Association of outdoor artificial light at night exposure with overweight and obesity among children and adolescents aged 9 to 18 years in China / 北京大学学报(医学版)

OBJECTIVE@#To analyze the association between outdoor artificial light-at-night (ALAN) exposure and overweight and obesity among children and adolescents aged 9 to 18 years in China.@*METHODS@#Using follow-up data of 5 540 children and adolescents aged 9 to 18 years conducted from November 2019 to November 2020 in eight provinces of China, latitude and longitude were determined based on school addresses, and the mean monthly average nighttime irradiance at the location of 116 schools was extracted by the nearest neighbor method to obtain the mean outdoor ALAN exposure [unit: nW/(cm2·sr)] for each school. Four indicators of overweight and obesity outcomes were included: Baseline overweight and obesity, persistent overweight and obesity, overweight and obesity progression and overweight and obesity incidence. Mixed effects Logistic regression was used to explore the association between ALAN exposure levels (divided into quintiles Q1-Q5) and baseline overweight and obesity, persistent overweight and obesity, overweight and obesity progression and overweight and obesity incidence. In addition, a natural cubic spline function was used to explore the exposure response association between ALAN exposure (a continuous variable) and the outcomes.@*RESULTS@#The prevalence of baseline overweight and obesity, persistent overweight and obesity, overweight and obesity progression and overweight and obesity incidence among the children and adolescents in this study were 21.6%, 16.3%, 2.9% and 12.8%, respectively. The OR value for the association between ALAN exposure and baseline overweight and obesity was statistically significant when ALAN exposure levels reached Q4 or Q5, 1.90 (95%CI: 1.26-2.86) and 1.77 (95%CI: 1.11-2.83), respectively, compared with the children and adolescents in the Q1 group of ALAN exposure. Similar to the results for baseline overweight and obesity, the OR values for the association with persistent overweight and obesity were 1.89 (95%CI: 1.20-2.99) and 1.82 (95%CI: 1.08-3.06) when ALAN exposure levels reached Q4 or Q5, respectively, but none of the OR values for the association between ALAN and overweight and obesity progression and overweight and obesity incidence were statistically significant. Fitting a natural cubic spline function showed a non-linear trend between ALAN exposure and persistent overweight and obesity.@*CONCLUSION@#There is a positive association between ALAN exposure and overweight and obesity in children and adolescents, and the promotion of overweight obesity in children and adolescents by ALAN tends to have a cumulative effect rather than an immediate effect. In the future, while focusing on the common risk factors for overweight and obesity in children and adolescents, there is a need to improve the overweight and obesity-causing nighttime light exposure environment.

The relationship between socioeconomic status and childhood overweight/obesity is linked through paternal obesity and dietary intake: a cross-sectional study in Chongqing, China

BACKGROUND@#The prevalence of obesity and overweight in childhood has increased dramatically over the past decades globally. Thus, the risk factors of overweight and obesity in children and adolescents must be studied.@*OBJECTIVES@#This study aimed to reveal the prevalence of childhood obesity and examine the relationship between socioeconomic status (SES) and z-body mass index (z-BMI) via parental obesity and dietary intake using path analysis.@*METHODS@#Stratified cluster sampling was used to select 17,007 participants aged 6-12 years on two avenues per region in urban, suburban, and rural areas. Path analysis was conducted to examine the mediators between SES and z-BMI.@*RESULTS@#The prevalence rates of overweight and obesity were 13.36% and 8.60%, respectively, and were positively correlated with the father's education level, family income, a birth weight > 3000g, a parental obesity history, vegetable intake and red meat intake (all P < 0.05). Four mediators (paternal obesity history, red meat intake, vegetable intake, and nutritional supplements) were observed, and the four path analyses were significant (all P < 0.05). The adjusted total effects on z-BMI were significant for income (β@*CONCLUSIONS@#The prevalence of overweight/obesity in children was notable, and the relationship between SES and z-BMI was mediated by paternal obesity history and dietary intake.

Pantallas, niños y confinamiento en pandemia: ¿debemos limitar su exposición? / Screens, children and lockdown in pandemics: should we limit their exposition?

Desde la aparición del cine, hace más de un siglo, hasta la actual invasión de dispositivos móviles, la velocidad en la evo-lución de las pantallas ha sido exponencial, y se ha acompañado de nuevas formas de consumir medios audiovisuales, de comunicarnos y de administrar nuestro tiempo de ocio. Las aplicaciones han dado un salto desde la computadora de escritorio a los smartphones, lo que facilitó su acceso en cualquier lugar y momento, haciendo que los niños y adolescentes de hoy (generación Z, nativos digitales y neodigitales) tengan más acceso a medios electrónicos que cualquier otra generación previa. En paralelo, ha crecido la preocupación por el efecto que estas pantallas podrían tener sobre el desarrollo infantil. A partir de los resultados de varias investigaciones, diferentes entidades desarrollaron recomendaciones sobre el uso de pantallas en niños, fijando la mayoría de ellas un límite "seguro" de consumo de dos horas al día. Sin embargo, la evidencia que las respalda es muy débil. Dada la actual situación de pandemia, que obliga a confinarnos en nuestros hogares, alejados físicamente de otras personas y sin acceso a actividades recreativas en el exterior, la mayoría de estas recomendaciones suenan bastante limitantes y difíciles de cumplir. Este artículo propone: 1) repasar la información disponible sobre el consumo de pantallas en niños, 2) exponer la evidencia que respalda las actuales recomendaciones de diferentes instituciones respecto de su uso, 3) evaluarla críticamente, visibilizando los vacíos de conocimiento, para jerarquizarlos a la hora de aconsejar sobre crianza a las familias que atendemos. (AU)

