Association between bone mineral density and content and physical growth parameters among children and adolescents diagnosed with HIV: a cross-sectional study

ABSTRACT BACKGROUND: During childhood and adolescence, there are significant increases in bone mineral content (BMC) and bone mineral density (BMD). OBJECTIVE: To investigate physical growth parameters associated with BMD and BMC among children and adolescents diagnosed with human immunodeficiency virus (HIV). DESIGN AND SETTING: Cross-sectional study conducted in Florianópolis, Brazil, among 63 children and adolescents (aged 8-15 years) diagnosed with HIV. METHOD: BMD, BMC and fat percentage z score were evaluated using dual X-ray absorptiometry. Age/height z score and body mass index (BMI)/age z score were obtained in accordance with international recommendations, and bone age was obtained through hand-wrist radiography. Sex, family income, information on HIV infection (T CD4+ lymphocyte count, viral load and type of antiretroviral therapy, moderate-vigorous physical activity and sedentary behavior) were used as adjustment variables in the analyses. Simple and multiple linear regression analyses were performed, with a significance level of P ≤ 0.05. RESULTS: Subtotal BMD (without the head region) was directly associated with bone age, BMI/age z score and fat percentage z score, even after adjusting for covariates. Subtotal BMC/height was directly associated with bone age, height/age z score, BMI/age z score and fat percentage z score, even after adjusting for covariates. CONCLUSION: Subtotal BMD and subtotal BMC/height were directly associated with physical growth indicators among children and adolescents diagnosed with HIV.

Excesso de adiposidade corporal periférica, central e geral em adolescentes de uma cidade do sul do Brasil / Excess of peripheral, central and general body adiposity in adolescents in a city in southern Brazil

Objetivo: estimar a prevalência e analisar os fatores sociodemográficos e de estilo de vida associados ao excesso de adiposidade periférica, central e geral em adolescentes. Método: estudo transversal, realizado na cidade de São José/Santa Catarina, Brasil, com 1.132 adolescentes (14-19 anos). As variáveis dependentes foram adiposidade periférica (dobra cutânea [DC] do tríceps), central (DC subescapular) e geral (presença de adiposidade periférica e central), classificadas pelo percentil 90 do Centers for Disease Control and Prevention. As variáveis independentes foram nível econômico, atividade física (AF) e hábitos alimentares, obtidos por meio de questionários. A maturação sexual foi avaliada segundo critérios de Tanner. Resultados: o excesso de adiposidade periférica, central e geral, foi de 11,1%, 10,3% e 7,1%, respectivamente, para adolescentes do sexo masculino e, 13,1%,14,7% e 9,8%, respectivamente, para adolescentes do sexo feminino. Os adolescentes do sexo masculino com baixos níveis de AF apresentaram maiores chances de excesso de adiposidade periférica (OR:2,32; IC95%: 1,09-5,37). As adolescentes do sexo feminino, no estágio maturacional pós-púbere apresentaram maiores chances de excesso de adiposidade central (OR:3,80; IC95%:2,25-6,41) e geral (OR:3,31; IC95%:1,79-6,10), e aquelas que estudavam no período noturno apresentaram menores chances de ter excesso de adiposidade central (OR:0,35; IC95%:0,18-0,71) e geral (OR:0,43; IC95%:0,19-0,95). Conclusão: o excesso de adiposidade se fez presente, sendo que o baixo nível de AF para os adolescentes do sexo masculino, o estágio maturacional póspúbere e o turno de estudo diurno foram fatores associados ao excesso de adiposidade para as adolescentes do sexo feminino. (AU)

Objective: to estimate the prevalence and to analyze sociodemographic and lifestyle factors associated with excess peripheral, central and general adiposity in adolescents. Method: a cross-sectional study, conducted in the city of São José/Santa Catarina, Brazil, with 1,132 adolescents (14-19 years old). The dependent variables were peripheral adiposity (tríceps skinfold), central (subscapular skinfold) and general (presence of peripheral and central adiposity), classified from the 90th percentile of the Centers for Disease Control and Prevention curve. The independent variables were economic level, physical activity (PA) and eating habits, obtained through questionnaires. The sexual maturation was evaluated according to Tanner criteria. Results: the excess of central and general peripheral adiposity was 11.1%, 10.3% and 7.1%, respectively, for male adolescents and 13.1%, 14.7% and 9.8%, respectively, for adolescent females. Males with low PA l evels presented higher odds of excess peripheral adiposity (OR: 2.32; 95% CI: 1.09-5.37). The female adolescents in the post-pubertal maturational stage presented higher odds of excess central adiposity (OR: 3.80; 95% CI: 2.25-6.41) and general adiposity (OR: 3.31; 95% CI: 1.79-6.10), and those who studied at night had a lower chance of having excess central adiposity (OR: 0.35, 95% CI: 0.18-0.71) and general adiposity (OR: 0.43; 95% CI: 0.19-0.95). Conclusion: the excess of adiposity was present and that the low level of PA for the male adolescents, the post-pubertal maturational stage and the daytime shift were factors associated with excess adiposity for female adolescents. (AU)

What anthropometric indicators are associated with insulin resistance? Cross-sectional study on children and adolescents with diagnosed human immunodeficiency virus

