[Body image is associated with anthropometric status in adolescents, but not with lifestyle]. / Imagem corporal está associada com estado antropométrico em adolescentes, mas não com estilo de vida.

Body image is a construct of the multifaceted representation of body identity that involves self-perception, beliefs, attitudes about the body itself, which can be influenced by several factors. This study evaluated the association of body image with anthropometric and lifestyle indicators among adolescents. The sample comprised 465 adolescents aged 10 to 17 years from public schools in the city of Salvador-Bahia. The Silhouettes Scale assessed the body image. The anthropometric data (body mass index and waist circumference), the lifestyle (Physical Activity Questionnaire for Adolescents and television time), economic and demographic data were evaluated. Polytomous logistic regression assessed associations of interest by STATA, version 16.0. Overweight (OR:9,7; CI95%:5,4-17,5) and abdominal obesity (OR:14,0; CI95%: 5,0-39,3) were positively associated with body dissatisfaction. However, there was no association with lifestyle variables (physical activity: OR: 1,7, CI: 0,9-2,9, and TV time: OR:1,2; CI:0,8-1,9). The conclusion reached is that anthropometric status is an essential indicator of adverse body image outcomes in adolescents.

A imagem corporal é um constructo da representação multifacetada da identidade corporal, envolve autopercepção, crenças e atitudes sobre o próprio corpo, podendo ser influenciada por diversos fatores. Este estudo avaliou a associação da imagem corporal com indicadores antropométricos e do estilo de vida em adolescentes. Constituíram a amostra 465 adolescentes de 10 a 17 anos de escolas públicas da cidade de Salvador, na Bahia. A imagem corporal foi avaliada pela Escala de Silhuetas. Os dados antropométricos (índice de massa corporal e a circunferência da cintura), de estilo de vida (Physical Activity Questionnaire for Adolescents e o tempo de televisão), econômicos e demográficos foram avaliados. Regressão logística politômica avaliou as associações de interesse. Os dados foram analisados pelo software STATA, versão 16.0. O sobrepeso/obesidade (OR: 9,7; IC95%: 5,4-17,5) e a obesidade abdominal (OR: 14,0; IC95%: 5,0-39,3) se mostraram positivamente associados à insatisfação corporal, mas não foi observada associação com as variáveis de estilo de vida (atividade física: OR: 1,7; IC95%: 0,9-2,9; e tempo de TV: OR: 1,2; IC95%: 0,8-1,9). Conclui-se que o estado antropométrico é um importante indicador dos desfechos negativos da imagem corporal em adolescentes.

Imagem corporal está associada com estado antropométrico em adolescentes, mas não com estilo de vida / Body image is associated with anthropometric status in adolescents, but not with lifestyle

Resumo A imagem corporal é um constructo da representação multifacetada da identidade corporal, envolve autopercepção, crenças e atitudes sobre o próprio corpo, podendo ser influenciada por diversos fatores. Este estudo avaliou a associação da imagem corporal com indicadores antropométricos e do estilo de vida em adolescentes. Constituíram a amostra 465 adolescentes de 10 a 17 anos de escolas públicas da cidade de Salvador, na Bahia. A imagem corporal foi avaliada pela Escala de Silhuetas. Os dados antropométricos (índice de massa corporal e a circunferência da cintura), de estilo de vida (Physical Activity Questionnaire for Adolescents e o tempo de televisão), econômicos e demográficos foram avaliados. Regressão logística politômica avaliou as associações de interesse. Os dados foram analisados pelo software STATA, versão 16.0. O sobrepeso/obesidade (OR: 9,7; IC95%: 5,4-17,5) e a obesidade abdominal (OR: 14,0; IC95%: 5,0-39,3) se mostraram positivamente associados à insatisfação corporal, mas não foi observada associação com as variáveis de estilo de vida (atividade física: OR: 1,7; IC95%: 0,9-2,9; e tempo de TV: OR: 1,2; IC95%: 0,8-1,9). Conclui-se que o estado antropométrico é um importante indicador dos desfechos negativos da imagem corporal em adolescentes.

Abstract Body image is a construct of the multifaceted representation of body identity that involves self-perception, beliefs, attitudes about the body itself, which can be influenced by several factors. This study evaluated the association of body image with anthropometric and lifestyle indicators among adolescents. The sample comprised 465 adolescents aged 10 to 17 years from public schools in the city of Salvador-Bahia. The Silhouettes Scale assessed the body image. The anthropometric data (body mass index and waist circumference), the lifestyle (Physical Activity Questionnaire for Adolescents and television time), economic and demographic data were evaluated. Polytomous logistic regression assessed associations of interest by STATA, version 16.0. Overweight (OR:9,7; CI95%:5,4-17,5) and abdominal obesity (OR:14,0; CI95%: 5,0-39,3) were positively associated with body dissatisfaction. However, there was no association with lifestyle variables (physical activity: OR: 1,7, CI: 0,9-2,9, and TV time: OR:1,2; CI:0,8-1,9). The conclusion reached is that anthropometric status is an essential indicator of adverse body image outcomes in adolescents.

