WEB OF TRANSFORMATIONS: impact of multicomponent intervention on the relationship between sociodemographic indicators, changes in body composition, cardiorespiratory fitness and biochemical markers in adolescents with overweight and obesity.

The study aims to analyze the relationships between changes after multicomponent intervention in sociodemographic indicators, body composition, cardiorespiratory fitness and biochemical markers in overweight/obese adolescents. Quasi-experimental study with 33 overweight/obese adolescents (17 in the intervention group (IG) and 16 in the control group (16)), in which the GI participated in the multicomponent intervention for 24 weeks. Sociodemographic indicators, body composition, cardiorespiratory fitness and biochemical markers were evaluated. Network analysis was performed using JASP software. In GI, the reduction in %BF proved to be the variable with greater connectivity and strength in the network compared to the control network. Changes in %BF were related to changes in ACR, BMI and leptin. It is concluded that the reduction in %BF is the most important variable in network relationships after the intervention, suggesting that the greater the reduction in %BF, the greater the effect on variables such as BMI, ACR and leptina.

Effects and Responsiveness of a Multicomponent Intervention on Body Composition, Physical Fitness, and Leptin in Overweight/Obese Adolescents.

Physical exercise reduces the biochemical markers of obesity, but the effects of multicomponent interventions on these markers should be explored. The present study aimed to elucidate how overweight/obese adolescents respond to a multicomponent program approach on body composition, physical fitness, and inflammatory markers, using a quasi-experimental study with 33 overweight/obesity adolescents (control group (CG) = 16; intervention group (IG) = 17). The intervention consisted of 24 weeks with physical exercises and nutritional and psychological guidance. Both groups were evaluated at the pre/post-intervention moments on body mass index (BMI); body fat (%Fat); waist circumference (WC); waist/hip ratio (WHR); waist-to-height ratio (WHtR), cardiorespiratory fitness (CRF); abdominal strength, flexibility; leptin; interleukin 6; interleukin 10; and tumor necrosis factor-alpha. Mixed-analysis of variance and generalized estimation equations were used for statistical analysis. There was an interaction effect between groups and time on %Fat (p = 0.002), WC (p = 0.023), WHR (p < 0.001), WHtR (p = 0.035), CRF (p = 0.050), and leptin (p = 0.026). Adolescents were classified as 82.4% responders for %Fat, 70.6% for WC, 88.2% for WHR, and 70.6% for CRF. Further, there was an association between changes in %Fat (p = 0.033), WC (p = 0.032), and WHR (p = 0.033) between responders and non-responders with CRF in the IG. There was a positive effect on body composition, physical fitness, and leptin. In addition, reductions in body composition parameters were explained by CRF improvements.

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

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

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

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

Effects of multicomponent interventions on biochemical markers in obese youth: a systematic review protocol / Efeitos de intervenções multicomponentes em marcadores bioquímicos em jovens obesos: um protocolo de revisão sistemática

Physical exercise is effective in modulating circulating inflammatory markers of obesity. However, little is known about the effects of interventions with physical exercise programs accompanied by nutritional and/or psychological guidance, configuring themselves as multicomponent programs. Thus, the aim of this review is to systematically evaluate the evidence related to the effects of mul-ticomponent weight-loss interventions in modulating circulating inflammatory markers in children and adolescents. Therefore, the following databases will be searched to identify all relevant articles: PubMed, SciELO, Lilacs, Web of Science, EMBASE, Scopus, SPORT Discus. Randomized con-trolled trials and quasi-experimental studies of children and adolescents (6 to 18 years old) will be included. Eligible interventions will target weight-related behaviors (including diet, physical activity, behavior modification and/or combinations thereof ). Two independent reviewers will select studies using Rayyan QCRI software and extract the data to a standard form. The main outcomes of the review will be the circulating values of leptin, interleukin 6 (IL-6) and tumor necrosis factor-alpha (TNF- α) in a quantitative way. To assess the methodological quality (or risk of bias) of individual studies, Effective Public Health Practice Project assessment tool will be used. The meta-analysis will be performed using the Review Manager software

