Correlates and impact of DSM-5 binge eating disorder, bulimia nervosa and recurrent binge eating: a representative population survey in a middle-income country.

PURPOSE: Binge eating disorder (BED), bulimia nervosa (BN) and recurrent binge eating (RBE) are binge eating spectrum conditions causing a significant impact in individual's health and functioning. Information regarding those conditions came mostly from high-income countries. The objective of this study was to assess the prevalence of DSM-5 BED, BN and RBE and correlates in a representative sample from a metropolitan area of a middle-income country. METHODS: The data were obtained from a cross-sectional population-based household survey in two stages in Rio de Janeiro, Brazil. Noninstitutionalized residents aged 18-60 years were assessed by lay interviewers using the Questionnaire of Eating and Weight Patterns-5 (QEWP-5). Positive cases and a paired sample screen-negative cases were reassessed by phone with the Eating Disorders Section of SCID-I-P (adapted for DSM-5). The data were collected from September 2019 to February 2020. RESULTS: Overall, 2297 individuals were interviewed. Prevalence of BED was 1.4%, BN 0.7%, RBE 6.2%. Psychiatric comorbidities, such as depression, anxiety and ADHD were significantly more prevalent in people with BED, BN and RBE than in people without these eating problems. Several medical conditions, when controlling for body mass index, were significantly more prevalent in people with BED, BN and RBE. People with BED and BN had marked impairments in work/school, social and family life, reduced mental and physical HRQoL and under half had sought treatment. CONCLUSION: As in high income countries, in Rio de Janeiro, Brazil, BED, BN and RBE are prevalent conditions and are associated with elevated BMI, functional impairment, psychiatric and medical comorbidity and poorer HRQoL.

Stability and bidirectional relationship between physical activity and sedentary behaviours in Brazilian adolescents: Longitudinal findings from a school cohort study.

PURPOSE: We investigated the stability, correlations and bidirectional relationship of light physical activities (PA), moderate and vigorous PA (MVPA), television viewing (TV) and video game/computer use (VG) in Brazilian adolescents. METHODS: Adolescent Nutritional Assessment Longitudinal Study-ELANA is a middle school cohort study conducted in Rio de Janeiro-Brazil in 2010-2012. Self-reported data on PA (International Physical Activity Questionnaire- IPAQ) and screen activities were obtained from 810 adolescents (mean ages of 10.9 years old (SD 0.78) for girls; 11 years old (SD 0.85) for boys) to perform autoregressive cross-lagged structural equation models in two time points for PA and three time points for screen activities. RESULTS: There was no significant stability of light PA and MVPA for boys and girls. Moderate stability of screen activities were found for both genders, with a significant coefficient of TV for boys (T1-T2:0.29; T2-T3:0.27 p<0.001); and VG for boys (T1-T2:0.33; T2-T3:0.35 p<0.001) and girls (T1-T2: 0.26; T2-T3:0.37 p<0.01). Significant lagged effects were obtained only among girls: light PA had effect on VG (-0.10 p<0.01), as well as in the opposite direction of TV on light PA (-0.03 p<0.01) and TV on MVPA (-0.11 p<0.01). CONCLUSION: The light PA, MVPA and screen activities (among girls) did not demonstrate stability over time. A warning scenario was suggested by the stability of high amounts of screen activities among boys over time. Screen activities had bidirectional association with light PA and MVPA among girls over time.

Variation of BMI and anthropometric indicators of abdominal obesity in Brazilian adolescents from public schools, 2003-2008.

OBJECTIVE: The aim of the present study was to compare BMI and anthropometric indicators of abdominal obesity in Brazilian adolescents from public schools between 2003 and 2008. DESIGN: A comparison of anthropometric indicators in adolescents was done based on two cross-sectional surveys conducted in 2003 (n 530) and in 2008 (n 498). BMI (= weight/height2), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were evaluated. The age-adjusted means were compared between the two studies by linear regression and the percentile values were compared by quantile regression. A P value <0·05 was adopted for statistical significance. SETTING: Metropolitan area of Rio de Janeiro, Brazil. SUBJECTS: Two probabilistic samples of students aged 15-19 years old, from public schools. RESULTS: There was a decrease in boys' mean WC (72·9 cm v. 70·9 cm, P = 0·01) and an increase in girls' mean BMI (21·1 kg/m2 v. 22·0 kg/m2, P = 0·03). Among boys, the WC, HC and WHtR percentiles were lower whereas the WHR percentiles were higher in 2008 than in 2003. Among girls, the percentiles of all measures were higher in 2008, except for WHR. CONCLUSIONS: Anthropometric measures among boys tended to decrease, while among girls there was a tendency to increase from 2003 to 2008, indicating an important gender effect and a higher morbidity risk associated with excess body fat in girls. The school setting offers opportunities for interventions to address this situation.