Association between gestational weight gain and birth weight: NISAMI Cohort / Associação entre ganho ponderal na gestação e peso ao nascer: Coorte NISAMI

Abstract Objectives: this study aims to evaluate the association between gestational weight gain and the weight of newborns from one municipality in Recôncavo Baiano region. Methods: this is a prospective cohort (NISAMI Cohort), conducted with 185 pregnant women living in the urban area of the municipality of Santo Antônio de Jesus, using the prenatal service of the Family Health Units, between April 2012 and June 2013. The pregestationalBMI and the third trimester of pregnancy were used to assess maternal anthropometric status.Birth weight data were collected from the Epidemiological Surveillance of the municipality. Stata 12.0 software was used for statistical analysis. Logistic regression analysis was used to evaluate to assess the association. Results: among the 185 women evaluated, 33.5% presented inadequate weight gain during pregnancy. The prevalence of inadequate birth weight was 20% (birth weight ≤ 2.999g and ≥ 4.000 g). It was observed that inadequate weight gain during pregnancy is considered an embarrassing factor for birth weight (OR= 2.6; CI95%= 1.5-3.5); adjusted for the following variables: alcohol consumption, duration of pregnancy, and gestational complications. Conclusion: the research results suggest that weight gain throughout pregnancy influences the weight of the conceptus, indicating the need for nutritional interventions in all trimesters of pregnancy, promoting a healthy weight gain throughout the gestational cycle.

Resumo Objetivos: avaliar a associação entre ganho ponderal na gestação e o peso de recém-nascidos em um município do Recôncavo Baiano. Métodos: trata-se de uma coorte prospectiva (Coorte NISAMI), conduzida com 185 gestantes residentes na zona urbana do município de Santo Antônio de Jesus, captadas no serviço de pré-natal das Unidades de Saúde da Família, entre abril de 2012 a junho de 2013. O IMC pré-gestacional e do terceiro trimestre da gestação foram utilizados para avaliar o estado antropométrico materno. Os dados de peso ao nascer foram coletados da Vigilância Epidemiológica do município. Utilizou-se o software Stata 12.0 para as análises estatísticas. Empregou-se análise de regressão logística para avaliar a associação. Resultados: das 185 mulheres, 33,5% apresentaram ganho ponderal inadequado ao longo da gestação. A prevalência de peso inadequado ao nascer foi de 20% (peso ao nascer ≤2.999g e ≥ 4.000 g). Observou-se que o ganho de peso inadequado no período gestacional é considerado fator constrangedor do peso ao nascer (OR= 2,6; IC95%= 1,5-3,5; ajustado pelas variáveis: consumo de bebida alcoólica, duração da gestação e intercorrências gestacionais. Conclusão: o resultado desta investigação sugere que o ganho de peso ao longo da gestação exerce influência no peso do concepto indicando necessidade de intervenções nutricionais em todos os trimestres da gestação, promovendo um ganho ponderal saudável em todo ciclo gestacional.

Anthropometric status and lipid profile among children and adolescents: Changes after 18-month follow-up.

BACKGROUND & AIMS: Overweight children and adolescents are more likely to evolve with high cholesterol, be obese adults and develop cardiovascular disease. The objective of this study was to identify the influence of anthropometric status on the changes in the lipid profile of children and adolescents during an 18-month follow-up period. METHODS: A cohort study involving 540 boys and girls from 7 to 15 years of age was conducted over 18 months' follow-up. The outcome variables were the lipid indicators and the principal exposure variable was anthropometric status, measured by different indicators. A generalized estimating equation (GEE) approach was used to identify the associations of interest. RESULTS: Irrespective of age, sex, socio-economic status, physical activity and diet, for each gain of 1 cm in the waist circumference (WC) mean in the adjusted model, triglyceride levels increased by a mean of 0.5 mg/dl (p < 0.000) and there was an increase of 0.21 mg/dL in the total cholesterol after the 18-month period. The increase of 0.1 in the mean body mass index (BMI) Z-score promoted a gain of 2.7 mg/dL in the triglycerides mean levels (p < 0.000) and an increase of 1.5 mg/dL in the total cholesterol mean levels (p = 0.014) after the follow-up period. Regarding the waist-to-height ratio (WHtR) and conicity index (CI), an increment of 40.6 mg/dL (p = 0.02) and of 30.1 mg/dL (p = 0.01) was observed in the triglycerides' mean when the participants increased 0.1 in the WHtR mean and CI mean, and the same was observed in the total cholesterol mean, with an increase of 45.4,g/dL (p = 0.02) and 19.3 mg/dL (p = 0.03), for each indicator, respectively. Changes of the traditional anthropometric indicators (WC and BMI) did not promote variations in the mean levels of LDL-cholesterol. HDL-cholesterol was not influenced by the changes in the anthropometric indicators. CONCLUSIONS: At the baseline, a higher triglyceride mean and lower levels of HDL-c were observed in children and adolescents with altered anthropometric status for all measures. Mean triglyceride and total cholesterol levels are influenced by changes in the anthropometric status, regardless of the measure, after 18 months of follow-up. However, for LDL-cholesterol, it was observed that changes in the traditional anthropometric indicators (WC and BMI) did not promote variations in the mean levels of this biochemical variable, while HDL-c was not influenced by changes in any of the anthropometric indicators.

Hypertriglyceridemic Waist Phenotype and Changes in the Fasting Glycemia and Blood Pressure in Children and Adolescents Over One-Year Follow-Up Period / Fenótipo Cintura Hipertrigliceridêmica e mudanças na glicemia de jejum e pressão arterial de crianças e adolescentes após um ano de seguimento

Abstract Background: The hypertriglyceridemic waist (HTW) phenotype is defined as the simultaneous presence of increased waist circumference (WC) and serum triglycerides (TG) levels and it has been associated with cardiometabolic risk in children and adolescents. Objective: The objective was to evaluate the influence of HTW phenotype in the fasting glycemia and blood pressure in children and adolescents over one-year follow-up period. Methods: It is a cohort study involving 492 children and adolescents from 7 to 15 years old, both genders, who were submitted to anthropometric, biochemical and clinical evaluation at the baseline, and also after 6 and 12 months of follow-up. Generalized Estimating Equation (GEE) models were calculated to evaluate the longitudinal influence of the HTW phenotype in the glycemia and blood pressure over one-year. Results: It was observed a prevalence of 10.6% (n = 52) of HTW phenotype in the students. The GEE models identified that students with HTW phenotype had an increase of 3.87 mg/dl in the fasting glycemia mean (CI: 1.68-6.05) and of 3.67mmHg in the systolic blood pressure (SBP) mean (CI: 1.55-6.08) over one-year follow-up, after adjusting for confounding variables. Conclusions: The results of this study suggest that HTW phenotype is a risk factor for longitudinal changes in glycemia and SBP in children and adolescents over one-year follow-up period.

