Phase angle is associated with the physical fitness of HIV-infected children and adolescents.

The objective of this study was to identify the association of phase angle with physical fitness in children and adolescents infected with HIV. Sixty-four children and adolescents infected with HIV (8-15 years old) were tested for vertical transmission. The electrical bioimpedance was used to obtain the phase angle. Body fat (BF) and lean soft tissue mass (LSTM) were measured by x-ray absorptiometry, and the manual grip strength was evaluated by dynamometry. The peak oxygen consumption (VO2 peak) was measured by respiratory change in a submaximal incremental test. Moderate-vigorous physical activity (MVP) and sedentary behavior were measured using accelerometers and were used as covariates. Multiple linear regression was used. The linear correlation analyses demonstrated that the phase angle was inversely proportional to relative BF (r = -0.26), but was not associated with absolute body fat (r = -0.02). The phase angle was directly associated with LSTM (r = 0.57), handgrip strength, and (r = 0.43) peak VO2 (r = 0.55). The phase angle was not associated with absolute BF (ß = -0.017, P = 0.413) and relative (ß = -0.014, P = 0.175). The phase angle presented a direct association with LSTM (ß = 0.041, P = 0.019) and peak VO2 (ß = 0.005; P = 0.019), regardless of age, sex, sexual maturation, MVPA, sedentary behavior, antiretroviral drugs, and viral load. No association was found between phase angle and handgrip strength (ß = 0.153; P = 0.199). It was concluded that phase angle was associated with LSTM and the aerobic fitness in HIV-infected children and adolescents.

Aerobic fitness and physical activity are inversely associated with body fat, dyslipidemia and inflammatory mediators in children and adolescents living with HIV.

This study aimed to investigate if moderate to vigorous physical activity (MVPA) and aerobic fitness are associated with cardiovascular risk factors in HIV+ children and adolescents. Sixty-five children and adolescents (8 to 15 years) provided minutes of MVPA measured by accelerometers and peak oxygen uptake (peak VO2) by breath-by-breath respiratory exchange. Cardiovascular risk factors were characterized by body fat, blood pressure, total cholesterol, HDL-c, LDL-c, triglycerides, glucose, insulin, C-reactive protein (CRP), interleukin (IL)-6, tumor necrosis factor-alpha (TNF-α) and carotid intima-media thickness. Results indicated that higher MVPA was associated with lower values of total (ß =  -3.566) and trunk body fat (ß = -3.495), total cholesterol (ß = -0.112) and LDL-c (ß = -0.830). Likewise, higher peak VO2 was associated with lower total (ß = -0.629) and trunk body fat values (ß = -0.592) and levels of CRP (ß = -0.059). The physically active participants had lower total cholesterol (-24.4 mg.dL-1) and LDL-c (-20.1 mg.dL-1) compared to participants judged to be insufficiently active. Moreover, participants with satisfactory peak VO2 showed lower total (-4.1%) and trunk (-4.3%) body fat, CRP (-2.3 mg.L-1), IL-6 (-2.4 pg.mL-1) and TNF-α (-1.0 pg.mL-1) compared to low peak VO2 peers. High levels of MVPA and aerobic fitness may prevent developing of cardiovascular risk factors in children and adolescents HIV+.

Are adolescents really being sedentary or inactive when at school? An analysis of sedentary behaviour and physical activity bouts.

This study analysed physical activity (PA) and sedentary behaviour (SB) performed in bouts during schooltime. Adolescents of two schools answered a questionnaire, had their height and weight measured and wore accelerometers during schooltime. Moderate-to-vigorous intensity PA was estimated in bouts of 2, 5 and 10 min, and SB in bouts of 5, 10, 30 and 60 min. Body mass index was calculated, and adolescents were classified as overweight or normal weight. Frequency, duration and volume of PA and SB were calculated for the whole sample and for those who performed at least one bout weekly. PA and SB differences between gender and weight status were tested using Mann-Whitney and t tests. A total of 415 adolescents (54% girls, 12.3 ± 1.3 years old, 34.6% overweight) performed 0.1 (± 0.2), 0.2 (± 0.5) and 0.4 (± 0.6) bouts of 10, 5 and 2 min of PA, and 10.6 (± 2.0), 6.0 (± 1.3), 1.1 (± 0.9) and 0.4 (± 0.5) bouts/day of 5, 10, 30 and 60 min of SB, respectively. Boys accumulated less SB and more PA in bouts. No differences were found for weight status.Conclusion: Adolescents hardly engaged in bouted PA and accumulated more SB in smaller bouts during schooltime. Bouted PA and SB were not associated with weight status. What is Known: • Adolescents are not engaging in enough PA and are accumulating large volumes of SB, which might negatively impact their health. • Schools play an important role in daily overall PA, with opportunities such as PE classes and recesses. But most classes are still undertaken in seated positions. What is New: • Adolescents hardly engage in bouted (> 10 m) PA when at school., and most SB is accumulated in short bouts (≤ 10m). • Weight status was not associated with bouted PA or SB at school.