Prevalence of anaemia and associated factors among children below five years of age in Cape Verde, West Africa.

This study estimated the prevalence of anaemia and associated factors in a probability sample of 993 chil- dren aged 6-59 months in Cape Verde, West Africa. Odds ratio (OR) and 95% confidence interval (95% CI) were estimated from a hierarchical model for multiple analysis to assess the association between anaemia and explanatory variables. The prevalence of anaemia was 51.8% (95% CI 47.7-55.8). Children who resided within poor household conditions (OR 1.99; 95% CI 1.06-3.71) were below 24 months of age (OR 3.23; 95% CI 2.03-5.15) and recently experienced diarrhoea (OR 1.58; 95% CI 0.99-2.50) were at high risk of anaemia. Anaemia should be considered a serious public-health concern in Cape Verde, mainly for chil- dren below 24 months. Further, special consideration should be given to children who have experienced recent diarrhoea and belong to families residing in poor household conditions.

Water and sugar-sweetened beverage consumption and changes in BMI among Brazilian fourth graders after 1-year follow-up.

OBJECTIVE: We examined whether drinking water per se is associated with drinking less of other beverages and whether changes in BMI are associated with the intake of water and other beverages. DESIGN: Secondary analysis of a randomized trial of fourth graders followed over 1 year. SETTING: Public schools in the metropolitan area of Rio de Janeiro, Brazil. SUBJECTS: Participants were 1134 students aged 10-11 years. RESULTS: At baseline, a higher frequency of water consumption was associated with a greater daily intake of fruit juice (P = 0.02) and a higher daily frequency of milk (P = 0.005). In the intervention group, the baseline frequency of water consumption was negatively associated with weight change over 1 year but without statistical significance (coefficient = -0.08 kg/m2; 95 % CI -0.37, 0.24 kg/m2), whereas fruit juice intake frequency was positively associated with weight change: each increase in fruit juice intake of 1 glass/d was associated with a BMI increase of 0.16 (95 % CI 0.02, 0.30) kg/m2. CONCLUSIONS: Our findings do not support a protective effect of water consumption on BMI, but confirm consumption of juice drinks as a risk factor for BMI gain. Students who reported high water consumption also reported high intake of other beverages; therefore, the promotion of water consumption per se would not prevent excessive weight gain.

Family food insecurity and nutritional risk in adolescents from a low-income area of Rio de Janeiro, Brazil.

The study objective was to analyse the association between food insecurity and the weight and height status of adolescents from a low-income area in the metropolitan region of Rio de Janeiro, Brazil. The population-based cross-sectional survey included 523 adolescents aged 12-18 years, selected by a three-stage cluster sample. Dietary intake was ascertained with a food frequency questionnaire and family food insecurity was assessed with a validated questionnaire. The analysis estimated weighted means of energy and nutrient intakes by families' socioeconomic characteristics and the association between dietary intake with overweight and stunting. The prevalence of mild family food insecurity was 36%, and 24% of the families reported moderate or severe food insecurity. Overweight prevalence was 24%, and the prevalence of stunting was 9%, with no significant differences between sex or age groups. Family food insecurity was associated with unfavourable socioeconomic characteristics, but there was no association between socioeconomic characteristics (including family food insecurity) and overweight or stunting. Moderate or severe family food insecurity was inversely associated with intake of protein and calcium. In addition, stunting was associated with low calcium and iron intake. The co-existence of family food insecurity with overweight and stunting implies a high nutritional risk for adolescents from poor areas of Rio de Janeiro. Nevertheless, the observed absence of a statistical association between family food insecurity and weight status attests to the complexity of this issue.

Composition of fatty acids in the maternal and umbilical cord plasma of adolescent and adult mothers: relationship with anthropometric parameters of newborn.

