Impact of the COVID-19 pandemic on mental health in parents of infants with colic and on healthcare use.

AIM: To examine the impact of the COVID-19 pandemic on the mental health of parents of infants with colic and on healthcare use. METHODS: Retrospective cohort study. Data of 64 parents of infants with colic prepandemic and 43 parents of infants with colic during the pandemic were analysed using validated questionnaires on parental stress, depression and anxiety. Additionally, we evaluated the number of outpatient clinic visits and admission rates pre- and during the pandemic by collecting data on the diagnosis treatment combination 'excessive crying' from electronic patient files in three secondary hospitals in the Netherlands. RESULTS: Mothers in the pandemic group reported significantly higher levels of depression than mothers in the prepandemic group (12.3 ± 7.0 and 8.8 ± 5.2; p = 0.04). Moreover, mothers showed a trend towards higher stress levels during the pandemic (29.6 ± 9.6 and 25.2 ± 8.1; p = 0.06). During the pandemic, admission numbers of infants with colic compared to prepandemic data increased with 34% (146 vs. 196). CONCLUSION: Mothers of infants with colic reported significantly more feelings of depression during the COVID-19 pandemic. Furthermore, the pandemic was associated with increased healthcare use amongst infants with colic. With the continuing pandemic, we recommend active perinatal support for this vulnerable population.

Hypertension and Different Levels of Body Mass Index and Cardiorespiratory Fitness Amongst Adolescents

Abstract Background Hypertension is an increasingly common problem in adolescents; amongst the associated factors, physical inactivity and obesity are increasing the risk of developing cardiovascular diseases. Objective To verify whether there is an association between higher blood pressure levels amongst adolescents with the relationship between different levels of body mass index (BMI) and cardiorespiratory fitness (CRF). Method Cross-sectional study consisting of 860 adolescents. Higher blood pressure (BP) was considered as borderline and hypertension as the classification. BMI was categorized as low-normal weight and overweight-obesity. The CRF was assessed by a nine-minute run/walk test and classified into low or appropriate levels (less and more favorable to health, respectively). Later, BMI and CRF were grouped into one categorical variable: (I) low/normal weight and appropriate CRF levels; (II) low/normal weight and low CRF levels; (III) overweight/obesity and appropriate CRF levels; and (IV) overweight/obesity and low CRF levels. Data were analyzed using Poisson regression, through the prevalence ratio (PR) and 95% confidence intervals (CI). The p-values of p <0.05 were considered significant. Results Adolescents with overweight/obesity and low CRF levels had a 22% higher BP prevalence. Moreover, children with overweight/obesity, but with appropriate CRF levels, have a 15% higher BP prevalence. Conclusion Adolescents with overweight/obesity had a higher prevalence of BP, regardless of CRF levels. It is suggested that maintaining normal BMI is a protective factor for less favorable BP.

ASSOCIATION BETWEEN THE SCREEN TIME AND THE CARDIORESPIRATORY FITNESS WITH THE PRESENCE OF METABOLIC RISK IN SCHOOLCHILDREN.

OBJECTIVE: To verify the association between screen time and cardiorespiratory fitness with the presence of metabolic risk in schoolchildren in an isolated and clustered manner. METHODS: Cross-sectional study with 1.200 schoolchildren from Santa Cruz do Sul-RS. Screen time and cardiorespiratory fitness were evaluated. The continuous metabolic risk score was calculated by summing the Z score of the waist circumference, systolic blood pressure, glucose, triglycerides, total cholesterol, low-density lipoprotein (LDL-C) and high-density lipoprotein (HDL-C). RESULTS: Children (34.3%) and adolescents (48.2%) had high screen time, while 44.3% of the children and 53.3% of the adolescents were unfit in relation to cardiorespiratory fitness. Regarding the relation of screen time/cardiorespiratory fitness, 14.7% of the children and 26.9% of the adolescents presented high screen time and low levels of cardiorespiratory fitness. The presence of metabolic risk was shown in children (17.1%) and adolescents (14.7%). The presence of metabolic risk was directly associated with low levels of cardiorespiratory fitness in children and adolescents. When analyzed in clusters, the metabolic risk in children was 11% more prevalent in subjects with low screen time/unfit and 12% in subjects with high screen time/unfit, whereas in adolescents, the prevalence of metabolic risk was also higher in those with low screen time/unfit (8%) and high screen time/unfit (7%). CONCLUSIONS: The presence of metabolic risk in children and adolescents was associated with low levels of cardiorespiratory fitness, independent of screen time, in an isolated or clustered manner.

