Direct costs for outpatient excess body weight treatment in Brazilian children and adolescents attending a public children's hospital

Abstract Objective: To estimate the direct costs of treating excess body weight in children and adolescents attending a public children's hospital. Methods: This study analyzed the costs of the disease within the Brazilian Unified Health System (SUS) for 2,221 patients with excess body weight using a microcosting approach. The costs included operational expenses, consultations, and laboratory and imaging tests obtained from medical records for the period from 2009 to 2019. Healthcare expenses were obtained from the Table of Procedures, Medications, Orthoses/Prostheses, and Special Materials of SUS and from the hospital's finance department. Results: Medical consultations accounted for 50.6% (R$703,503.00) of the total cost (R $1,388,449.40) of treatment over the period investigated. The cost of treating excess body weight was 11.8 times higher for children aged 5-18 years compared to children aged 2-5 years over the same period. Additionally, the cost of treating obesity was approximately 4.0 and 6.3 times higher than the cost of treating overweight children aged 2-5 and 5-18 years, respectively. Conclusion: The average annual cost of treating excess body weight was R$138,845.00. Weight status and age influenced the cost of treating this disease, with higher costs being observed for individuals with obesity and children over 5 years of age. Additionally, the important deficit in reimbursement by SUS and the small number of other health professionals highlight the need for restructuring this treatment model to ensure its effectiveness, including a substantial increase in government investment.

Organização, gestão e cuidado nutricional de pessoas com sobrepeso e obesidade na Atenção Primária à Saúde / Organization, management and nutritional care of overweight and obesity people in Primary Health Care

Objetivo: Avaliar a organização, gestão e o cuidado nutricional ofertado às pessoas com sobrepeso e obesidade na Atenção Primária à Saúde (APS). Métodos: Trata-se de um estudo transversal realizado com 54 profissionais da Atenção Primária à Saúde da cidade de Goiânia-GO. Os dados foram obtidos por meio do questionário eletrônico semiestruturado e autoaplicável. Resultados: Os profissionais participantes eram enfermeiros 88,9%, e com mais de cinco anos na função atual 79,6%. Ao analisar a infraestrutura e mobiliário, apenas 11,1% relataram cadeiras e bancos adequados, 33,3% acessibilidade física. O mapeamento do território foi referido por 51,8% dos profissionais. As principais estratégias para organização do cuidado e tratamento foram: central de regulação 79,6%, referência e contrarreferência 77,8%. Conclusão: Os resultados deste estudo refletem que a APS em Goiânia-GO, está em processo de implantação da gestão e cuidado nutricional que atendam às políticas públicas previstas para a prevenção e manejo do sobrepeso e obesidade.

Objective: To evaluate the organization, management, and nutritional care offered to overweight and obese individuals in primary healthcare (PHC) centers. Methods: A cross-sectional study was conducted with 54 professionals from PHC in the city of Goiânia-GO. Data were obtained using a semi-structured, self-administered electronic questionnaire. Results: The participating professionals were predominantly nurses (88.9%) with more than five years in their current position (79.6%). Regarding office infrastructure, including seating, only 11.1% reported adequate chairs and benches, while 33.3% reported adequate physical accessibility. Territory mapping was reported by 51.8% of professionals. The main strategies for organizing care and treatment were central regulation (79.6%), and referrals and counter-referrals (77.6%). Conclusion: The results of this study reflect that PHC in Goiânia-GO is in the process of implementing management services and nutritional care that meet the public policy standards envisaged for the prevention and management of overweight conditions and obesity.

Effects of a Multi-professional Intervention on Quality of Life of Women with Overweight or Obesity Post-Covid-19: A Pragmatic Trial

Obesity is a global Non-Communicable Chronic Disease (NCD) associated with various comorbidities and a high mortality rate. This scenario has increasingly affected the female population, leading to a rise in prevalence and related health issues. Therefore, the present study aimed to assess the health-related quality of life of women with overweight or obesity and symptoms of COVID-19 using a multi-professional intervention model. This research was conducted as a parallel group and repeated measures pragmatic trial, in which 28 participants aged between 25 and 65 were allocated into two groups: experimental (intervention group) and control (non-intervention participants). The Body Mass Index (BMI) was (30.5 ± 5.45 kg/m²) in the Experimental Group, and the Control Group was (31 ± 8.2 kg/m2). The 12-Item Health Survey (SF-12) questionnaire was applied to assess the quality of life in the physical and mental domains of COVID-19 survivors with different symptom severities (mild, moderate, severe) compared to the control group. At the end of the program, 28 participants finished the study (15 from the experimental group and 13 from the control group). The results indicated a significant improvement in the mental health domain only in the experimental group after the intervention period (p 0.05). Considering these findings, multi-professional actions emerge as a crucial component for enhancing the quality of life, particularly within mental health, during the 16-week intervention period.

La obesidad es una Enfermedad Crónica No Transmisible (ECNT) global asociada a diversas comorbilidades y una alta tasa de mortalidad. Este escenario ha afectado cada vez más a la población femenina, lo que ha llevado a un aumento en la prevalencia y problemas de salud relacionados. El presente estudio tiene como objetivo evaluar la calidad de vida relacionada con la salud de mujeres con sobrepeso u obesidad y síntomas de COVID-19 mediante un modelo de intervención multiprofesional. Esta investigación se llevó a cabo como un ensayo pragmático de grupos paralelos y medidas repetidas, en el que 48 participantes con edades comprendidas entre 25 y 65 años fueron alocadas en dos grupos: experimental (participantes de la intervención) y control (participantes de la no intervención). En el grupo experimental el Índice de Masa Corporal (IMC) fue de (30,5 ± 5,45 kg/m²). En el grupo control, el IMC fue (31 ± 8,2 kg/m²). Se utilizó el cuestionario de 12-Item Health Survey (SF-12) para evaluar la calidad de vida en los dominios físico y mental de las sobrevivientes de COVID-19 con diferentes grados de gravedad de síntomas (leves, moderados, graves) en comparación con el grupo de control (participantes que no recibieron intervenciones). Al final del programa, 28 participantes terminado el estudio (15 participantes de la intervención y 13 sin intervención). Los resultados indicaron una mejora significativa en el dominio de la salud mental solo en el grupo experimental después del período de intervención (p 0.05). A la luz de estos hallazgos, la rehabilitación multiprofesional emerge como un componente crucial para mejorar la calidad de vida, especialmente en el ámbito de la salud mental durante el período de intervención de 16 semanas.

