Risco psicossocial familiar, coping do tratamento da obesidade infantil e controle parental da alimentação / Family psychosocial risk, coping with child obesity treatment and parental feeding control

Este estudo analisou variáveis parentais relacionadas ao tratamento do sobrepeso/obesidade de crianças em tratamento ambulatorial, como o controle alimentar, estressores e enfrentamento (coping) da doença, e risco psicossocial familiar. Dezenove cuidadores responderam os instrumentos: Caracterização do Participante, Entrevista de Coping Parental, Psychosocial Assessment Tool 2.0 (PAT 2.0) e Comprehensive Feeding Practices Questionnaire (CFPQ). A maioria das famílias apresentou risco psicossocial médio-alto (Alvo = 52,6%; Clínico = 21,1%) e as práticas parentais de controle alimentar mais comuns foram o Incentivo ao Equilíbrio e à Variedade de alimentos, e a Restrição da alimentação. O controle alimentar é o maior estressor para os cuidadores, que reagem com raiva e tristeza, apesar de apresentarem um coping mais adaptativo. Os resultados indicam a necessidade de intervenções específicas para essa população em risco.

This study evaluated parental variables involved in the outpatient treatment of overweight/obese children, in variables included food control, stressors and coping, as well as family psychosocial risk. Nineteen caregivers filled out instruments such as Participant Characterization, Parental Coping Interview, Psychosocial Assessment Tool 2.0 (PAT 2.0) and Comprehensive Feeding Practices Questionnaire (CFPQ). Most families showed medium-high psychosocial risk (Targeted = 52.6%, Clinical = 21.1%) and the most common parental practice of food control was to Encourage Balance and Variety, and the Restriction of food. Food control is the major stressor for caregivers, who react with anger and sadness, despite having a more adaptive coping. The results indicate the need for specific interventions for this population at risk.

Acanthosis Nigricans: A Marker Of Metabolic Syndrome Among Obese Children

xThis was a prospective case controlled study to determine the association of Acanthosis Nigricans (AN) and Metabolic Syndrome (MS) in obese children 10–16 years of age. We recruited 50 obese children with AN (cases) and 50 obese children without AN (controls) attending the Pediatric OPD from May 2013 to August 2014 after obtaining informed consent from their parents. Children were defined as obese if their BMI was ≥ 95th percentile for age and sex (CDC). International Diabetes Federation (IDF) 2007 criteria were used to define MS. Detailed history, physical examination, anthropometry and blood sampling were done in each case. Samples for High Density Lipoprotein Cholesterol (HDL-C), Fasting Plasma Glucose (FPG) and Triglycerides (TG) were evaluated at the in-hospital NABL certified SRL laboratory. MS was found in 64% of obese children with AN as compared to 30% of obese children without AN which was highly significant. Therefore, AN is a significant marker of MS.

Translation and Cross-Cultural Adaptation of a Brazilian Version of the Child Feeding Questionnaire / Tradução e Adaptação Transcultural da Versão Brasileira do Questionário de Alimentação da Criança / Traducción y Adaptación Cultural de la Versión Brasileña del Cuestionario de la Alimentación del Niño

Abstract: The Child Feeding Questionnaire (CFQ) assesses parental attitudes, beliefs and practices about child feeding and obesity proneness. This research aimed to translate and to test the reliability of the CFQ and to evaluate this instrument in Brazilian families. The participants were 300 mothers and 300 children, aging from 2 to 11 years old, of both sexes. The translation, synthesis, back-translation, evaluation by an expert committee and pre-test were performed. Besides the application of questionnaire to mothers, data regarding anthropometric measurements in mothers and children was collected. The indexes of content validity index, test-retest reliability and internal consistencies were good. The parental factors Perceived parent weight, Perceived child weight, Concern about child weight, Restriction, Pressure to eat and Monitoring on child feeding were associated with overweight in childhood. In conclusion, these results highlight the validity and utility of the Brazilian version of the CFQ.

Resumo: O Questionário de Alimentação da Criança (QAC) avalia as crenças, atitudes e práticas dos pais em relação a alimentação e a propensão à obesidade dos filhos. Este estudo objetivou traduzir e testar a fidedignidade do QAC e avaliar este instrumento em famílias brasileiras. Os participantes foram 300 mães e 300 crianças, de 2 a 11 anos, de ambos os sexos. Realizou-se a tradução, síntese, retro-tradução, avaliação por comitê de especialistas e pré-teste.Para além da aplicação do questionário às mães, foram também recolhidos dados realtivos à avaliação antropométrica das mães e filhos. Os índices de validade de conteúdo, confiabilidade teste-reteste e consistência interna foram adequados. Os fatores Percepção do peso dos pais, Percepção do peso da criança, Preocupação com o peso da criança, Restrição, Pressão para comer e Monitoramento mostraram-se associados com a obesidade infantil. Em conclusão, esses resultados destacam a validade e a utilidade da versão brasileira do CFQ.

