Body fat percentage, cardiorespiratory fitness and arterial blood pressure in children and adolescents: a longitudinal analysis.

BACKGROUND: A better understanding of how cardiorespiratory fitness (CRF) and adiposity interact to associate with arterial blood pressure over time remains inconclusive. Thus, the aim of the present study was to examine whether changes in CRF moderates the association between body fat percentage (BF%) and arterial blood pressure in children and adolescents. METHODS: This is an observational longitudinal study with 407 children and adolescents aged 8-17 years followed-up for three years from a city in Southern Brazil. Participants were evaluated in 2011 and 2014. CRF was measured by validated field-based tests following the Projeto Esporte Brazil protocols and peak oxygen uptake (VO2peak) was estimated. BF% was determined by the measures of tricipital and subscapular skinfolds using equations according to sex. Systolic and diastolic blood pressure (SBP, DBP) were measured with a sphygmomanometer according to standard procedures. Moderation analyses included multiple linear regression models adjusted for sex, age, pubertal status, height, socioeconomic level, skin color, and the arterial blood pressure variable itself at baseline. RESULTS: It was observed a significant inverse association between VO2peak at baseline with SBP (ß = - 0.646 CI95% = - 0.976 - 0.316) and DBP (ß = - 0.649 CI95% = - 0.923 - 0.375) at follow-up and a positive association between BF% at baseline with SBP (ß = 0.274; CI95% = 0.094 0.455) and DBP (ß = 0.301; CI95% = 0.150 0.453) at follow-up. In addition, results indicated a significant interaction term between changes in VO2peak and BF% at baseline with both SBP (p = 0.034) and DBP at follow-up (p = 0.011), indicating that an increase of at least 0.35 mL/kg/min and 1.78 mL/kg/min in VO2peak attenuated the positive relationship between BF% with SBP and DBP. CONCLUSION: CRF moderates the relationship between BF% and SBP and DBP in children and adolescents.

Relationship between rs9939609 FTO polymorphism with waist circumference and body fat is moderated by ponderal index at birth in youth.

OBJECTIVE: The goal of this study was to analyze whether the relationship between the rs9939609 polymorphism of the fat mass and obesity-associated gene (FTO) with nutritional status is moderated by the ponderal index (PI) at birth in children and adolescents. METHODS: A cross-sectional study evaluated 382 schoolchildren aged 6-17 years. Anthropometric variables such as waist circumference (WC), body mass index (BMI) and body fat percentage (BF%) were used to assess nutritional status. Weight and height at birth were used for the PI calculation, which was divided into tertiles (lower, middle and upper). To compare the continuous variables between genotypes of the rs9939609 polymorphism, a recessive model (TT/AT vs. AA) and covariance analysis (ANCOVA) were used. RESULTS: The AA genotype of the rs9939609 polymorphism was associated with higher WC in schoolchildren born with lower PI (ß = 4.40; p = .048). However, for BF%, the genotype association was found in the upper PI tertile (ß = 7.35; p = .040). CONCLUSION: The relationship between WC and BF% with rs9939609 polymorphism (FTO) seems to be moderated by PI at birth. This is an important insight, since the data for intrauterine growth, genetic factors and the presence of obesity in children and adolescents are still contradictory.

Metabolic risk is associated with sociodemographic characteristics in adolescents from both rural and urban regions from southern Brazil.

