Temporal trend of food consumption markers, breakfast consumption and association with overweight/obesity in schoolchildren aged 7 to 10 years between 2007 and 2019.

Obesity has a multifactorial origin. Among the behavioural risk factors, excessive consumption of unhealthy foods, skipping breakfast and reduced physical activity stand out. The main objective of this article was to identify trends in dietary habits and their association with overweight/obesity over a 12-year period in schoolchildren aged 7 to 10 years in Florianópolis, southern Brazil. A cross-sectional panel analysis study, using anthropometric, sociodemographic, physical activity and food consumption data of schoolchildren aged 7 to 10 years, collected in three waves of the Study of Prevalence of Obesity in Children and Adolescents (EPOCA), carried out during the years 2007, 2012/2013 and 2018/2019, was performed. To analyse the trend in dietary variables over the years, the 95% CIs were compared with the non-overlap of intervals indicating statistical significance. Multiple logistic regression analysis was performed to test the association of weight status with dietary markers. The prevalence of overweight/obesity was 34.4%, 37.2% and 34.2% in 2007, 2012/2013 and 2018/2019, respectively, and there were no statistically significant differences among waves. There was a progressive and significant reduction in the consumption of soft drinks and sweets and in eating breakfast by schoolchildren, from 2007 to 2019. Breakfast consumption was inversely associated with the chance of overweight/obesity (OR 0.74, 95% CI 0.59-0.93), and female students were less likely to have overweight/obesity when compared to boys (OR 0.70, 95% CI 0.61-0.81). The reduction in the consumption of soft drinks and sweets over the years might be caused by efforts in public policies that intended to reduce the consumption of unhealthy foods among schoolchildren. The progressive and significant reduction in having breakfast should be better elucidated in future studies, to minimise the potential impact of this practice on schoolchildren's bodyweight.

Neighborhood Availability and Use of Food, Physical Activity, and Social Services Facilities in Relation to Overweight and Obesity in Children and Adolescents.

OBJECTIVE: To evaluate the association of a combined measure of availability and use of facilities from the food environment and overweight (including obesity) among schoolchildren, while taking into account the physical activity and social-assistance environments. METHODS: Cross-sectional study with a probabilistic sample of schoolchildren aged 7 to 14 years living in a southern Brazilian city (n = 2026). Multilevel analyses were performed with overweight as outcome and the food environment as main exposure. Models were adjusted for the physical activity and social-assistance environments, as well as individual and other residential neighborhood characteristics. RESULTS: Greater availability of restaurants around the home was associated with higher odds of overweight (odds ratio [OR] = 1.40; 95% CI = 1.06-1.85). Stronger associations were found for schoolchildren reporting to use restaurants (OR = 1.48; 95% CI = 1.15-1.90). This association remained significant after adjusting for the presence of other food retailers. Schoolchildren who had social-assistance facilities around their homes, but reported not to use them, showed consistently higher odds of being overweight (OR = 1.34; 95% CI = 1.01-1.78) as compared to schoolchildren who had these facilities near home and used them. The physical activity environment was not associated with the outcome. CONCLUSIONS: Availability and use of the food and social-assistance environments were significantly associated with overweight (including obesity) among the schoolchildren. Future research should consider the use of environmental facilities in combination to their geographical availability. Our results highlight the need for policies that limit the access to obesogenic food outlets by children and adolescents.

Body image and association with BMI, and purgative behaviours for weight control in adolescents aged 11-14 years.

We aimed to evaluate the association of overweight/obesity based in BMI and purgative behaviours with body image (BI). Methods: Cross-sectional study, with probabilistic sample of 976 adolescents, aged 11-14 years, from the city of Florianópolis, Brazil. Multivariate analyses were performed. Overweight (including obesity) and four variables related to purgative methods for body weight control or eating behaviour were evaluated as outcomes, while BI satisfaction was the primary independent variable in each model. Models were controlled for age, sex, type of school (public or private), intake of fruit and vegetables, number of daily meals, and physical activity scores levels. A total of 31·4 % of adolescents wanted to enlarge their silhouette and 45·6 % wanted to reduce it. Among overweight/obese adolescents, 9·6 % were satisfied with their bodies, while 89·8 % wanted to reduce it, while among the not overweight/obese adolescents, 45·4 % wanted to enlarge their silhouette (P < 0·001). Multivariate analysis showed that the odds for overweight/obesity is higher among adolescents who wanted to reduce their silhouette (OR = 11·20; 95 % CI = 5·55, 22·58). Adolescents who want to reduce their silhouette are more likely to use diuretics (OR = 3·08; CI = 1·78, 5·32) and to use laxatives (OR = 2·10; CI = 1·20, 3·68). A significant association was also found between dissatisfaction with BI and overeating (among those who want to enlarge their silhouette: OR = 1·78; CI = 1·12, 2·85 and among those who want to reduce their silhouette: OR = 1·81; CI = 1·03, 3·19). Conclusion: BI dissatisfaction was associated with overweight/obesity, as well with overeating, and the use of purgative methods.

Epidemiological characterization of notified human brucellosis cases in Southern Brazil.

