ABSTRACT
OBJECTIVE: To investigate how body mass index (BMI) and waist circumference (WC) may be associated with insulin resistance and type 2 diabetes (T2DM) in Brazilian adolescents. METHODS: Cross-sectional study using data from the Brazilian Study of Cardiovascular Risks in Adolescents (ERICA) including adolescents aged 12-17 years. The relationship between adiposity and T2DM was investigated using ordinal logistic regression models. To study the association between adiposity categories and the occurrence of insulin resistance, linear regression models were used. RESULTS: The prevalence of T2DM for the same BMI category did not increase with the presence of high WC. Regarding insulin resistance, for the same BMI categories, having a high WC resulted in a higher prevalence of insulin resistance (HOMA-IR). The only groups significantly associated with prediabetes and T2DM were those with obesity by BMI with elevated WC (POR 1.68, 95 % CI 1.45; 1.94) and obesity with normal WC (POR 1.58, 95 % CI 1.01; 2.46). Similar findings were observed concerning insulin resistance, where the increased WC had its greatest effect when associated with obesity by BMI (ß Coefficient 2.20, 95 % CI 1.89; 2.50). CONCLUSION: The combination of BMI and WC is better for assessing adolescents at risk of developing T2DM.
ABSTRACT
The double burden of malnutrition (DBM) is a condition in which malnutrition coexists with overweight, reflecting a new layer of malnutrition. Our objectives were to assess prevalence; test associations between DBM and 24-hour movement behaviors; and investigate whether DBM is associated with clusters of social determinants. Methods: This multicenter cross-sectional study included 1152 adolescents (12 to 17 years old) from four Brazilian cities. Body mass index (BMI, kg/m2) was used to estimate overweight, and the adopted cutoff points took into account the curves established for age and sex: Z-score > 1 and ≤2 (overweight) and Z-score > 2 (obesity). The serum concentration of 25-hydroxyvitamin D [25(OH)D] was stratified into three levels: vitamin D deficiency ≤ 20 ng/mL; vitamin D insufficiency = 21-29 ng/mL; optimal vitamin D ≥ 30 ng/mL. We used multilevel Poisson regression models to estimate prevalence ratios (PRs) and their respective 95% confidence intervals (95%CI) and to analyze the association between DBM and covariates. A significance level of p < 0.05 was considered. Cluster analyses were performed by applying a combination of hierarchical and non-hierarchical methods. Results: A population prevalence of DBM of 7.3% (95% CI: 5.9-8.9) was revealed. A percentage of 19.2% (95% CI: 17.0-21.6) of adolescents were overweight, and 8.3% (95% CI: 6.8-10.1) were obese. A total of 41.5% (95% CI: 38.7-44.4) had vitamin D deficiency, and 25.8% (95% CI: 23.4-28.4) had vitamin D insufficiency. However, 24-hour movement behaviors were not associated with DBM. Adolescents living in the southern region of the country, from public schools whose mothers have higher education, have a 1.94 [PR = 2.94 (95% CI: 1.20-7.23)] times greater chance of developing DBM. These results highlight the importance of specific factors to improve the nutritional health of adolescents, considering the specific social determinants identified in this study.
ABSTRACT
OBJECTIVE: To investigate the independent and joint associations between sedentary behaviors (SB) and physical activity (PA) with inhibitory control (IC) in adults. METHODS: A total of 111 participants (median age = 30 years; 60% women), completed the Stroop Color-Words test to assess IC. They also wore accelerometers for seven days to measure SB, light PA, moderate-to-vigorous PA (MVPA), and daily steps. We previously set cutoff points for SB and PA measurements and tested them to determine their association with IC. All analyses were adjusted for potential confounding factors including age, gender, post-secondary education, income, body mass index, and accelerometer wear time. RESULTS: Low SB, high MVPA, and high daily steps were independently associated with a better IC compared to their respective counterparts. Adults with low levels of SB and light PA demonstrated better IC performance (ß = -227.67, 95%CI = -434.14 to -21.20) compared to those with high SB and low light PA. Conversely, individuals with high SB and high light PA exhibited worse performance (ß = 126.80, 95%CI = 2.11 to 251.50) than those in the high SB and low light PA group. Furthermore, the joint association of low SB with high MVPA (ß = -491.12, 95%CI = -689.23 to -293.01) or low SB with high daily steps (ß = -254.29, 95%CI = -416.41 to -92.16) demonstrated better IC performance compared to those with high SB and low MVPA or low daily steps. CONCLUSION: Our findings highlight independent and joint associations between low SB, high MVPA, and high daily steps with enhanced IC in adults.
