Composición corporal y trastornos respiratorios del sueño en escolares de Valdivia, Chile / Relationship between body composition and sleep-disordered breathing in schoolchildren from Valdivia, Chile

Resumen: Introducción: La malnutrition por exceso en la infancia constituye una epidemia mundial y se asocia a múltiples enfermedades y complicaciones. Entre ellas, destacan los trastornos respiratorios del sueño (TRS), espectro de enfermedades que han emergido como un problema de salud relevante. Objetivo: Eva luar la relación entre la composición corporal y la presencia de TRS en escolares. Sujetos y Méto do: Estudio observacional analítico de corte transversal en 127 escolares de primero a octavo básico escogidos aleatoriamente de cinco establecimientos municipales de Valdivia, Chile. La incorporación al estudio ocurrió luego del proceso de consentimiento informado del responsable del escolar y asentimiento informado del menor. Se realizaron mediciones antropométricas y se determinó la presencia de TRS mediante el Pediatric Sleep Questionnaire (PSQ). Para el análisis se aplicó esta dística descriptiva, t de Student y test x2 para determinar asociación de variables con la presencia de TRS. Resultados: Destacó alta prevalencia de malnutrición por exceso (71,7%) y la obesidad alcanzó 39,4%. En tanto la prevalencia de TRS fue 32,3%. Hubo mayor proporción de niños con TRS en escolares obesos severos (56,3%), así como una media significativamente mayor en niños con TRS para los pliegues bicipital (14,6 mm ± 7,3 vs. 12,0 mm ± 6,6; p=0,002) y tricipital (19,8 ± 6,7 mm vs. 16,2 mm ± 6,0; p =0,04). Conclusiones: Existen altas prevalencias de malnutrición por exceso y TRS. De las medidas antropométricas, la presencia de TRS se asoció con mayor grosor de los plie gues bicipital y tricipital.

Abstract: Introduction: Overnutrition in childhood constitutes a global epidemic and has been associated with multiple di seases and complications. Among them, sleep-disordered breathing (SDB) stands out, a spectrum of diseases that have emerged as a relevant health problem. Objective: To evaluate the association bet ween nutritional status and SDB in schoolchildren. Subjects and Method: Cross-sectional analytical study of 127 schoolchildren randomly selected from five public schools in Valdivia, Chile. After the informed assent and informed consent process of the child and parents/guardian respectively, the students were incorporated into the study. Anthropometric measurements were performed and the presence of SDB was determined through the Pediatric Sleep Questionnaire (PSQ). For the data analysis, the t-test and x2 test were used to determine the association of variables with SDB. Re sults: There was a high prevalence of overnutrition (71.7%) and obesity reached 39.4%. Regarding the prevalence of SDB, it was 32.3%. There was a higher proportion of children with SDB in severely obese schoolchildren (56.3%), as well as, a significantly higher mean of biceps and triceps skinfold thickness in children with SDB (14.6 mm ± 7.3 vs. 12.0 mm ± 6.6, p = 0.002, and 19.8 ± 6.7 mm vs. 16.2 mm ± 6.0, p = 0.04, respectively). Conclusions: There is high prevalence of overnutrition and SDB. Out of the anthropometric measurements, the presence of SDB was associated with greater thickness of the biceps and triceps skinfolds.

Compliance of school food guidelines in primary schools in Mexico City

Childhood obesity is a major public health issue in Mexico. Schools are important settings to promote healthy eating habits. The aim of this study was to assess the extent of compliance with 2010 and 2014 Mexican school food guidelines in six public primary schools in Mexico City. The instruments for this study included semi-structured interviews (n=17) with principals, food vendors and members of the School Vending Committee, focus groups (n=10) with teachers and with parents, observation of six schools' environments, questionnaires applied to 325 schoolchildren from 4th, 5th and 6th grades and their parents, and a food analysis of items sold at school vending. Guidelines' compliance was assessed using all instruments accordingly. It was low in every dimension: 1) Acknowledgment of school food guidelines: None of the participants were familiar with the 2014 guidelines. 2) Healthy environment enhancement: Children lacked free access to safe drinking water. Children had up to five opportunities to eat during school day besides breakfast at home. Most children (67.7%) ate three to four times. 3) Operability of food and beverages sale and consumption: The only training provided to stakeholders was an annual session on hygiene to school food vendors. The majority of food and beverages offered at school vending exceeded energy, sodium, fat and added sugar content as established. Children sold energy-dense foods for school fundraising. Lack of dissemination and acknowledgment of the guidelines, defined roles and policy procedures, as well as training and capacity building for stakeholders impeded school food guidelines'proper implementation(AU)

La obesidad infantil es un problema de salud pública en México. La escuela es un lugar importante para promover hábitos saludables. El propósito del estudio fue evaluar el cumplimiento de los lineamientos escolares de alimentos de 2010 y 2014 en seis escuelas primarias públicas de la Ciudad de México. Los instrumentos incluyen entrevistas semi-estructuradas (n=17) con directores, vendedores de alimentos y miembros del Comité del Establecimiento de Consumo Escolar, grupos focales (n=10) con padres y con profesores, observación del entorno escolar, cuestionarios aplicados a 325 niños de 4º, 5º y 6º grado y a sus padres, y un análisis de los alimentos ofrecidos en la venta escolar. El cumplimiento de los lineamientos fue bajo en cada dimensión: 1) Conocimiento de los lineamientos: Ninguno de los participantes conocía los lineamientos de 2014. 2) Promoción de un ambiente saludable: No se tenía acceso libre a agua simple potable. Los niños tenían cinco oportunidades para comer durante la jornada escolar además del desayuno en casa. La mayoría de los niños (67.7%) comía de 3 a 4 veces. 3) Operatividad de la venta y consumo de alimentos y bebidas: La única capacitación fue una sesión anual de higiene a los vendedores. La mayoría de los alimentos y bebidas excedía los límites establecidos de calorías, sodio, grasa y azúcar añadida. Los niños vendían alimentos densos en energía para recaudar fondos. La falta de difusión de las guías, roles y políticas no definidos y una mínima capacitación obstaculizaron la implementación de los lineamientos(AU)

Obesidad infantil y asma bronquial / Child Obesity and bronchial asthma

Obesity and bronchial asthma have suffered a sustained increase in its prevalence worldwide. The relationship between both entities has been widely studied especially in the adult population. Obesity has been shown to be a risk factor for new bronchial asthma diagnoses and vice versa; and that both alter the evolution of the other. The relationship between them is based on systemic inflammatory factors and cardiometabolic factors rather than the fat load. In this review we will focus on the pathophysiology of metabolic and immunological alterations that link both diseases.