Resumo Fundamento: O fenótipo de cintura hipertrigliceridêmica (CHT) é definido como a presença simultânea de circunferência de cintura (CC) e níveis séricos de triglicérides (TG) aumentados e tem sido associado com risco cardiometabólico em crianças e adolescentes. Objetivo: Avaliar a influência do fenótipo CHT na glicemia de jejum e na pressão arterial em crianças e adolescentes em um período de acompanhamento de um ano. Métodos: Trata-se de um estudo de coorte envolvendo 492 crianças e adolescentes de 7 a 15 anos de ambos os sexos, que foram submetidos à avaliação antropométrica, bioquímica e clínica no início e também após 6 e 12 meses de seguimento. Os modelos de Equação de Estimulação Generalizada (GEE) foram calculados para avaliar a influência longitudinal do fenótipo CHT na glicemia e na pressão arterial ao longo de um ano. Resultados: Foi observada uma prevalência de 10,6% (n = 52) do fenótipo CHT nos estudantes. Os modelos GEE identificaram que os estudantes com fenótipo CHT apresentaram aumento de 3,87 mg/dl na média de glicemia em jejum (IC: 1,68-6,05) e de 3,67 mmHg na pressão arterial sistólica media (PAS) (IC: 1,55-6,08) depois de um ano de acompanhamento, após ajuste para variáveis de confusão. Conclusões: Os resultados deste estudo sugerem que o fenótipo CHT é um fator de risco para alterações longitudinais da glicemia e da PAS em crianças e adolescentes em um período de um ano de seguimento.

Hypertriglyceridemic Waist Phenotype and Changes in the Fasting Glycemia and Blood Pressure in Children and Adolescents Over One-Year Follow-Up Period.

BACKGROUND:: The hypertriglyceridemic waist (HTW) phenotype is defined as the simultaneous presence of increased waist circumference (WC) and serum triglycerides (TG) levels and it has been associated with cardiometabolic risk in children and adolescents. OBJECTIVE:: The objective was to evaluate the influence of HTW phenotype in the fasting glycemia and blood pressure in children and adolescents over one-year follow-up period. METHODS:: It is a cohort study involving 492 children and adolescents from 7 to 15 years old, both genders, who were submitted to anthropometric, biochemical and clinical evaluation at the baseline, and also after 6 and 12 months of follow-up. Generalized Estimating Equation (GEE) models were calculated to evaluate the longitudinal influence of the HTW phenotype in the glycemia and blood pressure over one-year. RESULTS:: It was observed a prevalence of 10.6% (n = 52) of HTW phenotype in the students. The GEE models identified that students with HTW phenotype had an increase of 3.87 mg/dl in the fasting glycemia mean (CI: 1.68-6.05) and of 3.67mmHg in the systolic blood pressure (SBP) mean (CI: 1.55-6.08) over one-year follow-up, after adjusting for confounding variables. CONCLUSIONS:: The results of this study suggest that HTW phenotype is a risk factor for longitudinal changes in glycemia and SBP in children and adolescents over one-year follow-up period. FUNDAMENTO:: O fenótipo de cintura hipertrigliceridêmica (CHT) é definido como a presença simultânea de circunferência de cintura (CC) e níveis séricos de triglicérides (TG) aumentados e tem sido associado com risco cardiometabólico em crianças e adolescentes. OBJETIVO:: Avaliar a influência do fenótipo CHT na glicemia de jejum e na pressão arterial em crianças e adolescentes em um período de acompanhamento de um ano. MÉTODOS:: Trata-se de um estudo de coorte envolvendo 492 crianças e adolescentes de 7 a 15 anos de ambos os sexos, que foram submetidos à avaliação antropométrica, bioquímica e clínica no início e também após 6 e 12 meses de seguimento. Os modelos de Equação de Estimulação Generalizada (GEE) foram calculados para avaliar a influência longitudinal do fenótipo CHT na glicemia e na pressão arterial ao longo de um ano. RESULTADOS:: Foi observada uma prevalência de 10,6% (n = 52) do fenótipo CHT nos estudantes. Os modelos GEE identificaram que os estudantes com fenótipo CHT apresentaram aumento de 3,87 mg/dl na média de glicemia em jejum (IC: 1,68-6,05) e de 3,67 mmHg na pressão arterial sistólica media (PAS) (IC: 1,55-6,08) depois de um ano de acompanhamento, após ajuste para variáveis de confusão. CONCLUSÕES:: Os resultados deste estudo sugerem que o fenótipo CHT é um fator de risco para alterações longitudinais da glicemia e da PAS em crianças e adolescentes em um período de um ano de seguimento.

Symptoms of asthma and associated factors in adolescents from Salvador, Bahia. / Sintomas de asma e fatores associados em adolescentes de Salvador, Bahia.