Subject(s)
Accelerometry , Exercise , Inhibition, Psychological , Sedentary Behavior , Humans , Female , Male , Adult , Cross-Sectional Studies , Brazil , Young Adult , Middle Aged , Stroop TestABSTRACT
This study aims to describe the mean height of adolescents from the five regions of Brazil and to evaluate socioeconomic and nutritional factors associated with normal growth. This is a cross-sectional study conducted in the Brazilian urban and rural areas with students aged 12 to 17 years (n = 71,553). Anthropometry, socioeconomic variables, physical activity, and diet were evaluated. Height-for-age z-scores were calculated and multiple linear regression models were used to investigate the association of exposure variables with height (outcome) by sex and age (12-13, 14-15, and 16-17 years). We observed a lower mean height in adolescents from the North Region and in individuals with low socioeconomic status. At 17 years of age, the closest to the final height in this sample, mean heights for girls and boys were 160.9 ± 0.1cm and 173.7 ± 0.3cm, respectively. In multiple linear regression analysis, physical activity (girls β = 0.119, 95%CI: 0.035; 0.202; boys β = 0.092, 95%CI: 0.012; 0.172) and high level of maternal education (girls β = 0.103, 95%CI: 0.001; 0.204; boys β = 0.39, 95%CI: 0.245; 0.534) were positively associated with height-for-age z-score in 16- to 17-year-old boys and girls. Other factors positively associated with height-for-age z-score in older students include higher protein consumption (β = 0.022, 95%CI: 0.010; 0.035) and obesity (β = 0.217, 95%CI: 0.084; 0.350) for boys, and low weight (β = 0.205, 95%CI: 0.028, 0.382) for girls. We observed differences in the mean height among adolescents from the five Brazilian regions. Normal growth, especially among older adolescents, was associated with high maternal education, practice of physical activity, protein consumption, and body mass index (BMI) categories.
Buscou-se descrever a altura média dos adolescentes das cinco regiões do Brasil e avaliar os fatores socioeconômicos e nutricionais que estejam associados ao seu crescimento normal. Este é um estudo transversal realizado em ambientes urbanos e rurais no Brasil com estudantes de 12 a 17 anos (n = 71.553). Avaliamos antropometria, variáveis socioeconômicas, atividade física e dieta. Calculou-se os escores-z por idade e investigou-se a associação das variáveis de exposição com altura (desfecho) por sexo e idade (12-13, 14-15 e 16-17 anos) através de múltiplos modelos de regressão linear. Observou-se menor altura média em adolescentes da região Norte e em baixos níveis socioeconômicos. Aos 17 anos, o mais próximo da altura final nesta amostra, as alturas médias para meninas e meninos foram de 160,9 ± 0,1cm e 173,7 ± 0,3cm, respectivamente. Na análise de regressão linear múltipla, atividade física (meninas β = 0,119, IC95%: 0,035; 0,202; meninos β = 0,092, IC95%: 0,012; 0,172) e Ensino Médio materno (meninas β = 0,103, IC95%: 0,201; 0,204; meninos β = 0,39, IC95%: 0,245; 0,534) estiveram positivamente associados ao escore-z de altura por idade em meninos e meninas de 16-17 anos. Maior consumo de proteína (β = 0,022, IC95%: 0,010; 0,035) e obesidade (β = 0,217, IC95%: 0,084; 0,350) estiveram positivamente associados ao escore-z de altura para a idade meninos mais velhos, enquanto a variável associada às meninas foi baixo peso (β = 0,205, IC95%: 0,028; 0,382). Observou-se diferenças na altura média de adolescentes das cinco regiões brasileiras. O crescimento normal, especialmente entre adolescentes mais velhos, esteve associado à escolaridade materna, à prática de atividade física, ao consumo de proteínas e às categorias de índice de massa corporal (IMC).