Brucellosis is one of the most important and widespread bacterial zoonotic diseases worldwide, and it is transmitted to humans from various sources, including direct contact with infected animals and the ingestion of contaminated products, including unpasteurized milk. There are only a few epidemiological studies on said disease in humans in Western Santa Catarina, a region instantiated by agriculture. Thus, the objective of this study was to characterize the epidemiological aspects of human brucellosis reported in Western Santa Catarina from 2013 to 2018. The data were provided by the Epidemiological Surveillance Board (Diretoria de Vigilancia Epidemiologica). The frequency of the disease in humans and the epidemiological profile of confirmed human cases were evaluated. Cases that were screened positive and those that were confirmed and submitted to the therapeutic protocol were analyzed. During the study period, 3,671 people were tested, of which 12.34% were screened positive (453/ 3,671) and 3.40% were confirmed (125/3,671). The year with the highest number of people testing positive was 2015 (123 cases), and 2018 was the year with the highest number of confirmed cases (39 cases). Confirmed cases predominated in males (48.8%), self-declared white (22.4%), aged 20-59 years old (60%), with incomplete primary education (22.4%), of rural origin (59.2%), with occupational contact with cattle (64.8%), engaged in professions directly linked to agricultural and livestock activities (55.5%), and who reported consumption of unpasteurized dairy products (59.2%). No seasonal variation was observed in case numbers. The results demonstrated that brucellosis is an endemic disease in Western Santa Catarina.

Epidemiological characterization of notified human brucellosis cases in Southern Brazil

ABSTRACT Brucellosis is one of the most important and widespread bacterial zoonotic diseases worldwide, and it is transmitted to humans from various sources, including direct contact with infected animals and the ingestion of contaminated products, including unpasteurized milk. There are only a few epidemiological studies on said disease in humans in Western Santa Catarina, a region instantiated by agriculture. Thus, the objective of this study was to characterize the epidemiological aspects of human brucellosis reported in Western Santa Catarina from 2013 to 2018. The data were provided by the Epidemiological Surveillance Board (Diretoria de Vigilancia Epidemiologica). The frequency of the disease in humans and the epidemiological profile of confirmed human cases were evaluated. Cases that were screened positive and those that were confirmed and submitted to the therapeutic protocol were analyzed. During the study period, 3,671 people were tested, of which 12.34% were screened positive (453/ 3,671) and 3.40% were confirmed (125/3,671). The year with the highest number of people testing positive was 2015 (123 cases), and 2018 was the year with the highest number of confirmed cases (39 cases). Confirmed cases predominated in males (48.8%), self-declared white (22.4%), aged 20-59 years old (60%), with incomplete primary education (22.4%), of rural origin (59.2%), with occupational contact with cattle (64.8%), engaged in professions directly linked to agricultural and livestock activities (55.5%), and who reported consumption of unpasteurized dairy products (59.2%). No seasonal variation was observed in case numbers. The results demonstrated that brucellosis is an endemic disease in Western Santa Catarina.

ASSOCIATION BETWEEN BREASTFEEDING AND OVERWEIGHT/OBESITY IN SCHOOLCHILDREN AGED 7-14 YEARS.

OBJECTIVE: To evaluate the prevalence of breastfeeding (BF) and the association between occurrence/duration of BF and overweight/obesity in schoolchildren aged 7-14 years. METHODS: This is a cross-sectional study, conducted in 2012-2013, on schoolchildren aged 7-14 years from Florianópolis, Santa Catarina, Southern Brazil. Weight and height were measured according to procedures of the World Health Organization. Breastfeeding and sociodemographic data were obtained from a questionnaire responded by parents/guardians. BF was categorized as a dichotomous variable (yes/no) and according to duration (months). Nutritional status was evaluated according to the Z score of the body mass index per age for sex and it was categorized into two groups: normal weight (

Association between breastfeeding and overweight/obesity in schoolchildren aged 7-14 years / Associação entre aleitamento materno e sobrepeso/obesidade em escolares de 7-14 anos

ABSTRACT Objective: To evaluate the prevalence of breastfeeding (BF) and the association between occurrence/duration of BF and overweight/obesity in schoolchildren aged 7-14 years. Methods: This is a cross-sectional study, conducted in 2012-2013, on schoolchildren aged 7-14 years from Florianópolis, Santa Catarina, Southern Brazil. Weight and height were measured according to procedures of the World Health Organization. Breastfeeding and sociodemographic data were obtained from a questionnaire responded by parents/guardians. BF was categorized as a dichotomous variable (yes/no) and according to duration (months). Nutritional status was evaluated according to the Z score of the body mass index per age for sex and it was categorized into two groups: normal weight (<Z score+1) and overweight/obesity (≥Z score+1). The adjusted analysis was performed by logistic regression in two age strata (age groups of 7-10 and 11-14 years). Results: 6.6% of schoolchildren had never breastfed; 16.8% had been breastfed for ≤3 months; 16.7%, for 4-6 months; and 59.9%, for ≥7 months. No statistically significant differences were found in the occurrence and duration of BF between the age groups. The prevalence of overweight/obesity was 34.2%. For age groups (7-10 and 11-14 years), the prevalence of overweight/obesity was 36.7% and 29.8%, respectively. Chance of overweight/obesity for the age group of 7-10 years was lower among schoolchildren who were breastfed (OR=0.54; 95%CI 0.33-0.88), when compared with those who never breastfed. When categorized, the chance of overweight/obesity in the age group of 7-10 years was lower for duration of BF ≤3 months (OR=0.41; 95%CI 0.20-0.83), and 4-6 months (OR=0.48; 95%CI 0.28-0.82) when compared with children who never breastfed. Conclusions: BF for at least six months was associated with a lower chance of overweight/obesity for schoolchildren aged 7-10 years. No association was found for schoolchildren aged 11-14 years.