OBJECTIVE: Identify the factors associated with asthma symptoms in adolescents. METHODS: Cross-sectional study with the participation of 1,176 students between the ages of 11 and 17 years old, in Salvador, Bahia, Brazil. The asthma symptoms were identified by using the standardized questionnaire from The International Study of Asthma and Allergies in Childhood Program (ISAAC), phase III. The subjects' food intake data were collected by a semiquantitative food frequency questionnaire (FFQ) comprised of 97 food items. All of the information was collected during a single interview. Anthropometric, socioeconomic, and demographic data were collected from the study population. The robust Poisson model was adopted to obtain the raw and adjusted PR (prevalence ratio). RESULTS: From the total number of adolescents, 57.6% are female and 83.71% of them were between 13 and 17 years old. The prevalence of asthma symptoms was of 7.6%, being higher among males (9.62%). The prevalence of wheezing in the last 12 months was 8.6%. Among the adolescents with rhinitis and eczema, the prevalence of asthma symptoms was of 15.2 and 14.3%, respectively. After an adjusted analysis, the following factors were identified: females PR = 0.64 (95%CI 0.42 - 0.96), rhinitis PR = 3.23 (95%CI 2.17 - 4.83) and the 2nd tertile of the healthy pattern (moderate consumption) PR = 0.61 (95%CI 0.37 - 0.99). CONCLUSION: Rhinitis and eczema were presented as risk factors for asthma symptoms. The healthy food intake pattern that had been stratified in tertiles, presented the 2nd tertile as a protector for asthma symptoms.

Sintomas de asma e fatores associados em adolescentes de Salvador, Bahia / Symptoms of asthma and associated factors in adolescents from Salvador, Bahia

RESUMO: Objetivo: Identificar os fatores associados a sintomas de asma em adolescentes. Métodos: Estudo transversal, com a participação de 1.176 alunos com idade entre 11 e 17 anos, em Salvador, Bahia, Brasil. Os sintomas de asma foram identificados utilizando-se o questionário padronizado do The International Study of Asthma and Allergies in Childhood Program (ISAAC), fase III. A avaliação do consumo alimentar dos adolescentes foi obtida por meio de questionário da frequência alimentar (QFA) semiquantitativo, com 97 itens alimentares, sendo as informações coletadas em uma única entrevista com os estudantes. Foram coletados dados antropométricos, socioeconômicos e demográficos da população do estudo. O modelo de Poisson robusto foi adotado para obtenção da razão de prevalência (RP) bruta e ajustada. Resultados: Do total de adolescentes, 57,6% são do sexo feminino e 83,7% tinham de 13 a 17 anos de idade. A prevalência de sintomas de asma encontrada foi de 7,6%, sendo mais elevada no sexo masculino (9,62%). A prevalência de chiado nos últimos 12 meses foi de 8,6%. Entre os adolescentes que tinham rinite e eczema a prevalência de sintomas de asma foi de 15,2 e 14,3% respectivamente. Após análise ajustada, os seguintes fatores se associaram à asma: sexo feminino RP = 0,64 (IC95% 0,42 - 0,96), rinite RP = 3,23 (IC95% 2,17 - 4,83) e o 2o tercil do padrão saudável (consumo moderado) RP = 0,61 (IC95% 0,37 - 0,99). Conclusão: Rinite e eczema apresentaram-se como fatores de risco para sintomas de asma. O padrão alimentar saudável estratificado em tercil apresentou o segundo tercil como protetor para sintomas de asma.

ABSTRACT: Objective: Identify the factors associated with asthma symptoms in adolescents. Methods: Cross-sectional study with the participation of 1,176 students between the ages of 11 and 17 years old, in Salvador, Bahia, Brazil. The asthma symptoms were identified by using the standardized questionnaire from The International Study of Asthma and Allergies in Childhood Program (ISAAC), phase III. The subjects' food intake data were collected by a semiquantitative food frequency questionnaire (FFQ) comprised of 97 food items. All of the information was collected during a single interview. Anthropometric, socioeconomic, and demographic data were collected from the study population. The robust Poisson model was adopted to obtain the raw and adjusted PR (prevalence ratio). Results: From the total number of adolescents, 57.6% are female and 83.71% of them were between 13 and 17 years old. The prevalence of asthma symptoms was of 7.6%, being higher among males (9.62%). The prevalence of wheezing in the last 12 months was 8.6%. Among the adolescents with rhinitis and eczema, the prevalence of asthma symptoms was of 15.2 and 14.3%, respectively. After an adjusted analysis, the following factors were identified: females PR = 0.64 (95%CI 0.42 - 0.96), rhinitis PR = 3.23 (95%CI 2.17 - 4.83) and the 2nd tertile of the healthy pattern (moderate consumption) PR = 0.61 (95%CI 0.37 - 0.99). Conclusion: Rhinitis and eczema were presented as risk factors for asthma symptoms. The healthy food intake pattern that had been stratified in tertiles, presented the 2nd tertile as a protector for asthma symptoms.

Risk Factors for Adopting Extreme Weight-Control Behaviors among Public School Adolescents in Salvador, Brazil: A Case-Control Study.

OBJECTIVE: This study identifies the risk factors for extreme weight-control behaviors among adolescents in public school in Salvador, northeastern Brazil. METHODS: A case-control study nested to a cross-sectional study, including 252 adolescents of both sexes, age between 11 to 17 years, with 84 cases and 168 age-matched controls was conducted. The variable outcome is represented by extreme weight-control behaviors, integrated by following the variables: self-induced vomiting and the use of laxatives, diuretics, or diet pills. Covariables included body image dissatisfaction, dieting, prolonged fasting, and self-perception of body weight. The study also investigated the demographic and anthropometric variables and economic conditions of the students' families. Conditional logistic regression was used to identify risk factors for the adoption of extreme weight-control behaviors among adolescents. RESULTS: Among the adolescents investigated, the conditional logistic regression explained 22% the occurrence of extreme weight-control behaviors and showed that these behaviors were positively associated to overweight (odds ratio [OR] = 3.61; 95% confidence interval [CI], 1.42-9.17), body image dissatisfaction (OR = 3.87; 95% CI, 1.75-8.54), and the adoption of a restrictive diet (OR = 2.83; 95% CI, 1.16-6.91). CONCLUSIONS: The results of this study suggest that among adolescents, overweight, body image dissatisfaction, and restrictive diet are important risk factors to adoption of extreme weight-control behaviors.

