Laparoscopic bariatric surgery in adolescents: early and five- year clinical and laboratory assessment / Cirurgia bariátrica videolaparoscópica em adolescentes: avaliação clínica e laboratorial precoce e após cinco anos

ABSTRACT BACKGROUND: Obesity has reached epidemic proportions among adolescents. Methods, such as bariatric surgery, have become the most effective treatment for patients with classes III and IV obesity. AIM: To evaluate weight loss, comorbidity remission, and long-term results of bariatric surgery in adolescents. METHODS: Study with adolescent patients undergoing bariatric surgery, evaluating laboratory tests, comorbidities, and the percentage of excess weight loss in the preoperative period and at one, two, and five years postoperatively. RESULTS: A total of 65 patients who met the inclusion criteria, with a mean age of 18.6 years, were included in the analysis. In the preoperative period, 30.8% of hypercholesterolemia, 23.1% of systemic arterial hypertension, and 18.4% of type 2 diabetes were recorded, with remission of these percentages occurring in 60, 66.7 and 83.4%, respectively. The mean percentage of excess weight loss was 63.48% after one year of surgery, 64.75% after two years, and 57.28% after five years. The mean preoperative total cholesterol level was 180.26 mg/dL, and after one, two, and five years, it was 156.89 mg/dL, 161.39 mg/dL, and 150.97 mg/dL, respectively. The initial mean of low-density lipoprotein was 102.19mg/dL and after five years the mean value reduced to 81.81 mg/dL. The mean preoperative glycemia was 85.08 mg/dL and reduced to 79.13 mg/dL after one year, and to 76.19 mg/dL after five years. CONCLUSIONS: Bariatric surgery is safe and effective in adolescents, with low morbidity, resulting in a loss of excess weight and long-term stability, improving laboratory tests, and leading to remission of comorbidities, such as diabetes mellitus, hypercholesterolemia, and systemic arterial hypertension.

RESUMO RACIONAL: A obesidade tomou proporções epidêmicas entre adolescentes, e procedimentos como a cirurgia bariátrica tornou-se o tratamento mais efetivo em pacientes com obesidade grau III e IV. OBJETIVOS: Avaliar a perda peso, a remissão de comorbidades, e resultados a longo prazo da cirurgia bariátrica em adolescentes. MÉTODOS: Estudo com pacientes adolescentes submetidos à cirurgia bariátrica, avaliando exames laboratoriais, comorbidades e o percentual de perda de excesso de peso, nos períodos pré-operatório e com 1, 2 e 5 anos de pós-operatório. RESULTADOS: Foram incluídos no estudo 65 pacientes que preencheram os critérios de inclusão, com a média de idade de 18,6 anos. No pré-operatório foram registrados: 30,8% hipercolesterolemia, 23,1% hipertensão arterial sistêmica e 18,4% diabetes tipo 2, ocorrendo remissão destes porcentuais em 60, 66,7 e 83,4%, respectivamente. O percentual médio de perda de excesso de peso após 1 ano foi de 63,48%, após 2 anos foi de 64,75% e após 5 anos foi 57,28%. O valor médio do colesterol total no pré-operatório era de 180,26mg/dL, e após 1 ano, 2 anos e 5 anos foram de 156,89mg/dL,161,39mg/dL e de 150,97mg/dL, respectivamente. A média inicial de lipoproteína de baixa densidade era 102,19mg/dL e após 5 anos o valor médio reduziu para 81,81 mg/dL. O valor médio da glicose pré-operatório era 85,08 mg/dL, após um ano uma média 79,13mg/dL, e com 5 anos 76,19 mg/dL. CONCLUSÕES: A cirurgia bariátrica é segura e eficaz em adolescentes, com baixa morbidade, resultando em uma perda do excesso de peso e estabilidade a longo prazo, melhorando exames laboratoriais e levando a remissão de comorbidades como diabetes mellitus, hipercolesterolemia e hipertensão arterial sistêmica.

Accuracy and capability of tri-ponderal mass index in assessing cardio-metabolic risk factors in Chinese children and adolescents aged 3 to 17 years, compared with body mass index / 中华医学杂志(英文版)

BACKGROUND@#Tri-ponderal mass index (TMI) has been reported to be a more accurate estimate of body fat than body mass index (BMI). This study aims to compare the effectiveness of TMI and BMI in identifying hypertension, dyslipidemia, impaired fasting glucose (IFG), abdominal obesity, and clustered cardio-metabolic risk factors (CMRFs) in 3- to 17-year-old children.@*METHODS@#A total of 1587 children aged 3 to 17 years were included. Logistic regression was used to evaluate correlations between BMI and TMI. Area under the curves (AUCs) were used to compare discriminative capability among indicators. BMI was converted to BMI- z scores, and accuracy was compared by false-positive rate, false-negative rate, and total misclassification rate.@*RESULTS@#Among children aged 3 to 17 years, the mean TMI was 13.57 ± 2.50 kg/m 3 for boys and 13.3 ± 2.33 kg/m 3 for girls. Odds ratios (ORs) of TMI for hypertension, dyslipidemia, abdominal obesity, and clustered CMRFs ranged from 1.13 to 3.15, higher than BMI, whose ORs ranged from 1.08 to 2.98. AUCs showed similar ability of TMI (AUC: 0.83) and BMI (AUC: 0.85) in identifying clustered CMRFs. For abdominal obesity and hypertension, the AUC of TMI was 0.92 and 0.64, respectively, which was significantly better than that of BMI, 0.85 and 0.61. AUCs of TMI for dyslipidemia and IFG were 0.58 and 0.49. When 85th and 95th of TMI were set as thresholds, total misclassification rates of TMI for clustered CMRFs ranged from 6.5% to 16.4%, which was not significantly different from that of BMI- z scores standardized according to World Health Organization criteria.@*CONCLUSIONS@#TMI was found to have equal or even better effectiveness in comparison with BMI in identifying hypertension, abdominal obesity, and clustered CMRFs TMI was more stable than BMI in 3- to 17-year-old children, while it failed to identify dyslipidemia and IFG. It is worth considering the use of TMI for screening CMRFs in children and adolescents.