Los objetivos fueron describir la estatura media de los adolescentes de las cinco regiones de Brasil y evaluar los factores socioeconómicos y nutricionales asociados al crecimiento normal. Estudio transversal realizado en entornos urbanos y rurales de Brasil con estudiantes de 12 a 17 años (n = 71.553). Se evaluaron la antropometría, las variables socioeconómicas, la actividad física y la dieta. Se calculó la puntuación Z de la altura para la edad y se utilizaron modelos de regresión lineal múltiple para investigar la asociación de las variables de exposición con la altura (resultado) por sexo y edad (12-13, 14-15 y 16-17 años). Se observó una estatura media más baja en los adolescentes de la región norte y en los de nivel socioeconómico bajo. A los 17 años, la edad más cercana a la estatura final en esta muestra, las estaturas medias de las chicas y los chicos eran de 160,9 ± 0,1cm y 173,7 ± 0,3cm, respectivamente. En el análisis de regresión lineal múltiple, la actividad física (chicas β = 0,119, IC95%: 0,035; 0,202; chicos β = 0,092, IC95%: 0,012; 0,172) y la madre con educación secundaria (chicas β = 0,103, IC95%: 0,001; 0,204; chicos β = 0,39, IC95%: 0,245; 0,534) se asociaron positivamente con la puntuación z de la altura para la edad en chicos y chicas de 16-17 años. En el caso de los chicos, el mayor consumo de proteínas (β = 0,022, IC95%: 0,010; 0,035) y la obesidad (β = 0,217, IC95%: 0,084; 0,350), mientras que, en el caso de las chicas, el bajo peso (β = 0,205, IC95%: 0,028; 0,382) también se asociaron positivamente con la puntuación z de la altura para la edad en los estudiantes mayores. Se observaron diferencias en la estatura media entre los adolescentes de las cinco regiones brasileñas. El crecimiento normal, especialmente entre los adolescentes de mayor edad, se asoció con la alta escolaridad de la madre, la práctica de actividad física, el consumo de proteínas y las categorías de índice de masa corporal (IMC).
Subject(s)
Humans , Male , Female , Adolescent , Aged , Cardiovascular Diseases/etiology , Cardiovascular Diseases/epidemiology , Socioeconomic Factors , Body Height , Brazil/epidemiology , Dietary Proteins , Body Mass Index , Cross-Sectional Studies , Risk Factors , Heart Disease Risk Factors , IncomeABSTRACT
ABSTRACT Objective: To evaluate the association between body weight perception and quality of diet among Brazilian adolescents. Methods: The sample was composed of 71,740 adolescents aged from 12 to 17 years-old enrolled in the Study of Cardiovascular Risks in Adolescents (Estudo de Riscos Cardiovasculares em Adolescentes - ERICA), carried out during 2013-2014. Body weight perception was self-reported. Food consumption was assessed by food record and quality of diet index for Brazilian adolescents (DQIA-BR) was calculated, considering the balance, diversity, and diet composition. The quality of diet was compared according to weight perception for the entire sample and after stratification by nutritional status. Linear regression models were used to assess the association between body weight perception and quality of diet. Results: Among the studied adolescents, 14.7 and 30.3% reported to be underweight or overweight in relation to their desired weight, respectively. Those who perceived themselves as overweight had lower quality of diet (DQIA-BR=16.0 vs. 17.4 points; p<0.001). After stratification by BMI, adolescents with normal weight (DQIA-BR=15.3 points) or overweight (DQIA-BR=16.1 points), but who perceived themselves as overweight showed lower quality of diet when compared to their peers. In adjusted analysis, overweight perception (β= -0.51; 95%CI -0.77; -0.24) was associated to lower quality of diet. However, this association was no longer significant after stratification by BMI status. Conclusions: Body weight perception can influence the consumption of healthy foods and the quality of diet, especially for those who consider themselves overweight. However, this association is influenced by nutritional status.