BACKGROUND: The prevalence of several cardiovascular metabolic disorders are increasingly cause for concern in adolescents worldwide. Given the complex interrelations between metabolic risk (MR) and sociodemographic variables, the present study aims to examine the association between the presence of MR with sociodemographic characteristics (sex, skin color, residential area, and parental socioeconomic status) in adolescents from Southern Brazil. METHODS: Cross-sectional study conducted with 1,152 adolescents (507 males) aged between 12 and 17 years. MR was assessed using a continuous score (cMetS; sum of Z-scores of the following variables: waist circumference, systolic blood pressure (SBP), glucose, high-density lipoprotein cholesterol [HDL-C, inverse], triglycerides [TG], and estimated cardiorespiratory fitness [CRF, inverse]). Poisson regression was used to examine associations between sociodemographic variables with the dichotomized cMetS and separate metabolic variables. The results were expressed with prevalence ratios (PR) and 95% confidence intervals (CI). RESULTS: The presence of MR (evaluated by the cMetS) was observed in 8.7% of adolescents. Higher MR was less prevalent among non-white adolescents (PR: 0.96; 95% CI: 0.93; 0.99). Adolescents living in rural areas had a lower prevalence of the following metabolic variables; low HDL-C (PR: 0.95; 95% CI: 0.94; 0.97), elevated TG (PR: 0.95; 95% CI: 0.92; 0.99), elevated glucose (PR: 0.96; 95% CI: 0.95; 0.98), and low CRF levels (PR: 0.88; 95% CI: 0.85; 0.92). Whereas, SBP was higher in those living in rural areas (PR: 1.11; 95% CI: 1.05; 1.17). In girls, there was a higher prevalence of raised TG (PR: 1.06; 95% CI: 1.02; 1.10) and lower levels of CRF (PR: 1.20; 95% CI: 1.16; 1.24), but a lower prevalence of elevated glucose (PR: 0.97; 95% CI: 0.97; 0.99). CONCLUSION: Higher MR prevalence was lower in those self-reporting non-white skin color and selected MR factors were less prevalent in those living in rural areas. The identification of groups at higher MR is important for early prevention and monitoring strategies for both Type 2 diabetes and later cardiovascular disease. Future studies should be conducted to assess the socio-cultural aspects of the relationships between MR and socio-cultural and lifestyle variables.

Integrated role of lifestyle habits in cardiometabolic risk factors according to sex in adolescents.

BACKGROUND: A healthy lifestyle should be adopted by young people to maintain cardiometabolic health. AIM: To verify the prevalence and the integrated role of lifestyle habits in cardiometabolic risk factors according to sex in adolescents. SUBJECTS AND METHODS: Cross-sectional study developed with 1502 adolescents, aged 10-17 years. Lifestyle habits included physical activity, screen time and sleep duration evaluated through a questionnaire. Cardiometabolic risk score (CMRS) was calculated by summing z-scores, divided by 6. For statistical analyses, multivariable binary and multinomial logistic regression models were used. RESULTS: 80.7% of the boys classified with adverse CMRS presented physical inactivity, compared to normal CMRS. In girls, 42.6% showed inadequate sleep compared to normal CMRS. Boys classified as inactive showed higher odds for obesity, as well as altered triglycerides (TGs), and systolic blood pressure, risk for cardiorespiratory fitness (CRF), high waist circumference, and CMRS, compared to the active. A prolonged screen time increased the odds for altered glucose and decreased the odds for altered TGs. In girls, inadequate sleep duration presented higher odds for overweight, obesity, risk for CRF, and high CMRS, compared to adequate sleep. CONCLUSION: Physical activity for boys and sleep duration for girls are important to maintain healthy metabolic health amongst youth.

Child's body mass index and mother's obesity: the moderating role of physical fitness.

