Impact of maternal dietary counseling in the first year of life on DNA methylation in a cohort of children.

Epigenetic modifications established during prenatal and early life, including DNA methylation, have been suggested as potential mediators of the interaction between environmental exposures during the perinatal period and adult metabolic health adverse outcomes, especially cardiometabolic complications and overweight. The effect of a dietary intervention in the first year of life on global methylation levels in leukocyte samples from a cohort of children born between 2001 and 2002 in southern Brazil was examined. Overall methylation measurements were performed using enzyme-linked immunosorbent assays on DNA samples from 237 children at 4 years old. Mean methylation values were higher in the intervention group (mean: 2.20 ± 1.31%) than in the control group (mean: 1.65 ± 1.11%; P = 0.001). It was observed that nutritional counseling in the first year increased breastfeeding duration and stimulated the development of healthier eating habits. Therefore, these factors might have contributed to increase global DNA methylation. The findings of the present study reinforce the notion that performing nutritional interventions in the early stages of life is important and provide further evidence of the interaction between the environment and epigenetic traits.

Polymorphisms in LEPR, PPARG and APM1 genes: associations with energy intake and metabolic traits in young children.

OBJECTIVE: To assess the association of single nucleotide polymorphisms (SNPs) in five genes - leptin, leptin receptor (LEPR), adiponectin (APM1), peroxisome proliferator-activated receptor gamma (PPARG) and uncoupling protein 1 - with anthropometric, metabolic, and dietary parameters in a Southern Brazilian cohort of 325 children followed up from birth to 4 years old. MATERIALS AND METHODS: SNPs were analyzed using polymerase chain reaction-based procedures, and their association with phenotypes was evaluated by t-test, analysis of variance, and general linear models. RESULTS: LEPR223Arg allele (rs1137101) was associated with higher daily energy intake at 4 years of age (P = 0.002; Pcorrected = 0.024). PPARG 12Ala-carriers (rs1801282) presented higher glucose levels than Pro/Pro homozygotes (P = 0.007; Pcorrected = 0.042). CONCLUSIONS: Two of the six studied SNPs presented consistent associations, showing that it is already possible to detect the influences of genetic variants on susceptibility to overweight in 4-year-old children.

Polymorphisms in LEPR, PPARG and APM1 genes: associations with energy intake and metabolic traits in young children / Polimorfismos nos genes LEPR, PPARG e APM1: associações com ingestão energética e parâmetros metabólicos em crianças em idade precoce

OBJECTIVE: To assess the association of single nucleotide polymorphisms (SNPs) in five genes - leptin, leptin receptor (LEPR), adiponectin (APM1), peroxisome proliferator-activated receptor gamma (PPARG) and uncoupling protein 1 - with anthropometric, metabolic, and dietary parameters in a Southern Brazilian cohort of 325 children followed up from birth to 4 years old. MATERIALS AND METHODS: SNPs were analyzed using polymerase chain reaction-based procedures, and their association with phenotypes was evaluated by t-test, analysis of variance, and general linear models. RESULTS: LEPR223Arg allele (rs1137101) was associated with higher daily energy intake at 4 years of age (P = 0.002; Pcorrected = 0.024). PPARG 12Ala-carriers (rs1801282) presented higher glucose levels than Pro/Pro homozygotes (P = 0.007; Pcorrected = 0.042). CONCLUSIONS: Two of the six studied SNPs presented consistent associations, showing that it is already possible to detect the influences of genetic variants on susceptibility to overweight in 4-year-old children.