O exercício físico é eficaz na modulação dos marcadores inflamatórios circulantes da obesidade. Porém, pou-co se sabe sobre os efeitos de intervenções com programas de exercícios físicos acompanhados de orientações nutricionais e/ou psicológicas, configurando-se como programas multicomponentes. Assim, o objetivo des-te protocolo é propor uma revisão sistematicamente das evidências relacionadas aos efeitos de intervenções multicomponentes para perda de peso na modulação de marcadores inflamatórios circulantes em crianças e adolescentes. Para tanto, as seguintes bases de dados serão pesquisadas para identificar todos os artigos relevantes: PubMed, SciELO, Lilacs, Web of Science, EMBASE, Scopus, SPORT Discus. Serão incluídos ensaios clínicos randomizados e estudos quase experimentais com crianças e adolescentes (6 a 18 anos). As intervenções elegíveis terão como foco a melhora dos comportamentos relacionados ao peso (incluindo dieta, atividade física, modificação de comportamento e/ou combinações dos mesmos). Dois revisores independentes selecionarão estudos usando o software Rayyan QCRI e extrairão os dados em um formulário padrão. O principal resultado da revisão serão os valores circulantes de leptina, interleucina 6 (IL-6) e fator de necrose tumoral alfa (TNF-α) de forma quantitativa. Para avaliar a qualidade metodológica (ou risco de viés) de estudos individuais será utilizada a ferramenta de avaliação Effective Public Health Practice Project. A meta-análise será realizada no software Review Manager

Association between cardiorespiratory fitness and cardiometabolic risk factors in Brazilian children and adolescents: the mediating role of obesity parameters.

BACKGROUND: There is a lack of clarity as to which obesity parameters may be more important in the association between cardiorespiratory fitness (CRF) and cardiometabolic risk factors (CMRF). AIM: To verify the mediating role of different obesity parameters on the association between CRF and CMRF in normal weight and overweight/obese children and adolescents. METHODS: This cross-sectional study comprised 999 children and adolescents (534 boys) aged 7-14 years from the south of Brazil. Body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) and percentage of body fat were assessed. Participants were classified as normal weight, overweight and obese according to BMI. CRF was evaluated by the 6-minute run/walk test. . A continuous CMRF score was calculated by summing the Z-scores of the following variables: systolic and diastolic blood pressure, glucose, total cholesterol, high-density lipoprotein cholesterol and triglycerides. Data analysis was performed using partial correlation and linear regression models. RESULTS: BMI, WC, WHtR and percentage of body fat mediated the relationship between CRF and CMRF in overweight/obese boys and girls but not those of normal weight. Additionally, the percentage of the influence of each obesity parameter was 20% for BMI and WC, 16% for percentage of body fat and 18% for WHtR in girls. For boys, the mediation effect was 25% for BMI, 26% for WC, 28% for percentage of body fat and 25% for WHtR. CONCLUSION: Adiposity plays a central role in CMRF; therefore, maintaining an adequate weight status should be an important objective of health-promoting programmes in early age.Abbreviations: CMRF, cardiometabolic risk factors; CRF, cardiorespiratory fitness; BMI. body mass index; HDL-c, high-density lipoprotein cholesterol, PROCESS PROESP-Br, Projeto Esporte Brasil; SPSS, Package for Social Sciences; TC, total cholesterol; TG, triglycerides; WC, waist circumference; WHtR, waist-to-height ratio; %BF, percentage of body fat.

Food Consumption is Associated with Hyperuricemia in Boys.