RESUMO Objetivo: Avaliar a associação entre percepção de peso corporal e qualidade da dieta de adolescentes brasileiros. Métodos: A amostra estudada foi composta de 71.740 adolescentes de 12-17 anos participantes do Estudo de Riscos Cardiovasculares em Adolescentes (ERICA) realizado entre 2013 e 2014. A percepção do peso corporal foi avaliada por questionário autoaplicável; o consumo alimentar, por recordatório alimentar; e a qualidade da dieta pelo índice de qualidade da dieta de adolescentes brasileiros (IQDA-BR), considerando o equilíbrio, a diversidade e a composição da dieta. A qualidade da dieta foi comparada de acordo com a percepção do peso para toda a amostra e após estratificação por índice de massa corpórea (IMC). Modelos de regressão linear foram utilizados para avaliar a associação entre distúrbios na percepção do peso e qualidade da dieta. Resultados: Entre os adolescentes, 14,7 e 30,3% percebiam-se abaixo ou acima do peso, respectivamente. Aqueles que se percebiam acima do peso apresentaram menor qualidade da dieta (IQDA-BR=16,0 vs. 17,4 pontos; p<0,001). Após estratificação por IMC, adolescentes com peso normal (IQDA-BR=15,3 pontos) ou excesso de peso (IQDA-BR=16,1 pontos), mas que se percebiam como acima do peso, apresentaram pior qualidade da dieta se comparados ao demais. Em análise ajustada, perceber-se acima do peso (β= -0,51; intervalo de confiança de 95% - IC95% -0,77; -0,24) foi associado a pior qualidade da dieta, porém essa associação perdeu significância após a estratificação por IMC. Conclusões: A percepção do peso corporal parece influenciar o consumo de alimentos saudáveis e a qualidade da dieta principalmente daqueles que se consideram acima do peso, contudo essa associação é influenciada pelo estado nutricional.
Subject(s)
Humans , Male , Female , Child , Adolescent , Weight Perception/physiology , Body Image/psychology , Diet/trends , Eating/psychology , Self Concept , Brazil/epidemiology , Body Mass Index , Linear Models , Nutritional Status/physiology , Cross-Sectional Studies , Diet/statistics & numerical data , Overweight , Self Report , Heart Disease Risk Factors , Nutritive ValueABSTRACT
Abstract Objectives The purpose of this study was to evaluate the agreement and risk factors for underestimation and overestimation between nutritional status and self-perceived body image and to assess the prevalence and associated factors for dissatisfaction with body weight among Brazilian adolescents. Methods Students aged 12-17 years participating in the Study of Cardiovascular Risk in Adolescents ("ERICA"), a multicenter, cross-sectional, school-based country-wide study, were included (n = 71,740). Variables assessed as covariates were sex, age, skin color, socioeconomic status, and common mental disorders (screened by the General Health Questionnaire, GHQ-12). Multinomial logistic regression was used to explore the association between covariates and combinations between self-perceived body image and body mass index (agreement, underestimation and overestimation). The associations between dissatisfaction with body weight and exposure variables were investigated using multivariable Poisson regression models. Results Approximately 66% students rightly matched their body mass index with self-perceived weight (kappa coefficient was 0.38 for boys and 0.35 for girls). Agreement was higher among younger students and adolescents from low income households. Male sex, older age, and GHQ-12 score ≥3 were associated with weight overestimation. Prevalence of dissatisfaction with body weight was 45.0% (95% CI: 44.0-46.0), and higher among girls, older adolescents, those with underweight or overweight/obesity, as well as those who were physically inactive and with GHQ-12 ≥3. Conclusions Most of the sample rightly self-perceived their body image according to body mass index. Students with body image misperception and those dissatisfied with their weight were more likely to present a positive screening for common mental disorders.
Resumo Objetivos A finalidade deste estudo foi avaliar a concordância e os fatores de risco para subestimação e superestimação entre o estado nutricional e a autoimagem corporal e para avaliar a prevalência e os fatores associados à insatisfação com o peso corporal entre adolescentes brasileiros. Métodos Foram incluídos estudantes entre 12 e 17 anos que participavam do Estudo de Riscos Cardiovasculares em Adolescentes ("ERICA"), um estudo multicêntrico, transversal, nacional e de base escolar (n = 71.740). As variáveis analisadas como covariáveis foram sexo, idade, cor da pele, situação socioeconômica e transtornos mentais comuns (triados pelo Questionário de Saúde Geral, QSG-12). A regressão logística multinomial foi usada para explorar a associação entre as covariáveis e as combinações entre a autoimagem corporal e o índice de massa corporal (concordância, subestimação e superestimação). As associações entre a insatisfação com o peso corporal e as variáveis de exposição foram investigadas com os modelos multivariáveis de regressão de Poisson. Resultados Aproximadamente 66% dos estudantes associaram corretamente seu índice de massa corporal com o peso autopercebido (o coeficiente kappa foi 0,38 para meninos e 0,35 para meninas). A concordância foi maior entre jovens e adolescentes de baixa renda. Sexo masculino, adolescentes mais velhos e um escore QSG 12 ≥ 3 foram associados à superestimação do peso. A prevalência de insatisfação com o peso corporal foi 45,0% (IC de 95%: 44,0-46,0), maior entre meninas, adolescentes mais velhos, aqueles abaixo do peso ou com sobrepeso/obesidade, fisicamente inativos e com QSG-12 ≥ 3. Conclusões A maior parte da amostra associou corretamente sua imagem corporal de acordo com o índice de massa corporal. Estudantes com distorção da autoimagem corporal e aqueles insatisfeitos com seu peso foram mais propensos a apresentar rastreamento positivo para transtornos mentais comuns.