A obesidade é uma Doença Crônica Não-Transmissível (DCNT) com alcance mundial, associada a diversas comorbidades e alta taxa de mortalidade. Esse quadro tem afetado cada vez mais o público feminino, com aumento da prevalência e doenças correlatas. O objetivo deste estudo foi avaliar a qualidade de vida relacionada à saúde de mulheres com sobrepeso ou obesidade com sintomas da COVID-19 utilizando um modelo de intervenção multiprofissional. Esta pesquisa foi conduzida como um ensaio pragmático de grupos paralelos e medidas repetidas, no qual 28 participantes de idade entre 25 a 65 anos foram distribuídas em dois grupos: experimental (participantes das intervenções) e controle (não participantes das intervenções). No grupo experimental o Índice de Massa Corporal (IMC) foi de (30,5 ± 5,45 kg/m²) e no grupo controle, IMC foi de (31 ± 8,2 kg/m²). Utilizou-se o questionário 12-Item Health Survey (SF-12) para analisar a qualidade de vida nos domínios físico e mental das sobreviventes da COVID-19 nas diferentes sintomatologias (COVID leve, moderada e grave) em comparação com o grupo controle (não participantes das intervenções). Ao final do programa, 28 participantes finalizaram o estudo (15 do grupo experimental e 13 do grupo controle). Os resultados indicaram uma melhoria significativa no domínio de saúde mental apenas no grupo experimental após o período de intervenção (p 0,05). Diante dos resultados a reabilitação multiprofissional emerge como componente importante para a melhoria da qualidade de vida, especialmente no âmbito da saúde mental durante as 16 semanas de intervenção.

Association between early childhood caries and nutritional status in children in a peruvian social program: a cross-sectional study / Asociación entre caries de la primera infancia y estado nutricional en niños de un programa social peruano: un estudio transversal

Introduction: Early childhood caries is still very prevalent, mainly in developing countries, and it is related to the quality of life of children due to early tooth loss. Objective: The study objective was to determine the association between dental caries and its clinical consequences on nutritional status in children of the "Vaso de Leche (Glass of Milk)'' social program, in Puno City, Peru, during the year 2020. Materials and Methods: An observational, descriptive-correlational, cross-sectional study; the sample consisted of 740 children between 1 and 5 years old who met the selection criteria; the clinical consequences of untreated dental caries were evaluated using the PUFA index and the prevalence of caries with def-t; the nutritional status was determined by the weight and height of the child according to protocols (NTS No. 357 - MINSA /2017/ DGIESP); the data were analyzed with the SPSS-v25 program, the association between variables was evaluated with the chi-square test, Mann-Whitney U test and Spearman's Rho test, considering significance at a p-value <0.05. Results: No significant relationship was found when dental caries was evaluated with the nutritional condition (p<0.05). However, when the def-t index values were related to the nutritional condition of the children, a significant difference was found (p<0.05). There was no significant difference with the PUFA index (p>0.05). Conclusions: There is no association between early childhood caries and nutritional status in children aged between 3 and 5 years; however, a significant relationship was found between the values of the def-t index and the nutritional status of the children.

Introducción: La caries infantil temprana sigue siendo muy prevalente, principalmente en los países en desarrollo, y está relacionada con la calidad de vida de los niños debido a la pérdida temprana de dientes Objetivo: El objetivo del estudio fue determinar la asociación entre la caries dental y sus consecuencias clínicas sobre el estado nutricional en niños del programa social "Vaso de Leche", en la ciudad de Puno, Perú, durante el año 2020. Materiales y Métodos: Estudio observacional, estudio descriptivo-correlacional, transversal; la muestra estuvo conformada por 740 niños entre 1 y 5 años que cumplieron con los criterios de selección, se evaluaron las consecuencias clínicas de la caries dental no tratada mediante el índice PUFA y la prevalencia de caries con d-t; el estado nutricional se determinó mediante el peso y talla del niño según protocolos (NTS N°357 MINSA/2017/DGIESP; los datos se analizaron con el programa SPSS-v25, la asociación entre variables se evaluó con el chi); -cuadrado, U de Mann-Whitney y Rho de Spearman, considerando significancia a un valor de p<0,05. Resultado: No se encontró relación significativa cuando se evaluó la caries dental con la condición nutricional (p<0,05). Sin embargo, cuando los valores del índice d-t se relacionaron con la condición nutricional de los niños, se encontró una diferencia significativa (p<0,05). No hubo diferencia significativa con el índice PUFA (p>0,05). Conclusión: No existe asociación entre caries de la primera infancia y el estado nutricional en niños de 3 a 5 años; sin embargo, se encontró una relación significativa entre los valores del índice d-t y el estado nutricional de los niños.

Impacto de la pandemia por SARS-CoV-2 en el índice de masa corporal de niños asistidos en la Ciudad Autónoma de Buenos Aires / Impact of the SARS-CoV-2 pandemic on the body mass index of children seen in the City of Buenos Aires

Introducción. El sobrepeso y la obesidad infantil constituyen un problema de salud pública. El inicio de la pandemia por COVID-19 pudo haber favorecido esta patología. El puntaje Z del índice de masa corporal (Z-IMC) es un indicador aceptado para su diagnóstico y seguimiento. Objetivo. Evaluar si la prevalencia de sobrepeso y obesidad, y el Z-IMC en niños de 2 a 5 años aumentó durante la pandemia. Población y métodos. Estudio de cohorte retrospectiva. Se incluyeron pacientes asistidos en efectores públicos de salud del Gobierno de la Ciudad Autónoma de Buenos Aires (GCABA), de 2 a 5 años de edad, con registro de peso y talla en dos consultas, antes y después de haber comenzado el aislamiento social preventivo y obligatorio (ASPO). Se registró estado nutricional (Z-IMC) y variación del Z-IMC entre ambas consultas. Resultados. Se evaluaron 3866 sujetos, edad promedio 3,4 ± 0,8 años; el 48,1 % fueron mujeres. El intervalo promedio entre consultas fue 14,3 ± 2,5 meses. La prevalencia de sobrepeso/obesidad aumentó del 12,6 % (IC95% 11,6-13,6) al 20,9 % (IC95% 19,6-22-2); p <0,001, al igual que el Z-IMC (0,4 ± 1,1 vs. 0,8 ± 1,3; p <0,001). Conclusión. La prevalencia de sobrepeso y obesidad, y el Z-IMC en niños de 2 a 5 años aumentó significativamente durante la pandemia.

Introduction. Childhood overweight and obesity are a public health problem. The onset of the COVID-19 pandemic may have contributed to this condition. The body mass index (BMI) Z-score has been accepted as an indicator for overweight and obesity diagnosis and follow-up. Objective. To assess whether the prevalence of overweight and obesity and the BMI Z-score in children aged 2 to 5 years increased during the pandemic. Population and methods. Retrospective, cohort study. Patients included were those seen at public health care facilities in the City of Buenos Aires (CABA), who were aged 2 to 5 years, had weight and height values recorded at 2 different visits, before and after the establishment of the preventive and mandatory social isolation policy. Patients' nutritional status (BMI Z-score) and the variation in this indicator between both visits were recorded. Results. A total of 3866 subjects were assessed; their average age was 3.4 ± 0.8 years; 48.1% were girls. The average interval between both visits was 14.3 ± 2.5 months. The prevalence of overweight/ obesity increased from 12.6% (95% CI: 11.6­13.6) to 20.9% (95% CI: 19.6­22.2), p < 0.001, and so did the BMI Z-score (0.4 ± 1.1 versus 0.8 ± 1.3, p < 0.001). Conclusion. The prevalence of overweight and obesity and the BMI Z-score in children aged 2 to 5 years increased significantly during the pandemic.

