Temporal trend of food consumption markers, breakfast consumption and association with overweight/obesity in schoolchildren aged 7 to 10 years between 2007 and 2019.

Obesity has a multifactorial origin. Among the behavioural risk factors, excessive consumption of unhealthy foods, skipping breakfast and reduced physical activity stand out. The main objective of this article was to identify trends in dietary habits and their association with overweight/obesity over a 12-year period in schoolchildren aged 7 to 10 years in Florianópolis, southern Brazil. A cross-sectional panel analysis study, using anthropometric, sociodemographic, physical activity and food consumption data of schoolchildren aged 7 to 10 years, collected in three waves of the Study of Prevalence of Obesity in Children and Adolescents (EPOCA), carried out during the years 2007, 2012/2013 and 2018/2019, was performed. To analyse the trend in dietary variables over the years, the 95% CIs were compared with the non-overlap of intervals indicating statistical significance. Multiple logistic regression analysis was performed to test the association of weight status with dietary markers. The prevalence of overweight/obesity was 34.4%, 37.2% and 34.2% in 2007, 2012/2013 and 2018/2019, respectively, and there were no statistically significant differences among waves. There was a progressive and significant reduction in the consumption of soft drinks and sweets and in eating breakfast by schoolchildren, from 2007 to 2019. Breakfast consumption was inversely associated with the chance of overweight/obesity (OR 0.74, 95% CI 0.59-0.93), and female students were less likely to have overweight/obesity when compared to boys (OR 0.70, 95% CI 0.61-0.81). The reduction in the consumption of soft drinks and sweets over the years might be caused by efforts in public policies that intended to reduce the consumption of unhealthy foods among schoolchildren. The progressive and significant reduction in having breakfast should be better elucidated in future studies, to minimise the potential impact of this practice on schoolchildren's bodyweight.

Dietary patterns and biochemical markers related to diabetes mellitus: an association analysis based on data from the Study of Cardiovascular Risk in Adolescents (ERICA).

OBJECTIVE: The aim of this study was to investigate the association between dietary patterns and biochemical markers related to diabetes mellitus (DM): glucose, insulin, glycated hemoglobin (HbA1c), and homeostasis model assessment of insulin resistance index from 35 454 Brazilian adolescents 12 to 17 y of age. METHODS: Dietary patterns were derived using factor analysis by the principal components method. The data originated from the school-based study ERICA (Study of Cardiovascular Risk in Adolescents) carried out between 2013 and 2014. Linear regression models analyzed the associations. RESULTS: Three dietary patterns were found: traditional Brazilian, bread and coffee, and Western. An inverse association was found in young girls between the traditional Brazilian pattern and fasting glucose (ß = -0.76; P = 0.005) and HbA1c in the second and third tertiles (ß = -0.04; P = 0.002; ß = -0 .06; P < 0.001), and the Western pattern with HbA1c (ß = -0.02; P = 0.035). In boys, a positive association was found between the second tertile of the dietary pattern and insulin (ß = 0.48; P = 0.009) and homeostasis model assessment of insulin resistance index (ß = 0.11; P = 0.012). CONCLUSIONS: This study showed that the traditional Brazilian pattern was inversely associated with blood glucose and HbA1c values in girls. Furthermore, the data suggest that there is an important difference between boys and girls in the association of dietary patterns and the markers used.

Trends in the prevalence of obesity, overweight, and thinness among schoolchildren aged 7-14 years from southern Brazil (2002-2019).