Subject(s)
Humans , Male , Female , Child , Adolescent , Body Image , Nutritional Status , Self Concept , Body Weight , Brazil , Body Mass Index , Cross-Sectional StudiesABSTRACT
As doenças cardiovasculares são a principal causa de morte no Brasil. Os fatores de risco modificáveis dessas doenças podem ser observados desde a infância e sua persistência está associada ao diagnóstico precoce de morbidades. Neste contexto, a adolescência é considerada um período chave para estratégias de prevenção. Com objetivo de avaliar a prevalência de fatores de risco cardiovascular e seus fatores as-sociados foi planejado o Estudo de riscos cardiovasculares em adolescentes (ERICA), um inquérito multicêntrico de base escolar com abrangência nacional que envolveu mais de 70 mil adolescentes, entre 12 e 17 anos, de cidades brasileiras com mais de 100 mil habitantes. Os principais resultados do estudo apontaram prevalências preo-cupantes de sobrepeso/obesidade (25,5%, IC 95%: 24,4%-26,6%), pressão arterial elevada (9,6%, IC 95%: 8,9%-10,3%) e HDL-c baixo (47,3%, IC 95%: 45,2%-49,3%). A prevalência de síndrome metabólica foi de 2,6% (IC 95%: 2,3%-2,9%). Além disso, mais da metade dos adolescentes reportaram um estilo de vida sedentário. As estimativas regionais apontaram a região sul como a que tem maiores prevalências de fatores de risco. O ERICA foi um estudo pioneiro no Brasil e os adolescentes que participaram do estudo no Rio de Janeiro, Porto Alegre, Brasília e Fortaleza serão acompanhados em uma nova etapa. Os primeiros resultados do ERICA podem servir de referência para futuras pesquisas sobre riscos cardiovasculares entre adolescentes brasileiros, bem como subsidiar políticas públicas de saúde.
Cardiovascular disease is the leading cause of mortality in Brazil. Modifiable risk factors for this group of diseases can be observed since childhood, and their persisten-ce is associated with the early diagnosis of morbidities. In this context, adolescence is considered a key period for prevention strategies. In order to evaluate the prevalence of cardiovascular risk factors and their associated factors, the Study of Cardiovascular Risks in Adolescents ("ERICA") was planned. This is a multicenter school-based nationwide survey involving more than 70,000 adolescents aged between 12 and 17 years from Brazilian cities with more than 100 thousand inhabitants. The main results of the study indicated concerning prevalence of overweight/obesity (25.5%, 95% CI: 24.4%-26.6%), high blood pressure (9.6%, 95% CI: 8.9%-10.3%) and low HDL-c (47.3%, 95% CI: 45.2%-49.3%). The prevalence of metabolic syndrome was 2.6% (95% CI: 2.3%-2.9%). In addition, more than half of adolescents reported a sedentary lifestyle. Regional estimates pointed to the south as the region with the highest prevalence of risk factors. ERICA was a pioneering study in Brazil and the adolescents who participated in the study in Rio de Janeiro, Porto Alegre, Brasília and Fortaleza will be followed in a new stage. The first results of ERICA can both serve as a reference for future research on cardiovascular risks among Brazilian adolescents and support public health policies.