Effects of school-based interventions on blood pressure in obese children: metanalysis / Efeitos de intervenções de base escolar na pressão arterial de crianças com obesidade: metanálise

Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA), a systematic review with metanalysis was conducted to identify and summarize the effects of school-based physical activity interventions that sought to control and / or reduce blood pressure (systolic and diastolic) in children and / or adolescents with overweight and / or obesity. In September 2022, potential studies were searched in five electronic databases (Pubmed, Scielo, Scopus, Sportdiscus, and Web of Science) and in reference lists. Randomized controlled trials conducted in schools with interventions involving physical activity and assessment of systolic and diastolic blood pressure in children and adolescents aged 6 to 19 years with overweight and / or obesity were con-sidered for synthesis. The risk of bias was assessed using an adapted version of the Effective Public Health Practice Project tool (EPHPP). Metanalysis was developed from the random model. Four studies were included. For systolic blood pressure, a summary effect of -0.10 (95% CI: -0.39; 0.19; I2 = 0%) was observed. For diastolic pressure, the metanalysis indicated -0.33 (95% CI: -0.62; -0.04; I2 = 11%). Considering the promising effects on diastolic blood pressure, we suggest the develop-ment of more school-based interventions based on physical activity practice for overweight and / or obese populations, which may also add environmental elements, longer duration, multicomponent approaches, and parent / guardian involvement to their strategies.

Com base na declaração Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), foi realizada uma revisão sistemática com metanálise para identificar e sumarizar os efeitos de intervenções escolar baseadas na atividade física que buscaram o controle e / ou redução da pressão arterial (sistólica e diastólica) em crianças e / ou adolescentes com excesso de peso e / ou obesidade. Em setembro de 2022, estudos potenciais foram pesquisados em cinco bases de dados eletrônicas (Pubmed, Scielo, Scopus, Sportdiscus, e Web of Science) e em listas de referências. Foram considerados para a síntese ensaios controlados randomizados realizados em escolas, com intervenções que envolviam a atividade física e avaliação da pressão arterial sistólica e diastólica em crianças e adolescentes dos 6 aos 19 anos com excesso de peso e/ ou obesidade. O risco de viés foi avaliado utilizando uma versão adaptada do instrumento Effective Public Health Practice Project (EPHPP). A metanálise foi elaborada a partir do modelo randômico. Foram incluídos quatro estudos. Para a pressão arterial sistólica, observou-se um efeito sumarizado de -0,10 (IC 95%: -0,39; 0,19; I2 = 0%). Para a pressão diastólica, a metanálise indicou -0,33 (IC 95%: -0,62; -0,04; I2 = 11%). Considerando os efeitos promissores na pressão arterial diastólica, sugerimos o desenvolvimento de mais intervenções escola-res fundamentadas na prática de atividade física às populações com sobrepeso e / ou obesidade, que possam agregar também, em suas estratégias, elementos ambientais, maior duração, abordagens multicomponentes e envolvimento dos pais / responsáveis.

Obesidad como factor implicado en la gravedad de la infección por SARS-CoV-2 / Obesity as a factor involved in the severity of SARS-CoV-2 infection / Obesidade como um fator implicado na gravidade da infecção por SARS-CoV-2

Las personas obesas enfrentan mayores complicaciones al contraer SARS-CoV-2 debido a su estado proinflamatorio crónico y respuesta inmune reducida, relacionados con el exceso de tejido adiposo. La interacción del virus con los receptores ACE2 y la retención de lípidos ectópicos renales son aspectos clave en este contexto. Objetivo. Analizar las características específicas de la obesidad que aumentan la susceptibilidad a síntomas graves de COVID-19, a partir de artículos publicados entre 2020 y 2022, y promover futuras investigaciones. Metodología. Se realizó una revisión sistemática de artículos originales entre 2020 y 2022 utilizando términos clave y operadores booleanos en bases de datos como PubMed, Scopus, ProQuest, etc. Se excluyeron estudios no originales para obtener investigaciones más específicas. Resultados. De 180 artículos encontrados, 42 fueron seleccionados. Entre estos, se destacó que pacientes obesos, especialmente hombres de edad avanzada, presentaron severas complicaciones. Sin embargo, jóvenes con obesidad severa y personas con bajo peso también mostraron mayor riesgo de mortalidad. La disminución de la función pulmonar, bajos niveles de vitamina D, y la alteración de ACE2 fueron implicados en la gravedad de la infección. La hiperglucemia asociada a la obesidad aumentó el riesgo de ingreso a UCI y ventilación mecánica, mientras que la resistencia a la insulina empeoró el pronóstico. Conclusión. La obesidad emerge como un factor de riesgo importante para la gravedad y mortalidad por COVID-19, señalando la necesidad de una atención específica para este grupo de pacientes y la continuación de investigaciones en el área.

Obese individuals face greater complications in contracting SARS-CoV-2 due to their chronic proinflammatory state and reduced immune response, related to excess adipose tissue. Virus interaction with ACE2 receptors and renal ectopic lipid retention are key issues in this context. Objective. To analyze the specific features of obesity that increase susceptibility to severe COVID-19 symptoms, from articles published between 2020 and 2022, and to promote future research. Methodology. A systematic review of original articles between 2020 and 2022 was conducted using key terms and Boolean operators in databases such as PubMed, Scopus, ProQuest, etc. Non-original studies were excluded to obtain more specific research. Results. Of 180 articles found, 42 were selected. Among these, it was highlighted that obese patients, especially elderly men, presented severe complications. However, young people with severe obesity and people with low weight also showed a higher risk of mortality. Decreased lung function, low vitamin D levels, and altered ACE2 were implicated in the severity of infection. Obesity-associated hyperglycemia increased the risk of ICU admission and mechanical ventilation, while insulin resistance worsened prognosis. Conclusion. Obesity emerges as an important risk factor for severity and mortality due to COVID-19, pointing to the need for specific attention to this group of patients and further research in the area.

As pessoas obesas enfrentam maiores complicações para contrair o SARS-CoV-2 devido ao seu estado pró-inflamatório crônico e à resposta imunológica reduzida, relacionados ao excesso de tecido adiposo. A interação do vírus com os receptores ACE2 e a retenção ectópica renal de lipídios são questões fundamentais nesse contexto. Objetivo. Analisar as características específicas da obesidade que aumentam a suscetibilidade a sintomas graves da COVID-19, com base em artigos publicados entre 2020 e 2022, e promover pesquisas futuras. Metodologia. Foi realizada uma revisão sistemática de artigos originais entre 2020 e 2022 usando termos-chave e operadores booleanos em bancos de dados como PubMed, Scopus, ProQuest, etc. Estudos não originais foram excluídos para obter pesquisas mais específicas. Resultados. Dos 180 artigos encontrados, 42 foram selecionados. Entre eles, destacou-se que os pacientes obesos, especialmente os homens mais velhos, apresentaram complicações graves. No entanto, jovens gravemente obesos e pessoas abaixo do peso também apresentaram maior risco de mortalidade. A diminuição da função pulmonar, os baixos níveis de vitamina D e a alteração da ACE2 foram implicados na gravidade da infecção. A hiperglicemia associada à obesidade aumentou o risco de internação na UTI e de ventilação mecânica, enquanto a resistência à insulina piorou o prognóstico. Conclusões. A obesidade surge como um importante fator de risco para a gravidade e a mortalidade da COVID-19, apontando para a necessidade de atenção específica a esse grupo de pacientes e de mais pesquisas na área.

