Grupo multifamiliar em transtornos alimentares durante a primeira onda da pandemia de covid-19: transição para a modalidade online / Multifamily group on eating disorders during the first wave of the covid-19 pandemic: transitioning to the online modality / Grupo multifamiliar de trastornos alimentarios durante la primera ola de la pandemia de la covid-19: transición a la modalidad en línea

As restrições impostas pela pandemia de covid-19 levaram os serviços de saúde a reorganizarem seu funcionamento, ajustando-se à modalidade remota. A transição repentina e sem o devido preparo técnico impôs desafios adicionais para usuários e profissionais. Para aprimorar as estratégias assistenciais, torna-se imprescindível dar voz aos usuários dos serviços, para que narrem suas experiências e possam manifestar suas facilidades e dificuldades com essa passagem. Este estudo tem como objetivo investigar como os principais cuidadores familiares de pessoas com transtornos alimentares vivenciaram a transição do grupo de apoio para o formato remoto e identificar vantagens e desvantagens percebidas nesse modelo. Estudo clínico-qualitativo, exploratório, realizado em um serviço de atendimento especializado de um hospital terciário. O cenário investigado foi o grupo de apoio psicológico aberto a familiares que, desde o início da pandemia de covid-19, passou a ser oferecido na modalidade online. Participaram do estudo cinco mães e três pais presentes em 13 sessões grupais consecutivas. Entrevistas individuais foram aplicadas com a Técnica do Incidente Crítico logo após o término de cada encontro grupal, totalizando 26 entrevistas audiogravadas, transcritas e submetidas à análise temática. A transição para o online foi vivenciada pelos participantes como um recurso válido para permitir que o grupo funcionasse em tempos de grave crise sanitária. Como vantagens, foram mencionadas: a continuidade do cuidado, maior acessibilidade e facilidade em relação à logística da participação. Como limitações do formato online, foram destacadas: nem todos os familiares contam com conexão de internet de qualidade e possível dificuldade para manusear a tecnologia digital. Apesar dos desafios impostos pela súbita mudança para a modalidade online, na perspectiva dos usuários do serviço os esforços de adaptação foram bem-sucedidos, possibilitando a continuidade do cuidado à saúde mental.(AU)

The constraints imposed by the COVID-19 pandemic led health services to reorganize their operation, adjusting to the online modality. The sudden and unprepared technical transition has imposed additional challenges for both users and professionals. To improve care strategies, it is essential to give voice to services users, so that they can narrate their experiences and express their facilities and difficulties with this transition. This study aims to investigate how main family caregivers of people with eating disorders experienced the transition of the support group to the remote modality and to identify perceived advantages and disadvantages in this model. This is a clinical-qualitative, exploratory study carried out in a specialized care service of a tertiary hospital. The investigated setting was the psychological support group open to family members, which since the beginning of the COVID-19 pandemic has been offered online. Five mothers and three fathers who attended 13 consecutive group sessions participated in the study. Individual interviews were carried out with the Critical Incident Technique shortly after the end of each group meeting with all members, totaling 26 audio-recorded interviews. Data were subjected to thematic analysis. Transition was experienced as a valid resource to maintain the group active in times of a severe health crisis. As advantages of the remote modality were mentioned: continuity of care, greater accessibility, and ease in relation to the logistics of participation. As limitations of the online format were highlighted: not everyone has a good-quality connection to the internet, and difficulty in handling the digital technology. Despite the challenges imposed by the sudden shift to the online modality, from the service users' perspective the adaptation efforts were successful, enabling continuity of mental health care.(AU)

Las limitaciones que impuso la pandemia de la COVID-19 llevaron a los servicios sanitarios a reorganizar su funcionamiento adaptándose a la modalidad remota. El súbito cambio y sin la preparación técnica adecuada implicó retos adicionales a los usuarios y profesionales. Para mejorar las estrategias de atención es fundamental dar voz a los usuarios de los servicios, para que puedan narrar sus experiencias y expresar sus facilidades y dificultades con esta transición. Este estudio pretende investigar cómo han vivido los cuidadores de personas con trastornos alimentarios la transición del grupo de apoyo presencial al formato remoto e identificar las ventajas y desventajas percibidas en este modelo. Se trata de un estudio clínicocualitativo, exploratorio. El escenario investigado fue el grupo de apoyo psicológico abierto a los familiares en la modalidad en línea. Cinco madres y tres padres participaron en 13 sesiones de grupo consecutivas. Se realizaron entrevistas individuales con la técnica de incidentes críticos inmediatamente después de cada reunión del grupo, con un total de 26 entrevistas grabadas en audio, transcritas y sometidas a análisis temático. La transición a la red fue experimentada como un recurso válido para permitir que el grupo funcione en tiempos de crisis sanitaria grave. Las ventajas de la modalidad remota fueron conexión segura en tiempos de confinamiento físico, continuidad, mayor accesibilidad y facilidad en relación con la logística de la participación. Las limitaciones del formato en línea fueron la falta de una conexión de calidad a Internet y la posible dificultad de manejo de la tecnología digital. A pesar de las dificultades impuestas por el cambio repentino a la modalidad en línea, desde la perspectiva de los usuarios del servicio los esfuerzos de adaptación fueron un éxito, lo que permitió seguir con la atención de salud mental.(AU)

Índice de masa corporal, peso ideal y porcentaje de grasacorporal en personas de diferentes grupos etarios / Body mass index, ideal weight and percentage of body fat inpeople of different age groups