Obesidad y asma bronquial han sufrido un aumento sostenido de su prevalencia a nivel mundial. La relación entre ambas entidades ha sido ampliamente estudiada especialmente en población adulta. Se ha demostrado que obesidad es un factor de riesgo de nuevos diagnósticos de asma bronquial y viceversa; y que ambas alteran la evolución de la otra. La relación entre ellas se sustenta en factores inflamatorios sistémicos y factores cardiometabólicos más que en la carga adiposa. En esta revisión nos centraremos en la fisiopatología de las alteraciones metabólicas e inmunológicas que ligan ambas enfermedades.

Physical fitness and activity, metabolic profile, adipokines and endothelial function in children / Aptidão e atividade física, perfil metabólico, adipocinas e função endotelial em crianças

Abstract Objectives: The prevalence of obesity is increasing. The aim of this study was to investigate if there is endothelial dysfunction in children with normal or excess weight, and whether the metabolic profile, adipokines, and endothelial dysfunction would be more strongly associated with physical fitness or with physical activity levels. Method: Cross-sectional study involving children aged 5-12 years. The evaluation included venous occlusion plethysmography, serum levels of adiponectin, leptin and insulin, lipid profile, physical activity score (PAQ-C questionnaire), and physical fitness evaluation (Yo-Yo test). Results: A total of 62 children participated in this study. Based on the body mass index, 27 were eutrophic, 10 overweight and 25 obese. Triglycerides, LDL cholesterol, HOMA-IR, and leptin were higher in the obese and excess-weight groups compared to the eutrophic group (p < 0.01). HDL cholesterol and adiponectin levels were higher in the eutrophic group compared to the obese and excess-weight groups (p < 0.01). Flow-mediated vasodilation after hyperemia was higher in the eutrophic group in comparison to obese and excess-weight subjects (p < 0.05). There was no difference in the physical activity levels among groups measured by PAQ-C. The Yo-Yo test was significantly associated with HDL cholesterol (rho = −0.41; p = 0.01), and this association remained after adjusting for body mass index z-score (rho = 0.28; p = 0.03). Conclusion: This study showed that endothelial dysfunction is already present in obese children, suggesting a predisposition to atherosclerotic disease. Moreover, HDL cholesterol levels were correlated with physical fitness, regardless of body mass index.

Resumo: Objetivos: A prevalência da obesidade está aumentando. O objetivo deste estudo foi investigar se há disfunção endotelial nas crianças com peso normal ou excesso de peso e se o perfil metabólico, as adipocinas e a disfunção endotelial seriam mais fortemente associados à aptidão física ou aos níveis de atividade física. Método: Estudo transversal que envolve crianças de 5-12 anos. A avaliação incluiu pletismografia de oclusão venosa, níveis séricos de adiponectina, leptina, insulina e lipidograma, escore de atividade física (questionário PAQ-C) e avaliação da aptidão física (teste Yo-yo). Resultados: Um total de 62 crianças participou deste estudo. Com base no índice de massa corporal, 27 eram eutróficos, 10 estavam acima do peso e 25 estavam obesos. Os níveis de triglicerídeos, colesterol LDL, HOMA-RI e leptina estavam mais elevados nas crianças obesas e com excesso de peso que o grupo de eutróficos (p < 0,01). Os níveis de colesterol HDL e adiponectina estavam mais elevados no grupo de eutróficos em comparação ao grupo de obesos e com excesso de peso (p < 0,01). A vasodilatação mediada pelo fluxo após hiperemia foi maior no grupo de eutróficos em comparação aos indivíduos obesos e com excesso de peso (p < 0,05). Não houve nenhuma diferença nos níveis de atividade física entre os grupos medidos pelo PAQ-C. O teste de ida e volta foi significativamente associado ao colesterol HDL (ró = −0,41; p = 0,01) e essa associação continuou após ajustar o escore z do índice de massa corporal (ró = 0,28; p = 0,03). Conclusão: Este estudo mostrou que a disfunção endotelial já está presente nas crianças obesas, sugeriu uma predisposição à doença aterosclerótica. Além disso, os níveis de colesterol HDL foram correlacionados à aptidão física, independentemente do índice de massa corporal.

The longitudinal relationship between motor competence and measures of fatness and fitness from childhood into adolescence / Relação longitudinal entre a coordenação motora e as medidas de gordura e aptidão física da infância à adolescência

Abstract Objectives: To examine longitudinal (seven years) relationships among cardiorespiratory fitness (VO2peak), body fatness, and motor competence. Method: Data were collected as part of the Copenhagen School Child Intervention Study (CoSCIS). Body fatness was assessed by the sum of four skinfolds. VO2peak was measured directly in a continuous running protocol. Motor competence was assessed using the Körperkoordinationtest für Kinder. This study used multilevel linear mixed models to evaluate the reciprocal longitudinal association between body fatness, VO2peak, and motor competence. All regressions were stratified by sex and adjusted by intervention and pubertal status. All variable coefficients were standardized. Results: A reciprocal relationship was observed between children's motor competence with body fatness and VO2peak at the seven-year follow-up (6 -13 years of age). Children with higher motor competence at baseline had a lower risk of having higher body fatness (βboys = −0.45, 95% CI: −0.52 to −0.38; βgirls = −0.35, 95% CI: −0.42 to −0.28) and higher VO2peak (βboys = 0.34, 95% CI: 0.27 -0.40; βgirls = 0.27, 95% CI: 0.20 -0.33) during childhood. Alternatively, higher body fatness or lower levels of VO2peak at baseline were associated with lower motor competence during childhood. Conclusions: These data suggest motor competence, body fatness, and VO2peak demonstrate reciprocal relationships across childhood (6 -13 years of age). Interventions addressing motor competence, cardiorespiratory fitness, and body fatness in early childhood are recommended, as intervention effects are likely to be enhanced because of the mutual reciprocal associations between these three variables.

Resumo Objetivos: Examinar as relações longitudinais (sete anos) entre a aptidão cardiorrespiratória (VO2 pico), gordura corporal e coordenação motora. Método: Os dados foram coletados como parte do Copenhagen School Child Intervention Study (CoSCIS). A gordura corporal foi avaliada pela soma de quatro dobras cutâneas. O VO2 pico foi medido diretamente em um protocolo de corrida contínua. A coordenação motora foi avaliada com o teste de coordenação corporal para crianças (Körperkoordination für Kinder - KTK). Usamos modelos lineares mistos multiníveis para avaliar a associação longitudinal recíproca entre a gordura corporal, o VO2 pico e a coordenação motora. Todas as regressões foram estratificadas por sexo e ajustadas para intervenção e estado puberal. Todos os coeficientes das variáveis foram padronizados. Resultados: Observamos uma relação recíproca entre a coordenação motora e a gordura corporal. As crianças com maior coordenação motora no início do estudo apresentaram menor risco de ter maior nível de gordura corporal (βmeninos = -0,45, IC de 95%: -0,52: -0,38; βmeninas = -0,35, IC de 95%: -0,42: -0,28) e maior VO2 pico (βmeninos = 0,34, IC de 95%: 0,27: 0,40; βmeninas = 0,27, IC de 95%: 0,20: 0,33). Por outro lado, maior nível de gordura corporal ou menores níveis de VO2 pico no início do estudo foram associados a menor coordenação motora durante a infância. Conclusões: Esses dados sugerem que a coordenação motora, gordura corporal e VO2 pico demonstram relações recíprocas durante a infância (6-13 anos). São recomendadas intervenções que abordem a coordenação motora, a aptidão cardiorrespiratória e a gordura corporal na primeira infância, pois os efeitos da intervenção são provavelmente maiores devido às associações recíprocas mútuas entre essas três variáveis.

