Prevalence of overweight preschool children in public day care centers: a cross-sectional study

Influência da ambiência escolar no estado nutricional de pré-escolares de Macaé, Rio de Janeiro, Brasil

Resumo Objetivou-se avaliar a ambiência escolar e o estado nutricional de pré-escolares da rede pública de Macaé. Trata-se de um estudo transversal, com dados antropométricos secundários, coletados entre 2012 e 2014. Foram analisadas 962 crianças, de 2,1 a 6,6 anos, de quatro escolas, segundo recomendação da Organização Mundial da Saúde. A ambiência foi avaliada, qualitativamente, por observação direta. Por regressão logística, foi verificado se a chance de ocorrer desvios nutricionais diferia entre as escolas. A prevalência de excesso nutricional foi alarmante, principalmente nos menores de cinco anos (13,7%). Em crianças com cinco anos ou mais, as duas escolas, com ampla rede social de apoio no entorno, tiveram menor chance de ocorrer excesso nutricional (Odds Ratio de 0,40 e 0,33; p < 0,05). A escola com mais lanchonetes e propagandas de alimentos no território teve maior proporção de obesidade. Fatores positivos de ambiência dentro da escola, como ausência de cantina comercial, não conseguiram evitar o excesso nutricional. Este estudo adverte a respeito da relevância do entorno, sobretudo do apoio social. Esse é pouco abordado na literatura em nutrição, mas pode ser diferencial no perfil nutricional, em especial quando aspectos-chave de proteção no interior da escola estão adequados.

Preditores de riscos nutricionais de crianças assistidas em creches em município de porte médio do Brasil

Resumo Objetivos Identificar variáveis preditoras do estado nutricional (déficit de estatura, excesso de peso) de crianças assistidas em creches públicas municipais de Campina Grande, Paraíba, Brasil. Metodologia Estudo transversal que analisou a associação de variáveis das crianças, maternas e socioeconômicas com o déficit de estatura e o excesso de peso de crianças assistidas em creches. Os dados antropométricos foram obtidos obedecendo às recomendações da Organização Mundial da Saúde. Resultados Das 793 crianças estudadas, 6,4% foram diagnosticadas com déficit de estatura e 31,8% com excesso de peso. Maiores prevalências de déficit de estatura foram encontradas, em relação às respectivas categorias de referência, nos casos de crianças que nasceram com baixo peso, de mães com baixa estatura, de domicílios sem coleta de lixo e de famílias numerosas. Domicílios com consumo de água para beber não tratada e sem rede de esgoto foram preditores do excesso de peso. Conclusões O estado nutricional de crianças assistidas em creches caracteriza-se pela manutenção da baixa estatura que coexiste com prevalências maiores de excesso de peso, diagramado pelas condições socioeconômicas e por antecedentes como o baixo peso ao nascer e a baixa estatura materna.

PERCEPÇÃO DA OBESIDADE JUVENIL ENTRE PROFESSORES DE EDUCAÇÃO FÍSICA NA EDUCAÇÃO BÁSICA

RESUMO Introdução: A obesidade pode ter início em qualquer idade, no entanto, tem ocorrido de modo crescente na população juvenil, o que, segundo casos registrados, é causa de inúmeros problemas de saúde. Objetivo: Analisar as percepções de professores de Educação Física atuantes em escolas de educação básica na cidade de Ouro Preto, MG, Brasil, com relação à obesidade juvenil e o papel da escola e da Educação Física como formas de controle. Métodos: Trata-se de estudo descritivo exploratório, no qual se utilizou a versão traduzida para o português do instrumento Perceptions of Youth Obesity and Physical Education Questionnaire em um grupo amostral de 15 professores licenciados em Educação Física de ambos os sexos (8 homens e 7 mulheres), atuantes em escolas de educação básica na cidade de Ouro Preto, MG, Brasil. Resultados: Os professores têm conhecimento das implicações da obesidade na saúde e qualidade de vida dos jovens, assim como da necessidade de intervenção. A partir da percepção desses professores, observa-se que a escola se configura como um espaço apropriado para abordar esse tema entre os jovens. Na perspectiva da educação para e pelo movimento, o professor de Educação Física pode auxiliar os jovens a promoverem mudanças significativas na forma física, a partir da adoção de um estilo de vida saudável e de orientações básicas de bons hábitos alimentares. Conclusão: A insuficiência da carga horária semanal de aulas de Educação Física para lidar com o tema da obesidade de forma sistemática, bem como suas implicações, é consenso entre esses professores.

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 2-4 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.

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.

[Characterization of anthropometric assessment studies of Brazilian children attending daycare centers]

OBJECTIVE

To obatin an overview of available information on the anthropometric assessment of Brazilian children attending daycare centers.

DATA SOURCE

A literature search was carried out in the PubMed, LILACS and SciELO databases of studies published from 1990 to 2013 in Portuguese and English languages. The following search strategy was used: (nutritional status OR anthropometrics OR malnutrition OR overweight) AND daycare centers, as well as the equivalent terms in Portuguese. In the case of MEDLINE search, the descriptor Brazil was also used.

DATA SYNTHESIS

It was verified that the 33 studies included in the review were comparable from a methodological point of view. The studies, in general, were characterized by their restrictive nature, geographical concentration and dispersion of results in relation to time. Considering the studies published from 2010 onwards, low prevalence of acute malnutrition and significant rates of stunting and overweight were observed.

CONCLUSIONS

Despite the limitations, considering the most recent studies that used the WHO growth curves (2006), it is suggested that the anthropometric profile of Brazilian children attending daycare centers is characterized by a nutritional transition process, with significant prevalence of overweight and short stature. We emphasize the need to develop a multicenter survey that will more accurately define the current anthropometric nutritional status of Brazilian children attending daycare centers.