Since the creation of cinema more than a century ago, and until the current invasion of mobile devices, the speed in the evolution of the screens has been exponential, which comes with new ways of consuming multimedia, communicating and managing our leisure time. Applications have made a leap from desktop computers to smartphones, facilitating their access anywhere and anytime, allowing children and teenagers today (Generation Z, digital and neo-digital natives) to have moreaccess to electronic media than any other previous generation. At the same time, concern has grown about the effect these screens could have on child development. Based on the results of several investigations, different entities developed recommendations on the use of screens in children, setting most ofthem a "safe" limit of consumption of two hours a day. However, the supporting evidence is very weak.In the context of the current pandemic, which forces us to confine our selves to our homes, physically away from other people and without access to recreational outdoor activities, most of these recommendations sound quite limiting and difficult to accomplish. This article proposes: 1) to review the information available on-screen consumption in children, 2) to expose the evidence that supports current recommendations of different institutions regarding its use, 3) to critically evaluate it, making the gapsin knowledge visible, in order to prioritize them when giving the families we care for advice on parenting. (AU)

Overweight and associated factors in children and adolescents with phenylketonuria: a systematic review / Excesso de peso e fatores associados em crianças e adolescentes com fenilcetonúria: uma revisão sistemática

ABSTRACT Objective: To verify the occurrence of overweight in children and adolescents with phenylketonuria and to identify possible causal factors. Data sources: A systematic review was performed in the SciELO, PubMed and VHL databases using the descriptors "Phenylketonurias", "Overweight", "Child" and "Adolescent". Original articles conducted with children and adolescents, published between 2008 and 2018 in Portuguese, English or Spanish languages were included. Data synthesis: A total of 16 articles were identified and, after screening procedures, 6 studies were selected for the review. Overweight in children and adolescents with phenylketonuria was a frequent occurence in the studies included in this review, ranging from 7.8 to 32.6%. The female sex was the most affected by the nutritional disorder. Furthermore, a high caloric intake combined with a lack of stimuli to practice physical activities were main factors associated with the excessive weight in the population of interest. Conclusions: Excess weight can be considered a common outcome in children and adolescents with phenylketonuria. It is mainly caused by inadequate food consumption and sedentary lifestyle. The importance of early identification of nutritional disturbances in children and adolescents with phenylketonuria should be emphasized, in order to prevent associated chronic diseases and to promote health by encouraging continued healthy eating habits and the regular practice of physical exercises.

RESUMO Objetivo: Verificar a ocorrência de excesso de peso em crianças e adolescentes com fenilcetonúria e identificar possíveis fatores causais. Fontes de dados: Revisão sistemática realizada nas bases de dados Scientific Eletronic Library Online (SciELO), Publisher Medline (PubMed) e Biblioteca Virtual em Saúde (BVS) com os descritores "Phenylketonurias", "Overweight", "Child" e "Adolescent". Foram incluídos artigos originais sobre crianças e adolescentes, publicados entre 2008 e 2018 nos idiomas português, inglês ou espanhol. Síntese dos dados: Foram identificados 16 artigos e, após aplicação dos procedimentos de seleção, 6 estudos foram selecionados para compor a revisão. O excesso de peso em crianças e adolescentes com fenilcetonúria foi evento frequente nos estudos incluídos na presente revisão, variando de 7,8 a 32,6%. Aponta-se o sexo feminino como o grupo mais acometido pelo distúrbio nutricional. O principal fator associado ao excesso de peso na população de interesse na população de interesse foi o consumo calórico elevado aliado à falta de estímulos para a prática de atividades físicas. Conclusões: O excesso de peso pode ser considerado um desfecho comum em crianças e adolescentes com fenilcetonúria, sendo ocasionado principalmente pelo consumo alimentar inadequado e pelo sedentarismo. Salienta-se a importância da identificação precoce de agravos nutricionais em crianças e adolescentes fenilcetonúricos, a fim de prevenir doenças crônicas associadas e promover a saúde, com incentivo à manutenção de hábitos alimentares saudáveis e à prática regular de exercícios físicos.