BACKGROUND: Considering the importance of long chain polyunsaturated fatty acids to fetal development and the lack of studies that have compared the status of fatty acids between adolescents and adults mothers, the purpose of this study was to evaluate the composition of fatty acids in maternal and umbilical cord plasma from adolescent and adults mothers. METHODS: Forty pregnant adolescents and forty pregnant adults were selected to assess the distribution profile of fatty acids in the maternal and umbilical cord plasma. Quantification of fatty acids in the total lipids of the sample groups was performed through the use of gas-liquid chromatography. RESULTS: The maternal and umbilical cord plasma of the adolescents showed a greater concentration of AA than did that of the adults (P < 0.05). However, a greater percentage of EPA was found in the umbilical cord plasma of the adults (P < 0.05). DHA in the plasma of the adolescent mothers correlated positively to birth weight and head circumference. CONCLUSIONS: This suggests that in situations of greater nutritional risk, as in adolescent pregnancy, n-3PUFA concentrations have a greater influence on the proper development of newborns. Moreover, variations in fatty acid concentrations in the maternal and cord plasma of adolescents and adults may indicate that pregnancy affects the LC-PUFA status of adults and adolescents in distinct ways.

Prevalence of metabolic syndrome and of its specific components among adolescents from Niterói City, Rio de Janeiro State, Brazil.

OBJECTIVE: To compare the prevalence of metabolic abnormalities (MA) and metabolic syndrome (MS) assessed by different criteria among Brazilian adolescents. SUBJECTS AND METHODS: Weighted prevalence of MA and MS were estimated using criteria adapted from the International Diabetes Federation (IDF), National Cholesterol Education Program, Adult Treatment Panel III (NCEP/ATP III), and the World Health Organization (WHO) in a probabilistic sample of 577 students aged 12-19. RESULTS: The most prevalent MA was low concentration of HDL-C as per IDF (32.5%) and NCEP/ATP III (41.6%) criteria and hypertension as per the WHO's criterion (12.4%). Prevalence of MS using the NCEP/ATP III criterion (6.04%) was five times higher than the WHO's (1.1%) and the IDF's (1.6%) criteria. As expected, MS was significantly higher among overweight than among non-overweight adolescents. CONCLUSION: Low prevalence of MS but high prevalence of some MA were found. These findings suggest that the diagnosis of MA is more relevant in clinical practice especially in overweight adolescents.

Prevalence of metabolic syndrome and of its specific components among adolescents from Niterói City, Rio de Janeiro State, Brazil / Prevalência de síndrome metabólica e de componentes específicos da síndrome em adolescentes de Niterói, Rio de Janeiro, Brasil

OBJECTIVE: To compare the prevalence of metabolic abnormalities (MA) and metabolic syndrome (MS) assessed by different criteria among Brazilian adolescents. SUBJECTS AND METHODS: Weighted prevalence of MA and MS were estimated using criteria adapted from the International Diabetes Federation (IDF), National Cholesterol Education Program, Adult Treatment Panel III (NCEP/ATP III), and the World Health Organization (WHO) in a probabilistic sample of 577 students aged 12-19. RESULTS: The most prevalent MA was low concentration of HDL-C as per IDF (32.5 percent) and NCEP/ATP III (41.6 percent) criteria and hypertension as per the WHO's criterion (12.4 percent). Prevalence of MS using the NCEP/ATP III criterion (6.04 percent) was five times higher than the WHO's (1.1 percent) and the IDF's (1.6 percent) criteria. As expected, MS was significantly higher among overweight than among non-overweight adolescents. CONCLUSION: Low prevalence of MS but high prevalence of some MA were found. These findings suggest that the diagnosis of MA is more relevant in clinical practice especially in overweight adolescents.

OBJETIVO: Comparar a prevalência de alterações metabólicas (AM) e de síndrome metabólica (SM) avaliadas por três diferentes critérios nos adolescentes brasileiros. SUJEITOS E MÉTODOS: Foram estimadas prevalências expandidas de AM e SM pelos critérios adaptados do International Diabetes Federation (IDF), National Cholesterol Education Program, Adult Treatment Panel III (NCEP/ATP III) e o World Health Organization (WHO), em uma amostra probabilística de 577 estudantes de 12 a 19 anos. RESULTADOS: Baixa concentração de HDL-C foi a AM mais prevalente segundo critérios do IDF (32,5 por cento) e do NCEP/ATP III (41,6 por cento), e hipertensão pelo critério do WHO (12,4 por cento). A prevalência de SM pelo critério NCEP/ATP III (6,04 por cento) foi cinco vezes mais alta do que pelos critérios WHO (1,1 por cento) e IDF (1,6 por cento) e, como era esperado, foi significantemente mais elevada entre adolescentes com sobrepeso. CONCLUSÃO: Foram encontradas menores prevalências de SM e maiores prevalências de algumas AM. Esses resultados sugerem que o diagnóstico das AM é mais relevante na prática clínica especialmente para adolescentes com excesso de peso.

Anthropometric measurements of adolescents from two Amazonian ecosystems: variations according to seasonality.