OBJECTIVE: To analyze the obesity, overweight, and thinness trends among Brazilian schoolchildren by sex, age group, and type of school according to World Health Organization (WHO) and International Obesity Task Force (IOTF) criteria. METHODS: We conducted four surveys between 2002 and 2018/19 involving schoolchildren aged 7-14 years from a state capital in southern Brazil. Weight status was classified using both WHO and IOTF criteria. RESULTS: In the total sample, obesity prevalence based on the IOTF and the WHO criteria were 72% and 44% higher in 2018/19 compared with 2002, respectively. Over the whole period, the obesity prevalence increased among children (WHO: 10.1% vs. 14.1%; IOTF: 5.0% vs. 8.3%), and those from public schools (WHO: 10.5% vs. 16.4%; IOTF: 5.6% vs. 10.1%). There was no significant reduction in thinness prevalence over the analyzed period. CONCLUSION: Obesity prevalence remains on an upward trend in a state capital in southern Brazil, especially among children from public schools. A higher prevalence of overweight and obesity was observed using the WHO criteria compared with IOTF criteria.

Omega-3 and omega-6 fatty acids food intake and metabolic syndrome in adolescents 12 to 17 years old: A school-based cross-sectional study.

BACKGROUND & AIMS: Fatty acids (FAs) of the omega-3 and omega-6 family are considered essential, and adequate intake seems to be associated with lower risk of developing chronic non-communicable diseases. The objective was to evaluate the association of omega-3 and omega-6 FAs dietary intake with the prevalence of MS and its components waist circumference (WC), blood pressure (BP), fasting blood glucose, triglycerides and High Density Lipoprotein - cholesterol (HDL-c) in Brazilian adolescents aged 12-17 years. METHODS: This is a school-based cross-sectional investigation, using data from the Study of Cardiovascular Risks in Adolescents (ERICA), carried out between 2013 and 2014. The following variables were collected and assessed: 1) sociodemographic (sex, age, type of school, school location whether urban or rural and region of the country); 2) food consumption was measured through a 24-h Food Recall (24 hR), and a second 24 hR was applied to 7% of the total sample; 3) anthropometrics (weight, height, WC), BP and biochemical (glycemia, triglycerides and HDL-c) were also assessed. Logistic regression analysis was performed according to gender and age group. RESULTS: A total of 36,751 adolescents participated in the study. The intake of omega-3 FAs in the total population was 1.71 g/day and of omega-6 FAs, 13.56 g/day, with an omega-6/omega-3 ratio of 7.93:1. It was found that higher intake of omega-3 FAs was associated with an 53% lower chance of low HDL-c. For omega-6 FAs, no significant results were found. CONCLUSIONS: The findings indicated an association between omega-3 FAs and HDL-c. More studies are needed to elucidate the effects of omega-6 FAs.

Methodological aspects and characteristics of participants in the study on the prevalence of obesity in children and adolescents in Florianópolis, Southern Brazil, 2018-2019: EPOCA study.

PURPOSE: To describe the methodological aspects and characteristics of the participants of the EPOCA survey. METHODS: The study was conducted with schoolchildren aged between seven to 14 years old from 30 schools in Florianópolis, Southern Brazil. Body mass, height, girths, and skinfold thicknesses were measured. Food consumption and physical activity from the previous day were self-reported using the validated Web-CAAFE questionnaire. Adolescents completed a specific questionnaire about physical activity, meal consumption, and weight control behaviors. Parents/guardians responded to a sociodemographic and habits questionnaire. RESULTS: A total of 1671 schoolchildren participated in the study (response rate: 27.2%). About 63% of schoolchildren were enrolled in public schools. Most studied in the morning shift (54.2%), were female (53.1%) and aged between seven and 10 years (58.1%). The prevalence of overweight was 33.7% and obesity was 11.3%. CONCLUSIONS: The data obtained will allow us to assess the trend in the prevalence of overweight and obesity and associated factors when compared to other surveys performed. Descriptions of the logistics and protocols can help in the development and improvement of similar studies. It is hoped that the results of EPOCA 2018/2019 may help in the design of obesity prevention policies and programs for this population.

Scientific evidence of the association between oral intake of OMEGA-3 and OMEGA-6 fatty acids and the metabolic syndrome in adolescents: A systematic review.