El objetivo es comparar el IMC con el porcentaje de grasa corporal y el peso ideal, para complementar el IMC en el diagnóstico de obesidad, de un grupo de adultos. Métodos: estudio descriptivo, transversal, prospectivo y correlacional, en una muestra de 797 adultos con edad entre 17 y 96 años, atendidos en diferentes centros clínicos de Caracas, entre 2015 y 2018. Las variables son: edad, peso, talla y se calcularon el IMC, porcentaje de grasa corporal (PGC) y peso ideal (PI). Se clasificaron por sexo, grupo etáreo y según el IMC en normalidad y obesidad. Se utilizaron dos fórmulas para el PGC: Deurenberg y Regresión; y tres fórmulas para PI: Lorenz, Ramírez et al y Broca. Se obtuvieron medidas descriptivas, asociación, correlación, comparación de promedios y prueba de normalidad, mediante el soware Excel, Epidat.2. Resultados: Promedios de IMC y PGC aumentan hasta los 40 años y disminuye hasta los 79 años, las variables Talla ­ PI Broca, e IMC- PGCR correlacionan bien (r>0,75). Los promedios del IMC, PGCD, PGCR, PI Broca y PI Lorenz, según sexo, son significativos (p<0,000); para el IMC, en Normalidad y Obesidad, los promedios de peso, IMC, PGCD y PGCR son mayores en grupo de Obesidad, y significativos (p<0,000). La prueba de normalidad Shapiro-Francia comprobó que la distribución del IMC, PGCD, PGCR y PI Lorenz, provienen de una población distribuida normalmente (p< 0,000). Conclusiones: el IMC aun cuando es utilizado más frecuentemente para diagnosticar obesidad, clasifica con normalidad, a quienes tienen un alto porcentaje de grasa corporal(AU)

The objective is to compare BMI with the percentage of body fat and ideal weight, to supplement BMI in the diagnosis of obesity, from a group of adults. METHODS: descriptive, cross-cutting, prospective and correlational study, in a sample of 797 adults between 17 and 96 years old, attended in different clinical centers of Caracas, between 2015 and 2018. the variables are: age, weight, size and BMI was calculated, percentage of body fat (BFP) and ideal weight (IW). they were classified by sex, age group and BMI in normality and obesity. Two formulas were used for BFP: Deurenberg and Regression; and three formulas for IW: Lorenz, Ramirez-Lopez et al and Broca. Descriptive measures, association, correlation, average comparison and normality test were obtained, using Excel software, Epidat.2. RESULT: BMI and BFP averages increase to 40 years and decrease to age 79, the variables Size ­ IW Broca, and BMI- BFPR correlate well (r>0.75). e average BMI, BFPD, BFPR, IW Broca and IW Lorenz, depending on gender, are significant (p<0.000); for BMI, in Normality and Obesity, the weight averages, BMI, BFPD and BFPR are higher in the Obesity group, and significant (p<0,000). the Shapiro-France normality test found that the distribution of BMI, BFPD, BFPR and IW Lorenz, comes from a normally distributed population (p< 0.000). CONCLUSIONS: BMI even though it is most commonly used to diagnose obesity, it classifies normally, those with a high percentage of body fat(AU)

Equations for calculating ideal body weight in patients on mechanical ventilation in adult intensive care units in Latin America: exploratory review / Ecuaciones para calcular el peso ideal en pacientes con ventilación mecánica en unidades de cuidado intensivo adulto en Latinoamérica: revisión exploratoria

Abstract Introduction Ideal body weight calculation is used in critical medicine for drug dosing and setting ventilation parameters. However, the suggested and used equations were designed on the basis of anthropometric variables that do not represent the Latin American population. Objective To map and present the current evidence on the equations used to calculate ideal weight in patients on mechanical ventilation in intensive care units in Latin America. Material and Methods Exploratory review using the Joanna Briggs Institute method conceived by Arskey / O'Malley. A search was performed in the BVS, LILLACS, REDALYC, Ovid, Google Scholar and Scielo databases using keywords and MeSH terms in Spanish, English, and Portuguese, with no time limitation. The results are presented in descriptive tables. Results Overall, 1126 studies were identified and 1120 were excluded; 6 studies were reviewed and 3 additional studies were identified through a manual search. The studies were published in Chile, Brazil, Mexico, Ecuador, and Peru. In 89%, the ARDS Network equation was used to calculate tidal volume. Acute respiratory distress syndrome was the most reported pathology (33%). Conclusions Adult intensive care units in Latin America use the equation suggested by the ARDS Network, which was designed in a population with different anthropometric characteristics.

Resumen Introducción El cálculo del peso ideal se utiliza en medicina crítica para dosificación de medicaciones y programación de parámetros ventilatorios; sin embargo, las ecuaciones sugeridas y usadas fueron diseñadas con variables antropométricas que no representan la población latinoamericana. Objetivo Mapear y presentar la evidencia actual de las ecuaciones utilizadas para calcular el peso ideal en pacientes con ventilación mecánica en unidades de cuidado intensivo de Latinoamérica. Material y métodos Revisión exploratoria con el método del Instituto Joanna Briggs concebido por Arskey y O'Malley. Se realizó una búsqueda en las bases de datos BVS, LILACS, Redalyc, Ovid, Google Scholar y SciELO con el uso de palabras clave y términos MeSH en idiomas español, inglés y portugués, sin límites de tiempo. Los resultados se presentan de forma descriptiva. Resultados Se identificaron 1.126 estudios, se excluyeron 1.120, se revisaron seis y se encontraron tres adicionales mediante búsqueda manual. Los estudios fueron publicados en Chile, Brasil, México, Ecuador y Perú. En el 89 % se usó la ecuación del ARDS Network para calcular volumen corriente. El síndrome de dificultad respiratoria aguda fue la patología más informada (33 %). Conclusiones En las unidades de cuidado intensivo adulto de Latinoamérica se usa la ecuación sugerida por el ARDS Network diseñada en población con características antropométricas diferentes.