Effectiveness of the Brazilian Conditional Cash Transfer Program--Bolsa Alimentação--on the variation of linear and ponderal increment in children from northeast of Brazil.

BACKGROUND: Social programs can improve the conditions required for families provide sufficient care and attention for an adequate health and nutrition. OBJECTIVE: This study evaluates the effectiveness of the Brazilian's conditional cash transfer program--Bolsa Alimentacao (PBA) on children anthropometric status. METHODS: A cohort of 1847 children, followed for 12 months: 1615 PBA children; 232 non-PBA. There were 316 (14.6%) missing children during the study. A quasi-experimental study adopting the before-after strategy was applied and the effectiveness approach was used to assess the impact of the program on children nutritional status. Multilevel analysis with three levels was used in the statistical analysis. The mean increment variations of height-for-age and weight-for-age were the outcome variables and the participation in the PBA was the exposition. Four participation groups were established: children not exposed to the program (internal control group); exposed to the program throughout the 12 months, exposed to the program only in the last 6 months; and exposed to the program only in the first 6 months. Repeated measures were obtained at baseline and at 12 months. RESULTS: It was found that the exposure to the program was associated to a mean variation in weight-for-age of 0.34 Z-score (IC = 0.04; 0.63) and height-for-age of 0.38 (IC = 0.05; 0.70) for children who were regular program beneficiaries during the follow-up. The exposure to the program in other periods was not statistically associated with a mean variation in the indicators. CONCLUSIONS: Cash transfers direct to the family were associated to anthropometric deficits reduction in childhood.

Triagem sorológica para doença celíaca em adolescentes / Serologic screening of celiac disease in adolescents

OBJETIVO: Este estudo objetivou identificar a soroprevalência da doença celíaca em adolescentes de escolas públicas da cidade de Salvador, Bahia. MÉTODO: Trata-se de um estudo transversal com amostra probabilística de 1.213 adolescentes de 11 a 17 anos, de ambos os sexos. O índice de massa corporal foi utilizado para o diagnóstico do estado nutricional, adotando-se os percentis segundo idade e sexo, propostos pela World Health Organization. O anticorpo anti-transglutaminase humana da classe imunoglobulina A (anti-tTG-IgA) foi adotado como teste sorológico para triagem da doença celíaca e foi determinado pela técnica do ensaio imunoabsorvente ligado à enzima (ELISA). Foi realizada análise descritiva, utilizando-se a proporção e a média (desvio padrão). RESULTADOS: O sexo feminino predominou entre os adolescentes, e a maioria encontrava-se com adequado estado nutricional. O anticorpo anti-tTG-IgA foi positivo em 6/1.213 (0,49%) adolescentes. CONCLUSÃO: A soroprevalência de doença celíaca entre os adolescentes estudados foi 0,49%. Novas investigações são necessárias para confirmar a prevalência de doença celíaca nessa faixa etária. .

OBJECTIVE: This study aimed to identify the seroprevalence of celiac disease in adolescents from public schools in the city of Salvador, Bahia. METHODS: This was a cross-sectional study with probabilistic sample of 1,213 adolescents, aged 11 to 17 years old, of both genders. The body mass index was used to determine the participants' nutritional status based on the percentiles for age and gender recommended by the World Health Organization. Measurement of the anti-human transglutaminase immunoglobulin A (anti-tTG-IgA) antibody was established as the specific screening test for celiac disease, which involved an enzyme-linked immunosorbent assay (ELISA). Descriptive analysis was performed using proportions and means (standard deviation). RESULTS: The female gender prevailed in the sample, and most of the participants had normal weights. The anti-tTG-IgA antibody was positive in 6/1,213 (0.49%) adolescents. CONCLUSION: The seroprevalence of celiac disease was 0.49% in the investigated adolescents. Further studies are necessary to establish the prevalence of celiac disease in this age range. .

Serologic screening of celiac disease in adolescents.

OBJECTIVE: This study aimed to identify the seroprevalence of celiac disease in adolescents from public schools in the city of Salvador, Bahia. METHODS: This was a cross-sectional study with probabilistic sample of 1,213 adolescents, aged 11 to 17 years old, of both genders. The body mass index was used to determine the participants' nutritional status based on the percentiles for age and gender recommended by the World Health Organization. Measurement of the anti-human transglutaminase immunoglobulin A (anti-tTG-IgA) antibody was established as the specific screening test for celiac disease, which involved an enzyme-linked immunosorbent assay (ELISA). Descriptive analysis was performed using proportions and means (standard deviation). RESULTS: The female gender prevailed in the sample, and most of the participants had normal weights. The anti-tTG-IgA antibody was positive in 6/1,213 (0.49%) adolescents. CONCLUSION: The seroprevalence of celiac disease was 0.49% in the investigated adolescents. Further studies are necessary to establish the prevalence of celiac disease in this age range.

Is overweight a risk factor for wheezing in pre-school children? A study in 14 Brazilian communities

To evaluate the association between overweight and wheezing in pre school children in 14 small Brazilian communities...