Aerobic Fitness and Moderate to Vigorous Physical Activity in Children and Adolescents Living with HIV.

PURPOSE: To examine aerobic fitness, total moderate to vigorous physical activity (MVPA) and also patterns in terms of MVPA between children and adolescents with human immunodeficiency virus (HIV) and controls, and to determine whether differences, if any, are associated with HIV, sex and highly active antiretroviral therapy (HAART). METHOD: A cross-sectional analysis was carried out with 130 children and adolescents, aged between 8 and 15 years, divided into two groups (HIV group= 65 patients, control group= 65 healthy participants). Total MVPA was measured by accelerometers and 5 and 10-min bouts were estimated. The peak oxygen uptake (peak VO2) was measured by breath-by-breath respiratory exchange in an incremental cycle ergometer test. RESULTS: HIV-positive participants had lower peak VO2 (39.2 ± 6.8 vs. 44.5 ± 9.1 ml.kg-1min-1), lower bouts of MVPA of 5-min (19.7 ± 16.6 vs. 26.6 ± 23.5) and 10-min (3.6 ± 3.9 vs. 5.8 ± 7.2), but similar total MVPA (49.5 ± 28.9 vs. 49.1 ± 30.6 min.day-1). HIV infection in untreated, nonprotease inhibitors (PI)- based HAART and PI-based HAART patients was associated with lower 8.5 (95%CI= 12.5-4.6), 7.1 (95%CI= 10.6-3.6) and 4.5 (95%CI= 7.0-2.0) ml.kg-1min-1 of peak VO2. CONCLUSION: Children and adolescents with HIV demonstrated lower aerobic fitness compared with the controls and the absence of HAART may increase peak VO2 impairment. Lower bouts of MVPA were also observed in HIV group despite the similar values of total MVPA of controls.

Prediction of Areal Bone Mineral Density and Bone Mineral Content in Children and Adolescents Living With HIV Based on Anthropometric Variables.

Children and adolescents living with HIV have low bone mass for age. There are reliable and accurate methods for evaluation of bone mass, however, alternative methods are necessary, especially, for application in limited-resource scenarios. Anthropometry is a noninvasive and low cost method that can predict bone mass in healthy youths. The aim of the study was to develop predictive equations for bone mineral content and bone mineral density in children and adolescents living with HIV based on anthropometric variables. Forty-eight children and adolescents of both sexes (24 females) from 7 to 17 years, living in greater Florianopolis area, Santa Catarina, Brazil, who were under clinical follow-up at "Hospital Infantil Joana de Gusmão", participated in the study. Dual-energy X-ray absorptiometry was used to evaluate whole-body bone mineral content (BMC) and areal bone mineral density (aBMD). Height, body weight, bone diameters, arm circumference, and triceps skinfold were measured and the body mass index and arm muscle area were calculated. Multiple regression models were fitted to predict BMC and aBMD, using backward selection (p ≥ 0.05). Two predictive models with high R2 values (84%-94%) were developed. Model 1 to estimate aBMD [Y = -0.1450124 + (height × 0.0033807) + (age × 0.0146381) + (body mass index × 0.0158838) + (skin color × 0.0421068)], and model 2 to estimate BMC [Y = 1095.1 + (body weight × 45.66973) + (age × 31.36516) + (arm circumference × -53.27204) + (femoral diameter × -9.594018)].The predictive models using anthropometry provided reliable estimates and can be useful to monitor aBMD and BMC in children and adolescents living with human immunodeficiency virus where limited resources are available.

Association Between Aerobic Fitness And High Blood Pressure in Adolescents in Brazil: Evidence for Criterion-Referenced Cut-Points.