OBJETIVO: Avaliar a associação de polimorfismos de nucleotídeo único (SNPs) em cinco genes: leptina, receptor da leptina (LEPR), adiponectina (APM1), receptor ativado por proliferadores de peroxissomas gama (PPARG) e proteína desacopladora 1 com parâmetros antropométricos, metabólicos e dietéticos em uma coorte sul-brasileira composta por 325 crianças acompanhadas desde o nascimento até os 4 anos. MATERIAIS E MÉTODOS: Os SNPs foram analisados por meio da reação em cadeia da polimerase e sua associação com os fenótipos foi avaliada utilizando teste T, análise de variância e análise fatorial. RESULTADOS: O alelo LEPR223Arg (rs1137101) foi associado a uma maior ingestão energética diária aos 4 anos (P = 0,002; Pcorrigido = 0,024). Os portadores do alelo PPARG12Ala (rs1801282) apresentaram maior glicemia em relação aos homozigotos Pro/Pro (P = 0,007; Pcorrigido = 0,042). CONCLUSÕES: Dois dos seis SNPs estudados apresentaram associações consistentes, mostrando que aos 4 anos de idade já é possível detectar as influências de variantes genéticas sobre a suscetibilidade ao excesso de peso.

Risk factors for high blood pressure in low income children aged 3-4 years.

UNLABELLED: This study aimed to evaluate the effect of dietary sodium intake on blood pressure among low income children aged 3-4 years. Data were collected during a randomized trial conducted in São Leopoldo, Brazil, with 500 mother-child pairs recruited from the maternity ward of a local hospital. Breastfeeding data were obtained during the children's first year of life. At 3 to 4 years of age, children's anthropometric, dietary, and blood pressure assessments were obtained. Sodium intake was estimated from two multiple-pass 24-h dietary recalls. Systolic blood pressure > 90th percentile for age, sex, and height was classified as high systolic blood pressure, according to the population-based percentiles provided by the Task Force on Hypertension Control in Children and Adolescents. Blood pressure data were obtained from 331 children at 3 to 4 years. The mean value of systolic blood pressure was 91.31 mmHg (SD = 8.30 mmHg) and 5.2% (n = 17) presented high systolic blood pressure. The results of the multivariable analyses showed that children who consumed more than 1,200 mg of sodium/day and with waist-to-height ratio higher than 0.5 presented, respectively, 3.32 (95%CI 0.98-11.22) and 8.81 (95%CI 2.13-36.31) greater risk of having high systolic blood pressure. Exclusive breastfeeding, child overweight and change in body mass index z score during the first year of life were not associated with the outcome. CONCLUSIONS: The results of this study suggest that at preschool age sodium intake and high waist-to-height ratio are risk factors for high systolic blood pressure.

Association between a frequent variant of the FTO gene and anthropometric phenotypes in Brazilian children.

BACKGROUND: Our goal was to analyze the association of the fat mass and obesity- associated (FTO) gene rs9939609 variant (T/A) with the anthropometric and dietary intake phenotypes related to obesity in Brazilian children. METHODS: We analyzed the association of this single nucleotide polymorphism (SNP) with phenotypes related to the accumulation of body mass in a cohort of 348 children followed from the time of birth until 8 years old and then replicated the main findings in an independent schoolchildren sample (n = 615). RESULTS: At the age of 4, we observed a significant association between the A/A genotype and a higher mean BMI Z-score (P = 0.036). At the age of 8, the A/A individuals still presented with a higher BMI Z-score (P = 0.011) and with marginal differences in the volume of subcutaneous fat (P = 0.048). We replicated these findings in the schoolchildren sample, which showed that those with at least one copy of the A allele presented with a higher BMI Z-score (P = 0.029) and volume of subcutaneous fat (P = 0.016). CONCLUSION: Our results indicate that this FTO variant is associated with increased body mass and subcutaneous fat in Brazilian children beginning at the age of 4.