Body mass index and physical fitness in Brazilian adolescents / Índice de massa corporal e aptidão física em adolescentes brasileiros

Abstract Objective: Evaluate the relationship between body mass index and physical fitness in a cross-sectional sample of Brazilian youth. Methods: Participants were 3849 adolescents (2027 girls) aged 10 -17 years. Weight and height were measured; body mass index was calculated. Physical fitness was evaluated with a multistage 20 m shuttle run (cardiovascular endurance), standing long jump (power), and push-ups (upper body strength). Participants were grouped by sex into four age groups: 10 -11, 12 -13, 14 -15, and 16 -17 years. Sex-specific ANOVA was used to evaluate differences in each physical fitness item among weight status categories by age group. Relationships between body mass index and each physical fitness item were evaluated with quadratic regression models by age group within each sex. Results: The physical fitness of thin and normal youth was, with few exceptions, significantly better than the physical fitness of overweight and obese youth in each age group by sex. On the other hand, physical fitness performances did not consistently differ, on average, between thin and normal weight and between overweight and obese youths. Results of the quadratic regressions indicated a curvilinear (parabolic) relationship between body mass index and each physical fitness item in most age groups. Better performances were attained by adolescents in the mid-range of the body mass index distribution, while performances of youth at the low and high ends of the body mass index distribution were lower. Conclusion: Relationships between the body mass index and physical fitness were generally nonlinear (parabolic) in youth 10 -17 years.

Resumo Objetivo: Avaliar a relação entre o índice de massa corporal e a aptidão física em uma amostra transversal de jovens brasileiros. Métodos: Os participantes foram 3.849 adolescentes (2.027 meninas) entre 10-17 anos. Foram medidos o peso e a estatura e foi calculado o índice de massa corporal. A aptidão física foi avaliada com: a corrida vaivém de 20 metros de vários estágios (resistência cardiovascular), impulsão horizontal (energia) e flexões (força superior do corpo). Os participantes foram agrupados por sexo em quatro faixas etárias: 10-11, 12-13, 14-15 e 16-17 anos. A Anova específica para sexo foi usada para avaliar as diferenças em cada item de aptidão física entre as categorias de status do peso por faixa etária. As relações entre o índice de massa corporal e cada item de aptidão física foram avaliadas com os modelos de regressão quadrática por faixa etária com relação ao sexo. Resultados: A aptidão física de jovens magros e normais foi, com poucas exceções, significativamente melhor do que a aptidão física de jovens com sobrepeso e obesos em cada faixa etária por sexo. Por outro lado, os desempenhos na aptidão física não diferiram de forma consistente, em média, entre jovens magros e com peso normal e entre jovens com sobrepeso e obesos. Os resultados das regressões quadráticas indicaram uma relação curvilínea (parabólica) entre o índice de massa corporal e cada item de aptidão física na maior parte das faixas etárias. Os melhores desempenhos foram obtidos pelos adolescentes na faixa intermediária da distribuição do índice de massa corporal, ao passo que os desempenhos dos jovens nas extremidades inferiores e superiores da distribuição do índice de massa corporal foram menores. Conclusão: As relações entre o índice de massa corporal e a aptidão física foram, em geral, não lineares (parabólica) nos jovens entre 10-17 anos.

Relación entre adiposidad corporal y salto horizontal en niños y adolescentes escolares / Relationship between body adiposity and horizontal jump in school children and adolescents

Resumen: Un alto nivel de aptitud física en la infancia y la adolescencia se asocia con resultados de salud física y mental más favorables. Objetivo: Comparar la adiposidad corporal y el salto horizontal con estudios internacionales y analizar la relación entre indicadores de adiposidad corporal y salto horizontal en niños y adolescentes. Pacientes y Método: Estudio descriptivo en 812 adolescentes de Talca (Chi le), con un rango de edad entre 10,0 a 16,9 años. Se evaluó el peso, estatura, la circunferencia de la cintura (CC) y el Salto Horizontal (SH) previo calentamiento de 10-15 minutos para evaluar la fuerza explosiva de las extremidades inferiores según protocolo de Castro-Piñero et al. Se comparó la adiposidad y el SH con estudios nacionales e internacionales. La normalidad de los datos fue ve rificada por el test de Kolmogorov-Smirnov. Se crearon curvas de percentiles (p50) suavizadas para el IMC, CC y SH para cada sexo según el método LMS. Resultados: Los adolescentes mostraron discrepancias en la adiposidad corporal y en el desempeño del SH con los estudios internacionales. En ambos sexos se verificaron correlaciones negativas y significativas entre el IMC y el SH (hom bres r= -0,104 y mujeres r= -0,149) y entre la CC y el SH (hombres r= -0,100 y mujeres r= -0,131). Los adolescentes que fueron clasificados en el tercil 1 (bueno) y tercil 2 (satisfactorio) presentaron menor adiposidad corporal (IMC y CC) y mejor desempeño en el SH en relación a los del tercil 3 (pobre). Conclusión: Se observó mayor adiposidad corporal y menor desempeño en el SH respecto a los estudios internacionales. Además, se verificó una relación negativa entre adiposidad corporal y SH. Estos hallazgos sugieren que el aumento progresivo de la adiposidad conforme la edad aumenta limita negativamente el desempeño de la fuerza de las extremidades inferiores de los niños y ado lescentes estudiados.

Abstract: A high level of physical fitness in childhood and adolescence is associated with more favorable phy sical and mental health outcomes. Objective: To compare body adiposity and horizontal jump per formance with international studies and to analyze the relationship between body adiposity and ho rizontal jump performance indicators in children and adolescents. Patients and Method: Descriptive study conducted on 812 adolescents from Talca (Chile), with an age range between 10.0 and 16.9 years. Weight, height, waist circumference (WC) and Horizontal jump (HJ) were evaluated after warm-up for 10 to 15 minutes to evaluate the explosive strength of the lower extremities according to the protocol of Castro-Piñero et al. Adiposity and HJ were compared with national and international studies. The data normality was verified by the Kolmogorov-Smirnov test. Smoothed percentile cur ves (p50) were created for BMI, WC, and HJ for each gender according to the LMS method. Results: Adolescents showed differences in body adiposity and HJ performance with international studies. In both genders, negative and significant correlations were found between the BMI and the HJ (men r = -0.104 and women r = -0.149) and between the WC and the HJ (men r = -0.100 and women r = -0.131). The adolescents who were classified in tertile 1 (good) and tertile 2 (satisfactory) had lower body adiposity (BMI and WC) and better HJ performance than those in tertile 3 (poor). Conclusion: Higher body adiposity and lower HJ performance were observed compared to international studies. In addition, a negative relationship between body adiposity and HJ was found. These findings suggest that the progressive increase of adiposity as age increases negatively affects the strength performance of the lower extremities of the studied children and adolescents.