AIMS: To conduct a systematic review of the literature on the scientific evidence of the oral intake of omega-3 and omega-6 FAs and metabolic syndrome (MS) in adolescents. DATA SYNTHESIS: The study was registered in PROSPERO (number 42020185370). Studies were carried out with adolescents aged 10-19 years, who presented as intervention/exposure the oral intake of omega-3 and/or omega-6 fatty acids (FAs), in the databases PubMed, Scopus, Web of Science, LILACS, CENTRAL, and PQDT Global e BDTD. The tools used to assess the risk of bias were RoB 2.0, Agency for Healthcare Research and Quality (AHRQ), and Newcastle-Ottawa Scale. Fifteen papers retrieved published from 2010 to 2019 were included (n = 3534); nine were randomized studies and controlled clinical trials, four were cross-sectional studies, one was a retrospective cohort study, and one case-control study. No studies have evaluated the effect or association of omega-3 and/or of omega-6 FAs with actual MS, only with its components. The randomized clinical trials identified the effects of omega-3 FA on the decrease in blood pressure (n = 1 out of six), glycemia (n = 2 out of seven), and triglycerides (n = 5 out of eight), and the increase in HDL-c (n = 2 out of eight) considering the comparison between the group that received omega-3 FA and the control group. CONCLUSIONS: Scientific evidence is controversial on the association between oral intake of omega-3 FAs and MS in adolescents, due to the heterogeneity between studies and the divergence of results for the same MS component.

Age at menarche and its association with overweight including obesity and socio-economic conditions of Brazilian schoolgirls: A time-trend analysis.

This study aims to describe the time trend of age at menarche in Brazilian schoolgirls evaluated in 2007, 2012/2013 and 2018/2019, and to assess its association with having overweight, including obesity and socio-economic conditions. Three cross-sectional studies were carried out in 2007, 2012/2013 and 2018/2019 in schoolchildren enrolled between the second and ninth years of elementary school and comprising 838, 688 and 326 schoolgirls, respectively. Body mass index Z scores were calculated and categorised as either without overweight or with overweight (including obesity). The type of school (a proxy of socio-economic condition) was categorised as either public or private. Menarche data were collected using the status quo and recall methods. The mean age at menarche was estimated by survival analysis. Differences in age at menarche according to the year of survey, weight status and type of school were verified by the Log-Rank test and Cox's univariate and multiple regression. There was an increase in the prevalence of overweight in girls throughout the surveys, with 21.4% in 2007, 27.2% in 2012 and 28.5% in 2018 (p = 0.007) having overweight. There was a decrease in the mean age at menarche between 2007 and 2018/2019 (12.3 vs. 11.9 years, respectively). The mean age at menarche in girls with overweight was lower in the three time periods when compared to girls without overweight (11.9, 11.8 and 11.5 vs. 12.4, 12.4 and 12.1, respectively). Girls with overweight were more likely to have had earlier age at menarche than girls without overweight (Hazard Ratio 1.57; 95% CI 1.36; 1.80). There were no differences in the age at menarche according to the type of school. The increase in the prevalence of girls with overweight (including obesity) may be associated with the age at menarche. Girls with overweight had a higher risk of earlier age at menarche than girls without overweight.

Body image and association with BMI, and purgative behaviours for weight control in adolescents aged 11-14 years.