Methods for evaluating overweight and obesity among children and adolescents and application in SPSS and SAS / 中华预防医学杂志

Overweight/obesity has become one of the major public health problems among children and adolescents all over the world. The current screening standards for overweight and obesity in children and adolescents are not unified. It is easy to make mistakes and inefficient to evaluate item by item or develop self-written packages. Taking the"Screening standards for overweight and obesity in Chinese school-age children and adolescents"as an example, this study introduced four methods and procedures for evaluating overweight and obesity among children and adolescents from the world and China and described their application methods in combination with specific cases. At the same time, the SPSS and SAS packages were compiled and the specific application steps were explained, so that users could correctly and quickly screen overweight and obesity among children and adolescents, and conduct horizontal comparisons of similar studies across different regions.

Comportamiento del sobrepeso y la obesidad en niños y adolescentes. Policlínico Docente Héroes del Moncada. 2019 / Behavior of overweight and obesity in children and adolescents. Teaching Polyclinic Heroes del Moncada. 2019

RESUMEN Introducción: la obesidad es considerada como un problema de salud pública. Por lo general, tiende a comenzar desde edades tempranas. La Organización Mundial de la Salud la ha definido como la epidemia del siglo XXI, por las dimensiones que ha adquirido en las últimas décadas y su impacto en la morbimortalidad, en la calidad de vida y en el elevado costo sanitario. Desde 1973, la incidencia de obesidad a escala mundial se ha triplicado. Objetivo: caracterizar el comportamiento de la obesidad y el sobrepeso en menores de 19 años, en el Consultorio 12 del Policlínico Docente Héroes del Moncada, de Cárdenas, en 2019. Materiales y métodos: se realizó un estudio descriptivo, transversal, en el período de junio de 2018 a junio de 2019. El universo estuvo constituido por 68 niños de 0 a 19 años, con antecedentes de sobrepeso y obesidad. Resultados: el grupo de edades más afectado fue el de los niños de 0 a 4 años; ambos sexos tuvieron igual comportamiento. La mayoría de los niños no realizaba ejercicios físicos. Los alimentos más consumidos fueron los azucarados y los carbohidratos. El factor genético estuvo presente en todos los participantes. Conclusiones: para la prevención de obesidad en la infancia, Cuba cuenta con un primer nivel de atención accesible a toda la población. Se considera que se debe aprovechar esta fortaleza y realizar una labormás enérgica con la familia y la interacción de equipos interdisciplinarios, donde intervengan nutriólogos y licenciados en Educación Física, para así evitar este mal entre los niños y jóvenes (AU).

ABSTRACT Introduction: Obesity is considered a public health problem. In general, it tends to start from early ages. The World Health Organization has defined it as the epidemic of the 21st century due to the dimensions it has acquired in recent decades, and its impact on morbidity, mortality, in life quality, and its high sanitary cost. Since 1973, the incidence of obesity worldwide has increased three times. Objective: to characterize obesity and overweight behavior in children and adolescents aged less than 19 years, form the Family Medical Office 12 of the Teaching Polyclinic Héroes del Moncada, of Cardenas, in 2019. Materials and methods: a descriptive, cross-sectional study was carried out in the period from June 2018 to June 2019. The universe was formed by 68 children aged 0-19 years, with antecedents of overweight and obesity. Results: the most affected age group was the one formed by children aged 0-4 years; both sexes behaved the same. Most of children did not exercised. The most consumed foods were sugar and carbohydrates. The genetic factor was present in all the participants. Conclusions: for preventing obesity in childhood, Cuba has a first health care level accessible to the whole population. The authors consider that this strength should be used, and more active work should be carried out with the family and the interaction of an interdisciplinary team integrated by nutritionists and graduated of Physical Education, to avoid this condition among children and youth (AU).

New reference parameters for body mass index in children aged six to ten years / Novos parâmetros de referência do índice de massa corpórea para crianças de seis a dez anos

ABSTRACT Objective: To determine new body mass index (BMI) reference values to classify the nutritional status of children aged six to ten years old from the city of Montes Claros (state of Minas Gerais), Southeast Brazil. Methods: The sample consisted of 3,863 individuals from both genders. Body mass and height were measured to determine the BMI. We adopted the Lambda, Mu, and Sigma (LMS) method to obtain the cut-off points. After that, each stratum curve was smoothed using quartic polynomials by gender. Average interpolation was used to determine the biannual distribution values. We calculated the 3rd, 85th, and 95th centiles to classify underweight, overweight, and obesity, respectively, according to gender and age. Results: After tabulating the LMS parameters at biannual intervals by gender, we plotted a graphic with seven centiles of BMI distribution and calculated the new BMI parameters for children aged 6-10 years old from the city of Montes Claros. The cut-off values for underweight, overweight, and obesity classification were, respectively, 17.5, 25 and 30 kg/m2. Conclusions: For the studied children, the use of traditional BMI references may result in the overestimation of underweight and underestimation of overweight and obesity. Studies should be carried out with periodic updates, respecting the characteristics of each location in order to use BMI reference values to classify the nutritional status of children and adolescents.

RESUMO Objetivo: Determinar novos valores de referência do índice de massa corporal (IMC) para a classificação do estado nutricional de crianças de seis a 10 anos da cidade de Montes Claros (MG) Brasil. Métodos: Foi utilizada uma amostra de 3.863 sujeitos de ambos os sexos, sendo mensurados massa corporal e estatura para a determinação do IMC. Para a obtenção dos pontos de corte utilizou-se o método Lambda, Sigma e Mu (LMS). Em seguida, as curvas de cada estrato foram suavizadas por polinômios de 4º grau por sexo, e, por interpolação das médias aritméticas, foram obtidos os valores semestrais da distribuição. Foram calculados os percentis 3%, 85% e 95% para a classificação de baixo peso, sobrepeso e obesidade, respectivamente, de acordo com sexo e idade. Resultados: Após a tabulação em intervalos semestrais dos valores dos parâmetros LMS por sexo, foi possível construir o gráfico com sete centis da distribuição do IMC, sendo apresentados os novos parâmetros do IMC para crianças de 6 a 10 anos de Montes Claros, equivalentes aos valores 17,5, 25 e 30 kg/m2 para baixo peso, sobrepeso e obesidade respectivamente. Conclusões: Em relação à população de Montes Claros, a utilização das tradicionais referências para o IMC pode resultar em uma superestimativa do baixo peso e subestimativa do sobrepeso e obesidade. O que se sugere é que, para o uso de valores de referência do IMC para classificar o estado nutricional de crianças e adolescentes, sejam realizados estudos com atualizações periódicas, respeitando as características de cada localidade.