Insulin-like growth factor binding protein-1, non-alcoholic fatty liver disease, and its relationship with fructose consumption in children with obesity

Background Over consumption of added sugar is associated with obesity, non-alcoholic fatty liver disease (NAFLD), and insulin resistance (IR). Objective The objective of the study was to study the insulin-like growth factor binding protein-1 (IGFBP-1) and NAFLD and their relationship with fructose consumption in children with obesity. Methods A cross-sectional study was carried out in children 6-11 years old with obesity. Anthropometric measurements, fructose consumption, glucose, lipid profile, insulin, and IGFBP-1 levels were evaluated; the homeostatic model assessment of IR (HOMA-IR) was used. NAFLD was evaluated by ultrasound. Results We studied 83 children with a mean age of 9.2 ± 1.3 years. About 93% of the girls presented IR and lower levels of IGFBP-1 (p = 0.0001). The group with the lower levels of IGFBP-1 had higher HOMA-IR (p = 0.000002); IGFBP-1 was associated with fructose consumption (r = −0.25; p = 0.03), body mass index (BMI) (r=−0.42; p = 0.02), and HOMA-IR (r=−0.61; p = 0.002). About 81% of the children were classified as having mild or moderate/severe NAFLD, and these groups had higher HOMA-IR (p = 0.036) and fructose consumption (p = 0.0014). Conclusions The girls had more metabolic alterations. The group with lower levels of IGFBP-1 (hepatic IR) was associated with higher BMI, HOMA-IR, and fructose consumption; the group with higher severity of NAFLD showed higher HOMA-IR and fructose consumption.

Inactive behavior in adolescent students of the brazilian western amazon / Comportamento inativo em estudantes adolescentes da amazônia ocidental brasileira

ABSTRACT Objective: To identify the prevalence of physical inactivity in adolescent students in the city of Porto Velho, RO, Northern Brazil, and its associated factors. Methods: School-based study, conducted with 2,694 adolescents. The self-reported variable for outcome was physical inactivity. Factors associated with inactive behavior were verified by multiple logistic regression. The independent variables were inserted into the model in hierarchical blocks. Results: The overall prevalence of inactive behavior was 39.5%. Females showed a higher prevalence of physical inactivity (46.2%) than males (31.4%). Adolescents in private schools and with reports of negative health perception had a high prevalence of physical inactivity. Regarding associated factors, the female sex showed a magnitude of association of 1.84 with physical inactivity. Being in a private school was associated with a 2.54 times greater chance of physical inactivity compared to public school students. Going to school by bus, car or motorcycle was associated with a 1.29 and 1.63 higher chance of physical inactivity respectively. Adolescents who reported having a negative health perception had 1.29 higher chance of physical inactivity, while having excess body fat showed magnitude of association of 1.36 in adolescents. Conclusions: There was a high prevalence of physical inactivity in the studied adolescents. Considering that the behavior of physical inactivity adopted during adolescence may continue in adulthood, the promotion of actions that can change this behavior may improve health in the future as well as quality of life.

RESUMO Objetivo: Identificar a prevalência do comportamento inativo de estudantes adolescentes da cidade de Porto Velho, RO, Brasil, e os fatores associados a ele. Métodos: Estudo de base escolar realizado com 2.694 adolescentes. A variável autorreferida à exposição ao desfecho foi a inatividade física. Verificam-se os fatores associados ao comportamento inativo pela regressão logística múltipla. As variáveis independentes foram inseridas no modelo em blocos hierarquizados. Resultados: A prevalência geral de comportamento inativo foi de 39,5%. O sexo feminino mostrou maior prevalência de comportamento inativo (46,2%) do que o masculino (31,4%). Adolescentes em escolas particulares e com relatos de percepção de saúde negativa apresentaram alta prevalência de comportamento inativo. Na verificação dos fatores associados, o sexo feminino mostrou magnitude de associação de 1,84 com o comportamento inativo. Estar institucionalizado em escola particular mostrou 2,54 vezes mais chance de ter comportamento inativo em comparação aos estudantes das escolas públicas. A locomoção para escola por ônibus e carro ou motocicleta revelou magnitudes de associação com o comportamento inativo de 1,29 e 1,63, respectivamente. Adolescentes que apontaram a percepção de saúde negativa tiveram 1,29 mais chance de ter comportamento inativo em relação ao relato de saúde positiva, enquanto ter excesso de gordura corporal mostrou magnitude de associação de 1,36 em adolescentes. Conclusões: A prevalência de comportamento inativo foi alta em estudantes adolescentes. Considerando que o comportamento inativo adotado durante a adolescência pode permanecer nos anos posteriores, sugere-se a promoção de ações para a modificação de comportamento visando à melhoria da saúde e qualidade de vida.

The role of the obesogenic environment and parental lifestyles in infant feeding behavior / O papel do ambiente obesogênico e dos estilos de vida parentais no comportamento alimentar infantil

ABSTRACT Objective: To identify the role of the obesogenic environment and parental lifestyles in infant feeding behavior. Data sources: The searches were performed in PubMed, Medline, Cochrane, Lilacs and Scielo databases, in Portuguese, English and Spanish. The descriptors used were found in the Medical Subject Headings and in the Descriptors in Health Sciences being these: Comportamento alimentar/Feeding Behavior/ Conducta Alimentaria; Crianças/Child/ Niño; Relações familiares/Family Relations/Relaciones Familiares; e Ecologia/ Ecology/ Ecología. These were combined by the Boolean operator AND. Data synthesis: Researchers consider that parents (orprimary caregivers) are responsible, in part, for the unhealthy eating behavior presented by children, and for them to change it is necessary to change the behavior of the family, ensuring the correct choice of food and the practice of physical activity. The family environment has a significant impact on the development of eating behavior, so adults should provide a good model of this behavior for children. Conclusions: It was verified through this review that, in order to maintain and develop a healthy eating behavior, it is necessary to reach different spheres of life of the individual - physical, social, psychological, family, cultural and mediatic environment.