Timing of permanent tooth emergence is associated with overweight/obesity in children from the amazon region

Abstract The aim of this study was to evaluate the association between timing of permanent tooth emergence with overweight and obesity in children from Brazilian Amazon region. The studied population consisted of 192 children, 09 to 12 year-old, from public schools at Manaus, Amazonas-Brazil. Clinical examination was performed and the tooth emergence was evaluated according to the number of permanent erupted teeth. Body mass index z-score was calculated. For the statistical analysis 'Overweight/obese' group was compared with 'Normal weight' group in a case to control ratio 1:2. The t-test based on age was used for means comparison between the groups. A linear regression analysis using age and gender as co-variants was used. The established alpha was 5%. One hundred twenty-seven children were classified as normal weight and 65 were classified as overweight/obese (49 were overweight and 16 were obese). Overweight/obesity condition was associated with the gender, in which boys had a higher chance to present higher weight conditions (OR=1.84; CI 95% 1.06-3.37; p=0.04). The mean number of permanent teeth was higher in the overweight/obesity group (p<0.001). Linear regression analysis demonstrated that nutritional status, gender and age were strongly associated with number of permanent erupted teeth (p<0.05). In conclusion, our study demonstrated that timing of permanent tooth emergence is associated with overweigh/obesity in children from Manaus, Brazil.

Resumo O objetivo deste estudo foi avaliar se a erupção dentária está associada com sobrepeso/obesidade em crianças da região Amazônica brasileira. A população estudada foi composta por 192 crianças, de 9 a 12 anos, de escolas públicas de Manaus, Amazonas-Brasil. O exame clínico foi realizado e a erupção dentária foi avaliada de acordo com o número de dentes permanentes irrompidos. O índice de massa corporal escore-z foi calculado. Para a análise estatística, comparou-se o grupo "sobrepeso / obesidade" com o grupo "peso normal" em uma proporção de controle 1: 2. O teste t baseado na idade foi utilizado para comparação das médias entre os grupos. Uma análise de regressão linear usando idade e sexo como co-variáveis foi utilizada. O alfa estabelecido foi de 5%. Cento e vinte e sete crianças foram classificadas com peso normal e 65 foram classificados com sobrepeso / obesidade (49 com sobrepeso e 16 com obesidade). A condição de sobrepeso / obesidade associou-se ao gênero, no qual os meninos tiveram maior chance de apresentar condições de maior peso (OR = 1,84; IC 95% 1,06-3,37; p = 0,04). O número médio de dentes permanentes irrompidos foi maior no grupo sobrepeso / obesidade (p <0,001). A análise de regressão linear demonstrou que o estado nutricional, sexo e idade foram fortemente associados ao número de dentes permanentes irrompidos (p <0,05). Concluindo, nosso estudo demonstrou que o momento da erupção dos dentes permanentes é associado com sobrepeso / obesidade em crianças de Manaus, Brasil.

Frequência cardíaca máxima medida versus estimada por diferentes equações durante o teste de exercício cardiopulmonar em adolescentes obesos / Maximum heart rate measured versus estimated by different equations during the cardiopulmonary exercise test in obese adolescents

RESUMO Objetivo: Comparar os valores de frequência cardíaca máxima (FCmáx) medidos e estimados por diferentes equações durante o teste de exercício cardiopulmonar (TECP) em adolescentes obesos. Métodos: Trata-se de um estudo transversal. Foram incluídos adolescentes, de idades entre 15 e 18 anos, com obesidade (escore-Z do índice de massa corpórea - IMC>2,0). Coletaram-se dados demográficos e antropométricos, seguidos da realização do TECP, pela qual foi registrada a FCmáx. O valor mais elevado de frequência cardíaca (FC) atingida no pico do exercício foi considerado como a FCmáx. A comparação entre os valores de FCmáx medidos e os estimados pelas equações foi realizada empregando-se quatro equações prévias. Utilizaram-se a estatística descritiva e o teste de ANOVA (pós-teste de Bonferroni). Resultados: Foram incluídos 59 adolescentes obesos, sendo 44% do sexo masculino. A média de idade foi de 16,8±1,2 anos e a do IMC (escore-Z), de 3,0±0,7. No pico do exercício, a média de FCmáx (batimentos por minuto - bpm) foi de 190,0±9,2, o coeficiente de troca respiratória de 1,2±0,1 e o consumo máximo de oxigênio - VO2máx (mL/kg/min) - de 26,9±4,5. Ao comparar-se os valores medidos de FCmáx com os estimados pelas diferentes fórmulas, demonstrou-se que as equações "220-idade", "208-0,7 x idade" e a "207-0,7 x idade" superestimam (p<0,001) os resultados medidos de FCmáx em adolescentes obesos. Apenas a equação "200-0,48 x idade" apresentou resultados similares (p=0,103) com os valores mensurados no TECP. Conclusões: Os achados do presente estudo demonstram que a equação "200-0,48 x idade" parece ser mais adequada para estimar a FCmáx em adolescentes obesos.

ABSTRACT Objective: To compare the values of measured maximum heart rate (HRmax) and maximum heart rate estimated by different equations during the cardiopulmonary exercise test (CPET) in obese adolescents. Methods: This is a cross-sectional study. Adolescents aged between 15 and 18 years old, with obesity (BMI Z-score>2.0) were included. Demographic and anthropometric data were collected, followed by CPET, recording HRmax. The highest heart rate reached at peak exercise was considered as HRmax. The comparison between measured and estimated HRmax values was performed using four previous equations. Descriptive statistics and the ANOVA test (Bonferroni post-test) were used. Results: Fifty-nine obese adolescents were included, 44% of them male. The mean age was 16.8±1.2 years old and the BMI (Z-score) was 3.0±0.7. At peak exercise, the mean HRmax (bpm) was 190.0±9.2, the respiratory coefficient was 1.2±0.1, and the VO2max (mL/kg/min) was 26.9±4.5. When comparing the measured values of HRmax with those estimated by the different formulas, the equations "220-age", "208-0.7 x age" and "207-0.7 x age" were shown to overestimate (p<0.001) the measured HRmax results in obese adolescents. Only the "200-0.48 x age" equation presented similar results (p=0.103) with the values measured in the CPET. Conclusions: The findings of the present study demonstrate that the equation "200-0.48 x age" seems to be more adequate to estimate HRmax in obese adolescents.