PURPOSE: Criterion-referenced cut-points for health-related fitness measures are lacking. This study aimed to determine the associations between aerobic fitness and high blood pressure levels (HBP) to determine the cut-points that best predict HBP among adolescents. METHOD: This cross-sectional school-based study with sample of 875 adolescents aged 14-19 years was conducted in southern Brazil. Aerobic fitness was assessed using the modified Canadian Aerobic Fitness Test (mCAFT). Systolic and diastolic blood pressure were measured by the oscillometric method with a digital sphygmomanometer. Analyses controlled for sociodemographic variables, physical activity, body mass and biological maturation. RESULTS: Receiver Operating Characteristic (ROC) curves demonstrated that mCAFT measures could discriminate HBP in both sexes (female: AUC = 0.70; male: AUC = 0.63). The cut-points with the best discriminatory power for HBP were 32 mL·kg-1·min-1 for females and 40 mL·kg-1·min-1 for males. Females (OR = 8.4; 95% CI: 2.1, 33.7) and males (OR: 2.5; CI 95%: 1.2, 5.2) with low aerobic fitness levels were more likely to have HBP. CONCLUSION: mCAFT measures are inversely associated with BP and cut-points from ROC analyses have good discriminatory power for HBP.

Accuracy and measures of association of anthropometric indexes of obesity to identify the presence of hypertension in adults: a population-based study in Southern Brazil.

PURPOSE: This study proposes to examine the accuracy of four anthropometric indexes of obesity to identify the presence of hypertension and assess differences in the estimation and strength of effect measures of the association between each anthropometric measure and hypertension in Brazilian adults. METHODS: A population-based cross-sectional study was carried out with a sample of 1,720 adults from Florianópolis, Brazil. Receiver operating characteristic (ROC) curves were performed to identify the sensitivity and specificity of the best cutoff values for anthropometric indexes (body mass index-BMI, waist circumference-WC, waist-to height ratio-WHtR and conicity index-C-index) for prediction of hypertension. The associations between anthropometric indexes and hypertension were analyzed by Poisson regression expressed as Prevalence Ratios (95% CI) adjusted for socio-demographic variables, health behavior, height, and anthropometric indexes. RESULTS: Of the four anthropometric indexes studied, BMI, WC, and WHtR were found to have the largest areas under the ROC curve relative to hypertension in both sexes. The cutoff values in women and men associated with presence of hypertension were BMI of 24.9 and 24.6 kg/m(2), WC of 86.2 and 89.5 cm, WHtR of 0.49 and 0.50, and C-index of 1.15 and 1.18, respectively. WC and BMI had greater magnitude of association with presence of hypertension, adjusting for socio-demographic variables, health behavior, height, and anthropometric indexes in women and men, respectively. CONCLUSIONS: Anthropometric indexes provide an effective, simple, inexpensive, and non-invasive means for a first-level screening for hypertension.

Comparison of three criteria for overweight and obesity classification in Brazilian adolescents.

OBJECTIVE: To describe and compare the nutritional status of adolescents using three criteria for nutritional status classification (Conde & Monteiro, International Obesity Task Force - IOTF and Word Health Organization - WHO), to analyze the correlation between these three criteria as for the overweight proportion, and to investigate whether factors associated with overweight and obesity differ among the three criteria. METHODS: Demographic (gender, age, geographic area) and anthropometric (body weight, height) variables were measured in 33.728 adolescents aged 11 to 17 years. The following criteria were investigated: IOTF (2000); Conde & Monteiro (2006); and WHO (2007). RESULTS: The overall overweight prevalence was 20.6% for the Conde & Monteiro criteria; 15.3% for the IOTF criteria and 20.1% for the WHO criteria. Both for boys and girls, the estimated overweight prevalence using the Conde & Monteiro and WHO criteria were higher than that using the IOTF criteria. Higher concordance was found between the Conde & Monteiro (2006) and WHO (2007) criteria for all age groups. Regarding associated factors, similar associations were found for the three criteria for higher BMI classification: being male, 11-12 and 13-14 years of age and living in the Midwestern, Southeastern and Southern regions of Brazil. CONCLUSION: The criteria for BMI classification estimate overweight prevalence in a different way, and the criteria proposed by Conde & Monteiro resulted in higher prevalence in both sexes. Higher concordance between the Conde & Monteiro and WHO criteria was found for all age groups. The groups most vulnerable to showing overweight and obesity for the three criteria for BMI classification were males, age 11-12 and 13-14 years, and living in the Midwestern, Southeastern and Southern regions of Brazil. Overweight and obesity are considered a public health problem prevalent among adolescents in Brazil, regardless of the criteria adopted.