Subject(s)
Humans , Adolescent , Cardiovascular Diseases/complications , Cardiovascular Diseases/physiopathology , Cardiovascular Diseases/pathology , Metabolic Syndrome/diagnosis , Metabolic Syndrome/genetics , Sedentary Behavior/historyABSTRACT
Resumo Introdução Poucos estudos avaliaram a prevalência e os fatores associados a comportamentos de risco para doenças crônicas não transmissíveis (DCNT) em universitários de baixa renda no Brasil. Objetivo Investigar a prevalência simultânea de comportamentos de risco para DCNT (inatividade física, consumo infrequente de frutas e vegetais, consumo excessivo de álcool e tabagismo) nessa população. Método Estudo transversal, conduzido em 2013, com 766 estudantes residentes em moradia estudantil da Universidade Federal de Santa Maria, no Rio Grande do Sul, Brasil. A prevalência simultânea de comportamentos de risco foi avaliada a partir do somatório dos comportamentos avaliados. Regressão de Poisson foi utilizada para avaliar fatores associados com 3 ou mais comportamentos de risco simultaneamente. Resultados Observou-se que 1,8% dos estudantes não apresentou comportamentos de risco, enquanto 19,5%, 49,3%, 24,9% e 4,5% apresentaram um, dois, três ou quatro comportamentos de risco, respectivamente. Sexo masculino (RP = 1,35; IC95%: 1,08-1,69), excesso de peso no geral (RP = 1,37; IC95%: 1,08-1,73) e histórico de morbidade apenas nos homens (RP = 2,09; IC95%: 1,52-2,87) foram associados à simultaneidade de comportamentos de risco. A combinação envolvendo todos os fatores de risco teve prevalência acima do esperado (O/E = 1,76; IC95%: 1,24-2,50). Conclusão A prevalência simultânea de comportamentos de risco em universitários de baixa renda é elevada, conhecimento que pode auxiliar na formulação de programas de prevenção e intervenções.
Abstract Background Few studies have investigated the prevalence and correlates of risk factors for non-communicable diseases (NCDs) among low-income undergraduate students in Brazil. Objective To investigate the co-occurrence of the main behavioral risk factors for NCDs (physical inactivity, low fruit and vegetables intake, binge drinking and smoking) in this population. Method Cross-sectional study was carried out during 2013, with 766 undergraduate students living in student housing at the Universidade Federal de Santa Maria, RS, Brazil. The simultaneous prevalence of risk factors was evaluated by a score created from the sum of individual behaviors. Poisson regression was applied for evaluating the associated factors with ≥3 risk factors, simultaneously. Results It was observed that 1.8% of students show no risk factor, while 19.5%, 49.3%, 24.9% and 4.5% presented one, two, three and four risk factors, respectively. Male (PR=1.35; 95%CI: 1.08-1.69), overweight/obesity (PR=1.37; 95%CI: 1.08-1.73) and morbidity history (PR=2.09; 95%CI: 1.52-2.87), only in males, were associated with the co-occurrence of risk factors. The combination involving all four risk factors showed a higher prevalence than the expected (O/E=1.76: 95%CI: 1.24-2.50). Conclusion The simultaneous prevalence of risk factors in low-income college students was high, this finding that may help in the formulation of prevention programs and interventions.
ABSTRACT
ABSTRACT OBJECTIVE To evaluate the prevalence of leisure-time physical inactivity in Brazilian adolescents and their association with geographical and sociodemographic variables. METHODS The sample was composed by 74,589 adolescents participating in the Study of Cardiovascular Risks in Adolescents (ERICA). This cross-sectional study of school basis with national scope involved adolescents aged from 12 to 17 years in Brazilian cities with more than 100 thousand inhabitants. The prevalence of leisure-time physical inactivity was categorized according to the volume of weekly practice (< 300; 0 min). The prevalences were estimated for the total sample and by sex. Poisson regression models were used to assess associated factors. RESULTS The prevalence of leisure-time physical inactivity was 54.3% (95%CI 53.4-55.2), and higher for the female sex (70.7%, 95%CI 69.5-71.9) compared to the male (38.0%, 95%CI 36.7-39.4). More than a quarter of adolescents (26.5%, 95%CI 25.8-27.3) reported not practicing physical activity in the leisure time, a condition more prevalent for girls (39.8%, 95%CI 38.8-40.9) than boys (13.4%, 95%CI 12.4-14.4). For girls, the variables that were associated with physical inactivity were: reside in the Northeast (RP = 1.13, 95%CI 1.08-1.19), Southeast (RP = 1.16, 95%CI 1.11-1.22) and South (RP = 1.12, 95%CI 1.06-1.18); have 16-17 years (RP = 1.06, 95%CI 1.12-1.15); and belong to the lower economic class (RP = 1.33, 95%CI 1.20-1.48). The same factors, except reside in the Southeast and South, were also associated with not practicing physical activity in the leisure time for the same group. In males, as well as the region, being older (p < 0.001) and declaring to be indigenous (RP = 0.37, 95%CI 0.19-0.73) were also associated with not practicing physical activities in the leisure time. CONCLUSIONS The prevalence of leisure-time physical inactivity in Brazilian adolescents is high. It presents regional variations and is associated with age and low socioeconomic status. Special attention should be given to girls and to those who do not engage in any physical activity during the leisure time, so that they can adopt a more active lifestyle.