Predictive Utility of Anthropometric Based Cut-offs in Assessing Excess Adiposity among Preschool Children in a Multiethnic Population

ABSTRACT Objective: Screening for childhood obesity is a necessary step in developing appropriate and effective interventions. We evaluated the diagnostic performance of various recommended international anthropometric cut-offs based on body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), triceps skinfold (TSF), and mid-upper arm circumference (MUAC) in predicting excess adiposity (body fat ≥ 25%) in a random sample of Trinidadian preschoolers. Methods: After obtaining written parental consent, weight, height, WC, TSF, and MUAC were measured in 596 children using standard procedures. These were used to calculate BMI for age, WHtR, TSF-for-age z-scores, and MUAC-for-age z-scores. Percentage body fat was measured using a Tanita-531 foot-to-foot bioelectrical impedance analyser (BIA). Sensitivities, specificities and area under the receiver-operating curve analysis and predictive values were then computed in reference to BIA estimates. Results: The prevalence of excess adiposity was 12.2% and 5.1% among males and females, respectively. Sensitivities for the various cut-offs ranged from 20.0% to 75.0% and 57.1% to 96.9% among males and females, respectively. WHO-BMI recommended cut-offs and those based on MUAC z-scores had significantly higher sensitivities in females than in males. TSF z-scores had significantly lower sensitivities compared to those based on BMI and WHtR among males. Similarly, specificities ranged from 81.3% to 99.9% and 79.8% to 99.9% among males and females, respectively. In girls, cut-offs based on TSF z-scores had a higher likelihood ratio than cut-offs from Centers for Disease Control, International Obesity Task Force and WHtR. Diagnostic performance was not associated with ethnicity. Conclusion: Our results suggest that diagnostic performance was associated with gender and the cut-offs used; however, it was not associated with ethnicity.

Documento de trabajo: Malnutrición por exceso en la edad escolar: Estudio retrospectivo de una cohorte de niños y niñas de la Ciudad de Buenos Aires (2012-2017) / Discussion paper: Malnutrition due to excess in school age: Retrospective study of a cohort of boys and girls from the City of Buenos Aires (2012-2017)

La malnutrición por exceso es uno de los problemas de salud más prevalentes en niños y niñas en edad escolar, etapa en la que se observa un marcado incremento en el sobrepeso y la obesidad. Se describe el estado nutricional de una cohorte de niños y niñas que concurrieron a escuelas de gestión estatal de CABA, evaluados/as en 1º y 6º grado, se comparan las prevalencias de sobrepeso / obesidad y su asociación con sexo, zona de la ciudad, tipo de jornada escolar y realización de intervenciones educativas por parte del Programa Mi Escuela Saludable, y se analiza la incidencia del exceso de peso y, en particular, de la obesidad y su asociación con las variables mencionadas.

Un programa de prevención temprana de la obesidad: "HaViSa UC" (2009-2019) / An Early Obesity Prevention Program: HaViSa UC (2009-2019)

Resumen: Introducción: La prevención es la solución definitiva al grave problema epidemiológico nutricional de la niñez en nuestro país y el mundo, que es la obesidad. Objetivo: Describir los resultados de un programa de prevención de la obesidad en lactantes y preescolares, a diez años de su inicio. Sujetos y Método: Estudio retrospectivo, cuasi experimental, de la prevalencia de sobrepeso y obesidad, en niños y niñas asistentes a las salas-cuna y jardines infantiles de la Universidad Católica de Chile, desde la implementación en 2009 de un programa de promoción precoz de hábitos de vida saludable en alimentación y actividad física (HaViSa-UC), hasta 2019. Se obtuvo aprobación ética y se analizaron los registros anuales de las evaluaciones antropométricas (referencia OMS 2006), de cada mes de marzo, en los centros de tres campus universitarios, utilizando el programa Minitab 17. Las acciones implementadas por el HaViSa-UC fueron: evaluación del estado nutricional y comunicación con los padres, entrega de una alimentación saludable, promoción de un hábito activo de vida y educa ción para favorecer hábitos saludables de vida. Resultados: El promedio anual fue de 319 asistentes, 14% menores de dos años y 49,5% niñas. En marzo 2009 se detectó 32,6% de sobrepeso y 8,6% de obesidad, cifras que disminuyeron y se estabilizaron, alcanzando en marzo de 2019 a 23,8% y 4,7% respectivamente. Los eutróficos aumentaron desde 56,9% a 67,4%, sin aumentar el bajo peso. En el mismo período, zP/T bajó desde 0,84 ± 0,94 a 0,55 ± 0,87 (p = 0,00), y zT/E aumentó desde -0,36 ± 0,87 a -0,32 ± 0,90 (p > 0,05). Conclusión: Desde la implementación del programa HaViSa, en esta muestra de lactantes y preescolares la frecuencia de obesidad bajó en 45,4% y el sobrepeso en 27%, con estabilidad al cabo de diez años.

Abstract: Introduction: Prevention is the definitive solution to the serious nutritional epidemiological pro blem of children in our country and the world, obesity. Objective: To describe the results of an obesi ty prevention program for infants and preschoolers, ten years after its implementation. Subjects and Methods: Retrospective, and quasi-experimental study of the overweight and obesity prevalence, in children attending three nursery and preschool centers located at the Universidad Católica de Chile, since the implementation of a multidimensional program for early promotion of healthy lifestyle habits (HaViSa-UC) between 2009 and 2019. This study obtained ethical approval. Annual records of anthropometric assessment (WHO 2006) were analyzed using Minitab 17 software. The actions applied by the HaViSa-UC program were the assessment of nutritional status and communication with parents, delivery of healthy food, promotion of an active lifestyle, and education to encourage such healthy habits. Results: The annual mean was 319 subjects, 14% younger than two years old, and 49.5% were girls. In March 2009 (baseline), 32.6% had overweight and 8.6% obesity; both figures decreased reaching 23.8% and 4.7% respectively, in March 2019. Normal weight increased from 56.9 to 67.4% and malnutrition presented no increase. In the same period, zW/H dropped from 0.84 ± 0.94 to 0.55 ± 0.87 (p: 0.00), and zH/A increased from -0.36 ± 0.87 to -0.32 ± 0.90 (p > 0.05). Con clusion: Since the implementation of the HaViSa-UC Program, the frequency of obesity decreased by 45.4% and overweight by 27.2% in this sample of infants and preschoolers, remaining stable after 10 years.