Body mass index is associated with low postoperative cardiac output in patients undergoing aortic valve replacement / El índice de masa corporal se asocia a bajo gasto cardiaco postoperatorio de pacientes sometidos a reemplazo valvular aórtico

Abstract Background: Overweight and obesity (O/O) generate lipotoxicity of the cardiac fiber and increase the incidence and progression of aortic valve stenosis. The low cardiac output syndrome (LCOS) is a timing complication after to aortic valve replacement (AVR) surgery. Objective: The objective of the study was to investigate if body mass index (BMI) kg/m2 is a risk factor associated with LCOS and mortality in the post-operative period of AVR. Methods: A historic cohort study was designed, including patients with severe aortic stenosis (SAS), who were subjected to AVR. Results: 152 patients were included, 45 (29.6%), with normal weight (NW), 60 were overweight (39.5%), and 47 obese (30.9%). The prevalence of systemic hypertension (HT) was higher in O/O (p < 0.0001). Incidence of LCOS was 44.7%, being more frequent in the O/O groups compared to the NW group, 43.3%, 68.1%, and 22.2%, respectively, (p < 0.05 in overweight and p < 0.0001 in the obese). Assessing the presence or absence of LCOS associated with BMI as a numerical variable, we found that women, HT, BMI, left ventricular mass, and valve size, were associated with LCOS (p < 0.02, p < 0.02, p < 0.001, p < 0.032, and p < 0.045, respectively). Mortality was higher in patients who had LCOS (p < 0.02). Multivariate model showed that BMI was an independent risk factor for LCOS (odds ratio [OR] 1.21 [95% CI 1.08-1.35], p < 0.001). Conclusion: BMI is a risk factor associated to LCOS in the post-operative period of AVR in patients with SAS.

Resumen Antecedentes: El sobrepeso y la obesidad (O/O) generan lipotoxicidad de la fibra cardíaca y aumentan la incidencia y progresión de la estenosis de la válvula aórtica. El síndrome de bajo gasto cardíaco (SBGC) es una complicación postquirúrgica de la cirugía de reemplazo de válvula aórtica (RVA). Objetivo: Investigar si el índice de masa corporal kg/m2 (IMC) es un factor de riesgo asociado con SBGC y mortalidad en el postoperatorio de RVA. Métodos: Se diseñó un estudio de cohorte histórico, que incluyó pacientes con estenosis aórtica importante (EAI), que fueron sometidos a RVA. Resultados: Se incluyeron 152 pacientes, 45 (29.6%), con peso normal (N), 60 tenían sobrepeso (39.5%) y 47 obesos (30.9%). La prevalencia de hipertensión sistémica (HT) fue mayor en O/O (p < 0.0001). La incidencia de SBGC fue del 44.7%, siendo más frecuente en los grupos O/O en comparación con el grupo N, 43.3%, 68.1%, 22.2% respectivamente, (p < 0.05 en sobrepeso y p < 0.0001 en obesos). Al evaluar la presencia o ausencia de SBGC asociado con el IMC como una variable numérica, encontramos que las mujeres, HT, IMC, masa ventricular izquierda y tamaño de la válvula, se asociaron con SBGC (p < 0.02, p < 0.02, p < 0.001, p < 0.032, p < 0.045, respectivamente). La mortalidad fue mayor en pacientes con SBGC (p < 0.02). El modelo multivariado mostró que el IMC fue un factor de riesgo independiente asociado a SBGC [OR 1.21 (IC 95% 1.08-1.35), p < 0.001]. Conclusión: El IMC es un factor de riesgo asociado a SBGC en el postoperatorio de RVA en pacientes con EAI.

Comparación de mujeres jóvenes con obesidad y normopeso: vivencia corporal, hábitos saludables y regulación emocional / Comparison of young women with and without obesity: body experience, healthy habits and emotional regulation

RESUMEN La obesidad es un problema de salud pública, siendo especialmente importante entre mujeres jóvenes. El objetivo de este estudio fue comparar la vivencia corporal, los hábitos saludables y regulación emocional entre mujeres jóvenes chilenas con obesidad y normopeso. El estudio tuvo un enfoque cualitativo, de alcance exploratorio y diseño descriptivo-analítico. Para describir la muestra se usó el Multidimensional Body Self Relations Questionnaire (MBSRQ) que mide imagen corporal, el Dutch Eating Behavior Questionnaire (DEBQ) para evaluar ingesta emocional, y el Derogatis Symptom Checklist (SCL-90), que mide sintomatología psicológica. Se realizaron entrevistas en profundidad, que fueron analizadas utilizando codificación abierta de la Grounded Theory. Los resultados indican que ambos grupos presentan insatisfacción con la forma y peso de sus cuerpos, predominando en las participantes con obesidad al percibir limitaciones corporales. Las mujeres con obesidad describieron que regularon emociones negativas a través de la alimentación. Las participantes normopeso se caracterizaron por hábitos saludables, como actividad física y alimentación balanceada y en ambos grupos valorizan el cuidado del cuerpo y la estética personal, aunque sólo participantes normopeso presentaron conductas de cuidado efectivas.