ABSTRACT BACKGROUND: Studies that test associations between anthropometric indicators and insulin resistance (IR) need to provide better evidence in the context of the pediatric population (children and adolescents) with human immunodeficiency virus (HIV), as anthropometric indicators present a better explanation of the distribution of body fat. OBJECTIVE: To test the associations between anthropometric indicators and insulin resistance (IR) among children and adolescents diagnosed with HIV. DESIGN AND SETTING: Cross-sectional study on 65 children and adolescents (8-15 years) infected with HIV through vertical transmission conducted at the Joana de Gusmão Children's Hospital, Florianópolis, Brazil. METHODS: The anthropometric indicators measured were the abdominal (ASF), triceps (TSF), subscapular (SSF) and calf (CSF) skinfolds. The relaxed arm (RAC), waist (WC) and neck (NC) circumferences were also measured. Body mass index (BMI) was calculated from the relationship between body mass and height. IR was calculated through the Homeostasis Model Assessment for Insulin Resistance (HOMA-IR). Simple and multiple linear regression analyses were used. RESULTS: After adjustment for covariates (sex, bone age, CD4+ T lymphocytes, CD8+ T lymphocytes, viral load, and physical activity), associations between IR and models with SSF and CSF remained. Each of these explained 20% of IR variability. For females, in the adjusted analyses, direct associations between IR and models with ASF (R² = 0.26) and TSF (R² = 0.31) were observed. CONCLUSIONS: SSF and CSF in males and ASF and TSF in females were associated with IR in HIV-infected children and adolescents.

Association between excess peripheral, central and general adiposity with high blood pressure in adolescents in southern Brazil / Associação entre excesso de adiposidade periférica, central e geral com pressão alta em adolescentes do Sul do Brasil

Introduction: Excess adiposity is one of the main risk factors for cardiovascular diseases, including high blood pressure. Children and adolescents with obesity and hypertension are at greater risk of morbidity and mortality in adulthood. Objective: To analyze the association between excess peripheral, central and general adiposity with high blood pressure in adolescents in southern Brazil.Methods: This is a cross-sectional study with 1,132 adolescents (16.50 ± 1.14 years) of both sexes. Measurements were performed with the oscillometric method using digital sphygmomanometer, considering high systolic and diastolic blood pressure, values above the 95th percentile for sex and age. Peripheral adiposity (triceps skinfold) and central adiposity (subscapular skinfold) were classified as high from the 90th percentile of the Centers for Disease Control and Prevention reference distribution. For excess general adiposity, triceps and subscapular skinfold above the 90th percentile were simultaneously considered. Logistic regression was used with 5% significance level. Results: Male adolescents with high peripheral, central and general adiposity were, respectively, 2.43 (95% CI: 1.14; 5.19), 3.50 (95% CI: 1.66; 7.41) and 2.47 (95% CI: 1.01; 6.18) times more likely of having high SBP. Male adolescents with excess general adiposity were more likely of developing high diastolic blood pressure (OR: 3.31; 95% CI: 1.41; 7.70). Female adolescents with excess central and general adiposity were 4.15 (95% CI: 1.97; 8.77) and 3.30 (95% CI: 1.41; 7.77) times more likely of developing high diastolic blood pressure, respectively. Conclusion: Male adolescents with excess peripheral, central and general adiposity were more likely of having high systolic blood pressure and high diastolic blood pressure when presenting high general adiposity. In addition, female adolescents with high excess central and general adiposity were more likely of having high diastolic blood pressure.

Introdução: o excesso de adiposidade é um dos principais fatores de risco para doenças cardiovasculares, incluindo a hipertensão arterial. Crianças e adolescentes com obesidade e hipertensão apresentam maiores riscos de morbidez e mortalidade na vida adulta. Objetivo: analisar a associação entre excesso de adiposidade periférica, central e geral com pressão arterial (PA) elevada em adolescentes do Sul do Brasil. Método: estudo transversal com 1.132 adolescentes (16,50 ±1,14 anos) de ambos os sexos. As mensurações foram por método oscilométrico com esfigmomanômetro digital considerando como PA sistólica (PAS) e PA diastólica (PAD) elevadas, valores acima do percentil 95 para sexo e idade. A adiposidade periférica (dobra cutânea do tríceps) e central (dobra cutânea subescapular) foram classificadas em elevada a partir do percentil 90 da distribuição de referência do Centers for Disease Control and Prevention. Para excesso de adiposidade geral foram consideradas a dobra cutânea tricipital e subescapular acima do percentil 90, simultaneamente. Empregou-se regressão logística com nível de significância de 5%. Resultados: adolescentes do sexo masculino com adiposidade periférica, central e geral elevada apresentaram, respectivamente, 2,43 (IC95%: 1,14; 5,19), 3,50 (IC95%: 1,66; 7,41) e 2,47 (IC95%: 1,01; 6,18) vezes mais chances de PAS elevada. Adolescentes do sexo masculino com adiposidade geral elevada apresentaram maiores chances de desenvolver PAD elevada (OR: 3,31; IC95%: 1,41; 7,70). Adolescentes do sexo feminino com adiposidade central e geral elevada obtiveram 4,15 (IC95%: 1,97; 8,77) e 3,30 (IC95%: 1,41; 7,77) vezes mais chances de desenvolver PAD elevada, respectivamente. Conclusão: adolescentes do sexo masculino com adiposidade periférica, central e geral elevada tiveram mais chances de pressão arterial sistólica elevada e pressão arterial diastólica elevada quando apresentavam adiposidade geral elevada. Adolescentes do sexo feminino com adiposidade central e geral elevada apresentaram mais chances de pressão arterial diastólica elevada.