Anthropometric and Metabolic Responses in FTO rs9939609 Gene Polymorphism after a Multidisciplinary Lifestyle Intervention in Overweight and Obese Adolescents.

Few studies show the potential changing effect of fat-mass and obesity-associated ( FTO ) rs9939609 gene on cardiometabolic risk after a lifestyle intervention. This study aims to evaluate whether overweight and obese adolescents, carriers of the risk genotypes for obesity of the FTO rs9939609 gene polymorphism, have different anthropometric and biochemical responses to an interdisciplinary intervention program. The quasi-experimental study involved 34 adolescents aged 10 to 15 years. Schoolchildren with AA/AT genotype decreased glucose, total cholesterol, low-density lipoprotein cholesterol, and increased high-density lipoprotein cholesterol. However, there were no differences between the genotypes, suggesting that the "A" allele did not modify the subject's response to the intervention program.

Association between the screen time and the cardiorespiratory fitness with the presence of metabolic risk in schoolchildren / Associação entre o tempo de tela e a aptidão cardiorrespiratória e a presença de risco metabólico em escolares

ABSTRACT Objective: To verify the association between screen time and cardiorespiratory fitness with the presence of metabolic risk in schoolchildren in an isolated and clustered manner. Methods: Cross-sectional study with 1.200 schoolchildren from Santa Cruz do Sul-RS. Screen time and cardiorespiratory fitness were evaluated. The continuous metabolic risk score was calculated by summing the Z score of the waist circumference, systolic blood pressure, glucose, triglycerides, total cholesterol, low-density lipoprotein (LDL-C) and high-density lipoprotein (HDL-C). Results: Children (34.3%) and adolescents (48.2%) had high screen time, while 44.3% of the children and 53.3% of the adolescents were unfit in relation to cardiorespiratory fitness. Regarding the relation of screen time/cardiorespiratory fitness, 14.7% of the children and 26.9% of the adolescents presented high screen time and low levels of cardiorespiratory fitness. The presence of metabolic risk was shown in children (17.1%) and adolescents (14.7%). The presence of metabolic risk was directly associated with low levels of cardiorespiratory fitness in children and adolescents. When analyzed in clusters, the metabolic risk in children was 11% more prevalent in subjects with low screen time/unfit and 12% in subjects with high screen time/unfit, whereas in adolescents, the prevalence of metabolic risk was also higher in those with low screen time/unfit (8%) and high screen time/unfit (7%). Conclusions: The presence of metabolic risk in children and adolescents was associated with low levels of cardiorespiratory fitness, independent of screen time, in an isolated or clustered manner.

RESUMO Objetivo: Verificar a associação entre tempo de tela e aptidão cardiorrespiratória, de forma isolada e agrupada, e a presença de risco metabólico em escolares. Métodos: Estudo transversal com 1.200 escolares de Santa Cruz do Sul (RS). Foram avaliados o tempo de tela e a aptidão cardiorrespiratória. Foi calculado o escore de risco metabólico por meio da soma do escore Z, da circunferência da cintura, da pressão arterial sistólica, da glicose, dos triglicerídeos, do colesterol total, do colesterol da lipoproteína de baixa densidade (LDL) e do colesterol da lipoproteína de alta densidade (HDL). Resultados: Crianças (34,3%) e adolescentes (48,2%) apresentaram elevado tempo de tela, enquanto 44,3% das crianças e 53,3% dos adolescentes foram inaptos no tocante à aptidão cardiorrespiratória. Na relação tempo de tela/aptidão cardiorrespiratória, 14,7% das crianças e 26,9% dos adolescentes exibiram elevado tempo de tela e baixos níveis de aptidão cardiorrespiratória. A presença de risco metabólico foi evidenciada em crianças (17,1%) e em adolescentes (14,7%). A presença de risco metabólico esteve associada diretamente com baixos níveis de aptidão cardiorrespiratória nas crianças e nos adolescentes no que se refere às variáveis de forma isolada. Quando analisado de modo agrupado, o risco metabólico em crianças foi 11% mais prevalente em sujeitos com baixo tempo de tela/inaptos e 12% em sujeitos com elevado tempo de tela/inaptos, enquanto em adolescentes a prevalência de risco metabólico também foi superior nos escolares com baixo tempo de tela/inaptos (8%) e elevado tempo de tela/inaptos (7%). Conclusões: A presença de risco metabólico em crianças e adolescentes esteve associada com baixos níveis de aptidão cardiorrespiratória, independentemente do tempo de tela, tanto de modo isolado quanto agrupado.

Low levels of cardiorespiratory fitness and abdominal resistance are associated with metabolic risk in schoolchildren.