Asociación entre el polimorfismo rs9939609 del gen FTO y marcadores de adiposidad en población infantil chilena / Association between FTO gene rs9939609 and adiposity markers in Chilean children

Resumen: Introducción: La obesidad es una enfermedad inflamatoria donde la genética determina cierto nivel de riesgo. Aun cuando existen estudios que reportan asociación entre polimorfismos de FTO (fat-mass associated gene) y adiposidad, existe limitada evidencia en población infantil chilena. Objetivo: determinar la asociación entre el polimorfismo rs9939609 del FTO y marcadores de adiposidad en población in fantil chilena. Pacientes y Método: Estudio de corte transversal incluyó 361 participantes (de 6 a 11 años; 50% niñas). Los datos clínicos y la recolección de muestras de sangre se realizaron entre marzo y junio de 2008. El polimorfismo SNP (rs9939609), del gen FTO, se determinó utilizando ADN genómico extraído de leucocitos, utilizando el Mini Kit QIAamp DNA Blood (Qiagen GmbH, Hilden, Alemania). Los marcadores de adiposidad estudiados fueron, índice de masa corporal (IMC), masa grasa, perímetro de cintura (PC) y razón cintura/talla, y se compararon ajustados por sexo, edad y estadio de Tanner. La asociación entre el polimorfismo estudiado y los marcadores de obesidad se realizó mediante análisis de regresión lineal. Resultados: Al ajustar los marcadores por sexo, edad y estadío de Tanner se observó una asociación significativa entre el polimorfismo e indicadores de adi posidad. Por cada copia extra del alelo de riesgo se encontró un aumento de 2,47 kg de peso corporal, (IC 95%: 1,39-3,55); 1,06 kg/m2 de IMC, (IC 95%: 0,56-1,54); 2,55 cm de PC, (IC 95%: 1,26-3,85) y 1,98% de masa grasa, (IC 95%: 0,78-3,19). Al convertir los marcadores de adiposidad a z-score, la razón perímetro de cintura/talla arrojó la mayor asociación con el alelo de riesgo de FTO. Conclu sión: Este estudio indica asociación entre el polimorfismo rs9939609 del gen FTO con marcadores de adiposidad general y central en población infantil en Chile.

Abstract: Introduction: Obesity is considered a chronic inflammatory disease with an important genetic component. Although several studies have reported an association between the FTO (fat-mass associated gene) and adiposity in children, there is limited evidence in the Chilean population. Objective: To deter mine the association between the polymorphism rs9939609 of the FTO gene and markers of adipo sity in Chilean children. Patients and Method: Cross-sectional study which included 361 children aged between 6 and 11 years (50% were girls). Between March and June 2008, clinical data and blood sample collection was carried out. The rs9939609 single-nucleotide polymorphism (SNP) of the FTO gene, was determined using the genomic DNA extracted from leukocytes, using the QIAamp DNA Blood Mini Kit (Qiagen GmbH, Hilden, Germany).The adiposity markers included were body mass index (BMI), waist circumference (WC), body fat, and WC/H index; which were later compared adjusted by sex, age, and Tanner stage. Linear regression analyses were conducted to detect the association between the polymorphism and obesity markers. Results: After adjusting the models by age, sex, and Tanner stage, we found a significant association between the polymorphism and markers of adiposity. For each extra copy of the risk allele, we found an increase of 2.47 kg body weight (95% CI: 1.39-3.55); 1.06 kg/m2 BMI (95% CI: 0.56-1.54); 2.55 cm WC, (95% CI: 1.26-3.85); and 1.98% body fat (95% CI: 0.78-3.19). When converting adiposity markers to z-score, we found that WC/height index shows the strongest association with the risk allele FTO. Conclusion: This study supports the association between the rs9939609 SNP of the FTO gene and overall and central adiposity markers in Chilean children.

Tri-ponderal mass index and body mass index in prediction of pediatric metabolic syndrome: the CASPIAN-V study

ABSTRACT Objective Body mass index (BMI) and tri-ponderal mass index (TMI) are anthropometric measures to evaluate body adiposity in the various age groups. The present study aims to compare the predictive value of TMI and BMI for metabolic syndrome (Mets) in children and adolescents of both genders. Subjects and methods A cross-sectional study conducted on 3731 Iranian children and adolescents aged 7-18 years obtained from the fifth survey of 'Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable Disease' (CASPIAN-V) study. The predictive value of BMI and TMI for MetS were determined using Receiver-operator curves. Logistic regression analysis was used to assess the relationship between these indices with MetS. Results 52.6% of participants were boys. The mean (standard deviations) age for boys and girls were 12.62 (3.02) and 12.25 (3.05) years, respectively. In boys, the area under the curve (AUC) of TMI was greater than BMI for all age groups. AUC of TMI was also greater than BMI for age group of 11-14 years (AUC = 0.74; 95% CI (0.67, 0.81)) in girls. Furthermore, our findings showed that odds ratio of Mets for TMI was greater than BMI in age groups of 11-14 years (OR = 1.33 vs 1.22) and 15-18 years (1.16 vs 1.15) in girls and boys, respectively. Conclusion TMI and BMI had moderate predictive value for identifying MetS. However, TMI was a better predictor of MetS than BMI in both genders, especially in age groups of 11-14 and 15-19 years for girls and boys.

Composición corporal y trastornos respiratorios del sueño en escolares de Valdivia, Chile / Relationship between body composition and sleep-disordered breathing in schoolchildren from Valdivia, Chile

Resumen: Introducción: La malnutrition por exceso en la infancia constituye una epidemia mundial y se asocia a múltiples enfermedades y complicaciones. Entre ellas, destacan los trastornos respiratorios del sueño (TRS), espectro de enfermedades que han emergido como un problema de salud relevante. Objetivo: Eva luar la relación entre la composición corporal y la presencia de TRS en escolares. Sujetos y Méto do: Estudio observacional analítico de corte transversal en 127 escolares de primero a octavo básico escogidos aleatoriamente de cinco establecimientos municipales de Valdivia, Chile. La incorporación al estudio ocurrió luego del proceso de consentimiento informado del responsable del escolar y asentimiento informado del menor. Se realizaron mediciones antropométricas y se determinó la presencia de TRS mediante el Pediatric Sleep Questionnaire (PSQ). Para el análisis se aplicó esta dística descriptiva, t de Student y test x2 para determinar asociación de variables con la presencia de TRS. Resultados: Destacó alta prevalencia de malnutrición por exceso (71,7%) y la obesidad alcanzó 39,4%. En tanto la prevalencia de TRS fue 32,3%. Hubo mayor proporción de niños con TRS en escolares obesos severos (56,3%), así como una media significativamente mayor en niños con TRS para los pliegues bicipital (14,6 mm ± 7,3 vs. 12,0 mm ± 6,6; p=0,002) y tricipital (19,8 ± 6,7 mm vs. 16,2 mm ± 6,0; p =0,04). Conclusiones: Existen altas prevalencias de malnutrición por exceso y TRS. De las medidas antropométricas, la presencia de TRS se asoció con mayor grosor de los plie gues bicipital y tricipital.