Comparison of bone parameters by body region in university athletes: systematic review / Comparación de parámetros óseos por región corporal en atletas universitarios: revisión sistemática / Comparação dos parâmetros ósseos por região corporal em atletas universitários: revisão sistemática

ABSTRACT Introduction: Bone mineral density (BMD) and bone mineral content (BMC) vary depending on the type of sport practiced and the body region, and their measurement can be an effective way to predict health risks throughout an athlete's life. Objective: To describe the methodological aspects (measurement of bone parameters, body regions, precision errors and covariates) and to compare BMD and BMC by body region (total body, upper limbs, lower limbs and trunk) among university athletes practicing different sports. Methods: A search was performed on the databases PubMed, Web of Science, Scopus, ScienceDirect, EBSCOhost, SportDiscus, LILACS and SciELO. Studies were selected that: (1) compared BMD and BMC of athletes practicing at least two different sports (2) used dual-energy X-ray absorptiometry (DXA) to assess bone parameters (3) focused on university athletes. The extracted data were: place of study, participant selection, participants' sex, sport practiced, type of study, bone parameters, DXA model, software used, scan and body regions, precision error, precision protocol, covariates and comparison of bone parameters between different sports by body region. Results: The main results were: 1) BMD is the most investigated bone parameter; 2) total body, lumbar spine and proximal femur (mainly femoral neck) are the most studied body regions; 3) although not recommended, the coefficient of variation is the main indicator of precision error; 4) total body mass and height are the most commonly used covariates; 5) swimmers and runners have lower BMD and BMC values; and 6) it is speculated that basketball players and gymnasts have greater osteogenic potential. Conclusions: Swimmers and runners should include weight-bearing exercises in their training routines. In addition to body mass and height, other covariates are important. The results of this review can help guide intervention strategies focused on preventing diseases and health problems during and after the athletic career. Level of evidence II; Systematic Review.

RESUMEN Introducción: La densidad mineral ósea (DMO) y el contenido mineral óseo (CMO) varían en función del deporte practicado y de la región corporal, y su medición puede ser una forma efectiva de predecir los riesgos para la salud a lo largo de la vida de un atleta. Objetivo: Describir los aspectos metodológicos (medición de parámetros óseos, regiones corporales, errores de precisión y covariables) y comparar la DMO y el CMO por región corporal (cuerpo total, miembros superiores, miembros inferiores y tronco) en atletas universitarios de diferentes deportes. Métodos: La búsqueda se realizó en las bases de datos PubMed, Web of Science, Scopus, ScienceDirect, EBSCOhost, SportDiscus, LILACS y SciELO. Se seleccionaron estudios que: (1) compararon la DMO y el CMO de atletas que practicaban al menos dos deportes; (2) utilizaron la absorciometría de rayos X de doble energía (DXA) para evaluar los parámetros óseos y (3) se centraron en atletas universitarios. Los datos extraídos fueron: ubicación del estudio, selección de los participantes, sexo de los participantes, deporte practicado, tipo de estudio, parámetros óseos, modelo de DXA, software utilizado, escaneo y regiones corporales, error de precisión, protocolo de precisión, covariables y comparación de parámetros óseos entre deportes por región corporal. Resultados: Los principales resultados fueron: 1) DMO como el parámetro óseo más investigado; 2) cuerpo total, columna lumbar y parte proximal del fémur (principalmente cuello femoral) como las regiones corporales más estudiadas; 3) aunque no se recomienda, el coeficiente de variación fue el principal indicador de error de precisión; 4) la masa corporal total y la altura fueron las covariables más utilizadas; 5) los nadadores y corredores presentan valores más bajos de DMO y CMO; 6) se especula un mayor potencial osteogénico en jugadores del baloncesto y gimnastas. Conclusiones: Los nadadores y corredores deben incluir ejercicios con pesas en su rutina de entrenamiento. Además de la masa corporal y la altura, otras covariables son importantes. Los resultados de esta revisión pueden guiar las estrategias de intervención centradas en la prevención de enfermedades y problemas de salud durante y después de la carrera deportiva. Nivel de evidencia II, Revisión Sistemática.

RESUMO Introdução: A densidade mineral óssea (DMO) e o conteúdo mineral ósseo (CMO) variam dependendo do esporte praticado e região corporal, e sua medição pode ser uma forma eficaz de prever riscos para a saúde ao longo da vida de um atleta. Objetivo: Descrever os aspectos metodológicos (mensuração dos parâmetros ósseos, regiões corporais, erros de precisão e covariáveis) e comparar a DMO e o CMO por região corporal (corpo total, membros superiores, membros inferiores e tronco) em atletas universitários de diferentes modalidades esportivas. Métodos: A busca foi realizada nos bancos de dados PubMed, Web of Science, Scopus, ScienceDirect, EBSCOhost, SportDiscus, LILACS e SciELO. Foram selecionados estudos que: (1) compararam a DMO e o CMO de atletas que praticam pelo menos dois esportes; (2) usaram absorciometria de raios X de dupla energia (DXA) para avaliar os parâmetros ósseos e (3) com foco em atletas universitários. Os dados extraídos foram local do estudo, seleção dos participantes, sexo dos participantes, esporte praticado, tipo de estudo, parâmetros ósseos, modelo DXA, software utilizado, varredura e regiões corporais, erro de precisão, protocolo de precisão, covariáveis e comparação de parâmetros ósseos entre esportes por região do corpo. Resultados: Os principais resultados foram: 1) DMO como parâmetro ósseo mais investigado; 2) corpo total, coluna lombar e parte proximal do fêmur (principalmente colo do fêmur) como as regiões corporais mais estudadas; 3) embora não seja recomendado, o coeficiente de variação foi o principal indicador de erro de precisão; 4) massa corporal total e estatura como covariáveis mais usadas; 5) nadadores e corredores têm valores mais baixos de DMO e CMO e 6) especula-se que jogadores de basquete e ginastas têm maior potencial osteogênico. Conclusões: Nadadores e corredores devem incluir exercícios de sustentação de peso na rotina de treinamento. Além da massa corporal e da estatura, outras covariáveis são importantes. Os resultados desta revisão podem ajudar a orientar estratégias de intervenção focadas na prevenção de doenças e problemas de saúde durante e depois da carreira esportiva. Nível de evidência II, Revisão sistemática.