RESUMO Objetivo: Investigar a influência do ambiente obesogênico e dos estilos de vida parentais no comportamento alimentar infantil. Fonte de dados: Foram consultadas as bases de dados PubMed, Sistema Online de Busca e Análise de Literatura Médica (MEDLINE), Cochrane, Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs) e Scientific Electronic Library Online (SciELO) nos idiomas português, inglês e espanhol. Os descritores utilizados foram selecionados no Medical Subject Headings e no Descritores em Ciências da Saúde (DeCS): comportamento alimentar/feeding behavior/conducta alimentaria; crianças/child/niño; relações familiares/family relations/relaciones familiares; e ecologia/ecology/ecología. A pesquisa foi especificada utilizando-se o operador booleano AND. Síntese dos dados: A maioria dos estudos sugere que os pais (osprincipais cuidadores) são responsáveis, em parte, pelo comportamento alimentar não saudável apresentado pelos filhos, e para que esse comportamento se modifique é necessário mudar o comportamento da família, garantindo a escolha correta de alimentos acompanhada da prática de atividade física. O ambiente familiar mostra impacto significativo no desenvolvimento do comportamento alimentar, por isso os adultos devem fornecer um bom modelo desse comportamento para as crianças. É importante ressaltar a contribuição do ambiente físico, da cultura, da escola e da mídia no processo. Conclusões: Verificou-se nesta revisão que a formação do comportamento alimentar depende da interação de fatores relacionados à criança e aos cuidadores e sofre a ação de diversos fatores relacionados à vida do indivíduo - ambientes físico, social, familiar, cultural e midiático.

Estudio comparativo del estado nutricional de niños y niñas residentes en cuatro partidos de la provincia de Buenos Aires (Argentina), en el marco de la transición nutricional / Comparative study of the nutritional status of children living in four counties of the province of Buenos Aires (Argentina), in the context of nutrition transition

RESUMEN El objetivo fue evaluar y comparar el estado nutricional en poblaciones infanto-juveniles residentes en cuatro partidos de la provincia de Buenos Aires y observar si existen diferencias vinculadas a los contextos ambientales y socioeconómicos particulares, en el marco de la transición nutricional. Entre los ciclos lectivos 2008-2012, se relevó el peso y la talla y se calculó el índice de masa corporal de 7.873 escolares, entre 4 y 12 años de edad, residentes en los partidos de La Plata, Brandsen, Magdalena y Punta Indio. La información acerca del contexto de residencia se obtuvo mediante encuesta estructurada y autoadministrada. Alrededor del 40% de los escolares presentó malnutrición, y prevalecieron el sobrepeso en La Plata, la obesidad en Punta Indio y la desnutrición en Magdalena. El estado nutricional se vinculó con las condiciones socioambientales de residencia y dio cuenta de que estas poblaciones se ubican en distintas etapas del proceso de transición nutricional.

ABSTRACT The aim of this study was to evaluate and compare the nutritional status of child populations living in four counties of the province of Buenos Aires to observe differences related to particular environmental and socioeconomic contexts in the framework of the nutrition transition. During the school years corresponding to the 2008-2012 period, weight and height were measured and body mass index was calculated for 7,873 school children between the ages of 4 and 12 years from the counties of La Plata, Brandsen, Magdalena and Punta Indio. Information about the contexts of residence was obtained using self-administered structured surveys. About 40% of schoolchildren presented malnutrition, with a prevalence of overweight in La Plata, obesity in Punta Indio and undernutrition in Magdalena. The nutritional status of the study populations was associated with the socioenvironmental conditions of residence, indicating that these populations are at different stages of the nutrition transition process.

Percepción del gusto como factor de riesgo para obesidad infantil / Taste perception as a risk factor for childhood obesity

Resumen Objetivo Describir el papel de la percepción del gusto como factor de riesgo para el desarrollo de obesidad en niños. Material y métodos Se realizó una búsqueda inicial de artículos científicos publicados en PubMed entre el 1 de enero de 2011 y el 20 de marzo de 2016 para el tema sobrepeso y obesidad en niños de entre 0 y 12 años. Los algoritmos utilizados fueron (Obesity OR Overweight) AND Taste perception, Satiation, Satiety response, Appetite, Appetite regulation, Habituation, Taste receptors [MeSH] y PROP phenotype. En búsquedas subsecuentes se incluyeron artículos previos y posteriores a la fecha de la búsqueda general (hasta mayo 2018). Resultados Las preferencias por los sabores inician desde la gestación, por lo que los niños que son expuestos a sabores dulces en etapas tempranas de la infancia aumentan su riesgo de habituación a éstos. Asimismo, las experiencias hedónicas dadas por la ingestión de alimentos y bebidas dulces refuerzan el consumo de estos alimentos, lo que propicia la selección de productos o bebidas de sabor dulce en etapas posteriores. Estas preferencias se han asociado con el desarrollo de obesidad en los niños. Las variantes genéticas relacionadas con la percepción del gusto también pueden contribuir a la selección de cierto tipo de alimentos. Sin embargo, su relación con una mayor ingestión de energía, así como con un mayor peso corporal, ha sido poco explorada y ha mostrado resultados inconsistentes. Conclusiones Se requiere más evidencia para entender las interacciones ambientales y genéticas de la percepción del gusto, a fin de considerarlo un factor más en las intervenciones de política pública.

