RESUMO
CONTEXT: Prepubertal adiposity is associated with earlier puberty. It is unclear when this association starts, if all adiposity markers are similarly associated, and whether all pubertal milestones are similarly affected. OBJECTIVE: To evaluate the association between different adiposity markers during childhood and the timing of different pubertal milestones in Latino girls. DESIGN, SETTING, AND PARTICIPANTS: Longitudinal follow-up of 539 female participants of the Chilean Growth and Obesity Cohort recruited from childcare centers (mean age 3.5 years) from the southeast area of Santiago, Chile. Participants were singletons born between 2002 and 2003 within the normal birthweight range. Since 2006, a trained dietitian measured weight, height, waist circumference (WC) and skinfolds to estimate body mass index (BMI) Centers for Disease Control and Prevention percentiles, central obesity, percentage of fat mass (%FM), and fat mass index (FMI, fat mass/height2). MAIN OUTCOME: Since 2009, sexual maturation was assessed every 6 months to assess age at (1) thelarche, (2) pubarche, (3) menarche, and (4) peak height velocity (PHV). RESULTS: At thelarche, 12.5% were obese and 2% had central obesity. The median age of pubarche, menarche, and PHV were all associated with markers of adiposity at different time points during childhood whereas thelarche only with %FM and FMI. Adiposity clusters models showed that children with trajectories of high WC, %FM, and FMI during childhood were related with earlier thelarche, pubarche, menarche, and PHV but BMI trajectories only with menarche and PHV. CONCLUSIONS: Higher WC, %FM, and FMI were associated with earlier age at thelarche, pubarche, menarche, and PHV. The effect of BMI was less consistent.
Assuntos
Adiposidade , Hispânico ou Latino , Menarca , Criança , Pré-Escolar , Feminino , Humanos , Adiposidade/etnologia , Adiposidade/fisiologia , Índice de Massa Corporal , Hispânico ou Latino/estatística & dados numéricos , Menarca/etnologia , Menarca/fisiologia , Obesidade/epidemiologia , Obesidade/etnologia , Obesidade/fisiopatologia , Obesidade Abdominal/epidemiologia , Obesidade Abdominal/etnologia , Obesidade Abdominal/fisiopatologia , Puberdade , Chile/epidemiologiaRESUMO
We developed and pilot tested the effectiveness of a physically active academic program, Active Breaks (AB), whose objective is to increase school time moderate/vigorous physical activity (MVPA) among first graders, through daily 15-minute bouts of MVPA, at the beginning of the first lesson. Initially, 240 cards including one game each were developed and tested in first-grade students from 16 schools in Santiago. Trained observers and school teachers assessed the time, ease, and feasibility of implementation for each card. Barriers and facilitators to implementation were obtained from semistructured interviews to 14 teachers (out of 16). In eight schools (n = 556 students), we compared school time MVPA (with accelerometers) at baseline and follow-up, using test of proportions. One-hundred and twenty cards (games) complied with all aspects. AB were implemented 50% of the time with a duration of 14 minutes (SD = 5). More than 90% of the time, teachers felt competent to conduct AB, and children understood the instructions and enjoyed the activity. The main facilitators included teachers liking physical activity and considering it important, support of principal and school staff, and conducting AB inside the classroom. Barriers included teacher's workload and having to conduct AB during the first lesson. During the 4-month period of implementation, MVPA increased by 1.5 and 1.2 percentage points in boys and girls, respectively. The set of 120 cards is easy and feasible to implement. Moreover, preliminary results suggest they could be effective in increasing MVPA during school time, although studies with longer follow-ups are needed to assess the validity of these findings.