RESUMO Objetivo: Investigar prevalência e duração de aleitamento materno (AM) e sua associação com sobrepeso/obesidade em escolares de 7-14 anos. Métodos: Estudo transversal, realizado em 2012-2013, com escolares de 7-14 anos de Florianópolis, Santa Catarina. Peso e altura foram mensurados segundo preconizado pela Organização Mundial da Saúde (OMS). Dados sociodemográficos e sobre AM foram obtidos por questionários enviados aos responsáveis/cuidadores. A variável amamentação foi analisada como dicotômica (sim/não) e por duração (em meses). O perfil antropométrico foi avaliado por escore Z do índice de massa corporal (IMC) para a idade, segundo sexo, categorizado em: normal (<escore Z+1) e sobrepreso/obesidade (≥escore Z+1). Análises ajustadas foram realizadas (regressão logística) em dois estratos etários (7-10 e 11-14 anos). Resultados: 6,6% dos escolares nunca tinham sido amamentados, 16,8% foram amamentados por ≤3 meses, 16,7% por 4-6 meses e 59,9% por ≥7 meses. Não houve diferença estatística de ocorrência/duração de AM entre os grupos etários. A prevalência de sobrepeso/obesidade foi 34,2%. Nos grupos etários (7-10 e 11-14 anos), a prevalência foi 36,7% e 29,8%, respectivamente. A chance de sobrepeso/obesidade nos escolares de 7-10 anos foi menor entre aqueles que tinham sido amamentados (OR=0,54; IC95% 0,33-0,88), comparando com os nunca amamentados. Quando categorizada, a chance de ter sobrepeso/obesidade nos escolares de 7-10 anos foi menor quando a duração do AM foi ≤3 meses (OR=0,41; IC95% 0,20-0,83) e 4-6 meses (OR=0,48; IC95% 0,28-0,82), em comparação à ausência de AM. Conclusões: AM por pelo menos seis meses foi associado com menor chance de sobrepeso/obesidade para escolares de 7-10 anos. Não foi observada associação para o grupo 11-14 anos.

Epidemiological characterization of reported cases of brucellosis in cattle in the western region of the state of Santa Catarina, Brazil / Caracterização epidemiológica dos casos notificados de brucelose em bovinos na região Oeste do Estado de Santa Catarina, Brasil

ABSTRACT: Brucellosis is one of the most important and widespread bacterial zoonoses in the world. There are few epidemiological studies on brucellosis in cattle in the productive region of western Santa Catarina. Thus, the objective of this study was to characterize the epidemiological aspects of bovine brucellosis reported in this region from 2013 to 2018. Cattle data were provided by the Integrated Company for Agricultural Development of Santa Catarina (Companhia Integrada de Desenvolvimento Agrícola de Santa Catarina - CIDASC). The prevalence of the disease was evaluated in cattle and herds by means of temporal trend analysis and spatial distribution. Bovines with tests showing positive for brucellosis were analyzed for location (municipality) and year of confirmation of diagnosis. In the study period (2013-2018), 686,086 tests were performed for brucellosis, with a prevalence rate of 1.11% (7,586/686,086). Among the 80,171 herds tested, 0.95% were found to be positive (764/80171). The odds ratio of brucellosis occurrence in cattle increased significantly in 2015 (OR = 1.55) and 2016 (OR = 1.97) and decreased in 2014 (OR = 0.47) and 2017 (OR = 0.97). The disease is present in cattle in 61.07% (80/131) of the municipalities where the tests were performed. Results showed that brucellosis is endemic in the region.

RESUMO: A brucelose é uma das zoonoses bacterianas mais importantes e difundidas no mundo. São poucos os estudos epidemiológicos sobre a doença em bovinos na região produtiva do Oeste de Santa Catarina. Desta forma, o objetivo deste estudo foi caracterizar os aspectos epidemiológicos da brucelose bovina notificados nesta região entre os anos de 2013 a 2018. Os dados sobre os bovinos foram fornecidos pela Companhia Integrada de Desenvolvimento Agrícola de Santa Catarina (CIDASC). Foram avaliadas as prevalências da doença nos bovinos e rebanhos, por meio de análise de tendência temporal e distribuição espacial. Os bovinos, cujo exame confirmatório mostrou positividade para brucelose, foram analisados quanto à localização (município) e o ano de confirmação do diagnóstico. No período de estudo (2013-2018) foram realizados 686.086 testes para brucelose, encontrando-se prevalência de 1,11% (7.586/686.086) de animais positivos, enquanto a prevalência de rebanhos positivos, dentre os 80.171 testados, foi de 0,95% (764/80171). As razões de chances de ocorrência de brucelose nos bovinos aumentaram significativamente nos anos de 2015 (OR= 1,55) e 2016 (OR= 1,97) e diminuíram em 2014 (OR= 0,47) e 2017 (OR= 0,97). A doença está presente nos bovinos em 61,07% (80/131) dos municípios em que foram realizados os testes. Os resultados demonstram que a brucelose é endêmica na região.

[Factors associated with food consumption in schools and overweight/obesity in 7 to 10-year-old schoolchildren in the state of Santa Catarina, Brazil]. / Fatores associados ao consumo alimentar na escola e ao sobrepeso/obesidade de escolares de 7-10 anos de Santa Catarina, Brasil.