We aimed to evaluate the association of overweight/obesity based in BMI and purgative behaviours with body image (BI). Methods: Cross-sectional study, with probabilistic sample of 976 adolescents, aged 11-14 years, from the city of Florianópolis, Brazil. Multivariate analyses were performed. Overweight (including obesity) and four variables related to purgative methods for body weight control or eating behaviour were evaluated as outcomes, while BI satisfaction was the primary independent variable in each model. Models were controlled for age, sex, type of school (public or private), intake of fruit and vegetables, number of daily meals, and physical activity scores levels. A total of 31·4 % of adolescents wanted to enlarge their silhouette and 45·6 % wanted to reduce it. Among overweight/obese adolescents, 9·6 % were satisfied with their bodies, while 89·8 % wanted to reduce it, while among the not overweight/obese adolescents, 45·4 % wanted to enlarge their silhouette (P < 0·001). Multivariate analysis showed that the odds for overweight/obesity is higher among adolescents who wanted to reduce their silhouette (OR = 11·20; 95 % CI = 5·55, 22·58). Adolescents who want to reduce their silhouette are more likely to use diuretics (OR = 3·08; CI = 1·78, 5·32) and to use laxatives (OR = 2·10; CI = 1·20, 3·68). A significant association was also found between dissatisfaction with BI and overeating (among those who want to enlarge their silhouette: OR = 1·78; CI = 1·12, 2·85 and among those who want to reduce their silhouette: OR = 1·81; CI = 1·03, 3·19). Conclusion: BI dissatisfaction was associated with overweight/obesity, as well with overeating, and the use of purgative methods.

DASH diet (Dietary Approaches to Stop Hypertension) and overweight/obesity in adolescents: The ERICA study.

BACKGROUND & AIMS: Childhood and adolescent obesity is one of the most important issues in the global health of the population and has been increasing dramatically in recent decades. The aim of this study was to evaluate the association between overweight/obesity and the Dietary Approaches to Stop Hypertension (DASH) diet score in a representative sample of Brazilian adolescents. METHODS: Data from the Study of Cardiovascular Risks in Adolescents (ERICA), a national school-based survey, were used. A total of 71,553 adolescents (12-17 years old), of both sexes, participated in the study; they had their anthropometric measurements taken and responded to a 24-h dietary recall. Eight food components of the DASH score were evaluated. 1) fruits (except fruit juices), 2) vegetables (except potatoes and beans), 3) pulses/nuts, 4) whole grains, 5) low-fat and diet/light dairy products, 6) sodium, 7) red and processed meats, and 8) sugary drinks and fruit juices. A higher score was indicative of greater accordance with the DASH diet, with a final score ranging from eight to 40 points. The association between overweight/obesity and the DASH score was assessed using Poisson regression models. RESULTS: The highest prevalence of overweight/obesity was observed among boys aged 12-14 years (28.2%), white (27.7%), enrolled in private schools (32.4%) and among those who practiced ≥300 min physical activity/week (26.1%). The food groups most frequently consumed were sugary drinks, pulses and nuts, and red and processed meats. No association was found between overweight/obesity and the DASH diet score in Brazilian adolescents, in the adjusted analysis models. CONCLUSIONS: Low consumption of foods considered protective and high consumption of health-risk foods, even among adolescents with greater accordance with the DASH diet, may have contributed to these findings. Public health measures are needed to prevent/reduce the prevalence of overweight/obesity in adolescence, as it is a risk for overweight/obesity in adulthood as well as other complications, leading to loss of quality of life for the individual and increased health spending.

Association between pubertal development stages and body adiposity in children and adolescents.

BACKGROUND: The study aimed to analyze the association between pubertal development stages and adiposity in children and adolescents. METHODS: Cross-sectional study conducted in 2007 in Florianópolis, Brazil, with 2339 schoolchildren 32 aged 8 to 14 years old (1107 males). The outcome (adiposity) was evaluated using Z score and 33 percentilee values > = 85 of four skinfolds (triceps, subscapular, suprailiac and calf) and waist 34 circumference. Total body adiposity (Z score of the sum of skinfolds), central adiposity (Z score 35 of waist circumference) and peripheral adiposity (Z scores of triceps and calf skinfolds) were 36 estimated. Pubertal development stages was self-assessed according to Tanner stages of development. Thirty-seven Children and adolescents were classified according to tertiles of age for each pubertal development stages 38 stage - early, normal and late. Statistical analysis was performed using univariate and 39 multivariate Poisson regression models. RESULTS: Children and adolescent from both sexes with early pubertal development stages presented higher prevalence of central adiposity (waist circumference), with adjusted prevalence ratio (CI 95%) of 2.21 (1.12; 4.35) for males and 2.18 (1.04; 4.57) for females (reference group: normal pubertal development stages). Among females, there was a reduction in the prevalence of excess adiposity with decreased occurrence of early pubertal development stages. There was a strong relationship between adiposity and pubertal development stages. CONCLUSIONS: Excess adiposity was higher in both sexes for those with early pubertal development stages.