ABSTRACT Obesity is a public health problem and is especially important among young women. The objective of this study was to compare the body experience, food habits and emotional regulation among young women with and without obesity. The study had a qualitative approach, was exploratory in scope and had a descriptive-analytical design. To describe the sample, the Multidimensional Body Self Relations Questionnaire (MBSRQ) was used to measure body image, the Dutch Eating Behavior Questionnaire (DEBQ) to assess emotional intake, and the Derogatis Symptom Checklist (SCL-90), which measures psychological symptoms. In-depth interviews were conducted, which were analyzed using Grounded Theory's open theory. The results indicated that both groups showed dissatisfaction with the shape and weight of their bodies, with women with obesity reporting perceived body limitations. Women with obesity reported regulating negative emotions through food. Non-obese participants reported healthy habits, such as physical activity and a balanced diet, and in both groups, body care and personal aesthetics were valued, although only non-obese participants reported effective care behaviors.

Factores sociales en la vivencia del cuerp de mujeres con peso normal y con obesidad: rol de la madre, el padre y la pareja / Social factors that affect the corporal experience in normal weight and obse women: the mother's role, the father and the couple

El objetivo de este estudio fue describir y comparar la influencia de factores sociales, específicamente de vínculos cercanos (madre, padre y pareja), sobre la vivencia del cuerpo en mujeres jóvenes con peso normal y con obesidad. Se realizó una investigación exploratoria cualitativa y se analizaron los datos a través de codificación abierta, basada en la Teoría Fundamentada. La muestra estuvo conformada por ocho mujeres, cuatro con obesidad mórbida y cuatro normopeso, entre 20 y 25 años. Los resultados confirman que la insatisfacción corporal está presente en todas las participantes independiente de su peso corporal. Las personas cercanas ejercen presión por la delgadez, la madre estaría más centrada en lo estético, mientras el padre expresaría mayor preocupación por la salud. Las participantes se muestran vulnerables a los mensajes contradictorios de la pareja, generando inseguridad. Sin embargo, la presión de los vínculos cercanos no sería suficiente para generar cambios de hábitos. Se observa ambivalencia entre la valoración de un cuerpo delgado y otro curvilíneo, ideales que se superponen y generan malestar.

The objective of this study was to describe the influence of social factors, specifically close affective bonds (mother, father and couple), on body experience in young women with obesity and normal weight. A qualitative exploratory research was carried out and data were analyzed with Grounded Theory. A sample of eight women between 20 and 25 years old participated, four of them with morbid obesity and four with normal weight. The results confirm that body dissatisfaction is present in all the participants, which is associated with the pressure to be thin exerted by the people close to them. Mothers are more centered on the aesthetic, while fathers seem to have more concern about health. Participants are vulnerable to the couple's conflicting messages, generating insecurity. However, the pressure of the environment does not seem to be enough to change the habits. Ambivalence is observed between the appreciation of a thin body and a curvilinear one at the same time, ideals that overlap and generate discomfort.

Associações entre o índice de massa corporal e a agilidade em crianças e adolescentes / Asociaciones entre el índice de masa corporal y la agilidad en niños y adolescentes / Associations between the body mass index and agility in children and adolescents

Introdução: às associações entre o índice de massa corporal e a agilidade na infância, não estão bem esclarecidas na literatura. Objetivo: analisar a associação entre os níveis do índice de massa coporal e a agilidade em crianças e adolescentes. Método: estudo transversal com voluntários de 10 a 14 anos. Separados em: grupo com peso normal (PN= 22), grupo com excesso de peso/obesidade (EP/OB= 22). Todos passaram por medidas de antropometria e agilidade. A estatura e massa corporal foram aferidas para determinar o índice de massa corporal utilizando a sugestão da Organização Mundial da Saúde. Para medir a agilidade foi utilizado o teste Shutle Runpor exigir pouca habilidade motra e ter uma boa confiabilidade. Na semana que antecedeu as medidas definitivas, os voluntários foram familiarizados com os procedimentos e com a execução dos testes. Para todos os cálculos estatísticos adotou o nível de significância de (p≤ 0,05). Resultados: houve uma correlação significativamente positiva e moderada entre o índice de massa corporal e os níveis de agilidade no grupo como um todo (r= 0,46; p= 0,03). Já os resultados do teste t, confirmou-se a existência de diferença significativa entre o nível de agilidade do grupo com excesso de peso e obesidade e o grupo com peso normal (p< 0,05). Conclusão: houve correlação significativa entre o índice de massa corporal e os níveis de agilidade na amostra analisada; e que o grupo classificado pelo índice de massa corporal como EP/OB apresentou um nível de agilidade significativamente menor do que o grupo classificado como peso normal(AU)

Introducción: las asociaciones entre el índice de masa corporal y la agilidad en la infancia, no están bien aclaradas en la literatura. Objetivo: analizar la asociación entre los niveles del índice de masa corporal y la agilidad en niños y adolescentes. Método: estudio transversal con voluntarios de 10 a 14 años. Se separaron en: grupo con peso normal (PN= 22), grupo con sobrepeso/obesidad (EP/OB= 22). Todos pasaron por medidas de antropometría y agilidad. La estatura y masa corporal fueron evaluadas para determinar el índice de masa corporal utilizando la sugerencia de la Organización Mundial de la Salud. Para medir la agilidad se utilizó la prueba Shutle Run por exigir poca habilidad motra y tener una buena confiabilidad. En la semana que precedió a las medidas definitivas, los voluntarios se familiarizaron con los procedimientos y la ejecución de las pruebas. Para todos los cálculos estadísticos adoptó el nivel de significancia de (p≤ 0,05). Resultados: hubo una correlación significativamente positiva y moderada entre el índice de masa corporal y los niveles de agilidad en el grupo como un todo (r= 0,46, p= 0,03). Los resultados de la prueba t, confirmaron la existencia de una diferencia significativa entre el nivel de agilidad del grupo con sobrepeso y obesidad y el grupo con peso normal (p< 0,05). Conclusión: hubo correlación significativa entre el índice de masa corporal y los niveles de agilidad en la muestra analizada; el grupo clasificado por el índice de masa corporal como EP/OB presentó un nivel de agilidad significativamente menor que el grupo clasificado como peso normal(AU)