This paper aims to describe the nutritional status of Caboclo adolescents living in two areas of the Amazon Basin. Two cross-sectional studies, the first in the dry and the second in the wet season, were carried out in two Amazonian ecosystems: the forest and black water ecosystem, and the floodplain and white water ecosystem. Measurements of weight, stature, arm circumference and triceps, subscapular and suprailiac skinfolds were performed on 247 adolescents (10-19 years of age). Nutritional status was classified using body mass index according to international criteria and the prevalence of underweight and overweight was estimated. Linear mixed effects models were used with the anthropometric measurements as dependent variables and time interval, place of residence, sex, age and stature variation as independent variables. During the wet season, the prevalence of overweight among girls was higher in the forest (42%) than in the floodplain (9%). Longitudinal linear regression models showed that the arm circumference measurement was influenced both by seasonality and location, revealing that the increment between dry and wet seasons was less pronounced in the floodplain. At the time of the study, overweight already constituted a major public health concern among girls living in the forest area. In order to develop adequate public health policies for this important segment of the Amazon population further studies are necessary to investigate the role of environment and seasonality on the growth and nutritional status of adolescents.

Body mass index for predicting hyperglycemia and serum lipid changes in Brazilian adolescents / Índice de massa corporal para predizer hiperglicemia e alterações lipídicas em adolescentes brasileiros / Índice de masa corporal para predecir hiperglicemia y alteraciones lipídicas en adolescentes brasileros

OBJECTIVE: To determine the best cut-offs of body mass index for identifying alterations of blood lipids and glucose in adolescents. METHODS: A probabilistic sample including 577 adolescent students aged 12-19 years in 2003 (210 males and 367 females) from state public schools in the city of Niterói, Southeastern Brazil, was studied. The Receiver Operating Characteristic curve was used to identify the best age-adjusted BMI cut-off for predicting high levels of serum total cholesterol (>150mg/dL), LDL-C (>100mg/dL), serum triglycerides (>100mg/dL), plasma glucose (>100mg/dL) and low levels of HDL-C (< 45mg/dL). Four references were used to calculate sensitivity and specificity of BMI cut-offs: one Brazilian, one international and two American. RESULTS: The most prevalent metabolic alterations (>50 percent) were: high total cholesterol and low HDL-C. BMI predicted high levels of triglycerides in males, high LDL-C in females, and high total cholesterol and the occurrence of three or more metabolic alterations in both males and females (areas under the curve range: 0.59 to 0.67)...

OBJETIVO: Determinar os melhores pontos de corte do índice de massa corporal (IMC) para identificar alterações no perfil lipêmico e glicêmico em adolescentes. MÉTODOS: Foram avaliados 577 adolescentes de 12 a 19 anos (210 meninos e 367 meninas) em uma amostra probabilística de estudantes de escolas estaduais da cidade de Niterói (RJ), em 2003. Foi utilizada a curva Receiver Operating Characteristic para identificar o melhor ponto de corte, ajustado para idade, para predizer valores elevados de colesterol total sérico (>150mg/dL), LDL-C (>100mg/dL), triglicérides (>100mg/dL), glicose plasmática (>100mg/dL) e baixos valores de HDL-C (<45mg/dL). Quatro referências foram utilizadas para verificar a sensibilidade e especificidade dos pontos de corte: uma nacional, uma internacional e duas americanas. RESULTADOS: As alterações metabólicas de maior prevalência (>50 por cento) foram: colesterol total elevado e HDL-C baixa. O IMC foi capaz de predizer valores elevados de triglicérides nos meninos, LDL-C nas meninas e colesterol total e presença de três ou mais alterações metabólicas em ambos os sexos (área sob a curva - 0,59 a 0,67)...

OBJETIVO: Determinar los mejores puntos de corte del índice de masa corporal (IMC) para identificar alteraciones en el perfil lipémico y glicérico en adolescentes. MÉTODOS: Fueron evaluados 577 adolescentes de 12 a 19 años (210 niños y 367 niñas) en una muestra probabilística de estudiantes de escuelas estaduales de la ciudad de Niteroi, Sureste de Brasil, en 2003. Fue utilizada una curva Receiver Operating Characteristic para identificar el mejor punto de corte, ajustado a la edad, para predecir valores elevados de colesterol total sérico (=150mg/dL), LDL-C (=100mg/dL), triglicéridos (=100mg/dL), glicosis plasmática (>100mg/dL) y bajos valores de HDL-C (<45mg/dL). Cuatro referencias fueron utilizadas para verificar la sensibilidad y especificidad de los puntos de corte: una nacional, una internacional e dos americanas. RESULTADOS: Las alteraciones metabólicas de mayor prevalencia (>50 por ciento) fueron: colesterol total elevado y HDL-C bajo. El IMC fue capaz de predecir valores elevados de triglicéridos en los niños, LDL-C en las niñas y colesterol total y presencia de tres o más alteraciones metabólicas en ambos sexos (área bajo la curva - 0,59 a 0,67)...