Abstract: Introduction: Overnutrition in childhood constitutes a global epidemic and has been associated with multiple di seases and complications. Among them, sleep-disordered breathing (SDB) stands out, a spectrum of diseases that have emerged as a relevant health problem. Objective: To evaluate the association bet ween nutritional status and SDB in schoolchildren. Subjects and Method: Cross-sectional analytical study of 127 schoolchildren randomly selected from five public schools in Valdivia, Chile. After the informed assent and informed consent process of the child and parents/guardian respectively, the students were incorporated into the study. Anthropometric measurements were performed and the presence of SDB was determined through the Pediatric Sleep Questionnaire (PSQ). For the data analysis, the t-test and x2 test were used to determine the association of variables with SDB. Re sults: There was a high prevalence of overnutrition (71.7%) and obesity reached 39.4%. Regarding the prevalence of SDB, it was 32.3%. There was a higher proportion of children with SDB in severely obese schoolchildren (56.3%), as well as, a significantly higher mean of biceps and triceps skinfold thickness in children with SDB (14.6 mm ± 7.3 vs. 12.0 mm ± 6.6, p = 0.002, and 19.8 ± 6.7 mm vs. 16.2 mm ± 6.0, p = 0.04, respectively). Conclusions: There is high prevalence of overnutrition and SDB. Out of the anthropometric measurements, the presence of SDB was associated with greater thickness of the biceps and triceps skinfolds.

Prevalencia de sobrepeso y obesidad en estudiantes de una ciudad de la región sureste del Brasil / Prevalence of overweight and obesity in students of a city of the southeast region of Brazil

Introducción: La prevalencia de sobrepeso y obesidad a temprana edad está creciendo en proporciones epidémicas y se ha convertido en una preocupación de la salud pública, tanto en los países desarrollados como en países en desarrollo. Objetivos: Analizar y describir la prevalencia de sobrepeso y obesidad en niños de una ciudad del interior de una región del Sureste de Brasil. Métodos: Se trata de un estudio transversal, de carácter descriptivo e inferencial, en el cual se observaron 263 niños de diez a quince años de edad, 147 del sexo masculino y 116 del sexo femenino. Participaron en el estudio los estudiantes matriculados en dos escuelas públicas municipales de enseñanza fundamental. Las mediciones antropométricas se realizaron siguiendo las recomendaciones internacionales de la International Standards for Kinanthropometric Assessment y el índice de masa corporal se determinó usando la fórmula sugerida por la Organización Mundial de la Salud. Resultados: En cuanto a la prevalencia de sobrepeso y obesidad entre niños y niñas, se encontró que 23,2 por ciento de los estudiantes tenían sobrepeso y que el 12,2 por ciento, estaban con obesidad. Sin embargo, cuando se estratificó por sexo, el sobrepeso y la obesidad eran más frecuentes en las niñas (27,6 por ciento - 9,5 por ciento) que en los niños (19,7 por ciento- 15,5 por ciento), respectivamente. Conclusiones: La prevalencia de sobrepeso y obesidad entre los estudiantes de la presente investigación se mostró alta, lo cual demuestra la necesidad de programas de prevención e intervención(AU)

Introduction: The prevalence of overweight and obesity at an early age is growing in epidemic proportions and becoming a public health concern-in both developed and developing countries. Objectives: To analyze and describe the prevalence of overweight and obesity in children from a city in the interior of a region of southeastern Brazil. Methods: This is a cross-sectional, descriptive and inferential study, in which 263 children from ten to fifteen years of age were observed, 147 being male and 116 female. Students enrolled in two municipal public elementary schools participated in the study. The anthropometric measurements were made following the international recommendations of the International Standards for Kinanthropometric Assessment and the body mass index (BMI) was determined using the formula suggested by the World Health Organization. Results: In terms of the prevalence of overweight and obesity among boys and girls, it was found that 23,2 percent of the students were overweight and that 12.2 percent were overweight. However, when stratified by sex, overweight and obesity were more frequent in girls (27,6 percent- 9,5 percent), than in boys (19,7 percent - 15,5 percent), respectively. Conclusion: The prevalence of overweight and obesity among the students of this research was high, demonstrating the need for prevention and intervention programs(AU)

Associações entre problemas de saúde mental, comportamento alimentar e estado nutricional de pré-escolares no Município de Ribeirão Preto/SP / Associations between mental health problems, eating behavior and nutritional status of preschool children in the city of Ribeirão Preto/SP