Abstract Objective To describe the role of taste perception in the development of sweet taste habituation as well as its relationship to the development of obesity in children. Materials and methods An initial search of scientific articles published in PubMed between January 1st, 2011 and March 20th, 2016 was performed in children between 0 and 12 years old. The algorithms used were (Obesity OR Overweight) AND (Taste perception, Satiation, Satiety response, Appetite, Appetite regulation Habituation, Taste receptors [MeSH]) and PROP phenotype. Subsequent searches included papers published before and after date of initial search (until May 2018). Results Flavor preferences start as early as taste system development during pregnancy. Therefore, children who are exposed to sweet flavors in early childhood, increase their risk of habituation to them. Likewise, the hedonic experiences given by the ingestion of sweet foods and beverages, reinforce the consumption of these foods, perpetuating their selection in later stages. Preference for sweet taste has been associated with the development of obesity in children. Functional genetic variants related to taste perception can also contribute to the selection of certain types of foods and there is enough evidence that supports this idea. However, its contribution to a higher energy intake as well as a higher body weight has been poorly explored with inconsistent results. Conclusions More evidence is required to understand the environmental and genetic interactions of taste perception, so in turn, it can be consider as a key factor for preventing child obesity.

Valoración del riesgo cardiometabólico determinado por variables antropometricas en niños escolares con diversidad étnica / Assessment of cardiometabolic risk determined by anthropometric variables in school children with ethnic diversity

El aumento progresivo de la obesidad en la población escolar chilena es preocupante, los niños mapuches, corren un riesgo alto de ser obesos, debido a la rápida transculturación y el acceso deficiente a información de salud pública. El propósito del estudio fue comparar variables antropometricas y su relación con el riesgo cardiometabólico en niños Mapuches y no-Mapuches, pertenecientes a colegios rurales de la IX Región de Chile. Se evaluaron 239 escolares (118 niñas y 121 niños) entre 6 y 12 años, pertenecientes a 3 colegios de rurales de la comuna de Cholchol, Imperial y Galvarino de la región de la Araucanía Chile, perteneciendo 177 escolares a la etnia mapuche, participaron de la investigación de forma voluntaria. Se recolectaron datos respecto a descendencia étnica (mapuche, no mapuche), edad, peso, talla, circunferencia cintura (CC), relación cintura estatura (RCE) y el índice de masa corporal (IMC). En la comparación por sexo y etnia no existieron diferencias significativas (p>0,05). Las variables Antropométricas de peso, CC, RCE, IMC fueron mayores en los sujetos con obesidad y presentaron significancia (p<0.001). El IMC presentó elevada correlación con el CC y presentó significancia (p<0,001). El resultado de la correlación de variables en población Mapuche del IMC con el CC fue mayor (0,909, p<0,001), en comparación a los no-Mapuches. En esta investigación reportó una elevada prevalencia de malnutrición por exceso 43,9% del grupo total estudiado y una alta relación entre el IMC, el CC y la RCE, siendo mayor está en los niños con etnia mapuche(AU)

The progressive increase of obesity in the Chilean school population is worrisome, Mapuche children are at high risk of being obese, due to rapid transculturation and poor access to public health information. The purpose of the study was to compare anthropometric variables and their relationship with cardiometabolic risk in Mapuche and non-Mapuches children, belonging to rural schools of the IX Region of Chile. A total of 239 schoolchildren (118 girls and 121 boys) between 6 and 12 years of age were evaluated, belonging to 3 rural schools in the Cholchol, Imperial and Galvarino communes of the Araucanía region of Chile, belonging to 177 Mapuche students. the investigation on a voluntary basis. Data were collected regarding ethnic descent (Mapuche, non-Mapuche), age, weight, height, waist circumference (WC), waist height ratio (SBC) and body mass index (BMI). In the comparison by sex and ethnic group, there were no significant differences (p> 0.05). The anthropometric variables of weight, CC, ROSC, BMI were higher in subjects with obesity and presented significance (p <0.001). The BMI showed high correlation with CC and presented significance (p <0.001). The result of the correlation of variables in Mapuche population of BMI with CC was higher (0.909, p <0.001), compared to non-Mapuches. This study reported a high prevalence of malnutrition due to excess of 43.9% of the total group studied and a high relationship between BMI, CC and RCE, being higher in children with Mapuche ethnicity(AU)

Determinantes sociales de la salud asociados con el exceso de peso en la población infantil / Social determinants of health associated with overweight in children

Introducción: El exceso de peso en la población infantil se presenta como consecuencia de una serie de determinantes sociales de la salud. Objetivo: Analizar la asociación entre los determinantes sociales de la salud y el exceso de peso en niños menores de seis años. Métodos: Estudio de casos (exceso de peso) y controles (normopeso) en niños menores de seis años atendidos por consulta externa en el Hospital Infantil los Ángeles 2013-2015. La muestra quedó conformada por 175 casos seleccionados por números aleatorios de una base de datos de la institución de salud y 175 controles. Resultados: Los niños menores de dos años tenían menor riesgo de exceso de peso (OR= 0,15 IC95 por ciento 0,092- 0,27), que los de dos a seis años. En los menores que permanecieron en casa aumentó el riesgo de padecer el evento en estudio (OR= 10,4 IC95 por ciento 4,11-26,5). En los niños que fueron alimentados simultáneamente con formula y leche materna durante los primeros seis meses de vida acrecentó el riesgo de exceso de peso (OR= 13,0 IC 95 por ciento 2,17-76,1). Conclusiones: Determinantes sociales de la salud, como la edad, la permanencia en casa y la alimentación combinada con formula y leche materna en los primeros seis meses de vida, son factores importantes que se asocian con el exceso de peso en menores de 6 años(AU)