Association between handgrip strength and bone mass parameters in HIV-infected children and adolescents. A cross-sectional study

ABSTRACT BACKGROUND: Low bone mineral content (BMC) and bone mineral density (BMD) have been identified in human immunodeficiency virus (HIV)-infected children and adolescents. The direct adverse effects of HIV infection and combined antiretroviral therapy (ART) negatively contribute to bone metabolism. A direct relationship between muscle strength levels and BMD in HIV-infected adults and older adults has been described. However, it is unknown whether handgrip strength (HGS) is associated with bone mass in pediatric populations diagnosed with HIV. OBJECTIVE: To ascertain whether HGS levels are associated with BMC and BMD in HIV-infected children and adolescents. DESIGN AND SETTING: Cross-sectional study conducted in Florianãpolis, Brazil, in 2016. METHODS: The subjects were 65 children and adolescents (8-15 years) diagnosed with vertically-transmitted HIV. Subtotal and lumbar-spine BMC and BMD were obtained via dual-emission X-ray absorptiometry (DXA). HGS was measured using manual dynamometers. The covariates of sex, ART, CD4+ T lymphocytes and viral load were obtained through questionnaires and medical records. Sexual maturation was self-reported and physical activity was measured using accelerometers. Simple and multiple linear regression were used, with P < 0.05. RESULTS: HGS was directly associated with subtotal BMD (β = 0.002; R² = 0.670; P < 0.001), subtotal BMC (β = 0.090; R² = 0.734; P = 0.005) and lumbar-spine BMC (β = 1.004; R² = 0.656; P = 0.010) in the adjusted analyses. However, no significant association was found between HGS and lumbar-spine BMD (β = 0.001; R² = 0.464; P = 0.299). CONCLUSION: HGS was directly associated with BMD and BMC in HIV-infected children and adolescents.

Impact of physical activity on fatigue and quality of life of cancer patients / Impacto da atividade física na fadiga e qualidade de vida de pacientes com câncer / Impacto de la actividad física en la fatiga y calidad de vida de pacientes con cáncer

ABSTRACT Introduction: Physical exercise has been considered an important non-pharmacological treatment for reducing tiredness, pain, low self-esteem and increases in body mass in individuals diagnosed with cancer. Objective: To verify the relationship between fatigue, quality of life and levels of physical activity in cancer patients undergoing chemotherapy. Methods: Observational, cross-sectional study. The sample consisted of 85 adult patients undergoing cancer treatment at a university hospital. Physical activity was assessed by the IPAQ, and fatigue and quality of life by the PFS and EORTC QLQ-C30 questionnaires, respectively. Student's t and the Fisher's Exact tests were used to identify differences between active and physically inactive patients for the variables fatigue and quality. Additionally, covariance analysis (ANCOVA) was used, in which simple (outcome and exposure) and adjusted models (age, time of diagnosis and type of cancer) were tested. Results: The study included 85 cancer patients, with a mean of 51.78 years of age (±11.72). Most were female and not physically active. Patients classified as physically inactive had higher scores for "total fatigue" (p=0.01), "behavioral" (p=0.01), "affective" (p=0.02) and psychological/sensory fatigue (p=0.04), compared to the physically active patients (p=0.01). Patients classified as physically not very active presented poorer quality of life in the dimensions: "overall" quality of life (p=0.05) and "functional" (p=0.04), "appetite" (p=0.02), "insomnia" (p=0.0 2), "diarrhea" (p=0.04), "fatigue" (p=0.01), "pain" (p=0.01) and "nausea" (p=0.03), when compared to the physically active patients in both analyses; simple and adjusted. Conclusion: The practice of physical activity during treatment can be a determining factor for increasing quality of life and reducing fatigue in cancer patients, minimizing the adverse effects of chemotherapy. Level of evidence II; retrospective study.

