Position statement on nutrition therapy for overweight and obesity: nutrition department of the Brazilian association for the study of obesity and metabolic syndrome (ABESO-2022).

Obesity is a chronic disease resulting from multifactorial causes mainly related to lifestyle (sedentary lifestyle, inadequate eating habits) and to other conditions such as genetic, hereditary, psychological, cultural, and ethnic factors. The weight loss process is slow and complex, and involves lifestyle changes with an emphasis on nutritional therapy, physical activity practice, psychological interventions, and pharmacological or surgical treatment. Because the management of obesity is a long-term process, it is essential that the nutritional treatment contributes to the maintenance of the individual's global health. The main diet-related causes associated with excess weight are the high consumption of ultraprocessed foods, which are high in fats, sugars, and have high energy density; increased portion sizes; and low intake of fruits, vegetables, and grains. In addition, some situations negatively interfere with the weight loss process, such as fad diets that involve the belief in superfoods, the use of teas and phytotherapics, or even the avoidance of certain food groups, as has currently been the case for foods that are sources of carbohydrates. Individuals with obesity are often exposed to fad diets and, on a recurring basis, adhere to proposals with promises of quick solutions, which are not supported by the scientific literature. The adoption of a dietary pattern combining foods such as grains, lean meats, low-fat dairy, fruits, and vegetables, associated with an energy deficit, is the nutritional treatment recommended by the main international guidelines. Moreover, an emphasis on behavioral aspects including motivational interviewing and the encouragement for the individual to develop skills will contribute to achieve and maintain a healthy weight. Therefore, this Position Statement was prepared based on the analysis of the main randomized controlled studies and meta-analyses that tested different nutrition interventions for weight loss. Topics in the frontier of knowledge such as gut microbiota, inflammation, and nutritional genomics, as well as the processes involved in weight regain, were included in this document. This Position Statement was prepared by the Nutrition Department of the Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), with the collaboration of dietitians from research and clinical fields with an emphasis on strategies for weight loss.

Body mass index and waist circumference are good indicators for classifying children's nutritional status.

This study aimed to investigate the relationship between anthropometric indicators - body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) - and the sum of skinfold thicknesses in 7-10-year-old children attending a public school in São Paulo (SP). Height, weight, WC and triceps, biceps, subscapular and suprailiac skinfolds were measured, and the sum of skinfold thicknesses, BMI and WHtR were calculated. A Bland-Altman analysis was used in order to compare methods, with values transformed into z-scores. The analysis of limits of agreement and confidence intervals showed evidence of good agreement, above all between BMI and WC, and the sum of skinfold thicknesses, complying with strict agreement limits and differences smaller than 1 standard deviation (SD). WHtR showed moderate limits of agreement, from -1.02 to + 0.64 SD (boys) and -0.74 to + 1.12 SD (girls); its performance was not better than that of WC alone, the lower and upper limits of agreement for which were -0.91 to + 0.58 SD (boys) and -0.56 to + 0.89 SD (girls). The results support the use of anthropometric indicators to classify nutritional status, above all BMI and WC, in that both are similar when classifying children according to body fatness, and confer the advantages of being easy to obtain and affordable.

Índice de massa corpórea e perímetro da cintura são bons indicadores para classificação do estado nutricional de crianças / Body mass index and waist circumference are good indicators for classifying children& nutritional status

Resumo O estudo objetivou investigar a relação do índice de massa corpórea (IMC), do perímetro da cintura (PC) e da razão cintura/estatura (RCE) com a soma de dobras cutâneas em crianças de 7-10 anos de uma escola pública de São Paulo (SP). Foram tomadas as medidas estatura, peso, PC e dobras tricipital, bicipital, subescapular e suprailíaca, e calculados a soma de dobras cutâneas, o IMC e a RCE. Para a comparação de métodos utilizou-se a estratégia de Bland e Altman com valores transformados em z. Pela análise dos limites de concordância e seus respectivos intervalos de confiança, encontrou-se evidência de boa concordância, principalmente entre IMC e PC com a soma de dobras cutâneas, observando-se estreitos limites de concordância e diferenças menores que 1 desvio-padrão (dp). A RCE apresentou limites de concordância de amplitude moderada, de -1,02 a +0,64 dp (meninos) e -0,74 a +1,12 dp (meninas), e seu desempenho não foi melhor que o do PC isolado, cujos limites de concordância inferior e superior foram de -0,91 a +0,58 dp (meninos) e de -0,56 a +0,89 dp (meninas). Os resultados apoiam o uso de indicadores antropométricos para classificação do estado nutricional, especialmente IMC e PC, considerando que ambos são semelhantes ao classificar crianças segundo a gordura corporal e apresentam vantagens como facilidade de obtenção e baixo custo.

Abstract This study aimed to investigate the relationship between anthropometric indicators - body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) - and the sum of skinfold thicknesses in 7-10-year-old children attending a public school in São Paulo (SP). Height, weight, WC and triceps, biceps, subscapular and suprailiac skinfolds were measured, and the sum of skinfold thicknesses, BMI and WHtR were calculated. A Bland-Altman analysis was used in order to compare methods, with values transformed into z-scores. The analysis of limits of agreement and confidence intervals showed evidence of good agreement, above all between BMI and WC, and the sum of skinfold thicknesses, complying with strict agreement limits and differences smaller than 1 standard deviation (SD). WHtR showed moderate limits of agreement, from -1.02 to + 0.64 SD (boys) and -0.74 to + 1.12 SD (girls); its performance was not better than that of WC alone, the lower and upper limits of agreement for which were -0.91 to + 0.58 SD (boys) and -0.56 to + 0.89 SD (girls). The results support the use of anthropometric indicators to classify nutritional status, above all BMI and WC, in that both are similar when classifying children according to body fatness, and confer the advantages of being easy to obtain and affordable.