O Brasil vive uma transição nutricional, com mudanças no padrão alimentar, redução nos índices de desnutrição e aumento nos índices de obesidade em todas as faixas etárias, incluindo a infância. A obesidade infantil também pode estar associada a problemas na saúde mental de crianças muito novas, como ansiedade, depressão e problemas de comportamento. Sabe-se que o comportamento alimentar das crianças tem relação com seu estado nutricional, e ele começa a ser desenvolvido desde muito cedo na vida das crianças. Assim, o objetivo deste estudo foi investigar o comportamento alimentar e a saúde mental entre crianças de dois a quatro anos de idade e analisar possíveis associações entre estado nutricional, comportamento alimentar e problemas emocionais e/ou comportamentais neste grupo. Participaram 95 pais/responsáveis divididos em três grupos: eutróficos (N=34), sobrepeso (n=34) e obesidade (N=32). Os participantes responderam um questionário sociodemográfico, uma escala de rastreamento de problemas psicológicos e outra para investigação do comportamento alimentar. As entrevistas ocorreram em unidades de saúde ou na residência dos participantes, com duração média de 30 minutos. Os dados foram submetidos à estatística descritiva e inferencial. A média de idade dos participantes foi de 32,7(±7,39), exclusivamente mulheres; 25,3% das crianças tinham dois anos, 38,9% três e 35,8% estavam com quatro anos. As subescalas que tiveram maiores pontuações foram Prazer em comer (3,92) e Desejo de beber (3,34) e observou-se diferença estatisticamente significante entre sexos em Resposta à saciedade (t = 2,433; p = 0,018), com resultados mais elevados para as meninas, e entre grupos etários em Seletividade Alimentar (F(2;92) = 8,02, p = 0,001), com as crianças de dois anos apresentando menores pontuações. As crianças obesas obtiveram escores maiores nas subescalas de comportamento alimentar que refletem maior interesse pela comida, enquanto as eutróficas apresentaram melhores resultados naquelas que refletem menor interesse pelo alimento. Houve diferença significativa entre o grupo de obesos (maior média) com eutróficos (p = 0,01) e com sobrepeso (p < 0,001) quanto a Sobreingestão emocional; entre grupo sobrepeso (menor média) com eutróficos (p = 0,03) e com obesos (p = 0,03) quanto a Desejo de beber; e entre grupo obeso (menor média) e eutrófico quanto a Resposta à saciedade (p = 0,05). No que tange à saúde mental, 27,4% das crianças apresentaram escores muito altos no instrumento, sinalizando problemas psicológicos; as maiores pontuações médias ocorreram nas subescalas Hiperatividade (4,75) e Problemas de Conduta (4,75). Resposta à saciedade correlacionou-se com Problemas emocionais (r = 0,215; p = 0,037) e Hiperatividade (r = 0,244; p = 0,017); Subingestão emocional apresentou correlação com Problemas de conduta (r = 0,334; p = 0,001), Hiperatividade (r = 0,358; p = 0,000) e Problemas de relacionamento (r = 0,321; p = 0,002). Há evidências da associação entre estado nutricional e comportamento alimentar bem como deste último com saúde mental. Neste sentido, os resultados alertam para a necessidade de atenção ao comportamento alimentar e à saúde mental de crianças muito novas, visando à prevenção de problemas na saúde mental e do ganho de peso

Brazil is experiencing a nutritional transition, with changes in the dietary pattern, reduction in malnutrition rates and increase in obesity rates in all age groups, including childhood. Childhood obesity may also be associated with problems in the mental health of very young children, such as anxiety, depression and behavior problems. It is known that children's eating behavior is related to their nutritional status, and it begins to be developed very early in children's lives. Thus, the objective of this study was to investigate eating behavior and mental health among children from two to four years of age and to analyze possible associations between nutritional status, eating behavior and emotional and / or behavioral problems in this group. Participants included 95 parents / guardians divided into three groups: eutrophic (n = 34), overweight (n = 34) and obesity (n = 32). Participants answered a sociodemographic questionnaire, a psychological problem tracing scale and another for food behavior research. The interviews took place in Health Units or in the participants' residence, with an average duration of 30 minutes. Data were submitted to descriptive and inferential statistics. The mean age of the participants was 32.7 (± 7.39), exclusively women; 25.3% of the children were two years old, 38.9% were three and 35.8% were four years old. The subscales that had higher scores were Enjoyment of food (3.92) and Desire to drink (3.34) and a statistically significant difference was observed between sexes in Satiety responsiveness (t = 2,433; p = 0,018), with more results (F (2; 92) = 8.02, p = 0.001), with two-yearolds presenting lower scores. Obese children had higher scores on eating behavior subscales that reflect greater interest in food, while eutrophic ones presented better results in those that reflect less interest in food. There was a significant difference between the group of obese (higher mean) with eutrophic (p = 0.01) and overweight (p <0.001) regarding emotional overdose; between the overweight group (lower mean) with eutrophic (p = 0.03) and obese (p = 0.03) regarding Desire to drink; and between obese (lower mean) and eutrophic group as to Satiety responsiveness (p = 0.05). Regarding mental health, 27.4% of the children presented very high scores on the instrument, signaling psychological problems; the highest mean scores occurred in the Hyperactivity subscales (4.75) and Conduct Problems (4.75). Satiety responsiveness was correlated with Emotional problems (r = 0.215, p = 0.037) and Hyperactivity (r = 0.244; p = 0.017); Emotional undereating presented a correlation with Conduct Problems (r = 0.334, p = 0.001), Hyperactivity (r = 0.358, p = 0.000) and Peer Problems (r = 0.321, p = 0.002). There is evidence of the association between nutritional status and eating behavior as well as the latter with mental health. In this sense, the results point to the need for attention to the eating behavior and mental health of very young children, aiming at the prevention of problems in mental health and weight gain

Factores asociados a obesidad en pediatría, Hospital Mario Catarino Rivas, 2017-2018 / Factors associated with obesity in pediatric, Mario Catarino Rivas hospital, 2017-2018

Antecedentes: La obesidad infantil es una enfermedad crónica de origen multifactorial considerada uno de los problemas de salud pública más graves del siglo XXI. El problema es mundial que está afectando progresivamente a muchos países de bajos y medianos ingresos, sobre todo en el medio urbano. La prevalencia ha aumentado a un ritmo alarmante. Objetivo: Conocer los factores asociados con la Obesidad infantil en pacientes atendidos en Consulta externa de Endocrinología Pediátrica del Hospital Mario Catarino Rivas (HMCR) en el período de enero 2017-junio 2018. Pacientes y métodos: Diseño no experimental, estudio de casos y controles, edades comprendidas entre 2-17 años con 364 días de vida, los pacientescon obesidad fueron captados en ConsultaExterna de Endocrinología Pediátrica,eligiendo los controles en una relación 1:1 deConsulta Externa de Postgrado de Pediatría.Los datos se analizaron con SPSS versión23.Resultados:Los factores asociados aobesidad fueron: sexo femenino, tenerantecedentes familiares de obesidad, realizaractividad física diaria menor a 30 minutos,dedicar tiempo diario a los videojuegos.Conclusiones: Según el análisis de RegresiónLogística Binaria la probabilidad de desarrollarobesidad infantil se incrementa de formasignificativa si el individuo es del sexofemenino, tienen antecedentes de padres conobesidad, si no recibió Lactancia MaternaExclusiva (LME) en los primeros 6 meses, si realiza actividad física diaria menor de 30 minutos y si dedica tiempo diario a los videojuegos...(AU)

Estudio comparativo del estado nutricional de niños y niñas residentes en cuatro partidos de la provincia de Buenos Aires (Argentina), en el marco de la transición nutricional / Comparative study of the nutritional status of children living in four counties of the province of Buenos Aires (Argentina), in the context of nutrition transition

RESUMEN El objetivo fue evaluar y comparar el estado nutricional en poblaciones infanto-juveniles residentes en cuatro partidos de la provincia de Buenos Aires y observar si existen diferencias vinculadas a los contextos ambientales y socioeconómicos particulares, en el marco de la transición nutricional. Entre los ciclos lectivos 2008-2012, se relevó el peso y la talla y se calculó el índice de masa corporal de 7.873 escolares, entre 4 y 12 años de edad, residentes en los partidos de La Plata, Brandsen, Magdalena y Punta Indio. La información acerca del contexto de residencia se obtuvo mediante encuesta estructurada y autoadministrada. Alrededor del 40% de los escolares presentó malnutrición, y prevalecieron el sobrepeso en La Plata, la obesidad en Punta Indio y la desnutrición en Magdalena. El estado nutricional se vinculó con las condiciones socioambientales de residencia y dio cuenta de que estas poblaciones se ubican en distintas etapas del proceso de transición nutricional.