Anthropometric Characteristics, Body Composition and Nutritional Status of Younger Primary School Children in Montenegro: National Study / Características Antropométricas, Composición Corporal y Estado Nutricional de los Niños más Pequeños de la Escuela Primaria en Montenegro. Estudio Nacional

SUMMARY: This article has two aims: (a) first aim was to determine what is the most applicable and the simplest alternative for recommended BMI categories for underweight, overweight and obesity related to IOTF references, from the practical standpoint; (b) second aim was to determine the prevalence of the nutritional status in Montenegro on this representative sample of school children aged 9-13 years and compare them with peers from relevant and similar studies from both the local region and globally. A total sample of 1478 healthy children from Montenegro participated in this study divided into two sub-samples of 732 girls and 746 boys. According to the IOTF body mass index (BMI) reference values were used through ROC curve analysis to evaluate potential alternatives for estimation of the nutritional status of this sample of children. Only WHtR did not show significant age-related differences in the case of both genders. Considering the nutritional status of children from this study it has been found that boys have a considerably higher prevalence of being overweight (22.7 % vs. 16.4 %) and obese (7.5 % vs. 3.3 %) compared to girls. On the other hand, girls were more prevalent to be underweight (10.5 % vs. 7.5 %). WHtR seems like the best alternative for the estimation of obesity and being overweight due to simplicity and the equipment needed.

Este artículo tiene dos objetivos: (a) el primero fue determinar cuál es la alternativa más aplicable y más sencilla para las categorías de IMC recomendadas para bajo peso, sobrepeso y obesidad relacionadas con las referencias de la IOTF, desde el punto de vista práctico; (b) el segundo objetivo fue determinar la prevalencia del estado nutricional en Montenegro en esta muestra representativa de escolares de 9 a 13 años y compararlos con pares de estudios relevantes y similares tanto de la región local como a nivel mundial. En el estudio participaron 1478 niños sanos de Montenegro divididos en dos submuestras de 732 niñas y 746 niños. De acuerdo con el índice de masa corporal (IMC) de la IOTF, se utilizaron valores de referencia mediante análisis de curvas ROC para evaluar posibles alternativas para la estimación del estado nutricional de esta muestra en niños. Sólo el ICT no mostró diferencias significativas relacionadas con la edad en el caso de ambos sexos. Teniendo en consideración el estado nutricional de los niños, se determinó que los éstos tenían una prevalencia considerablemente mayor de sobrepeso (22,7 % frente a 16,4 %) y obesidad (7,5 % frente a 3,3 %) en comparación con las niñas. Por otro lado, las niñas tenían más prevalencia de bajo peso (10,5 % frente a 7,5 %). El WHtR parece la mejor alternativa para la estimación de la obesidad y el sobrepeso por su sencillez y equipamiento necesario.

Mapping and projections of obesity in the Brazilian adult population assisted in Primary Health Care: impact of the COVID-19 pandemic / Mapeamento e projeções da obesidade na população adulta brasileira atendida na Atenção Primária à Saúde: impacto da pandemia de COVID-19

Objective: To map the temporal evolution of overweight and obesity in Brazilian adults and estimate the prevalence of obesity for 2025 and 2030, evaluating the potential impact of the COVID-19 pandemic. Method: Data were collected on the nutritional status of adults from 2008 to 2021 from the Food and Nutrition Surveillance System (SISVAN), from which we calculated the prevalence and average annual rates of the variation of overweight and obesity. The projection of obesity, using linear regression, was analyzed in three scenarios: PP: with data from the pre-pandemic period (2008-2019); outlier: with adjustment of the data trend (2008-2021), including the pandemic period, considering a return of scenario PP for projections from 2022; P: adjustment of pandemic data (2019-2021) to estimate the projection. Result: In the period 2008­2021, we observed an average annual rate of overweight increase of 0.48 %/year. The prevalence of obesity more than doubled during this period, from 14.5% in 2008 to 32.9% in 2021 (i.e., an increase of 1.42). In the outlier scenario, the prevalence projections for obesity are 38.8% and 45.5% for 2015 and 2030, respectively. In the PP scenario (without the pandemic), the expected prevalence for the same period would be approximately 36.8% and 43.4%, respectively. Conclusion: Obesity and overweight follow an increasing trend. The COVID-19 pandemic accelerated the increase in the prevalence of obesity in Brazil and impacted its projections for the coming years

Objetivo: Mapear a evolução temporal de sobrepeso e obesidade de adultos brasileiros e estimar as prevalências de obesidade para 2025 e 2030, avaliando o potencial impacto da pandemia de COVID-19. Método: Foram coletados dados do estado nutricional de adultos de 2008 a 2021 do Sistema de Vigilância Alimentar e Nutricional (SISVAN), a partir dos quais foram calculadas as prevalências e taxas médias anuais da variação de sobrepeso e obesidade. A projeção da obesidade, utilizando regressão linear, foi analisada em três cenários: PP: com dados do período pré-pandemia (2008-2019); outlier: com ajuste da endência de dados (2008-2021), incluindo o período da pandemia, considerando um retorno do cenário PP para projeções a partir de 2022; P: ajuste dos dados da pandemia (2019-2021) para estimativa da projeção. Resultado: No período de 2008 e 2021, observamos uma taxa anual média de aumento de sobrepeso de 0,48 %/ano. A prevalência de obesidade mais que dobrou nesse período, passando de 14,5% em 2008 para 32,9% em 2021 (i.e., um aumento de 1,42). No cenário outlier, as projeções das prevalências de obesidade são de 38,8% e 45,5% para os anos de 2015 e 2030, respectivamente. No cenário PP (sem a pandemia), a prevalência esperada para o mesmo período estaria em torno de 36,8% e 43,4%, respectivamente. Conclusão: A obesidade e o sobrepeso seguem uma tendência de aumento crescente. A pandemia de COVID-19 acelerou o aumento da prevalência de obesidade no Brasil e impactou a sua projeção para os próximos anos.