Introduction: Overweight in children is a consequence of a series of social determinants of health. Objective: To analyze the relation between the social determinants of health and overweight in children. Methods: Cases study (overweight) and check-ups (normal weight) in children under six years old attended in the external consultations at Los Angeles Children's Hospital from 2013 to 2015. The sample consisted in 175 cases selected by random numbers from a database of the health institution and 175 check-ups. Results: Children under two years old had a lower risk of overweight (OR= 0.15 IC95 percent 0.092-0.27) than those in the ages from two to six years old. In the children who stayed at home increased the risk of suffering the event under study (OR= 10.4 IC95 percent 4.11-26.5). In children who were fed with formula and breast milk simultaneously during the first six months of life increased the risk of overweight (OR= 13.0 IC95 percent 2.17-76.1). These variables were associated with overweight. Conclusions: Social determinants of health, such as age, stay at home, and combined diet with formula and breast milk in the first six months of life are important factors associated with overweight in children under 6 years old(AU)

Prevalence of overweight and obesity and associated factors in school children and adolescents in a medium-sized Brazilian city

OBJECTIVES: The objective of this study was to describe the prevalence of overweight and obesity in school children and adolescents in a medium-sized Brazilian city. METHODS: In total, 1,125 children and adolescents between the ages of 5.6 and 18 years from public and private schools participated in the study. The sample included 681 girls and 444 boys. Each subject's weight and height were obtained according to Brazilian guidelines (SISVAN). The triceps (TSF), subscapular (SSF), biceps, suprailiac, femoral and calf skinfolds were measured in triplicate. Body mass index (BMI) was classified as the BMI percentile (BMIP) according to the World Health Organization (WHO) 2007 criteria. The percentage body fat (%BF) was obtained using the equations by Slaughter et al., 1998. Categorical variables were analyzed using the chi-squared test. RESULTS: Overall, 364 participants with excess weight were identified: 17.3% were overweight, and 15.0% were obese. Among the girls, 18.0% were overweight, and 12.5% were obese; among the boys, 15.3% were overweight, and 18.0% were obese. These prevalence rates were higher when the time spent watching TV or participating in media-related activities surpassed 5 hrs/day, when individuals belonged to a higher economic class and when the head of the family had a higher education level (≥12 years). CONCLUSION: It is important to emphasize the need to increase our understanding of factors associated with overweight and obesity, and it is essential to implement measures and policies aimed at reversing this trend, such as stimulating healthy eating habits and physical activity and reducing time spent watching TV and participating in other media activities, including video games and social networking.

Nutritional counseling promotes changes in the dietary habits of overweight and obese adolescents with polycystic ovary syndrome / O aconselhamento nutricional promove mudanças nos hábitos alimentares de adolescentes com excesso de peso e obesas e com síndrome dos ovários policísticos

Abstract Objective To evaluate the effects of nutritional counseling on the dietary habits and anthropometric parameters of overweight and obese adolescentswith polycystic ovary syndrome (PCOS). Methods This was a prospective, longitudinal and auto-controlled study. Thirty adolescents aged 13-19 years-old, diagnosed with PCOS received nutritional counseling and were followed-up for 6 months. After the follow-up period, the results were evaluated through body weight, body mass index (BMI) and waist circumference (WC). Results Sixty-percent of the adolescents adhered to the nutritional counseling and, of these, 50% lost weight. Adolescents who lost weight changed their dietary habits by adopting hypocaloric diets and eating more meals per day, as per nutritional counseling. The waist circumference (WC) decreased significantly, although the body weight decreased non-significantly after adoption of a hypocaloric diet. Conclusion Although there was no significant weight loss, there was a considerable reduction in theWCassociated with hypocaloric diets and with eating a greater number of meals per day.

Resumo Objetivo Avaliar os efeitos do aconselhamento nutricional sobre os hábitos alimentares e os parâmetros antropométricos de adolescentes com sobrepeso e obesidade e com síndrome do ovário policístico (SOP). Métodos Este foi um estudo prospectivo, longitudinal e autocontrolado. Trinta adolescentes com idades entre 13 e 19 anos e diagnosticadas com SOP receberam aconselhamento nutricional. Após 6 meses de acompanhamento, os resultados foram avaliados através do peso corporal, índice demassa corporal (IMC) e a circunferência da cintura (CC). Resultados Sessenta por cento das adolescentes aderiram ao aconselhamento nutricional e, destas, 50% perderam peso. Adolescentes que perderam peso mudaram seus hábitos alimentares adotando dietas hipocalóricas e comendo mais refeições por dia, seguindo orientação nutricional. A circunferência da cintura (CC) diminuiu significativamente, embora o peso corporal tenha diminuído de forma não significativa após a adoção de uma dieta hipocalórica. Conclusão Embora a perda de peso não tenha sido significativa, houve redução considerável da CC associada a dietas hipocalóricas e à ingestão de um maior número de refeições por dia.