Introduction: The associations between Body Mass Index and child agility are not well understood in the literature. Objective: To analyze the association between Body Mass Index levels and agility in children and adolescents. Methods: cross-sectional study with volunteers aged 10 to 14 years. Separated into: normal weight group (PN= 22), overweight/obese group (EP/OB= 22). All of them underwent anthropometric and agility measurements. Stature and body mass were measured to determine Body Mass Index using the suggestion of the World Health Organization. To measure agility, the Shutle Run test was used because it requires poor motor skills and good reliability. In the week preceding the definitive measures, the volunteers were familiar with the procedures and the execution of the tests. For all the statistical calculations it adopted the level of significance of (p≤ 0.05). Results: There was a significantly positive and moderate correlation between Body Mass Index and agility levels in the group as a whole (r= 0.46, p= 0.03). The results of the t-test confirmed the existence of a significant difference between the agility level of the overweight and obesity group and the normal weight group (p< 0.05). Conclusion: There was a significant correlation between Body Mass Index and agility levels in the sample analyzed; and that the group classified by BMI as EP/OB had a level of agility significantly lower than the group classified asnormal weight(AU)

Comparison of body composition and adipokine levels between thin and normal-weight prepubertal children / Comparação da composição corporal e dos níveis de adipocina entre crianças pré-púberes magras e com peso normal

Abstract Objective: Thinness can have substantial consequences for child development and health. Adipokines, including leptin and adiponectin, play a significant role in the regulation of important metabolic functions. The aim of this study was to investigate associations between body composition and serum leptin and adiponectin levels in thin and normal-weight children. Methods: The authors examined 100 healthy prepubertal children, who were divided into two subgroups: thin (n = 50) and normal-weight children (n = 50). Body composition was assessed by dual-energy X-ray absorptiometry. Serum concentrations of adipokines were determined by immunoenzymatic assays. Results: Thin children had a similar body height but significantly lower (p < 0.0001) body weight, body mass index, fat mass, lean mass, and bone mineral content compared with normal-weight children. Serum concentrations of leptin were about 2-fold lower (p < 0.0001) in thin vs. normal-weight subjects. Serum levels of total adiponectin, adiponectin multimers, and soluble leptin receptor (sOB-R) were similar in both groups. The leptin/soluble leptin receptor ratio and leptin/adiponectin ratios were lower (p < 0.0001) in thin vs. normal-weight children. In both groups of children, it was found that body composition parameters were positively related with leptin but not with adiponectin levels. Additionally, bone mineral content was positively related with body mass index, fat mass, lean mass, and leptin level in thin and normal-weight children. Conclusions: Prepubertal thin children have disturbances in body composition and adipokine profile. Early recognition of thinness and determination of body composition parameters and adipokine levels can be useful in medical and nutritional care of thin children for the optimization of bone mineral accrual.

Resumo Objetivo: A magreza pode ter consequências substanciais para o desenvolvimento e a saúde das crianças. As adipocinas, inclusive a leptina e a adiponectina, desempenham um papel significativo na regulação de importantes funções metabólicas. O objetivo do estudo foi investigar as associações entre a composição corporal e os níveis séricos de leptina e adiponectina em crianças magras e com peso normal. Métodos: Examinamos 100 crianças pré-púberes saudáveis, divididas em dois subgrupos: crianças magras (n = 50) e com peso normal (n = 50). A composição corporal foi avaliada pelo método de absorciometria de dupla energia de raios X. As concentrações séricas das adipocinas foram determinadas por ensaios imunoenzimáticos. Resultados: As crianças magras apresentaram altura semelhante, porém peso corporal (p < 0,0001), índice de massa corporal (IMC), massa gorda, massa magra e conteúdo mineral ósseo (CMO) significativamente menores em comparação com crianças com peso normal. As concentrações séricas de leptina foram aproximadamente duas vezes mais baixas (p < 0,0001) em indivíduos magros do que em crianças com peso normal. Os níveis séricos de adiponectina total, multímeros de adiponectina e receptor de leptina solúvel (sOB-R) foram semelhantes em ambos os grupos. Os índices de leptina/sOB-R e leptina/adiponectina foram inferiores (p < 0,0001) em crianças magras do que crianças com peso normal. Em ambos os grupos de crianças descobrimos que os parâmetros de composição corporal estavam positivamente relacionados à leptina, porém não aos níveis de adiponectina. Além disso, observamos que o CMO estava positivamente relacionado ao IMC, à massa gorda, à massa magra e ao nível de leptina em crianças magras e com peso normal. Conclusões: As crianças pré-púberes magras têm alterações na composição corporal e no perfil de adipocinas. O reconhecimento precoce da magreza e a determinação dos parâmetros de composição corporal e dos níveis de adipocina podem ser úteis no cuidado médico e nutricional de crianças magras para aprimoramento do acúmulo mineral ósseo.