Medidas antropométricas preditivas de pressão arterial elevada entre adolescentes / Anthropometric measurements predictive of high blood pressure in adolescents

Objetivo: Avaliar a capacidade preditiva da circunferência da cintura e do índice de massa corporal para identificar adolescentes com pressão arterial elevada. Métodos: estudo transversal com 1014 adolescentes (10 a 16 anos) do município de Portão, localizado no Rio Grande do Sul. O índice de massa corporal foi classificado de acordo com o referencial da Organização Mundial de Saúde e segundo Conde & Monteiro, e a circunferência da cintura foi classificada de acordo com o proposto por Taylor et al e Katzmarzyk et al. A pressão foi aferida por meio de aparelho digital. Resultados: A prevalência da pressão arterial elevada foi de 13,4%. As medidas antropométricas apresentaram correlação significativa com a pressão arterial. O critério brasileiro para o índice de massa corporal apresentou maior sensibilidade para identificar adolescentes com a pressão arterial elevada quando comparado ao referencial da Organização Mundial de Saúde (66,2% vs 58,8%). A circunferência da cintura , de acordo com Katzmarzyk et al apresentou maior sensibilidade quando comparada ao proposto por taylor et al. e à medida do índice de massa corporal...O índice de masas corporal e a circunferência da cintura podem ser utilizados como medidas simples e de baixo custo para avaliar risco de pressão arterial elevada entre adolescentes. O critério brasileiro para classificação do índice de massa corporal e o critério de circunferência de cintura de Katzmarzyk et al se mostraram bons instrumentos de triagem para identificar pressão arterial elevada entre os adolescentes

Objective: To assess whether waist circumference and body mass index can identify adolescents with high blood pressure. Methods: This is a cross-sectional study with adolescents from the city of Portão, Rio Grande do Sul. Body mass index was calculated, and the children were classified according to the World Health Organization’s growth charts and to Conde & Monteiro’s classification system. Waist circumference was classified as recommended by Taylor et al. and Katzmarzyk et al. Blood pressure was measured by a digital monitor.Results: The prevalence of high blood pressure was 13.4%. Anthropometric measurements were significantly correlated with systolic and diastolic blood pressures. The sensitivity of the Brazilian body mass index classification in identifying adolescents with high blood pressure was higher than that of the World Health Organization’s growth charts(66.2% vs 58.8%). Katzmarzyk’s et al. classification of waist circumference was more sensitive than Taylor’s et al. and body mass index classification. The area under the curve was similar for body mass index and waist circumference, ranging from 0.70 to0.89 for adolescents up to 14 years of age and from 0.57 to 0.77 for adolescents older than 14 years.Conclusion: Body mass index and waist circumference are simple and inexpensive measuremens that can be used for identifying adolescents at high risk of high blood pressure. The Brazilian body mass index classification and Katzmarzyk’s et al. waist circumference classification identified adolescents with high blood pressure well.

Práticas alimentares no primeiro ano de vida e fatores associados em amostra representativa da cidade de Porto Alegre, Rio Grande do Sul / Feeding practices and associated factors in the first year of life in a representative sample of Porto Alegre, Rio Grande do Sul, Brazil

OBJETIVO: Investigar a adequação das práticas alimentares no primeiro ano de vida e seus fatores associados na cidade de Porto Alegre (RS). MÉTODOS: Este estudo transversal foi realizado durante a Campanha Nacional de Imunização no ano de 2008. Utilizou-se amostragem por conglomerados em dois estágios e foram avaliadas 1.099 crianças menores de um ano de idade, em 31 postos de vacinação. A coleta de dados consistiu da aplicação de questionário estruturado sobre características maternas, uso de chupeta, consumo de leite materno, de leites artificiais, chá, água, alimentos complementares e de alimentos de baixo valor nutricional pelas crianças. Para estimar a associação entre variáveis maternas, uso de chupeta e práticas alimentares, foram utilizadas análises de regressão logística. RESULTADOS: A prevalência de aleitamento materno exclusivo foi de 47,1% entre as crianças com até quatro meses de vida e de 21,4% entre as crianças entre quatro e seis meses. A frequência de aleitamento materno exclusivo foi maior entre as crianças que não usavam chupeta, que não eram primogênitas e cujas mães não trabalhavam fora de casa ou estavam em licença maternidade. Melhores práticas de alimentação complementar foram observadas em crianças cujas mães tinham maior nível de escolaridade e trabalhavam fora de casa. CONCLUSÃO: Este estudo mostrou a existência de fatores de risco para a interrupção precoce do aleitamento materno exclusivo e o consumo de alimentos inadequados aos lactentes.