ABSTRACT The aim of this study was to evaluate and compare the nutritional status of child populations living in four counties of the province of Buenos Aires to observe differences related to particular environmental and socioeconomic contexts in the framework of the nutrition transition. During the school years corresponding to the 2008-2012 period, weight and height were measured and body mass index was calculated for 7,873 school children between the ages of 4 and 12 years from the counties of La Plata, Brandsen, Magdalena and Punta Indio. Information about the contexts of residence was obtained using self-administered structured surveys. About 40% of schoolchildren presented malnutrition, with a prevalence of overweight in La Plata, obesity in Punta Indio and undernutrition in Magdalena. The nutritional status of the study populations was associated with the socioenvironmental conditions of residence, indicating that these populations are at different stages of the nutrition transition process.

índice relação cintura-estatura para predição do excesso de peso em crianças / Waist-to-height ratio index or the prediction of overweight in children

RESUMO Objetivo: Identificar um indicador de adiposidade abdominal de baixo custo e com maior acurácia para predizer o excesso de peso em crianças de quatro a sete anos idade. Métodos: Estudo transversal com amostra de 257 crianças de 4 a 7 anos. Os indicadores de adiposidade abdominal avaliados foram: perímetro da cintura (PC), relação cintura-estatura (RCE) e percentual de gordura central (avaliado pela técnica dual energy X-ray absorptiometry - DEXA). O excesso de peso foi classificado pelo índice de massa corporal por idade (IMC/I). Nas análises, estimou-se a razão de prevalência (RP) pela regressão de Poisson com variância robusta e utilizou-se a curva (receiver operating characteristics ­- ROC), considerando como significância estatística p<0,05. Resultados: A prevalência de excesso de peso foi de 24,9%, e observou-se maior mediana dos indicadores de adiposidade abdominal no grupo de crianças com excesso de peso. As crianças com valores aumentados de PC (RP=4,1; IC95% 2,86-5,86), RCE (RP=5,76; IC95% 4,14-8,02) e percentual de gordura central (RP=2,48; IC95% 1,65-3,73) apresentaram maior prevalência de excesso de peso. Verificou-se, na análise de curva ROC, que o índice RCE apresentou maior área sob a curva, comparado ao PC e ao percentual de gordura central estimada pelo DEXA, na predição do excesso de peso. Conclusões: Diante dos resultados, sugere-se a utilização da RCE para triagem de crianças com excesso de peso.

ABSTRACT Objective: To identify a low-cost abdominal adiposity index that has a higher accuracy in predicting excess weight in children aged four to seven years old. Methods: A cross-sectional study with a sample of 257 children aged 4 to 7 years old. Indicators of abdominal adiposity assessed were: waist circumference (WC), waist-to-height ratio (WHR) and central fat percentage (measured by dual energy X-ray absorptiometry - DEXA). Overweight children were classified using body mass index by age (BMI/age). In the analysis, the prevalence ratio (PR) using Poisson regression with a robust variance was estimated, and a receiver operating characteristic (ROC) curve was built, with a statistical significance of p<0.05. Results: The prevalence of overweight children was 24.9% and a higher median of all abdominal adiposity indicators was observed in the overweight group. Children with increased values of WC (PR=4.1; 95%CI 2.86-5.86), WHR (PR=5.76; 95%CI 4.14-8.02) and a central fat percentage (PR=2.48; 95%CI 1.65-3.73) had a higher prevalence of being overweight. Using the ROC curve analysis, the WHR index showed a higher area under the curve, when compared to the WC and to the central fat percentage estimated by DEXA for predicting the classification of being overweight. Conclusions: Given the results, WHR is suggested for the screening of overweight children.

Validation of the Questionnaire "Stage of Change in Behavior of Scholars in Eating Habits and Physical Activity" (CEHAF) / Validación del cuestionario "Etapa de cambio del comportamiento de los escolares en hábitos alimentarios y actividad física" (CEHAF)

Abstract To validate the questionnaire "Stage of Change in Behavior of Scholars in Eating Habits and Physical Activity" (CEHAF). It is based on the Transtheoretical Model, and it intends to be a useful tool for developing strategies against childhood obesity. It measures knowledge, attitudes, and habits towards nutrition and physical activity. Observational, cross-sectional, randomized, and multi-center study in a sample of 1671 Mexican school-age children, from 8 to 12 years old, both genders. The CEHAF questionnaire is self-administered and consists of 35 questions, including 18 multiple choices, on habits and attitudes towards alimentation and physical activity. Reliability analysis through Cronbach's alpha resulted in an alpha coefficient of 0.845. The exploratory factor analysis revealed three theoretically-congruent factors. The final version of the CEHAF questionnaire was conformed of 14 items. The psychometric characteristics of the CEHAF questionnaire indicate that it is a valid and reliable tool for assessing the stage of change in school-age population.

Resumen Validar el cuestionario "Etapa de cambio del comportamiento de escolares en hábitos alimentarios y actividad física" (CEHAF), el cual está basado en el modelo transteórico, y pretende ser una herramienta útil para desarrollar estrategias para combatir la obesidad infantil. Dicha herramienta mide conocimientos, actitudes y hábitos sobre nutrición y actividad física. Estudio observacional, transversal y aleatorizado en una muestra de 1671 estudiantes mexicanos, de 8 a 12 años de edad, ambos sexos. El cuestionario CEHAF es auto-administrado y se conforma por 35 preguntas, incluyendo 18 de opción multiple, sobre hábitos de alimentación y actividad física. Resultados: El análisis de confiabilidad mediante alfa de Cronbach resultó en un coeficiente alfa de 0.845. El análisis factorial exploratorio reveló tres factores teóricamente congruentes. La versión final del cuestionario CEHAF estuvo compuesta de 14 items. Las características psicométricas del cuestionario CEHAF lo vuelven una herramienta válida y confiable para evaluar la etapa de cambio en estudiantes de escuela primaria.