RESUMO Introdução: O exercício físico tem sido considerado um importante tratamento não farmacológico para diminuir a sensação de cansaço, as dores, a baixa autoestima e o aumento da massa corporal em indivíduos com diagnóstico de câncer. Objetivo: Verificar a relação entre fadiga, qualidade de vida e níveis de atividade física em pacientes oncológicos submetidos à quimioterapia. Métodos: Estudo observacional, transversal. A amostra foi composta por 85 pacientes adultos em tratamento oncológico em hospital universitário. A atividade física foi avaliada pelo IPAQ, a fadiga e a qualidade de vida, pelos questionários PFS e EORTC QLQ-C30, respectivamente. Foram empregados os testes t de Student e Exato de Fisher para identificar diferenças entre os pacientes fisicamente ativos e pouco ativos para as variáveis de fadiga e qualidade de vida. Adicionalmente, foi empregada a análise de covariância (ANCOVA) em que foram testados modelos simples (desfecho e exposição) e ajustados (idade, tempo de diagnóstico e tipo de câncer). Resultados: Participaram do estudo 85 pacientes com câncer e média de 51,78 anos de idade (± 11,72). A maioria era do sexo feminino e pouco ativa fisicamente. Pacientes classificados como fisicamente pouco ativos apresentaram maiores escores de "fadiga total" (p = 0,01), "comportamental" (p = 0,01), "afetiva" (p = 0,02) e fadiga psicológica/sensorial (p = 0,04), em comparação com pacientes fisicamente ativos (p=0,01). Os pacientes classificados como fisicamente pouco ativos tinham pior qualidade de vida nas dimensões: qualidade de vida "geral" (p = 0,05) e "funcional" (p = 0,04), "apetite" (p = 0,02), "insônia" (p = 0,02), "diarreia" (p = 0,04), "fadiga" (p = 0,01), "dor" (p = 0,01) e "náuseas" (p = 0,03) quando comparados com os pacientes fisicamente ativos, em ambas as análises, simples e ajustada. Conclusão: A prática da atividade física durante o tratamento pode ser um fator determinante para aumentar a qualidade de vida e reduzir a fadiga em pacientes com câncer, minimizando os efeitos adversos da quimioterapia. Nível de Evidência II; Estudo retrospectivo.

RESUMEN Introducción: El ejercicio físico ha sido considerado un importante tratamiento no farmacológico para disminuir la sensación de cansancio, los dolores, la baja autoestima y el aumento de la masa corporal en individuos con diagnóstico de cáncer. Objetivo: Verificar la relación entre fatiga, calidad de vida y niveles de actividad física en pacientes oncológicos sometidos a quimioterapia. Métodos: Estudio observacional, transversal. La muestra fue compuesta por 85 pacientes adultos en tratamiento oncológico en hospital universitario. La actividad física fue evaluada a través de IPAQ, la fatiga y la calidad de vida, por los cuestionarios PFS y EORTC QLQ-C30, respectivamente. Fueron empleados los tests t de Student y Exacto de Fisher para identificar diferencias entre pacientes físicamente activos y poco activos para las variables de fatiga y calidad de vida. Adicionalmente, fue empleado el análisis de covariancia (ANCOVA) en el que fueron testeados modelos simples (resultado y exposición) y ajustados (edad, tiempo de diagnóstico y tipo de cáncer). Resultados: Participaron en el estudio 85 pacientes con cáncer y promedio de 51,78 años de edad (± 11,72). La mayoría era del sexo femenino y poco activa físicamente. Los pacientes clasificados como físicamente poco activos presentaron mayor puntuación de "fatiga total" (p = 0,01), "comportamental" (p = 0,01), "afectiva" (p = 0,02) y fatiga psicológica/sensorial (p = 0,04), en comparación con pacientes físicamente activos (p = 0,01). Los pacientes clasificados como físicamente poco activos tenían peor calidad de vida en las dimensiones: calidad de vida "general" (p = 0,05) y "funcional" (p = 0,04), "apetito" (p = 0,02), "insomnio" (p = 0,02), "diarrea" (p = 0,04), "fatiga" (p = 0,01), "dolor" (p = 0,01) y "náuseas" (p = 0,03), cuando comparados con los pacientes físicamente activos en ambos análisis, simples y ajustados. Conclusión: La práctica de actividad física durante el tratamiento puede ser un factor determinante para aumentar la calidad de vida y reducir la fatiga en pacientes con cáncer, minimizando los efectos adversos de la quimioterapia. Nivel de Evidencia II; Estudio retrospectivo.

Prevalence of body image dissatisfaction and association with teasing behaviors and body weight control in adolescents

Abstract Aims: The objective was to estimate the prevalence and the factors of behaviors of provocation and control of the weight associated with dissatisfaction with the body image among adolescents. Methods: Cross-sectional study with 580 adolescents (11 to 17 years old) from Criciúma, Brazil. The body image was evaluated by the silhouettes scale and the behaviors of provocation and weight control by questionnaires. A multinomial logistic regression was used (p ≤ 0.05). Results: Of the total number of adolescents, 48.6% were dissatisfied with being overweight (male 47.9%, female 49.3%) and 22.9% dissatisfied with thinness (male 23.8%, female 22.1%). Male adolescents who were dissatisfied with being overweight were more likely to be joked and laughed at because of their appearance and lower chances of being nicknames due to their size or body weight, while those who were unsatisfied with being thin were more likely to joke and laughter because of the appearance, compared to satisfied. Female adolescents who were dissatisfied with being overweight were more likely to be laughed at because they were uncoordinated and without food for 24 h, while those who were unsatisfied with being thin were less likely to be joking and laughing because of their appearance and higher chances to be the targets of laughter because they are uncoordinated, compared to those that are satisfied. Conclusion: The dissatisfaction with body image was associated with different behaviors of provocation and weight control according to sex.