Efecto de un programa de autocuidado en hábitos de vida saludable con relación a la obesidad en personal de salud de una institución de tercer nivel / Efeito de um programa de autocuidado nos hábitos de vida saudáveis em relação à obesidade em profissionais de saúde de uma instituição terciária / Effect of a self-care program on healthy lifestyle habits in relation to obesity in health personnel of a tertiary institution

Introducción. A nivel mundial, la obesidad es considerada como un problema de salud pública debido a que afecta a la población de todas las edades, incluso al mismo personal que trabaja en instituciones de salud, situación que repercute en su ámbito personal, familiar, pero sobre todo laboral, causando en el trabajador dificultad para realizar algunos procedimientos, ausentismo laboral, discapacidad parcial o total y/o necesidad de cuidado, entre otros.  Objetivo.  Evaluar el efecto de una intervención de autocuidado en hábitos de vida saludable con relación a la obesidad en personal de salud de una institución de tercer nivel.  Metodología. Estudio cuasi experimental, muestra 30 trabajadores con sobrepeso o algún grado de obesidad de una institución de salud de tercer nivel. Se impartieron 10 temas con relación a la obesidad, para cambiar hábitos deficientes por hábitos saludables, además de 10 sesiones de actividad física.    Resultados. Al final de la intervención, dos personas bajaron el nivel de su índice de masa corporal, una persona con obesidad grado III y una de grado II bajaron a peso normal. En cuanto a las medidas antropométricas posterior a la intervención, hubo reducción en cada uno de los parámetros, referente a la evaluación del cuestionario hábitos de vida saludable, relacionados con la obesidad posterior a la intervención, se encontraron cambios positivos en cada una de las dimensiones. Sin embargo, tanto en la reducción de IMC, así como en las dimensiones del cuestionario, la diferencia encontrada, no fue estadísticamente significativa.  Conclusiones. Los resultados sugieren que una intervención educativa en hábitos de vida saludable vinculados con la obesidad en personal de salud, son eficaces para contribuir al autocuidado de los trabajadores en el ámbito laboral

Introduction. Worldwide, obesity is considered a public health problem because it affects the population of all ages, including the same personnel who work in health institutions, a situation that has repercussions in their personal and family environment, but above all at work, causing the worker difficulty in performing some procedures, absenteeism, partial or total disability and/or need for care, among others. Objective. To evaluate the effect of a self-care intervention on healthy life habits in relation to obesity in health personnel of a third level institution. Methodology. Quasi-experimental study, sample of 30 workers with overweight or some degree of obesity in a tertiary health institution. Ten topics related to obesity were taught in order to change deficient habits for healthy habits, in addition to 10 sessions of physical activity. Results. At the end of the intervention, two people lowered their body mass index level, one person with grade III obesity and one with grade II obesity lowered to normal weight. Regarding the anthropometric measures after the intervention, there was a reduction in each one of the parameters, regarding the evaluation of the healthy life habits questionnaire, related to obesity after the intervention, positive changes were found in each one of the dimensions. However, both in the reduction of BMI and in the dimensions of the questionnaire, the difference found was not statistically significant. Conclusions. The results suggest that an educational intervention on healthy lifestyle habits related to obesity in health personnel is effective in contributing to the self-care of workers in the workplace

Introdução. A nível mundial, a obesidade é considerada um problema de saúde pública porque afecta a população de todas as idades, incluindo o próprio pessoal que trabalha nas instituições de saúde, situação que tem repercussões no seu ambiente pessoal e familiar, mas sobretudo no trabalho, causando ao trabalhador dificuldade na realização de alguns procedimentos, absentismo, incapacidade parcial ou total e/ou necessidade de cuidados, entre outros. Objectivos. Avaliar o efeito de uma intervenção de autocuidado sobre hábitos de vida saudáveis em relação à obesidade em profissionais de saúde de uma instituição de cuidados terciários. Metodologia. Estudo quase-experimental, amostra de 30 trabalhadores com excesso de peso ou algum grau de obesidade numa instituição de saúde terciária. Foram ensinados dez temas relacionados com a obesidade, com o objetivo de mudar hábitos deficientes por hábitos saudáveis, além de 10 sessões de atividade física. Resultados. No final da intervenção, duas pessoas baixaram o índice de massa corporal, uma pessoa com obesidade de grau III e uma com obesidade de grau II passaram para o peso normal. Relativamente às medidas antropométricas após a intervenção, verificou-se uma redução em cada um dos parâmetros, e relativamente à avaliação do questionário de hábitos de vida saudáveis relacionados com a obesidade após a intervenção, verificaram-se alterações positivas em cada uma das dimensões. No entanto, tanto na redução do IMC como nas dimensões do questionário, a diferença encontrada não foi estatisticamente significativa. Conclusões. Os resultados sugerem que uma intervenção educativa sobre hábitos de vida saudáveis ligados à obesidade no pessoal de saúde é eficaz para contribuir para o autocuidado dos trabalhadores no local de trabalho

Diagnóstico del estado nutricional, dislipidemia y factores de riesgo asociados en escolares indígenas yaquis / Diagnosis of nutritional status, dyslipidemia and associated risk factors in indigenous Yaqui schoolchildren

Resumen Antecedentes: La malnutrición es un problema mundial que afecta a niños escolares, capaz de incrementar el riesgo de enfermedades en la edad adulta. Adultos yaquis han presentado graves problemas de salud, por lo que los escolares podrían encontrarse en una situación similar. Objetivo: Evaluar el estado nutricional, el perfil lipídico y los factores asociados en una muestra de escolares yaquis. Material y métodos: Se estudiaron 109 escolares habitantes de los pueblos originarios, en quienes se realizaron mediciones antropométricas, se extrajo una muestra de sangre venosa en condición de ayuno y se aplicaron cuestionarios. Resultados: La prevalencia de sobrepeso/obesidad fue de 38.5 %, sin que se registraran casos de desnutrición crónica; 38.6 % de los escolares presentó dislipidemia. El consumo de fibra resultó ser un factor protector contra sobrepeso/obesidad y el consumo de grasa constituyó un factor de riesgo. La puntuación de actividad física resultó ser un factor protector contra dislipidemia y los factores de riesgo fueron puntuaciones Z del índice de masa corporal/edad, circunferencia de cintura, historia familiar de dislipidemias, nivel educativo y empleo permanente. Conclusiones: Los escolares yaquis padecen por igual alta proporción de sobrepeso/obesidad y dislipidemia. Los factores asociados pueden resultar útiles para el diseño de intervenciones contextualizadas para esta población.

Abstract Background: Malnutrition is a global problem that affects schoolchildren and can increase the risk of diseases in adulthood. Adult members of the Yaqui Indigenous group have been shown to have serious health problems, and Yaqui schoolchildren could therefore find themselves in a similar situation. Objective: To evaluate the nutritional status, lipid profile and associated factors in a sample of Yaqui schoolchildren. Material and methods: A total of 109 Yaqui schoolchildren who lived in their localities of origin were recruited. Anthropometric measurements were carried out, a venous blood sample was extracted in fasting conditions, and several questionnaires were applied. Results: The prevalence of overweight/obesity was 38.5%, with no cases of chronic malnutrition being recorded; 38.6% of the children had dyslipidemia. Fiber consumption was a protective factor against overweight/obesity, while fat intake was a risk factor. The physical activity score was found to be a protective factor against dyslipidemia, and the risk factors were BMI-for-age Z-scores, waist circumference, family history of dyslipidemia, educational level, and permanent employment. Conclusions: Yaqui schoolchildren equally suffer from a high proportion of overweight/obesity and dyslipidemia. The associated factors may be useful for the design of contextualized interventions for this population.