Nutritional status, tooth wear and quality of life in Brazilian schoolchildren

OBJECTIVE

To evaluate the correlation among nutritional status, tooth wear and quality of life in Brazilian schoolchildren.

DESIGN

The study followed a cross-sectional design. Nutritional status was measured via anthropometry using BMI and tooth wear was measured using the Dental Wear Index; both these assessments were carried out by a trained recorder according to standard criteria. A modified version of the Child Oral Impacts on Daily Performances was used to assess quality of life.

SETTING

City of Bauru, in Brazil.

SUBJECTS

A cluster sample of 396 schoolchildren (194 boys and 202 girls) aged 7-10 years.

RESULTS

The anthropometric assessment showed similar situations for both sexes regarding underweight (31·40 % in boys and 30·20 % in girls) and overweight/obesity (33·96 % in boys and 33·17 % in girls). The underweight children showed a greater severity of tooth wear in the primary teeth (OR=0·72; CI 0·36, 1·42), although in the permanent dentition the obese children had a greater severity of tooth wear (OR=1·42; 95 % CI 0·31, 6·55). The tooth wear was correlated with age for both dentitions.

CONCLUSIONS

Tooth wear in the primary and permanent dentition may be related to nutritional status. Tooth wear and obesity did not have a significant impact on the schoolchildren's perception of quality of life.

Relationship between birth weight and overweight/obesity among students in Florianópolis, Santa Catarina, Brazil: a retrospective cohort study

CONTEXT AND OBJECTIVE

Being born heavier than 4 kg is associated with current overweight and obesity over the long term. The objective here was to ascertain whether birth weight was related to overweight or obese status, among 7 to 14-year-old schoolchildren, taking into consideration the possible interactions between socioeconomic factors and other biological variables.

DESIGN AND SETTING

Retrospective cohort study on a probabilistic sample of 2,696 children and adolescents living in Florianópolis, Santa Catarina, Brazil.

METHODS

The following data were collected: anthropometric (student's weight, height and age; and parents' weight and height), socioeconomic (family income, number of people in house and parental schooling level), birth weight and gestational age. Overweight and obesity were classified using percentiles of body mass index and triceps and subscapular skinfolds. The outcome variables were overweight and obesity and the main explanatory variables were birth weight and birth weight according to gestational age. The control variables were the parents' nutritional status, their schooling level and the per capita family income. Poisson multivariate regressions were carried out.

RESULTS

Higher prevalence of high birth weight was observed among overweight male adolescents (PR = 1.14; 95% CI = 1.02-1.27; P = 0.03), but this was not observed among obese male adolescents. Low birth weight and being born small for gestational age were also not associated with the outcomes. Among overweight and obese children, birth weight was not significantly different from that of normal-weight children.

CONCLUSION

No significant association between birth weight and obesity was observed. However, there was a weak but significant association between high birth weight and overweight, among male adolescents.

Incidence of overweight/obesity in preschool children during a two-year follow-up

OBJECTIVE: To analyze the incidence of overweight/obesity and associated factors in children aged six years or less during a two-year follow-up. METHODS: This longitudinal cohort study followed 242 preschoolers from Florianópolis, Santa Catarina, from 2008 to 2010. The outcome was overweight/obesity (Z-score >+2) measured by accumulated incidence. The Chi-square test measured the differences between the study factors. The association between overweight/obesity and associated factors was analyzed by adjusted and crude rate ratios. RESULTS: Nine (4.00%) of the 222 non-overweight/obese children in 2008 were overweight/obese in 2010, indicating an accumulated incidence of overweight/obesity of 4.05% (1.4-6.7). The study accumulated incidence of overweight/obesity was 20.25/year/1000, similar to the incidence density of 20.65/year/1000. CONCLUSION: After adjustment, none of the study factors were associated with overweight/obesity. However, the lack of studies that investigate the incidence of overweight and obesity in preschoolers calls for longitudinal studies with larger samples that analyze not only the incidence of overweight/obesity but also other factors, such as the influence of parents' nutritional status on their offspring's nutritional status.

Prevalence of obesity and cardiovascular risk among children and adolescents in the municipality of Santa Cruz do Sul, Rio Grande do Sul

CONTEXT AND OBJECTIVE

Studies have demonstrated that metabolic complications from child obesity, although silent, increase the risk of development of cardiovascular diseases in adulthood. The present paper sought to describe the prevalence of overweight/obesity and analyze the possible relationship between obesity and other cardiovascular risk factors among children and adolescents.

DESIGN AND SETTING

Cross-sectional study, conducted in a university.

METHODS

The study included 564 children and adolescents, aged 8 to 17 years. Body mass index and waist circumference were used to evaluate obesity. Other cardiovascular risk factors were evaluated, like systolic and diastolic blood pressure, glycemia, triglycerides and total cholesterol. Descriptive analysis was used for sample characterization, the chi-square test for categorical variables and Pearson's linear correlation for evaluating the relationship between obesity indicators and other cardiovascular risk factors.

RESULTS

High prevalence of overweight/obesity was found among the schoolchildren (25.3% among the boys and 25.6% among the girls), along with abdominal obesity (19.0%). The overweight/obese schoolchildren presented higher percentages for the pressure and biochemical indicators, compared with underweight and normal-weight schoolchildren. Body mass index and waist circumference showed a weak correlation with the variables of age and systolic and diastolic blood pressure (P < 0.001), but there was no correlation between these obesity indices and biochemical variables.

CONCLUSION

The high prevalence of overweight/obesity and its relationship with other cardiovascular risk factors demonstrate that it is necessary to develop intervention and prevention strategies from childhood onwards, in order to avoid development of chronic-degenerative diseases in adulthood.