Estado proinflamatorio en niños obesos / Proinflammatory state in obese children

INTRODUCCIÓN: La presencia de un estado de inflamación de bajo grado en niños obesos, se debería, entre otros factores, a que el tejido adiposo de los obesos produce moléculas proinflamatorias que contribuyen al desarrollo de aterosclerosis. OBJETIVO: Determinar en una población de niños obesos los niveles séricos de ligando CD-40 soluble (sCD40L), proteína quimioatractante de monocitos 1 (MCP-1), interleuquina 6 (IL-6), Factor de Necrosis tumoral a (TNF-a) y Proteína C Reactiva ultrasensible (PCR-us), comparados con un grupo control y analizar la correlación de estas moléculas con las variables antropométricas y metabólicas. PACIENTES Y MÉTODO: Estudio transversal de 37 niños obesos de 8 a 12 años y 20 niños con peso normal. A todos los pacientes se les realizó una historia clínica consignando edad, peso, talla, IMC, circunferencia de cintura, estadios de Tanner y antecedentes familiares. Se determinaron los niveles séricos de sCD40L, MCP-1, IL-6, TNF-a y PCR-us mediante ELISA, PCR-us por quimioluminiscencia, glucemia, insulina plasmática, perfil lipídico y se calculó el índice HOMA. Los datos se expresaron como la mediana y rango intercuartil y se utilizó el coeficiente de Spearman para investigar las correlaciones entre variables. RESULTADOS: Los niños obesos presentaron valores significativamente mayores de sCD40L, MCP-1, IL-6, TNF-a, PCR-us que los niños controles. El índice de masa corporal y la circunferencia de cintura se correlacionaron positivamente con sCD40L y MCP-1. CONCLUSIÓN: Los niveles elevados de las moléculas estudiadas sugieren la presencia de inflamación de bajo grado asociada a obesidad en esta población.

INTRODUCTION: Obesity is a chronic disease that affects adults as well as children and is associated with insulin resistance, type 2 diabetes and cardiovascular disease. One of the reasons for the presence of low-grade inflammation in these patients could be that adipose tissue of the obese produces proin flammatory molecules that favor the development of atherosclerosis. OBJECTIVE: To determine serum levels of soluble CD40 ligand (sCD40L), monocyte chemoattractant protein 1 (MCP-1), interleukin 6 (IL-6), Tumor Necrosis Factor alpha (TNF-Α) and high sensitivity CRP (hsCRP), in an obese chil dren population compared to a control group, also to analyze the correlation of these molecules with the anthropometric and metabolic variables. PATIENTS AND METHOD: A cross-sectional, observational study was carried out on 37 obese children, aged 8 to 12 years, and 20 children with normal weight. Serum levels of sCD40L, MCP-1, IL-6, TNF-Α and hsCRP were determined. Data were expressed as the median and interquartil range and Spearman coefficient was used to investigate correlations between variables. RESULTS: Compared to the control group, obese children presented significantly higher values of sCD40L, MCP-1, IL-6, TNF-Α, and hsCRP than control group. Body mass index and waist circumference correlated positively with sCD40L and MCP-1. CONCLUSION: Elevated levels of the studied molecules studied suggest the presence of low-grade inflammation associated with obesity in this population.

Body mass index and association with use of and distance from places for physical activity and active leisure among schoolchildren in Brazil. Cross-sectional study

ABSTRACT BACKGROUND: We evaluated associations between use of public places for physical activity and active leisure (PAAL) and their distances from subjects' homes and indicators of overweight and obesity, among schoolchildren from different socioeconomic levels, in the city of Florianópolis, Brazil. DESIGN AND SETTING: Cross-sectional study conducted on a sample of 2,152 schoolchildren aged 7 to 14 years, enrolled at 30 public and private schools. METHODS: The exposure variables were the use of public places for PAAL in the neighborhood and their distance from schoolchildren's homes. The outcomes were body mass index (BMI) and waist circumference (WC). Univariate and multivariate linear regression analyses were conducted according to income strata. RESULTS: Among the schoolchildren from low-income families, living closer to parks/playgrounds was associated with lower BMI (β = -2.15; 95% confidence interval, CI = -2.53; -1.77) and lower WC (β = -0.11 95% CI = -0.17; -0.05), while living at these distances from football pitches was associated with higher BMI (β = 1.73; 95% CI = 0.31; 3.15) and larger WC measurements (β = 0.03; 95% CI = 0.005; 0.14). Among the schoolchildren in low-income groups, living at an intermediate distance from beaches was associated with lower BMI (β = -1.10; 95% CI = -1.61; -0.59). CONCLUSION: Living closer to parks/playgrounds was associated with lower BMI and WC among schoolchildren from low-income families. Living closer to football pitches was associated with higher BMI and WC among these schoolchildren. Living at intermediate distances from beaches was associated with lower BMI among these schoolchildren.

Influencia de la obesidad sobre la resistencia y conductancia específica de la vía aérea en niños escolares / The impact of obesity on specific airway resistance and conductance among schoolchildren

Introducción. La obesidad infantojuvenil es un problema epidemiológico en los países en vías de desarrollo. Su prevalencia entre los niños en edad preescolar y escolar supera el 30%. Esta se asocia a una amplia variedad de complicaciones de salud, entre ellas, una acelerada pérdida de la función pulmonar, que provoca cambios en la fisiología y mecánica ventilatoria. El objetivo de este estudio fue estudiar la asociación entre obesidad y aumento de la resistencia específica de las vías aéreas (specific resistance airway; sRaw, por sus siglas en inglés) en una muestra infantojuvenil obesa de la comuna de Talca. Material y método. En una muestra de 36 sujetos con un promedio de edad de 9,38 ± 1,99 años, dividida en dos grupos, peso normal y obesos, se midieron los pliegues tricipital, subescapular, abdominal y volúmenes pulmonares. Para el análisis estadístico, se determinó la normalidad de los datos y, posteriormente, se utilizaron los test t de Student o U de Mann-Whitney y Pearson o Spearman según correspondiera. Se consideró un nivel de significancia estadística de p < 0,05. Resultados. Al comparar sujetos de peso normal con obesos, se observó un aumento significativo de la sRaw y una disminución significativa de la conductancia específica de la vía aérea en sujetos obesos. Además, se observó una correlación buena y significativa entre sRaw y porcentaje de grasa. Conclusiones. Los sujetos obesos mostraron un aumento de la sRaw y disminución de la conductancia específica de la vía aérea.