The scope of this article is to investigate the association between the source of snacks consumed in schools, their nutritional value and overweight/obesity. It involved a cross-sectional study with 3,930 schoolchildren aged between 7 and10 in the state of Santa Catarina. Food consumption in the school was assessed with an illustrated 24-hour dietary recall and the source of snacks was investigated by structured interview. Soft drinks and artificial fruit juices, fried and processed snacks, ready-to-eat or sweetened snacks, delicacies and stuffed biscuits were classified as "low nutritional value foods," while fruit, natural fruit juices, vegetables, and vegetable soup were the "high nutritional value foods." Univariate and multiple logistic regression was conducted. Overweight/obesity was significantly associated with higher food consumption from the school canteen (OR = 1.34; CI = 1.07-1.68) in private schools. Bringing food from home was significantly associated with increased consumption of low nutritional foods, both in public (OR = 1.56; CI = 1.32-1.83) and private (OR = 2.64; CI = 1.76-3.97) schools. The results highlight the need for tightening of norms to reduce the availability of low nutritional value food in canteens, and actions to promote nutritional education involving the school community.

O objetivo deste artigo é investigar associação entre a proveniência de lanches consumidos na escola, seu valor nutricional e o sobrepeso/obesidade. Estudo transversal com 3.930 escolares de 7-10 anos de idade, de Santa Catarina. O consumo alimentar na escola foi avaliado com R-24 horas ilustrado, e a origem dos lanches por entrevista estruturada. Refrigerantes e sucos artificiais, frituras, salgadinhos industrializados, lanches prontos, doces, guloseimas e biscoitos recheados foram classificados como "lanches de baixo valor nutricional", enquanto frutas, sucos naturais, legumes, verduras e sopa de verduras foram os "lanches de alto valor nutricional". Realizou-se regressão logística univariada e múltipla. O sobrepeso/obesidade se associou significativamente ao consumo de alimentos provenientes da cantina (OR = 1,34; IC = 1,07-1,68), na rede particular. Trazer alimentos de casa foi significativamente associado ao maior consumo de lanches de baixo valor nutricional, nas escolas públicas (OR = 1,56; IC = 1,32-1,83) e nas particulares (OR = 2,64; IC = 1,76-3,97). Os resultados apontam a necessidade de expansão de normativas que minimizem a disponibilidade de alimentos de baixo valor nutricional nas cantinas e que promovam educação nutricional envolvendo a comunidade escolar.

Fatores associados ao consumo alimentar na escola e ao sobrepeso/obesidade de escolares de 7-10 anos de Santa Catarina, Brasil / Factors associated with food consumption in schools and overweight/obesity in 7 to 10-year-old schoolchildren in the state of Santa Catarina, Brazil

Resumo O objetivo deste artigo é investigar associação entre a proveniência de lanches consumidos na escola, seu valor nutricional e o sobrepeso/obesidade. Estudo transversal com 3.930 escolares de 7-10 anos de idade, de Santa Catarina. O consumo alimentar na escola foi avaliado com R-24 horas ilustrado, e a origem dos lanches por entrevista estruturada. Refrigerantes e sucos artificiais, frituras, salgadinhos industrializados, lanches prontos, doces, guloseimas e biscoitos recheados foram classificados como "lanches de baixo valor nutricional", enquanto frutas, sucos naturais, legumes, verduras e sopa de verduras foram os "lanches de alto valor nutricional". Realizou-se regressão logística univariada e múltipla. O sobrepeso/obesidade se associou significativamente ao consumo de alimentos provenientes da cantina (OR = 1,34; IC = 1,07-1,68), na rede particular. Trazer alimentos de casa foi significativamente associado ao maior consumo de lanches de baixo valor nutricional, nas escolas públicas (OR = 1,56; IC = 1,32-1,83) e nas particulares (OR = 2,64; IC = 1,76-3,97). Os resultados apontam a necessidade de expansão de normativas que minimizem a disponibilidade de alimentos de baixo valor nutricional nas cantinas e que promovam educação nutricional envolvendo a comunidade escolar.

Abstract The scope of this article is to investigate the association between the source of snacks consumed in schools, their nutritional value and overweight/obesity. It involved a cross-sectional study with 3,930 schoolchildren aged between 7 and10 in the state of Santa Catarina. Food consumption in the school was assessed with an illustrated 24-hour dietary recall and the source of snacks was investigated by structured interview. Soft drinks and artificial fruit juices, fried and processed snacks, ready-to-eat or sweetened snacks, delicacies and stuffed biscuits were classified as "low nutritional value foods," while fruit, natural fruit juices, vegetables, and vegetable soup were the "high nutritional value foods." Univariate and multiple logistic regression was conducted. Overweight/obesity was significantly associated with higher food consumption from the school canteen (OR = 1.34; CI = 1.07-1.68) in private schools. Bringing food from home was significantly associated with increased consumption of low nutritional foods, both in public (OR = 1.56; CI = 1.32-1.83) and private (OR = 2.64; CI = 1.76-3.97) schools. The results highlight the need for tightening of norms to reduce the availability of low nutritional value food in canteens, and actions to promote nutritional education involving the school community.

Association between food, physical activity, and social assistance environments and the body mass index of schoolchildren from different socioeconomic strata.