Spirometry and volumetric capnography in lung function assessment of obese and normal-weight individuals without asthma / Espirometria e capnografia volumétrica na avaliação da função pulmonar de indivíduos obesos e eutróficos sem asma

Abstract Objective: To analyze and compare lung function of obese and healthy, normal-weight children and adolescents, without asthma, through spirometry and volumetric capnography. Methods: Cross-sectional study including 77 subjects (38 obese) aged 5-17 years. All subjects underwent spirometry and volumetric capnography. The evaluations were repeated in obese subjects after the use of a bronchodilator. Results: At the spirometry assessment, obese individuals, when compared with the control group, showed lower values of forced expiratory volume in the first second by forced vital capacity (FEV1/FVC) and expiratory flows at 75% and between 25 and 75% of the FVC (p < 0.05). Volumetric capnography showed that obese individuals had a higher volume of produced carbon dioxide and alveolar tidal volume (p < 0.05). Additionally, the associations between dead space volume and tidal volume, as well as phase-3 slope normalized by tidal volume, were lower in healthy subjects (p < 0.05). These data suggest that obesity does not alter ventilation homogeneity, but flow homogeneity. After subdividing the groups by age, a greater difference in lung function was observed in obese and healthy individuals aged >11 years (p < 0.05). Conclusion: Even without the diagnosis of asthma by clinical criteria and without response to bronchodilator use, obese individuals showed lower FEV1/FVC values and forced expiratory flow, indicating the presence of an obstructive process. Volumetric capnography showed that obese individuals had higher alveolar tidal volume, with no alterations in ventilation homogeneity, suggesting flow alterations, without affecting lung volumes.

Resumo Objetivo: Analisar e comparar a função pulmonar de crianças e adolescentes obesos e eutróficos saudáveis, sem asma, pela espirometria e capnografia volumétrica. Métodos: Estudo transversal com 77 indivíduos (38 obesos) entre cinco e 17 anos. Todos fizeram espirometria e capnografia volumétrica. Os obesos repetiram as avaliações após o uso de broncodilatador. Resultados: Na avaliação da espirometria, os indivíduos obesos, quando comparados com o grupo controle, apresentaram menores valores no volume expiratório forçado no primeiro segundo pela capacidade vital forçada (VEF1/CVF) e nos fluxos expiratórios a 75% da CVF e entre 25-75% da mesma (p < 0,05). A capnografia volumétrica demonstrou que os obesos apresentam maior volume produzido de dióxido de carbono e volume corrente alveolar (p < 0,05). Além disso, a relação entre o volume espaço morto e volume corrente, bem como o slope da fase 3 normalizado pelo volume corrente, foi menor nos indivíduos saudáveis (p < 0,05). Esses dados sugerem que a obesidade não altera a homogeneidade da ventilação, mas sim dos fluxos. Ao subdividir os grupos por idade, foi observada maior diferença na função pulmonar entre indivíduos obesos e saudáveis na faixa acima de 11 anos (p < 0,05). Conclusão: Mesmo sem o diagnóstico de asma por critérios clínicos e sem resposta ao uso de broncodilatador, os indivíduos obesos apresentaram menores valores no VEF1/CVF e nos fluxos expiratórios forçados, o que indica a presença de processo obstrutivo. A capnografia volumétrica indicou nos indivíduos obesos maior volume corrente alveolar, sem alterações na homogeneidade da ventilação, o que sugere alteração nos fluxos, sem comprometimento dos volumes pulmonares.

Somatotype characteristics of normal-weight and obese women among different metabolic subtypes

ABSTRACT Background Obesity is a well known risk factor for the development of metabolic abnormalities. However, some obese people are healthy and on the other hand some people with normal weight have adverse metabolic profile, therefore it can be assumed that there is a difference in physical characteristics amongst these people. The aim of this study was to establish whether there are somatotype differences between metabolically healthy and metabolically obese women who are obese or of normal weight. Subjects and methods Study included 230 women aged 44.76 ± 11.21y. Metabolic status was assessed according to IDF criteria, while somatotype was obtained using Heath & Carter method. Results Significant somatotype differences were observed in the group of women with normal-weight: metabolically healthy women had significantly lower endomorphy, mesomorphy and higher ectomorphy compared to metabolically obese normal-weight women (5.84-3.97-2.21 vs. 8.69-6.47-0.65). Metabolically healthy obese women had lower values of endomorphy and mesomorphy and higher values of ectomorphy compared to ‘at risk’ obese women but the differences were not statistically significant (7.59-5.76-0.63 vs. 8.51-6.58-0.5). Ectomorphy was shown as an important determinant of the favorable metabolic profile (cutoff point was 0.80). Conclusion We concluded that, in addition to fat mass, metabolic profile could be predicted by the structure of lean body mass, and in particular by body linearity.

Age at menarche in schoolgirls with and without excess weight / Idade da menarca em escolares com e sem excesso de peso

OBJECTIVE: To evaluate the age at menarche of girls, with or without weight excess, attending private and public schools in a city in Southeastern Brazil. METHODS: This was a cross-sectional study comparing the age at menarche of 750 girls from private schools with 921 students from public schools, aged between 7 and 18 years. The menarche was reported by the status quo method and age at menarche was estimated by logarithmic transformation. The girls were grouped according to body mass index (BMI) cut-off points: (thin + normal) and (overweight + obesity). In order to ensure that they belonged to different strata, 328 parents of these schools answered a questionnaire to rate the student's socioeconomic level. RESULTS: Menarche was reported by 883 girls. Although they belonged to different classes (p < 0.001), there was no difference in the nutritional diagnosis (p = 0.104) between them. There was also no difference in age at menarche between the girls studying in private (12.1 years, 95% CI: 12.0-12.2) and public schools (12.2 years, 95% CI:12.1-12.3; p = 0.383). When evaluated by nutritional status, there was difference only in the age at menarche between girls from private schools with excess weight and without excess weight (11.6 and 12.3 years; p < 0.001). The girls with excess weight attending private schools also had earlier an menarche than those attending public schools (respectively, 11.6 and 12.1 years; p = 0.016). CONCLUSIONS: Although the students from private schools belonged to a higher socioeconomic status, there is currently no longer a large gap between them and girls from public schools regarding nutritional and socioeconomic factors that may influence the age at menarche. .