School randomised trial on prevention of excessive weight gain by discouraging students from drinking sodas.

OBJECTIVE: To determine whether an educational programme aimed at discouraging students from drinking sugar-sweetened beverages could prevent excessive weight gain. DESIGN: Forty-seven classes in twenty-two schools were randomised as intervention or control. SUBJECTS: Participants were 1140, 9-12-year-old fourth graders (435 in the intervention group and 608 in the control group). Sugar-sweetened beverages and juice intake were measured through one 24 h recall at baseline and another at the end of the trial. The main outcome was the change in BMI (BMI = weight (kg)/height (m2)), measured at the beginning and at the end of the school year. Intention-to-treat analysis was performed taking into account the cluster (classes) effect. RESULTS: A statistically significant decrease in the daily consumption of carbonated drinks in the intervention compared to control (mean difference = -56 ml; 95 % CI -119, -7 ml) was followed by a non-significant overall reduction in BMI, P = 0.33. However, among those students overweight at baseline, the intervention group showed greater BMI reduction (-0.4 kg/m2 compared with -0.2 kg/m2 in the control group (P = 0.11)), and this difference was statistically significant among girls (P = 0.009). Fruit juice consumption was slightly increased in the intervention group (P = 0.08), but not among girls. CONCLUSION: Decreasing sugar-sweetened beverages intake significantly reduced BMI among overweight children, and mainly among girls. Efforts to reduce energy intake through liquids need to emphasise overall sweetened beverages and addition of sugar on juices.

Body mass index for predicting hyperglycemia and serum lipid changes in Brazilian adolescents.

OBJECTIVE: To determine the best cut-offs of body mass index for identifying alterations of blood lipids and glucose in adolescents. METHODS: A probabilistic sample including 577 adolescent students aged 12-19 years in 2003 (210 males and 367 females) from state public schools in the city of Niterói, Southeastern Brazil, was studied. The Receiver Operating Characteristic curve was used to identify the best age-adjusted BMI cut-off for predicting high levels of serum total cholesterol (> or =150 mg/dL), LDL-C (> or =100 mg/dL), serum triglycerides (> or =100 mg/dL), plasma glucose (> 100 mg/dL) and low levels of HDL-C (< 45 mg/dL). Four references were used to calculate sensitivity and specificity of BMI cut-offs: one Brazilian, one international and two American. RESULTS: The most prevalent metabolic alterations (>50%) were: high total cholesterol and low HDL-C. BMI predicted high levels of triglycerides in males, high LDL-C in females, and high total cholesterol and the occurrence of three or more metabolic alterations in both males and females (areas under the curve range: 0.59 to 0.67), with low sensitivity (57%-66%) and low specificity (58%-66%). The best BMI cut-offs for this sample (20.3 kg/m(2) to 21.0 kg/m(2)) were lower than those proposed in the references studied. CONCLUSIONS: Although BMI values lower than the International cut-offs were better predictor of some metabolic abnormalities in Brazilian adolescents, overall BMI is not a good predictor of these abnormalities in this population.

Assessment of anthropometric indexes of children and adolescents with Down syndrome.

OBJECTIVE: To compare the agreement in the classification of the weight-for-age (W/A) and height-for-age (HA) indexes for children and adolescents with Down syndrome (DS) according to selected international reference distributions. METHODS: A cross-sectional study was carried out in children (2 to 9.9 years old) and adolescents (10 to 17.9 years old) with DS from cities in the state of Rio de Janeiro, Brazil, in 2005. The W/A and H/A indexes were classified according to the percentiles of two curves developed for individuals with DS and one distribution developed for healthy subjects. The cut-off limits applied for categorization were: below the 5th percentile (< P5) and above the 95th percentile (> 95). The weighted Kappa index was estimated to assess agreement between the classifications (p < 0.05). RESULTS: Information was obtained on 98 children and 40 adolescents. From 1.0 to 18.4% of the children were < P5 for W/A, and the agreement for this index was considered weak (Kappa = 0.16; 95%CI -0.03-0.34; p < 0.01); no agreement was observed between the H/A classifications. For adolescents, W/A < P5 varied from 2.5 to 5.0%; once more there was no agreement for this classification (Kappa = 0.16; 95%CI -0.15-0.48; p > 0.05). There was good agreement for the H/A index (Kappa = 1.00; 95%CI 0.23-1.00; p < 0.01). CONCLUSION: There was weak agreement between classifications of anthropometric indexes according to three different distributions. The data indicated that the construction of specific curves for individuals with DS would facilitate the identification of overweight, which is often observed among these patients.