The aim of this article was to evaluate associations between body mass index (BMI) and use of and distance from subjects homes of elements of the food and physical activity environments and use of social assistance environment, in schoolchildren from 7 to 14 years living in Florianópolis (South Brazil), stratified by monthly family income. A cross-sectional study was conducted with a probabilistic sample of 2152 schoolchildren. Univariate and multivariate linear regression analyses were conducted to test for associations between BMI and the use of and distance from supermarkets, bakeries and farmers' markets; use of and distance from parks/playgrounds and football pitches; and use of health centers, Reference Centers for Social Assistance, instructional facilities, residents associations, religious groups and a Brazilian program for cash transfer. Overweight and obesity rates were 21.5 and 12.7%, respectively. Among schoolchildren from low-income families, living more than 11 min' walk from parks/playgrounds was associated with higher BMI (ß = 0.53; 95% CI = 0.33-0.73). In the high-income strata, a longer distance from home to football pitches was associated with lower BMI (ß = -0.49; 95% CI = -0.69; -0.29). Neither food nor social assistance environments were associated with BMI of schoolchildren, even when analyzed by income strata.

Body mass index and association with use of and distance from places for physical activity and active leisure among schoolchildren in Brazil. Cross-sectional study.

BACKGROUND: We evaluated associations between use of public places for physical activity and active leisure (PAAL) and their distances from subjects' homes and indicators of overweight and obesity, among schoolchildren from different socioeconomic levels, in the city of Florianópolis, Brazil. DESIGN AND SETTING: Cross-sectional study conducted on a sample of 2,152 schoolchildren aged 7 to 14 years, enrolled at 30 public and private schools. METHODS: The exposure variables were the use of public places for PAAL in the neighborhood and their distance from schoolchildren's homes. The outcomes were body mass index (BMI) and waist circumference (WC). Univariate and multivariate linear regression analyses were conducted according to income strata. RESULTS: Among the schoolchildren from low-income families, living closer to parks/playgrounds was associated with lower BMI (ß = -2.15; 95% confidence interval, CI = -2.53; -1.77) and lower WC (ß = -0.11 95% CI = -0.17; -0.05), while living at these distances from football pitches was associated with higher BMI (ß = 1.73; 95% CI = 0.31; 3.15) and larger WC measurements (ß = 0.03; 95% CI = 0.005; 0.14). Among the schoolchildren in low-income groups, living at an intermediate distance from beaches was associated with lower BMI (ß = -1.10; 95% CI = -1.61; -0.59). CONCLUSION: Living closer to parks/playgrounds was associated with lower BMI and WC among schoolchildren from low-income families. Living closer to football pitches was associated with higher BMI and WC among these schoolchildren. Living at intermediate distances from beaches was associated with lower BMI among these schoolchildren.

Body mass index and association with use of and distance from places for physical activity and active leisure among schoolchildren in Brazil. Cross-sectional study

ABSTRACT BACKGROUND: We evaluated associations between use of public places for physical activity and active leisure (PAAL) and their distances from subjects' homes and indicators of overweight and obesity, among schoolchildren from different socioeconomic levels, in the city of Florianópolis, Brazil. DESIGN AND SETTING: Cross-sectional study conducted on a sample of 2,152 schoolchildren aged 7 to 14 years, enrolled at 30 public and private schools. METHODS: The exposure variables were the use of public places for PAAL in the neighborhood and their distance from schoolchildren's homes. The outcomes were body mass index (BMI) and waist circumference (WC). Univariate and multivariate linear regression analyses were conducted according to income strata. RESULTS: Among the schoolchildren from low-income families, living closer to parks/playgrounds was associated with lower BMI (β = -2.15; 95% confidence interval, CI = -2.53; -1.77) and lower WC (β = -0.11 95% CI = -0.17; -0.05), while living at these distances from football pitches was associated with higher BMI (β = 1.73; 95% CI = 0.31; 3.15) and larger WC measurements (β = 0.03; 95% CI = 0.005; 0.14). Among the schoolchildren in low-income groups, living at an intermediate distance from beaches was associated with lower BMI (β = -1.10; 95% CI = -1.61; -0.59). CONCLUSION: Living closer to parks/playgrounds was associated with lower BMI and WC among schoolchildren from low-income families. Living closer to football pitches was associated with higher BMI and WC among these schoolchildren. Living at intermediate distances from beaches was associated with lower BMI among these schoolchildren.

Utilization and environmental availability of food outlets and overweight/obesity among schoolchildren in a city in the south of Brazil.

Among the causes of obesity, environmental factors have also been studied, in addition to genetic, social, psychological, and hormonal factors. The distribution of food outlets, facilitating or hindering food acquisition, can promote body weight control by encouraging healthier food habits. The objective of this study was to investigate associations between environmental availability and utilization of food outlets and overweight/obesity in 7 to 14-year-old schoolchildren in Florianópolis, in the South of Brazil. A logistic regression analysis identified a positive association between overweight/obesity in 2195 schoolchildren and the presence of restaurants in the vicinity of their homes (buffer = 400 meters). Being a member of a family that utilizes public markets/greengrocers was also positively associated with overweight/obesity in the sample investigated. Identifying the distribution of these establishments in the vicinity of the homes of schoolchildren in middle-income countries is an important element in understanding the role played by the food environment in weight gain in a variety of different settings.