The aim of this study was to verify the association between children's body mass index and their mother's obesity, considering children's physical fitness as a possible moderator. Cross-sectional study developed with 1842 children and adolescents, aged seven to 17 years, from Santa Cruz do Sul-RS, Brazil. Body weight and height were assessed to determine body mass index. Cardiorespiratory fitness was determined by the 6-min walk/run test and muscular strength through the lower limb strength test. Mother's perception of obesity was self-assessed. Moderation was tested through a SPSS program extension. Results indicated that higher children's body mass index (p < 0.001) and lower levels of cardiorespiratory fitness (p = 0.001) and muscular strength (p = 0.035) were associated with mother's obesity. Likewise, higher body mass index (p < 0.001) and lower cardiorespiratory fitness (p < 0.001) in adolescents were associated with maternal obesity. Moreover, physical fitness moderates the relationship between body mass index and mother's obesity in children (cardiorespiratory fitness: ß = - 0.006; 95% CI = (- 0.010, - 0.001); muscular strength: ß = - 8.415; 95% CI = (- 12.526, - 4.304)) and in adolescents (cardiorespiratory fitness: ß = - 0.004; 95% CI = (- 0.008, - 0.0008); muscular strength: ß - 2.958; 95% CI = (- 5.615, - 0.030)).Conclusion: increasing physical fitness is an important strategy to protect youths from high body mass index, when their mothers are obese. What is Known: • Mother's obesity is associated with their children's body mass index. • Parents' obesity is associated with their children's physical fitness What is New: • Cardiorespiratory fitness and muscular strength are moderators in the relationship between mother's obesity and BMI of their children. • Children and adolescents with high cardiorespiratory fitness and muscular strength levels are protected against elevated body mass index, considering mother's obesity.

Reciprocal Longitudinal Relationship Between Fitness, Fatness, and Metabolic Syndrome in Brazilian Children and Adolescents: A 3-Year Longitudinal Study.

PURPOSE: To verify the reciprocal longitudinal relationships between cardiorespiratory fitness (CRF), percentage body fat (%body fat), and metabolic syndrome in Brazilian primary school students. METHOD: This longitudinal study involved 420 children and adolescents followed for 3 years (2011-2014). The continuous Metabolic Syndrome (cMetSyn) score was calculated by summing adjusted z scores of glucose, systolic blood pressure, total cholesterol/high-density lipoprotein cholesterol ratio, triglycerides, and waist circumference. The CRF was assessed using running/walking tests, and %body fat was assessed through sex-specific 2-site skinfold thickness. Cross-lagged panel models were used to analyze longitudinal reciprocal relationships between CRF and %body fat with cMetSyn. RESULTS: Results indicated that 2011 %body fat significantly predicted both 2014 CRF scores and 2014 cMetSyn scores (P < .001); however, 2011 CRF only predicted 2014 %body fat (P < .001) but not 2014 cMetSyn (P = .103). Furthermore, 2011 cMetSyn predicted 2014 %body fat (P = .002). The model explained 36%, 48%, and 37% of the variance in 2014 CRF, %body fat, and cMetSyn, respectively. CONCLUSION: The results suggest a reciprocal inverse relationship between %body fat and metabolic syndrome risk and that %body fat may play a more important role in the risk of developing metabolic syndrome compared with CRF.

Relationship between sleep duration and TV time with cardiometabolic risk in adolescents.

OBJECTIVE: To verify the association between sleep duration and television time with cardiometabolic risk and the moderating role of age, gender, and skin color/ethnicity in this relationship among adolescents. METHODS: Cross-sectional study with 1411 adolescents (800 girls) aged 10 to 17 years. Television time, sleep duration, age, gender, and skin color/ethnicity were obtained by self-reported questionnaire. Cardiometabolic risk was evaluated using the continuous metabolic risk score, by the sum of the standard z-score values for each risk factor: high-density lipoprotein cholesterol, triglycerides, glycemia, cardiorespiratory fitness, systolic blood pressure, and waist circumference. Generalized linear regression models were used. RESULTS: There was an association between television time and cardiometabolic risk (ß, 0.002; 95% CI, 0.001; 0.003). Short sleep duration (ß, 0.422; 95% CI, 0.012; 0.833) was positively associated with cardiometabolic risk. Additionally, age moderated the relationship between television time and cardiometabolic risk (ß, - 0.009; 95% CI, - 0.002; - 0.001), suggesting that this relationship was stronger at ages 11 and 13 years (ß, 0.004; 95% CI, 0.001; 0.006) compared to 13 to 15 years (ß, 0.002; 95% CI, 0.001; 0.004). No association was found in older adolescents (ß, 0.001; 95% CI, - 0.002; 0.002). CONCLUSIONS: Television time and sleep duration are associated with cardiometabolic risk; adolescents with short sleep have higher cardiometabolic risk. In addition, age plays a moderating role in the relationship between TV time and cardiometabolic risk, indicating that in younger adolescents the relationship is stronger compared to older ones.