OBJECTIVE: The present study aimed to investigate the adequacy of feeding practices in the first year of life and associated factors in the city of Porto Alegre (RS). METHODS: This cross-sectional study was performed during the national vaccination campaign in 2008. Two-stage cluster sampling was used and 1,099 children under one year of age were evaluated at 31 vaccination sites. Maternal and breastfeeding data and the use of pacifiers, infant formulas, tea, water, complementary foods and low-nutrient foods were investigated using a structured questionnaire. Logistic regres­sion analyses were used to estimate the association between maternal characteristics, use of pacifiers and infant feeding practices. RESULTS: The prevalence of exclusive breastfeeding was 47.1% in children aged up to four months and 21.4% in children aged four to six months. The prevalence of exclusive breastfeeding was higher in children who did not use pacifiers, who were not firstborns and whose mothers were on maternity leave or not employed. Better complementary feeding practices were observed among employed mothers with higher education level. CONCLUSION: This study evidenced the existence of risk factors for early discontinuation of exclusive breastfeeding and inappropriate feeding practices.

Long-term effectiveness of maternal dietary counseling in a low-income population: a randomized field trial.

OBJECTIVE: To assess the impact of dietary counseling given to mothers during the first year of infants' lives on food consumption, nutritional status, and lipid profile of the children up to 7 to 8 years old. METHODS: The randomized trial was conducted with 500 mothers who gave birth to full-term infants with birth weight ≥ 2500 g between October 2001 and June 2002 in São Leopoldo, Brazil. Mothers were randomly assigned to intervention (n = 200) and control groups (n = 300) and those in the intervention group received counseling on breastfeeding and complementary feeding by 12 fieldworkers on 10 home visits during the first year of children's lives. Blinded fieldworkers assessed dietary and anthropometric data at 12 to 16 months, 3 to 4 years, and 7 to 8 years and lipid profiles at 3 to 4 years and 7 to 8 years old. The lipid profile was the primary outcome. RESULTS: Of the 500 recruited children, 397 underwent the 12- to 16-month, 354 the 3- to 4-year, and 315 the 7- to 8-year assessment. The energy-dense foods intake was significantly lower in the intervention group at 12 to 16 months and 3 to 4 years old. At 3 to 4 years, serum lipid levels did not differ between groups. At 7 to 8 years, high-density lipoprotein levels were 0.11 mmol/L higher (0.00 to 0.20), and triglycerides concentration was 0.13 mmol/L lower (-0.25 to -0.01) in intervention children but only among the girls. Overweight/obesity rates did not differ between groups. CONCLUSIONS: Dietary counseling for mothers during infancy decreased the energy-dense foods consumption and improved lipid profile.

Sleep duration and body mass index among southern Brazilian preschoolers.

Prevention and treatment of overweight are particularly complex, reinforcing the importance of studies aimed at clarifying their range of causes and effects. Thus, the objective of this study was to evaluate the relationship between night sleep duration and anthropometric measurements. A cross-sectional analysis was performed from data from 348 children aged 3 and 4 years in São Leopoldo/RS. Night sleep duration was reported by their mothers and body mass index, waist circumference and skinfold thickness were measured according to standard protocol. The analyses were adjusted for energy intake and hours of television watching. Overweight children had, on average, 0.39 hours less sleep than those with normal weight (9.77 ± 1.44 versus 10.17 ± 1.34; 95% CI 0.03 to 0, 76). We observed an inverse association between night sleep duration and z score values of body mass index for age (B = -0.12 95% CI -0.22 - -0.02). Waist circumference and skinfold thickness showed an inverse relationship with sleep duration, but without any statistic differences. Among preschool children in southern Brazil, smaller night sleep duration was associated with higher body mass index.

Maternal dietary counseling reduces consumption of energy-dense foods among infants: a randomized controlled trial.