Background Low levels of physical fitness are associated with metabolic disorders in adults. However, this relationship has been little explored in children and adolescents. The aim of the present study was to investigate whether there is an association between physical fitness related to health and the presence of metabolic risk in schoolchildren. Methods The sample for this cross-sectional study was composed of 1251 schoolchildren of both genders between 7 and 17 years of age. Three indicators of physical fitness related to health were evaluated: cardiorespiratory fitness (CRF), flexibility and abdominal resistance. The continuous metabolic syndrome score (cMetS) was calculated by using the sum of the Z scores of the following indicators: body mass index (BMI), systolic blood pressure, glucose, total cholesterol, high- and low-density lipoprotein cholesterol (HDL-c and LDL-c) and triglycerides. Subsequently, the cMetS was dichotomized, considering the presence or absence of metabolic risk. The data were analyzed using prevalence ratio (PR) values and 95% confidence intervals (CI), using Poisson regression. Results A higher prevalence of metabolic risk was found among students with low levels of CRF (PR: 1.48; CI: 1.10-1.98) and abdominal resistance (PR: 1.45; CI: 1.08-1.95). No association with flexibility was found. Conclusions Low levels of CRF and abdominal resistance are associated with the presence of metabolic risk in schoolchildren.

High blood pressure in schoolchildren: Associated sociodemographic and biochemical factors. / Pressão arterial elevada em escolares: fatores sociodemográficos e bioquímicos associados.

INTRODUCTION AND OBJECTIVE: Pediatric hypertension has increased in the last decade, and it is thus crucial to identify the factors associated with the development of high blood pressure (BP) and other cardiovascular disorders. The aim of this study was to determine whether there is an association between high BP and sociodemographic and biochemical factors in schoolchildren. METHODS: This cross-sectional study included 1201 children and adolescents, between seven and 17 years old, of both sexes. The sociodemographic data analyzed were gender, age, school system and socioeconomic status. Among biochemical indicators, blood glucose, triglycerides, total cholesterol, HDL-cholesterol (HDL-C) and LDL-cholesterol (LDL-C) were assessed. In the analysis of BP, schoolchildren were classified as normal, borderline or hypertensive. Associations were tested using Poisson regression through prevalence ratios (PR). RESULTS: High BP was identified in 16.2% of the students. In females, the prevalence of high BP was 7% lower than in males (p=0.001), but was higher among adolescents (PR: 1.11, p<0.001) and schoolchildren in the state school system (PR: 1.05; p=0.013). Concerning biochemical indicators, BP change was associated with pre-diabetes (PR: 1.09; p=0.001) and borderline HDL-C (PR: 1.09; p=0.007). CONCLUSION: Among the sociodemographic factors associated with high BP are male gender, adolescence and attending the state education system. This condition was also associated with pre-diabetes and borderline HDL-C.

Comparison between different criteria for metabolic syndrome in schoolchildren from southern Brazil.

The metabolic syndrome (MetS), although more frequent in adults, is already evident in the infant-juvenile population. On the other hand, there are different criteria for the diagnosis, without a consensus of which is the best to be used in this population. The aim of this study was to evaluate the agreement between different criteria for diagnosis of MetS in adolescents from southern Brazil. A cross-sectional study consisting of a sample of 1200 subjects, 679 females, aged between 12 and 17 years. MetS was assessed by three different criteria: Cook (2003), Ferranti (2004), and International Diabetes Federation - IDF (2007). The agreement between the criteria was evaluated by the Kappa index. Low prevalence of MetS was found among schoolchildren (1.9% for Cook, 5.0% for Ferranti, and 2.1% for IDF). Regular (Ferranti - IDF: Kappa 0.382; p < 0.001) and moderate (Cook - Ferranti: Kappa 0.542; p < 0.001; Cook - IDF: Kappa 0.532; p < 0.001) agreement was demonstrated between the criteria. Elevated blood pressure was the most frequent condition in all the criteria, and the least frequent condition was in the glycemia (Cook and Ferranti) and high-density lipoprotein cholesterol levels. CONCLUSION: The low prevalence of MetS and the low agreement among the existing criteria suggest the elaboration of new criteria for the diagnosis of MetS in the child and adolescent population. What is Known: • There are different criteria for the diagnosis of the metabolic syndrome (MetS), without a consensus of which is the best to be used in the infant-juvenile population. What is New: • Low prevalence of MetS identified among schoolchildren and the low agreement among the existing criteria suggest the elaboration of new criteria for the diagnosis of MetS in the child and adolescent population.