Comparação entre distribuições de referência para a classificação do estado nutricional de crianças e adolescentes com síndrome de Down / Assessment of anthropometric indexes of children and adolescents with Down syndrome

OBJETIVO: Avaliar a concordância da categorização dos índices peso para idade (P/I) e estatura para idade (E/I) em indivíduos com síndrome de Down segundo diferentes curvas. MÉTODOS: Desenvolveu-se estudo transversal em crianças (2 a 9,9 anos de idade) e adolescentes (10 a 17,9 anos de idade) com síndrome de Down assistidos em instituições da região metropolitana do Rio de Janeiro. Os índices de P/I e E/I foram categorizados segundo os percentis de três curvas: duas para indivíduos com síndrome de Down e outra para indivíduos saudáveis. Os limites utilizados na categorização foram o percentil 5 (P5) e o percentil 95 (P95). Utilizou-se o Kappa ponderado na avaliação da concordância das classificações (significativo quando p < 0,05). RESULTADOS: Foram obtidas informações de 98 crianças e 40 adolescentes. Entre as crianças, o P/I < P5 variou de 1,0 a 18,4 por cento; a concordância para essa categorização foi considerada fraca (Kappa = 0,16; IC95 por cento -0,03-0,34; p < 0,01); para E/I, não foi observada concordância na classificação. Entre os adolescentes, a categorização do P/I < P5 variou de 2,5 a 5,0 por cento; a concordância para essa classificação foi fraca (Kappa = 0,16; IC95 por cento -0,15-0,48; p > 0,05); para E/I, a concordância foi boa (Kappa = 1,00; IC95 por cento 0,23-1,00; p < 0,01). CONCLUSÃO: A concordância entre as classificações dos índices P/I e E/I geradas por diferentes distribuições mostrou-se fraca. Os dados indicam que o desenvolvimento de curvas específicas para indivíduos com síndrome de Down seria útil para a identificação de distúrbios ponderais, como o excesso de peso, que é freqüentemente observado nesse grupo.

OBJECTIVE: To compare the agreement between classifications of children and adolescents with Down syndrome (DS) by weight for age (W/A) and height for age (H/A) indexes according to a selection of international reference curves. METHODS: A cross-sectional study was carried out of children (2 to 9.9 years old) and adolescents (10 to 17.9 years old) with DS from cities in the state of Rio de Janeiro, Brazil, in 2005. The W/A and H/A indexes were classified according to the percentiles of two curves developed for individuals with Down syndrome and one distribution developed for healthy subjects. The cut-off limits applied for categorization were: below the 5th percentile (< P5) and above the 95th percentile (> 95). The weighted Kappa index was estimated to assess agreement between the classifications (p < 0.05). RESULTS: Information was obtained on 98 children and 40 adolescents. From 1.0 to 18.4 percent of the children were < P5 for W/A and the agreement for this index was considered weak (Kappa = 0.16; 95 percentCI -0.03-0.34; p < 0.01) no agreement was observed between the H/A classifications. For adolescents, W/A < P5 varied from 2.5 to 5.0 percent; and once more there was no agreement for this classification (Kappa = 0.16; 95 percentCI -0.15-0.48; p > 0.05). There was good agreement for the H/A index (Kappa = 1.00; 95 percentCI 0.23-1.00; p < 0.01). CONCLUSION: There was weak agreement between classifications of anthropometric indexes according to three different distributions. The data indicate that the construction of specific curves for individuals with DS would facilitate the identification of overweight, which is often observed among these patients.

[Association between central body anthropometric measures and metabolic syndrome components in a probabilistic sample of adolescents from public schools]. / Associação das medidas antropométricas de localização de gordura central com os componentes da síndrome metabólica em uma amostra probabilística de adolescentes de escolas públicas.