Cutoff points for continuous metabolic risk score in adolescents from southern Brazil.

OBJECTIVE: There is no consensus on the best diagnostic criteria for metabolic syndrome (MetS) in the child and adolescent population. Thus, the present study aimed to establish cutoff points for a continuous metabolic risk score (cMetS) in adolescents from southern Brazil. METHODS: This was a cross-sectional study conducted between 2014 and 2015. The sample consisted of 1739 schoolchildren (985 girls), aged 10-17 years. cMetS was calculated by sum of the Z-score of the following parameters: waist circumference, systolic blood pressure, glucose, high-density lipoprotein cholesterol, triglycerides, and cardiorespiratory fitness. Three diagnostic criteria of MetS were used to create cut points for cMetS. RESULTS: The best cutoff point for cMetS was set at 3.40 for boys (sensitivity: 100.0%, specificity: 92.9%, AUC: 0.978) and 3.61 for girls (sensitivity: 100, 0%, specificity: 93.1%, AUC: 0.991). For these cutoff points, metabolic risk was found in 8.9% of adolescents (9.4% for boys and 8.5% for girls). A linear relationship was found between the mean values of cMetS and the number of components of MetS (mean cMetS -1.09 for no component present and 6.66 for 3 or more components). CONCLUSIONS: The use of cMetS is valid for adolescents and can detect a greater proportion of students with metabolic risk, compared to the current criteria for diagnosis of MetS.

Comparison between different criteria for metabolic syndrome in schoolchildren from southern Brazil.

The metabolic syndrome (MetS), although more frequent in adults, is already evident in the infant-juvenile population. On the other hand, there are different criteria for the diagnosis, without a consensus of which is the best to be used in this population. The aim of this study was to evaluate the agreement between different criteria for diagnosis of MetS in adolescents from southern Brazil. A cross-sectional study consisting of a sample of 1200 subjects, 679 females, aged between 12 and 17 years. MetS was assessed by three different criteria: Cook (2003), Ferranti (2004), and International Diabetes Federation - IDF (2007). The agreement between the criteria was evaluated by the Kappa index. Low prevalence of MetS was found among schoolchildren (1.9% for Cook, 5.0% for Ferranti, and 2.1% for IDF). Regular (Ferranti - IDF: Kappa 0.382; p < 0.001) and moderate (Cook - Ferranti: Kappa 0.542; p < 0.001; Cook - IDF: Kappa 0.532; p < 0.001) agreement was demonstrated between the criteria. Elevated blood pressure was the most frequent condition in all the criteria, and the least frequent condition was in the glycemia (Cook and Ferranti) and high-density lipoprotein cholesterol levels. CONCLUSION: The low prevalence of MetS and the low agreement among the existing criteria suggest the elaboration of new criteria for the diagnosis of MetS in the child and adolescent population. What is Known: • There are different criteria for the diagnosis of the metabolic syndrome (MetS), without a consensus of which is the best to be used in the infant-juvenile population. What is New: • Low prevalence of MetS identified among schoolchildren and the low agreement among the existing criteria suggest the elaboration of new criteria for the diagnosis of MetS in the child and adolescent population.

A nationwide survey of Antimicrobial Stewardship in Pediatric Intensive Care Unit: implementation notes from the Brazilian underground.

A multicenter diagnostic study was conducted to investigate the implementation of an Antimicrobial Stewardship Program in Brazilian Pediatric Intensive Care Units. The analysis unveiled the main implementation impediments of the Antimicrobial Stewardship Program such as the lack of professionals and resources available to the program.