Abdominal obesity in schoolchildren: association with socioeconomic and demograhic indicators / Obesidade abdominal em escolares: associação com indicadores socioeconômicos e demográficos

Obesity among children is considered a concern in public health in Brazil. Careful attention must be given to abdominal obesity because of its association with heart diseases and metabolic problems that may reach children. This study aimed to analyze the association between abdominal obesity, and socioeconomic and demographic indicators in schoolchildren engaged in elementary public schools in the city of Santa Izabel do Oeste (Southern Brazil). A cross-sectional investigation was carried out to investigate waist circumference (WC) and waist to height ratio (WHR). Univariate and multivariate logistic regressions were used to analyze associations. A sample of 361 students from 5 to 9 years old (mean 7.82±1.3) was analyzed, of which 19.1% presented high WC, 22.7% high WHR, and 16.1% had high measurements in both. Among socioeconomic factors ≥11 years of maternal education was significantly associated to high WHR (OR= 1.79; CI95%=1.02- 3.15). The active transport provoked lower odds of both WC (OR=0.28 [95% CI=0.09-0.86]) and WHR (OR=0.20 [95% CI=0.07-0.58]). The findings show that schoolchildren whose mothers had higher educational level present higher odds for elevated WHR. Using active transportation was significantly and inversely associated to odds of both higher WHR and WC. The results indicate the importance of adopting strategies to improve the practice of physical activities that result in higher energetic expenditure. Adopting continues actions to promote health food intake are also necessary. Both actions could be planned on behalf of the Health in School Program and the School Feeding Program.

A obesidade em crianças é considerada um problema de saúde pública no Brasil. Importante atenção deve ser dada à obesidade abdominal, visto que se associa a doenças cardiovasculares e distúrbios metabólicos que podem surgir já na infância. Assim, este estudo objetivou analisar a associação entre obesidade abdominal e indicadores socioeconômicos e demográficos, em escolares do ensino fundamental, matriculados em escolas públicas de Santa Izabel do Oeste­PR. Foi realizado estudo transversal, que investigou circunferência da cintura (CC) e razão cintura-estatura (RCE). Para as análises de associação, utilizou-se regressão logística bivariada e multivariada. Analisaram-se 361 escolares de 5 a 9 anos de idade (7,82 ± 1,3). Destes, 19,1% apresentaram CC elevada, 22,7% RCE elevada, e 16,1% ambas as medidas elevadas. Dentre os fatores socioeconômicos, a escolaridade materna ≥11 anos de estudo associou-se significativamente à RCE elevada (OR= 1,79; IC95%=1,02-3,15). A utilização de transporte ativo resultou em menor razão de chances para obesidade abdominal considerando-se tanto CC (OR=0,28 [IC95%=0,09-0,86) quanto RCE (OR=0,20 [IC 95%=0,07-0,58]). Os resultados mostraram que crianças cujas mães possuíam maior escolaridade apresentaram maiores chances para aumento da RCE. Utilizar transportes ativos se associou inversamente às chances de presença de RCE e CC altas. Ambos os resultados indicam a importância de se adotarem mais estratégias para aumentar a prática de atividades físicas que resultem em gasto calórico entre estes escolares, assim como adotar ações contínuas para a promoção da alimentação adequada e saudável, que poderiam ser planejadas no âmbito do Programa Saúde na Escola e do Programa de Alimentação Escolar.

Purchase of family farm and organic foods by the Brazilian School Food Program in Santa Catarina state, Brazil / Aquisição de alimentos da agricultura familiar e orgânicos pelo Programa Nacional de Alimentação Escolar no estado de Santa Catarina

ABSTRACT Objective To describe the purchase of family farm and organic foods by the Brazilian School Food Program in the municipalities of the state of Santa Catarina, Brazil. Methods This is an analytic and descriptive study conducted from 2010 to 2011. An electronic survey was sent to all 293 Santa Catarina municipalities. The Chi-square test investigated the association between the study variables. Results Between 2010 and 2011, the number of municipalities that purchased family farm foods increased by 36%, with a total of 96% of Santa Catarina municipalities buying family farming foods in 2011. Of the 96%, 70% complied with Article 14 of Law nº 11,947/2009, which determines that at least 30% of the funds provided by the National Fund for the Development of Education should be spent on family farm products, and 48% purchased organic foods. The South was the state region that most complied with Article 14 (85%; p=0.02). However, as municipality size increased, compliance with Article 14 decreased (p=0.04). The municipalities that had the most difficulties buying family farm and organic foods were those with the lowest Municipal Human Development Index and number of students. Conclusion Most Santa Catarina municipalities purchased family farm foods in 2011, and most municipalities that complied with Article 14 of Law nº 11,947/2009 were in the South state region. Finally, municipalities with low Municipal Human Development Index and number of students had the most difficulties buying family farm foods.