Influence of sexual maturation status on the relationship between body adiposity indicators and age: a cross-sectional study.

OBJECTIVES: To determine the influence of sexual maturation status on adiposity indicators of children and adolescents. RESULTS: 2412 individuals participated, 1285 (47.4%) males and 1408 (52.6%) females. There was moderate to weak correlation between age and adiposity indicators for both sexes. By analyzing the relationship between age and body fat indexes adjusted for Sexual Maturation Status, several changes were observed, mainly in girls. Precocious maturation was associated with increased adiposity indicators in girls, whereas late maturation was associated with decreased adiposity indicators in both sexes. Precocious maturation was associated with increased adiposity indicators in girls, whereas late maturation was associated with decreased adiposity indicators in both sexes.

Association between food, physical activity, and social assistance environments and the body mass index of schoolchildren from different socioeconomic strata.

The aim of this article was to evaluate associations between body mass index (BMI) and use of and distance from subjects homes of elements of the food and physical activity environments and use of social assistance environment, in schoolchildren from 7 to 14 years living in Florianópolis (South Brazil), stratified by monthly family income. A cross-sectional study was conducted with a probabilistic sample of 2152 schoolchildren. Univariate and multivariate linear regression analyses were conducted to test for associations between BMI and the use of and distance from supermarkets, bakeries and farmers' markets; use of and distance from parks/playgrounds and football pitches; and use of health centers, Reference Centers for Social Assistance, instructional facilities, residents associations, religious groups and a Brazilian program for cash transfer. Overweight and obesity rates were 21.5 and 12.7%, respectively. Among schoolchildren from low-income families, living more than 11 min' walk from parks/playgrounds was associated with higher BMI (ß = 0.53; 95% CI = 0.33-0.73). In the high-income strata, a longer distance from home to football pitches was associated with lower BMI (ß = -0.49; 95% CI = -0.69; -0.29). Neither food nor social assistance environments were associated with BMI of schoolchildren, even when analyzed by income strata.

Effects of the Dietary Approach to Stop Hypertension (DASH) diet on blood pressure, overweight and obesity in adolescents: A systematic review.

BACKGROUND & AIMS: The high prevalence of overweight/obesity, and arterial hypertension (AH) in adolescence is a public health problem worldwide. The aim of the article is to perform a systematic review looking to verify the effects of DASH diet on overweight/obesity and blood pressure (BP) in adolescents. METHODS: Systematic search of the literature conducted until March 2018. Five databases were investigated. We follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) Statement. The systematic review protocol was recorded in PROSPERO (CRD42016046968). Two reviewers examined 1005 abstracts. The risk of bias was assessed using STROBE or CONSORT. RESULTS: Seven studies were eligible, three cross-sectional, two cohort and two randomized clinical trials (RCTs). Cross-sectional study found that a higher DASH score was associated with decreased body composition measurements; the other two did not find associations between DASH scores, body weight, and BP. Cohort studies found that the DASH diet resulted in lower levels of diastolic BP and lower body mass index gain over 10 years. One RCT showed that the DASH diet proved to be effective in improving systolic BP and another RCT observed a decrease in the prevalence of AH. CONCLUSIONS: The DASH diet may have beneficial effects on the alterations of BP, overweight and obesity in adolescence. However, adherence to this dietary pattern is still low. It is believed that, in the future, dietary interventions based on DASH may be part of public policies to combat AH and overweight/obesity, since all age groups of the population can adopt this dietary pattern.

Utilization and environmental availability of food outlets and overweight/obesity among schoolchildren in a city in the south of Brazil.