Association of flexibility with sociodemographic factors, physical activity, muscle strength, and aerobic fitness in adolescents from southern brazil / Associação da flexibilidade com fatores sociodemográficos, atividade física, força muscular e aptidão aeróbia em adolescentes do sul do brasil

ABSTRACT Objective: To identify sociodemographic, physical activity, and physical fitness factors associated with flexibility. Methods: Cross-sectional study with 909 adolescents (486 girls) aged 14 to 19 years from the city of São José, Santa Catarina, Brazil. To evaluate flexibility, we used the sit and reach test. Sociodemographic and physical activity data were collected by a self-administered questionnaire. We analyzed muscle strength with manual dynamometry. Aerobic fitness was assessed with the modified Canadian aerobic fitness test, and physical activity with a questionnaire. We used multiple linear regression to identify the variables associated with flexibility, with a significance level of 5%. Results: For each additional centimeter in the girls' levels of flexibility, the boys were 2.94 cm less flexible. In addition, the increment of 0.12 kg/force in muscle strength levels increased the levels of flexibility in 1 cm. Conclusions: Lower levels of flexibility were associated with male adolescents and with reduced strength levels.

RESMO Objetivo: Identificar os fatores sociodemográficos, de atividade física e da aptidão física associados à flexibilidade. Métodos: Estudo transversal com 909 adolescentes (486 meninas) de 14 a 19 anos da cidade de São José, Santa Catarina, Brasil. A flexibilidade foi avaliada por meio do teste de sentar e alcançar. Os dados sociodemográficos e de atividade física foram levantados por meio de questionário autoadministrado. A força muscular foi analisada por meio da dinamometria manual. A aptidão aeróbia foi analisada por meio do teste canadense modificado de aptidão aeróbia, enquanto a atividade física foi avaliada por questionário. Utilizou-se regressão linear múltipla para identificar as variáveis associadas à flexibilidade, com nível de significância de 5%. Resultados: Verificou-se que a cada centímetro a mais nos níveis de flexibilidade nas meninas, os meninos tiveram 2,94 cm a menos de flexibilidade. Ademais, o incremento de 0,12 kg/força nos níveis de força muscular aumentou em 1 cm os níveis de flexibilidade. Conclusões: Menores níveis de flexibilidade estiveram associados aos adolescentes do sexo masculino. Além disso, menores níveis de flexibilidade foram diretamente associados aos adolescentes que apresentavam menores níveis de força.

Diversity of parameters in the muscle strength evaluation of Brazilian school children and adolescents: a systematic review / Diversidade de parâmetros na avaliação da força muscular de crianças e adolescentes escolares brasileiros: revisão sistemática

Abstract Muscle strength (MS) is considered important indicative of global health regardless of age or clinical condition. The aim of this study was to summarize evidence from research carried out in Brazil that investigated MS in school children and adolescents, showing the objectives, tests, protocols and quantitative of youngsters who met the health criteria for MS. Systematic review conducted in the PubMed, Web of Science, Scopus, Sportdiscus, LILACS and Scielo databases, with complementary searches in reference lists. In all articles, the risk of bias was analyzed. Of the 15,609 articles initially identified, 27 were included, comprising data from 29,604 children and adolescents. The 27 studies included presented moderate (37%) and low risk of bias (63%). Three out of four studies investigating MS in children and adolescents were carried out in southern and southeastern Brazil (77.7%). It was found that 65.9% of boys and 58.2% of girls had adequate levels of MS for health, with results varying from 14.8% to 66.0% in girls and from 20.4% to 76.9% in boys. Several MS measurement protocols were identified; however, horizontal jump was the most used test to evaluate MS (59.2%). MS is a physical valence searched in children and adolescents and a variety of protocols are used. In addition, it is necessary to propose MS cutoff points based on health criteria for the accurate estimation of this physical valence in children and adolescents in Brazil.

Resumo A força muscular (FM) é considerada importante indicativo de saúde global independentemente da idade ou condição clínica. Objetivou-se sumarizar as evidências originárias de pesquisas realizadas no Brasil que investigaram FM em crianças e adolescentes escolares, evidenciando os objetivos, testes, protocolos e o quantitativo de jovens que atenderam os critérios de saúde para FM. Revisão sistemática conduzida nas bases de dados PubMed, Web of Science, Scopus, Sportdiscus, LILACS e Scielo, com buscas complementares em listas de referência. Em todos os artigos, o risco de viés foi analisado. Dos 15.609 artigos inicialmente identificados, 27 foram incluídos, compreendendo dados de 29.604 crianças e adolescentes. Os 27 estudos inclusos apresentaram moderado (37%) e baixo risco de viés (63%). Três a cada quatro estudos que investigaram FM em crianças e adolescentes foram provenientes de estados da região sul e sudeste do Brasil (77,7%). Foi encontrado que 65,9% de meninos e 58,2% de meninas apresentavam níveis adequados de FM para saúde, com resultados variando de 14,8% a 66,0% nas meninas e de 20,4% a 76,9% nos meninos. Diversos protocolos para mensurar FM foram identificados, contudo, o salto horizontal foi o teste mais empregado para avaliar a FM (59,2%). A FM é uma valência física pesquisada em crianças e adolescentes e uma variedade de protocolos são utilizados. Ainda, se faz necessário a proposição de pontos de corte para FM baseados em critérios de saúde para a acurada estimativa dessa valência física em crianças e adolescentes do Brasil.