Resumen: El Cuestionario de Alimentación Infantil (acrónimo en inglés CFQ) evalúa las creencias, actitudes y prácticas de los padres con relación al poder y la propensión a la obesidad de los niños. Este estudio tuvo como objetivo traducir y poner a prueba la fiabilidad del CFQy evaluar este instrumento en las familias brasileñas. Los participantes fueron 300 madres y 300 niños, 2-11 años, de ambos géneros. La traducción, síntesis, retro traducción, evaluación por el comité de expertos y pre-test se llevaron a cabo. Además de la aplicación del cuestionario, también fueron recolectados datos relativos a la evaluación antropométrica de las madres y los niños. Los índices de validez de contenido, fiabilidad test-retest y consistencia interna fueron adecuados. Los factores Percepción del peso de los padrea, Percepción del peso del hijo, Preocupación con el peso del niño, Restricción, Presión para comer y Monitoreo estaban asociados con la obesidad infantil. En conclusión, estos resultados ponen de manifiesto la validez y utilidad de la versión brasileña del CFQ.

Contribuições da clínica da parentalidade no atendimento de um caso de obesidade infantil / Contributions of the clinic of parentality in the psychological treatment of a child obesity case / Contribuciones de la clínica de la parentalidad en un caso de obesidad infantil

Estudos a respeito da obesidade indicam que, para além de questões genéticas, seu surgimento pode estar associado às primeiras relações interpessoais. O presente artigo tem como objetivo discutir as contribuições que a clínica da parentalidade pode trazer para o tratamento da obesidade infantil a partir de recortes de um caso clínico. Para tanto, será apresentado o conceito de parentalidade, sua derivação clínica e questões da contemporaneidade que interferem no processo de se tornar pai e mãe. A interpretação do material clínico revelou que o comportamento de comer compulsivo da criança estava relacionado à fragilização parental, em acordo com os dados da literatura. Assim, trabalhar no contexto da clínica da parentalidade pode favorecer a melhora do sintoma na medida em que liberta a criança de um legado inenarrável e fortalece tanto o lugar subjetivo da criança quanto as funções parentais. Além disso, nos casos necessários, pode contribuir para a construção de uma demanda para terapia familiar.

Studies about obesity show that, in addition to possible genetic constitution, its appearance may be associated with early interpersonal relationships. This paper aims to discuss, through clips of a clinical case, contributions that the clinic of parentality may have for the treatment of infantile obesity. For this purpose, the concept of parentality, its clinical derivation and issues related to contemporaneity which interfere in the process of becoming a mother and a father will be introduced. The interpretation of the clinical material revealed that the child behavior of eating compulsively was related to parental fragility, according to the scientific literature. Thus, working in the context of the clinic of parentality may favor relieving of the symptom as it releases the child of an unspeakable legacy and strengthens its subjective position and parental functions. Furthermore, when necessary, it's possible to contribute for bringing up a demand for family therapy.

Estudios con respeto a la obesidad indican que, además de cuestiones genéticas, su surgimiento puede estar asociado a las primeras relaciones interpersonales. El presente artículo tiene por objetivo discutir las contribuciones que la clínica de la parentalidad puede traer para el tratamiento de la obesidad infantil, a partir de recortes de un caso clínico. Para tanto, será presentado el concepto de parentalidad, su derivación clínica y cuestiones de la contemporaneidad que interfieren en el proceso de tornarse padre y madre. La interpretación del material clínico reveló que el comportamiento de comer compulsivo del niño estaba relacionado a la fragilidad parental, de acuerdo con los datos de la literatura. Así, trabajar en el contexto de la clínica de la parentalidad puede favorecer la mejora del síntoma en la medida en que liberta el niño de un legado inenarrable y fortalece tanto el lugar subjetivo del niño como las funciones parentales. Además, en los casos en que es necesario, pueden contribuir para la construcción de una demanda para terapia familiar.