OBJECTIVE: To evaluate the impact of a dietary counseling in reducing the intake of energy-dense foods by infants. DESIGN: A randomized controlled trial. SETTING AND PARTICIPANTS: São Leopoldo, Brazil. Mothers and infants of a low-income-group population were randomized into intervention (n = 163) and received dietary counseling during 10 home visits, or control (n = 234) groups. MAIN OUTCOMES MEASURES: Child consumption of sugar-dense (SD) and lipid-dense (LD) foods at 12 to 16 months. ANALYSIS: The effect of the intervention was expressed by relative risks and 95% confidence intervals. Poisson regression analysis was used to determine the association between exclusive breastfeeding and the energy-dense foods intake. RESULTS: A smaller proportion of infants from the intervention group consumed candy, soft drinks, honey, cookies, chocolate, and salty snacks. In the intervention group, there was a reduction of 40% and 50% in the proportion of infants who consumed LD and SD foods, respectively. Being breastfed up to 6 months reduced the risk for consumption of LD and SD foods by 58% and 67%, respectively. CONCLUSIONS AND IMPLICATIONS: Dietary counseling to mothers may be effective in reducing the consumption of energy-dense foods among infants, and it is helpful in improving early dietary habits.

Waist-to-height ratio as a screening tool for children with risk factors for cardiovascular disease.

BACKGROUND: Waist-to-height ratio (WHtR) has been recommended as a tool for predicting cardiovascular risk in children. However, there is little evidence about the accuracy of using WHtR as a predictor of disease risk in pre-school children. AIMS: To assess the accuracy of waist-to-height ratio (WHtR), waist circumference (WC) and body mass index (BMI) as well as to determine the optimal cut-off values for each of these measures in order to identify pre-school children with cardiovascular risks. SUBJECTS AND METHODS: This study conducted a cross-sectional analysis of 315 children between 3-4 years of age. Multiple risk factors for cardiovascular disease (MRFCD) were defined as having two or more of the following conditions: HDL-c < 35 mg/dL, LDL-c ≥ 110 mg/dL, triglycerides ≥ 150 mg/dL and systolic and/or diastolic blood pressure ≥ 90(th) percentile. RESULTS: The accuracy of WHtR in identifying cardiovascular risk in pre-school children was not significantly different compared to BMI or WC, for both sexes. The optimal cut-off measures for predicting cardiovascular risk in boys and girls, respectively, were as follows: 0.51 and 0.49 for WHtR; 0.61 and 0.69 for BMI Z-score; and 51.2 cm and 50.2 cm for WC. CONCLUSIONS: The data support the use of a 0.5 cut-off value for WHtR to predict cardiovascular risk factors among pre-school children and suggest that using WHtR is comparable to both BMI and WC.

Maternal dietary counseling in the first year of life is associated with a higher healthy eating index in childhood.

Food preferences are established in early childhood and track later in life. Therefore, it is important to promote healthy feeding practices as early as possible. A randomized field trial was conducted with 500 mother-child pairs from a low-income area of São Leopoldo, State of Rio Grande do Sul, Brazil, to evaluate the impact of a nutritional intervention in the first year of life on the dietary quality of 3- to 4-y-old children. Mother-child pairs were randomized either to intervention and control groups and dietary counseling was provided for mothers in the intervention group during 10 home visits in the course of the first year of life. These visits were carried out by fieldworkers who counseled the mothers about the Ten Steps for Healthy Feeding from Birth to Two Years of Age, based on the WHO guidelines. Dietary intake was assessed at 3-4 y of age for 345 children using two 24-h food recalls. Overall diet quality was determined by the Healthy Eating Index. The prevalence of poor diet in the intervention group was lower compared with the control group [relative risk (RR) = 0.30; 95% CI = 0.13-0.71). The number of children who achieved the 75th percentile for the vegetable and fruit component score was higher in the intervention than in control group (RR = 1.95; 95% CI = 1.31-2.89 and RR = 1.49; 95% CI = 1.07-2.07, respectively). Such data provide evidence that dietary counseling for mothers during the first year of life improves the overall dietary quality of children in a low-income population.

Frequency of public child care service use and associated factors.