It was investigated the association of waist circumference (WC), abdominal circumference (AC), Waist-to-Hip ratio(WHR) and Waist-Height ratio (WHtR) adjusted by body mass index (BMI) and % body fat (BF) with metabolic syndrome components in a probabilistic sample of 610 adolescents aged 12-19 years (222 boys and 388 girls) from public schools of Niterói, Rio de Janeiro. Fasting glucose and lipids were assayed using automated enzymatic method and insulin was determined by radioimmuno assay. Systolic (SBP) and diastolic (DBP) blood pressure were measured using an automated recorder and % BF by electric bioimpedance. The association of the anthropometric measures with metabolic syndrome components was evaluated by multivariate linear regression adjusted according to the age, BMI or %BF. In boys, a positive association between WC (beta=1.03 p<0.01) and WHtR (beta= 2.33, p< 0.05; beta=2.12 and p< 0.01) with triglycerides was maintained after BMI and % BF adjusting, respectively. WC was associated with SBP after % BF adjusting both for boys (beta= 0.70 p<0.01) and girls (beta=0.68 p<0.01). In conclusion, WC was the measure of central body fat that presented the best association with components of metabolic syndrome in adolescents.

Associação das medidas antropométricas de localização de gordura central com os componentes da síndrome metabólica em uma amostra probabilística de adolescentes de escolas públicas / Association between central body anthropometric measures and metabolic syndrome components in a probabilistic sample of adolescents from public schools

Avaliou-se a associação entre medidas antropométricas de localização de gordura central: circunferências da cintura (CC) e abdominal (CA) e as razões cintura/quadril (RCQ) e cintura/estatura (RCE), independente do percentual de gordura corporal ( por centoGC) e índice de massa corporal (IMC), com os componentes da síndrome metabólica (SM) em uma amostra probabilística de 610 (222 meninos e 388 meninas) adolescentes de 12 a 19 anos de escolas públicas de Niterói, RJ. Foram avaliados glicose e perfil lipídico pelo método enzimático automatizado, insulina pela técnica de radioimunoensaio, por centoGC pela bioimpedância elétrica e a pressão arterial sistólica (PAS) e diastólica com manômetro digital. A associação entre as medidas antropométricas foi verificada por meio de regressão linear múltipla, com ajuste para IMC, por centoGC e idade. Nos meninos, a associação positiva entre CC (b = 1,03, p < 0,01) e RCE (b = 2,33, p < 0,05; b = 2,12 e p < 0,01) com triglicerídios foi mantida independente de IMC e por cento de GC, respectivamente. A CC se correlacionou com a PAS independente do por centoGC, tanto nos meninos (b = 0,70 p < 0,01) quanto nas meninas (b = 0,68 p < 0,01). Conclui-se que a CC foi a medida de gordura central que apresentou a melhor associação com os componentes da SM nos adolescentes.

It was investigated the association of waist circumference (WC), abdominal circumference (AC), Waist-to-Hip ratio(WHR) and Waist-Height ratio (WHtR) adjusted by body mass index (BMI) and percent body fat (BF) with metabolic syndrome components in a probabilistic sample of 610 adolescents aged 12-19 years (222 boys and 388 girls) from public schools of Niterói, Rio de Janeiro. Fasting glucose and lipids were assayed using automated enzymatic method and insulin was determined by radioimmuno assay. Systolic (SBP) and diastolic (DBP) blood pressure were measured using an automated recorder and percent BF by electric bioimpedance. The association of the anthropometric measures with metabolic syndrome components was evaluated by multivariate linear regression adjusted according to the age, BMI or percentBF. In boys, a positive association between WC (b=1.03 p<0.01) and WHtR (b= 2.33, p< 0.05; b=2.12 and p< 0.01) with triglycerides was maintained after BMI and percent BF adjusting, respectively. WC was associated with SBP after percent BF adjusting both for boys (b= 0.70 p<0.01) and girls (b=0.68 p<0.01). In conclusion, WC was the measure of central body fat that presented the best association with components of metabolic syndrome in adolescents.

[Fat intake and hypercholesterolemia in a probabilistic sample of adolescents from Niterói, Rio de Janeiro]. / Consumo de gordura e hipercolesterolemia em uma amostra probabilística de estudantes de Niterói, Rio de Janeiro.

OBJECTIVE: To evaluate the relationship between fat intake and serum cholesterol. METHODS: A survey was conducted in a probabilistic sample of students from public schools in Niterói, state of Rio de Janeiro, Brazil. Anthropometric data were collected on 610 youngsters, 573 of them had blood drown, and 539 answered a simplified questionnaire on fat intake. Multivariate linear regression included as confounders: parents' cholesterolemia, adolescent age and body mass index (BMI). RESULTS: The prevalence of high concentrations (> 170 mg/dL) of serum cholesterol was 31.2%. Both sexes presented high frequencies (45% approximately) of inadequate intake of fatty foods. Prevalence of overweight was 15.7%, without significant statistical difference between sexes (p= 0.83). Total fat intake as measured by the questionnaire and each one of the nine high fat items was not associated with youngsters' cholesterol. Among girls BMI and parents' hypercholesterolemia were associated with cholesterol levels, but for boys only age showed statistically significant association. Lack of association between fat intake and cholesterol levels was observed. CONCLUSION: The combined higher prevalence of hypercholesterolemia, overweight and intake of high fat foods suggest that only public health action may curb these epidemics. This may indicate that overall energy intake should be the target of the actions.