Nem só de pão se vive: a voz das mães na obesidade infantil / One does not live of bread only: the mothers' voice in the child's Obesity / No solo de pan se vive: la voz de las madres en la obesidad infantil

A obesidade infantil tornou-se uma preocupação mundial e de saúde pública. Sabe-se que existem diversos fatores que predispõem à doença (biológicos, econômicos, pessoais, socioculturais e familiares), porém, nesta pesquisa, o objetivo geral foi compreender os elementos presentes na história familiar de crianças com obesidade. Participaram seis mães e uma avó de crianças, na faixa etária entre oito a dez anos incompletos, que se encontravam em atendimento em um ambulatório de referência para obesidade infantil. Foi utilizada uma entrevista com roteiro previamente estabelecido e, posteriormente, os resultados foram analisados com base na análise de conteúdo temática. Pode-se concluir que as famílias apresentaram falta de coesão acerca das normas alimentares e de limites à criança, conflitos conjugais e familiares e dificuldades em adequar o ambiente às recomendações solicitadas pelos profissionais.

Childhood obesity has become a global and a public health concern. Although we are aware that there are several factors that predispose to the disease (biological, economic, personal, social, cultural and familial), the general objective of this research was focused on understanding the elements present in children with a family history of obesity. The participants were six mothers and one grandmother of children aged between 8-10 years old, who were in attendance in an outpatient clinic of reference for childhood obesity in Recife. An interview with previously established routine was used, and later the results were analyzed based on the thematic content analysis. It can be concluded that the families showed lack of cohesion about the food standards and limits to the child, familial and conjugal conflicts, and difficulties in adapting the environment to the assistance requested by the professionals.

La obesidad infantil se volvió una preocupación mundial y de salud pública. Se sabe que existen diversos factores que predisponen a la enfermedad (biológicos, económicos, personales, socioculturales y familiares), sin embargo, en esta investigación, el objetivo general fue comprender los elementos presentes en la historia familiar de niños con obesidad. Participaron seis madres y una abuela de niños, con edades entre ocho a diez años aún no completados, que se encontraban en servicio en una clínica de referencia para obesidad infantil. Fue utilizada una entrevista con un guión previamente establecido y, posteriormente, los resultados fueron analizados con base en el análisis del contenido temático. Se puede concluir que las familias presentaron falta de cohesión acerca de las normas alimenticias y de límites al niño, conflictos conyugales y familiares y dificultades en adecuar el ambiente a las recomendaciones solicitadas por los profesionales.

Incidence and Complications of Obesity in Pubescent School Children

PURPOSE: In recent years, obesity in children has become one of the major nutritional problems, and the trend is that number of obese children is increasing. The purpose of this research is to examine the incidence of obesity in pubescent school children in Seoul and Cheju, and to analyze body fat component, complications and eating habits of those obese children in order to obtain basic information for prevention of obesity in children in the future. METHODS: The total number of 4,555 junior high school students from 4 schools consisting of 1,234 boys and 3,321 girls were examined based on their height and weight. For those children, obesity index was calculated based on the 50th percentile obtained from standard weight for height of children proposed by the Korean Pediatric Association in 1985. The body fat component was measured and compared between 275 children of 530 obese children(11.6%) and 275 children from the control group by Futrex-5000 A body fat and fitness computer. Of those children, oral glucose tolerance test, blood pressure, and biochemical studies were performed on 31 children whose follow-up was possible, and their exercise load and eating habits were examined. RESULTS: It was found that 11.6% of the subject children were obese, which consisted of 12.4% in boys and 11.4% in girls. The study showed 11.4% obesity ratio in Seoul and 13.2% obesity ratio in Cheju, but the difference was insignificant. Percents of bodyfat was 25.3+/-5.7% (mean+/-SD) for control group, 32.9+/-4.8% for mild obesity group, 35.6% for moderate obesity group, and 37.2+/-4.0% for severe obesity group. The morbidity of complications of those 31 children whose follow-up was possible showed the highest percentage of 29.0% in hyperlipidemia, and lower percentage in hypertension, elevated AST and/or ALT, glucose intolerance, diabetes, respectively. The eating habit analysis showed the total calorie intake/total energy expenditure ratio of 1.10 which is higher in calories than energy consumption, and the food intake evaluation showed that 23.3% of fat was contained in total calorie intake. CONCLUSIONS: The childhood obesity becomes the primary cause of adult obesity, hypertension and diabetes, and therefore, eating habits and exercise load should be carefully observed in order to prevent childhood obesity. In addition to the health care provided currently by schools, regular physical check-up should undertaken for early diagnosis to conduct appropriate tests and treatment.