OBJECTIVE: Assess the maternal socio-demographic factors associated with the frequency of use of child care services by low income families. METHODS: Cross-sectional analysis of 393 children between 12 and 16 months old who participated in a randomized field trial during their first year of life in a program of nutritional intervention. The study began in the Brazilian Unified Health System (Sistema Unico de Saúde, SUS) of the maternity hospital in the city of São Leopoldo, state of Rio Grande do Sul, Brazil. Children were examined regarding child care follow-up and vaccination schedule by checking the immunization chart. Data were analyzed using statistical tests Pearson's chi square and prevalence ratio (PR) with respective 95% confidence interval. RESULTS: The frequency of children who were not continuously taken to the child care service was 53.2%. Multivariate analysis suggests that the factors associated with the lack of continuous use of the service were: mother's educational level

Frequência de utilização do serviço público de puericultura e fatores associados / Frequency of public child care service use and associated factors

Objetivo: Avaliar os fatores sociodemográficos associados à frequência da utilização do serviço de puericultura por famílias de baixo nível socioeconômico. Métodos: Análise transversal de 393 crianças, com idades entre 12 e 16 meses, que participaram de um ensaio de campo randomizado no primeiro ano de vida em um programa de intervenção nutricional. O estudo iniciou nos setores de atendimento do Sistema Único de Saúde da maternidade da cidade de São Leopoldo (RS). As crianças foram avaliadas quanto ao acompanhamento na puericultura e calendário de vacinação. Para análise dos dados utilizou-se teste qui-quadrado de Pearson e razão de prevalência (RP) com respectivo intervalo de confiança de 95 por cento (IC95 por cento). Resultados: A frequência de crianças que não foram levadas regularmente foi de 53,2 por cento. A análise multivariada sugere que os fatores associados à ausência de utilização regular do serviço foram: escolaridade materna < 8 anos (RP 1,32; IC95 por cento 1,02-1,71), estrutura familiar não nuclear (RP 1,32; IC95 por cento 1,10-1,59) e não ser filho único (RP 1,38; IC95 por cento 1,10-1,72). Os motivos relatados para o não acompanhamento da criança na puericultura foram: 66,2 por cento consideraram desnecessário, 21,7 por cento referiram insatisfação com o serviço, 6,05 por cento impossibilidade devido ao emprego e 6,05 por cento outros motivos. Conclusão: A elevada frequência de crianças que não são levadas para acompanhamento no serviço de puericultura está associada à baixa escolaridade materna e à estrutura familiar, além da percepção de que é desnecessário na ausência de doença da criança.

Objective: Assess the maternal socio-demographic factors associated with the frequency of use of child care services by low income families. Methods: Cross-sectional analysis of 393 children between 12 and 16 months old who participated in a randomized field trial during their first year of life in a program of nutritional intervention. The study began in the Brazilian Unified Health System (Sistema Único de Saúde, SUS) of the maternity hospital in the city of São Leopoldo, state of Rio Grande do Sul, Brazil. Children were examined regarding child care follow-up and vaccination schedule by checking the immunization chart. Data were analyzed using statistical tests Pearsons chi square and prevalence ratio (PR) with respective 95 percent confidence interval. Results: The frequency of children who were not continuously taken to the child care service was 53.2 percent. Multivariate analysis suggests that the factors associated with the lack of continuous use of the service were: mothers educational level < 8 years (PR 1.32 95 percentCI 1.02-1.71), non-nuclear family structure (PR 1.32 95 percentCI 1.10-1.59) and not being an only child (PR 1.38 95 percentCI 1.10-1.72). The reasons for lack of follow-up, according to the mothers were: the fact that they thought it unnecessary for 66.2 percent, problems with the service for 21.7 percent, difficulties related to their jobs for 6.05 percent, and other reasons for 6.05 percent. Conclusion: The high frequency of children who were not taken to the child health care service for follow-up is associated with low maternal educational level and family structure, as well as the perception that follow-up visits are not necessary when the child does not have a disease.