Vulnerabilidad socioeconómica y obesidad en escolares chilenos de primero básico: comparación entre los años 2009 y 2013 / Socioeconomic vulnerability and obesity in Chilean schoolchildren attending first grade: comparison between 2009 and 2013

INTRODUCCIÓN: Estudios que han mostrado asociación entre obesidad y nivel socioeconómico no son concluyentes. OBJETIVOS: Determinar el riesgo de estudiantes chilenos de primero básico de presentar obesidad según vulnerabilidad socioeconómica (VSE) en los años 2009 y 2013 y verificar el cambio observado en el riesgo en ese período, por sexo y área geográfica. PACIENTES Y MÉTODO: Estudio trans versal (N= 175.462 en 2009) y (N= 189.055 en 2013) que incluyó: peso, talla, rural/urbano, sexo y VSE, datos provenientes de encuesta JUNAEB. Se determinaron ZIMC/edad, % obesidad y 3 grupos según VSE (muy vulnerables, moderados, no vulnerables). Para comparar ZIMC entre grupos, se utilizó test t y para las variables predictoras (grado de VSE) y respuesta (obesidad), por sexo y área, se utilizó C2. Regresión logística determinó OR de presentar obesidad según VSE. RESULTADOS: % de obesidad fue 19,6% y 24,1% en 2009 y 2013, mayor en hombres. OR de presentar obesidad en el 2009 fue: 0,85 (0,82-0,88) y 0,70 (0,64-0,75) en estudiantes más vulnerables, y 0,94 (0,91-0,97) y 0,81 (0,74-0,88) en aquellos con vulnerabilidad moderada; en 2013, 0.96 (0,93-0,98) y 0,89 (0,82-0,96) en estudiantes más vulnerables, y 0,99 (0,96-1,02) y 0,94 (0,86-1,02) en estudiantes con vulnerabilidad moderada, en áreas urbanas y rurales respectivamente. El mayor incremento en obesidad se observó en los más vulnerables de zona rural (de 16,6 a 24,3%). CONCLUSIÓN: El mayor % de obesidad fue observado en niños no vulnerables. Aun cuando los estudiantes más vulnerables de zonas rurales presentan el menor % de obesidad en ambos años, el mayor incremento en el período se observó en este grupo.

INTRODUCTION: Although obesity is related to socioeconomic level, studies are inconclusive. OBJECTIVES: To determine obesity risk according to socioeconomic vulnerability among Chilean children (1st grade) in 2009 and 2013 and assess its change during that period, by sex and geographical area. PATIENTS AND METHOD: Cross-sectional study (N = 175,462 in 2009) and (N = 189,055 in 2013) which included: weight, height, rural / urban, gender and vulnerability obtained from JUNAEB's survey. BMI Z, % obesity and 3 categories of vulnerability (very vulnerable, moderate, non-vulnerable) were determined. For the descriptive analyses, we used t tests and for predictor variables (2 categories of vulnerability) and outcome (obesity) by sex and area, we used %2. Logistic regression models determined OR to develop obesity by. RESULTS: % obesity was 19.6% and 24.1% in 2009 and 2013, higher in boys. In urban and rural areas respectively, OR to develop obesity were: 0.85 (0.82-0.88) and 0.70 (0.64-0.75) in the most vulnerable students and 0.94 (0.91-0.97) and 0.81 (0.74-0.88) in those with moderate vulnerability in 2009 and 0.96 (0.93-0.98) and 0.89 (0.82-0.96) in the most vulnerable students and 0.99 (0.96-1.02) and 0.94 (0.86-1.02) in students with moderate vulnerability in 2013. The highest increase in obesity was observed among the most vulnerable group from rural areas (16, 6 to 24.3%). vulnerability. CONCLUSION: The non-vulnerable group had the highest % obesity. Although the most vulnerable students in rural areas had the lowest obesity risk in both years, the highest increase in obesity during the period, occurred in that group.

Caracterización clínica de lactantes menores de un año, con excesiva ganancia de peso durante la alimentación con leche materna / Clinical features of infants younger than one year with excessive weight gain while being breast fed

Introducción: La lactancia materna es recomendada como fuente de alimentación optima para los primeros meses de vida. En nuestro Servicio hemos recibido un grupo particular de niños alimentados con lactancia materna exclusiva, que muestran aumento excesivo de peso desde el primer semestre de vida. Objetivo: describir las características clínicas de un grupo de lactantes menores de un año, con aumento excesivo de peso y alimentación con lactancia materna. Población y métodos: estudio observacional, prospectivo y longitudinal. Incluimos todos los niños menores de un año derivados al servicio de Nutrición entre 2003 y 2015, con lactancia materna exclusiva durante los primeros 6 meses, persistencia de la misma al momento de la evaluación y peso- edad mayor a 2 desvíos estándar (DS). Describimos características clínicas y de laboratorio de los lactantes y sus madres, así como el patrón alimentario que pudiera explicar esta inusual ganancia de peso. Resultados: incluimos 73 lactantes, 63% niñas. El 64% tenía peso-talla mayor a 2DS a los 3 meses de vida y el 100% a los 6 meses. No se pudo establecer patrón hambresaciedad. El 44% de las madres aumentó más de 18 kilogramos durante el embarazo. Las niñas nacidas de las madres que habían aumentado más de 18 Kg fueron significativamente más grandes al nacer. En el 14% de los lactantes se encontró alguna enfermedad de base. De toda la muestra, el 75% presentó anemia y el 14.5% hipotiroidismo. Conclusiones: describimos un grupo de lactantes con aumento excesivo de peso desde los primeros 3 meses de vida que se mantiene durante toda la etapa de lactancia materna. Diferentes factores como relación madre-hijo, patrón alimentario, composición de la leche humana, predisposición genética; podrían haber contribuido con este patrón de crecimiento.(AU)