Incidence of Arterial Hypertension is Associated with Adiposity in Children and Adolescents. / Incidência de Hipertensão Arterial está Associada com Adiposidade em Crianças e Adolescentes.

BACKGROUND: The increase of hypertension in children and adolescents has attracted the attention of the scientific community largely due to its association with the obesity epidemic. OBJECTIVES: To describe the incidence of hypertension and its relationship with the cardiometabolic and genetic profile in children and adolescents from a city in southern Brazil in a three-year period. METHODS: This longitudinal study followed 469 children and adolescents, aged 7-17 years old (43.1% boys), assessed at two-time points. We evaluated systolic and diastolic blood pressures (SBP and DBP), waist circumference (WC), body mass index (BMI), body fat percentage (%BF), lipid profile, glucose, cardiorespiratory fitness (CRF), and rs9939609 Polymorphism ( FTO ). Cumulative incidence of hypertension was calculated, and multinomial logistic regression was conducted. The statistical significance was established as p < 0.05. RESULTS: After three years, the incidence of hypertension was 11.5%. Overweight or obese individuals were more likely to become borderline hypertensive (overweight OR: 3.22, 95% CI: 1.08-9.55; obesity OR: 4.05, 95% CI: 1.68-9.75), and obese individuals were more likely to become hypertensive (obesity OR: 4.84, 95% CI: 1.57-14.95). High-risk WC and %BF values were associated with hypertension development (OR: 3.41, 95% CI: 1.26-9.19; OR: 2.49, 95% CI: 1.08-5.75, respectively). CONCLUSIONS: We found a higher incidence of hypertension in children and adolescents as compared with previous studies. Individuals with higher values of BMI, WC and %BF at baseline were more likely to develop hypertension, suggesting the importance of adiposity in the development of hypertension even in such a young population.

FUNDAMENTO: O aumento de hipertensão em crianças e adolescentes tem atraído a atenção da comunidade científica, especialmente por sua associação com a epidemia da obesidade. OBJETIVOS: Descrever a incidência de hipertensão e sua relação com o perfil cardiometabólico e genético em crianças e adolescentes de uma cidade do sul do Brasil em um período de três anos. MÉTODOS: Este estudo longitudinal acompanhou 469 crianças e adolescentes com idade entre 7 e 17 anos (43,1% do sexo masculino), avaliados em dois momentos. Avaliamos pressão arterial sistólica (PAS), pressão arterial diastólica (PAD), circunferência da cintura (CC), índice de massa corporal (IMC), porcentagem de gordura corporal (%GC), perfil lipídico, glicemia, aptidão cardiorrespiratória (APCR), e polimorfismo rs9939609 (gene FTO ) ( fat mass and obesity - associated gene ). A incidência cumulativa da hipertensão foi calculada, e realizada regressão logística multinominal. A diferença estatística foi estabelecida em p<0,05. RESULTADOS: Após três anos, a incidência de hipertensão foi de 11,5%. Indivíduos com sobrepeso e indivíduos obesos apresentaram maior probabilidade de se tornarem indivíduos classificados como borderline para hipertensão (sobrepeso OR: 3,22; IC95%: 1,08-9,55; obesidade OR: 4,05; IC95%: 1,68-9,75), e indivíduos obesos apresentaram maior probabilidade de se tornarem hipertensos (obesidade OR: 4,84; IC95%: 1,57-14,95). Valores de CC e de %GC considerados de alto risco foram associados com o desenvolvimento de hipertensão (OR: 3,41; IC95%: 126-9,19; OR: 2,49, IC95%: 1,08-5,75, respectivamente). CONCLUSÃO: Encontramos uma incidência de hipertensão em crianças e adolescentes mais alta em comparação a estudos anteriores. Indivíduos com valores mais altos de IMC, CC e %GC no baseline apresentaram maior probabilidade de desenvolverem hipertensão, sugerindo a importância da adiposidade no desenvolvimento de hipertensão, mesmo em uma população tão jovem.