OBJETIVO: Avaliar a idade da menarca em meninas, com e sem excesso de peso, que frequentam escolas particulares e públicas de uma cidade do sudeste do Brasil. MÉTODOS: Estudo transversal que comparou a idade da menarca de 750 meninas de escolas particulares com 921 alunas de escolas públicas, com idades entre sete e 18 anos. A menarca foi relatada pelo método status quo e a idade da mesma estimada pelo logito. As meninas foram agrupadas pelos pontos de corte do IMC em (magreza + eutrofia) e (sobrepeso + obesidade). Com o intuito de certificar que elas pertenciam a classes diferentes, 328 pais responderam a um questionário para classificar o nível econômico dos alunos. RESULTADOS: A menarca foi referida por 883 meninas. Embora elas pertençam a classes econômicas distintas (p < 0,001), não houve diferença quanto ao diagnóstico nutricional (p = 0,104). Também não houve diferença na idade da menarca entre as que estudam em escolas particulares (12,1 anos; IC95%%: 12,0-12,2) e públicas (12,2 anos; IC95%%: 12,1-12,3); p = 0,383. Quando avaliadas pelo diagnóstico nutricional só houve diferença na idade da menarca das meninas com e sem excesso de peso de escolas particulares (11,6 e 12,3 anos; p < 0,001). As meninas com excesso de peso das escolas particulares também menstruaram mais cedo do que as das escolas públicas (respectivamente, 11,6 e 12,1 anos; p = 0,016). CONCLUSÕES: Embora as alunas das escolas particulares ainda pertençam a classes mais altas, atualmente, não existe mais um abismo nutricional e socioeconômico tão grande entre elas quanto a fatores que podem influenciar na idade da menarca. .

Asociación entre malnutrición por exceso con caries temprana de la infancia / Association between overweight and early childhood caries

Objective: To determine whether overweight is a risk factor for the development of early childhood caries (ECC) in preschoolers. Patients and Method: An observational retrospective cohort study was performed in 196 children under 2 years of age at Calbuco Hospital, Los Lagos Region, Chile, who were admitted between 2007 and 2009. Patients were grouped based on their nutritional status at admission in the two following categories: eutrophic and overweighed children as a result of excessive intake. Information regarding caries incidence and nutritional status were annually retrieved from records until the age of 5 years, according to medical and dental records. Results: At the beginning of the study, 33.67% were overweight and 16.33% were obese, reaching 40% overweight and 20.56% obese at four years of age. The incidence of early childhood caries in overweighed children was 57.14% compared to 40.82% in normal weight children (p = 0.022), with 1.4 RR (95% CI, 1044-1.88). Conclusions: The increased risk of early childhood decay in overweighed patients makes necessary to create instances of timely mutual referral between the professional that diagnoses overweighed children and the pediatric dentist in order to develop preventive treatments for both diseases.

Objetivo: Determinar si la malnutrición por exceso es un factor de riesgo para el desarrollo de caries temprana de la infancia (CTI) en preescolares. Pacientes y Método: Se realizó un estudio observacional de cohorte retrospectivo en 196 niños de 2 años del Hospital de Calbuco, Región de Los Lagos, Chile, ingresados durante los años 2007 a 2009. Los pacientes fueron agrupados de acuerdo a su estado nutricional al ingreso en niños eutróficos y niños con malnutrición por exceso. La información respecto a incidencia de caries y el estado nutricional fueron recuperados de la ficha anualmente hasta la edad de 5 años, según registro de las fichas médicas y odontológicas. Resultados: El 33,67% estaba en sobrepeso al inicio de la cohorte y el 16,33% obeso, alcanzando 40% sobrepeso y 20,56% obesidad a los cuatro años de edad. La incidencia de caries temprana de la infancia en niños con malnutrición por exceso fue de 57,14% en relación al 40,82% de los niños eutróficos (p = 0,022) con RR de 1,4 (95% IC, 1.044-1,88). Conclusiones: El mayor riesgo asociado a CTI en pacientes con malnutrición por exceso invita a generar las instancias de derivación oportuna desde el profesional que pesquisa a niños con malnutrición por exceso hacia el odontólogo infantil, con el fin de desarrollar intervenciones preventivas para ambas patologías.