Obesidade, perfil lipídico e hábitos alimentares de escolares: comparação entre municípios de dois estados da região Sul do Brasil / Obesity, lipid profile and feeding habits in school children: comparing municipalities in t wo brazilian southern states

O objetivo foi comparar o perfil nutricional, lipídico e hábitos alimentares de escolares de dois municípios do sul do Brasil. O estudo transversal avaliou indicadores de obesidade, perfil lipídico e hábitos alimentares de escolares de 7-17 anos, de Santa Cruz do Sul­RS e Chapecó­SC. Observou-se diferença (p<0,05) no sobrepeso/obesidade (37,0% Chapecó vs 29,2% Santa Cruz do Sul) e circunferência da cintura elevada (34,8% Chapecó vs 21,2% Santa Cruz do Sul); triglicerídeos (41,4%) e HDL-C (23,5%) foram mais elevados em Chapecó (p<0,001) e colesterol total (56,1%), LDL-C (36,4%) e glicemia (8,7%) em Santa Cruz do Sul (p<0,05). Chapecó apresenta maior consumo de frutas (16,8% infrequente) e doces (41,3% frequente) e Santa Cruz do Sul de feijão/arroz (57,0% diário), refrigerantes (24,4% diário) e salgadinhos (24,0% diário) p<0,05. Conclui-se que houve diferenças no perfil nutricional, lipídico e hábitos alimentares entre dois municípios, demonstrando que indicadores de saúde podem variar em diferentes regiões.

Nutritional, lipid and feeding habits of school children in two municipalities in South Brazil are compared. Transversal study analyzed indicators of obesity, lipid profile and feeding habits of school children, aged between 7 and 17 years, in Santa Cruz do Sul RS Brazil, and Chapecó SC Brazil. Difference (p<0.05) in overweight/obesity (37.0% Chapecó vs 29.2% Santa Cruz do Sul) and high waist circumference (34.8% Chapecó vs 21.2% Santa Cruz do Sul); triglycerides (41.4%) and HDL-C (23.5%) showed higher rates in Chapecó (p<0.001); total cholesterol (56.1%), LDL-C (36.4%) and glycaemia (8.7%) were higher in Santa Cruz do Sul (p<0.05). Chapecó had a high input of fruit (16.8% infrequent) and sweets (41.3% frequent) contrasting with beans/rice (57.0% daily), soft drinks (24.4% daily) and snacks (24.0% daily) in Santa Cruz do Sul (p<0.05). Results show that differences in nutritional profile existed between the two municipalities and, consequently, health indicators vary within different regions.

Perfil sociodemográfico associado em nível de aptidão física relacionada à saúde em escolares / Social and demographic profile associated to physical capacity level related to school children´s health

Este estudo teve como objetivo verificar se existe associação entre fatores sociodemográficos e níveis de aptidão física relacionada à saúde em escolares. Foram sujeitos deste estudo transversal 1.000 crianças e adolescentes, de sete a 17 anos de idade, de Santa Cruz do Sul-RS. Analisou-se o nível socioeconômico, o perfil nutricional, a flexibilidade, a resistência abdominal e a aptidão cardiorrespiratória (APCR). Todas as análises foram realizadas no programa estatístico SPSS v. 23.0, considerando um nível de significância de p<0,05. Resultados demonstraram que a prevalência de sobrepeso/obesidade foi superior no sexo masculino (RP: 1,05; p=0,025) e inferior entre os adolescentes (RP: 0,89; p<0,001). Por outro lado, escolares do sexo masculino apresentam prevalência 6% menor de baixos níveis de APCR (p=0,001). Adolescentes (RP: 1,07; p=0,005), estudantes da rede municipal (RP: 1,10; p=0,049) e da zona urbana (RP: 1,09; p=0,002) apresentam maior prevalência de baixos níveis de APCR. Concluiu-se que fatores sociodemográficos estão associados aos baixos níveis de aptidão física em escolares.

The association between socio-demographic and physical capacity levels related to school children´s health is investigated. Current transversal study comprised 1000 children and adolescents, aged between 7 and 17 years, in Santa Cruz do Sul RS Brazil. The socio-economic level, nutritional profile, flexibility, abdominal resistance and cardiorespiratory fitness (CRF) were analyzed with statistical program SPSS v. 23.0, at significance level p<0.05. Results demonstrated that prevalence of overweight/obesity was higher in males (PR: 1.05; p=0.025) and lower among adolescents (PR: 0.89; p<0.001). Moreover, male school children had a 6% prevalence lower than APCR low levels (p=0.001). Adolescents (PR: 1.07; p=0.005), school children in public schools (PR: 1.10; p=0.049) and students from the rural area (PR: 1.09; p=0.002) had a higher prevalence in APCR low levels. Socio-demographic factors are actually associated to low levels of physical capacity in school children.