Ética e aspectos psicossociais em crianças e adolescentes candidatos a cirurgia bariátrica / Ethics and psychosocial aspects in child and adolescent candidates for bariatric surgery / Ética y aspectos psicosociales en relación a niños y adolescentes candidatos a cirugía bariátrica

Resumo Tratamento e prevenção da obesidade na infância e adolescência são discutidos entre médicos e público leigo. Há poucas informações disponíveis sobre cirurgia bariátrica nessa faixa etária quanto a consequências em longo prazo, mas dados sugerem que esse procedimento é oferecido cada vez mais frequentemente. Surgem questões éticas de extrema relevância relacionadas a conceitos como beneficência, autonomia, capacidade e igualdade. O objetivo deste trabalho é discutir aspectos éticos e biopsicossociais envolvidos na decisão sobre a intervenção cirúrgica para casos de obesidade em crianças e adolescentes. Trata-se de revisão de literatura mediante pesquisa no banco de dados PubMed entre maio de 1994 e maio de 2015, utilizando os termos "ethics" e "bariatric surgery" × "adolescents" × "children". Verificou-se que o tratamento cirúrgico da obesidade em crianças e adolescentes é controverso. Médicos devem estar atentos ao disponibilizar para pais e pacientes todas as informações atualmente existentes.

Abstract The treatment and prevention of obesity in childhood and adolescence are often discussed by both physicians and the lay public. Even with little information in relation to the long-term consequences of bariatric surgery in this age group, there is evidence to suggest that this procedure is being offered more and more frequently. Extremely relevant ethical issues exist relating to concepts such as beneficence, autonomy, capacity and equality. The aim of this paper was to discuss the ethical and biopsychosocial aspects involved in decisions about performing this surgery to treat obesity in children and adolescents, through a literature review of Pubmed from May 1994 to May 2015 using the terms "ethics" and "bariatric surgery" × "adolescents" × "children". The surgical treatment of obesity in children and adolescents is controversial. Physicians should be aware of this and make currently existing information available to parents and patients.

Resumen El tratamiento y la prevención de la obesidad en la infancia y en la adolescencia suelen ser discutidos entre los médicos y el público en general. Incluso con escasa información sobre la cirugía bariátrica en este grupo etario en relación con sus consecuencias a largo plazo, existen datos que sugieren que este procedimiento se ofrece cada vez con más frecuencia. Surgen cuestiones éticas de extrema relevancia vinculadas a conceptos como beneficencia, autonomía, capacidad e igualdad. El objetivo de este trabajo es discutir los aspectos éticos y biopsicosociales que intervienen en la decisión sobre la realización de cirugías para casos de obesidad en niños y adolescentes. El estudio se trató de revisión de literatura, mediante investigación en la base de datos PubMed para el período comprendido entre Mayo de 1994 y Mayo de 2015, utilizando los términos "ética" y "cirugía bariátrica" × "adolescentes" × "niños". Se verificó que el tratamiento quirúrgico de la obesidad en niños y adolescentes es controvertido. Los médicos deben estar atentos a poner a disposición de los padres y pacientes todas las informaciones actualmente existentes.

Accuracy of different cutoff points of body mass index to identify overweight according to body fat values estimated by DEXA / Precisão de diferentes pontos de corte do índice de massa corporal para identificar sobrepeso de acordo com valores de gordura corporal estimados por DEXA

Abstract: Objective: To evaluate the sensitivity and specificity of different cutoff points of body mass index for predicting overweight/obesity according to body fat values estimated by DEXA among Brazilian adolescents. Methods: Cross-sectional study including 229 male adolescents aged 10-15 years, in which body adiposity and anthropometric measures were assessed. Nutritional status was classified by BMI according to cutoff points described in scientific literature. Results: Moderate agreements were observed between body fat estimated by DEXA and cutoffs proposed by Cole et al. (K = 0.61), Conde and Monteiro (K = 0.65), Must et al. (K = 0.61) and WHO (K = 0.63). The BMI in continuous form showed good agreement with the Dexa (ICC = 0.72). The highest sensitivity was observed for cutoff by Conde and Monteiro (0.74 [0.62, 0.84]) and the highest specificity by Cole et al. (0.98 [0.94, 0.99]). For the areas under the ROC curve of cutoff points analyzed, significant difference comparing the cutoff points by Cole et al. and Conde and Monteiro (0.0449 [0.00294, 0.0927]) was observed. Conclusions: The cutoff proposed by Conde and Monteiro was more sensitive in identifying overweight and obesity when compared to the reference method, and the cutoff proposed by Cole et al. presented the highest specificity for such outcomes.

Resumo: Objetivo: Avaliar a sensibilidade e a especificidade de diferentes pontos de corte do índice de massa corporal para o prognóstico de sobrepeso/obesidade de acordo com os valores de gordura corporal estimados por absorciometria de raios X de dupla energia (DEXA) entre adolescentes brasileiros. Métodos: Estudo transversal que inclui 229 adolescentes do sexo masculino entre 10-15 anos, no qual foram avaliadas a adiposidade corporal e as medidas antropométricas. A situação nutricional foi classificada pelo IMC de acordo com os pontos de corte descritos na literatura científica. Resultados: Foram observadas concordâncias moderadas entre a gordura corporal estimada por DEXA e os cortes propostos por Cole et al. [K = 0,61], Conde e Monteiro [K = 0,65], Must et al. [K = 0,61] e a Organização Mundial de Saúde (OMS) [K = 0,63]. O IMC de forma contínua mostrou uma boa concordância com a DEXA [CCI = 0,72]. A maior sensibilidade foi observada em cortes por Conde e Monteiro [0,74 (0,62, 0,84)] e a maior especificidade por Cole et al. [0,98 (0,94, 0,99)]. Nas áreas abaixo da curva de ROC de pontos de corte analisados, foi observada uma diferença significativa ao se compararem os pontos de corte de Cole et al. e Conde e Monteiro [0,0449 (0,00294, 0,0927)]. Conclusões: O corte proposto por Conde e Monteiro foi mais sensível na identificação de sobrepeso e obesidade em comparação com o método de referência e o corte proposto por Cole et al. apresentou a maior especificidade para esses resultados.