Fatores associados ao hábito de assistir TV em excesso entre adolescentes / Factors associated with excessive television watching among adolescents

OBJETIVO: Avaliar a freqüência com que os adolescentes assistem televisão na região Sul do Brasil e quais fatores estão associados a esse comportamento. MÉTODOS: Estudo transversal, com 722 adolescentes entre 10 e 19 anos. Foi calculado a média de horas diárias que os adolescentes assistiam televisão. Foi realizada análise de regressão logística para analisar possível associação entre fatores sociodemográfico, antropométricos, atividade física, sexo e idade, com o hábito de assistir mais do que 4 horas diárias de televisão. RESULTADOS: Entre os adolescentes estudados, 41,1 por cento assistiam mais do 4 horas de TV por dia. A prevalência de adolescentes que assistiam > 4h de TV foi maior entre aqueles com menos de 16 anos. Ser filho de mãe com escolaridade maior do que 8 anos (OR 1,9; IC 1,25-2,89) e possuir circunferência da cintura maior do que o percentil 80 (OR 2,77; IC 1,33-5,77) foi positivamente associado ao hábito de assistir televisão mais do que 4 horas diárias. CONCLUSÕES: Maior escolaridade materna e circunferência da cintura maior do que o percentil 80 estão associados ao comportamento de assistir TV em excesso entre os adolescentes. Esses achados devem ser utilizados para direcionar a elaboração de programas de saúde pública, especialmente por meio das escolas, enfocando adolescentes com faixa etária entre 10 e 15 anos, assim como devem servir de alerta para os profissionais de saúde e educadores.

OBJECTIVE: to evaluate the frequency adolescents watch TV in southern Brazil and which factors are associated with this behavior. METHODS: This was a cross-sectional study. The sample consisted of 722 adolescents between 10 and 19 years of age. Logistic regression analysis was used to verify association between socio-demographic and anthropometric factors, physical activity, age and sex with the adolescents who watched TV for more than four daily hours. RESULTS: Forty-one percent of the adolescents watched more than four daily hours of TV. The prevalence of adolescents who excessively watched TV was higher among those under 16 yr of age (PR 1.92; CI 1.33-2.78). Having a mother with higher educational background (PR 1.51; CI 1.08-2.11), and having waist circumference above 80 percentile (PR 1.63; CI 1.09-2.44) were positively associated with the habit of watching more than 4 hours/day of television. CONCLUSIONS: Higher mother educational background and higher waist circumference are associated with excessive television watching. These results can be useful to create health programs at schools, focusing adolescents between 19 and 15 years old.

Adequação da ingestão dietética de atletas adolescentes de 4 modalidades esportivas / Dietary intake adequacy of adolescent athletes of 4 sports

O presente estudo objetivou avaliar a ingestão alimentar quanto à qualidade nutricional de atletas adolescentes do sexo feminino, comparando modalidades esportivas que apresentam características distintas quanto ao gasto energético e ao controle de peso corporal das atletas. Foram estudadas as atletas entre 10 e 14 anos, pertencentes às equipes de natação, vôlei, ginástica olímpica e rítmica do Clube Grêmio Náutico União de Porto Alegre. O cálculo da ingestão de nutrientes foi baseado no registro alimentar de três dias. A ingestão de macro e micronutrientes foi comparada com as recomendações da Organização Mundial de Saúde e com as Dietary References Intake, respectivamente. Foram estudadas 45 atletas (13 nadadoras, 17 jogadoras de vôlei, sete atletas da ginástica olímpica e oito da ginástica rítmica). A natação foi o grupo que apresentou maior média de consumo de energia com diferença de aproximadamente 1000 Kcal/dia das demais modalidades. Com relação ao consumo de carboidrato por quilo de peso corporal, as atletas de natação e GRD apresentaram maior consumo em relação as demais atletas. A média de ingestão de ferro das atletas das quatro modalidades fi cou a cima do recomendado. O vôlei foi a modalidade com maior porcentual de atletas com consumo excessivo de proteína e lipídio, e ingestão insuficiente de carboidrato em relação ao valor energético total. É importante a elaboração de programas de educação alimentar e o acompanhamento nutricional periódico de atletas adolescentes.

