important” status and emotions and competition, “important”. Accordingly, girls tend to be more “moderately active,” “overweight” and “obese” and to regard technical competence as an “important” motivational domain for physical activity when compared to boys. Participants aged 10 to 11 years were more “very active”, were more “overweight” and “obese” and considered specific affiliation more “totally important” when compared to younger participants. Conclusion: The participants of social sports projects of this sample demonstrated a level of physical activity and weight status within recommended levels, and were motivated to participate in sports in most of the domains observed. Level of evidence III; Diagnostic studies - Investigating a diagnostic test.

Comparison of methods to measure body fat in 7-to-10-year-old children: a systematic review

OBJECTIVE

To investigate methodological aspects in body fat (BF) measurements in 7-to-10-year-old children.

STUDY DESIGN

Systematic review of the literature.

METHODS

The studies were chosen from the PubMed and Scielo databases according to a protocol that defined: inclusion criteria; a search and quality-assessment strategy; and information extraction.

RESULTS

27 studies published from 2004 to 2014 were included. The literature describes skinfold measurements and dual energy X-ray absorptiometry (DEXA) as being the reference methods most widely used in the assessment of the ability of methods to identify BF. The most commonly-used statistical analyses were the Pearson correlation coefficient, and sensitivity and specificity performance analyses. The comparison between the tested methods and the references showed that body mass index (BMI) and waist circumference (WC) are strongly correlated to BF as calculated by bioelectrical impedance or skinfolds, and that there is a moderate positive correlation with percent body fat as calculated by DEXA, air-displacement plethysmography (ADP) or isotope dilution. There was a moderate positive correlation between waist-to-height ratio (WHtR) and BF, as estimated by ADP and skinfolds. Performance studies suggest that BMI and WC are very specific but less sensitive methods.

CONCLUSIONS

The results of this systematic review show favourable evidence for the use of anthropometric indicators - above all BMI and WC- in the measurement of BF, when more accurate techniques such as DEXA and ADP are not feasible. They also demonstrate features that make them advantageous for epidemiological studies in a child population, since they are easy and safe to obtain and well tolerated by the children.

Excesso de peso e variáveis associadas em escolares de Itajaí, Santa Catarina, Brasil

ResumoObjetivou-se avaliar a associação das variáveis socioeconômicas, demográficas, dos comportamentos relacionados à saúde e características do ambiente familiar com a prevalência de excesso de peso em alunos do 1º ao 5º ano de escolas do município de Itajaí, Santa Catarina. As variáveis socioeconômicas, demográficas e referentes aos comportamentos e características do ambiente familiar foram identificadas por meio de questionário aplicado aos pais/responsáveis. Foi aferido e determinado o estado nutricional pelo Índice de Massa Corporal e circunferência da cintura. A associação entre o excesso de peso e as demais variáveis foi investigada por meio do teste do Qui-Quadrado de Pearson e de Tendência Linear. A população constituía-se de 417 escolares, 95,2% da amostra. Os dados indicaram que 44,0% apresentaram excesso de peso, que esteve associado à melhor qualidade da dieta (49,4%, p = 0,051), menor frequência de consumo de biscoitos e salgadinhos, hábito de realizar refeições em frente à televisão, ao excesso de peso dos pais (51%, p = 0,002), ao escore da atuação da família na alimentação (51,9%, p = 0,029) e atividade física das crianças. Sugere-se que as ações em saúde devem considerar o entorno familiar e o contexto social das crianças para fomentar estilos de vida mais saudáveis.

[Waist circumference, waist/height ratio, and neck circumference as parameters of central obesity assessment in children]

Objective:

To analyze studies that assessed the anthropometric parameters waist circumference (WC), waist-to-height ratio (WHR) and neck circumference (NC) as indicators of central obesity in children.

Data sources:

We searched PubMed and SciELO databases using the combined descriptors: "Waist circumference", "Waist-to-height ratio", "Neck circumference", "Children" and "Abdominal fat" in Portuguese, English and Spanish. Inclusion criteria were original articles with information about the WC, WHR and NC in the assessment of central obesity in children. We excluded review articles, short communications, letters and editorials.

Data synthesis:

1,525 abstracts were obtained in the search, and 68 articles were selected for analysis. Of these, 49 articles were included in the review. The WC was the parameter more used in studies, followed by the WHR. Regarding NC, there are few studies in children. The predictive ability of WC and WHR to indicate central adiposity in children was controversial. The cutoff points suggested for the parameters varied among studies, and some differences may be related to ethnicity and lack of standardization of anatomical site used for measurement.

Conclusions:

More studies are needed to evaluate these parameters for determination of central obesity children. Scientific literature about NC is especially scarce, mainly in the pediatric population. There is a need to standardize site measures and establish comparable cutoff points between different populations.

Relationship between anthropometric measures and cardiovascular risk factors in children and adolescents

BACKGROUND

Obesity has been identified as an important risk factor in the development of cardiovascular diseases; however, other factors, combined or not with obesity, can influence cardiovascular risk and should be considered in cardiovascular risk stratification in pediatrics.

OBJECTIVE

To analyze the association between anthropometry measures and cardiovascular risk factors, to investigate the determinants to changes in blood pressure (BP), and to propose a prediction equation to waist circumference (WC) in children and adolescents.