INTRODUCTION: Hyperuricemia is related to health issues among children and adolescents, once the uric acid concentration is associated with metabolic syndrome, hypertension, insulin resistance, obesity, and dyslipidemia. However, few studies are addressing uric acid levels and food uptake in this age group. AIM: To verify the association between food consumption and uric acid in children and adolescents. METHODS: This is a cross-sectional study developed with 2335 children and adolescents of both genders aged 6-17 years old. Blood collection was performed after 12 h of fasting. Uric acid values were classified according to tertiles, in which the highest tertile was considered as hyperuricemia. Food consumption was evaluated by weekly consumption frequency questionnaire. Pearson correlation and logistic binary regressions were used for statistical analysis. Models were adjusted for age, systolic blood pressure, body mass index (BMI), and skin color/ethnicity. RESULTS: It was found an association between red meat consumption and hyperuricemia only in boys in the crude model (OR = 1.56; 95% CI 1.12; 2.18). Also, there was an association between pasta (OR = 1.52; 95% CI 1.11; 2.10) with hyperuricemia in boys, when adjusted age, systolic blood pressure, BMI, and skin color/ethnicity. CONCLUSION: The knowledge of food patterns which are predisposing factors for the increase in serum uric acid levels is important for the implementation of strategies and public health policies for health promotion among children and adolescents.

Relação tempo de tela e aptidão cardiorrespiratória: associação com pressão arterial alterada em escolares / Relation between screen time and cardiorespiratory fitness: association with altered blood pressure in schoolchildren

Objetiva-se verificar se a relação tempo de tela (TT) e aptidão cardiorrespiratória (APCR) está associada com as alterações na pressão arterial (PA) em crianças e adolescentes. Trata-se de um estudo transversal com 2166 escolares, de ambos os sexos, com idades entre 6 e 17 anos. Foi aplicado um questionário com questões referentes ao estilo de vida, para verificação do TT (computador, vídeo game e TV), que foi computado em horas e classificado como elevado TT (≥ 2 horas diárias) e baixo TT (< 2 horas diárias). Para avaliação da PA, foi considerada alterada nos casos limítrofes e hipertensão, para pressão arterial sistólica (PAS) e diastólica (PAD). A APCR foi avaliada por meio do teste de corrida/caminhada de 6 minutos. Para a análise dos dados foi utilizada a estatística descritiva, por meio da frequência e percentual, para caracterizar os sujeitos, sendo aplicada a regressão de Poisson para obtenção dos valores de razão de prevalência (RP) e intervalos de confiança (IC), na relação da variável preditora (relação TT/APCR) com o desfecho (PA alterada). Como resultados encontrados, observou-se que 24,8% dos escolares apresentam elevado TT e baixos níveis de APCR. Em relação à PA, 18,7% dos indivíduos estiveram com a PAS alterada e 15,4% com PAD alterada. A associação entre PA alterada e a relação TT/APCR somente foi evidenciada para PAS entre as meninas. Nesse sentido, observou-se que a alteração na PAS é mais prevalente entre os escolares com baixo TT/inapto (RP: 1,07; p=0,008) e com elevado TT/inapto (RP: 1,06; p=0,029). Conclui-se que as meninas com baixos níveis de APCR, independente do TT, apresentam maior prevalência de PAS alterada....(AU)

This study aims to verify if the relation of screen time (ST) and cardiorespiratory fitness (CRF) is associated with the presence of alteration in blood pressure (BP) in children and adolescents. This is a cross-sectional study with 2166 students, aged 6 to 17 years. A questionnaire with questions related to lifestyle was used to verify the ST (computer, video game and TV), which was computed in hours and classified as high ST (≥ 2 hours daily) and low ST (<2 hours daily). For BP evaluation, borderline cases and hypertension were considered as altered BP, for systolic (SBP) and diastolic (DBP) pressure. CRF was assessed by the 6-minute walk/run test. For data analysis, descriptive statistics were used, by means of frequency and percentage, to characterize the subjects, and Poisson regression was used to obtain the prevalence ratio (PR) and confidence intervals (CI) values, in relation to the predictor variable ST/CRF) with the outcome (PA altered). As results, we observed that 24.8% of the students present high ST and low levels of CRF. In relation to BP, 18.7% and 15.4% of subjects had altered SBP and DBP, respectively. The association between altered BP and the ST/CRF ratio was only evidenced for SBP among girls. In this sense, it was observed that the change in SBP is more prevalent among schoolchildren with low ST/inapt (PR: 1.07, p = 0.008) and with high ST/inapt (PR: 1.06, p = 0.029). It is concluded that girls with low CRF levels, regardless of ST, present a higher prevalence of altered SBP....(AU)