Body image and anthropometric indicators in adolescents living with HIV / Imagem corporal e indicadores antropométricos emadolescentes vivendo com HIV

Abstract The aim of this study was to compare body image and anthropometric indicators among adolescents living with HIV and healthy adolescents (control group). In addition, we verified the associations of anthropometric indicators, infection/treatment, sexual maturity, and sociodemographic characteristics with body image in adolescents living with HIV. One hundred and eleven adolescents aged 10 to 15 years were divided into those living with HIV (n = 57) and a control group (n = 54). Body image was investigated using an eight-point body silhouette scale. Body weight, height, circumferences, and skinfolds were measured. Body image dissatisfaction was found in 54.4% of the adolescents living with HIV, with 38.6% of them wishing to increase their body size. Conversely, body image dissatisfaction was due to the desire to reduce body size in the control group (40.7%). No difference between the HIV and control groups was found for the anthropometric indicators analyzed. Gender (β = -0.52), age (β = 0.18), body weight (β = 0.07), body mass index (β = -0.19), and upper arm muscle area (β = -0.08) explained 42% of the variation in the body image score of adolescents living with HIV. Thinness is the main reason for body image dissatisfaction in adolescents living with HIV. Almost half the body dissatisfaction of adolescents living with HIV was explained by demographic and anthropometric variables.

Resumo Objetivou-se comparar a imagem corporal e os indicadores antropométricos entre adolescentes vivendo com HIV e sem o diagnóstico da infecção (grupo controle). Além disso, foram testadas associações entre variáveis antropométricas, infecção / tratamento, maturação sexual e sociodemográficas com a imagem corporal em adolescentes vivendo com HIV. Participaram 111 adolescentes com idade de 10 a 15 anos, divididos em adolescentes que vivem com HIV (n = 57) e controles (n = 54). A imagem corporal foi investigada a partir da escala de oito silhuetas corporais. As medidas antropométricas realizadas foram massa corporal, estatura, perímetros e dobras cutâneas. Foi encontrado que 54,4% dos adolescentes que vivem com o HIV estavam insatisfeitos com a imagem corporal, sendo que 38,6% indicaram insatisfação por magreza. Por outro lado, adolescentes do grupo controle demonstraram insatisfação com a imagem corporal por excesso de peso (40,74%). Não foi encontrada diferença entre o grupo HIV e controle para os indicadores antropométricos analisados. O sexo (β = -0,52), a idade (β = 0,18), a massa corporal (β = 0,07), o índice de massa corporal (β = -0,19) e a área muscular do braço (β = -0,08) explicaram 42% da variação do escore de imagem corporal em adolescentes que vivem com HIV. A insatisfação com a imagem corporal no grupo HIV é apontada pela magreza e no controle pelo excesso de peso. Quase metade da variação da imagem corporal dos adolescentes que vivem com HIV foram explicadas pelas variáveis demográficas e antropométricas.

Prevalence and factors associated with sedentary behavior in the school recess among adolescents

To estimate the prevalence of sedentary behavior in school recess and to verify sociodemographic factors (sex, age, economic level and type of school), anthropometric indicators (body mass index [BMI] and waist circumference) and lifestyle (level of physical activity and eating habits) associated with adolescents. Method: A cross-sectional study with 583 adolescents (aged 11-17 years), from the city of Criciúma, Brazil. Sedentary behavior during school recess was self-reported. Sociodemographic and lifestyle information was obtained through a self-administered questionnaire. BMI was calculated and waist circumference was measured. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (95% CI). Results: The prevalence of sedentary behavior during school recess was 50.6% (male 44.5%, female 56.7%). Adolescents aged 14-17 years (male [OR: 2.11, 95% CI: 1.26-3.53], female [OR: 2.52, 95% CI: 1.46-4.34]), from private schools (male [OR: 2.55, 95% CI: 1.49-4.37], female [OR: 2.15, 95% CI: 1.23-3.78]) were more likely to remain in sedentary behavior during school recess. Girls with high waist circumference (OR: 1.70; 95% CI: 1.01-2.84) and inadequate eating habits (OR: 2.12; 95% CI: 1.05-4.24) were more likely to remain in sedentary behavior during school recess. Conclusion: Half of the adolescents presented sedentary behavior during school recess. Adolescents from private schools and in the age group of 14-17 years and girls with high waist circumference and inadequate eating habits were more likely to remain in sedentary behavior during school recess.(AU)

Are traditional body fat equations and anthropometry valid to estimate body fat in children and adolescents living with HIV?

Abstract The aim of this study was to assess the validity of traditional anthropometric equations and to develop predictive equations of total body and trunk fat for children and adolescents living with HIV based on anthropometric measurements. Forty-eight children and adolescents of both sexes (24 boys) aged 7-17 years, living in Santa Catarina, Brazil, participated in the study. Dual-energy X-ray absorptiometry was used as the reference method to evaluate total body and trunk fat. Height, body weight, circumferences and triceps, subscapular, abdominal and calf skinfolds were measured. The traditional equations of Lohman and Slaughter were used to estimate body fat. Multiple regression models were fitted to predict total body fat (Model 1) and trunk fat (Model 2) using a backward selection procedure. Model 1 had an R2 = 0.85 and a standard error of the estimate of 1.43. Model 2 had an R2 = 0.80 and standard error of the estimate = 0.49. The traditional equations of Lohman and Slaughter showed poor performance in estimating body fat in children and adolescents living with HIV. The prediction models using anthropometry provided reliable estimates and can be used by clinicians and healthcare professionals to monitor total body and trunk fat in children and adolescents living with HIV.