Among the causes of obesity, environmental factors have also been studied, in addition to genetic, social, psychological, and hormonal factors. The distribution of food outlets, facilitating or hindering food acquisition, can promote body weight control by encouraging healthier food habits. The objective of this study was to investigate associations between environmental availability and utilization of food outlets and overweight/obesity in 7 to 14-year-old schoolchildren in Florianópolis, in the South of Brazil. A logistic regression analysis identified a positive association between overweight/obesity in 2195 schoolchildren and the presence of restaurants in the vicinity of their homes (buffer = 400 meters). Being a member of a family that utilizes public markets/greengrocers was also positively associated with overweight/obesity in the sample investigated. Identifying the distribution of these establishments in the vicinity of the homes of schoolchildren in middle-income countries is an important element in understanding the role played by the food environment in weight gain in a variety of different settings.

[Association between dietary intake, physical activity, socioeconomic factors and body fat percentage among schoolchildren]. / Associação entre consumo alimentar, atividade física, fatores socioeconômicos e percentual de gordura corporal em escolares.

The scope of this article was to assess the association between dietary intake, physical activity and socioeconomic factors associated with body fat percentage in 7 to 14-year-old schoolchildren. It is a cross-sectional study with a probability sample of 2,481 students from public and private schools in Florianópolis, Santa Catarina, Brazil. Body fat percentage was investigated by measuring triceps and subscapular skin folds. Poisson regression was performed to test the association between excess body fat and independent variables, estimating prevalence ratios and 95% confidence intervals. The prevalence of excess body fat was 23.9%, though there was no significant difference between sex (p = 0.359) and age (p = 0.202). Excess body fat was associated with different factors in 11 to 14-year-old schoolchildren, namely eating less than three meals a day (OR = 1.62, CI: 1.38 to 1.91) and consumption of high-risk food more than 3 times a day (OR = 0.61 CI: 0.47 to 0.79). No significant difference was observed with physical activity. The high prevalence of excess body fat detected reveals the need for fostering the adoption of healthier behavioral practices (in relation to nutrition and physical activity) by schoolchildren.

Association between body image dissatisfaction and obesity among schoolchildren aged 7-10years.

OBJECTIVE: The aim of this study is to evaluate the association between body image dissatisfaction and measurements of obesity - body mass index, waist circumference and body fat percentage - in students aged 7 to 10years in Florianopolis, Santa Catarina. METHODS: Body image dissatisfaction was assessed by the Figure Rating Scale for Brazilian children. Association analyses were performed using multinomial logistic regression. RESULTS: Body dissatisfaction was prevalent in 82.9% of the students, of whom 59.9% desired a smaller body size and 23.0% desired a larger body size, with a significant difference between the sexes. In boys, overweight, obesity and central obesity remained associated with the desire for a smaller body size, whereas for girls overweight and excess body fat were associated with the desire for a smaller body size. CONCLUSIONS: The results point to a normative discontent and indicate the need to include the topic of body image in the school curriculum.

ERICA: prevalence of healthy eating habits among Brazilian adolescents.

OBJECTIVE To describe the prevalence of eating habits considered healthy in adolescents according to sex, age, education level of the mother, school type, session of study, and geographic region. METHODS The assessed data come from the Study of Cardiovascular Risks in Adolescents (ERICA), a cross-sectional, national and school-based study. Adolescents of 1,247 schools of 124 Brazilian municipalities were evaluated using a self-administered questionnaire with a section on aspects related to eating behaviors. The following eating behaviors were considered healthy: consuming breakfast, drinking water, and having meals accompanied by parents or legal guardians. All prevalence estimates were presented proportionally, with their respective 95% confidence intervals. The Chi-square test was used to evaluate the differences in healthy eating habits prevalences according to other variables. The module survey of the Stata program version 13.0 was used to analyze complex data. RESULTS We evaluated 74,589 adolescents (72.9% of the eligible students). Of these, 55.2% were female, average age being 14.6 years (SD = 1.6). Among Brazilian adolescents, approximately half of them showed healthy eating habits when consuming breakfast, drinking five or more glasses of water a day, and having meals with parents or legal guardians. All analyzed healthy eating habits showed statistically significant differences by sex, age, type of school, session of study, or geographic region . CONCLUSIONS We suggest that specific actions of intersectoral approach are implemented for the dissemination of the benefits of healthy eating habits. Older female adolescents (15 to 17 years old) who studied in public schools, resided in the Southeast region, and whose mothers had lower education levels, should be the focus of these actions since they present lower frequencies concerning the evaluated healthy habits.