This study aims to investigate the nutritional quality of dietary composition of female adolescent athletes, comparing sports modalidities with different caracteristics as for energy expenditure and body weight control severity. This study included swimmers, volleyball players, olympic and artistic gymnasts, between 10 and 14 years old, from Grêmio Náutico União Club, Porto Alegre. Nutrient intake was based on 3-day food records. Macro- and Micro- nutrients intake was compared recommendations of World Health Organization and to Dietary References intake, respectively. We studied 45 athletes (13 swimmers, 17 volleyball players, 7 olympic gymnasts and 8 artistic gymnasts). The swimmers presented higher energy intake, approximately 1000kcal/day higher than the other sports. Swimmers and artistic gymnasts showed hogher carbohydrate intake per kilogram body weight than the other sports. The mean iron intake was higher than de recommendation for all athletes. The volleyball athletes showed higher prevalence of excessive protein and lipid intake and insufi cient carbohydrate intake. A nutrition educational program and periodical nutritional attendance of female adolescent athletes is necessary.

Avaliação de duas classificações para excesso de peso em adolescentes brasileiros / Evaluation of two classifications for overweight among Brazilian adolescents

Estudo transversal com 418 adolescentes entre dez e 19 anos, de escola particular da cidade de São Paulo, em 1998. O objetivo foi avaliar os valores críticos propostos para diagnóstico de excesso de peso de adolescentes brasileiros. O percentual de gordura corporal foi medido pela absorção de duplo feixe de energia. Utilizou-se como ponto de corte para excesso de adiposidade 25 por cento para meninos e 30 por cento para meninas. O índice de massa corporal foi classificado de acordo com Cole et al e Conde & Monteiro. O referencial brasileiro apresentou maior sensibilidade entre as meninas de menor (44,2 por cento vs. 32,6 por cento) e maior faixa etária (18,9 por cento vs. 17 por cento), assim como entre os meninos de maior faixa etária (83,3 por cento vs 50 por cento). A proposta de Conde & Monteiro apresentou maiores valores preditivos positivos e negativos e predisse com maior sensibilidade o excesso de adiposidade na população estudada.

A cross-sectional study carried out among 418 adolescents between ten and 19 years old at a private school in the city of São Paulo in 1998. The objective of the study was to evaluate the proposed thresholds for diagnosing overweight among Brazilian adolescents. The percentage body fat was measured by dual energy X-ray absorptiometry. The cutoff points used for excess body fat were 25 percent for boys and 30 percent for girls. The body mass index was classified in accordance with Cole et al and with Conde & Monteiro. The Brazilian reference (Conde & Monteiro) presented higher sensitivity among younger girls (44.2 percent vs. 32.6 percent), older girls (18.9 percent vs. 17 percent) and older boys (83.3 percent vs. 50 percent). The Conde & Monteiro proposal presented higher positive and negative predictive values and provided higher-sensitivity predictions of excess body fat among the study population.

[Evaluation of two classifications for overweight among Brazilian adolescents]. / Avaliação de duas classificações para excesso de peso em adolescentes brasileiros.

A cross-sectional study carried out among 418 adolescents between ten and 19 years old at a private school in the city of São Paulo in 1998. The objective of the study was to evaluate the proposed thresholds for diagnosing overweight among Brazilian adolescents. The percentage body fat was measured by dual energy X-ray absorptiometry. The cutoff points used for excess body fat were 25% for boys and 30% for girls. The body mass index was classified in accordance with Cole et al and with Conde & Monteiro. The Brazilian reference (Conde & Monteiro) presented higher sensitivity among younger girls (44.2% vs. 32.6%), older girls (18.9% vs. 17%) and older boys (83.3% vs. 50%). The Conde & Monteiro proposal presented higher positive and negative predictive values and provided higher-sensitivity predictions of excess body fat among the study population.