The triglyceride-glucose index as an indicator of insulin resistance and cardiometabolic risk in Brazilian adolescents.

Objective: To set cutoff points for the triglyceride and glucose index (TyG) as a marker of insulin resistance (IR) for the pediatric population. Subjects and methods: This was a cross-sectional study with schoolchildren population-based data using data of 377 schoolchildren age 10 to 17 years of both sexes. We studied metabolic variables associated with IR indicators, such as fasting insulin and blood glucose, to calculate the homeostatic model assessment (HOMA-IR), and we studied triglycerides (TG) to determine the TyG index. We obtained TyG cutoff values for IR using the receiver operation characteristic (ROC), with definitions of sensitivity (Sen), specificity (Spe), and area under the ROC curve (AUC), with the HOMA-IR as reference. Results: The cutoff points of the TyG index for IR in adolescents are 7.94 for both sexes, 7.91 for boys, and 7.94 for girls, indicating moderate discriminatory power. When we also considered anthropometric variables of excess weight [TyG-BMI (body mass index)] and visceral fat [TyG-WC (waist circumference)], these indexes reached AUC values higher than 0.72, enhancing their potential use for a good diagnosis. Conclusion: TyG has proven to be a useful instrument for identifying IR in adolescent health screening, with high discrimination capacity when added to anthropometric variables, making it a feasible and inexpensive option.

The stability of cardiometabolic risk factors clustering in children and adolescents: a 2-year longitudinal study.

Objective: The present study aims to verify the odds of remaining with the clustering of 3 or more, 4 or more, and 5 or more risk factors across a 2-year time span. Methods: Observational longitudinal study that included 358 children and adolescents (10.96 ± 2.28 years of age at baseline). Cardiorespiratory fitness, glucose, systolic blood pressure, total cholesterol/high-density lipoprotein cholesterol ratio, triglycerides, and waist circumference were assessed. The number of children in whom the risk factors were not independently distributed was analyzed. Odds ratios of presenting n risk factors clustered at follow-up according to the number of risk factors observed at baseline were calculated. Results: More participants than expected were found presenting clustering of 4 or more and 5 or more risk factors at both baseline (11.7% and 5.6%, respectively) and follow-up (9.5% and 5.6%, respectively). The odds ratios calculated demonstrated that the odds of presenting the same number of risk factors clustered or more at follow-up increased according to the number of risk factors clustered at baseline. Conclusion: The higher the number of risk factors a child had at baseline, the higher the odds of presenting the same number of risk factors or more after two years of follow-up. Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-022-01174-1.

Profile of tobacco growers with green tobacco sickness in Southern Brazil.

Introduction: Green tobacco sickness affects tobacco growers while handling tobacco leaves, regardless of the cultivation stage. Objectives: To characterize the sociodemographic and occupational profiles of tobacco growers with green tobacco sickness, as well as their health habits. Methods: This was a cross-sectional, descriptive study with information from a database obtained from a previous study conducted in a Southern Brazilian municipality. The data were analyzed using absolute and relative frequency. Results: We identified 8 cases of tobacco growers with green tobacco sickness, whose sociodemographic and occupational profiles and health habits were described. Conclusions: The data obtained in this study corroborate the existing literature on tobacco growers. The sociodemographic and occupational profiles and the health habits of our study participants have already been described in other studies, as well as of tobacco growers without green tobacco sickness.

Micronuclei frequency and renal function markers in gym members: The moderating role of supplement intake.

This research investigates the moderating role of dietary supplement intake in the relationship between MNi frequency and renal markers in gym members. A cross-sectional study was carried out with gym members of all sexes, between 20 and 59 years of age, with data on supplement use obtained via questionnaire. Renal markers (urea and creatinine) were assessed by blood collection. Buccal mucosa cells were collected to assess MNi frequency by buccal micronucleus cytome assay. Moderation was tested using multiple linear regression models by PROCESS macro for SPSS. Results showed significant interactions for supplement use (p = 0.001) and supplement type, ergogenic (p = 0.003) and sports food (p = 0.003), with MNi for urea. For creatinine, only supplement use showed interaction with MNi frequency (p = 0.048). In conclusion, supplement intake is a moderator in the relationship between MNi frequency and renal function markers in gym members.