Introduction. Child and adolescent obesity is an epidemiological problem in developing countries. Its prevalence among preschoolers and schoolchildren is over 30%. It has been associated with a wide range of health complications, including rapid loss of lung function leading to changes in physiology and ventilatory mechanics. The objective of this study was to analyze the association between obesity and the increase in specific airway resistance (sRaw) in a sample of obese children and adolescents from the district of Talca. Material and method. In a sample of 36 subjects with an average age of 9.38 ± 1.99 years, divided into 2 groups (normal weight and obese), the tricipital, subscapular, and abdominal skinfolds and lung volumes were measured. For the statistical analysis, data normality was determined and then the Student's t test or the Mann-Whitney U test and Pearson's or Spearman's correlations were used, as applicable. A value of p < 0.05 was considered statistically significant. Results. When comparing normal weight and obese subjects, a significant increase in sRaw and a significant reduction in specific airway conductance (sGaw) were observed in obese subjects. In addition, an adequate and significant correlation was observed between sRaw and fat percentage. Conclusions. Obese subjects showed an increased sRaw and a reduced sGaw.

Associação entre o equilíbrio postural e indicadores antropométricos em escolares / Association between postural balance and anthropometric indexes in elementary schoolchildren

RESUMO Objetivo: Analisar a associação entre o equilíbrio postural e indicadores antropométricos em escolares do primeiro ano do ensino fundamental. Métodos: Estudo transversal, descritivo e quantitativo que incluiu crianças regularmente matriculadas no primeiro ano do ensino fundamental, de ambos os sexos, na faixa etária de 6 a 7 anos. Foram excluídas as crianças com qualquer incapacidade física ou cognitiva, as que não participaram de todas as etapas de avaliação do estudo ou as que não conseguiram realizar a avaliação do equilíbrio postural. As crianças realizaram uma avaliação do equilíbrio por meio da posturografia dinâmica computadorizada (PDC), por meio dos testes de organização sensorial (TOSs) em seis diferentes condições sensoriais. Para verificar os indicadores antropométricos, foram avaliadas as medidas de peso corporal e estatura, para posterior cálculo do índice de massa corporal (IMC), sendo este categorizado em quatro grupos: baixo peso, normal, sobrepeso e obesidade. Resultados: Foram incluídas 80 crianças (6,2±0,8 anos), sendo 47 meninas (58,8%). A análise dos indicadores antropométricos identificou 26,3% de escolares com sobrepeso e 15% com obesidade. As crianças apresentaram médias abaixo dos valores de referência considerados para sua faixa etária nas condições III e VI. Foi verificada associação negativa entre a condição V com o IMC e uma associação positiva entre os valores abaixo da normalidade na condição VI com o sobrepeso e a obesidade. Conclusões: Foram verificadas associações entre o excesso de peso corporal e valores abaixo da normalidade em algumas condições do equilíbrio, indicando que os indicadores antropométricos interferiram no equilíbrio postural das crianças.

ABSTRACT Objective: To analyze the association between postural balance and anthropometric indicators in elementary school students. Methods: This cross-sectional, descriptive and quantitative study included children enrolled in the first year of elementary school, of both sexes, in the age group of 6 to 7 years. Children with any physical or cognitive impairment, children who did not participate in all stages of the study evaluation, or those who failed to perform postural balance assessments were excluded. The children underwent a balance evaluation through a computerized dynamic posturograph, with sensory organization tests (TOSs) in six different sensory conditions. In order to verify the anthropometric indicators, the body weight and height measurements were evaluated for later calculation of the body mass index (BMI), which was categorized into four groups: low weight, normal, overweight and obesity. Results: Eighty children with a mean age of 6.2±0.8 years were included, being 47 girls (58.8%). The analysis of the anthropometric indicators identified that 26.3% of students were overweight and 15% were obese. The children had averages below the reference values considered for their age range in conditions III and VI. There was a negative association between condition V and BMI and a positive association between values below normal in condition VI with overweight and obesity. Conclusions: There were associations between excess body weight and values below normal in some balance conditions, indicating that the anthropometric indicators interfered in the children's postural balance.

Is brand visibility on snacks packages affecting their consumption in children? Results from an experimental ad-libitum study

The aims of the study were to assess the effects of the brand when snacking in children 6-11 years old and to evaluate the effect of different levels of brand awareness on children's intake. A 3x2 factorial design was adopted, and 96 children were randomized based on their brand awareness scores, assessed using the IBAI instrument and the study was conducted over two experimental sessions. First, 11 snacks were presented to the half of children laying on their own branded packages, whilst to the other half unbranded. In a second afternoon break, on a different day, the condition of branded/unbranded was crossed-over. Children were randomized in three groups based on combinations of concomitant TV and advertising exposure. Caloric intake (Kcal) of snacks eaten during sessions was taken as the main study outcome. No significant differences in energy intake were recorded according to brand visibility, both in children with high and low brand awareness. Exposure to TV and advertising showed no significant association with energy intake in the different groups and with the likelihood of being a high consumer. The present study suggested that brand visibility did not promote a higher caloric intake in 6-11 years old children during a snacking occasion(AU)

Los objetivos del estudio fueron el evaluar los efectos de las marcas comerciales durante una merienda en niños de entre 6 y 11 años de edad, así como analizar el efecto de diferentes niveles de conciencia de marca en el consumo de los niños. Se utilizó un diseño factorial 3x2, y se asignó al azar a 96 niños según sus puntuaciones de conciencia de marca, que fueron evaluados mediante el instrumento IBAI. El estudio se realizó en dos sesiones experimentales. En primer lugar, se presentaron 11 bocadillos (alimentos), a la mitad de los niños colocando en sus propios paquetes de marca, mientras que a la otra mitad sin marca. En un segundo recreo de la tarde, otro día, se realizó un cruce en la condición de bocadillos de marca y sin marca. Los niños fueron asignados al azar en tres grupos, según combinaciones concomitantes de exposición a la televisión y a pautas publicitarias. La ingesta calórica (Kcal) de bocadillos consumidos durante las sesiones se adoptó como principal resultado del estudio. No se registraron diferencias significativas en el consumo de energía dependiendo de la visibilidad de la marca, ni en los niños con un alto o bajo reconocimiento de marcas. La exposición a la televisión y a la publicidad no mostró una asociación significativa con el consumo de energía en los diferentes grupos y ni con la probabilidad de ser un gran consumidor. El presente estudio sugiere que la visibilidad de las marcas no promueve una mayor ingesta calórica en niños de entre 6 y 11 años de edad en el contexto de una merienda(AU)