Development and validation of anthropometric equations to estimate appendicular muscle mass in elderly women.

OBJECTIVE: This study aimed to examine the cross validity of two anthropometric equations commonly used and propose simple anthropometric equations to estimate appendicular muscle mass (AMM) in elderly women. METHODS: Among 234 physically active and functionally independent elderly women, 101 (60 to 89 years) were selected through simple drawing to compose the study sample. The paired t test and the Pearson correlation coefficient were used to perform cross-validation and concordance was verified by intraclass correction coefficient (ICC) and by the Bland and Altman technique. To propose predictive models, multiple linear regression analysis, anthropometric measures of body mass (BM), height, girth, skinfolds, body mass index (BMI) were used, and muscle perimeters were included in the analysis as independent variables. Dual-Energy X-ray Absorptiometry (AMMDXA) was used as criterion measurement. The sample power calculations were carried out by Post Hoc Compute Achieved Power. Sample power values from 0.88 to 0.91 were observed. RESULTS: When compared, the two equations tested differed significantly from the AMMDXA (p <0.001 and p = 0.001). Ten population / specific anthropometric equations were developed to estimate AMM, among them, three equations achieved all validation criteria used: AMM (E2) = 4.150 +0.251 [bodymass (BM)] - 0.411 [bodymass index (BMI)] + 0.011 [Right forearm perimeter (PANTd) 2]; AMM (E3) = 4.087 + 0.255 (BM) - 0.371 (BMI) + 0.011 (PANTd) 2 - 0.035 [thigh skinfold (DCCO)]; MMA (E6) = 2.855 + 0.298 (BM) + 0.019 (Age) - 0,082 [hip circumference (PQUAD)] + 0.400 (PANTd) - 0.332 (BMI). The equations estimated the criterion method (p = 0.056 p = 0.158), and explained from 0.69% to 0.74% of variations observed in AMMDXA with low standard errors of the estimate (1.36 to 1.55 kg) and high concordance (ICC between 0,90 and 0.91 and concordance limits from -2,93 to 2,33 kg). CONCLUSION: The equations tested were not valid for use in physically active and functionally independent elderly women. The simple anthropometric equations developed in this study showed good practical applicability and high validity to estimate AMM in elderly women.

Morphological characteristics of professional ballet dancers of the Bolshoi theater company.

The objective of this study was to describe the morphological profile ofprofessional dancers compared with university physical education students. Thirty-five subjects were evaluated as follows: 13 professional ballet dancers of the Bolshoi Theater Company, six males and seven females, and 22 university physical education students, 11 males and 11 females. Body mass, height, skinfold (triceps, biceps, subscapular, chest, axilla, supraspinale, Iliac crest, abdominal, Front thigh, medial calf) girth (Arm flexed and tensed, forearm, waist, gluteal girth, Mid-thigh girth and calf) and breadth (wrist, ankle, Biepicondylar humerus and femur) were evaluated and somatotype, body fat percentage (BF%) body mass index (BMI), Sigma7 Skinfolds lean body mass, bone, residual and muscle mass were calculated. Dancers showed lower values for BMI, sum of seven skinfolds, BF%, body fat percentage, fat mass, residual mass (p<0.05). For females, lean body mass was also lower in the group of dancers. Body muscle values were lower for university physical education students of both sexes (p<0.05). When assessing differences between male and female dancers and male and female university physical education students, dancers appeared to be more homogeneous than students. As for somatotype, male dancers showed predominance of mesomorphy over the other components and female dancers showed predominance of ectomorphy. The intense training in classical ballet interfered in body composition components, changing them significantly.

Is high body fat estimated by body mass index and waist circumference a predictor of hypertension in adults? A population-based study.