METHODS

We evaluated 1,950 children and adolescents, aged 7 to 18 years. Visceral fat was assessed by WC and waist-hip relationship, BP and body mass index (BMI). In a randomly selected subsample of these volunteers (n = 578), total cholesterol, glucose and triglycerides levels were evaluated.

RESULTS

WC was positively correlated with BMI (r = 0.85; p < 0.001) and BP (SBP r = 0.45 and DBP = 0.37; p < 0.001). Glycaemia and triglycerides showed a weak correlation with WC (r = 0.110; p = 0.008 e r = 0.201; p < 0.001, respectively). Total cholesterol did not correlate with any of the variables. Age, BMI and WC were significant predictors on the regression models for BP (p < 0.001). We propose a WC prediction equation for children and adolescents: boys: y = 17.243 + 0.316 (height in cm); girls: y = 25.197 + 0.256 (height in cm).

CONCLUSION

WC is associated with cardiovascular risk factors and presents itself as a risk factor predictor of hypertension in children and adolescents. The WC prediction equation proposed by us should be tested in future studies.

Wait list status of pediatric dialysis patients in North America

Kidney transplantation is the treatment of choice for the majority of pediatric patients with end-stage kidney disease. Previous studies demonstrating racial or gender disparities in access to the deceased donor transplant list could not evaluate the impact of medical concerns or patient preference on waitlist status. We undertook a retrospective cohort study using the NAPRTCS registry to begin to determine barriers to wait list registration for kidney transplantation among pediatric dialysis patients. Clinical and demographic factors were compared in listed vs. non-listed patients. Reasons cited for not listing patients were examined by clinical and demographic factors. At dialysis initiation, 88.7% of pediatric dialysis patients were not on the renal transplant wait list. Twelve months after dialysis initiation, 67.1% of pediatric dialysis patients were not on the wait list. The groups least likely to be on the wait list were infants (adjusted OR 0.23, 95% CI 0.16, 0.32) and girls (adjusted OR 0.78, 95% CI 0.67, 0.90) after adjusting for multiple confounders. The reason most often cited for not listing was medical reason for young infants and that the transplant workup was pending for girls. Further study is needed to identify barriers to wait list registration.

Correlação entre índice de massa corporal e circunferência da cintura em crianças

OBJETIVO: Estabelecer uma correlação entre a circunferência da cintura e o Índice de Massa Corporal (IMC) na determinação do excesso de peso e distribuição de gordura em crianças de escolas públicas de Fortaleza - CE. MÉTODOS: Trata-se de um estudo transversal, realizado em 12 escolas da rede da pública da cidade de Fortaleza- CE. Participaram 727 crianças de ambos os sexos, com idade variando entre 6 a 11 anos. A coleta de dados ocorreu de março a junho de 2008. RESULTADOS: Os resultados do inquérito mostraram que, de acordo com o IMC,11,4% das crianças encontravam-se em sobrepeso, 6,6% eram obesas e 30,9% apresentaram obesidade central. CONCLUSÃO: Nem toda criança obesa apresentava obesidade central, demonstrando que uma só medida antropométrica não é eficaz na determinação do padrão de gordura na infância.

Prevalência de excesso de peso e obesidade abdominal, segundo parâmetros antropométricos, e associação com maturação sexual em adolescentes escolares

Este estudo objetivou estimar a prevalência de excesso de peso e obesidade abdominal em escolares segundo antropometria e maturação sexual. Foi um estudo transversal, incluindo 1.405 escolares de 10-14 anos, de ambos os sexos, residentes no Recife, Pernambuco, Brasil, em 2007. Foi avaliado o índice de massa corporal (IMC), a circunferência da cintura (CC) e razão da cintura-estatura (RCEst). A maturação sexual foi auto-avaliada, definindo-se como precoce quando o escolar apresentava idade cronológica inferior à mediana de idade para o referido estágio. A prevalência de excesso de peso foi de 20,4% (IC95%: 18,3-22,6) e a de obesidade abdominal foi de 14,9% (IC95%: 13,1-16,9) para CC e 12,6% (IC95%: 10,9-14,4) para RCE. O IMC, a CC e a RCEst apresentaram uma forte correlação positiva (rho ≅ 0,8; p < 0,001). A prevalência de excesso de peso e de obesidade abdominal foi maior (p < 0,05) nos estágios finais de maturação sexual em ambos os sexos. A alta prevalência de excesso de peso requer medidas urgentes de prevenção e controle desse distúrbio, sendo recomendada a inclusão da maturação sexual na avaliação do estado nutricional.

Nutritional status of an economically-privileged convenience sample of urban children in Guatemala City

BACKGROUND

The worldwide pandemic of overweight and obesity has now reached low-income tropical societies.

OBJECTIVE

To determine whether overweight or obesity is present among children from middle-class Guatemala City homes.

METHODS

A total of 363 children, 173 boys and 190 girls aged 72-131 months, were included for height, weight, and abdominal circumference at its narrowest point (natural waist).

RESULTS

Overall, 58.6% of subjects presented a body mass index within the normal Center for Disease Control and Prevention curve limits, whereas 3.9% fell below this range (low weight), 17.4% were in the risk of overweight range, and 20.1% were classified as overweight. The mean natural waist circumference was 62.6+/-0.9 cm. The waist-circumference-to-height ratio had a median of 0.47, with 36.9% of all children having a waist-circumference-to-height ratio exceeding the proposed 0.5 upper limit.

CONCLUSIONS

Nutrition transition has reached the juvenile population of this Central American republic, at least in its urban, privileged groups.