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

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

Associação entre a obesidade infantil e a capacidade cardiorrespiratória: revisão sistemática / Association between childhood obesity and cardiorespiratory fitness: a systematic review / Asociación entre la obesidad infantil y la capacidad cardiorrespiratoria: revisión sistemática

Objetivo: Verificar as evidências científicas a respeito da associação entre obesidade infantil e aptidão cardiorrespiratória. Métodos: Realizou-se uma revisão de literatura advinda da busca de artigos, publicados nos últimos cinco anos, nas bases de dados SciELO e Portal de Periódicos da CAPES. Os descritores utilizados foram aptidão física, sobrepeso/obesidade e crianças/adolescentes/escolares. Incluíram-se no estudo artigos completos publicados em periódicos, nos idiomas inglês, português e espanhol, com ano de publicação no período de 2010 a 2015, e que tinham como objetivo a predição da aptidão cardiorrespiratória com testes de exercício na obesidade infantil. Resultados: Ao todo foram 97 artigos pesquisados, mas, após análise e submissão aos critérios de inclusão e exclusão, restaram cinco artigos, sendo dois em língua portuguesa, dois em espanhol e um em inglês. Dos cinco artigos analisados, quatro estudos relataram que a capacidade cardiorrespiratória foi afetada pelos índices de adiposidade corporal. Conclusão: Foi evidenciada associação inversa entre o índice de massa corporal e o condicionamento cardiorrespiratório, em que os escolares com excesso de peso apresentaram menores índices de aptidão cardiorrespiratória.

Objective: To investigate the scientific evidence regarding the association between childhood obesity and cardiorespiratory fitness. Methods: A review was conducted on the literature arising from the search of articles published in the last five years in the databases SciELO and CAPES Journal Portal (Portal de Periódicos da CAPES). The descriptors used were cardiorespiratory fitness, overweight/obesity and children/adolescents/students. The study included full articles published in periodicals in English, Portuguese and Spanish, with publication year from 2010 to 2015, which aimed to predict the cardiorespiratory fitness with use of exercise testing in childhood obesity. Results: A total of 97 articles were surveyed but, after consideration and submission to the inclusion and exclusion criteria, five articles remained, two of them published in Portuguese, two in Spanish and one in English. Of the five articles analyzed, four studies reported that the cardiorespiratory fitness was affected by the body adiposity indexes. Conclusion: An inverse association was observed between the body mass index and the cardiorespiratory fitness, and the overweight students showed lower levels of cardiorespiratory fitness.

Objetivo: Verificar las evidencias científicas sobre la asociación entre la obesidad infantil y la aptitud cardiorrespiratoria. Métodos: Se realizó una revisión de la literatura a través de la búsqueda de artículos publicados en los últimos cinco años en la base de datos SciELO y en el Portal de Periódicos Capes. Los descriptores utilizados fueron "aptitud física", "sobrepeso/obesidad" y "niños/adolescentes/escolares". Se incluyeron en el estudio los artículos completos publicados en periódicos; en los idiomas inglés, portugués y español; con año de publicación entre el período de 2010 y 2015 y que tenían en su objetivo la predicción de la aptitud cardiorrespiratoria a través de pruebas de ejercicios para la obesidad infantil. Resultados: De los 97 artículos investigados se han quedado cinco artículos después del análisis y sumisión a los criterios de inclusión y exclusión siendo dos publicados en el idioma portugués, dos en español y uno en inglés. Cuatro de los cinco artículos analizados relataron que la capacidad cardiorrespiratoria ha sido influenciada por los índices de adiposidad corporal. Conclusión: Se evidenció la asociación inversa entre el índice de masa corporal y el acondicionamiento cardiorrespiratorio siendo los escolares con exceso de peso los que presentaron índices de aptitud cardiorrespiratoria más bajos.