Prevalence of metabolic syndrome in Brazilian children using three different sets of international criteria.

INTRODUCTION: Background: the aim of the present study was to compare the prevalence of metabolic syndrome in Brazilian children aged 6-10 years using three different international criteria. Methods: systolic and diastolic blood pressure (SBP and DBP), high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, fasting glucose, and insulin levels were measured in 290 schoolchildren, and the presence of metabolic syndrome was analyzed according to the criteria established by Cook, Boney, and Ferreira. Results: the prevalence of metabolic syndrome was 2.27 % (Boney and Ferreira criteria) and 7.58 % (Cook criteria) for girls, and 3.8 % (Boney and Ferreira criteria) and 5.06 % (Cook criteria) for boys. Agreement in pairs showed a concordance of 57.5 % (Kappa = 0.57) between Boney and Cook criteria, and 65.2 % (Kappa = 0.65) between Cook and Ferreira. The greatest concordance found was 77 % (Kappa = 0.77) between Boney and Ferreira criteria, demonstrating a substantial agreement. Conclusion: prevalence according to Boney and Ferreira criteria was lower than according to Cook criteria. Therefore, we suggest the use of Cook criteria in clinical practice for the diagnosis of metabolic syndrome, since this criterion provided a wider diagnostic range, thereby reducing the risk of underdiagnosis.

INTRODUCCIÓN: Antecedentes: el objetivo del presente estudio fue comparar la prevalencia del síndrome metabólico en niños brasileños de 6 a 10 años de edad, usando tres diferentes criterios internacionales. Métodos: se midieron la presión arterial sistólica y diastólica, el colesterol de alta y baja densidad, los triglicéridos, la glucemia en ayunas y la insulinemia en 290 escolares, y se analizó la presencia del síndrome metabólico de acuerdo con los criterios de Cook, Boney y Ferreira. Resultados: las prevalencias del síndrome metabólico encontradas fueron del 2,27 % (criterios de Boney y Ferreira) y 7,58 % (criterios de Cook) para las niñas, y del 3,8 % (criterios de Boney y Ferreira) y 5,06 % (criterios de Cook) para los niños. La concordancia por pares fue del 57,5 % (Kappa = 0,57) entre los criterios de Boney y Cook, y del 65,2 % (Kappa = 0,65) entre los criterios de Cook y Ferreira. La mayor concordancia encontrada fue del 77 % (Kappa = 0,77) entre los criterios de Boney y Ferreira, demostrando una concordancia sustancial. Conclusiones: la prevalencia de acuerdo con los criterios de Boney y Ferreira fue inferior a la encontrada con los criterios de Cook. Por lo tanto, sugerimos el uso de los criterios de Cook en la práctica clínica para el diagnóstico del síndrome metabólico, ya que utilizando este criterio se obtiene un rango diagnóstico más amplio, reduciéndose así el riesgo del infradiagnóstico.

Influence of glycemic index and glycemic load of the diet on the risk of overweight and adiposity in childhood. / Influência do índice glicêmico e carga glicêmica da dieta sobre o risco de sobrepeso e adiposidade na infância.

OBJECTIVE: To investigate the association between the glycemic index and the glycemic load of the diet with the risk of overweight and high adiposity in children with 5 years of age. METHODS: Cross-sectional study nested in a cohort of 232 children born and living in Diamantina (MG, Brazil). Parents and/or guardians provided the food intake data, using a semiquantitative food frequency questionnaire, past history and socioeconomic conditions. Anthropometric and fatness data were collected from the children. The dietary glycemic index and the glycemic load were calculated from the food intake. The glycemic index and glycemic load effect on overweight and adiposity in children was assessed by the Poisson regression (p<0.05). RESULTS: The prevalence of overweight by body mass index was 17.3%, and high adiposity was observed in 3.4% and 6.9% by triceps skinfold and subscapular skinfold, respectively. No difference was reported between the mean body mass index, triceps skinfold and subscapular skinfold according to the glycemic index and glycemic load tertiles; however, the overweight group presented a higher carbohydrate intake (p=0.04). No association was found between glycemic index and glycemic load with overweight and adiposity among the children assessed. CONCLUSIONS: The glycemic index and glycemic load of the diet were not identified as risk factors for overweight and adiposity in this cross-sectional study.

Atualização sobre o uso de medicamentos durante amamentação / Update on medication use during breastfeeding

The use of drugs during lactation is an important issue, since mothers, at times, for various reasons, will need to be under medication. In spite of the scientific data on maternal breast feeding as to the important advantages and benefits, the use of drug consumption can lead to early weaning. Therefore, it is necessary to inform correctly mothers about risks of drugs during breastfeeding to avoid early weaning. The objective of this study is to review existing literature and contribute towards recent findings regarding maternal breastfeeding and drugs.

O uso de drogas durante a amamentação é um tema de grande importância prática, visto a freqüente necessidade do uso de medicamentos durante algum momento da lactação. Apesar de todas as vantagens proporcionadas pelo aleitamento materno, as estatísticas revelam que dentre os fatores responsáveis pelo abandono precoce da amamentação, destacam-se os problemas relacionados aos riscos de exposição dos lactentes a medicações utilizadas pela mãe. Portanto, surge a necessidade da divulgação de informações atualizadas sobre o uso de drogas e amamentação, com o intuito de racionalizar o uso de medicamentos durante a lactação e principalmente de evitar o desmame precoce. Este estudo tem como objetivo realizar uma revisão de publicações mais relevantes abordando o tema uso de medicamentos durante a lactação.