Introduction: Maternal breastfeeding is recommended as the best source of nutrition in the first months of life. At our Department we have seen a group of exclusively breastfed children who showed excessive weight since the first semester of life. Objective: To describe the clinical features of a group of infants under one year of age with excessive weight gain while being breast-fed. Population and methods: A prospective, longitudinal, observational study was conducted. We included all infants under one year of age who were referred to the Department of Nutrition between 2003 and 2015, who were exclusively breastfed during the first 6 months of life and were still being breastfed at the moment of the evaluation, and who had a weight-for-age of more than 2 standard deviation (SD). We describe the clinical and laboratory features of the infants and their mothers, as well as feeding patterns that may explain this unusual weight gain. Results: We included 73 infants, 63% girls. Overall, 64% had a weight-for-height greater than 2 SD at 3 months of life and 100% at 6 months of life. No hunger-satiety pattern could be established. Of the mothers, 44% gained more than 18 kg during the pregnancy. The girls born from mothers who had increased more than 18 Kg were significantly larger at birth. In 14% of the infants, an underlying disease was found. Of all the infants in the sample, 75% had anemia and 14.5% hypothyroidism. Conclusions: We describe a group of infants with excessive weight gain in the first 3 months of life which was maintained throughout the maternal breastfeeding period. Different factors, such as the motherchild relationship, feeding pattern, human milk composition, and genetic predisposition may have contributed to this particular growth pattern. (AU)

Crescimento alcançado e estado nutricional de escolares / Attained growth and nutritional status of schoolchildren

O aumento da prevalência do excesso de peso é observado em todas as idades, inclusive nos países em desenvolvimento. O objetivo foi avaliar o crescimento alcançado e o estado nutricional de crianças de duas gerações de escolares: uma no início da idade escolar e outra na transição para a adolescência. A análise de amostra, com 1082 crianças, divididas em dois grupos de idade, um grupo de 6 e 7 anos (G1) e o outro de 9 e 10 anos (G2), do Ensino Fundamental da Rede Pública de Florianópolis. Para classificação do estado nutricional dos escolares utilizou-se o parâmetro escore z de IMC (zIMC), para crianças com cinco anos e mais (OMS 2007). Foram realizadas análises de tendência central, dispersão e proporções. Os resultados foram: idade média de G1 e G2 foi respectivamente de 6,5 anos, desvio padrão (dp) de 0,31, e de 9,6 anos (dp= 0,26); média de estatura (E) da amostra (escore z de E: 0,25, dp=1,09) foi superior à do referencial; prevalência de excesso de peso (sobrepeso, obesidade e obesidade grave, juntos) foi de 42,5%. A distribuição dos escolares segundo escore z de IMC, mostrou desvio para a direita, com uma média de zIMC de 0,78 e dp=1,32 (IC95% 0,69 a 0,85), sem diferença estatística entre G1 e G2. Em conclusão, os escolares apresentavam em 2012, crescimento adequado de estatura concomitantemente à ausência de desnutrição e a uma prevalência bastante elevada de excesso de peso, o que pode ser atribuído a uma etapa avançada de Transição Nutricional(AU)

The increasing prevalence of obesity is occurring in all ages, including in developing countries. The objective was to evaluate the achieved growth and nutritional status of two groups of schoolchildren from public schools: one at the beginning of school age and another in the transition to adolescence. The analysis of sample with 1082 children, divided into two groups according to the age, a group of 6 and 7 years (G1) and the other with 9 and 10 years (G2), from the public elementary schools of Florianopolis. For nutritional status classification of schoolchildren used the parameter z score of BMI (zBMI,) for children with five years and older (WHO 2007). Measures of central tendency, dispersion and proportions based data analysis. The results were: the average age of G1 and G2 was respectively of 6.5 years (SD= 0.31), and 9.6 years (SD= 0.26); average of attainted growth (z score of height to age - H/A) of the sample (H/A: 0.25, SD= 1.09) was above the benchmark; the prevalence of overweight (overweight, obesity and severe obesity together) was 42.5%. The z score of BMI distribution showed a deviation to the right, with an average of 0.78 and positive z score a SD = 1.32 (95% CI 0.69 to 0.85), without statistical difference between G1 and G2. In conclusion, the schoolchildren showed in 2012 appropriate height growth concomitantly to the absence of malnutrition and a very high prevalence of excess weight, which can represent a late stage of Nutritional Transition(AU)