RESUMO
Abstract Background: Long-term outcomes of patients with Fontan circulation are uncertain regarding the prevalence and role of risk factors (RFs) such as increased body mass index (BMI), arterial hypertension, and hypercholesterolemia. Objectives: To describe the prevalence of RFs in patients with univentricular heart, with variable follow-up times. Methods: This mixed cohort study was performed with 66 patients, who underwent blood count, fasting blood glucose, C-reactive protein (CRP), and lipid profile tests; systolic/diastolic blood pressure (SBP/DBP) measurements; and anthropometric and sociodemographic data collection. Cardiovascular RFs among first-degree relatives and physical activity habits were also assessed. Prevalence was described using proportions, with a 95% confidence interval. Continuous variables (height, weight, age, SBP, DBP) were described as means and standard deviations (m±SD). Associations between RFs were assessed using chi-squared or Fisher's exact tests. Spearman's correlation was used for analyzing CRP and the presence of 2 or more RFs. The Shapiro-Wilk test was used to check for data normality. Statistical significance considered p<0.05. Results: In our population, 19.7% were overweight, mean SBP was 89.44±37.4, and mean DBP was 60.0±26.08. The most prevalent diseases in the interviewees' families were systemic arterial hypertension (30.3%), obesity (16.7%), and 2 or more cardiovascular RFs among first-degree relatives (13.8%). We observed a trend towards significance between the presence of 2 familial RFs and overweight, as well as a risk profile for cardiovascular disease. There was an association between the BMI percentile, the presence of 2 or more RFs (p<0.05), and CRP (p<0.01). Conclusions: Overweight is common in patients with univentricular heart, being related to more than 2 cardiovascular RFs among first-degree relatives; physical inactivity and changes in lipid profiles are also frequent.
RESUMO
Abstract Background: Schools have become a key figure for the promotion of health and obesity interventions, bringing the development of critical awareness to the construction and promotion of a healthy diet, physical activity, and the monitoring of the nutritional status in childhood and adolescence. Objectives: To describe a study protocol to evaluate the effectiveness of an intervention designed to improve knowledge of food choices in the school environment. Methods: This is a cluster-randomized, parallel, two-arm study conducted in public elementary and middle schools in Brazil. Participants will be children and adolescents between the ages of 5 and 15 years, from both genders. The interventions will be focusing on changes in lifestyle, physical activities and nutritional education. Intervention activities will occur monthly in the school's multimedia room or sports court. The control group arm will receive usual recommendations by the school. The primary outcome variable will be anthropometric measures, such as body mass index percentiles and levels of physical activity by the International Physical Activity Questionnaire. Results: We expect that after the study children will increase the ingestion of fresh food, reduce excessive consumption of sugary and processed foods, and reduce the hours of sedentary activities. Conclusion: The purpose of starting the dietary intervention at this stage of life is to develop a knowledge that will enable for healthy choices, providing opportunities for a better future for this population.
Resumo Fundamento: As escolas tornaram-se essenciais para a promoção de saúde e de intervenções para obesidade, propiciando o desenvolvimento de consciência crítica para a construção e promoção de dieta saudável, atividade física e monitoramento do status nutricional na infância e adolescência. Objetivos: Descrever um protocolo de estudo para avaliar a eficiência de uma intervenção projetada para aprimorar o conhecimento sobre escolhas alimentares no ambiente escolar. Métodos: Estudo clínico randomizado em cluster, paralelo, de dois braços, conduzido em escolas públicas de ensino fundamental e médio no Brasil. Os participantes serão crianças e adolescentes entre 5 e 15 anos de idade, dos dois sexos. As intervenções se concentrarão em mudanças de estilo de vida, atividade física e educação nutricional. As atividades de intervenção ocorrerão mensalmente na sala de multimídia ou quadra de esportes das escolas. O grupo controle receberá as recomendações usuais através da escola. O desfecho primário será a mudança nas medidas antropométricas, como índice de massa corporal e os níveis de atividade física conforme o Questionário Internacional de Atividade Física. Resultados: Esperamos que, após o estudo, as crianças aumentem o consumo de alimentos frescos, reduzam o consumo excessivo de alimentos açucarados e processados, e reduzam as horas gastas em atividades sedentárias. Conclusão: O propósito de iniciar a intervenção dietética nessa fase da vida é desenvolver o conhecimento que permitirá escolhas saudáveis, propiciando oportunidades para um melhor futuro para essa população.