RESUMO OBJETIVO Avaliar a prevalência de inatividade física no lazer em adolescentes brasileiros e sua associação com variáveis geográficas e sociodemográficas. MÉTODOS A amostra foi composta por 74.589 adolescentes participantes do Estudo de Riscos Cardiovasculares em Adolescentes (ERICA). Esse estudo transversal de base escolar com abrangência nacional envolveu adolescentes brasileiros de 12 a 17 anos de municípios com mais de 100 mil habitantes. A prevalência de inatividade física no lazer foi categorizada de acordo com o volume de prática semanal (< 300; zero min). As prevalências foram estimadas para o total da amostra analisada e por sexo. Modelos de regressão de Poisson foram utilizados para avaliar fatores associados. RESULTADOS A prevalência de inatividade física no lazer foi de 54,3% (IC95% 53,4-55,2), superior no sexo feminino (70,7%, IC95% 69,5-71,9) comparado ao masculino (38,0%, IC95% 36,7-39,4). Mais de um quarto dos adolescentes (26,5%, IC95% 25,8-27,3) referiram não praticar atividade física no lazer, condição mais prevalente no sexo feminino (39,8%, IC95% 38,8-40,9) que no masculino (13,4%, IC95% 12,4-14,4). Para o sexo feminino, as variáveis que se associaram à inatividade física foram: residir nas regiões Nordeste (RP = 1,13, IC95% 1,08-1,19), Sudeste (RP = 1,16, IC95% 1,11-1,22) e Sul (RP = 1,12, IC95% 1,06-1,18); ter 16-17 anos (RP = 1,12, IC95% 1,06-1,15); e pertencer à classe econômica mais baixa (RP = 1,33, IC95% 1,20-1,48). Os mesmos fatores, exceto residir no Sudeste e Sul, também associaram-se com não praticar atividade física no lazer no mesmo grupo. No sexo masculino, além da região, ser mais velho (p < 0,001) e declarar-se indígena (RP = 0,37, IC95% 0,19-0,73) associaram-se à prevalência de não praticar atividade física no lazer. CONCLUSÕES A prevalência de inatividade física no lazer em adolescentes brasileiros é elevada, apresenta variações regionais e está associada à idade e ao baixo nível socioeconômico. Especial atenção deve ser dada às meninas e aos que não praticam nenhuma atividade física no lazer, a fim de que estes possam adotar estilo de vida mais ativo.
Subject(s)
Humans , Male , Female , Adolescent , Exercise , Surveys and Questionnaires , Sedentary Behavior , Leisure Activities , Socioeconomic Factors , Brazil/epidemiology , Spatial Analysis , Life StyleABSTRACT
A pressão arterial elevada (PAE) é o principal fator de risco para mortalidade no mundo, porém poucos adolescentes conhecem os valores de sua pressão arterial. Em jovens, o sobrepeso é o principal determinante para PAE. O objetivo deste estudo foi avaliar a capacidade de indicadores antropométricos de obesidade como preditores de PAE em adolescentes. Realizou-se um estudo transversal com 1.142 adolescentes, de ambos os sexos, 14-19 anos, da cidade de Santa Maria, RS. Foram verificados os seguintes indicadores antropométricos: índice de massa corporal (IMC), circunferência da cintura (CC), razão cintura-estatura (RCE) e índice de adiposidade corporal (IAC). A PAE foi identificada quando acima do percentil 95. Utilizou-se a análise das curvas Receiver Operating Characteristic (ROC) com intervalos de confiança de 95%, os pontos de corte com melhor acurácia foram identificados pelos valores de sensibilidade e especificidade. A prevalência de PAE foi de 23,6%, superior entre os rapazes (33,2%). Os maiores valores para área sob as curvas ROC foram: RCE (0,73; IC95%: 0,69-0,77) e IAC (0,71; IC95%: 0,67-0,75) para moças. Para os rapazes: IMC (0,64; IC95%: 0,60-0,68) e RCE (0,63; IC95%: 0,59-0,68). Os pontos de corte propostos para RCE (rapazes=0,44; moças=0,45) foram os que apresentaram maiores valores absolutos de sensibilidade e especificidade, ambos acima de 60%. Conclui-se que medidas antropométricas de adiposidade são válidas para identificação de PAE em adolescentes. Rapazes e moças com RCE ≥0,44 e ≥0,45, respectivamente, possuem alto risco de apresentar PAE.