Dietary patterns in Mexico and obesity in children

his cross-sectional study aims to investigate food habits, socio-economic status and blood lipids profile in schoolchildren (10-11 years of age) living in a low-income area of Mexico (the city of Montemorelos), characterizing lipid concentrations among children obese and evaluating the impact of socio-economic factors and dietary habits on blood lipids profile of these children. Complete data were available for 156 children (78 boys and 78 girls), food habits and socio economic status were assessed using a questionnaire developed from the one previously used from the enKid study conducted on Spanish children. Food reported in the questionnaire was classified in four food groups (animal source food/legumes, grains/tubers, fruits/vegetables, fats/sweets), beverages were classified separately. Blood samples were analyzed to determine concentrations of: total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, glucose. Children were found to eat fats and sweets more frequently than other food groups. The 59 children, found to be obese and overweight, presented significant higher blood lipid levels (except to glucose levels) than normal weight kids. Using random forests, we found out that food and beverage consumption plays a key role in influencing blood lipids profile in children overweight and obese. Given these observations, it's crucial to develop health care policies promoting healthy eating habits among schoolchildren taking into account the specific characteristics of this geographical area in Mexico(AU)

Este estudio transversal tiene como objetivo investigar los hábitos alimentarios, el nivel socioeconómico y el perfil de lípidos sanguíneos en niños en edad escolar que viven en una zona de bajos recursos en México, caracterizando las concentraciones de lípidos en niños obesos/sobrepeso y evaluar el impacto de los factores socioeconómicos y hábitos dietéticos en el perfil de lípidos de estos niños. Mediante un cuestionario utilizado previamente en el estudio enKid realizado con niños españoles lo realizaron en forma completa 156 niños (78 niños y 78 niñas), se evaluó los hábitos alimentarios y el estado socioeconómico. Los alimentos reportados en el cuestionario se clasifica en cuatro grupos de alimentos (alimentos fuente animal / legumbres, granos / tubérculos, frutas / verduras, grasas / dulces), las bebidas fueron clasificadas por separado. Se analizaron muestras de sangre para determinar las concentraciones de: colesterol total, LDL-colesterol, HDL-colesterol, triglicéridos, glucosa. Los 59 niños, obesos/sobrepeso, presentaron niveles de lípidos en sangre significativamente más altos que los niños de peso normal. Usando Selvas Aleatorias nos enteramos de que los alimentos y el consumo de bebidas juegan un rol clave para influir en el perfil de lípidos en la sangre en niños obesos/sobrepeso. Teniendo en cuenta estas observaciones, es crucial desarrollar políticas de salud que promueven hábitos alimenticios saludables entre los escolares, teniendo en cuenta las características específicas de esta área geográfica en México(AU)

What is breakfast for Mexican children?

In order to face with the concerning rising prevalence of overweight and obesity in childhood, Mexican government has implemented Nutritional Indications (NI) for preschool and schoolchildren. The aim of our study is to investigate what Mexican children have for breakfast and if they meet NI, which recommends that daily breakfast should include one food from each of the three recommended food groups (grains and tubers, animal source food and legumes, fruits and vegetables). We considered a sample of 120 male children aged 3-14 years, their mothers were asked to complete a questionnaire and to fill a breakfast diary for one week. Food was grouped in the three recommended food groups and a further group including fats and sweets was considered. Only 32 children met NI at least once a week (compliant children) and nobody followed NI throughout the week. The analysis on breakfast records showed a low intake of the fruits and vegetables food group. Children were more likely to follow NI when they had breakfast with family members. We show that children do not meet breakfast's NI, but further researches are needed to investigate the long-term impact of NI on Mexican children eating patterns(AU)

Para hacer frente al aumento de la prevalencia de sobrepeso y obesidad en la infancia, el Gobierno Mexicano ha implementado las indicaciones nutricionales (IN) para niños en etapas preescolar y escolar. El objetivo de nuestro estudio es investigar los componentes del desayuno en la dieta de niños Mexicanos, además del cumplimiento con las IN, que recomiendan que el desayuno diario debe incluir un alimento de cada uno de los tres grupos alimenticios recomendados (granos y tubérculos, alimentos de origen animal, y legumbres, frutas y verduras). Se consideró una muestra de 120 niños (de género masculino) con edades entre 3 y 14 años. Se solicitó a sus madres completar un cuestionario y realizar un registro diario de los componentes del desayuno durante una semana. Los alimentos se agruparon según dictan las IN; además, un grupo que incluye grasas y dulces fue también considerado. Sólo 32 niños cumplieron con las IN al menos una vez a la semana (los niños que cumplen) y ninguno siguió las IN durante toda la semana. El análisis sobre los registros diarios mostró un bajo consumo del grupo de alimentos compuesto por frutas y verduras. El justo seguimiento de las IN ha sido más probable cuando el desayuno se ha realizado con miembros de la familia. Se demuestra que los niños no cumplen el IN del desayuno, pero se necesitan más investigaciones para investigar el impacto a largo plazo de IN sobre los hábitos alimenticios de los niños mexicanos(AU)

Eating patterns in mexico and obesity in children: results from the nutrirun project

This study aims to compare obesity rates, physical activity levels and compliance with Nutritional Indications (NI), provided by the Estrategia contra el sobrepeso y la obesidad, between three consecutive years (2011, 2012, 2013) in children enrolled in the NutriRun project. Data were collected during the race Carrera Kinder Generación en Movimiento held in Mexico City in 2011, 2012 and 2013. A medical-dietetic questionnaire was administered to parents, investigating what kind of food their children usually had for breakfast, lunch and dinner, physical activity levels and family medical history. Children were weighed and measured and BMI was calculated. In order to evaluate compliance with NI, food reported in the medical-dietetic questionnaire for breakfast and dinner was classified in four main food groups and in other four main food categories for lunch, according to NI. The analysis of overweight/obesity in 2011, 2012 and 2013 revealed a significant reduction (p-value 0.001) of children overweight/obese and an increase of normal weight ones. However, in all the three considered years, they were found to not follow NI because of a poor consumption of fruits and vegetables and of salad. Therefore, further health care policies promoting fruits and vegetables consumption among Mexican families are needed(AU)

Este estudio tiene como objetivo comparar las tasas de obesidad, los niveles de actividad física y el cumplimiento de las Indicaciones Nutricionales (IN), proporcionada por la Estrategia contra el sobrepeso y la obesidad, entre los tres años consecutivos (2011, 2012, 2013) en los niños que participaron en el proyecto NutriRun. Los datos fueron recolectados durante la carrera Kinder Generación en Movimiento, celebrada en la Ciudad de México en 2011, 2012 y 2013. Un cuestionario médico-dietético se administró a los padres, investigando qué tipo de alimentos por lo general tenían sus hijos para el desayuno, el almuerzo y la cena, los niveles de actividad física y el historial médico de la familia. Los niños fueron pesados y medidos y se calculó el IMC. Con el fin de evaluar el cumplimiento de las NI, la comida reportada en el cuestionario médico-dietético se clasificó, para el desayuno y la cena, en cuatro grupos de alimentos principales y en otros cuatro principales categorías de alimentos para el almuerzo, de acuerdo con las NI. El análisis de las tendencias de sobrepeso/obesidad en 2011, 2012 y 2013 demostró una reducción significativa (p-valor de 0,001) de los niños obesos/sobrepeso y un aumento de peso normal. Sin embargo, en los tres años considerados, se encontró que los niños no siguen las IN, debido a un pobre consumo de frutas y verduras y de la ensalada. Por lo tanto se necesitan nuevas políticas de atención a la salud que promuevan el consumo de frutas y verduras entre las familias mexicanas(AU)