BACKGROUND: The aim of this study was to assess the predictive capacity of body fat percentage (%BF) estimated by equations using body mass index (BMI) and waist circumference (WC) to identify hypertension and estimate measures of association between high %BF and hypertension in adults. METHODS: This is a cross-sectional population-based study conducted with 1,720 adults (20-59 years) from Florianopolis, southern Brazil. The area under the ROC curve, sensitivity, specificity, predictive values, and likelihood ratios of cutoffs for %BF were calculated. The association between %BF and hypertension was analyzed using Poisson regression, estimating the unadjusted and adjusted prevalence ratios and 95% CI. RESULTS: The %BF equations showed good discriminatory power for hypertension (area under the ROC curve > 0.50). Considering the entire sample, the cutoffs for %BF with better properties for screening hypertension were identified in the equation with BMI for men (%BF = 20.4) and with WC for women (%BF = 34.1). Adults with high %BF had a higher prevalence of hypertension. CONCLUSIONS: The use of simple anthropometric measurements allowed identifying the %BF, diagnosing obesity, and screening people at risk of hypertension in order to refer them for more careful diagnostic evaluation.

The simultaneous presence of health risk behaviors in freshman college students in Brazil.

The objective of this study was to assess the prevalence and factors associated with simultaneous health risk behaviors in freshmen college students enrolled in a Brazilian university. We interviewed 738 students (59.2% men) with average age of 20.1 years (CI 95%: 19.8-20.5). The risk behaviors assessed were smoking habit, alcohol use, unhealthy diet and physical inactivity. Independent variables were sex, age, employment, marital status, maternal education, study shift and socioeconomic level. It was found that 8.7% were smokers, 45.9% showed alcohol abuse, 59.4% had inadequate diet and 18.5% were physically inactive. Of the students, 20.2% showed no risk behavior, 39.1% one behavior, 29.0% two risk behaviors and 11.7% three and/or four risk behaviors. Males (OR: 2.04, CI 95%: 1.13-3.67) and night shift students (OR: 1.83, CI 95%: 1.01-3.33) were more likely to have three and/or four risk behaviors. Health promotion interventions focusing simultaneous behavior changes should be employed at the university.

Prevalence and factors associated with high body fat in adolescents from a region of Brazil.

The objective of this study was to identify the prevalence and factors associated with high body fat in adolescents. A cross-sectional study conducted with 601 students from both sexes aged 14-17 years who live in Midwestern state of Santa Catarina, Brazil. Body adiposity was assessed by the sum of subscapular and triceps skinfolds. Sociodemographic variables such as lifestyle, aerobic fitness and nutritional status were assessed. For data analysis, Poisson regression multivariable was used. The prevalence of high body fat was 51.2% for girls and 31.2% for boys. Higher prevalences of high body fat were observed for girls aged 16-17 years (PR: 1.15, CI 95%: 1.07-1.24) and overweight (PR: 1.36, CI 95%: 1.27-1.44) and for boys with high socioeconomic level (PR: 1.21, CI 95%: 1.09-1.34), inadequate eating habits (PR: 1.11, CI 95%: 1.02-1.21), physically inactive (PR: 1.10, CI 95%: 1.02-1.19) and overweight (PR: 1.46, CI 95%: 1.35-1.57). The prevalence of high body fat was high and factors associated with this outcome are different for each sex; thus, interventions for prevention and control of obesity should be different for girls and boys.

Muscle mass indicators as fat-free mass and lean soft tissue mass are associated with handgrip strength in HIV-diagnosed children and adolescents.

OBJECTIVE: To verify the association between fat free mass (FFM) and lean soft tissue mass (LSTM) with handgrip strength (HGS) in HIV children and adolescents, according to sex. METHOD: This cross-sectional study included 65 HIV children and adolescents, aged from 8-15 years (30 boys and 35 girls). FFM and LSTM were measured by dual-energy X-ray absorptiometry (DXA). HGS was measured with hydraulic dynamometer. Bone age was assessed by radiography of the wrist of the left carpus and moderate to vigorous physical activity was obtained through the use of accelerometers. The use of antiretroviral drugs (ART) was obtained from the medical records of each participant. RESULTS: For boys, the FFM model explained 86% the HGS variability (p < 0.001). For girls, the FFM model explained 90% the HGS variability (p < 0.001). LSTM explained 88% the HGS variability for both sexes. CONCLUSION: FFM and LSTM were directly associated with HGS. However, models with bone age, physical activity level and type of ART improved the explanatory power of LLM and LSTM in HGS.

Does antiretroviral therapy change the relationship between body composition and muscle strength in children and adolescents diagnosed with HIV?