Prevalence and factors associated with vitamin A deficiency in children and adolescents / Prevalência e fatores associados à deficiência de vitamina A em crianças e adolescentes

Objective: To identify the prevalence and factors associated with vitamin A deficiency (VAD) in children and adolescents. Methods: This was a cross-sectional study involving 546 schoolchildren, aged between 7 and 14 years, of both genders, enrolled in public elementary schools. Blood was collected for measurement of serum retinol. The retinol concentration in the samples was determined by high performance liquid chromatography (HPLC). Data were collected on anthropometrics, dietary, demographic, and socioeconomic factors. Polytomous logistic regression was used to evaluate the associations of interest. Results: Approximately 27.5% of the students had retinol values < 30 μg/dL. The multivariate analysis showed, after the appropriate adjustments, a positive and statistically significant association of moderate/severe VAD (OR = 2.19; 95% CI 1.17 to 4.10) and marginal VAD (OR = 2.34; 95% CI 1.47 to 3.73) with age < 10 years. There was also association of VAD moderate/severe (OR = 2.01; 95% CI 1.01 to 5.05) and borderline VAD (OR = 2.14; 95% CI: 1.08 to 4.21) with the anthropometric status of underweight. Lower intake of retinol was detected among those with severe VAD. Conclusion: VAD is a health concern among children and adolescents. Lower weight and younger schoolchildren had greater vulnerability to VAD. .

Objetivo: Identificar prevalência e fatores associados à deficiência de vitamina A (DVA) entre crianças e adolescentes. Métodos: Estudo transversal envolvendo 546 escolares, com idade entre 7 e 14 anos, de ambos os sexos, matriculadas na rede pública do ensino fundamental. O sangue foi coletado para dosagem dos níveis séricos de retinol. A concentração de retinol das amostras foi determinada pelo método da cromatografia líquida de alta eficiência (CLAE). Coletaram-se dados antropométricos, alimentares, demográficos e socioeconômicos. Utilizou-se da regressão logística politômica para avaliar as associações de interesse. Resultados: Aproximadamente 27,5% dos estudantes apresentaram valores de retinol < 30 μg/dL. Em análise multivariada, verificou-se, após devidos ajustes, associação positiva e estatisticamente significante da DVA moderada/grave (OR = 2,19; IC 95%: 1,17-4, 10) e da DVA marginal (OR = 2,34; IC 95%: 1,47-3,73) com a idade < 10 anos. Verificou-se, igualmente, associação da DVA moderada/grave (OR = 2,01; IC 95%: 1,01-5,05) e DVA marginal (OR = 2,14; IC 95%: 1,08-4,21) com o estado antropométrico magreza. Menor consumo de retinol foi detectado entre aqueles com DVA grave. Conclusão: A deficiência de vitamina A configura-se como um problema de saúde preocupante entre os escolares e adolescentes. Constatou-se maior vulnerabilidade dos escolares de baixo peso e mais jovens à DVA. .

Prevalence and factors associated with vitamin A deficiency in children and adolescents.

OBJECTIVE: To identify the prevalence and factors associated with vitamin A deficiency (VAD) in children and adolescents. METHODS: This was a cross-sectional study involving 546 schoolchildren, aged between 7 and 14 years, of both genders, enrolled in public elementary schools. Blood was collected for measurement of serum retinol. The retinol concentration in the samples was determined by high performance liquid chromatography (HPLC). Data were collected on anthropometrics, dietary, demographic, and socioeconomic factors. Polytomous logistic regression was used to evaluate the associations of interest. RESULTS: Approximately 27.5% of the students had retinol values<30 µg/dL. The multivariate analysis showed, after the appropriate adjustments, a positive and statistically significant association of moderate/severe VAD (OR=2.19; 95% CI 1.17 to 4.10) and marginal VAD (OR=2.34; 95% CI 1.47 to 3.73) with age<10 years. There was also association of VAD moderate/severe (OR=2.01; 95% CI 1.01 to 5.05) and borderline VAD (OR=2.14; 95% CI: 1.08 to 4.21) with the anthropometric status of underweight. Lower intake of retinol was detected among those with severe VAD. CONCLUSION: VAD is a health concern among children and adolescents. Lower weight and younger schoolchildren had greater vulnerability to VAD.

[Dietary patterns of children under five years of age living in the State capital and other counties of Bahia State, Brazil, 1996 and 1999-2000]. / Padrões alimentares de crianças menores de cinco anos de idade residentes na capital e em municípios da Bahia, Brasil, 1996 e 1999/2000.

This cross-sectional study included 3,817 preschool children, of whom 1,770 in Salvador, Bahia State, Brazil, and 2,047 in urban and rural areas from nine other municipalities (counties) in the same State. The study used 24-hour recall and principal components analysis to identify and compare dietary patterns. The sample was stratified by age and area. In the first six months of life, breast milk composed the second and third patterns, with positive loadings for children in all 10 municipalities. For children under 17 months of age, pattern 1 was characterized by cow's milk, flour, and sugar, except in rural areas. Pattern 2 was similar for children aged 6-17 months and consisted of bread/cookies, rice, beans, and meat. For children 18-23 months of age in urban areas, pattern 1 showed negative loadings for sugar, cow's milk, and flour. In children over 24 months of age, fruits were not part of the first pattern. The study showed low consumption of milk and low variety of fruits and vegetables. This food consumption profile indicates the need for early interventions to promote healthy eating habits.