ATIVIDADE FÍSICA E GORDURA CORPORAL DE ADOLESCENTES VIVENDO COM HIV: UM ESTUDO COMPARATIVO / PHYSICAL ACTIVITY AND BODY FAT IN ADOLESCENTS LIVING WITH HIV: A COMPARATIVE STUDY

RESUMO Objetivo: Comparar a atividade física habitual entre adolescentes que vivem com o vírus da imunodeficiência humana (HIV) e seus pares saudáveis e testar a relação com indicadores antropométricos de gordura corporal. Método: Estudo transversal, com dois grupos de investigação, composto por 57 adolescentes (10-15 anos) com HIV e 54 adolescentes aparentemente saudáveis, pareados por sexo e idade. Medidas antropométricas foram realizadas e a atividade física habitual foi obtida por um questionário aplicado em entrevista. Os grupos foram comparados de acordo com os exercícios físicos e foi testada a correlação linear e correlação parcial (ajustada por sexo e idade) entre atividade física e os indicadores antropométricos. Resultados: Adolescentes que vivem com HIV apresentaram menor escore total de atividade física, comparados aos pares saudáveis (1,73 versus 2,14; p<0,001); porém tiveram maior participação nas práticas de educação física escolar. Ambos os grupos praticaram futebol e caminhadas mais frequentemente, entre as atividades físicas relatadas. Não houve correlação entre o escore total de atividade física e os indicadores antropométricos de gordura corporal, quando ajustado por sexo e idade. As variáveis sexo feminino (β=21,51), meses de exposição à terapia antirretroviral (β=1,26) e as classes econômicas “B” e “C” (β= 22,05 e β=28,15, respectivamente) explicaram 33% do somatório de dobras cutâneas de adolescentes que vivem com HIV (F=6,70; p<0,001). Conclusões: Adolescentes com o HIV têm menor escore de atividade física comparados aos pares saudáveis, porém a educação física escolar se mostrou um espaço favorável para o aumento dessa prática.

ABSTRACT Objective: To compare regular physical activity among adolescents living with human immunodeficiency virus (HIV) with their healthy peers, and to evaluate the relationship with anthropometric indicators of body fat. Methods: This was a cross-sectional study which investigated two groups: 57 adolescents (10-15 years of age) living with HIV, and 54 apparently healthy adolescents matched for sex and age. Physical activity was evaluated using a questionnaire and anthropometric measurements were performed. The groups were compared in terms of physical activity, and the linear and partial correlations (adjusted for age and sex) between physical activity and the anthropometric indicators were tested. Results: Adolescents living with HIV had a lower total activity score than their healthy peers (1.73 versus 2.14; p<0.001), but participated more frequently in physical education activities. Soccer and walking were the physical activities most frequently reported by adolescents of the two groups. No correlation was observed between total physical activity score and anthropometric indicators of body fat when adjusted for sex and age. Female gender (β=21.51), months of exposure to antiretroviral therapy (β=1.26), and socioeconomic classes B and C (β=22.05 and 28.15, respectively) explained 33% of the sum of skinfolds in adolescents living with HIV (F=6.70; p<0.001). Conclusions: Adolescents living with HIV have lower physical activity scores compared with their healthy peers, but physical education was found to be an opportunity to increase physical activity.

Comparison of three criteria for overweight and obesity classification among adolescents from southern Brazil

AIM: To estimate the prevalence of the classifications of overweight and obesity in adolescents according to three criteria for nutritional status classification (Conde & Monteiro, International Obesity Task Force - IOTF and Word Health Organization - WHO), and to investigate whether sociodemographic factors associated with overweight and obesity differ among the three criteria. METHOD: cross-sectional study with 1,132 adolescents (14-19 years old) living in Brazil. Body Mass Index (BMI) was classified according to three criteria for nutritional status. A self-administered questionnaire was used to collect sociodemographic information. Sexual maturation was measured by self-reported Tanner stage ratings. Multinomial logistic regression was used to estimate the Odds Ratio and 95% confidence intervals. RESULTS: The prevalence of the classification "overweight" (from here on referred to simply as "overweight") was 23.1% for WHO; 23.7% for Conde Monteiro criteria: and 19.2% for IOTF. Both boys and girls aged 17-19 were more likely to be overweight using the WHO and Conde & Monteiro criteria than those using the IOTF criteria. Girls in the post-pubertal maturational stage were less likely of being overweight or obese using the three criteria. CONCLUSION: The three criteria result in different prevalence measures, with WHO and Conde and Monteiro criteria being more approximate in terms of prevalence and correlated factors when compared to IOTF criteria.

Association between different contexts of physical activity and abdominal obesity and excess weight in adolescents

Abstract Aim: To investigate the association between different contexts of physical activity (school commuting, participation in Physical Education classes, school recess, physical activity to improve muscular strength / endurance and overall physical activity) with abdominal obesity and excess weight in adolescents. Method: Cross-sectional study with 1,132 adolescents (14-19 years), enrolled in public schools in São José, Brazil. Information regarding the contexts of physical activity was obtained through questionnaires. The anthropometric indicators used to identify excess weight and abdominal obesity were body mass index (BMI) and waist circumference (WC). Binary logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (95% CI). Results: Adolescents who actively commuted to school for 10 minutes or longer were 36% less likely (OR: 0.64, 95% CI: 0.58 a 0.71) of having abdominal obesity investigated by WC and 25% less likely (OR: 0.75, 95% CI: 0.65 a 0.86) of having excess weight investigated by means of BMI. The other physical activity contexts were not associated with anthropometric indicators. Conclusion: Active commuting to school was associated with lower odds of having abdominal obesity and excess weight in adolescents. Thus, active commuting to school can be an alternative for maintaining adequate levels of body composition.