Association between simple anthropometric measures in children of different ethnicities: results from the OBEY-AD study

Body mass index (BMI) is considered a good predictor of overall adiposity, with significant sensitivities in identifying overweight children. Recently, it has been suggested that other anthropometric measures may also be employed as adequate surrogates for imaging techniques and BMI. However, it is well known that differences exist in body fat distribution among different ethnicities. The present study aims at assessing the relationship between anthropometric measures in children from different geographical regions. The OBEY-AD is an international study enrolling 2720 children (3-11 years of age), balanced by gender. Children underwent anthropometric assessment. The association between these anthropometric measures was estimated using linear mixed models. South-American children had a higher BMI and waist and hip circumference compared to European and Indian ones. Conversely, Indian children were found to be taller and to have a higher waisthip ratio than those of European and South-American kids, suggesting a different body composition of Indian children compared to those of the other ethnic groups. Overall, this data provides further evidence on the differences in anthropometric measures between the Indian, South American and European child populations(AU)

El índice de masa corporal (IMC) es considerado un buen indicador de adiposidad general, con una capacidad significativa para la identificación de niños con sobrepeso. Recientemente, se ha sugerido que también es posible utilizar otras medidas antropométricas como sustitutos adecuados de las técnicas de diagnóstico por imagen y del IMC. Sin embargo, es bien sabido que existen diferencias en la distribución de la grasa corporal entre diferentes grupos étnicos. El objetivo del presente estudio es evaluar la relación entre las medidas antropométricas en niños de diferentes regiones geográficas. El OBEYAD es un estudio internacional que incluyó a 2720 niños (de entre 3 y 11 años de edad), equilibrados por sexo. A los niños se les realizó una evaluación antropométrica. Se realizó la estimación de la asociación entre estas medidas antropométricas por medio de modelos lineales mixtos. Los niños de América del Sur tuvieron valores más altos de IMC, circunferencia de cintura y cadera, en comparación con los resultados de los niños europeos e hindúes. Por el contrario, se encontró que los niños de la India tenían una mayor estatura y una relación cintura-cadera mayor que la de los niños europeos y sudamericanos, lo que sugiere la existencia de una composición corporal diferente en los niños hindúes respecto de los de los otros grupos étnicos. Este hallazgo fue confirmado asimismo en el modelo lineal. En general, estos datos proporcionan evidencia adicional sobre las diferencias en las medidas antropométricas entre la población infantil de la India, de América del Sur y de Europa(AU)

Overweight in youth and sleep quality: is there a link?

ABSTRACT Objective Overweight seems to be related to a higher prevalence of sleep disturbances. Decreased sleep duration and altered sleep quality are risk factors for obesity. Our aim was to compare the sleep pattern of overweight children with that of a matched control group and assess the relationship between sleep quality and obesity. Materials and methods Retrospective cohort study comparing 41 overweight children with a normal-weight control group, both submitted to polysomnography. The samples were matched for age, sex, and apnea-hypopnea index. Body mass index (BMI) z-scores were calculated using World Health Organization (WHO) growth charts. Insulin resistance in the study group was determined using the homeostatic model assessment for insulin resistance (HOMA-IR). Sleep patterns were compared. The statistical analysis was performed using SPSS® version 21. Results The mean age (± standard deviation) of the population was 10 ± 3.4 years (min. 5 years; max. 17 years). Fifty-six percent of the participants in both groups were girls. N3% was lower in the study group (18.95 ± 6.18%) compared with the control group (21.61 ± 7.39%; t (40) = 2.156, p = 0.037). We found a correlation in the study group between HOMA-IR and N3% (Rs = -0.434, p = 0.008). Conclusion The present study suggests a link between overweight/obesity and altered sleep quality due to compromised non-rapid eye movement sleep, an indirect marker of sleep quality. There was also a link between slow-wave sleep duration and insulin resistance. We must find a strategy to provide adequate slow-wave sleep duration to reduce the obesity epidemic at young ages. Further research is needed.

Dietary patterns, nutritional profile, and body mass index in Mexican schoolchildren: a cross-sectional study

Childhood obesity is a serious public health problem in Mexico. In this study, childhoodspecific dietary patterns and their relationship with overweight-obesity prevalence, nutrient profiles and types of foods consumed were studied. A descriptive cross-sectional study of 724 randomly selected schoolchildren between 9 to 12 years old from Nayarit State, Mexico was performed. Data on anthropometric characteristics and food intake were recorded. Seven dietary patterns and three specific diets were identified by multivariate analysis. A dietary pattern characterized by high legume, snack and low beverage intake was negatively associated with weight and body mass index. The overall overweight and obesity prevalence was 20.2% and 20.6%, respectively. Diet type significantly influenced (p<0.05) protein, carbohydrates and fat intake but did not show correlation with the overweightobesity status. Simple sugars, candies, pastries and sweetened beverages appeared in all dietary patterns. Dietary patterns in countries with a wide gastronomic diversity should be considered to design preventive nutrition intervention programs(AU)

La obesidad infantil es un problema de salud pública en México. En este trabajo, se estudiaron los patrones dietéticos de escolares mexicanos y su relación con la prevalencia de sobrepeso-obesidad, el perfil de nutrientes y los principales grupos de alimentos consumidos. Se llevó a cabo un estudio transversal descriptivo donde participaron 724 escolares seleccionados al azar de entre 9 a 12 años del Estado de Nayarit, México evaluándose las características antropométricas y la ingesta de alimentos. Siete patrones dietéticos y tres dietas específicas fueron identificados mediante análisis multivariado. Un patrón de dieta caracterizada por una alta ingesta de legumbres y aperitivos junto con una baja ingesta de bebidas azucaradas se asoció negativamente con el peso e índice de masa corporal. La prevalencia de sobrepeso y obesidad fue del 20.2 y 20.6%, respectivamente. El tipo de dieta influyó significativamente (p<0.05) en la ingesta de proteínas, hidratos de carbono y el consumo de grasas, pero no mostró correlación con la condición de sobrepeso-obesidad. Los azúcares simples, dulces, postres y bebidas endulzadas aparecieron en todos los patrones dietéticos. Los patrones dietéticos en los países con una gran diversidad gastronómica podrían ser considerados de interés para diseñar programas de intervención nutricional preventiva(AU)