Efectos de un programa de ejercicio físico con enfoque sanológico en universitarios / Effects of a physical exercise program with a sanological approach in university students / Efeitos de um programa de exercícios físicos com abordagem saudável em estudantes universitários

Objetivo: identificar el efecto del programa de ejercicio físico del proyecto institucionalUSCO saludable con enfoque sanológico en 40 jóvenes universitarios con sobrepeso. Metodología: se plantea un estudio mixto el cual utiliza metodología cuantitativa y cualitativa. En específico, se desarrolló un estudio cuasiexperimental de un solo grupo con valoración antes y después, los datos se tomaron de la revisión de historias clínicosanológicas del programa de ejercicio físico, de la dimensión actividad física. Del proyecto USCO Saludable, se seleccionaron 40 estudiantes con un índice de masa muscular (IMC) entre los rangos de 25 a 30 kg/m2. Se utilizó un instrumento denominado historia clínico-sanológica, esta fue diseñada, ajustada y estandarizada por los investigadores Pedro Reyes Gaspar y Dolly Arias Torres. Los datos se trabajaron a través de entrevista semiestructurada, mediante la creación de códigos y categorías con el programa ATLAS. ti 6.0. Para la comparación del IMC se empleó la prueba de Wilcoxon y el tamaño del efecto por medio de la g de Hedges en el programa SPSS versión 24. Resultados: después de la intervención, en el grupo de estudiantes universitarios con sobrepeso se observaron cambios importantes en la comprensión del concepto de salud, salud actual y del ejercicio físico como herramienta de cuidado de la salud y la vejez. Además, se identificó un cambio significativo en el IMC de la población. Conclusiones: la estrategia de ejercicio físico desde un enfoque sanológico es factible y eficaz, debido a los cambios significativos en el pensamiento y comportamiento en la salud de estudiantes universitarios con sobrepeso.

Objective: to identify the effect of the physical exercise program, of the healthy USCO institutional project with a sanological approach, on 40 overweight university students. Methodolgy: a mixed study is proposed using quantitative and qualitative methodology. Specifically, a quasiexperimental study of a single group was developed with evaluation before and after, the data was taken from the review of clinical-sanological histories of the physical exercise program, of the physical activity dimension, of the Healthy USCO project, 40 students with BMI (body mass index) between the ranges of 25 to 30 kg/ m2 were selected. An instrument called clinical-sanological history was used, it was designed, adjusted, and standardized by researchers Pedro Reyes Gaspar and Dolly Arias Torres. The data was processed through a semi-structured interview through the creation of codes, and categories with the ATLAS.ti 6.0 software, for the comparison of the BMI the Wilcoxon test was used and the effect size through Hedges' G in the SPSS program version 24. Results: after the intervention, important changes were observed in the understanding of the concept of health, current health, and physical exercise as a tool for health care and old age in a group of overweight university students. Furthermore, a significant change in the BMI of the population was identified. Conclusions: the strategy of physical exercise from a sanological approach is feasible and effective due to the significant changes in the thinking and behavior in the health of overweight university students.

Objetivo: identificar o efeito do programa de exercícios físicos do projeto institucional USCO saudável com enfoque saudável em 40 universitários com excesso de peso. Metodologia: propõe-se um estudo misto que utiliza metodologia quantitativa e qualitativa. Especificamente, foi desenvolvido um estudo quase-experimental de grupo único com avaliação antes e depois, os dados foram retirados da revisão dos registros clínico-saúde do programa de exercício físico, da dimensão atividade física. Do projeto USCO Healthy, foram selecionados 40 alunos com índice de massa muscular (IMC) entre 25 e 30 kg/m2. Foi utilizado um instrumento denominado histórico clínico-saúde, desenhado, ajustado e padronizado pelos pesquisadores Pedro Reyes Gaspar e Dolly Arias Torres. Os dados foram trabalhados por meio de entrevista semiestruturada, mediante criação de códigos e categorias com o programa ATLAS.ti 6.0. Para a comparação do IMC foi utilizado o teste de Wilcoxon e o tamanho do efeito por meio do g de Hedges no programa SPSS versão 24. Resultados: após a intervenção, no grupo de universitários com excesso de peso, foram observadas mudanças importantes na compreensão do conceito de saúde, saúde atual e exercício físico como ferramenta de cuidado à saúde e à velhice. Além disso, foi identificada uma alteração significativa no IMC da população. Conclusões: a estratégia de exercício físico sob uma abordagem de saúde é viável e eficaz, devido às mudanças significativas no pensamento e no comportamento de saúde de estudantes universitários com excesso de peso

Mediating effects of metabolic related indicators on the association between childhood overweight/obesity and left ventricular hypertrophy / 中国学校卫生

Objective@#To examine the mediating effects of blood pressure, glucose, lipids, and serum uric acid on the association between childhood overweight/obesity and left ventricular hypertrophy (LVH), and to provide scientific evidence for the prevention and control of cardiovascular diseases during childhood.@*Methods@#One public school in Huantai County, Zibo City was selected to conduct the baseline survey from November 2017 to January 2018 using a convenient cluster sampling method. A total of 1 400 children aged 6 to 11 were included in the study. According to the classification criteria based on body mass index (BMI), participants were divided into the non overweight/obese group ( n =787) and the overweight/obese group ( n =613). The mediating effects of metabolic variables on the association between childhood overweight/obesity and left ventricular hypertrophy (LVH) were analyzed using the "mediation" package in R software.@*Results@#Children who were overweight/obese had higher levels of BMI- Z score (2.0±0.8), systolic blood pressure (SBP) (109.1±8.9 mmHg), diastolic blood pressure (DBP) (65.4±6.8 mmHg), fasting plasma glucose (FPG) (4.8±0.5 mmol/L), insulin (INS) (11.3±7.6 μU/mL), apolipoprotein B (ApoB) (0.7±0.2 g/L), lowdensity lipoprotein cholesterol (LDL-C) (2.4±0.7 mmol/L), total cholesterol (TC) (4.2±0.9 mmol/L), triglycerides (TG) (0.9±0.4 mmol/L), and serum uric acid (SUA) (321.2±91.4 μmol/L) compared to those who were non-overweight/obese [the corresponding values were (-0.2±0.7),(104.3±8.8) mmHg, (62.2±6.2) mmHg, (4.7±0.6) mmol/L, (6.1±4.2) μU/mL, (0.6±0.2) g/L, (2.2±0.6) mmol/L, (4.1±0.7) mmol/L, (0.7±0.2) mmol/L, and (278.6±74.7) μmol/L, respectively], whereas the levels of high density lipoprotein cholesterol (HDL-C) were lower in overweight/obese children (1.5±0.3 mmol/L) than in non-overweight/obese children (1.7±0.4 mmol/L). All differences were statistically significant ( t =53.66, 9.88, 9.19, 3.60, 16.32, 7.36, 5.11, 2.55, 11.08, 9.58, -10.31, P <0.05). After adjusting for potential covariates, overweight/obese children had 8.72 times increased risk of developing LVH compared to the non-overweight/obese children ( OR=8.72, 95%CI =5.45-14.66， P <0.01). Mediation analysis showed that INS, HDL-C, LDL-C, TG, ApoB, and SUA partially mediated the association between childhood overweight/obesity and LVH, and among these, INS and TG had relatively strong mediating effects, accounting for 28.05% and 13.71% of the total effects, respectively.@*Conclusions@#INS, HDL-C, LDL-C, TG, ApoB, and SUA are intermediate risk factors on the association between childhood overweight/obesity and LVH. Keeping metabolic indicators (especially INS and TG) at healthy levels is particularly important for reducing the burden of cardiovascular diseases in overweight/obese children.