High blood pressure (HBP) is the leading risk factor for mortality worldwide, but few adolescents know their blood pressure numbers. In youth, overweight is a key risk factor for HBP. The objective of this study was to evaluate the capability of anthropometric indicators of obesity as predictors of HBP in adolescents. We conducted a cross-sectional study with 1,142 adolescents, both sex, 14-19 years old, from Santa Maria, RS, Brazil. The following anthropometric indicators were analyzed: body mass index (BMI), waist circumference (WC), waist-height ratio (WHR), and body adiposity index (BAI). The HBP was identified when above the 95 percentile for blood pressure. We used the analysis of Receiver Operating Characteristic (ROC) curves with 95% confidence interval, cutoff points with better accuracy were identified by sensitivity and specificity values. The prevalence of HBP was 23.6%, and it was higher among boys (33.2%). The highest values for area under de ROC curves were: WHR (0.73; 95%CI: 0.69-0.77) and BAI (0.71; 95%CI: 0.67-0.75) for girls. For boys: BMI (0.64; 95%CI: 0.60-0.68) and WHR (0.63; 95%CI: 0.59-0.68). The cutoff points proposed for WHR (boys=0.44; girls=0.45) presented de highest sensitivity and specificity values, both above 60%. The results of this study support that anthropometric measures of adiposity are valid in the identification of HBP in adolescents. Boys and girls with WHR ≥0.44 and ≥0.45, respectively, are at high risk for HBP.
ABSTRACT
A obesidade é uma epidemia mundial e continua a aumentar entre crianças e adolescentes de diversos países. O estudo teve como objetivo verificar a prevalência e fatores associados ao sobrepeso/obesidade em adolescentes matriculados no 1º ano do ensino médio da cidade de Santa Maria-RS. Estudo transversal, de base escolar, realizado durante o segundo semestre letivo de 2008. Adolescentes de 14 a 18 anos responderam a um questionário e tiveram a massa corporal e a estatura mensuradas. As prevalências de sobrepeso e obesidade foram definidas de acordo com o referencial do índice de massa corporal para jovens brasileiros. Os fatores associados ao sobrepeso/obesidade foram determinados por regressão de Poisson. A amostra compreendeu 424 adolescentes (54,7% meninos), com média de idade de 15,7 anos (±0,89). A prevalência de sobrepeso/obesidade foi de 23,8% (IC95% 19,75-27,85). Estiveram associadas a esse desfecho, após ajuste para possíveis fatores de confusão, as variáveis: sexo masculino (RP=2,45; IC95% 1,63-3,68), ser dispensado das aulas de educação física (RP=2,73; IC95% 1,88-3,95) e ter uma boa relação com os colegas (RP=1,57; IC95% 1,12-2,19). Pode-se concluir que a prevalência de sobrepeso/obesidade na amostra estudada foi elevada, alertando para a necessidade de programas de prevenção ao excesso de peso nessa faixa etária.
Obesity is a worldwide epidemic that keeps on rising among children and adolescents from several countries. The purpose of this study was to verify the prevalence of overweight/obesity and its correlates in adolescents enrolled in the 1st year of high school in the municipality of Santa Maria, state of Rio Grande do Sul, Brazil. A cross-sectional, school-based, study was performed during the second semester of 2008. Adolescents aged 14 to 18 years old responded to a questionnaire and had their body mass and stature measured. The prevalence of overweight and obesity was defined according to the Brazilian reference for body mass index in adolescents. Correlates of overweight/obesity were determined by Poisson regression. The sample included 424 adolescents (54.7% boys) with mean age of 15.7 years (±0.89). The prevalence of overweight/obesity was 23.8% (95%CI; 19.75-27.85). After adjusting for potential confounding factors, the following variables were associated with overweight/obesity: sex (PR=2.45; 95%CI 1.63-3.68), having been dismissed from physical education classes (PR=2.73; 95%CI 1.88-3.95) and having a good relationship with classmates (PR=1.57; 95%CI 1.12-2.19). It was concluded that the prevalence of overweight/obesity in this sample was high, prompting the need for preventive programs of excessive weight in this age group.