RESUMO Objetivo Descrever a aquisição de alimentos da agricultura familiar e alimentos orgânicos, no âmbito do Programa Nacional de Alimentação Escolar em municípios catarinenses. Métodos Trata-se de pesquisa descritivo-analítica, realizada entre 2010 e 2011. Enviou-se um questionário eletrônico aos 293 municípios catarinenses existentes na época. Testou-se associação entre as variáveis por meio do Qui-quadrado de heterogeneidade. Resultados Entre 2010 e 2011, o número de municípios que comprava alimentos da agricultura familiar evoluiu 36%, com um total de 96% comprando deste mercado em 2011. Destes, 70% cumpriam a obrigatoriedade prevista no artigo 14 da Lei nº 11.947/2009 (investir no mínimo 30% dos recursos advindos do Fundo Nacional de Desenvolvimento da Educação na compra da Agricultura Familiar) e 48% compravam alimentos orgânicos. A mesorregião do estado com mais municípios que cumpriam o artigo 14 foi a região Sul (85%; p=0,02). Quanto ao porte dos municípios, observou-se que quanto maior era o número de habitantes, menor o percentual de cumprimento do artigo 14 (p=0,04). Os municípios que mais relataram dificuldades para a compra de alimentos orgânicos e da agricultura familiar foram os com menor Índice de Desenvolvimento Humano Municipal e com menor número de estudantes. Conclusão A maioria dos municípios catarinenses comprou da agricultura familiar em 2011 e a maioria dos que cumprem a meta prevista no artigo 14 da Lei nº 11.947/2009 fica na região Sul do estado. Ainda, municípios com menor Índice de Desenvolvimento Humano Municipal e menos alunos enfrentam mais dificuldades para a execução das compras.

Relationship between birth weight and overweight/obesity among students in Florianópolis, Santa Catarina, Brazil: a retrospective cohort study / Relação entre peso ao nascer e sobrepeso/obesidade em estudantes de Florianópolis, Santa Catarina, Brasil: estudo de coorte retrospectivo

CONTEXT AND OBJECTIVE: Being born heavier than 4 kg is associated with current overweight and obesity over the long term. The objective here was to ascertain whether birth weight was related to overweight or obese status, among 7 to 14-year-old schoolchildren, taking into consideration the possible interactions between socioeconomic factors and other biological variables. DESIGN AND SETTING: Retrospective cohort study on a probabilistic sample of 2,696 children and adolescents living in Florianópolis, Santa Catarina, Brazil. METHODS: The following data were collected: anthropometric (student's weight, height and age; and parents' weight and height), socioeconomic (family income, number of people in house and parental schooling level), birth weight and gestational age. Overweight and obesity were classified using percentiles of body mass index and triceps and subscapular skinfolds. The outcome variables were overweight and obesity and the main explanatory variables were birth weight and birth weight according to gestational age. The control variables were the parents' nutritional status, their schooling level and the per capita family income. Poisson multivariate regressions were carried out. RESULTS: Higher prevalence of high birth weight was observed among overweight male adolescents (PR = 1.14; 95% CI = 1.02-1.27; P = 0.03), but this was not observed among obese male adolescents. Low birth weight and being born small for gestational age were also not associated with the outcomes. Among overweight and obese children, birth weight was not significantly different from that of normal-weight children. CONCLUSION: No significant association between birth weight and obesity was observed. However, there was a weak but significant association between high birth weight and overweight, among male adolescents. .

CONTEXTO E OBJETIVO: Nascer com peso > 4 kg se associa a sobrepeso e/ou obesidade em longo prazo. O objetivo foi verificar se o peso ao nascer foi um fator relacionado ao estado de sobrepeso ou obesidade atuais, em escolares de 7-14 anos, levando em consideração interações possíveis com fatores socioeconômicos e outras variáveis biológicas. TIPO DE ESTUDO E LOCAL: Estudo coorte retrospectivo numa amostra probabilística de 2.696 crianças e adolescentes residentes em Florianópolis, Santa Catarina, Brasil. MÉTODOS: Coletaram-se dados antropométricos (peso, estatura e idade dos escolares, peso e estatura dos pais), socioeconômicos (renda familiar, número de pessoas na casa, escolaridade dos pais) e de peso ao nascer e idade gestacional. Sobrepeso e obesidade foram definidos utilizando-se os percentis de índice de massa corporal e as dobras cutâneas tricipital e subescapular. Sobrepeso e obesidade foram desfechos, e peso ao nascer e peso ao nascer/por idade gestacional foram variáveis explanatórias principais. As variáveis de controle foram: estado nutricional dos pais, seu nível de escolaridade e renda familiar per capita. Foram realizadas regressões de Poisson. RESULTADOS: Nos adolescentes do sexo masculino com sobrepeso, houve maior prevalência de elevado peso ao nascer (RP = 1,14; 95% IC = 1,02-1,27; P = 0,03). Naqueles com obesidade, não foi observado o mesmo. Baixo peso ao nascer e nascer pequeno para a idade gestacional também não se associaram aos desfechos. Nas crianças com sobrepeso ou obesidade, o peso ao nascer não diferiu daquele entre as eutróficas. CONCLUSÃO: Não se observou associação significativa entre peso ao nascer e obesidade. Porém, houve associação significativa, ainda que fraca, entre elevado peso ao nascer e sobrepeso, ...

Relationship between birth weight and overweight/obesity among students in Florianópolis, Santa Catarina, Brazil: a retrospective cohort study.

CONTEXT AND OBJECTIVE: Being born heavier than 4 kg is associated with current overweight and obesity over the long term. The objective here was to ascertain whether birth weight was related to overweight or obese status, among 7 to 14-year-old schoolchildren, taking into consideration the possible interactions between socioeconomic factors and other biological variables. DESIGN AND SETTING: Retrospective cohort study on a probabilistic sample of 2,696 children and adolescents living in Florianópolis, Santa Catarina, Brazil. METHODS: The following data were collected: anthropometric (student's weight, height and age; and parents' weight and height), socioeconomic (family income, number of people in house and parental schooling level), birth weight and gestational age. Overweight and obesity were classified using percentiles of body mass index and triceps and subscapular skinfolds. The outcome variables were overweight and obesity and the main explanatory variables were birth weight and birth weight according to gestational age. The control variables were the parents' nutritional status, their schooling level and the per capita family income. Poisson multivariate regressions were carried out. RESULTS: Higher prevalence of high birth weight was observed among overweight male adolescents (PR = 1.14; 95% CI = 1.02-1.27; P = 0.03), but this was not observed among obese male adolescents. Low birth weight and being born small for gestational age were also not associated with the outcomes. Among overweight and obese children, birth weight was not significantly different from that of normal-weight children. CONCLUSION: No significant association between birth weight and obesity was observed. However, there was a weak but significant association between high birth weight and overweight, among male adolescents.