Identification of food intake patterns and associated factors in teenagers / Identificação dos padrões de consumo alimentar e fatores associados em adolescentes

[{"text": "OBJECTIVE: To identify schoolchildren\"s dietary patterns and investigate the demographic, social, and economic determinants of the differences found between patterns. METHODS: The sample consisted of 1,330 students aged 11 to 17 years attending the public schools of Salvador, Bahia, Brazil. The subjects' food intake data were collected by a semiquantitative Food Frequency Questionnaire comprising 97 food items. All information was collected during a single interview. The exposure variables were gender, age, and socioeconomic class, and the outcome variables were categorized food consumption pattern in \"mixed pattern\", \"traditional pattern\", and \"healthy pattern\". The data were treated by simple and multiple linear regression analyses and the dietary patterns determined by factor analysis. RESULTS: Most participants were female (56.9%) and over 13 years old (79.2%). The \"mixed pattern\" was positively associated with females (β=0.181, p<0.001). The \"traditional pattern\" was negatively associated with classes D, C, and B (β=-0.149, p<0.007), and the \"healthy pattern\" was negatively associated with females (β=-0.200, p>0.0001) and classes D, C, and B (β=-0.125, p<0.023). CONCLUSION: Three dietary patterns were identified among the adolescents, namely mixed, traditional, and healthy. Gender and socioeconomic class were associated with dietary patterns. Male teenagers and those in the lower socioeconomic classes had a healthier dietary pattern than their peers of higher socioeconomic classes and females. .", "_i": "en"}, {"text": "OBJETIVO: Identificar os padrões de consumo alimentar entre escolares e investigar os determinantes demográficos, sociais e econômicos dos diferentes padrões encontrados. MÉTODOS: Foi estudada uma amostra de 1 330 indivíduos entre 11 e 17 anos, estudantes da rede pública de ensino, em Salvador, Bahia. A avaliação do consumo alimentar dos adolescentes foi obtida por meio de Questionário da Frequência Alimentar semiquantitativo, com 97 itens alimentares, sendo as informações coletadas em uma única entrevista com os estudantes. As variáveis de exposição foram sexo, idade e o indicador econômico; a variável desfecho foi padrão de consumo alimentar categorizada em misto, tradicional e saudável. Os dados foram analisados pela regressão linear simples e múltipla, e os padrões alimentares foram obtidos a partir da análise fatorial. RESULTADOS: A partir da análise das características da população, observou-se o predomínio do sexo feminino (56,9%), e idade maior que 13 anos (79,2%). A adoção do padrão alimentar misto esteve associada positivamente ao sexo feminino (β= 0,181), p<0,001. O padrão tradicional associou-se negativamente às classes D, C, B (β=-0,149), p<0,007, enquanto o padrão alimentar saudável esteve associado negativamente ao sexo feminino (β=-0,200), p<0,0001 e às classes D, C, B (β=-0,125), p<0,023. CONCLUSÃO: Foram identificados, entre os adolescente, três padrões alimentares: misto, tradicional e saudável. Observou--se que o sexo e o indicador da condição econômica estiveram associados aos padrões alimentares. Os adolescentes da classe econômica mais baixa e do sexo masculino adotam consumo alimentar mais saudável em relação àqueles das ...", "_i": "pt"}]

Padroes alimentares de criancas menores de cinco anos de idade residentes na capital e em municipios da Bahia, Brasil, 1996 e 1999/2000 / Dietary patterns of children under five years of age living in the State capital and other counties of Bahia State, Brazil, 1996 and 1999-2000 / Patrones de alimentacion de ninos menores de cinco anos de edad que viven en la capital y los municipios de Bahia, Brasil, 1996 y 1999/2000

Estudo transversal com 3.817 pré-escolares, 1.770 residentes em Salvador, Bahia, Brasil, e 2.047 nas áreas urbana e rural de 10 municípios baianos. Utilizou-se recordatório de 24 horas (R24h) e empregou-se análise fatorial por componentes principais com objetivo de identificar e comparar os principais padrões alimentares dessas crianças. Estratificou-se a amostra por idade e área. Antes dos seis meses de vida o leite materno compôs o 2o e 3o padrões com carga positiva para crianças dos dez municípios. Para menores de 17 meses, o padrão 1 foi caracterizado por leite de vaca, farinhas e açúcares. Em áreas urbanas, pão/biscoito, arroz, feijão e carne integraram o padrão 2 aos 6-17 meses. Aos 18-23 meses, o padrão 1 apresentou carga negativa para açúcares, leite de vaca e farinhas, exceto na área rural. Frutas não fizeram parte do padrão 1 no grupo de 24 meses e mais. Observou-se baixo consumo de leite materno e pouca variação de frutas e legumes a partir dos seis meses. Tal perfil de consumo alimentar indica a necessidade de intervenções cada vez mais precoces para promoção de hábitos alimentares saudáveis. .

This cross-sectional study included 3,817 preschool children, of whom 1,770 in Salvador, Bahia State, Brazil, and 2,047 in urban and rural areas from nine other municipalities (counties) in the same State. The study used 24-hour recall and principal components analysis to identify and compare dietary patterns. The sample was stratified by age and area. In the first six months of life, breast milk composed the second and third patterns, with positive loadings for children in all 10 municipalities. For children under 17 months of age, pattern 1 was characterized by cow’s milk, flour, and sugar, except in rural areas. Pattern 2 was similar for children aged 6-17 months and consisted of bread/cookies, rice, beans, and meat. For children 18-23 months of age in urban areas, pattern 1 showed negative loadings for sugar, cow’s milk, and flour. In children over 24 months of age, fruits were not part of the first pattern. The study showed low consumption of milk and low variety of fruits and vegetables. This food consumption profile indicates the need for early interventions to promote healthy eating habits.

Estudio transversal realizado con 3.817 niños en edad preescolar, 1.770 residentes en Salvador, Bahía, Brasil, y 2.047 en las zonas urbanas y rurales de 10 municipios de Bahía. Se utilizó el recordatorio de 24 horas (R24h) y el análisis de componentes principales, con el fin de identificar y comparar los hábitos alimentarios. Se estratificó la muestra según edad y área. Antes de los 6 meses de vida, la leche materna compone los 2o y 3o patrones, con cargas positivas en los niños de 10 municipios. Para los menores de 17 meses, el patrón 1 se caracteriza por leche de vaca, harina y azúcar. El patrón 2 fue similar en niños de 6 a 17 meses y consistía en frijoles, carne, pan/galletas, arroz. Para niños de 18 a 23 meses en las zonas urbanas el patrón 1 mostraron cargas negativas en azúcares, leche y harina. Teniendo en cuenta el grupo de mayores de 24 meses, las frutas no eran parte del primer patrón. Se encontró un bajo consumo de leche y baja variabilidad de frutas y hortalizas. Este perfil indica la necesidad de intervenciones cada vez más tempranas para promover hábitos alimenticios saludables. .

