Prevalence of metabolic syndrome in adolescents based on three diagnostic definitions: a cross-sectional study

ABSTRACT Objective: There is no consensus as to the best criterion for the evaluation of metabolic syndrome (MS), impairing the estimation of its prevalence. This study aims to compare MS estimates using three recommended definitions for adolescents based on a cross-sectional study nested in the Consortium of Brazilian Birth Cohorts in São Luís, Maranhão. Subjects and methods: A total of 2,515 adolescents aged between 18 and 19 years were evaluated. The criteria of International Diabetes Federation (IDF) and National Cholesterol Education Program Panel III (NCEP-ATP) modified by Cook and cols. (2003) and De Ferranti and cols. (2004) defined SM. To compare the estimates of MS prevalence, the chi-square, Fisher's exact and Cohen's Kappa index tests were used. Results: Among the 2,064 participants evaluated in the final sample. The prevalence of MS ranged from 4.2% (95% CI: 3.3-5.1) to 10.2% (95% CI: 8.8-11.4). When comparing the estimates of MS prevalence in the total sample and by sex, a statistically significant difference was observed. The agreement between the criteria ranged from 0.42 (CI 95%: 0.35-0.49) to 0.55 (CI 95%: 0.48-0.62) in the total sample, 0.33 (CI 95%: 0.24-0.42) to 0.59 (95%CI: 0.47-0.71) among boys and 0.39 (95% CI: 0.26-0.52) to 0.54 (95% CI: 0.44-0.64) among girls. Conclusion: Different criteria provide different estimates for the prevalence of MS in adolescents, reflecting the importance of establishing a consensus.

Consumo de frutas, verduras e legumes por gestantes adolescentes / Consumption of fruits, green vegetables and legumes by pregnant adolescents / Consumo de frutas, verduras y legumbres de adolescentes embarazadas

Objetivo: Determinar o estado nutricional e os fatores associados ao consumo alimentar de frutas, verduras e legumes por gestantes adolescentes atendidas em um serviço público de referência para assistência pré-natal. Métodos: Estudo transversal e analítico, com 73 gestantes adolescentes de 10 a 19 anos, atendidas no Núcleo de Assistência ao Adolescente (NASA) do Hospital Materno Infantil, em São Luís, Maranhão. Utilizou-se o Questionário de Frequência de Consumo Alimentar (QFCA), medidas antropométricas (peso, altura, índice de massa corporal - IMC - pré-gravídico e gravídico) e questionário socioeconômico. As variáveis dependentes foram o consumo de frutas, verduras e legumes, e as independentes foram escolaridade, estado civil, raça, renda, situação demográfica, dados gestacionais e antropométricos. Resultados: Observou-se que 39,7% apresentaram IMC pré-gestacional de desnutrição, 50,7% de eutrofia, e menos de 10% sobrepeso ou obesidade. Para o IMC gestacional, os valores se alteraram, com 27,4% das gestantes desnutridas, 57,5% eutróficas e 15,1% com sobrepeso. Observou-se que os maiores percentuais de adequação para o consumo de frutas, verduras e legumes foram em adolescentes casadas ou em união estável (65,4%), que não trabalhavam (92,3%) e com renda familiar menor que 1 salário mínimo (84,62%). Entretanto, a única associação positiva encontrada com o consumo de frutas, verduras e legumes foi o início do pré-natal. Conclusão: A maior parte das gestantes avaliadas apresentou-se eutrófica, apesar de cerca de um quarto apresentar baixo peso durante a gestação. Além disso, elas não consumiam uma dieta balanceada, com uma ingestão abaixo do recomendado de FVL. Entre os fatores relacionados a um melhor consumo de FVL destaca-se o início do acompanhamento pré-natal no primeiro trimestre.

Objective: To determine the nutritional status and the factors associated with dietary intake of fruits, green vegetables and legumes by pregnant adolescents attending a public service of reference for prenatal care. Methods: Analytical cross-sectional study, with 73 pregnant adolescents aged between 10 and 19 years, attended to at the Service Center for Adolescents (NASA) of the Mother and Child Hospital, in São Luís, Maranhão. The study used the Food Frequency Questionnaire (FFQ), anthropometric measurements (weight, height, pregravid and gestational body mass index), and a socioeconomic questionnaire. The dependent variable was the consumption of fruits, green vegetables and legumes, and the independent variables were level of education, civil status, race, income, demographic status, pregnancy and anthropometric data. Results: It was observed that 39.7% had pregravid BMI of malnutrition, 50.7% were eutrophic, and less than 10% were overweight or obese. For the gestational BMI, the values changed, with 27.4% of undernourished pregnant women, 57.5% eutrophic and 15.1% overweight. The highest percentages of adequacy for consumption of fruits, green vegetables and legumes were observed in adolescents who were married or in a stable union (65.4%), did not work (92.3%), and had family income below one minimum wage (84.62%). However, the only positive association found with the consumption of fruits, green vegetables and legumes was the beginning of prenatal care. Conclusion: Themajor part of the evaluated pregnant adolescents was eutrophic, although about one fourth presented low weight during pregnancy. Moreover, they did not consume a balanced diet, with an intake of fruits, green vegetables and legumes below the recommended. Among the factors related to better consumption of these foods, the beginning of prenatal follow-up in the first trimester stands out.

Objetivo: Determinar el estado nutricional y los factores asociados al consumo alimentario de frutas, verduras y legumbres por adolescentes embarazadas asistidas en un servicio público de referencia para asistencia prenatal. Métodos: Estudio transversal y analítico con 73 embarazadas adolescentes entre 10 y 19 años asistidas en el Núcleo de Asistencia al Adolescente (NASA) del Hospital Materno Infantil de São Luís, Maranhão. Se utilizó el Cuestionario de Frecuencia de Consumo Alimentario (QFCA), las medidas antropométricas (peso, altura, índice de masa corporal - IMC - pre-gravidico y gravidico) y cuestionario socioeconómico. Las variables dependientes fueron el consumo de frutas, verduras y legumbres y las independientes fueron la escolaridad, el estado civil, la raza, la renta, la situación demográfica, los datos de la gestación y antropométricos. Resultados: Se observó que el 39,7% presentaron IMC pre-gestacional de desnutrición, el 50,7% de eutrofia y menos del 10% de sobrepeso u obesidad. Los valores se alteraron para el IMC gestacional con el 27,4% de las embarazadas desnutridas, el 57,5% de eutróficas y el 15,1% de sobrepeso. Se observó que los mayores porcentuales de adecuación para el consumo de frutas, verduras y legumbres fueron en adolescentes casadas o con pareja de hecho (65,4%), que no trabajaban (92,3%) y tenían renta familiar menor que 1 sueldo mínimo (84,62%). Sin embargo, la única asociación positiva encontrada con el consumo de frutas, verduras y legumbres fue el inicio del prenatal. Conclusión: La gran mayoría de las embarazadas evaluadas estaba eutrófica aunque el alrededor de un cuarto de ellas tuvo bajo peso durante el embarazo. Además, ellas no tenían una dieta balanceada con una ingestión abajo del recomendado de FVL. De entre los factores relacionados al mejor consumo de FVL se destaca el inicio del seguimiento del prenatal en el primer trimestre.