Influência da televisão no consumo alimentar e na obesidade em crianças e adolescentes: uma revisão sistemática / Television influence on food intake and obesity in children and adolescents: a systematic review

O objetivo deste trabalho foi identificar a influência da televisão no consumo alimentar e na obesidade em crianças e adolescentes. Realizou-se revisão sistemática nas bases MedLine, PubMed, SciELO-Brasil e Lilacs, capturando-se 73 artigos publicados entre 1997 e 2007. Definiu-se não analisar artigos com adultos ou pré-escolares, notas, comunicações, revisões, amostras de população específica (indígenas, por exemplo) e enferma (exceto obesidade), e estudos de intervenção, selecionando-se vinte artigos para análise. Em seis, dentre oito estudos brasileiros, observou-se associação significativa entre televisão e obesidade, e, em um destes, também se verificou associação positiva entre televisão e consumo alimentar. Nas investigações internacionais, observaram-se seis, dentre dez artigos, evidenciando associação entre televisão e obesidade, além de se identificar associação inversa entre televisão e tempo de atividade física. Em cinco artigos, do total de seis internacionais que investigaram o consumo alimentar, observou-se associação significativa entre televisão e ingestão alimentar, verificando-se que crianças e adolescentes que despendem maior tempo com a televisão tendem a ingerir menos frutas e verduras, e mais porções de salgadinhos, doces e bebidas com elevado teor de açúcar. A associação entre televisão e consumo alimentar foi evidente (85 por cento dos artigos), e a associação com obesidade apareceu em 60 por cento dos artigos. Ao identificar-se que o tempo em frente à TV associa-se à inadequação dos hábitos alimentares e à redução da atividade física, revela-se o hábito de assistir à televisão como um importante fator que pode propiciar a obesidade entre crianças e adolescentes.

The objective of this study was to identify the influence that watching television has on food intake and obesity in children and adolescents. A systematic review of the MedLine, PubMed, SciELO-Brasil and Lilacs databases was done which resulted in 73 articles published between 1997 and 2007. Articles with adults or preschoolers, notes, communications, reviews, samples of specific populations (Indians for example) or diseases (except for obesity) and intervention studies were excluded, resulting in 20 articles for analysis. In six of eight Brazilian studies, there was a significant association between watching television and obesity. In one of them, there was also a significant association between watching television and food intake. In six of ten international studies, there was a positive association between watching television and obesity and a negative association between times spent watching television and doing physical activity. In five out of six international studies that investigated food intake, there was a significant association between watching television and food intake. It was also found that children and adolescents who spend more time watching television tend to consume less fruits and vegetables and more salty snacks, sweets and sugar-rich beverages. The association between watching television and food intake was evident, found in 85 percent of the articles, and the association between watching television and obesity was found in 60 percent of the articles. Since time spent watching television is associated with unhealthy food habits and reduced levels of physical activity, it becomes an important factor in the promotion of obesity in children and adolescents.

Peso ao nascer e obesidade em crianças e adolescentes: uma revisão sistemática / Birth weight and obesity in children and adolescents: a systematic review

OBJETIVO: Verificar o nível de evidência científica e epidemiológica da hipótese de associação entre peso ao nascer e sobrepeso/obesidade na infância e na adolescência, a partir de revisão sistemática da literatura. MÉTODO: Foi realizada revisão sistemática nas bases MedLine/Pubmed, Scielo-Brasil e Lilacs. Adaptou-se a escala de Downs & Black para avaliar a qualidade metodológica dos catorze artigos selecionados. Os artigos foram classificados em duas categorias de análise, de acordo com o índice de desenvolvimento humano do país onde o estudo foi realizado: a) peso ao nascer e sobrepeso/obesidade em países com desenvolvimento humano elevado; e b) peso ao nascer e sobrepeso/obesidade em países com desenvolvimento humano elevado, mas ainda ascendente, e com desenvolvimento humano médio. RESULTADOS: Em ambas as categorias predominou a associação entre elevado peso ao nascer e sobrepeso/obesidade. Além disso, na primeira categoria, um dos sete artigos mostrou que o baixo peso ao nascer foi preditor de maior percentual de gordura corporal e abdominal. Na segunda categoria, três artigos mostraram associação do catch-up growth com sobrepeso/obesidade, e um mostrou o baixo peso ao nascer como fator protetor do sobrepeso (incluindo obesidade). Foram capturados quatro artigos brasileiros, dentre os quais dois não identificaram associação estatisticamente significativa entre peso ao nascer e sobrepeso/obesidade. CONSIDERAÇÕES FINAIS: O elevado peso ao nascer apareceu associado ao sobrepeso/obesidade na maioria dos artigos. Há necessidade de se continuar investigando sobre a associação entre o baixo peso ao nascer e sobrepeso/obesidade.