Background: HIV infection and prolonged use of antiretroviral therapy (ART) can impact the body composition and muscle strength of HIV-infected children and adolescents. Therefore, the aim was to verify the association between lean soft tissue mass (LSTM) and handgrip strength (HGS) in children and adolescents diagnosed with HIV using or not using ART (with or without protease inhibitors [PI]).Method: Cross-sectional study with 65 children and adolescents diagnosed with HIV aged 8-15 years of both sexes. LSTM was obtained through dual X-ray absorptiometry (DXA) and HGS using hydraulic dynamometer. Information on viral load, CD4+ T lymphocytes and type of ART (with or without [PI]) were obtained from medical records. Simple and multiple linear regression (adjusted for viral load and CD4+ T lymphocytes) was used, with p < 0.05.Results: For children and adolescents diagnosed with HIV using ART without PI, the model (LSTM, viral load and CD4+ T lymphocytes) explained 68% of HGS variability. For group with ART and PI, the model explained 73%. For group that did not use ART, the model was not associated with HGS.Conclusion: The magnitude of the association between LSTM and HGS was greater than in children and adolescents using ART with PI. ImpactIt is recognized that in the long-term antiretroviral drugs can negatively impact the body composition of children and adolescents diagnosed with HIV. However, few studies have investigated the short-term impact of drug use.The use of antiretroviral therapy (ART) with protease inhibitor (PI) increased the explanatory power of lean soft tissue mass with muscle strength in children and adolescents diagnosed with HIV.These results demonstrate the importance of antiretroviral drugs in the short term. Further studies are needed to identify how and when interventions are needed to reduce the negative effects of drugs in the long term.

Association between bone mineral density and content and physical growth parameters among children and adolescents diagnosed with HIV: a cross-sectional study.

BACKGROUND: During childhood and adolescence, there are significant increases in bone mineral content (BMC) and bone mineral density (BMD). OBJECTIVE: To investigate physical growth parameters associated with BMD and BMC among children and adolescents diagnosed with human immunodeficiency virus (HIV). DESIGN AND SETTING: Cross-sectional study conducted in Florianópolis, Brazil, among 63 children and adolescents (aged 8-15 years) diagnosed with HIV. METHOD: BMD, BMC and fat percentage z score were evaluated using dual X-ray absorptiometry. Age/height z score and body mass index (BMI)/age z score were obtained in accordance with international recommendations, and bone age was obtained through hand-wrist radiography. Sex, family income, information on HIV infection (T CD4+ lymphocyte count, viral load and type of antiretroviral therapy, moderate-vigorous physical activity and sedentary behavior) were used as adjustment variables in the analyses. Simple and multiple linear regression analyses were performed, with a significance level of P ≤ 0.05. RESULTS: Subtotal BMD (without the head region) was directly associated with bone age, BMI/age z score and fat percentage z score, even after adjusting for covariates. Subtotal BMC/height was directly associated with bone age, height/age z score, BMI/age z score and fat percentage z score, even after adjusting for covariates. CONCLUSION: Subtotal BMD and subtotal BMC/height were directly associated with physical growth indicators among children and adolescents diagnosed with HIV.

Epidemiology of whole body, peripheral, and central adiposity in adolescents from a Brazilian state capital.

The aim of this study was to associate the epidemiology of whole body, peripheral, and central adiposity with sociodemographic characteristics, health-related behaviors, and biological maturation of adolescents from a Brazilian state capital. A cross-sectional school-based study was conducted in Florianopolis, Santa Catarina, Brazil with 818 adolescents aged 14 to 18 years, and 61.8% female. The peripheral adiposity was assessed by the triceps skinfold thickness and the central adiposity by the subscapular skinfold thickness, using cutoff greater than or equal to percentile 90 of the Centers for Disease Control and Prevention reference curve. Adolescents with high whole body adiposity were those showing skinfold thickness values above the reference percentile. Logistic regression analysis was applied using multivariable model. The prevalence of high whole body, peripheral, and central adiposity was 8.0%, 8.7%, and 10.3% for boys and 3.8%, 6.3%, and 11.1% for girls, respectively. Factors associated with this outcome in boys were overweight/obesity and low aerobic fitness (p < 0.05). Besides these factors, girls were also associated with excessive body fat, low paternal schooling, and puberty status (p < 0.05). Physical activity, sedentary behavior, and eating habits were not associated with this outcome. It was concluded that the main predictors of high body adiposity were overweight and low aerobic fitness in both sexes and low parental schooling and puberty status in females.

Epidemiology of abdominal obesity among adolescents from a Brazilian State Capital.