From pregnancy to breastfeeding: adequate maternal body mass index is essential to prevent a high body mass index in your children.

OBJECTIVES: To verify the associations between prenatal and perinatal factors with offspring body mass index (BMI) and the moderator role of maternal BMI in this relationship. METHODS: Cross-sectional study developed with 1,562 children and adolescents aged between 6 and 17 years, as well as their mothers, from southern Brazil. The prenatal and perinatal factors, weight, and height for the calculation of maternal BMI were self-reported. For the calculation of BMI, weight and height of the child/adolescent were measured on an anthropometric scale with a coupled stadiometer. Linear regression models were used for the moderation analysis. All analyzes were adjusted for the mother's and child's age, sex, sexual maturation, skin color/race, and educational level. RESULTS: cesarean as type of delivery (ß=0.66; 95% CI=0.22 1.04; p=0.002) and pregnancy complications (ß=0.60; 95% CI=0.15 1.04; p=0.002) were positively associated with offspring BMI. Schoolchildren who were breastfed for 4-6 months showed -0.56 kg/m2 of BMI (95% CI=-1.06-0.06; p=0.02). Birth weight was also associated with BMI, with low weight being inversely (ß=-0.59; 95% CI=-1.03-0.15; p=0.008), while overweight was positively related (ß=0.84; 95% CI=0.08 1.60; p=0.02). The moderation analysis indicated a positive interaction between the mother's BMI and cesarean, pregnancy complications, and smoking with the offspring's BMI. On the other hand, there was an inverse association between breastfeeding from 7 to 12 months and the offspring BMI, only in mothers with high BMI. CONCLUSIONS: Adequate maternal BMI is essential to prevent a high BMI in their children, especially when considering the influence of prenatal and perinatal risk factors.

Spatial distribution and incidence of HIV/AIDS cases in Santa Cruz do Sul, state of Rio Grande do Sul, 2001 to 2020. / Distribuição espacial e incidência de casos de HIV/aids em Santa Cruz do Sul, Rio Grande do Sul, 2001 a 2020.

OBJECTIVE: to describe the spatial distribution, treatment status and characteristics of cases of people infected with the human immunodeficiency virus HIV in Santa Cruz do Sul, RS, 2001 to 2020. METHODS: descriptive study with data from individuals undergoing treatment for HIV/AIDS, in Santa Cruz do Sul, diagnosed from January 2001 to October 2020. RESULTS: 708 (94.4%) cases were analyzed, of these (58.2%) were male, with a mean age of 39 years, the maximum incidence rate was in 2019 (59.4/100,000 inhabitants), there was a high frequency of cases in the south and central region of the city, 92.9% of these individuals were still in active treatment and the dropout rate was 7.1% in the period. CONCLUSION: a higher incidence of HIV was observed in adult male, from the central and southern regions of the city, with a treatment rate close to the goals of the World Health Organization and a low dropout rate.

Cardiometabolic risk factors in children and adolescents from southern Brazil: comparison to international reference values.