Association between inaccurate estimation of body size and obesity in schoolchildren.

OBJECTIVES: To investigate the prevalence of inaccurate estimation of own body size among Brazilian schoolchildren of both sexes aged 7-10 years, and to test whether overweight/obesity; excess body fat and central obesity are associated with inaccuracy. METHODS: Accuracy of body size estimation was assessed using the Figure Rating Scale for Brazilian Children. Multinomial logistic regression was used to analyze associations. RESULTS: The overall prevalence of inaccurate body size estimation was 76%, with 34% of the children underestimating their body size and 42% overestimating their body size. Obesity measured by body mass index was associated with underestimation of body size in both sexes, while central obesity was only associated with overestimation of body size among girls. CONCLUSIONS: The results of this study suggest there is a high prevalence of inaccurate body size estimation and that inaccurate estimation is associated with obesity. Accurate estimation of own body size is important among obese schoolchildren because it may be the first step towards adopting healthy lifestyle behaviors.

Hunger, food and drink in Brazilian popular music: a brief overview.

The article reflects on how the themes of hunger, consumption of soft drinks and consumption of beans and rice are addressed in Brazilian popular music. We investigate the years of military dictatorship (1964-1985). The focus of the analysis is on the so-called protest song, a musical genre characterized by aesthetic, cultural, political, ideological and social criticism to military rule. The study of the ideology and philosophy of language of Mikhail Bakhtin is the theoretical reference; especially his concepts of "ideological sign" and "word." Analysis reveals that the protest song portrayed elements of the economic, political and social contexts and led to the diffusion of healthy or unhealthy eating habits or ideologies, contributing to the construction of the Brazilian dietary identity.

[Effect of breastfeeding on obesity of schoolchildren: influence of maternal education]. / Efeito do aleitamento materno sobre a obesidade em escolares: influência da escolaridade da mãe.

OBJECTIVE: To evaluate the association between duration of breastfeeding (BF) and obesity in schoolchildren of Florianópolis (SC), and the role of possible effect modifiers. METHODS: Cross-sectional study with a random sample of 2,826 schoolchildren (7-14 years). Weight and height were measured according to standardized procedures. Data concerning BF and sociodemographic variables were obtained from a questionnaire sent to parents/guardians. Children's nutritional status was evaluated by BMI-for-age z-score for gender (WHO reference curves). Adjusted analyses were performed through logistic regression, considering a possible interaction among variables. RESULTS: Prevalence of obesity was 8.6% (95% CI: 7.6-9.7%) and 55.7% (95% CI: 53.8-57.6%) received breastmilk for ≥6 months. BF was not associated with obesity, even in the adjusted analysis. Stratified analysis according to maternal schooling showed that, in children aged 7-10 years and children whose mothers had 0-8 years of schooling, the chance of obesity was lower among those breastfeed for >1 month, especially among those who received breastmilk for 1-5 months (OR=0.22; 95% CI 0.08-0.62). Among children of women with higher educational level (>8 years), the chance of obesity was 44% lower in those who were breastfed for >12 months (p-value for interaction <0.01). This interaction was not found in older children (11-14 years). CONCLUSIONS: Among children of women with lower schooling, BF for any period longer than 1 month is protective against obesity; however, for a higher maternal schooling, BF for less than 12 months increases the odds of obesity.