The objective of this study was to investigate the effects of socioeconomic, demographic and lifestyle factors on abdominal obesity in adolescents from a Brazilian state capital. In this cross-sectional study, 656 high school students (423 girls and 233 boys) from public schools, ranging in age from 14 to 19 yr, were evaluated. Abdominal obesity was identified based on waist circumference. Socioeconomic data (socioeconomic status, household head's education, and school grade), demographic data (gender and age), and information regarding lifestyle (physical activity, eating habits, aerobic fitness, and nutritional status) were collected. Logistic regression was used for multivariate analysis. The prevalence of abdominal obesity was 6.6% (95% confidence interval [CI]: 4.6-8.4). Being in the second (odds ratio [OR] = 0.41; 95% CI: 0.19-0.88) or third year (OR = 0.18; 95% CI: 0.06-0.59) of high school was a protective factor against abdominal obesity. In addition, students presenting low aerobic fitness (OR = 4.10; 95% CI: 1.62-10.4) and those with excess weight (OR = 208.6; 95% CI: 47.7-911.7) had a higher probability of abdominal obesity. In conclusion, demographic factors such as school grade, lifestyle habits, low aerobic fitness and excess weight are associated with central obesity.

Association between handgrip strength and bone mass parameters in HIV-infected children and adolescents. A cross-sectional study.

BACKGROUND: Low bone mineral content (BMC) and bone mineral density (BMD) have been identified in human immunodeficiency virus (HIV)-infected children and adolescents. The direct adverse effects of HIV infection and combined antiretroviral therapy (ART) negatively contribute to bone metabolism. A direct relationship between muscle strength levels and BMD in HIV-infected adults and older adults has been described. However, it is unknown whether handgrip strength (HGS) is associated with bone mass in pediatric populations diagnosed with HIV. OBJECTIVE: To ascertain whether HGS levels are associated with BMC and BMD in HIV-infected children and adolescents. DESIGN AND SETTING: Cross-sectional study conducted in Florianãpolis, Brazil, in 2016. METHODS: The subjects were 65 children and adolescents (8-15 years) diagnosed with vertically-transmitted HIV. Subtotal and lumbar-spine BMC and BMD were obtained via dual-emission X-ray absorptiometry (DXA). HGS was measured using manual dynamometers. The covariates of sex, ART, CD4+ T lymphocytes and viral load were obtained through questionnaires and medical records. Sexual maturation was self-reported and physical activity was measured using accelerometers. Simple and multiple linear regression were used, with P < 0.05. RESULTS: HGS was directly associated with subtotal BMD (ß = 0.002; R² = 0.670; P < 0.001), subtotal BMC (ß = 0.090; R² = 0.734; P = 0.005) and lumbar-spine BMC (ß = 1.004; R² = 0.656; P = 0.010) in the adjusted analyses. However, no significant association was found between HGS and lumbar-spine BMD (ß = 0.001; R² = 0.464; P = 0.299). CONCLUSION: HGS was directly associated with BMD and BMC in HIV-infected children and adolescents.

Association between phase angle and isolated and grouped physical fitness indicators in adolescents.

OBJECTIVE: Examine association between phase angle and isolated and grouped physical fitness indicators in adolescents. METHODS: The sample consisted of 353 adolescents, aged 10-16 years. Phase angle was calculated based on crude resistance and reactance values (50 kHz frequency) obtained by tetrapole electrical bioimpedance (BIA). Fat mass and lean mass were estimated by means of anthropometric equations. Hydraulic dynamometer was used to measure handgrip strength and aerobic fitness was obtained by means of the 20-m back-and-forth test. The z-score for isolated and grouped physical fitness indicators was calculated. Covariates were age, habitual physical activity and screen time (obtained by questionnaire), and sexual maturation (self-reported). RESULTS: For males, phase angle was directly associated with lean mass (ß = 0.02, p < 0.01), handgrip strength (ß = 0.03, p < 0.01), and aerobic fitness (ß = 0.01, p = 0.05), even adjusting for covariates. For females, phase angle was directly associated with lean mass (ß = 0.02; p = 0.04) after adjusting for covariates. Phase angle was directly associated with composite physical fitness z-score in both sexes (male, ß = 0.09, p < 0.01, female, ß = 0.03, p = 0.05), even adjusting for covariates. CONCLUSIONS: Phase angle was directly associated with isolated and grouped physical fitness indicators in adolescents. In this way, the phase angle can be used to monitor the health of adolescents.