Effectiveness of the Brazilian Conditional Cash Transfer Program--Bolsa Alimentação--on the variation of linear and ponderal increment in children from northeast of Brazil.

BACKGROUND: Social programs can improve the conditions required for families provide sufficient care and attention for an adequate health and nutrition. OBJECTIVE: This study evaluates the effectiveness of the Brazilian's conditional cash transfer program - Bolsa Alimentacao (PBA) on children anthropometric status. METHODS: A cohort of 1847 children, followed for 12 months: 1615 PBA children; 232 non-PBA. There were 316 (14.6%) missing children during the study. A quasi- experimental study adopting the before-after strategy was applied and the effectiveness approach was used to assess the impact of the program on children nutritional status. Multilevel analysis with three levels was used in the statistical analysis. The mean increment variations of height-for-age and weight-for-age were the outcome variables and the participation in the PBA was the exposition. Four participation groups were established: children not exposed to the program (internal control group); exposed to the program throughout the 12 months, exposed to the program only in the last 6 months; and exposed to the program only in the first 6 months. Repeated measures were obtained at baseline and at 12 months. RESULTS: It was found that the exposure to the program was associated to a mean variation in weight-for-age of 0.34 Z-score (IC=-0.44; 0.63) and height-for-age of 0.38 (IC=0.05; 0.70) for children who were regular program beneficiaries during the follow-up. The exposure to the program in other periods was not statistically associated with a mean variation in the indicators. CONCLUSIONS: Cash transfers direct to the family were associated to anthropometric deficits reduction in childhood.

Objetivo: Evaluar la eficacia del programa de transferencia de ingreso brasileno - Bolsa Alimentacao (PBA) sobre la variacion media del incremento del peso e de la talla de ninos. Métodos: Cohorte de 1.847 ninos fue seguida durante 12 meses: 1.615 eran ninos PBA; 232 eran ninos no PBA. Se han registrado la pierda de 316 (14,6%) ninos durante el estudio. Se adopta el diseno casi-experimental y la estrategia antes-despues con el enfoque de eficacia para evaluar el impacto del programa sobre el estado antropometrico de los ninos. La regresion lineal multinivel fue usada en el analisis estadistico. La variacion media del incremento del crecimiento de la talla y del peso para la edad fueron los outcomes and la participacion en el programa la variable de exposicion principal. Se establecieron cuatro grupos de participacion en el programa: ninos no expuesto al programa (control interno; expuestos al programa durante 12 meses de acompanamiento, expuesto al programa solo en los ultimos 6; ninos expuestos al programa solo en los primeros 6 meses. Las medidas repetidas se obtuvieron al inicio y a los 12 meses del seguimiento. Resultados: Despues de ajustar los efectos por los factores de confusion, la exposicion al programa se asocio a una variacion media de peso por edad de 0,34 Z-score (IC = -0,44- 0,63) y talla para la edad de 0,38 Z-score (IC = 0,05-0,70) para los ninos que fueron expuestos al programa durante los 12 meses. La exposicion al programa en otros periodos de seguimiento no fue estadisticamente asociado con una variacion media de peso o la talla para la edad. Conclusiones: Transferencias directas de ingreso a la familia se asociaron con la reduccion de los deficits antropometricos en la infancia.

Nutritional status of indigenous children: findings from the First National Survey of Indigenous People's Health and Nutrition in Brazil.

INTRODUCTION: The prevalence of undernutrition, which is closely associated with socioeconomic and sanitation conditions, is often higher among indigenous than non-indigenous children in many countries. In Brazil, in spite of overall reductions in the prevalence of undernutrition in recent decades, the nutritional situation of indigenous children remains worrying. The First National Survey of Indigenous People's Health and Nutrition in Brazil, conducted in 2008-2009, was the first study to evaluate a nationwide representative sample of indigenous peoples. This paper presents findings from this study on the nutritional status of indigenous children < 5 years of age in Brazil. METHODS: A multi-stage sampling was employed to obtain a representative sample of the indigenous population residing in villages in four Brazilian regions (North, Northeast, Central-West, and Southeast/South). Initially, a stratified probabilistic sampling was carried out for indigenous villages located in these regions. Households in sampled villages were selected by census or systematic sampling depending on the village population. The survey evaluated the health and nutritional status of children < 5 years, in addition to interviewing mothers or caretakers. RESULTS: Height and weight measurements were taken of 6,050 and 6,075 children, respectively. Prevalence rates of stunting, underweight, and wasting were 25.7%, 5.9%, and 1.3%, respectively. Even after controlling for confounding, the prevalence rates of underweight and stunting were higher among children in the North region, in low socioeconomic status households, in households with poorer sanitary conditions, with anemic mothers, with low birthweight, and who were hospitalized during the prior 6 months. A protective effect of breastfeeding for underweight was observed for children under 12 months. CONCLUSIONS: The elevated rate of stunting observed in indigenous children approximates that of non-indigenous Brazilians four decades ago, before major health reforms greatly reduced its occurrence nationwide. Prevalence rates of undernutrition were associated with socioeconomic variables including income, household goods, schooling, and access to sanitation services, among other variables. Providing important baseline data for future comparison, these findings further suggest the relevance of social, economic, and environmental factors at different scales (local, regional, and national) for the nutritional status of indigenous peoples.