Clinical features and serum lipidomic profile of patients with nonalcoholic fatty liver disease and healthy individuals in the overweight population / 临床肝胆病杂志

objectiveTo investigate the differences in clinical indices and lipid metabolism between the patients with nonalcoholic fatty liver disease （NAFLD） and healthy individuals in the overweight population. MethodsIn this study， body mass index （BMI）>23 kg/m2 was defined as overweight. A total of 62 overweight patients with NAFLD who were admitted to Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from August 2020 to April 2021 were enrolled as overweight NAFLD group， and 50 overweight individuals who underwent physical examination during the same period of time were enrolled as control group. Clinical information and blood biochemical parameters were recorded for all subjects. Ultra-performance liquid chromatography-tandem mass spectrometry was used to analyze serum lipidomic profile， and principal component analysis and orthogonal partial least squares-discriminant analysis were used to perform the multivariate statistical analysis of lipidomic data. The chi-square test was used for comparison of categorical data between two groups， and the independent-samples t test or the Wilcoxon rank-sum test was used for comparison of continuous data between two groups. ResultsThe overweight NAFLD group had a significantly higher BMI than the overweight control group （Z=-2.365， P=0.018）. As for serological markers， compared with the overweight control group， the overweight NAFLD group had significantly higher levels of red blood cells， hemoglobin， hematocrit， uric acid， total protein， globulin， alkaline phosphatase， gamma-glutamyl transpeptidase， alanine aminotransferase， aspartate aminotransferase， cholinesterase， low-density lipoprotein， total cholesterol， triglyceride， apolipoprotein B， and blood glucose （all P<0.05）. The lipidomic analysis showed that there was a significant difference in lipid metabolism between the two groups， and a total of 493 differentially expressed lipids were identified （VIP value>1， P<0.05）， among which 143 lipids were significantly upregulated and 350 lipids were significantly downregulated in the overweight NAFLD group. The mean total fatty acid content in the overweight NAFLD group was 3.6 times that in the overweight control group. Compared with the overweight control group， the overweight NAFLD group had a significant reduction in the content of triglyceride with>3 unsaturated bonds （P<0.001） and a significant increase in the content of triglyceride with ≤3 unsaturated bonds （P<0.001）. ConclusionCompared with healthy overweight individuals， overweight NAFLD patients tend to have significant abnormalities in some biochemical parameters and lipid metabolites， with significant increases in the content of fatty acid in blood and the types of saturated fat chains in triglycerides.

Efficacy of the combination of semaglutide, insulin degludec, and metformin in the treatment of type 2 diabetes mellitus and poor glycemic control accompanied by overweight or obesity / 中国基层医药

Objective:To investigate the efficacy of the combination of semaglutide, insulin degludec, and metformin in the treatment of type 2 diabetes mellitus and poor glycemic control accompanied by overweight or obesity.Methods:A total of 160 patients with type 2 diabetes mellitus and poor glycemic control accompanied by overweight or obesity were included in this case-control study after receiving treatment at Bayannur Hospital from April 2022 to March 2023. These patients were divided into a control group and an observation group based on different treatment regimens, with 80 patients in each group. The control group was treated with degludec insulin combined with metformin, while the observation group was treated with semaglutide, degludec insulin, and metformin. The treatment lasted for 12 weeks in both groups. The changes in fasting plasma glucose, 2-hour postprandial blood glucose (2 h PG), glycosylated hemoglobin, time in range for 2 h PG, fasting insulin, Homeostatic Model Assessment for Insulin Resistance index, body mass index, and visceral fat area and adverse reactions were monitored.Results:The overall response rate in the observation group was 100% (80/80), which was significantly higher than 97.5% (78/80) in the control group (χ 2 = 11.03, P < 0.05). After treatment, the levels of 2 h PG, glycosylated hemoglobin, fasting insulin, Homeostatic Model Assessment for Insulin Resistance index, body mass index, visceral fat area in the observation group were (7.35 ± 0.17) mmol/L, (6.08 ± 0.24)%, (10.30 ± 2.58) μU/mL,(2.69 ± 0.66), (24.40 ± 0.68) kg/m 2, (80.20 ± 8.94) cm 2, respectively, which were significantly lower than (7.92 ± 0.24) mmol/L, (6.34 ± 0.27)%,(13.71 ± 3.13) μU/mL,(3.57 ± 0.83), (26.77 ± 3.49) kg/m 2, (116.12 ± 34.09) cm 2 respectively in the control group ( t = -0.73, -3.74, -4.20, -4.15, -3.35, -5.10, all P < 0.05). The time in range for 2 h PG in the observation group was (72.68 ± 4.09)%, which was significantly higher than (50.16 ± 10.00)% in the control group ( t = -10.42, P < 0.05). The incidence of adverse reactions in the observation group was 3.8% (3/80), which was slightly, but not significantly, higher than 2.5% (2/80) in the control group ( P > 0.05). Conclusion:The combination of semaglutide, degludec insulin, and metformin demonstrates an ideal clinical effect in the treatment of type 2 diabetes mellitus and poor glycemic control accompanied by overweight or obesity. This combined approach can effectively regulate fasting and postprandial blood glucose levels, markedly decrease the body mass index and visceral fat levels, and improve insulin resistance while not significantly increasing the incidence of adverse reactions.

Study on the Risk Prediction Models of Overweight and Obesity in Medical Students / 中国卫生统计

Objective To construct logistic regression,random forest and SVM models to predict the influencing factors of overweight and obesity in medical students,and the prediction performance of the three models was compared,so as to obtain the optimal model for the risk assessment of overweight and obesity.Methods Participants included 1 866 medical students from a city in Hebei Province from May to December 2020.The relevant data of overweight and obesity screening were collected through self-test questionnaire;three models of logistic regression,random forest and SVM are constructed by python.Results The test set showed that the accuracy of logistic regression,random forest and SVM models were 96.26%,98.66%and 98.13%respectively;the specificity were 99.77%,100%and 99.00%,respectively;and the AUC were 0.88,0.99 and 0.88 respectively.Random forest is the optimal prediction model;according to the random forest model results,subjective well-being,negative events and students'economic status are more than 10%of weight in the model.Conclusion Subjective well-being,negative events and students'economic status are the main factors affecting the incidence of overweight and obesity in medical students;the prediction performance of random forest model was better than logistic regression model and SVM model.