OBJECTIVES: To compare cardiometabolic risk factors of Brazilian children and adolescents with international reference values. Cardiometabolic risk factors constitute the Metabolic Syndrome, whose evaluation is important to assess pediatric populations' health and potential to experience metabolic disorders. METHODS: Cross-sectional study that included 2,250 randomly selected children and adolescents (55.6% girls), aged 6 to 17. Cardiometabolic parameters (body mass index [BMI], waist circumference [WC], systolic and diastolic blood pressures [SBP and DBP], total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], TC:HDL-C ratio, triglycerides [TG], glucose and peak oxygen uptake [VO2peak]), and clustered risk scores were compared to international age- and sex-specific reference values. A clustered risk score was calculated by summing the WC, glucose, SBP, TG, and the TC:HDL-C ratio Z-scores divided by five. A second clustered was calculated including VO2peak (inverted) Z-score, but divided by six. RESULTS: The clustered risk score, considering the all ages sample, was better in the Brazilian boys (-0.20 [-0.41;0.01] and -0.18 [-0.37;0.01], including or not VO2peak, respectively) but not significantly, and worse in girls (0.24 [0.05;0.43] and 0.28 [0.11;0.44], including or not VO2peak, respectively) than the international reference. Additionally, Brazilian youth had a statistically better profile in TC, LDL-C, HDL-C, TC:HDL-C ratio, and VO2peak (only girls) as well as a worse profile in BMI, WC, SBP, DBP, TG (only girls), and VO2peak (only boys). CONCLUSIONS: The clustered cardiometabolic risk score (including or not VO2peak), considering the all ages sample, was better in the Brazilian boys, but not significantly, and worse in girls compared to the international reference.

BMI Fails to Reflect the Developmental Changes in Body Fatness between Boys and Girls during Adolescence.

Body mass index (BMI) is thought to reflect excess adiposity in both youth and adults alike. However, the association between BMI and fatness varies, especially as children grow into adults. Thus, the present study sought to address this issue by characterizing how BMI reflects age and sex differences in body fatness in 7-16-year-old children. METHODS: This cross-sectional study was conducted with 2150 children and adolescents, aged 7 to 16 years from the city of Santa Cruz do Sul, Brazil. BMI (kg/m2), and percentage body fat, using tricipital and subscapular folds, were assessed. For statistical analysis, ANOVA and ANCOVA were used. RESULTS: When considered in isolation, there was no significant interaction in the age-by-sex differences in BMI (p = 0.69). However, when we controlled for percent body fatness, the analysis revealed considerable age-by-sex differences in BMI (p < 0.001). CONCLUSION: For the same body fat (%), there are no differences in BMI in children <10 years.

A Multicomponent Intervention Program With Overweight and Obese Adolescents Improves Body Composition and Cardiorespiratory Fitness, but Not Insulin Biomarkers.

Objective: To verify the effect of a multicomponent intervention with overweight/obese adolescents on physical fitness, body composition, and insulin biomarkers. Methods: A quasi-experimental study with 37 adolescents, aged 10 to 17 years, of both sexes, overweight and obese, allocated in two groups (Intervention-IG Group, n = 17; Control-GC Group, n = 20). The IGs were submitted to a multicomponent intervention for 6 months (three weekly sessions) consisting of physical exercises (sports, functional circuit, recreational, and water activities) and nutritional and psychological guidance. Participants were assessed before and after intervention on body composition [body mass index (BMI), body fat, waist circumference, and waist-to-hip ratio (WHR)], physical fitness [cardiorespiratory fitness (CRF) and abdominal strength], and biomarkers of insulin (glucose, insulin, evaluation of the homeostasis model of insulin, and resistin resistance). The prevalence of responders in both groups was obtained according to the theoretical model applied in previous studies similar to this one to determine the cutoff points for response to intervention. Poisson regression was used to verify the difference in the prevalence ratio (PR) of the interviewees between the groups. Results: The responders' prevalence between groups CG and IG showed significant differences for body fat (CG = 30.0%; IG = 70.6%; PR = 1.396; p < 0.001), WHR (CG = 30.0%; IG = 76.5%; PR = 1.730; p < 0.001), and CRF (CG = 15.0%; IG = 52.5%; PR = 1.580; p < 0.001). Conclusions: A 6-month multicomponent intervention program improved certain body composition parameters and the CRF of overweight and obese adolescents but did not improve insulin biomarkers. Clinical Trial Registration: Clinical Trials under Protocol ID: 54985316.0.0000.5343.