Doença hepática gordurosa não alcoólica em pacientes com índice de massa corporal normal: etiologia e fatores de risco associados em um hospital terciário / Non-alcoholic fatty liver disease in patients with normal body mass index: etiology and associated risk factors in a tertiary hospital

Introdução: A prevalência de doença hepática gordurosa não alcoólica (DHGNA) está aumentando, inclusive em pacientes não obesos. O presente estudo tem como objetivo determinar a prevalência de pacientes com peso normal e com esteatose não alcóolica, determinar a frequência de esteatose primária e secundária e comparar os fatores de risco conforme o índice de massa corporal (IMC). Métodos: Estudo transversal que avaliou pacientes com evidência de esteatose em exames de imagem. Foram avaliados dados demográfi cos, perfil virológico e lipídico, provas de função hepática; os dados foram comparados entre grupos subdivididos de acordo com IMC (<25 e ≥25). Resultados: A percentagem de pacientes com esteatose e IMC normal foi de 10,9%. Não houve diferença na prevalência de Diabetes melitus tipo 2, hipertensão arterial sistêmica ou tabagismo entre os grupos. Causas secundárias de esteatose foram encontradas em 12 pacientes (09 com hepatite C, 01 com doença celíaca, 01 com hepatite autoimune e 01 com hemocromatose). Houve um percentual maior de causas secundárias específicas no grupo com IMC <25. Conclusão: Em pacientes com esteatose e sem sobrepeso/obesidade, fatores secundários sempre devem ser investigados (AU)

Introduction: The prevalence of nonalcoholic fatty liver disease (NAFLD) is increasing, even in non-obese patients. This study aims to determine the prevalence of normal-weight patients with non-alcoholic steatosis, determine the frequency of primary and secondary steatosis, and compare risk factors according to the body mass index (BMI). Methods: Cross-sectional study that evaluated patients with evidence of steatosis on imaging. Demographics, virologic and lipid profiles, and liver function tests were evaluated; the data were compared between groups divided according to BMI (<25 and ≥25). Results: The percentage of patients with normal BMI and steatosis was 10.9 %. There was no difference in the prevalence of diabetes mellitus type 2, hypertension or smoking between the groups. Secondary causes of steatosis were found in 12 patients (09 with HCV, 01 with celiac disease, 01 with autoimmune hepatitis, and 01 with hemochromatosis). There was a higher percentage of specifi c secondary causes in the group with BMI <25. Conclusion: In patients with steatosis and without overweight/obesity, secondary factors should always be investigated (AU)

Efecto del Noni-C sobre el peso corporal y los parámetros sanguíneos / Effect of Noni-C on the body weight and the blood parameters

Introducción: estudios etnomédicos revelan cualidades beneficiosas del fruto de noni, un amplio rango de propiedades medicinales originado de las diferentes partes de la planta y larga historia de su utilidad como alimento. Objetivos: determinar efecto del Noni-C (polvo seco del fruto de Morinda citrifolia L.) sobre el peso corporal y los parámetros sanguíneos, en modelo experimental desarrollado en ratas Wistar machos in vivo. Métodos: se utilizaron dos grupos de animales: I, control sin tratamiento y II, tratado con Noni-C a la dosis de 14,5 mg/kg por un período de 21 d. Los parámetros estudiados fueron peso corporal al inicio y semanalmente; hematocrito, hemoglobina, proteínas totales y albúmina al final. Resultados: se obtuvo menor aumento del peso en el grupo tratado con Noni-C a la dosis de 14,5 mg/kg por 21 d, pero hubo significativa elevación de la hemoglobina en este grupo. Conclusiones: se demostró que el Noni-C tiene efecto sobre el peso corporal y los parámetros sanguíneos

Introduction: ethnomedical studies reveal the beneficial qualities of the Noni fruit, a wide range of medicinal properties stemming from the various parts of the plant and a long history as food. Objectives: to determine the effect of Noni-C (dry powder from Morinda citrifolia L. fruit) on the body weight and the blood parameters by using an in vivo experimental model with male Wistar rats. Methods: two groups of animals were used, that is, Group I comprised controls without treatment and Group II included rats treated with 14.5 mg/kg of Noni during 21 days. The studied parameters were body weight at the beginning of the experiment and then weekly, whereas hematocrit, hemoglobin, total proteins and albumin were counted at the end. Results: lower weight increase was seen in the Noni C-treated group, but the rise of hemoglobin count was significant. Conclusions: it was demonstrated that Noni-C has an impact on the body weight and the blood parameters

Insatisfação com a imagem corporal e fatores associados em universitários / Body Image dissatisfaction and associated factors among college students

O objetivo deste estudo foi analisar a insatisfação com a imagem corporal e verificar a associação com o estado nutricional e variáveis sociodemográficas (sexo, faixa etária, turno de estudo e trabalho remunerado) em universitários. Participaram do estudo 865 universitários. A prevalência de insatisfação com a imagem corporal foi de 77,9% e as variáveis associadas a este desfecho foram sexo e estado nutricional (avaliado pelo IMC com base em dados autorreferidos). Os homens apresentaram mais frequentemente o desejo de aumentar o peso e as mulheres, de reduzir. Universitários com excesso de peso demonstraram maior desejo de reduzir o peso corporal (RC = 6,83; IC-95% = 3,72-12,54), e aqueles com baixo peso apresentaram mais chance de desejar aumentar (RC = 3,06; IC-95% = 1,59-5,88). Destaca-se a importância de promover ações de incentivo à prática de atividades físicas e à adoção de hábitos alimentares saudáveis, bem como a prevenção de comportamentos de risco adotados no sentido de modificara imagem corporal.

The objective of this study was to analyze the body image dissatisfaction and its association with nutritional status and socio-demographics variables (sex, age group, period of study and paid employment) among college students. The study involved 865 college students. The prevalence of body image dissatisfaction was 77.9%and sex and nutritional status (assessed by body mass index based on self-reported measures) were associated with this outcome. Men, more often, desired to increase body weight and women, to reduce it. Overweight college students were more likely to desire to reduce body weight (OR = 6.83; 95% CI = 3.72-12.54), and those who were underweight were more likely to desire to increase it (OR = 3.06; 95% CI = 1.59-5.88). Thus, it is highlighted the importance of policy to promote physical activity practices and adoption of healthy eating habits, as well as to prevent risk behaviors adopted to change the body image.