Consumo de gordura e hipercolesterolemia em uma amostra probabilística de estudantes de Niterói, Rio de Janeiro / Fat intake and hypercholesterolemia in a probabilistic sample of adolescents from Niterói, Rio de Janeiro

OBJETIVO: Avaliar a associação entre consumo de gordura e colesterol total sérico (CT). MÉTODOS: O inquérito foi realizado em uma amostra probabilística de adolescentes das escolas estaduais de Niterói, RJ. Foram obtidos dados antropométricos de 610 jovens, 577 participaram da coleta de sangue e 539 responderam o questionário de consumo alimentar. A análise multivariada de regressão linear incluiu como variáveis de confusão a hipercolesterolemia nos pais, idade e índice de massa corporal (IMC). RESULTADOS: Concentrações aumentadas de CT (> 170 mg/dL) ocorreram em 31,2 por cento dos jovens. Ambos os sexos apresentaram freqüências elevadas (aproximadamente 45 por cento) de consumo inadequado de gorduras. O sobrepeso foi de 15,7 por cento, sem diferença estatisticamente significante entre os sexos (p= 0,83). Nenhum item alimentar isolado apresentou associação com o CT. IMC e presença de hipercolesterolemia nos pais mostraram associação estatisticamente significante com os teores de CT das meninas, e idade associou-se somente para os meninos. Verificou-se ausência de associação entre consumo de gordura e valores de CT. CONCLUSÕES: A combinação de altas taxas de hipercolesterolemia, sobrepeso e consumo de alimentos ricos em gordura sugerem que somente ações coletivas podem reduzir essas epidemias e que a redução na ingestão energética excessiva deve ser o principal objetivo destas ações.

OBJECTIVE: To evaluate the relationship between fat intake and serum cholesterol. METHODS: A survey was conducted in a probabilistic sample of students from public schools in Niterói, state of Rio de Janeiro, Brazil. Anthropometric data were collected on 610 youngsters, 573 of them had blood drown, and 539 answered a simplified questionnaire on fat intake. Multivariate linear regression included as confounders: parents' cholesterolemia, adolescent age and body mass index (BMI). RESULTS: The prevalence of high concentrations (> 170 mg/dL) of serum cholesterol was 31.2 percent. Both sexes presented high frequencies (45 percent approximately) of inadequate intake of fatty foods. Prevalence of overweight was 15.7 percent, without significant statistical difference between sexes (p= 0.83). Total fat intake as measured by the questionnaire and each one of the nine high fat items was not associated with youngsters' cholesterol. Among girls BMI and parents' hypercholesterolemia were associated with cholesterol levels, but for boys only age showed statistically significant association. Lack of association between fat intake and cholesterol levels was observed. CONCLUSION: The combined higher prevalence of hypercholesterolemia, overweight and intake of high fat foods suggest that only public health action may curb these epidemics. This may indicate that overall energy intake should be the target of the actions.

Ingestäo e hábitos alimentares de adolescentes gestantes / Ingestion and feeding habits of pregnant adolescents

O estudo teve como objetivo avaliar a ingestão alimentar de adolescentes gestantes, por meio de método recordatório de 24 horas e de freqüência do consumo alimentar. Foram estudadas 140 adolescentes gestantes, atendidas em alguns Serviços de Saúde da rede Municipal de Cuiabá, na faixa etária de 12 a 18,9 anos, em diferentes períodos gestacionais. Verificou-se que 62,9 por cento das adolescentes gestantes apresentaram ingestão energética inferior às recomendações do NRC (1989) e 62,1 por cento ingestão protéica superior a estas recomendações, sendo evidenciado um equilíbrio entre as proteínas de origem animal e vegetal. O cálcio e o ferro, também, encontraram-se abaixo dos valores recomendados para mais de 2/3 das adolescentes. Quanto aos hábitos alimentares, a maioria das adolescentes relatou não terem ocorrido modificações qualitativas devido à gestação. O percentual de baixo peso ao nascer entre os filhos das adolescentes foi de 5,4 por cento e esta variável não foi influenciada pela ingestão energético-protéica das adolescentes.