Effect of spousal synchronous exercise and diet intervention on maternal and neonatal outcomes in overweight pregnant women with gestational diabetes mellitus / 中国医科大学学报

Objective To analyze the effect of spousal synchronous exercise and diet intervention on maternal and neonatal outcomes in overweight pregnant women with gestational diabetes mellitus(GDM).Methods We divided 120 overweight pregnant women with GDM into intervention and control groups(n= 60 per group),who received spousal synchronous and routine exercise and diet interventions,respectively.The age,body mass index(BMI),and levels of fasting blood glucose(FPG),2-hour postprandial blood glucose(2 h-PG),and glycosylated hemoglobin(HbA1c)at the first prenatal examination were recorded.The levels of FPG,2 h-PG,and HbA1c at the diagnosis of GDM and gestational week 28,delivery mode,and incidence of complications during the delivery were compared between the groups.The self-rating depression scale and self-rating anxiety scale were used to evaluate the women's mental status after delivery.The body weight,blood glucose level,Apgar score,and incidence of complications including macrosomia,hypoglycemia,and asphyxia in the new-borns were compared between the groups.Results The groups did not differ significantly in term of age,BMI,FPG,2 h-FPG,or HbA1c at GDM diagnosis(P>0.05).At gestational week 28,the FPG,2 h-FPG,and HbA1c levels were significantly lower than those before the intervention in both groups,and were also significantly lower in the intervention group than in the control group(P<0.05).Com-pared with the control group,the proportion of natural delivery was significantly higher and the incidence of complications was sig-nificantly lower in the intervention group(P<0.05).The anxiety and depression status were significantly better in the intervention group than in the control group(P<0.05).Compared with the control group,the frequency of macrosomia and blood glucose levels were significantly lower and the Apgar scores were significantly higher in the intervention group(P<0.05).Conclusion Spousal synchronous exercise and diet intervention may effectively decrease the blood glucose and HbA1c levels in overweight pregnant women with GDM,decrease the incidence of maternal and neonatal complications,and improve pregnant women's mental status.

Research progress in the correlation between maternal depression and childhood obesity / 中国儿童保健杂志

Maternal depression can cause physical and mental harm to herself. This condition can lead to poor physical development in early offspring (newborns). However, the effect of maternal depression on the long-term physical development of offspring remains controversial. Studies have shown that offspring exposed to maternal depression in developed countries are at an increased risk of obesity. In view of the high incidence of maternal depression and childhood obesity in China, this article reviews the correlation between maternal depression and offspring obesity, aiming to provide insights for relevant research in China and offer references for the prevention and intervention of maternal depression and childhood obesity.

Status quo of overweight, obesity and elevated blood pressure among children and adolescents aged 7 - 17 years in Mengzi City / 中国儿童保健杂志

【Objective】 To analyze the association of overweight and obesity with elevated blood pressure(BP) among children and adolescents in Mengzi City, in order to provide reference for making effective interventions. 【Methods】 A total of 30 classes of students in 14 schools were selected into this study by a stratified random cluster sampling method from October 2020 to September 2021. The paticipants completed a questionnaire survey, and had their height, weight and BP measured. Logistic regression analysis was used to evaluate the association of overweight and obesity with elevated BP. 【Results】 A total of 4 015 children and adolescents aged 7 - 17 years were involved in the study. The detection rate of overweight, obesity and elevated BP was 12.53%, 10.01% and 12.38%, respectively. The detection rate of elevated BP was 9.96%, 19.48% and 25.62% in normal weight, overweight and obese groups, respectively. The risk of elevated BP in the overweight and obese groups was 2.190 times(95%CI: 1.696 - 2.926, P<0.001) and 3.243 times(95%CI: 2.501 - 4.204, P<0.001) as high as that in normal weight groups. The dietary and exercise behaviors of 1 604 adolescents were analyzed, it was found that the detection rate of obesity was significntly higher in non-boarding students(15.09%) and those who consumed fresh fruits at least once a day(13.49%)(χ2=18.012, 7.225, P<0.05), the detection rate of elevated BP was significantly higher in among those who did not consume sugary beverages(16.88%), and performed moderate-to-high intensity physical exercise of 60 minutes or more ≤ 2 days per week(16.88%)(χ2=9.403, 14.921,P<0.01). 【Conclusions】 The risk of developing hypertension increases with the high prevalence of overweight and obesity and is strongly associated with multiple factors. Therefore, it is essential to conduct effective weight control and behavioral lifestyle interventions among children and adolescents.

Epidemiological survey and influencing factors of overweight and obesity among preschool children in Suzhou / 中国儿童保健杂志

【Objective】 To investigate the prevalence and influencing factors of overweight and obesity among preschool children in Suzhou. 【Methods】 A stratified cluster random sampling method was used to select 24 452 children aged 3 - 6 years in different districts of Suzhou from December 2021 to June 2022. Then the prevalence rate of overweight and obesity was determined by physical measurements. A case-control study was conducted with a questionnaire survey of 3 786 children(1 893 in the obesity group and 1 893 in the control group) to analyze the factors influencing preschool obesity. 【Results】 1) The overall detection rates of overweight among preschool children in Suzhou was 14.8%(boys 14.6%, girls 15.0%). The overall detection rates of obesity was 7.9%(boys 8.7%, girls 7.1%), with a statistically significant difference between boys and girls(χ2=19.828, P<0.01). 2) There was statistically significant difference in the detection rates of obesity among different age groups(χ2=98.415, P<0.01), with the lowest rate in the 3 - 4 years old group(5.8%) and the highest rate in the 6 - 7 years old group(11.8%). 3) The overall detection rates of mild, moderate and severe obesity was 4.8%, 2.6% and 0.5%, respectively. The proportion of moderate and severe obesity significantly increased with age(χ2=57.275, P<0.01). 4) Risk factors for preschool obesity included birth weight >4 000g, cesarean section, parental overweight/obesity, strong appetite of children, eating speed <10min/meal, high frequency of fried food consumption(>1time/week), eating while watching television, sedentary behavior >2h/d, insufficient exercise endurance, screen time >1h/d, and late bedtime(after 21∶30)(P<0.05). Protective factors for preschool obesity included larger breakfast consumption, fruits and vegetables as regular snacks, and physical activity after meals(P<0.05). 5) Factors influencing the degree of preschool obesity included paternal overweight(OR=1.33, 95%CI:1.06 - 1.65), paternal obesity(OR=1.91, 95%CI:1.46 - 2.49), maternal overweight(OR=1.25, 95%CI:1.01 - 1.54), maternal obesity(OR=1.94, 95%CI:1.40 - 2.69), low education level of father(junior high school or below)(OR=1.57, 95%CI:1.25 - 1.96), strong appetite of children(OR=1.72, 95%CI:1.41 - 2.11), eating speed <10min/meal(OR=1.29, 95%CI:1.05 - 1.57), sedentary behavior >2h/d(OR=1.51, 95%CI:1.24 - 1.85), insufficient exercise endurance(OR=1.56, 95%CI:1.12 - 2.19), and screen time>1h/d(OR=1.42, 95%CI:1.16 - 1.75). 【Conclusions】 The detection rates of overweight and obesity among preschool children in Suzhou are relatively high, and the detection rate and severity of obesity increase with age. In addition to genetic factors, preschool obesity are also associated with pregnancy and birth history, as well as unhealthy lifestyle after birth.